By Kevin Begos
A Universal Struggle
Cultural differences abound in the Middle East, but the challenges and compassion associated with cancer are much the same
By Kevin Begos
On a recent morning in Amman, Jordan, a middle-aged woman sat in a small room at the King Hussein Cancer Center and spoke of breast cancer and how it caused her husband to disown her. Dalal Khaldi, 57, is conservatively dressed in an abayah—the traditional Islamic black head-to-toe garment, as well as a hijab, which covers her hair but not her face. She was diagnosed with breast cancer in 2005, and her husband immediately stopped sleeping with her and failed to provide any financial help for medical treatments. “When I was in a room, he left the room,” she says. Ultimately, the two divorced, and Khaldi now lives in near-poverty, though her cancer is in remission.
But Khaldi’s story is only one snapshot of a society—and a medical profession—that’s undergoing tremendous changes. In another part of the city, Suzan Murad and Khalid Dwaik welcome guests into their luxurious home. Dressed in what might be called Middle Eastern couture—a beautiful, full-length dress with traditional Islamic geometric patterns down the sides—Murad, 37, is one of the first women in Jordan to have had reconstructive surgery after breast cancer. Dwaik, an engineer who works for a French-Jordanian telecom company, is dressed in a suit and tie.
Dwaik hopes to form a support group for Middle Eastern men to teach them how to accept—and stand by—wives, sisters or daughters who have breast cancer. It’s an idea that combines two subjects many people in the region still don’t feel at ease talking about: sexuality and cancer. The discomfort is partly because many still think of cancer as incurable, or contagious. Even doctors and staff at the King Hussein Cancer Center—a clean and modern comprehensive care facility that opened in 1997—say that friends and family members are openly uncomfortable discussing the hospital, or even mentioning saratan, the Arabic word for cancer.
But people and governments in Arab countries throughout the Middle East are now being forced to confront cancer as never before. Historically, rates in these nations were far lower than in the United States. According to the Middle East Cancer Consortium, the overall incidence in Jordan from 1996 to 2001 was about one-third that of the U.S.; the incidence in Egypt was about one-half. There are differences among countries and types of cancer, but in general, cancer incidence is rising, many researchers say.
The local and international medical community is taking notice. In March, the American Association for Cancer Research (AACR) held its first-ever conference in the Middle East, outside of Amman, giving CR an opportunity to speak to cancer patients, doctors and scientists from Saudi Arabia, Lebanon, Kuwait, Israel and other countries. French researchers at the conference noted that cancer’s burden has shifted from industrialized nations to medium- and low-resource countries. “This is in marked contrast to the situation a few decades ago when cancer was considered to be a disease of Westernized, developed countries,” they reported. In Jordan, cancer is now the second-leading cause of death after heart disease, and a drive through Amman suggests some possible reasons why.
Pizza Hut. KFC. Burger King. There are dozens of fast-food outlets and even a Cinnabon at the international airport, and Western diets may contribute to Western patterns of disease. A sleepy backwater 100 years ago, Amman is now home to between 2 million and 3 million people, depending on how you count the huge influx of Iraqis fleeing the neighboring war over the last few years. There are traffic jams and a Cadillac dealer, as well as sprawling slums filled with Palestinian refugees. On the street you’re just as likely to meet people dressed in suits and ties, or jeans, as someone wearing traditional garb. The call to prayer echoes from loudspeakers outside mosques, but pop music pulses from Hummers and BMWs, too. Cell phone and electronics shops outnumber traditional markets. And though Americans see a flood of media coverage about the region, most of it is one-dimensional: war and extremism. The situation on the ground isn’t so simple. Society is becoming more conservative and more worldly at the same time, depending on where you look.