Connecting with Communities | Podcast

Nurse practitioner Munira MaalimIsaq understands the importance of connection intimately. She immigrated from Somalia to the United States with her parents when she was nine years old and remembers well the difficulties they had navigating the American health care system with limited English.

“Since I’ve gotten older,” she says, “I’ve realized that most of the time, people were just doing things for us instead of asking us how we wanted to be taken care of and what our opinion was.” But as Munira points out, a language barrier or lack of understanding shouldn’t be an excuse to give patients care without their input.

Those experiences, along with Munira’s personal drive to give back, have informed her career ever since. In efforts to promote connection and health literacy in her community, Munira takes part in food drives, blood drives and other initiatives alongside her nursing work. The results have been rewarding. Listen to the episode or read the transcript.

Effective care includes all voices

A care provider’s connection with their patients is important for more than just navigating appointments – it can directly impact the effectiveness of the care provided. Munira uses the example of diabetes: getting the diagnosis is one thing, but the provider also has to be able to discuss the lifestyle changes involved in treating it, and have conversations about setting goals around them. Otherwise, those necessary changes are much less likely to happen.

Making this level of connection possible takes work. At the height of the COVID-19 pandemic, for example, when many people were seeking end-of-life care for loved ones, Munira and colleagues working on health equity went into the community to conduct interviews and get opinions on Methodist Hospital’s approach. What they found was tension resulting from miscommunication and misunderstandings of medical terminology.

Munira and company were able to take the feedback they got, incorporate it into Methodist’s approach and forms, then review it again with the community. The improvements were notable and exciting, and they could only be achieved by listening.

Trust transfers

The COVID-19 pandemic also gave Munira another success story. The data was showing that vaccination rates in Somali, Muslim, Asian and Hispanic communities in the Twin Cities were low. As a member of all of these communities, Munira went out with her colleagues to provide education and correct misinformation around the virus and its vaccines. As a community member, she was well-received. She was able to address concerns about the vaccine’s contents and side effects, and ended up giving out more than 1,500 shots on her own.

But this outreach had another surprising, positive result: since then, people from those communities have been contacting Munira for advice on choosing doctors and getting care. She and her colleagues didn’t simply convince people to get vaccinated – they built lasting trust that now extends to Methodist as an institution.

Change can be hard, but it’s worth making

Community outreach isn’t always as straightforward as Munira’s vaccination experience. Back in 2018, she realized that there weren’t any support groups in the Twin Cities that were specific to Somali people with substance use or mental health issues, as they were sensitive topics within the community. And when she set out to find ways to create those spaces, she was met with a lot of resistance.

It took nine months to get the conversation to a productive place. There was a lot of stigma and fear that came up, with some prominent community members even calling Munira’s idea unacceptable. Other people would ask her if she was pushing a personal issue onto the community. She was afraid that she might damage the trust she had built. But she stuck to the message that it was for the good of the community, and when the spaces were finally created, the results cast all of that negativity in a new light.

Around 170 people now attend weekly meetings, and Munira regularly gets to see people become comfortable enough in them to ask for help outside of the meetings. To her, the resistance she encountered before now serves as proof that her work was necessary, because those voices might have otherwise kept people from getting the help they needed.

As Munira demonstrates, authentic connections between providers and patients are deeply important. They’re how we make sure that people get the care they need when they need it. We can’t accept gaps in communication or understanding as excuses to compromise care. If we want to bridge those gaps, we have to build trust by meeting people where they are, both in our clinics and in our communities.

To hear more from Munira about her community work, overcoming barriers to connection and the role of cultural humility in establishing trust, listen to this episode of Off the Charts.