Essays, poems and Stories of an African-American

Wednesday, 25 March 2015

Targeting Africans and recent Immigrants from Africa living in the Bay Area (West Coast of USA)



Targeting Africans and recent immigrants from Africa living in Bay Area.

1.0     ABSTRACT
This concept note is about Africans and recent immigrants from Africa (from here on referred to as beneficiaries) in the West Coast Bay Area. It is also about how best they can be involved in owning skills for health living and outcomes in USA. In 2012, a friend knocked on our door, her roommate was having a baby. This was in Los Angeles CA. It was 2:00 am. We rushed her to a hospital which we had googled and fortunately was 15 minutes away. She did not have insurance, we collected money towards that. She was admitted and delivered a bouncing baby girl. The previous week, we had helped another person who had chest pain. We prevailed on him to go to the hospital. This was a saving moment for him. He was diagnosed with a buildup of fluid in the pleural space. A month before I had talked to a friend who was complaining of frequent micturition, thirst and frequent fatigue after simple daily activities. I escorted her to Hospital and she was diagnosed with Diabetes. In Boston MA, a friend continued complaining of stomach pain and she could point it out in the right lower quadrant. It turned out she had appendicitis, a diagnosis arrived at after we rushed her to Hospital. A mother was overwhelmed by developmental delays of her son. She even relocated for fear of stigma among the African communities that had embraced her on arrival in USA. But, counseling and reassurance enabled her overcome her own fears and she is now a strong advocate in her area for children with disabilities. A doctor and mother to a daughter who had sickle cell disease never gave up seeking treatment for the daughter. The family went through all the processes of an autologous bone marrow transplant, the daughter is now free of sickle cells. I[1] have attended many African community, cultural and social events[2] as part of my own understanding of other Africans, how they socialize and also as an appraisal, the precursor for starting a dedicated healthy living support platform. As a volunteer and Trustee with the African Empowered Communities-USA[3], we reach out to Africans new in USA and engage them in activities that increase awareness, world view, cultural sensitivity and utilization of the service delivery systems in USA. The goal being full utilization and full integration. There are patterns through which beneficiaries can be mobilized, empowered to become fully involved participants in healthy living. This tool is a mobilization tool tailored for Africans new in America. It can be copied for other immigrant communities too. It is based on Using Community or Social Events (UCEs/USEs) to continue mobilizing beneficiaries of healthy living in USA. On outcome is making health, nutrition and a quality life part of their plans[4].

