As the US grapples with the global coronavirus pandemic, families across the country are staying at home and practicing social distancing. Health experts are recommending people limit their exposure to others and remain in their homes as much as possible. In an effort to provide vital health information to everyone, some health organizations have created messages about coronavirus geared towards Somalis in the US. There are cultural aspects and family dynamics to consider when encouraging Somali-Americans to practice social distancing and staying at home.
The following article hopes to present some of the cultural practices and beliefs that could be providing unique challenges to families who are attempting to social distance during this time. It will conclude with some tips to address these challenges and help more Somali families stay safe during the coronavirus pandemic.
Family Dynamics
Somali families can be large, consisting of many children. Children are viewed as a blessing. Families are also multi-generational with grandparents living in the house alongside their children and grandchildren (Lewis, 2009). Dr. Samira Hassan, a Somali-British physician practicing in the UK, further explained that “elderly Somalis are almost always cared for by their own families as it is not common to see Somali elders living alone or placed in care homes.” Offspring typically stay in the family home until they are married.
What this means is that in a typical Somali home, you may have several children ranging in age along with grandparents. Extended relatives such as cousins, nieces and nephews may also live in close proximity to the grandparents and are considered a part of the family. It is typical to have aunts, uncles, and cousins come over to the main house where grandma or grandpa lives (Lewis, 2009).
Farah Ibrahim, a Somali-American currently teaching in China, returned to her family in Northern Virginia when the pandemic was in its early stages in January. At that point, health officials were recommending travelers coming from China self-quarantine for two weeks. She was living in her mother’s home and would have her sisters and nieces and nephews come over to visit during this self-quarantine period. Her family didn’t believe or trust what was on the news and they didn’t find it necessary to keep their distance from her.
As we know, the elderly is a high-risk group for coronavirus. According to the CDC, 8 out 10 reported coronavirus related deaths have been people over the age of 65. Therefore, it has been recommended that nursing facilities that house seniors restrict visitors to ensure their safety. But what about families who have senior members living with them?
In the case of many Somali families, many extended members come to visit their elders. Telling these individuals to avoid coming to the house to visit grandma can be deemed extremely disrespectful. Grandma herself may not understand why she can no longer go to her other son’s house or visit her daughter’s children for example.
Dr. Carey Jackson, a Professor of Medicine at the University of Washington’s School of Medicine and Medical Director of the International Medicine Clinic and EthnoMed at Harborview Medical Center in Seattle, summarizes: “Somalis are a very communal people and to be forced into distancing is just a particularly difficult habit to break. This means praying together, breaking the fast together, cooking together. You can’t put Henna on yourself very well. Think about ways to do that safely. Consequently, it is a helpful exercise to think about ways people can distance safely and yet pray together, break the fast together. It is one thing to suggest it, it is another to show them how to Zoom, to describe different alternative scenarios for ritual washing and praying so that they don’t have to forgo the faith that sustains them when they need it the most.”
Any message about social distancing will have to take these scenarios into consideration.
Occupations
Another aspect to consider are the socio-economic burdens being placed on families while they practice social distancing. A lot of Somali families have members who work multiple service-oriented jobs such as grocery store clerks and delivery employees, to support their families.
“Many people are in jobs that are considered essential and have to come and go,” Dr. Jackson says. This increases their risk for exposure as well as their families. There is also a large number of Somali men who work for ride-share companies such as Uber, Lyft and traditional taxis. “My dad is a cab driver and most of his friends are. It is hard for them to get an income during this time,” Farah says. These workers are either out of a job or currently in contact with people in a closed proximity. It isn’t possible to adhere to maintaining six feet of distance between you and others when you are in a car or across a cashier.
Many families don’t see much of a choice between working to support themselves and staying home. For some, following social distancing puts their families in too much of a financial risk. Adding to this pressure is the cultural expectation based on gender roles. “Many of our Somali workers are key breadwinners not only to their immediate families but also send money to their extended families in Africa who rely on them for their subsistence,” Dr. Samira Hassan explained. Traditionally, men are expected to support the family. Missing out on work can be viewed as not fulfilling their responsibility to their family (Lewis, 2009).
Beliefs about Sickness and Death
Somali culture draws from Islamic beliefs on predestination. Somalis believe that death is something that is preordained to occur at a specific time (Lewis, 2009). Therefore, no efforts you take will alter this. Likewise with illness; if it is written for you to catch the coronavirus and die from it then no amount of social distancing and hand-washing will change this reality.
