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For Some Refugees, Women’s Health Care Is A Culture Shock

BUFFALO, N.Y. — Dinnertime is nearing, and the kitchen on this tidy house is buzzing. Lamyaa Manty, a 29-year-old Iraqi refugee, wears a neon-pink T-shirt and stirs an enormous pot of eggplant, onion, potatoes and tomatoes on the range, a staple of Iraqi cooking referred to as tepsi.

Spinning round with a butterfly internet in her hand and dancing to Arabic music is Fatima Abdullah, an exuberant 9-year-old.

At the middle of the exercise is Fatima’s aunt, Salima Abdullah Khalifa, a burgundy-haired matriarch from Baghdad, who pours Pepsi into small glasses on the desk.

This is a discovered household. Manty was Khalifa’s neighbor in Baghdad. When Manty misplaced her whole household, Khalifa took care of her. The two spent 5 years collectively in Jordan, ready for his or her refugee purposes to be processed.

Khalifa’s husband, brother and three sons have been killed in Iraq, and restarting life in Buffalo, on the shores of Lake Erie, with such profound ache in her coronary heart has been making an attempt. Certain American customs bewilder her. When it involves health care, Khalifa was startled to seek out that male docs within the U.S. look at women and that she is meant to get a checkup on the clinic even when she is just not sick.

“We don’t have primary [care] doctor in my country,” stated Walaa Kadhum, a fellow refugee and Khalifa’s pal who helps translate. In Iraq, the women say, solely the very sick or the very wealthy acquired medical remedy. But right here within the United States, they’ve main care docs and get annual checkups.

Perhaps probably the most distressing of these checkups for a lot of conservative Muslim women is a Pap smear, a screening check for cervical most cancers. The check is uncommon within the creating world, in accordance with international health specialists, and for conventional Muslim women, like Manty, who’re anticipated to be virgins till they marry, the invasive process is a profound menace.

“If she’s not a virgin, she can’t marry,” defined Kadhum. “They say, ‘This is a bad girl. We can’t marry you. Until she [is] married, nobody [touches] her.”

Manty stated if she doesn’t marry, she is going to by no means get examined for cervical most cancers or have a vaginal examination. Khalifa, now 51, had her first examination at 45, when she resettled in Buffalo.

Physicians who deal with refugee women say it’s not unusual to seek out undiagnosed cervical most cancers, sexually transmitted illnesses or persistent pelvic ache.

Dr. Magda Osman, an obstetrician and gynecologist on the Buffalo Medical Group who’s initially from Egypt, stated lots of her refugee sufferers ultimately comply with a Pap check as soon as they perceive the health advantages. But for women who nonetheless object, she tries to elucidate that Islam doesn’t forestall them from taking good care of their health.

“A lot of cultural issues may not be religious issues but they’re so ingrained in people that they don’t know the difference,” stated Osman.

The single women she sees typically worry a Pap check will break their hymen, which may be very problematic for a younger lady if it calls her virginity into query. But it may be a strict tradition — not the Quran — implementing that concept, Osman stated.

“A certain percentage of women will not bleed on the first time they’re sexually active,” she stated. “But if you go to many cultures around the world, if there is no blood then that woman is ostracized. But that’s not religion.”

At the Jericho Road health clinic in Buffalo, the employees is well-versed in these cultural beliefs. Heidi Nowak, a household nurse practitioner, stated she doesn’t push sufferers to violate their beliefs, however she is going to advocate for his or her health.

The stereotype that conventional Muslim women who cowl themselves are meek is a fable, Nowak stated. Her feminine Muslim sufferers are assertive and lots of of them have questions on intercourse, she stated.

“Some of the young Iraqi women will come to me. They’re planning to get married in two months, and they want to be prepared, so they’ll ask me questions about it,” she stated. “’What does sex feel like? How does it work?’ Or I’ll have them come to me after and say, ‘It was terrible.’”

One of the most important challenges serving strict Muslim refugee women, stated Nowak, is their reticence — or outright refusal — to be seen by a male physician.

Not removed from the clinic, Kuresha Noor, a caseworker for Journey’s End Refugee Services, a resettlement company, visits the house of a Somali mom and her three youngsters who resettled in Buffalo earlier this yr.

The women, coated in conventional Somali robes and headscarves referred to as garbasaars, sit on the sofa within the threadbare condo. The caseworker and her shopper are each pregnant and neither lady needs any male physicians to care for them or attend their deliveries.

Americans appear to have a tough time understanding why many conservative Muslim women have a choice for feminine docs, Noor stated.

“They’re not aware of it,” she stated of Americans. In her tradition, she stated, no man besides her husband can take a look at her. If he did, she stated, it will be as if “I’m not a good wife, like I’m not respecting his rights as a man. That’s what I feel.”

Doctors in Buffalo say the prohibition towards male docs has led to some harrowing moments within the supply room — couples who refused to consent to male obstetricians, even throughout an emergency.

Fatuma Abdi Noor, the newly arrived pregnant mom from Somali, stated her faith does permit a male physician to assist her in an emergency.

“It’s not a sin. God knows you didn’t do it on purpose,” she stated. “You won’t feel shame or sinned, because God was always there and knows what’s in your heart.”

She was in a refugee camp in Kenya with little medical care throughout her previous pregnancies. Now, within the U.S., she welcomes prenatal checkups, even when her tradition and faith collide with some health care practices.

“It gives me peace,” she stated, “because I know the baby is healthy.”

KHN’s protection of women’s health care issues is supported partially by The David and Lucile Packard Foundation.

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