The Executive Summary:
I have interacted with Africans and recent immigrants from Africa in the Bay area for one full year. Anecdotal information estimates give about 20,000 Africans and recent immigrants from Africa above 21 years live in the entire Bay Area. In presenting this note I hope to reach out to whoever can support my desire for promoting practices that in turn improve on quality of life, mental-health and nutrition of beneficiaries (whose population estimation was arrived at anecdotally)[5].
The concept note is divided into the following sections: 1.0   Abstract is a short narrative and introduction 1.1, Background, shows who the beneficiaries are, attempts a social diagnosis and then shows activities geared at obtaining healthy outcomes. It further introduces opportunities where diet, play and mental health are integrated in beneficiary daily, community and social events. 1.2. Goal, 1.3 introduces the Management plan, 2.0. Shows how Using Community or Social Events (UCEs/USEs) to continue mobilizing beneficiaries of health services, 2.1. Description, 2.1.1 Long Term Objective, 2.1.2. Short Term Objective, 2.2. Problem Statement and Justification, 2.3. Proposed Interventions /Solutions, 3.0      Project Technical Approach / Activities, 3.1. The following are the aspirations, 4.0. Monitoring and Evaluation, 5.0 Sustainability.
1.1     Background and Diagnosis:
Innovative ways to get beneficiaries to access the life improving health services in their vicinities[6] can be explored. Cause and effect scenarios play a major role on decisions to place importance on health or prioritize it. Responses as to attendance are placed in three categories whose acronym is CAT. C for chasing; A for aversion; T for tenacity.
Chasing papers and documentation requirements, chasing the dollar to pay bills and chasing an ‘Americanness’ embracing and pursuing happiness in the present, replacing receding nostalgia. In other words, doing away with old life!
There is an aversion for hospitals which in their psyche are places of doom; anecdotal feedback is resplendent with conversations alluding to lengthy procedures and invasiveness; many deliberately turn away or dislike healthy living patterns that take them away from set ways; many have ingrained tabooist tendencies that affect placing trust in health systems and providers. Such remarks like “I cannot undress before ‘them’ are common.”
Tenacity is explained by belief in that African perpetual virility, invincibility and a post arrival shock. The belief is that of an African who arrived when many years of socialization have rewarded a healthy life, weight gain and longevity. That inertia becomes the survival closet or locker whose access is only open to an owner. Past deeply held beliefs and ways that enabled one to navigate life in Africa are now questioned through apparent stories of consequences of reckless lifestyles around diet, play and mental-health. But all is not gloom and dire straits!
The following can be the opportunities:
1.     To establish a resource and drop-in center as a static facility to conduct activities geared at entrenching good Diet, Play and Mental Health (DPM) living practices. Themes will be linked with International days of celebration, religious festivity days and other social-cultural events[7].
2.     To design, develop and maintain a website with updated tips and information on healthy living targeting Africans new in America. The website will be a portal highlighting African community events and activities e.g. Moroccan, Zimbabwean, Angolan, Senegalese, Ivorian, Gambian, Ghanaian, Ugandan, South African, Cape Verdean, Swazi, Lesotho and Kenyan. The website has the advantage of anonymous information sharing and as an interactive social media tool.
3.     To develop a schedule to promote and engage beneficiaries in conscietization and owning of good Diet, Play and Mental-Health (DPM) practices[8]. This will use informal and formal meetings as means of guiding conversation and decisions to adopt healthy living lifestyles. Households will be encouraged to engage in such activities like ‘game nights.’ It will then be possible to start healthy living conversations or even continue with them.
4.     Develop a yellow pages pull out with addresses and locations where beneficiaries can meet, socialize and start or continue conversations around diet, play and mental health living. The pull out will be a hard copy used as a desk reference tool.
5.     Link up with service providers and solicit for space, time and tailored opportunities to increase beneficiary conscientious utilizing of services. Such spaces will be booked at gyms, cinemas, recreation parks and other venues[9].
6.     Develop the “drums-and-fire” networks to check on or support each other as part of adherence and decision support mechanisms. This will tap into contacts’ lists as well as a list-serve. This will also employ another mobilization tool among Africans called the “ear-to-the-ground.” This derives from ancient African ways of sharing information[10]. Info-blasts will be maintained through the list-serve, elders of communities, religious leaders and social media platforms.
7.     Involve Africans in extravaganza activities focusing on health with the support of Certified Therapeutic Recreation Specialists (CTRS), social workers and counselors. It is hoped that retreats, camps and seminars focusing on knowledge sharing will be the main activities. These will integrate events recognizing elders and leaders who have helped beneficiaries to embrace and adhere to healthy living practices.
1.2     The Diet, Play and Mental-Health (DPM) goals:
To engage beneficiaries in activities that help them achieve physical, cognitive, social empowerment and skills through participation. The target area is San Francisco, Oakland, Brisbane, Richmond, Concord, Colma, Treasure Island, Daly City, South San Francisco and San Jose. Africans have established entertainment, food art, sport, residences, businesses and networks in these areas. It is these spaces that will be tapped into.
1.3     Tentative Community Liaison:
Thomas Rogers Muyunga Mukasa is the lead and reporting focal person.
2.0 Using Community or Social Events (UCEs/USEs) to continue mobilizing beneficiaries of health services:
2.1. Description
2.1.1  Long Term Objective:
The objectives, among others, include; managing the project, conducting a social mapping exercise to develop an information matrix with input by Africans, empowering beneficiaries to participate in initiatives to improve on their health, engage in community and social events to raise awareness on link between diet, play and mental-health. Disseminate information in form of newsprint pull outs, social media apps and use of other communication means. Set up African community event days where among other activities, proper nutrition is encouraged, health, hygiene, livelihood and socializing are promoted.
2.1.2  Short Term Objective:
2.1.2.1. To identify and generate a list of venues in San Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San Francisco and San Jose where drop-in meeting places where ‘diet, play and healthy living’ retreats or camps can be conducted.
2.1.2.2. To identify and work  with focal persons in San Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San Francisco and San Jose.
2.1.2.3. To identify and generate a list of health and human services facilities in San Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San Francisco and San Jose where drop-in meeting places where ‘diet, play and healthy living’ services are provided.  Make a list and develop a yellow page news print pull out.
2.1.2.5. To set up a management team for the full cycle of the project.
2.2     Problem Statement and Justification
Africans new in America are faced with challenges that in turn affect the way they access health care services and the way they engage in healthy living.  A paucity of tailored and funded programs catering to ‘diet, play and mental health’ among Africans has left them to access other integration and social services which are well funded but subsume the need for a stand-alone DPM program.  This is a gap that can be filled by dedicated communication for behavior change.
2.3     Proposed Interventions /Solutions (April 2015-March 2016)
2.3.0. To establish a resource and drop-in center as a static facility to conduct activities geared at entrenching good Diet, Play and Mental-health (DPM) practices, by April 2015.
2.3.1. The first proposed activity is setting up linkages through department of health, SF, Mayors’ offices and other service providers whose mission is geared towards health and development. Meanwhile a social media and hotline facility will soon be established by May 2015.
2.3.2. To identify and generate a list of venues in San Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San Francisco and San Jose where drop-in meeting places where ‘diet, play and healthy living’ retreats or camps can be conducted, by June –July 2015.
2.3.3. To identify and work  with focal persons in San Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San Francisco and San Jose, by May 2015.
2.3.4. To identify and generate a list of health and human services facilities in San Francisco, Oakland, Brisbane, Richmond, Colma, Treasure Island, Daly City, South San Francisco and San Jose where drop-in meeting places where ‘diet, play and healthy living’ services are provided.  Make a list and develop a yellow page news print pull out, by June 2015.
2.3.5. To set up a management team for the full cycle of the project, by May 2015.
2.3.6. To design, develop and maintain a website with updated tips and information on healthy living targeting Africans new in America, by May 2015.
2.3.7. To develop a schedule to promote and engage Africans in conscietization and owning of good Diet, Play and Mental-Health (DPM) related practices. This will use informal and formal meetings as means of guiding conversation and decisions to adopt healthy living lifestyles. Households will be encouraged to engage in such activities like ‘game nights.’ It will then be possible to start healthy living conversations or even continue with them.
2.3.8. Develop a yellow pages pull out with addresses and locations where Africans can meet, socialize and start or continue conversations around diet, play and healthy living.
2.3.9. Link up with service providers and solicit for space, time and tailored opportunities to increase African new Immigrants’ conscientious utilizing of services.
2.3.10. Develop the “drums-and-fire” networks to check on or support each other as part of adherence and decision support mechanisms. This will tap into contacts’ lists as well as a list-serve. This will also employ another mobilization tool among Africans called the “ear-to-the-ground.” This derives from ancient African ways of sharing information. Info-blasts will be maintained through the list-serve, elders of communities, religious leaders and social media platforms.
2.3.11. Involve Africans in extravaganza activities focusing on health with the support of Certified Therapeutic Recreation Specialists (CTRS), social workers and counselors.

