Today , I have the skies on my mind. The first plane I rode I was 2 months old. Since then I've been on over 200. Seriously, I've flown 2 - 4- 6 x a year/ for my lifetime. I nicknamed myself Mariposa, because I feel more at home in the skies than I do on the ground. It's a second home. I'm an expert traveler Alhamdllilh. I know just what to expect, how disgusted I will be by the bathrooms, and what I will want to eat when the airport stores are closed bc it's 2 am in whichever country I've landed in. I know that I will probably leave my socks in one country (or worse, one of a pair!), my favorite scarf in another, my favorite books in one country or another. I am positive that my kids' favorite stuffy lamb is somewhere still stuck between chairs at JFK.   I have seen how the airplanes and airports have changed over the years (for example ppl can't smoke on planes anymore ha ha). I've flown on the Concorde, PanAm, TWA- long gone now. When I was a child, traveling was definitely more fun. First bc it wasn't as crowded, so my sisters and I got special attention and got to see the pilot controls.  2ndly there were no weight limits on luggage to speak of. 3rdly there wasn't all this security. 4thly did I mention how it wasn't crowded? And I guess as kids, the airport was our playground. I have grown up on planes. I've cried after leaving my family and sister Allah yirhamha just buried, I've cried over myself, a broken women after falling apart, and smiled as the same woman stood up again stronger than before, traveling a short while after. I've worried over a newer scarier world to travel after 9/11. I've tried not to breathe as COVID surrounded us. I've meditated, prayed, and discovered the world in the safety of my seat. I've planned and practiced for interviews and jobs on the plane. I've watched dumb movies. Yup, as alone as I could be, with a whole bunch of other travelers. I love the travel prayer. "O Allah, You are The Companion on the journey and The Successor over the family, O Allah, I take refuge with You from the difficulties of travel, from having a change of hearts and being in a bad predicament, and I take refuge in You from an ill fated outcome with wealth and family." When I hear it I get a sense of calm, I leave the trip up to God, and I remember how this is all God's world. With God in my heart, it is also MY world. The sky, the earth, we each of us are connected. We are citizens of the sky and earth. I know this and believe this with all my heart. Borders, wars, seem so stupid to me. More connects us, than divides us, if we care to notice. Love, music, sports, knowledge, families, jobs, sickness, treatment- all cross borders. This is what should matter, right? All I can say, as I see the skies violated by missiles and bombs , is that no... All this violence is #NotInMyName   None of it is. #WeWantPeace #globalcitizen #traveling https://www.facebook.com/share/p/1C7MittJuh/

Elif Shafak is a well renown Turkish author. Her works span from politics to history to fiction to drama and much more. This book, “The Bastard of Istanbul,” is one of her older books, and the second of hers to be written in the English language. In this book, Shafak introduces two families, an Armenian one living in diaspora in San Francisco, and a Turkish family based in Istanbul. They don’t know, but the two families are intimately intertwined through the marriage of a Turk- “Reza,” to his Armenian orphan child-wife “Shushan,” in the early 1920’s. Only Banu, through her clairvoyance and communication with her enslaved “Djinn” Jinn, has discovered the connections. Banu becomes witness to the murder and destruction of the Armenian community in the genocide of 1915 through the eyewitness account by one who has lived hundreds of years and seen the worst of humanity. The reader joins Bannu and the Jinn on this journey, visiting the past, the present, and years in between. As I read this book, having born witness to an ongoing genocide in Palestine, and having born witness to the current demonization and terrorism of the “other” brown people to justify another “cleansing” of another society in the US, the similarities are eerie. First, there is the targeting of intellectuals by those in power. The first to be murdered in the Armenian community were the intellectuals. The writers. The doctors. The leaders of the community. Once the brains had been done away with, there was no one left to lead. Then, came the families. Forced to march a death march, the old, the sick, the very young died off on the side of the road while the others were forced to march on. Death marches, concentration camps, unlawful imprisonment of hundreds, “disappearance,” rendition, torture… it goes on and on. The demonization of the “other.” In the book, the Armenians are referred to as “rebels.”  They are blamed for destabilizing the nation. Blamed for being traitors. Rumored to have killed the Turks first. Thugs, terrorists, illegals, etc. Essential to be done away with for the success of the new Tukish nation. Their “removal” is somehow justified in the eyes of a power-greedy nation. Denial. Modern Turks who describe the Armenian genocide as a “collective hysteria.” Ridiculous comments such as, “if there really was a genocide, why are there so many left?” The blame, “oh that was another government.” “That was before the modern Turkish state.” “That was the Ottomans.” Conveniently ignoring the fact that the current government continues to deny the Armenian genocide.   The book eloquently portrays the victimization of the survivors and the intergenerational trauma of the Armenian diaspora. Shushan is the matriarch, an elderly lady who holds onto her faith and culture in every corner of the home. She holds a deep secret of loss, a son she was forced to leave behind in Turkey- the ultimate price for her to be free… The diasporan family has a desire to stay together, to protect their language, beliefs. Their kids go to Armenian camps to learn the language, and Armenian food is cooked at home. Armaroush, the granddaughter, is named after the great grandmother who died during the death march. “Amy” is constantly under pressure to not read as much. It is better for her not to be so bright and educated. In their history, to survive, it is better not to be an intellectual. There is also a sense of intolerance. Amy’s mother is emotionally abused her husband’s Armenian family, as they constantly refer to her as an “oder” or outsider.  The marriage eventually ends with divorce, and resentment on both sides. In retaliation, Amy’s mother decides to date a Turk- knowing that would irk her ex’s family. The irony is that Turk will later be the reason that Amy braves a trip to Istanbul, to stay with his family and explore her history and roots in Turkey. Elif Shafak has never been an author who minces her words or shies away from the difficult, uncomfortable realities of today and yesterday. Here, she addresses the question of retribution, “I’m sorry for what my ancestors did to your ancestors.”  Is it enough for there to be an apology from a granddaughter of one who witnessed a genocide? And how much does it mean, when the government itself refuses to acknowledge or provide any form of retribution?  Elif Shafak was prosecuted for “insulting Turkey” by publishing this book. Most importantly, for portraying the genocide as a fact rather than a questionable truth.  Lastly, she addresses many of her usual themes. Through the characters and persona of the city, she describes the contradictions and struggles between the conservative and religious with the ultra secular and agnostic - classic for families in Istanbul. She mentiones LGBTQ in the fringes of society, violence and oppression against women. Incest, domestic violence harassment and cruelty are also protrayed. Love, in all its different forms. This book is not an easy read, so take your time and give yourself some space to contemplate and digest. Totally recommend if you are like me, trying to make sense of all the injustices worldwide historically and through today.

