Bedouin Patients

The hospital I work in gets quite a few bedouins coming in for treatment from all around Saudi. It's a large tertiary referral hospital, which means many patients were referred there because they could not be treated elsewhere or their cases were so difficult or rare it needed special care. Which makes these patients even more interesting! Bedouins come to our hospital from all over Saudi-Arabia, but mainly from the tribes that originate around the Najd area. Read more here  http://en.wikipedia.org/wiki/Najd

What is generally meant by the term "Bedouin" is the nomadic Arab people who dwell in the desert areas reaching from Western Sahara to the Arabian Peninsula. Bedouins used to follow water and pastures and were nomadic, not staying in one place for a long period of time. Nowadays many of them have settled in certain areas and formed small towns cities like Dammam on the east coast of KSA.

The Bedouins are divided into tribes of which the largest ones are Al-Shammari (everywhere!) Al-Harbi (Mecca area), and Al-Mutairi, Al-Qahtani, Al-Subaie, Al-Dossary all originally from Najd valley and around. Most patients will have one of these very common surnames, kind of like mr. Smith or in Finland mr.Virtanen.

I work on an inpatient ward where nurses are typically assigned to 3-5 patients at a time. We look after them the whole 12 hour shift, usually for a few days in a row. This enables a lot of one on one time with the patients and since the patients will always have private rooms, women will be relaxed and at ease. I feel very lucky to have been able to take such an intimate look into their lives, culture and traditions.

In my opinion Bedouins are generally the nicest patients in all aspects. I've found them to be friendly, genuine, warm, curious, easy-going (hardly complain), they have excellent sense of humour, are talkative and just about the most hospitable people you will ever meet. Hardly any of them speak English though, and sometimes their Arabic accents are difficult (sometimes impossible!) for even our Saudi nurses to understand. So basic Arabic language skills are really essential for more interaction with them. But actually even before I learned Arabic I found it was easy to get along with them by using sign language! They were always in for a little fun!

Typically the Bedouin patient will have one or two sitters present at all times. Read more about the way Saudis visit the sick in hospitals here. They will have large families and it wouldn't be strange to see ones with over 10 children. Visitors often come every evening and they will enjoy a meal or coffee and dates together.

Bedouin patients tend to have a few peculiarities compared to other Saudis. Especially the really nomadic ones have habits that they continue in the hospital, like sleeping on the floor rather than the bed! They will take the sheets off the bed and put them on the floor. Not even the pillow is needed. The sitters have a sofabed available but it's hardly used. Bedouins like to keep things simple and they don't like "modern day luxury" such as bedding.

When the patient has guests they will usually eat on the floor and with their hands. A sheet is spread on the floor and people will gather around it. Chairs and tables might be regarded as unnecessary luxuries. The youngest son or daughter will serve the food and tea or coffee out of respect to the elderly. They will most likely have their own tea or coffee pots with them in the hospital.

Guests will typically bring along dates, arabic sweets, camel milk or date filled small cakes called mammoul. The nurse will be invited to have a taste of their coffee and foods, sometimes they insist that the nurse joins them on the floor. If I have time on my hands I will sometimes join them for their dinner which they tend to eat very late. Usually long after ishaa prayers, near midnight!

I've encountered Bedouin patients that didn't know how to use the western style toilet. Some even made their business on the floor next to it. It's the first time they see a toilet seat and they don't know what to do with it.

The male Bedouins will often chew on miswak,which is a stick used to clean the teeth. Unfortunately some of them also spit on the floor after using it!

Another thing I've noticed is that Bedouins don't like to "waste" water. In other words take showers or wash their hair too often. I guess this comes from living in such harsh environments with constant lack of water. They use the water very sparingly to wash themselves, mainly it's used for performing ablutions (washing before prayer). It takes a lot of convincing or sometimes even doctors order to get them to wet themselves totally under running water!

Since they've been living all their lives in the desert, I figure their bodies have become accustomed to being warm all the time. The Bedouin patient will usually ask for the airconditioning to be turned off because they feel cold. It's actually not possible to turn it off, so then they will ask to get extra blankets even during hot summer months. The men wear thobes made out of thick wool in the winter, which for them seems to end around May when the temperature starts raising above 40. Especially in the winter months they will have layers after layers of thick clothing even though the heating is on max in the room. The women and the men like to keep their own clothing on instead of changing to hospital gowns.

When a Bedouin patient has fever he/she will be very afraid of "cooling" themselves. The more they have fever, the more the clothing and blankets will be on. Sometimes an offer of applying an icepack will result in surprises and suspicious looks. They might politely take it, but when the nurse leaves off it comes! This is sometimes a bit frustrating because the patients are convinced that warm is good cold is bad!

Bedouins love henna. Older men will sometimes color their beards with it, resulting in an orange tinged tone. Older ladies with grey hair use henna which results in the same orangy tone as the mens beards. The women will color their long naturally coal black hair with it resulting in a nice dark red tinge. Additionally they might apply decorative patterns on their hands for special occasions like Eids and weddings. The everyday henna for the hands is applied to the palms and tips of fingers so that it looks like they have very dark orange nail polish on. First time I saw this I thought to myself boy are those some dirty hands! The women will do the same with the soles of their feet and toes.

Some elderly women have tattoos on their faces sort of look like map signs. I'm not sure what they use to do them but the color is usually dark blue. It will look like small markings resembling X's or T's around her cheeks, forehead and temples. I found out this is a sign that the lady in question is of high status within her tribe. She might be the eldest woman of her tribe.

Most elderly patients will likely not know their exact age and might only be able to give you an estimate. Older generation Saudis didn't register births and they also count age according to the Hijri calendar. Also Saudi-Arabia didn't register female births until the 1970's. Estimating their age is not easy because of the harsh weather and constant exposure to sun, Bedouin often look older than their actual age. I've had very old Bedouin patients, some reaching over 100 years. They might have been healthy and never visited a hospital up to that day they come in.

Another peculiar thing which I've noticed is some of the older generation have a thin thread tied to their waists. First time I encountered one I immediately wanted to cut it off because of infection risk. They strictly refused and seemed horrified of my suggestion to remove it even though it was already harming the skin because it had become too tight. I've seen this on both men and women.
The reason for this is that they don't want to get fat so it's a weight control belt! The thread is there to remind you that you've eaten too much when the thread feels uncomfortably tight.
I wonder would this be worth patenting? The Bedouin weight loss belt!