3.0     Project Technical Approach / Activities
Project activities / objectives will mainly involve mobilizing Africans to access DPM related services.
3.1     The following are the aspirations:
(i). Designed and presented concept note.
(ii). Identified the leaders, role models and facilitators.
(iii). Developed the strategic line concept note to become the blue print for budgeting.
(iv). Demonstrated how one can establish a well-coordinated and integrated use of community or social events to integrate ‘Diet, Play, Mental-Health’ related services.
(v). Have rolled plans and schedules for interventions to be carried out over a period of implementation.
(vi). A yellow page pull out with information that is ‘Diet, Play, Mental-health’ related.
4.0     Monitoring and Evaluation
4.1. Monitoring will be continuous at various levels and will mainly be participatory in nature using attendance and exit reports to gauge impact. The yellow pages will regularly be distributed and updated; on spot visits at planned events will be an opportunity to collect data and consolidation activities.  Reported data will be collected and collated for processing. Media outlets will be involved in reporting outcomes.
4.2. A monitoring tool will be developed to report on uptake, popularity of program and any other experiences. It will be possible to increase on gender related participation in as a health seeking outcome.
4.3. This initiative will also be monitored by sponsors. Quarterly implementation and financial reports shall be sent regularly to sponsors.
4.4. Evaluation of impact will be undertaken based on the following indicators:
i. Number of events in different cities or localities
ii. Number of referrals and linkages.
 iii. Continuity.
5.0.    Sustainability
5.1. The initiative will focus on use of appropriate and locally available resources. The attendant capacity building of the beneficiary communities in participatory skills is hoped to have three outcomes: individual empowerment in linking diet, play on mental health; increased utilization of services; and managing time for self-improvement.



