Navigating care for Bedouin patients with diabetes

Abstract

The Bedouin Arab population in the southern Negev region of Israel has faced health problems as a result of transitioning rapidly from a nomadic agricultural lifestyle to a more modern urban lifestyle. Like many populations around the world, the Bedouins have changed their diets and become more sedentary and this has led to a high rate of diabetes. In this case report, we examine how diabetes has affected the life of an influential man in the Bedouin community and the significance this case has in the greater context of a global rise in chronic disease.

“I Had to Rediscover Our Healthy Food”: An Indigenous Perspective on Coping with Type 2 Diabetes Mellitus

“…An analysis of the theoretical underpinnings of this cluster of studies reveals a common narrative. According to the minorities in transition approach, the high prevalence of T2DM and the negative treatment outcomes among ethnic minorities in Western society are the result of a rapid transition from a nomadic agricultural lifestyle to a modern urban lifestyle, e.g., [ 13 , 19 , 20 , 21 ].…”

“…Another example of a study that used the minority in transition approach is the study by Dunton et al who presented a case study of an influential patriarchal figure in a Bedouin community to demonstrate how traditional social and gender practices, within the wider setting of a rapid transition to modernization, can complicate coping with T2DM [ 21 ]. They focused on the social responsibility of the sheik (an honorific title in Arab culture commonly used to designate the ruler of a tribe/community) to host family, friends, and other influential figures in the community.…”

“…The responsibility of hosting means frequent social gatherings in which the sheik and the guests feel a social obligation to eat foods rich in carbohydrates and sugars, as well as sugary drinks. They concluded their analysis with the claim that “These cultural norms present a challenge to diabetes care and management” [ 21 ] (p. 1). However, the researchers ignored the fact that before the disruption of the traditional nomadic lifestyle, sugary foods and drinks were not as central to social gatherings as they are today, and events were part of a lifestyle that included regular physical activity.…”

“…Hence, this approach considers modern living conditions as the norm. Many studies acknowledge that a modern or urban lifestyle includes many risk factors for T2DM, such as a lack of physical activity or processed foods, but these elements are seen as necessary and inevitable, e.g., [ 19 , 21 , 22 , 23 ]. Since modern ways of life are seen as positive and the default in the Western world, traditional (i.e., non-Western) norms and practices are singled out as the problem.…”

Global Health Education and Advocacy: Using BMJ Case Reports to Tackle the Social Determinants of Health

“…Dunton et al describe the case of a Bedouin patient in Southern Israel and his access of health-care services ( 44 ). Despite a robust universal health-care system and a culturally competent doctor, the patient still presented late in the course of his disease and was non-adherent to some aspects of his therapy.…”