How can we provide equal Health Care in a society with the gender inequality?
I want to touch a very touchy topic – cultural customs impacting medical care. Some might see this as intruding or offensive. Acknowledging the delicate issue, I will attempt to touch the topic gently. The fact is that cultural patterns do exist. While they do not include all individuals in a certain population they do tend repeat themselves. Thus cultural factors have to be taken into account in clinic.
I was asked to explain in Arabic to a mom about the severe neurologic disorder that her son suffers from. The attending physician thought that despite the prolonged hospitalization the mom did not understand her son’s illness. After I explained about the disorder and its consequences she broke into tears. Turns out that her husband who speaks Hebrew was the one who communicated with the doctors and he told her that this is a mild issue that will disappear in time. She was very insulted from her husband that withheld the truth from her; she thought he did it because he assumed she will stop taking care of the child. Since that case I decided that I would try to speak Arabic directly to the mom and not relay on the father for translation. My Arabic is basic but the results are great: the women are happy with a direct communication, treatment become more effective because the main caregiver is usually the mom and …my Arabic improves with time.
Points when providing medical care to Muslim women:
Escort- Arab women will not arrive alone they will be accompanied by other family members. This may be problematic if you would like to touch a delicate subject. In these cases, I ask the family member to leave the room and this request is usually respected.
Language – never assume that the translation of the escorting family member is accurate. Hospitals and Clinics to have translation services that can be used. Learning a new language is always an option.
Cultural dependent expressions – don’t ask the parents if there are relatives. The answer will be negative since according to the Islam relatives or not allowed to marry. Relatives are considered brothers and sisters. Cousins are allowed to marry. Consider rephrasing your question as: “are you from the same family?” Or “Is there any blood relation between you?”
Answering questions- In some cultures it is impolite for women to answer before their husbands. So if you asked in general are there any questions and the husband said that there aren’t any questions his wife is refrained from asking. Try to address the woman first and ask her if she understood everything and if she has questions and only then ask the husband.
Women and travel in the Arab world
In terms of gender inequality, the Israeli Arab women is in a much better place compared to her peers in other Arab Nations. She has much more freedom in dress code, polygamy and education. When speaking about Medical Care in the middle east we need to acknowledge the travel limitations for women. Many do not have a driving license and/ or cannot travel without a proper escort. In these cases, telemedicine has the advantage to brings the medical services directly home without need of travel.