Helping Somalis connect with U.S. healthcare

When you get sick, you probably call your provider or message your care team. Sometimes, you are diagnosed over the phone and a prescription is sent to your pharmacy.

This is a typical healthcare experience in the U.S., but to someone from Somalia, navigating our health system is a new, foreign experience.

A different system

Farhiyo Said, a native Somali, has lived in the U.S. for seven years. She has spent the last three in St. Peter, Minn.

"The health environment is different in Somalia," says Said. "People walk everywhere, it's sunny and you burn off the food you eat. Here, people drive everywhere. Somalis gain weight because we eat the same, but don't walk as much."

Reduced physical activity and an often misunderstood view of U.S. healthcare have caused a health decline in the St. Peter Somali population. In 2014, Fardousa Jama, a Mayo Clinic Health System translator and a Somali community facilitator in St. Peter, and her father, worked with the University of Minnesota's Family Medicine Residency Program to survey Somalis in the community. They found that Somalis needed help understanding how to navigate health systems.

With Mayo Clinic Health System administrative staff, nursing and physician support, the University of Minnesota Family Medicine Residency faculty and residents wrote a grant on behalf of Mayo Clinic Health System to address the healthcare needs identified by the Somali community, developed a curriculum and delivered 12 monthly seminars to the Somali community in St. Peter from June 2015 to June 2016. During the classes, which were open to any Somalis, Mayo Clinic Health System family medicine resident providers taught nutrition and exercise, and discussed how to take advantage of services that healthcare systems offer. Providers also addressed basic healthcare questions, such as "What is health?" and "When should you go to the doctor?" Owing to the great success of the sessions, Mayo Clinic Health System offered to take over the Somali Health Literacy Project starting July 1, 2016.

Nadia Malik, M.D., a Family Medicine physician at Mayo Clinic Health System in St. Peter, has been involved with the project from the beginning. "Dr. Malik is highly spoken of in the Somali community," says Jama. "Mayo staff members teach us about staying healthy, but doctors hear our perspectives too. The class is a learning experience between doctor and patient. Dr. Malik is meeting us where we are. She's a phenomenal woman."

Dr. Malik is Said's primary provider and recommended her for the program because of Said's active involvement in the community.

Said says she has learned a lot from the program, especially about mental health, which is a taboo topic for Somalis. "I share what I learned with everybody who wasn't able to come to the classes," she says. "Everybody is different within our community. Some are quick to trust, some need to build it. But I have trust, and I believe the doctors here can do good."

As for Dr. Malik, she says she learns something new about Somali culture every day. "I've learned about their health, their diets, and their daily habits and routines," she says. "I've learned how to best explain the clinic visit to them, and that taking medication is not easy for them — but that's improving. It shows us that we're definitely making a difference."

The University of Minnesota Family Medicine Residency faculty and residents will continue their investigation by examining how their project impacted patient care statistics for Somali patients being seen at Mayo Clinic Health System in St. Peter.