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Linnaeus University Department: School of Health Health Care in an Intercultural Perspective-Caring Science with focuses on Nursing, 1VÅ210

. Spring Semester, 2010

Circumcision in Sweden

Hossam Ashour Dhorgham dr_samasemo@yahoo.com Assistant: Raneem Samir Al-Sharif sharifr3@yahoo.com Supervisor: Judy Chow

ABSTRACT INTRDUCTION Background AIM METHODS LIMITATION RESULT AND ANALYSIS. Circumcision from medical prospective Circumcision in Islam Circumcision in Egypt Circumcision in Sweden DISCUSSION REFERENCES 7 3 4. 5 6 6 6 7 7 8 9 10 11 .

. cultural. 2010 In this paper I studied the effect of different religious. Department: School of Health. Methods used was internet search and course book.ABSTRACT Hossam Ashour Dhorgham Linnaeus University. 1VÅ210. background and ethics on healthcare system and how the different cultures and religion like Islam affects the Sweden healthcare system and what is its reaction. Spring Semester. Health Care in an Intercultural Perspective-Caring Science with focuses on Nursing. analysis of my interviews and discussion compare my finding to my study Recommendation I hope that leaders in Sweden make the circumcision in the healthcare insurance.

So all the since must serve the human first and satisfy their needs. prevention and amelioration of undesirable events or harm that can occur in the treatment process” (Chiu C.INTRODUCTION: The entire world became now as one village. one sun and one sky and all must live together over this land. mental. All healthcare systems must be committed to the international healthcare standards like The International Society for Quality in Health Care which guides the healthcare organization for improvement of the service and fulfill the healthcare quality dimensions (Chiu C. 1946). 2008). Also problem and war results` can transmitted or affect other distance country like what is happened in Iraq 2003 invasion and a lot of Iraq citizen went out searching for Asylum in other country like Sweden . Health was defined by World Health Organization as “A state of complete well being in different areas (physical.O. effective and respect human rights. So it is one earth or Land. And one of the most sensitive and important field for the human being is healthcare system. and social) and not only the absence of disease” (W. 2008). no country can stand alone and isolated from the global change. To keep this human being in good health it needs healthcare system. And those Asylums transmit their culture and background which affect others and affected by others. Health care system has its standards which make the quality of service safer. The developed country has good things and undeveloped country also has good thing so it will be much better to make merge between these things in all fields with respecting others. Human being is the most important being over the land. Equity means . The most important dimensions of the healthcare quality are patient safety and equity. Patient safety is defied as “the avoidance. And the healthcare organizations like hospital tried to improve their services to cover this definition. as example what happened in Iceland Volkmann in April 2010 is good example of how country could be affected by other causes even if it is so fair.H. This means that the care should be given for the non healthy and healthy people. rich and poor people and from developed or undeveloped country.

origin. From those two standards and from my background as I am a pediatrician (child doctor) in Egypt and I am very interested in improving the healthcare system in Egypt and also interested to know how a developed country likes Sweden implement the international healthcare standard.000-350. For these reasons through this short paper I need to study how The Health Care System in Sweden as a European developed healthcare system which aims to assure good health and equity between the Swedish citizens how will deal with the circumcision and compare it with what is happening Egypt as developing Islamic country through my experience as a pediatrician. sex.that all the people must receive good healthcare service regardless to their color. race and religion (W. . This type of surgery is not covered by the national health insurance system in Sweden (Ministry of health. Circumcision of boys is one of the most interesting topic which mean remove some or part surgically from the external genitalia of boys and girls. . In the first days for me Sweden I met one Sweden citizen who asked me to make Circumcision to his son called M. So the Sweden healthcare system deals with intercultural problems which make the implementation of healthcare standards more difficult. which make these Muslims try to do it out of Sweden or illegal in Sweden with lower fees. cultures and religion of the emigrants. Circumcision of boys is so important habit between some religions and some cultures like Muslims. Sweden).M.O. These Muslims used to do circumcision to their children.H.3% total populations 9000000 (Wikipedia 2010). 2006). There are 300. This way of circumcision may cause complication for the children if done by wrong way. because about 14% of the Sweden population is immigrant (Ministry for Foreign Affairs 2010).000 Muslims live in Sweden which means it is around 3. age. so I found that it is very interesting to study Circumcision in Sweden and what will be the fate of M.M. And also I need to know how the Sweden healthcare system will deal with different nationality.

