H U M A N I T A R I A N W O R K SHow to conciliate religionand humanitarian surgeryin Islamic developing countriesDr. Christian EchinardPresident, HumaniTerra InternationalPresident, <strong>IPRAS</strong> FoundationDeveloping Islamic countries are quiet and peacefulareas, most of the time. In some cases however, thework of humanitarian teams is not as easy as that… Thefollowing lines try to analyze the specific problems thatcould be encountered in some places, where the religionis dominating and ruling the public life and the culturalhabits in such a way, that things are becoming so differentand thus more difficult to understand for an occidentalmind. And after all, if we want to help them, we first haveto understand them….SPECIFICITY OF WORKING CONDITIONSFOR THE HUMANITARIAN TEAMSThe teams are faced, most of the time, with a triplespecific deal: the religion, the women’s condition and thecorruption …The religion• About Islam: Islam is a beautiful religion, spread allover the world. However, the territory where it is theA man in Kabul…predominant religion geographically extends, more orless horizontally, from the western part of Africa to theFar East end of the southern Asian continent, includingMalaysia and Indonesia. Historically and theologically,there are several “families” of Islam, such as Shiites,Sunnites, Kharijists… all of these groups coexist in amore or less complex harmony in the many developingcountries, where humanitarian teams are performingsurgical camps or missions.Moreover, Islam is, most of the time, a state religionand therefore this religion often becomes a realpolitical-religious rule.In fact, there are, as far as geography and culture areconcerned, several Islams… Because of local politicaland cultural factors, Islam in Maghreb is not exactlythe same as the one in Indonesia and is also differentfrom the Islamic beliefs of central Asia or Turkey, forinstance.The medical and surgical humanitarian teams workingin different parts of the world will be faced with a“soft” or “moderate” Islam in some places, or with a“hard” or “strong” Islam in other countries…• The Muslim population: it seems that the actualnumber of Muslims in the world reaches approximately1.5 billion people. Etymologically, the word Muslimcomes from the Persian “Musilman”, plural of Musilm,whose root is the verb “Aslama” (to be resigned, to besubmitted … to God, of course). This great number ofpeople and the strength of their faith put Islam as oneof the major religions in the world, especially in thepoorest parts of the world.• Their position towards illness and medical care is notidentical everywhere. Muslims of the world, thoughthey cannot really read and deeply study the enormousamount of rules of the Koran, are very faithful and,most of the time, respect the 5 main rules (five prayersa day, pilgrimage, Ramadan…) As far as illnessand medical care are concerned, there is, in fact, no26 <strong>IPRAS</strong> Journal www.ipras.org Issue 7
Women from the mountains in Afghanistanspecific rule. For some of them, illness is consideredas a punition of God and requires little care, for someothers, on the opposite, it is something that must betreated absolutely immediately.The women, of course, have a special status… Insome remote places they should not be touched by amale doctor… The problem is that, very often, thereis no female doctor… This is very frequently thecase in Afghanistan, where women die because theirhusbands refuse the help of a male doctor, especiallyfor delivery. This is, of course, an extreme point ofview. In most cases things are much simpler and thereal rule in the Islamic religion is that, when there is anecessity, women can be treated by any male doctor,Muslim or of any religion. Necessity creates the lawand the rule… a safe and good advice…The women’s condition: female mortalitycreates a terrible disorder• Gender mortality: this is a real economical anddemographical problem. In most of the Islamicdeveloping countries, the female to male ratio is, onaverage, 900/1000; It is the opposite in occidentalareas: 100 females for 90 males in Europe, whereasin Bangladesh and Pakistan the ratio is 100 women for106 males. Another interesting sign is that, in those twocountries, the average duration of life is the same in menand women (56 years); in Europe and America femaleslive approximately ten years longer than males…This over-mortality in the female population is due toseveral factors, such as the way of life, the number ofchildren, the amount work done by women… but alsodue to the high maternity mortality and the increasedlevel of violence towards them.• Materity mortality: in Afghanistan, one woman diesevery 21 minutes due to delivery problems! In centralAsia Islamic areas, 2000 female patients die in 100 000births! In Europe the average is only 10-20/100 000.• Violence towards women is also an important cause offemale over-mortality.It can be in the form of domestic and marital abuse. Itreaches 50% in some of these countries, the championbeing Bangladesh, where more than one wife out oftwo is regularly beaten. In Pakistan, 300 women arekilled every year by their husband, brother or son, inthe name of honor.Among the worst crimes, forced or induced suicidesby flame are very frequent in Iran, Afghanistan(especially the Herat area), Pakistan, Iraq, but also inAfrica (Zimbabwe, Egypt…)In Pakistan and Bangladesh, there are many acid attacksagainst women, committed by jealous or unsatisfiedhusbands. This type of acid burn on the face leads toextremely severe contractures and real disfigurations ofthe wives. Two NGOs have been created to fight againstthat, the “Acid Survivors Foundation” ran by ValerieKhan in Pakistan and Monira Rahman in Bangladesh.Apart from marital aggressions, these gender crimes canalso be the result of abusive punishment or usual violencesuch as stoning, rape, excision, any kind of mutilation(hand or nose…), sexual slavery and forced pregnancy.Moreover, many rapes have been committed in thesecountries as a war weapon, in order to humiliate theenemy. In Kuwait, over 5000 rapes were committedagainst the local women by the Iraqi forces, when theyinvaded this country in 1990. In Algeria, between 1995and 1998, rapes were committed in the name of the Jihadin order to render the females impure and dishonored…Issue 7 www.ipras.org <strong>IPRAS</strong> Journal 27
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7th Issue December 2011IPRAS Journa