JAFFA – A group of American doctors who founded a gynecology information website in December said they were surprised to learn nearly half the traffic has come from Middle Eastern and Southeast Asian countries, including, Saudi Arabia, Kuwait, Iran and Malaysia.
The strange traffic patterns might highlight a worrying phenomenon in the Muslim countries where studies indicate large numbers of women refrain from seeking medical attention for feminine diseases for fear of being divorced, generating family stigma or due to Islamic restrictions on seeing male doctors.
"Are our high Middle Eastern traffic trends a good thing or not?" asked Saul Weinreb, senior medical consultant for AskMyGyn.com. "Of course I'm happy that we can provide people with reliable information, but I'm concerned that these women may not have access to real health-care providers."
Indeed, in the Middle East, reluctance evidenced by women needing medical care has resulted in deadly consequences.
Breast cancer is the No. 1 killer of women in the United Arab Emirates and Saudi Arabia, with large numbers dying because they don't seek medical treatment in time.
In Saudi Arabia, upwards of 70 percent of breast cancer cases are not reported until they are at a very late stage, compared with 30 percent or less in the U.S., according to statistics cited by MSNBC.
A 1999 survey in Egypt found perceptions women held about their own health was the single most important factor governing their utilization of health services. One-half of the women participating in the study reported having reproductive tract infections, 56 percent evidenced genital prolapse and 63 percent were anemic. But the majority did not seek health services, and most of the women stated they saw their conditions as normal.
A more recent study in Egypt found most women surveyed reported at least one gynecological condition but said as long as they were able to have children and do their daily work, they felt they did not need care. The study, by the Egyptian Social Science and Medicine Institute, cited lack of dialogue about gynecological issues between women and their husbands.
According to an article last May in the Middle East Journal of Family medicine, dismal rates of death to breast cancer in Jordan are primarily due to late diagnosis.
When women do seek medical care, there have been reported instances in which their husbands pulled them from diagnostic tests because female technicians or doctors were not available.
MSNBC reported from Saudi Arabia last October: "One Saudi woman ignored the cancer growing in her breast because she didn't want to risk a referral to a male doctor. Another was divorced by her husband on the mere suspicion she had the disease, while a third was dragged away from a mammogram machine because the technicians were men."
Samia al-Amoudi, a Saudi gynecologist, recounted the story of a woman whose husband several times pulled her away from mammogram rooms because the technicians were male.
"The first thing women ask me when I tell them to get a mammogram is: 'Will the radiologist be male or female?'" she told MSNBC.
In U.S.-occupied Iraq, male gynecologists have been threatened with death for attempting to treat women. Nongovernmental organizations have warned that female doctors are scarce and male doctors are being intimidated against treating women.
Walid Rafi, spokesman for the Iraqi Medical Association, told the IRIN news service last November he knew of at least 22 male gynecologists who received threatening letters.
"In one case the extremists tried to carry out their threat. They kidnapped the son of a doctor and only released him after the doctor had closed his clinic in Karada district, in Baghdad," Rafi said.
"We are worried about women's health in this country. Few of them have access to good medical care and now with the fear of male gynecologists, few remain in the job, and this could have a serious impact in the coming months."
Mayada Zuhair, spokeswoman for the Women' Rights Association, told IRIN that extremists dictate "[male] doctors are not allowed to see the private parts of women."
She said she knew of two cases in which doctors reportedly were killed in November 2002 after leaving their clinics.
"A message was left near their bodies saying that was the end for any doctor who insists in invading the privacy of Muslim women," Zuhair said.
To raise awareness of the status of female health issues in the Middle East, AskMyGyn.com announced it will donate 25 cents for every gynecology question asked on its website to Doctors Without Borders, a group that provides emergency care to needy victims worldwide.
"We realize the importance of what we are doing, so our doctors at decided to take another step toward bringing quality health-care information to people around the world," said Steven Freidman of AskMyGyn.com
To interview Aaron Klein, contact M. Sliwa Public Relations by e-mail, or call 973-272-2861 or 212-202-4453.