Public Health – What’s Everyone Talking About?

In America, health care and health policies are becoming more and more of a debated issue. What is the right way to handle the issue? What stance should be taken? Well, for the Middle East and North Africa (MENA) regions, they are gearing up for the same topic. I was intrigued on what was being focused on in their recent health discussions, but there are still areas that need to be covered and given the attention that they deserve. This post will be covered Non-Communicable Diseases, Mental Health (Disabilities), and Refugee Healthcare discussions.

Region

Non-Communicable Diseases

As I understand, non-communicable diseases are illnesses that cannot be transmitted – the only develop from genetics or mutations. In MENA regions, diseases such as heart disease (44%), stroke (35%), and diabetes (87%) are causing more premature death and disability than they have in past years. This is hypothesized to be because of poor diets, high body mass indexes, and large amounts of smoking in the region. The rates of these types of diseases are increasing as time goes on because the environmental factors cannot be overcome.

The leading causes of disease were diverse and, sometimes, surprising. Between preterm birth complications in Algeria and Palestine, depression in Jordan, and coronary heart disease in Egypt, Iran, and Lebanon, there are obviously a multitude of areas that need attention but do not respond to the same treatments. Unless effective preventive measures are implemented effectively and quickly, the illnesses could have significant social and economic consequences, especially in areas where transmittable diseases, such as HIV/AIDS and tuberculosis, are there already.

Mental Health

Accounting for 13% of the total global burden of disease, untreated mental health disorders are one of the leading causes of disability, causing lasting disruptions in mood, thinking and daily functioning. As outlined in Access to Mental Health Care in the Middle East, mental health is not a strong priority in the MENA region and services are not widespread despite the increasing efforts made. The decreased prioritization around mental health issues means that government implementation of the available resources (if there are any) in each area are not concentrated on this issue just yet.

There are different options to handling mental illness cases, especially since they differ individually, but it has been reported that Arabs endorsed greater beliefs in supernatural causes of mental illness. This comes from Islamic beliefs in “a dangerous, unprovoked spirit”, “a spirit that was angry because someone did wrong” and “evil eyes”. It has also been established that Arabs generally hold stigmatizing beliefs towards seeking professional mental health services, both within the MENA region and in the United States.

Figure 1While there are many similarities within the Arab nations and cultures about mental health, cultural and religious variations are predicted to be the keys to the success or failure of attitude and treatment towards the problem.

Refugee Healthcare

As taken from Global Health Middle East, “[Syria and neighboring countries] are struggling to cope with the staggering number of refugees, who have strained health, education and other infrastructure. As more refugees stream over the border every day, the UN is being forced to prioritize the most vulnerable due to lack of funds.” Attention needs to be paid to the healthcare needs of refugees both in terms of war/trauma injuries and emergency care, but also to the long-term healthcare polices for those with chronic diseases and mental health issues, as seen by the tweets below. There is an express interest in aiding refugees in the most efficient ways possible, but it seems like no one truly knows how. There are many organizations that have focused on emergency response, but that only goes so far.

Tweet1

The rapid shifts in disease burden place poor people in low – and middle – income countries at high risk of not having access to appropriate services and incurring payments for health care that push them deeper into poverty,said Timothy Evans, Director of Health, Nutrition and Population at the World Bank Group. The question is, with an ongoing war and a need for humanitarian aid, where will the long-term funding for refugee health come from? What possibilities are there for regional areas to contribute aid?

Currently, most health services in the MENA regions are based on a curative model, which is expensive to maintain and ineffective in addressing the emerging health challenges. With the rapid growth of health discussions, it is clear that there are efforts to change how the issues are handled, but who is going to answer and solve these problems? Who will be accountable for delivering services to those who need them?

References: Providing Healthcare in Crisis, Social Barriers to Mental Health Services, The Middle East and Health, Public Health in the Middle East, The World Bank

Evil Eyes All Around!

In ancient legend, it is believed that the evil eye was the biggest threat to someone who accepted praise for something beyond what they truly deserved. That person would become “so swollen with pride” that doom would come from the evil eye in the form of incurable illnesses. Society thought that “gods were punishing those who had become too proud of their own achievements” and would restore the balance of humanity by destroying their ego.

