Common Chronic Disease Patterns in Arabian Gulf, Saudi Arabia & YemenDr. O. P. Kapoor
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An Arab in the modern world is an unique social phenomenon. Sudden infusion of a large amount of wealth in a relatively underdeveloped, uneducated and a somewhat isolated community has produced a situation which deserves a close study by sociologists.

Medical care facilities in Arab countries were primitive before the influx of petro dollars. A rich Arab now finds it possible to travel to different parts of the world and demand the best of the medical care to which he is entitled because of his wealth. An Arab patient has become a common sight in many of the premier medical centres of the world. Many of us can consider ourselves privileged that a large number of Arab patients descend on our medical clinics for their multitude of health problems and have full faith and trust in us.

A wealthy patient has several things going against him in getting proper treatment. He is overinvestigated, given multiple diagnostic labels, and overtreated, very often needlessly. In the case of Arab patients the problem is still more complex because he cannot communicate with his doctor in his own language. He is in an alien society whose customs and ways of living are different. Both the doctor and the patient cannot communicate with each other; on the other hand, each one wants the best of the other. The problems that arise from this alienation and failure of communication are liable to bring disrepute to our medical profession.

I have in the past written three volumes of 'Guides for General Practitioners'. I developed confidence when these books became so popular that amongst practitioners some of them consider me as their "guide, friend and a philosopher". Even the B. C. Roy National Award given to me by the Medical Council of India as an "outstanding medical teacher" is largely a recognition of the success of these guides. In my humble way, I tried to show to the general practitioners a common sense approach to identify their patients, understand their symptoms and try to find out what merits serious attention and what needs just a watchful interim treatment with 'placebos'.

I have been fortunate in having a large Arab clientele. I have made attempts to study their language. I have studied their social mores and living style. I can make out how serious are their complaints. From the nature of their brief encounters with me I have learnt to place an Arab patient in his correct geographical milieu.

An Arab patient comes from a very wide geographical region, euphemistically termed as Middle East or Gulf, both of which are omnibus terms which fail to describe the roots and soil from which a particular Arab patient is moulded. A Kuwaiti behaves differently as compared to Saudi. A Bahraini is different from Yemeni and so on and so forth. In fact the common clinical ailments of Yemenis are so characteristic that I have a chapter in the book entitled "Functional Arab Syndrome".

My purpose in writing this book is not to write a medical treatise full of statistical figures and charts. The purpose is very simple. Based on my clinical impressions of Arab patients, I have given a general guideline as to the behaviour of an Arab patient in a medical clinic. It should permit a doctor to recognise the Arab in its social context. It would also help him to separate the wheat from the chaff and differentiate between functional and organic. It is meant to promote better communication between a doctor and an Arab patient, an interaction where two different cultures touch each other in mute expectations.

In a way, the present work is an extension of my previous volumes for General Practitioners, primarily with an intention to induce the doctor to understand his patient in a rational commonsense way for better diagnosis and sensible treatment. Once the diagnosis is established there is nothing specifically different in treating an Arab patient. The book is based on personal experience of 3000 Arab patients seen in my consulting practice over the last fifteen years.

Towards the end, for comparison, I have given an analysis of similar number of random Arab patients admitted at Jaslok Hospital. The analysis shows that Arabs suffer from nearly the same diseases as in any other part of the world. But what I have discussed in this book is their day to day common problems which we encounter in private practice, for which usually the patients do not go to the hospitals. And these problems have not been discussed in standard textbooks of medicine, written so far. Thus I have purposely omitted discussion of diseases like Bilharziasis and sickle cell anaemia which have been adequately dealt with in the standard medical textbooks.

Finally I must add that I have never met more generous, warmhearted, God-fearing, trustworthy and friendly people than the Arabs. The book owes a lot to their patience and trust in my ministration.

Insha Allah.

O. P. Kapoor