[1] Thomas Rogers M. M, is a resident of USA since 2012. He worked in Uganda with Ministry of Health as an officer under Communicable and Non-communicable disease Commission. He worked in 15 African countries under the Eastern and Southern Africa Health Network. In USA, he is a volunteer with UCSF, HIV/Hepatitis Community Advisory Board. He has interacted with many Africans in the Bay Area and this concept is the outcome of that interaction. You are reading it because Thomas is soliciting your support to start the BayHeal Initiative.
[2] Food, Music/Entertainment, Parenting, Grooming, Work and Housing are 6 aspects that draw Africans in Bay Area together. Knowledge of dates, activities & venues (DAV tool) will get one the numbers to reach out to with messages. Radio stations (e.g. KALW FM 91.7 has African night on Thursday-9am-11am).
[3] An organization engage in planning trade fares and market place-related activities all over California. In the Bay Area, it has featured at: Santa Rosa, San Jose, Ashley and San Francisco Market places.
[4] Health, nutrition, quality of life plans include: Safe motherhood, mental-health, Oral Health, diet plans, medical checkups, exercise and such activities promoting health.
[5] Eritreans (^ 400[ below 21; 100]), Ethiopians (^300[below 21; 100), Somali (^200[below 21;90]), Ugandans (^300[below 21; 100]), Kenyans(^700[below 21; 300]), Sierra-Leoneans(^100), Senegalese (^100), Liberians( ^100), Mozambiquans(^60) Angolans(^70) Ghanaians(^900[below 21; 400]), Nigerians(^1,000[ below 21; 400]), Zimbabweans(^100), Congolese(^100), Egyptians(^500), Moroccans(^200), Zambians(^60), Malawian(^40). These figures are arrived at from anecdotal responses. There could be more. It requires a bigger sample, perhaps more resources and a better structured inquiry will reveal better numbers.
[6] San Francisco, Oakland, Brisbane, Richmond, Concord, Colma, Treasure Island, Daly City, South San Francisco and San Jose have services ranging from Hospitals, Human Services’ Agencies, Department of Public Health and various support organizations.

[7] HBV-HIV Research Study (415-206-8236), Bridge HIV study part of the join prep.org. , shape up San Francisco part of the Opentruthnow.org. , ymacasf.org/bayview, SFrecpark.org, Project Open Hand Diabetes Study, Stop Smoking Classes by SFSmokegree.org at 2550 23rd St. Bldg. 40, 5th Floor, Solarium Classroom, SFGH (this may even demystify or assuage the hospital aversion), HIPS Study on Communication between Women and their doctors for 45-65 year olds; Study on Women’s Health, Aging &Sexuality. Information such as: appointment scheduling at say, Family Health Clinic (this may help improve on planning and attendance at clinics). Cal wellness with tailored prevention, primary care, health education/outcome plans and oral health.
[8] Plans can be made to enable beneficiaries benefit from utilization of these resources: Bayview, Hunters Point, Bernal Heights (in-door basketball Courts on 500 Moultrie St.), Balboa Park, Castro (the Eureka Valley Rec. Center on 100 Collingwood St.), Chinatown (Betty Ann Ong Chinese Recreation Center on 3rd floor, 1199 Mason St. or the Willie Woo Woo Wong Clubhouse on 830 Sacramento St.), Excelsior Park (McLaren Park, University St. at Mansell St.), Glen Park &West Portal ( Glen Canyon Park recreation Center, Bosworth &O’Shaughnessy Blvd.), Mission (Power play for 6-18, Boys & Girls Club of SF Tenderloin Clubhouse, 115 Jones St.). Western Addition (Hamilton Recreation Center 1900 Geary Blvd.)
[9] See 8 above.
[10] Anthropo-ethno tools.

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