DisplayWhile the legend has changed some over the years, it is still told in many societies. Some believe that there are three types of evil eyes – the first is unconscious evil eyes. These harm people and things without intending to. The second type intends to harm. The third one is an unseen, hidden evil that is the most formidable one out of the three. While the classic, traditional evil eye amulet is a cobalt blue evil eye bead with white and turquoise circles in the middle, they can also come in different colors that supposedly offer protection in more specific areas like health and love. Glass eye beads are generally blue because cobalt and turquoise blues are thought to be the most defensive colors against the bad luck that results from the negative attention or jealousy of others. The bead will often be shiny in order to “reflect back the evil” from the wearer. It is believed that not only do the evil eyes protect the wearer from ill, but they also encourage positive thinking–basically protecting you from your own negativity!

Bracelet

Even though the beautiful, blue eye beads are typically seen alone in jewelry, they can also be paired with the hand of Hamsa. The Hamsa hand is a hand with (usually) two thumbs and three fingers pointing downwards. With blue glass eye beads made of striking cobalt blue, vivid reds, lemon yellows or pure white glass with black center dots strung on red cord, evil thoughts are thought to quickly evaporate before their purposeful stare. “Hamsa” is an Arabic word (خمسة), which means five (referring to the fingers of the hand). In Jewish culture, the hamsa is called the Hand of Miriam; in Muslim culture, the Hand of Fatima, in the name of Mohammed’s daughter.

Evil Eye The hamsa is usually worn as a charm, but also appears either directly painted on walls or as a plaque. Additionally, it is hung over doors and windows much like a horseshoe. When received as a gift, if one does not believe in the evil eye entirely, it works as a “hand of friendship” by connecting two people together (typically in jewelry form). There are plenty of shops selling glass evil eye beads for tourists across the Middle East, as they are usually uncommon for Westernized citizens to be wearing. However, they are making an appearance on various clothing, jewelry, and even makeup/nail art here in America. I have seen various drawings of hamsas in buildings around Ohio University’s campus and, lately, as a popular tattoo choice. They range from simple to complex designs and I love how accepted they’ve become. Now that I know what these symbols stand for and why they are cherished, I have a much bigger appreciation for them. (And now I really want to own one!)

The myth of the evil eye seems to make a lot of sense in our current world. When you think about it, the idea that too much fame, money or praise can bring about one’s downfall is prevalent all over pop culture in America, which reinforces the idea of the evil eye. Lindsay Lohan, Charlie Sheen, Kim Kardashian, etc. are prime examples of celebrities that fall into this category. Pop culture has been filled with celebrities that are not the best role models and it makes a negative precedent for the rest of society. I think we could benefit from taking a page from the evil eye legend.

Protected

I personally love the concept and design of the evil eye! I think it’s a simple, yet powerfully symbolic way to tie yourself to a religion (similarly to a cross for Christianity), but also to a culture or relationship. It is also something a esthetically beautiful that I am drawn into every time I see them. What do you think? Would you buy an evil eye or hamsa talisman? Do you think the symbol will continue to evolve with the societies that use them?

References: BellaOnline, Fire Mountain Gems and Beads, Jewish Gift Place, EvilEyeStore, Sahra Design

Right To Love

In the Middle East, perceptions of “gay” or “homosexual” are different from those of the West, and even Ohio University. Simply going against cultural norms can cause one to be labeled as “gay” in the Middle East; this categorization of homosexuality may be on pure assumption as well. Unlike Western culture, there are many classifications of “gay” in the Middle East, including words that do not have English translations. Another contribution to the mislabel of “gay” can be the lack of distinction between “sex” and “gender”, which, as a communication studies major, I have recently studied extensively. It’s not easy to be gay in any part of the world, but in the Middle East it’s almost like being invisible and at risk at the same time.

Recently, homosexuality has become readily accepted in many countries, including the United States, but in the Middle East it is the excuse for the arbitrary detention, arrest, torture, and deaths of hundreds of people. There are, however, always differing treatments across countries in the Middle East, similar to the U.S.’s state treatments. Israel is often seen as the exception by accepting homosexuality and even allowing “Pride Parades” to occur throughout the country, but many residents of the Middle East have been reported to claim homosexuality is a Western “problem.” They emphasize the differences between Eastern and Western cultures and claim that homosexuality cannot be tolerated. But are we truly that different?

“In Iran, we don’t have homosexuals, like in your country.”

