Culture and Health

Understanding Culture is important to determine the health of a population. Culture determines the health behaviors, perception of illness, the use of health services, and types of health treatments (Skolnik, 2020).

The Middle East is home to modern, high-tech, Western-based biomedicine, but popular healing traditions still exist among the rural populations. The cause of illness is complex and difficult to categorize with beliefs ranging from naturalistic to personalistic to supernatural (Healing and Medicine, n.d).
Islamic belief: the soul is not separated from the body. It is closely intertwined with the physical and psychological and imbalance or disharmony may be the cause of illness.
Druze belief: reincarnation. Misdeeds in ones past life may result in punishment by suffering and illness in ones current life.
Christian belief: hide feelings of emotion or share feelings with selective individuals. Illness viewed as a time of spiritual refinement with possible need for confession.
Tribal belief: misfortune and illness are related to supernatural forces.
All groups use prayer, reading religious text, mediation of saints, visiting holy places and holy sites, and spiritual support from an imam, priest, or other religious person (sheikh).
Suffering is commonly understood as a normal part of life.
Tend to accept fate and view life as a testing place.
Catastrophes and illnesses may be seen as an opportunity for growth and strengthening of faith.
Mental health is not well understood and carries a negative connotation, but the awareness and concepts of mental health in Syria have gradually changed.
The conflict-related violence is having an overwhelming effect on the mental and psychosocial health and well-being of the Syrian people. The experiences of conflict-related violence and concerns about the situation in Syria along with the stress of displacement, poverty, lack of basic needs and services, risks of violence and exploitation, isolation and discrimination, loss of family and community supports, and uncertain future are affecting the health of Syrians. There are a wide range of health problems relating to the conflict including emotional, cognitive, physical, social and behavioral (Hassan, et al., 2015).

Men

Dress varies from traditional baggy trousers to Western styles.
Assume the role of guardianship, which includes authority over medical treatment, education, career guidance, and marriage consent.
An older male has the ultimate authority and is responsible for providing for family members.
May have up to 4 wives, but can be prevented by court if incapable of providing adequate financial support (9% urban and 16.3% rural). This practice has been made illegal in the Kurdish controlled areas, but still remains in practice (Commins, et al, 2020; Social Instiutions & Gender Index, 2014).

Effects on Health

Mental health is causing increased health problems among all groups, men, women, and children.
Women are at increased risk for rape and domestic abuse. Rape is being used as a weapon of war. Domestic violence is a social taboo.
Honor killings: estimated to be around 300-400 in 2012. Considered illegal with criminal penalties in the Kurdish region.
Depending on strictness of religion, women may not be able to see a male health care provider (Social Institutions & Gender Index, 2014).

Women

Dress varies from latest European fashion to completely veiled.
Many are highly educated, but due to war adolescent girls have had their education interrupted.
Women have equal rights: entitled to receive the same education and to seek employment, but the traditional attitude of females being inferior remains strong.
Women are the decision-makers and breadwinners in 1:3 households due to the war.
Women make up 14% of the workforce with 90% being in agriculture and 1% in administrative or managerial positions.
12.4% of the People's Assembly in the government are women.
Women are responsible for running the household, and are considered the possession of a man.
Women often face legal and social restrictions, and their freedom of expression, association and assembly are all heavily restricted (Commins, et al, 2020; Hilton, 2017; Social Institutions & Gender Index, 2014).
Women play a large part in the Kurdish region and have roles in government and military. The Women's Protection Unit (YPJ) is strictly an all female military combat unit.

Cultural Practices

As stated earlier, modern Western medicine is available and widely used, but traditional medicine is still used throughout the region. The types of traditional medicine used vary by tribe and region. Below is a list of some of the more common practices.

Arab folk medicine:

amulets which contain religious sayings and tied around neck or fastened to clothing
evil eye viewed as the primary reason for infant and child death
cupping
traditional and spiritual healers which is prohibited by Islam, but still widely acknowledged
Arabic doctors use herbal, spiritual and other physical remedies and can charge high prices for their services

Faith Healing:

prayers
laying on of hands
recitation of holy verses from the Qur'an
writing of religious amulets (Healing and Medicine, n.d.).

Diet Restrictions:

Islam: no pork, blood, alcohol, or shellfish; "halal"
Yazidism: no pork or leafy green vegetables
Christian: no restrictions, besides certain holidays

Medicine:

People tend to expect medicine to treat their problems rather than lifestyle changes
Injections are considered the medicine of treatment; more pain, more effective
Antibiotics are widely distributed with lack of regulation

Though there are many different types of practices that can have a positive or negative impact on health, the two I am listing are Ramadan and sugar water and swaddling for babies.

Ramadan is a Muslim holiday that occurs each year. This is a month of strict fasting. Fasting starts at sunrise and end at sunset. During this time period a person is not allowed to eat, drink, smoke, have sexual intercourse, or any evil intentions and actions (Realin & Preston, 2017). After sundown, a large meal is eaten to break the fast. More food is consumed during the month of Ramadan than during a normal month. A person who is ill and pregnant women are given exceptions, but depending on the situation they may have to complete their fasting in another month. For this reason, many who should not fast, due to health reasons, fast which causes an increase in health problems. If Ramadan occurs in the summer months, many people experience symptoms of dehydration. Medications which should be taken regularly are now stopped or taken when the individual can eat. This can cause poor control of chronic health conditions. Nursing mothers experience difficulty with breast feeding and start feeding their babies formula or other foods to help compensate.
Many babies are tightly wrapped and tied into their beds for months. They are removed for feeding and changing. This causes many to have poor muscle tone and a delay in physical development. Many mothers feed their babies sugar water to keep the quiet and help them sleep, so they can have time to do their own work. This can cause malnutrition in infants who are crying because they are not receiving enough food. Sugar water has been noted to have a calming effect and provide pain relief in infants, but it also can lead to electrolyte disturbances and loss of appetite (Goldman, 2016).