Yahoo Search for my required literature. Sweden Health Care System. Textbook of International Health for Basch. I have used the databases of internet and books because these are the most convenient and easy way to my article. circumcision in Islam). METHODS: As I have chosen the method for this assignment to reading reference books. I made three interviews with two healthcare providers in Sweden and Muslim citizens in Sweden which helped me in understanding how people here in Sweden deal with circumcision. Health Care and Social Services in seven European Countries for The National Board Of Health And Welfare). On internet mainly. Health and Illness for Helman. I have also used internet articles about Health care in an Intercultural prospective and especially on the topic of circumcision. I have also used some books which are related to Health care and Intercultural prospective.AIM: The purpose of this study is to understand how the healthcare system in Sweden deals with of other cultures. Limitation: I did all my effort to try to have a good understanding of Sweden healthcare system but the language was a big obstacle in facing me plus shortage of time. I have used the following keywords for my search (Health care. Intercultural Perspective. I have used Google Search. The books for this course are (Culture. .

Circumcision is not in Islamic religion only but it was also a very old habit was done by ancient Egyptian people for more than four thousand years B.C. Circumcision in Islam Circumcision is mentioned in Hadith only in Islam which means that the Profit Mohamed asked the Muslims to do circumcision for males newborn which make all Muslims do this religious habit since more than one thousand and four hundred years (Wikipedia2010). . But circumcision has lots of complications if it is done in wrong way likes local infection. It means that circumcision is not always so easy procedure and it needs sterile place. Also it is contraindicated in some situations which mean it is very dangerous if it done and the healthcare provider mustn’t do it so it need expert and professional doctor to do it as in cases of hypospadius .RESULT AND ANALYSIS Circumcision from medical prospective: Circumcision in medicine is defined as the surgical removal of some of the prepuce from the penis. hemorrhage and deformity all these types of complication be more and more when the child become older and it may need for general anesthesia (Norman S 2008). sterile instrument and expert healthcare provider to take the decision of circumcision and manage the complication if it happened.. It protects the child from urinary tract infection as the circumcised Children are less infected by urinary tract infection and also help in protection from sexual transmitted diseases for in the adulthood (Schoen E 2005). systemic infection. the best time for it is three weeks old because after this time will need general anesthesia which may be risky for the child(Norman S 2008).bleeding tendency and local infection(Norman S 2008). But also at the same time Islam roles don’t accept any dangers or risk from doing circumcision. And Circumcision also done in other religions as Jewish people (Nandakumar 2007).

But he thinks to travel outside Sweden to do it or try to go to non professional people in Sweden to do it and take the risk of complication.Muslim consider circumcision as good advice and believe in circumcision will protect the child and make child more healthy away from evil and bad things. These mosaic systems in Egypt make the healthcare system so fragile to be broken. These systems include: Ministry of Health (MOH) facilities and services. However. It mean that if patient can't find specific service in public place he can ask it from other private places and also can go to non professional person like traditional medicine or non certified midwife to make circumcision which makes some complications without any supervision. Health Insurance Organization. the Egyptian healthcare system is a highly mosaic one. with different public and different private health care providers. Pharmacies. More than twenty years Circumcision in Egypt was doing by non professional person who sometime made complication as neonatal tetanus. I made interview with one Swedish citizen he is Muslim and he has boy 5 years old he still searching for a cheap place in Sweden to make circumcision for his child. But now the government facilitate doing Circumcision in the hospital under professional healthcare supervision to make it safer. Egypt is Islamic country classified by The World Bank as a developing country which has a lowincome for healthcare per capita GNP was US$ 790 in 1995 (WHO 2006) . other national health agencies. Teaching Hospitals. . Healthcare services in Egypt are provided through three subsectors: the government sector. Traditional providers and others (Nandakumar 2007) . public medical providers (including Defense Ministry hospitals). each one of these sectors contains its own organizations and systems (Nandakumar 2007) . Private clinics. Private hospitals. Circumcision in Egypt Circumcision in Egypt is normal habit as it is related in the Islamic religion. University hospitals. This man is coming from Arabic origin and knows that circumcision is so cheap in his country and it is so expensive in Sweden. sepsis and dysfunction. parastatal sector and private sector.