-Iranian President Mahmoud Ahmadinejad (Source)

I identify as a follower of Catholicism, a religion that is seemingly intolerant of homosexuality entirely, and I wondered if Islam followed that stance. Just like Catholicism, Islam is interpreted differently by different followers, but generally its teachings regarding sexuality (homosexual or heterosexual) can be reduced to the importance of procreation and formalized frameworks for sexual activity. Criticisms of homosexuality are generally found in Hadith, history or teachings of the Prophet Muhammad that were passed down orally through history until they were recorded in writing. Many Hadith reports contradict each other, but they include severe condemnations of homosexuality.

The Pew Research Center, as part of a fascinating new report on global attitudes toward homosexuality, asked people in 39 different countries a deceptively straightforward question: “Should society accept homosexuality?” People could answer yes, no or decline the question.

The “yes” answers are mapped out below. In red countries, less than 45 percent of respondents said homosexuality should be accepted by society. In blue countries, more than 55 percent said it should be accepted. Purple countries fall in that middle range of about half. Additionally, as you can see in the line graph, they plotted where a country’s tolerance for homosexuality falls.

Homosexuality Map

Homosexuality Scale

However, even with oppressive forces against them, homosexual individuals in the Middle East have found ways to flourish. Beirut’s vitality as a Mediterranean capital of night life has fueled a LGBT scene like any other and in recent years, Lebanon has become one of the most liberal Arab counties when it comes to sexuality and sexual behavior. Also, isolated and secret groups have been known to form to provide support to the LGBT community, despite popular discrimination.

Whether because of politics, religion, or common cultural practices, homosexuals within the Middle East continue to fight for their lives and their right to love. Only with the cessation of these practices and the advocacy of human rights for all people will human beings truly achieve peace. What have we done in Athens to promote a peaceful environment? What cultural values do we show when we are accepting of LGBT identities?

References: The Washington Post, The New York Times, theguardian.com, International Gay & Lesbian Human Rights Commission, Humanitarian News & Analysis, Human Rights & Human Welfare

Expression through Henna

For over five thousand years the art of henna (Arabic) or mehndi (Hindi) has been used as a way of enhancing beauty. Legend has it that Mohammad used henna to dye his beard and that the henna flower was the Prophet’s favorite. The plant has since been associated with positive magic and “provides a link to an ancient age full of good and bad spirits.” It holds a place in religious, magical, and cultural practice.

Arabic Henna

Enough though there is some controversy over the creation of henna as a dying agent, the earliest clear evidence of henna application appears on the hair and nails of Egyptian mummies. It is believed that the henna plant, Lawsonia inermis, originated in Persia and is now found throughout parts of Asia and the Middle East. Henna has also been used for medicinal purposes, to dye cloth and leather as well as hair, and to color the manes of horses and fur of other animals.

Feet Henna

In Arab weddings, brides would, and still, participate in a traditional henna ceremony. Henna is a symbol of good luck, health, and sensuality and thus used for marital purposes as well. Typically, the bride’s hands and feet are painted with intricate designs with a paste of dried henna leaves. Black henna is reserved for the soles of feet and hands while red henna is used for the tips of fingers and toes (as seen above). It is carefully applied and needs to dry for long periods of time without being removed, bumped, or otherwise touched; this is when the staining happens. (The longer the paste is left to dry, the darker and deeper the stain will be.) Henna can be used in the actual ceremony as well. What is the religious implication of henna in weddings? As I see it, each culture’s take on henna is different, but the purposes are similar.

Each henna artist usually has a personal recipe and apreferred technique. Some artists will use toothpicks, plastic cones, Henna Handsor tools from henna kits; all of these make the application easier, but require different skill sets. The paste is also made according to the artist’s skill level – if the paste is thicker, then it is harder to apply and if it is thinner, it is easier. The designs range from simple to intricate in every culture, but can have many distinct differences. Arabic henna designs are usually large, floral patterns on the hands and feet. Indian mehndi involves fine, thin lines for lacy, floral and paisley patterns covering entire hands, forearms, feet and shins. African henna patterns are bold, large geometric designs.

Modern day Arab women still use henna for body adornment, but in a more fun 2014-10-14 16.25.46and decorative way. Western societies have also adopted henna as a way to temporarily tattoo oneself (as seen right by the University Program Council at Ohio University) in addition to other methods of self-decoration. What is the cultural implication of henna as used in present day societies? I personally have gone to a party with henna and my friends and I match our henna designs. For me, it’s used as a personal bonding measure between my closest friends. Have you ever tried henna? What’s your favorite design?

                             References: Henna: An Enduring Tradition, Customs of Middle Eastern Makeup and Decoration, HennaArt Connection, Henna, Silk and Stone, Earth Henna