Culture Shock! United Arab Emirates(Culture Shock! Guides)
Reel Bad Arabs: How Hollywood Villifies a People
The Middle
Eastern Community
The "Arab World" includes 22 countries in the Middle East
and North Africa, with a population of 180 million. Arabs are
inhabitants of the Arab World who speak various dialects of the
Arabic language and share the values and beliefs of the Arab culture.
Religion :
The majority of Arabs are Muslims. There are a large number of Arab
Christians in Lebanon, Syria Palestine, Iraq and Egypt. Many
Muslim Arabs who are conservative in their religious beliefs do not
eat pork or drink alcohol. They observe a fast in the daytime during
Ramadan. Some Muslim women wear long dresses and scarves to cover the body.
We as nurses should recognize that there are over 7 million Muslims
in America, and over 1.5 billion world wide all of whom must observe
prayer 5 times a day.
Health practices :
Some people wear amulets for protection against the evil eye or will
burn incense to keep the evil eye away from the sick. Such practices
are declining and are used primarily to avoid illness and harm to a
healthy person. Also, prayers and reading from Al Quran or the
Bible help give comfort to patients and family members and enhance
the patient's recovery.
Arab culture and Islamic religion emphasize maintaining good health,
especially through personal hygiene practices and a healthy diet.
They place a high value in modern Western medicine and have
confidence in the medical profession.
Patient and family will not wait long to seek professional help and
are usually anxious to receive a medication as soon as possible. They
will answer questions, will listen carefully to the health care
provider's advice, explanations and warnings, and will follow the
provider's directions carefully. Once symptoms have improved, many
patients will stop taking the prescribed medication or will not
return for a scheduled follow-up appointment.
An Arab patient seeing a doctor expects relief from pain and to
receive a medication on the first visit. Patients like doctors to
explain the reasons for not getting medications and for all
laboratory testing. Nurses are perceived as helpers, not health care
professionals, and their suggestions and advice are not taken
seriously. Doctors may need to explain the nurse's role to the
patient. Arabs are not accustomed to the profession of social
workers. They rely on their families, other relatives and close
friends for support and help.
Generally, both male and female Arab patients and their children
prefer to be seen by male doctors. For pregnancy or gynecological
needs, women prefer a female doctor, however. In Arab culture, women
are reluctant to discuss these concerns with men. It is common for
the family member to stay with the patient and to help answer
questions about the patient's health. In Arab countries, patients are
told only the good news about their disease. In severe cases, the
doctors generally report the seriousness of the illness and its
likely consequences to a selected family member.
Arabs believe that recovery from illness has to do with seeking a
professional treatment and submission to God's will. They
consider death to be a destiny decided by God. Family members need to
be with the body until it is ready to be removed from the hospital.
Muslims prefer to bury the body on the day death occurs.
Social customs : Elders have a
prestigious status in the Arab family because of their experience.
Family members look to elders for advice. An individual who becomes
sick will turn first to family members, especially elders, for
support, comfort and advice. They may recommend safe, simple home remedies.
When a patient is admitted to the hospital, it is a social obligation
for friends and family to visit and bring presents such as flowers,
cookies or chocolate.
In the Arab Culture there is a strong sense of Paternalism what most
Westerners call "Male Dominance". What is so
important to the balance of the subject is to understand that the
females role is equivalent and she is the Maternal powerhouse in her
home. Men by culture give orders, but by the faith of Islam
they are the "protectors" of their families. They do
take orders from their womenfolk but within the construct of the
family for it would be disrespectful to do so socially. 1
Maternal and child health : Most Arabs
consider childbirth to be a female issue only. A woman in labor is
usually surrounded by female relatives and friends. Fathers are not
admitted to the labor room. Midwives play an important role in
prenatal care, delivery and post delivery consultation and are held
in high regard in society and in the medical profession. Arab women
prefer to breasted their newborns. Arabs in general do not approve
having an abortion.
It is an Arab tradition to circumcise newborn boys.
Privacy : Some Arabs are reluctant
to disclose detailed information about themselves and their families
to strangers. They tend to give as little information as possible and
may not give enough for a proper diagnosis. Being conservative, they
may be embarrassed by questions about their sexual relationships and
other personal questions.
Sexual problems and venereal diseases are difficult for Arab patients
to deal with. Women are shy to talk about their private lives and may
feel more comfortable with women doctors.
Typically, Arabs look down on people who are mentally ill. Patients
with mental health concerns do not like to share this information
with their relatives or friends and are shy of seeking professional help.