This belief can lead to families not adhering to stay at home measures because they view them as pointless. Nothing they do will protect them from this virus if it’s meant for them to catch it. Farah’s mother expressed this belief through her statement, “Dad isla koray, way isla dhintaan” (Those who are raised together, die together). In other words, we are born together, we die together and the specifics (in this case the virus) don’t really change the inevitable. “Social distancing is particularly difficult, especially due to deaths of many Somalis resulting in family and friends feeling compelled to visit the family of the deceased, to console and pray for them, as part of our Islamic tradition,” Dr. Hassan added.
Efforts to Address Social Distancing
Language is one of the barriers blocking Somali families from access to the correct information about Coronavirus. Somali health organizations such as the Somali Health Board in Seattle, Washington and the Somali health organizations in Minnesota have started campaigns aimed at providing information in the Somali language. Information is in multiple written and video formats and being shared across social media platforms such as Facebook and WhatsApp, both widely used in the Somali community. These measures are important first steps. These are also common platforms for the spread of misinformation, so making sure the correct health information is there is vital.
Access to Wi-Fi, as well as a smartphone or a laptop, however is not guaranteed for everyone. Somali culture has a rich oral tradition and social gatherings such as in mosques used to be a place to communicate and share important news. Due to present circumstances, this avenue is no longer available. Dr. Jackson mentions, “Information often comes at the mosque and yet people are to avoid congregation so it’s a double bind.” It is necessary to find other means of conveying health information.
Tips for Addressing Challenges
The following section focuses on ways to overcome some of the challenges Somali families could be facing during the pandemic, including some practical tips community health workers can consider and that hopefully will increase the number of families practicing social distancing.
- “Trust in God, but tie your camel”
This is a beloved Islamic tradition based on the Prophet Muhammed’s statement when a man asked, if he should trust in God and tie his camel or let the camel free and trust in God. The Prophets response was, “Trust in God, and tie (the camel).” Muslims take this to mean that trust in God is followed by taking practical steps to safeguard yourself.
In the case of this virus, it is not Islamic to think, “I will trust in God and disregard all safety measures.” Rather, it’s encouraged to wear face masks, do hand hygiene, and practice social distancing of 6 feet. Balancing taking action and letting go in our own lives is something we’re all often called to do and yet many of us respond in all action and no faith or rely too heavily on faith when it might behoove us to take a bit more action in our lives. Do your best and leave the rest to God.
- Get more information out in a variety of ways
Somali communities in other states and countries can learn from what the Somali Health Board has been able to put together for their community and expand on it for their respective communities. Dr. Hassan and her colleagues have led by carrying out information sessions on Facebook, Zoom and other teleconferences. Trusted community leaders such as Imams of mosques should be included in getting the message out through multiple platforms including phone calls and text messages.
“Some sessions have been done along with local community leaders and an Imam to join up the Medical, Islamic and community perspectives on the current pandemic,” Dr. Hassan said. This is especially important when it comes to addressing cultural and religious beliefs that may hinder someone from taking preventative measures against coronavirus. A trusted religious leader could provide the support medical officials need to convince people to take this disease seriously and follow social distancing guidelines.
- Raise awareness of programs that can help families struggling financially
This pandemic has placed financial challenges to families some of whom were already struggling. Providing timely information on possible programs to help alleviate some of the burden could allow families maintain social distancing and get the relief they need.
- Create accurate and specific messages about social distancing and COVID-19
Health guidelines should be presented to Somali communities in a multi-language format that clearly address the realities of the Somali family. Instead of a general message of stay at home and limit your gatherings, a tailored message explaining why the elderly shouldn’t have outside visitors might be more effective. “Short clips via YouTube or other means, that can easily be shared via WhatsApp is ideal – WhatsApp is the MOST commonly used medium to share information particularly with older Somali women, who are well connected to several WhatsApp groups in their community,” Dr. Hassan said.
Common questions such as what to do in the event that one of the family members has COVID-19 should be answered with clear instructions and guidelines. Keep in mind that there are situations where many family members are living in smaller spaces. Keeping the ill family member in a separate room or bathroom may not be possible. What is the family’s best option at that point?
This article aimed to highlight some of the cultural and religious beliefs that Somali families may be dealing with while practicing social distancing, and to provide some practical guidelines that may help in addressing the challenges Somali families face during this time.
References
- Lewis, T. Somali cultural profile. https://ethnomed.org/culture/somali/
- CDC. Coronavirus Disease 2019. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html