References

Commins, D. D., Irvine, V. E., Smith, C. G., Hourani, A. H., Hamidé, A., Scullard, H. H., Gadd, C. J., Ochsenwald, W. L., Polk, W. R., & Salibi, K. S. (2020). Syria. Encyclopaedia Britannica. Retrieved from https://www.britannica.com/place/Syria

Goldman, R. (2016). Sugar water for babies: Benefits and risks. Parenthood. Retrieved from https://www.healthline.com/health/parenting/sugar-water-for-babies

Hassan, G., Kirmayer, L. J., Mekki-Berrada, A., Quosh, C., el Chammay, R., Deville-Stoetzel, J. B., Youssef, A., Jefee-Bahloul, H., Barkeel-Oteo, A., Coutts, A., Song, S., & Ventevogel, P. (2015). Culture, context and the mental health and psychosocial wellbeing of Syrians: A review for mental health and psychosocial support staff working with Syrians affected by armed conflict [PDF]. UNHCR. Retrieved from https://www.unhcr.org/55f6b90f9.pdf

Healing and Medicine: Popular Healing Practices in Middle Eastern Cultures. (n.d.). Encyclopedia of Religion. Retrieved from https://www.encyclopedia.com/environment/encyclopedias-almanacs-transcripts-and-maps/healing-and-medicine-popular-healing-practices-middle-eastern-cutures

Hilton, D. (2017). The shifting role of women in Syria’s economy. The Tahrir Institute for Middle East Policy. Retrieved from https://timep.org/syrias-women/economy/the-shifting-role-of-women-in-syrias-economy/

Realin, A. P. & Preston, L. R. (2017). Personalizing patient care. Altamonte Springs, FL: Florida Hospital Publishing

Social Institutions & Gender Index. (2014). Syrian arab republic [PDF]. OECD. Retrieved from https://www.genderindex.org/country/syrian-arab-republic/

Skolnik, R. L. (2020). Global health 101. Burlington, MA: Jones & Bartlett Learning

Culture and Health

Understanding Culture is important to determine the health of a population. Culture determines the health behaviors, perception of illness, the use of health services, and types of health treatments (Skolnik, 2020).

Islamic belief: the soul is not separated from the body. It is closely intertwined with the physical and psychological and imbalance or disharmony may be the cause of illness.

Druze belief: reincarnation. Misdeeds in ones past life may result in punishment by suffering and illness in ones current life.

Christian belief: hide feelings of emotion or share feelings with selective individuals. Illness viewed as a time of spiritual refinement with possible need for confession.

Tribal belief: misfortune and illness are related to supernatural forces.

All groups use prayer, reading religious text, mediation of saints, visiting holy places and holy sites, and spiritual support from an imam, priest, or other religious person (sheikh).

Suffering is commonly understood as a normal part of life.

Tend to accept fate and view life as a testing place.

Catastrophes and illnesses may be seen as an opportunity for growth and strengthening of faith.

Mental health is not well understood and carries a negative connotation, but the awareness and concepts of mental health in Syria have gradually changed.

Men

Dress varies from traditional baggy trousers to Western styles.

Assume the role of guardianship, which includes authority over medical treatment, education, career guidance, and marriage consent.

An older male has the ultimate authority and is responsible for providing for family members.

May have up to 4 wives, but can be prevented by court if incapable of providing adequate financial support (9% urban and 16.3% rural). This practice has been made illegal in the Kurdish controlled areas, but still remains in practice (Commins, et al, 2020; Social Instiutions & Gender Index, 2014).

Effects on Health

Mental health is causing increased health problems among all groups, men, women, and children.

Women are at increased risk for rape and domestic abuse. Rape is being used as a weapon of war. Domestic violence is a social taboo.

Honor killings: estimated to be around 300-400 in 2012. Considered illegal with criminal penalties in the Kurdish region.

Depending on strictness of religion, women may not be able to see a male health care provider (Social Institutions & Gender Index, 2014).

Women

Dress varies from latest European fashion to completely veiled.

Many are highly educated, but due to war adolescent girls have had their education interrupted.

Women have equal rights: entitled to receive the same education and to seek employment, but the traditional attitude of females being inferior remains strong.

Women are the decision-makers and breadwinners in 1:3 households due to the war.

Women make up 14% of the workforce with 90% being in agriculture and 1% in administrative or managerial positions.

12.4% of the People's Assembly in the government are women.

Women are responsible for running the household, and are considered the possession of a man.

Women often face legal and social restrictions, and their freedom of expression, association and assembly are all heavily restricted (Commins, et al, 2020; Hilton, 2017; Social Institutions & Gender Index, 2014).

Women play a large part in the Kurdish region and have roles in government and military. The Women's Protection Unit (YPJ) is strictly an all female military combat unit.

Cultural Practices