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Health & Spirit

For some refugees, women's health care is a culture shock

Sarah Varney, Kaiser Health News on

Published in Health & Fitness

BUFFALO, N.Y. -- Dinnertime is nearing, and the kitchen in this tidy home is buzzing. Lamyaa Manty, a 29-year-old Iraqi refugee, wears a neon-pink T-shirt and stirs a big pot of eggplant, onion, potatoes and tomatoes on the stove, a staple of Iraqi cooking called tepsi.

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

At the center of the activity is Fatima's aunt, Salima Abdullah Khalifa, a burgundy-haired matriarch from Baghdad, who pours Pepsi into small glasses on the table.

This is a found family. Manty was Khalifa's neighbor in Baghdad. When Manty lost her entire family, Khalifa took care of her. The two spent five years together in Jordan, waiting for their refugee applications to be processed.

Khalifa's husband, brother and three sons were killed in Iraq, and restarting life in Buffalo, on the shores of Lake Erie, with such profound pain in her heart has been trying. Certain American customs bewilder her. When it comes to health care, Khalifa was startled to find that male doctors in the U.S. examine women and that she is supposed to get a checkup at the clinic even when she is not sick.

"We don't have primary (care) doctor in my country," said Walaa Kadhum, a fellow refugee and Khalifa's friend who helps translate. In Iraq, the women say, only the very sick or the very rich received medical treatment. But here in the United States, they have primary care doctors and get annual checkups.

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Perhaps the most distressing of those checkups for many conservative Muslim women is a Pap smear, a screening test for cervical cancer. The test is rare in the developing world, according to global health experts, and for traditional Muslim women, like Manty, who are expected to be virgins until they marry, the invasive procedure is a profound threat.

"If she's not a virgin, she can't marry," explained Kadhum. "They say, 'This is a bad girl. We can't marry you. Until she (is) married, nobody (touches) her."

Manty said if she does not marry, she will never get tested for cervical cancer or have a vaginal exam. Khalifa, now 51, had her first exam at 45, when she resettled in Buffalo.

Physicians who treat refugee women say it's not uncommon to find undiagnosed cervical cancer, sexually transmitted diseases or chronic pelvic pain.

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