The small white building at 3416 Nicollet Ave. S. is the new home to a “tiny, but mighty” nonprofit. It’s called Isuroon, which translates as “self-empowered women” in Somali.The organization works to reduce health disparities and promote reproductive health for Somali women. Staff encourages preventive care for Somalis who traditionally only visit the doctor when ill. And they push doctors to become educated in Somali culture. Isuroon is also working to open a food shelf on Nicollet, and partnering on a project to improve care for pregnant women in Somalia.
“They have come a long way, to be taking on a project like hunger in the community, and going from pretty much nothing to the point where they are leasing space,” said Jeff Corn, community programs coordinator at the Center for Urban and Regional Affairs at the University of Minnesota.
Preventive health care is difficult for women who live in poverty and are busy raising children, said Fartun Weli, executive director of Isuroon.
“Women are not a priority — everyone else is,” she said. “She’s taking care of everyone else.”
Women who benefit from Isuroon’s work are people like Leyla Ahmed, who obtained a driver’s license with Weli’s help and underwent cancer screening for the first time along with a dozen other women.
Ahmed previously lived with her grandmother in Kenya, where she said women stay home to clean and cook. Her grandmother encouraged her to move to the U.S.
“Better life, better school,” she said.
Ahmed said she decided to work for Weli after hearing her story. Weli is a Somali immigrant with two decades of medical experience and degrees in business and public health. When she experienced infertility, she couldn’t find a place to talk about the issue in terms of both Somali and Western values. Weli said it’s traditionally taboo to speak publicly about reproductive health, though women always find a way to tell each other stories in private. In 2010 she started a support group on the topic of infertility, giving women a place to talk about fallopian tubes and irregular periods.
In a report by Isuroon Board Chair Nancy Deyo, Somali men said wives who give birth every year are the envy of the community. Women feel pressure to birth large families, and infertility can be viewed as a tragedy.
“What they most need is that emotional support,” Weli said. “You are worth something.”
Her focus on reproductive health grew into scrutiny of the health care system’s cultural sensitivity.
“Historically minorities don’t have good health outcomes,” she said, referring to rates of premature births and less frequent preventive screening. “How do we fix that? … It’s not because these people don’t want to take care of themselves.”
Deyo partnered with Weli to interview women who had given birth first in Somalia or refugee camps and later in the U.S., to learn about the differences in their experiences.
“The core of the work we do is knowing these differences,” Weli said.
The 2013 report described a vivid contrast between birth stories in the two countries:
— In Somalia, women give birth at home, perhaps with the help of a midwife. The labor can last for days while women walk and pray through the pain, trusting Allah for the timing of delivery. So the Western model of ongoing prenatal care, drugs used to induce pregnancy, and pushing while strapped to a heart monitor is an unwelcome change.
— Somali women have a strong preference for female health care providers. For women who traditionally don’t allow husbands in the room while they give birth, it’s excruciating for a man to deliver a baby.
— Women express frustration with language barriers at hospitals and find that important information is lost in translation.
— Somali women feel rushed into cesarean sections. The word “surgery” means “slaughter” in Somali, and they know women who have died undergoing the procedure in Somalia. Women worry about their ability to have more children after the operation.
“These childbirth journeys — even the seemingly sedate stories of Western medicine — were as horrifying to the Somali women as their stories of inhumane suffering and death in Somalia and the refugee camps were to us all,” Deyo writes.
— Women also miss Somalia’s traditional 40-day “ummul” after giving birth, in which family members stay in the home for 40 days, cook and care for children, and treat the recovering mother “like a queen.” Given the Western nuclear family structure, the quick transition back to work is difficult.
“After you deliver and leave the hospital, don’t be surprised if you end up going shopping at Cub Foods on the way home,” one woman says in the report.
To help promote culturally-sensitive health care, Isuroon suggests providing more interpreters, female doctors and midwives. Isuroon also recommends education on caring for women who have undergone female genital cutting. Weli said she’s met plenty of health providers who care, but don’t understand the culture and don’t have enough time to build meaningful relationships. Lessons in Somali culture are not part of most doctors’ training requirements, Weli said. Unless providers are given the time and money to learn, it won’t happen, she said.
To help solve the problem, Isuroon offers brown bag lunch education to medical students. The organization is also trying to make change in public policy, traveling to the Capitol to advocate for health education funding.
“For anything to change we have to change policy as well,” she said.
Corn has collaborated with Isuroon on research within the Somali community. He learned many are concerned about education for themselves and their children, and people are worried about poverty and putting food on the table.
“It’s hard to organize people and be an advocate if people are hungry,” he said. “The food shelf is one project that grew out of that research.”
Isuroon is looking to raise $250,000 to launch a food shelf based at Isuroon. Weli’s vision would provide more than food, she said. It would help move people to the next level and reduce their worries about where their next meal is coming from, she said.
“We’re not giving up,” she said.
Isuroon has also partnered with the University of Minnesota on breast and cervical cancer research to help inform a culturally-specific program for health education in support of East African women.
Isuroon spent time in places like Karmel Mall last summer to promote cervical cancer screening.
“It’s treatable, but our community did not know,” Weli said.
Isuroon also pays attention to health issues in Somalia.
According to UNICEF, the child and maternal mortality rates in Somalia are among the highest in the world. One out of 10 children dies before their first birthday, and one out of 12 women dies due to pregnancy-related causes. Weli attributes the poor survival rate to war, malnutrition, and a lack of facilities, staff and good blood banks.
Isuroon is partnering with the United Nations Population Fund on a program to launch clinics in Somalia that can safely perform C-sections and come with trained staff and an attached blood bank. The initiative involves training thousands of community health workers to identify at-risk mothers.
Isuroon is hosting a health conference on Nov. 12 at the Humphrey School of Public Affairs called “Safe Mothers, Safe Newborns.” The conference includes state legislators, staff from Georgetown University and the University of Minnesota, the executive director of Safe Hands for Girls, and the chief technical adviser for reproductive and maternal health at the United Nations Population Fund in Somalia.
Isuroon is working to find 300 individual donors willing to spend $20 per month to sustain the organization. Isuroon is also looking for volunteers, particularly people willing to share their stories through social media and public education.
“There is so much power we have and strength,” Weli said. “…We are tiny, but mighty.”