Diet : Diet may be an issue for
Muslim patients. During Ramadan, many patients resist taking
medications or eating during the daytime. Since Muslims do not eat
pork, patients may not eat all hospital meals. Some eat only Halal
meat (meat from animals slaughtered according to Islamic tradition).
Because of shyness, fear of rejection, or lack of knowledge, many
Arab patients will not ask for different meals.
1-
A 27 year old Arab man refused to allow a male lab technician to
enter his wife's room to draw blood. She had just given birth. The
staff finally convinced the husband of the need, he reluctantly
allowed the technician in the room. However, he took the precaution,
of making sure his wife was completely covered. Only her arm stuck
out from beneath the covers. For Arab families, honor is one of the
highest values. Since family honor is dependent on female purity,
extreme modesty and sexual segregation must be maintained at all
times. Male nurses should not be assigned to female Muslim patients.
In many parts of the world, female purity and modesty are major values.
In this instance his sense of responsibility and
need to protect her modesty from very much an "intrusive"
health care experience for the most part could be curbed by a simple
sign placed on the door that says "Please Knock before entering,
this pt. observes modest dress and requires the announcement of your
presence." This would help communicate to the pt. and her
husband that
we understand and wish to honor your
modesty. This is empowering for the family. The rudeness
or sense of oppression of the pt. the nurses might have felt would be
understandable. However, when ever patients. or their families
are rude or pushy we only need ask ourselves .... What is the
underlying motive behind rudeness .... The answer is fear.
2-
When the nurse entered the room of her Iranian patient, she found
the patient huddled on the floor, mumbling. At first she thought the
patient had fallen out of bed, but when she tried to help her up the
patient became visibly upset. She spoke no English and the nurse had
no idea what the problem was. The patient had been praying.
She was practicing her religion in the
traditional manner. Since she was scheduled for surgery the next day,
she thought it was especially important to pray.
Devout Muslims believe they must pray to Mecca,
the Holy Land, five times a day. Traditionally, they pray on a prayer
rug placed on the floor. If the nursing staff had some understanding
of Muslim customs, they could have arranged to provide the patient
some privacy during certain times of the day so she could pray.
3-
A nineteen-year-old Saudi Arabian woman had just given birth. Her
husband moved into the hospital room with his wife immediately after
she gave birth. He kept the door to the room shut, and questioned
everyone who entered, including the nurses. The nurses were not happy
but felt they had no choice but to comply.
Although the patient could speak some English,
the only time she would speak directly to the nurses was when her
husband was out of the room. Otherwise, he answered all questions
addressed to her. He also decided when she would eat and bathe. As
leader of the family, he felt it was his role to act as intermediary
between his wife and the world.
The truth is Labor hurts like hell, and
technology is scary as hell, the idea of an epidural is often
misunderstood, and many women fear it therefore don't opt for
it. In the faith of Islam, heaven rests beneath the feet
of mothers .....Strange isn't it for a male dominated society.
The truth is women are sacred and revered, often protected, not
because she can't handle herself or has no voice, but because the
solidarity of the family unit depends on her well being. 1
4-
TRANSCULTURAL NURSING CARE OF AN
ARABIAN PATIENT
Nurses need to be culturally competent in the
prenatal care of women from Saudi Arabia. A basic understanding of
the Arab culture, attitudes, values, beliefs and practices is addressed.
References :
Galanti G.A.: Caring for Patients
from Different Cultures. University of Pennsylvania Press,
Philadelphia, 1991
Laffrey, S.C., A.I. Meleis, J.G.
Lipson, M. Solomon and P.A. Omidian. "Arab-American Health Care
Needs." Social Science and Medicine 29(7): 877-83 (1989).
Lipson, J.G., A.E. Reizian and
A.I. Meleis. "Arab-American Patients: A Medical Record
Review." Social Science and Medicine 24(2): 101-07 (1987).
Meleis, A.I. "The Arab
American in the Health Care System." American Journal of Nursing
81(6): 1180-83 (June 1981).
1 Najah Bazzy R.N.
The Arab World: Society, Culture, and State
Culture Shock! United Arab Emirates(Culture Shock! Guides)
Reel Bad Arabs: How Hollywood Villifies a People
1-
A 27 year old Arab man refused to allow a male lab technician to
enter his wife's room to draw blood. She had just given birth. The
staff finally convinced the husband of the need, he reluctantly
allowed the technician in the room. However, he took the precaution,
of making sure his wife was completely covered. Only her arm stuck
out from beneath the covers. For Arab families, honor is one of the
highest values. Since family honor is dependent on female purity,
extreme modesty and sexual segregation must be maintained at all
times. Male nurses should not be assigned to female Muslim patients.
In many parts of the world, female purity and modesty are major values. 
