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Al-Ahram Weekly 10 - 16 August 2000 Issue No. 494 
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Published in Cairo by AL-AHRAM established in 1875 |
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Al-Ahram Weekly 10 - 16 August 2000 Issue No. 494
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| Published in Cairo by AL-AHRAM established in 1875 |
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Egypt Region International Economy Opinion Culture Books Travel Living Sports Profile People Time Out Chronicles Cartoons
Our bodies, our lives
By Reem LeilaInequality among male and female adolescents is particularly obtrusive when it comes to health care. Though medical services are theoretically available to both boys and girls, male teenagers, especially among the poorer classes, generally enjoy more attention and care from their families than their sisters do. This discrimination often means that affirmative action explicitly privileging women is needed to redress the situation.
At Al-Galaa Teaching Hospital (GTH), designers of a new health programme believe that gender segregation can also make positive differences for those traditionally deprived of equal access to health care, so they have set up a clinic on the hospital premises specialising in the physical and psychological problems of girls and young women aged 10 to 19. The clinic is open on Mondays; services are free. According to Dr Hisham El-Misilhi, the director of GTH, although the Egyptian Constitution stipulates that access to medical services must be equal, with no discrimination on the basis of gender, in practice matters are somewhat different. "In general," he notes, "the lower the family's social class, the less women enjoy their rights as human beings." Boys' health receives greater attention, he adds, as early as the weaning period.
Early marriage and pregnancy, delayed as well as early puberty, and female genital mutilation (FGM) are the most common problems facing girls and young women. Official statistics indicate that over 30 per cent of married women were first married at 16 years of age or younger, while nearly 67 per cent of girls are subjected to FGM. Approximately seven per cent suffer from either early or late maturity. Most of these problems prevail in poor families, especially in rural areas, El-Misilhi says.
Early marriage and FGM are crimes against individuals as well as society, he believes; yet they are not generally recognised as such. In fact, few other groups are discriminated against so routinely as are young girls, argues El-Misilhi. "I have noticed that this special category of females is totally neglected. People focus on either children or adults."
Ibtisam Hassan, a 19-year-old kindergarten teacher, was waiting for her turn at the clinic. She recently became pregnant after two years of fertility treatment. "I heard about the new clinic and its team of doctors. I decided to come in for a follow-up. I want to have a healthy baby, and the doctors are going to help me choose a healthy diet to follow for my sake as well as the baby's," she said.
One section of the clinic is especially for young mothers-to-be. Although women are often reluctant to seek health care for themselves -- having been taught from a young age that they are "less important" or "less deserving" than their male siblings -- they will do so willingly when they know their condition will affect that of their unborn children. According to Hossam Ashour, a GTH paediatrician, the early detection of potential threats to children's health and normal growth will help prevent many problems in later stages. "The clinic provides young mothers-to-be with certain nutritional guidelines and emphasises the importance of a healthy diet. The paediatricians also help young mothers come up with a balanced diet on a limited budget," says Ashour.
Diet is particularly important since women are often the last members of the family to eat. They may not share meals with the men, but instead eat whatever is left after having cleared the table. In the case of scarce commodities (like meat, which poor families rarely consume due to its high cost), boys will get the lion's -- and sometimes the only -- share.
The clinic staff, however, also pays attention to other problems. Patients who suffer from early or delayed puberty, for example, may suffer psychological disorders. In such cases, the patient is introduced to a psychologist before being examined by a doctor. Hoda is nearly nine, but she has already reached puberty. Her mother died in childbirth, and Hoda came to the GTH with her father, who teaches at Suez Canal University. A month ago, he noticed that his daughter had started menstruating, and was developing much faster than her classmates. "I did not know what to do. I know that these are the signs of maturity, but I was worried because my daughter is still a child," says Hoda's father, who took her to doctors in Port Said but received no advice.
Early puberty is not necessarily a problem, but Hoda was very disturbed. Crying, she explained: "The kids at school make fun of my breasts, and when I started bleeding I was scared I would die like my mother. I do not want to leave father alone, I love him very much." El-Misilhi says Hoda will meet a counselor before seeing the doctor.
Mona is 19 and a university student, but has not yet begun menstruating. She first came to GTH two months ago. "I am tired of being abnormal. I look like a boy. I went to several gynaecologists before coming here, but they couldn't help me. At GTH, the doctors have told me there is hope." Mona has met nearly all the clinic's doctors. Dr Ola Shaaban, a psychiatrist, notes: "It was very difficult to convince Mona that she is quite normal. She suffers from a simple disturbance of the ovarian functions, which can be cured with regular treatment."
El-Misilhi attributes the growing number of patients to the fact that the clinic's doctors work as a team, which is not the case in other establishments. There are future plans to set up similar clinics across the country. "Hopefully, that will make it easier for young women all over Egypt to receive adequate health care -- and, perhaps, redress the gender-based inequality in access to medical services."