Circumcision in Sweden: A lot of debate had been around circumcision in Sweden since long time not in sweden only but in Europe because they think it is the child right to chose and it is not only by parent but in 2006 Sweden gave the right to Muslim and Jewish to do circumcision and also gave the religion man right to do circumcision (WHO 2006). Sweden is divided into twenty one county councils (areas). public transportation and regional development. the national board of health and welfare (sociastyelsen) which is responsible for auditing and the Swedish council of technology assessment in health care (SBU) which is responsible on guideline production. The responsibility of the county councils is to provide good level of health services. The third level is the local authorities which responsible on the old and disabled people. equity and social security are the most important values the affect the health care system . In Sweden there is a very strong welfare system which depends mainly in taxes so the populations in Sweden pay high percent of taxes which more than 30% and depend on very small percent on patient fees. It is divided into three level of authority the first level is the central governance. This central governance is divided into three organizations the ministry of health and social affairs social department which is responsible for legislation production. Healthcare system in Sweden is strong system with good skeleton. All the above three levels are controlled by political person so democracy . culture. Anna-Christn Valtridsson. The second level in Swedish is country councils. she is nurse in Carema health care center said that a lot of people who come from Arabic country ask about circumcision but it is stile not cover by insurance and expensive surgery . But this must happen under the umbrella of Sweden healthcare system. I met two healthcare providers in Sweden Vaxjo who work with child health to ask about circumcision in Sweden. education.

smell for Christian or Indian. food. religious. political and economic organization (Helman 2007) . culture and ethics . taste herbs. But I don’t think it is enough to accept only the Circumcision but also it needs the leaders to cover this type of sugary under the insurance surveys because it is still expensive for the Muslim Sweden citizen and push them at some time to try to do circumcision with non-healthcare provider with the lowest expenses. I wish that the leader in Sweden make Circumcision under the insurance.M. And this was said to me when I asked the father of M.DISCUSSION: In this short paper I focus on Male Circumcision and I did not speak about female Circumcision because it is so difficult between Arabic people to speak this issue and they think it is Shameful. word as Quran and movement like . religion .Circumcision) and acceptance to their culture . that any health care system especially the social one never be analyzed in isolation from other sectors or dimensions of that society . color like special plants used for treatment. background. Helman define ritual as repetitive work which specific for each group or culture example especial clothes for example in (Christian.g. like its social. The most interesting finding at 2006 The Sweden system respect the other Ritual by accepting the need of Jewish and Muslim to certify the religious men (mohels ) for making Circumcision. body decoration as jewelries.Circumcision under non healthcare provider will increase the risk of complication and that is what is happening in Egypt that Circumcision in some rural area done with non professional healthcare provider and with no supervision from the government. because the people come from Islamic country know very well that it is not so expensive surgery at their country. that is different in western country which is easier to speak and discus topic related to that issue (Helman 2007). I found that Sweden healthcare system is trying to adapt itself to the new coming immigrant citizen . So this high cost push people to do Circumcision under non healthcare provider and may be without official supervision . Muslim and Jewish people every leader in these religions has to wear special type of clothes.that is going with what Anthropology found. as what is happening with Muslim( e. sounds like bell or azan.

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