Where the Jasmine Blooms by Zeina Sleiman In this book by Zeina Sleiman, Jasmine is searching. She is searching for escape, away from an abusive soon-to-be-ex husband. She is searching for her identity, as a Palestinian-Canadian. She is searching for family bonds, cut off for unknown reasons. She is searching for answers. Most importantly, what happened to her father? Once upon a time in Lebanon, she lived with her brother, mother, father. Once upon another time she lived in Canada with her mother, brother. Why? She decides to travel to Lebanon, to take up a research project through the American University of Beirut, and to take that time to reconnect and contemplate. Once there, she meets up with her cousin, who has had a very different life than hers. Her cousin grew up in a crowded refugee camp in Lebanon, in a "limbo state." Neither Palestinian, because she has no country, nor Lebanese, because they are not allowed to take the Lebanese citizenship. Her cousin is also searching, for herself, her future which appears miserable, and her brother, who has also disappeared. Throughout the book, Jasmine meets another wanderer/searcher a Korean-Lebanese who takes her back to who she used to be, and makes her question friendship, honesty, the past and present. She meets her aunt and uncle, and sees the stark difference between the two- one in a poor refugee camp, the other in the fancy areas of Beirut with political and financial power. Jasmine travels for vacation only to be caught in another Israeli bombing. She recieves strange notes and articles, all of which indicate that her father is in hiding, or was, she doesn't know. Through the lives of the two cousins, we see the struggle of the Palestinians, an intergenerational trauma with so many unanswered questions. We see the men who are lost- either to gang warfare or to the struggle for Palestinian freedom. We see resiliance, and power as the girls reclaim their right to survive, to exist, to Be. Wonderfully written, I recommend this book to anyone who would like to see the Palestinian struggle from the eyes of today's youth, and how politics and history has shaped them and their families.

[The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures by Ann Fadiman ] The Spirit Catches You and You Fall Down , by Ann Fadiman, is considered of the genre medical anthropology.  I had never actually heard of this subfield of anthropology but it “examines the cultural, social, and biological factors that influence health, illness, and healthcare practices.”  The author herself is not an anthropologist, she is a writer, but the book delves deeply into the medical field and is often used as an example of medical anthropology. The story is about Lia. Lia was born with a seizure disorder. Her parents, Hmong immigrants, don’t speak English. Not only that, but their understanding of seizure disorders is based on a strong belief in an alternative parallel spiritual world where deebs or evil spirits can influence any individual’s well-being. They believe that during a seizure, a spirit catches you and you fall down . Children with this affliction are seen to be exceptional, with a special direct connection to spirits. In Hmong culture, most ailments are believed to be caused by those spirits. Elaborate incantations or rituals are performed to bring the healthy soul back. The Hmong believe strongly in herbal remedies, and non-medical treatments such as “cupping.” Many of the words used in medical terminology simply do not exist in the Hmong language, such as “pancreas,” or “depression.” Depression for example, in addition to the influence of a deeb , is often described by Hmongs as a “broken liver.” Difficult liver, broken liver, rotten liver  are all used to describe grief, loneliness, memory loss, and more. When it comes to medical decisions and treatments, social norms are strictly defined. Any medical related decision must be made with the agreement of clan leaders, family elders, and the male patriarch.   It is in this context that Lia’s world collides between Western medicine and her family’s belief system. As a newborn, her parents bring her to the hospital. She is given antibiotics for pneumonia. The parents have no way of explaining the seizures they see in English, since they don’t speak the language. And even if they could, a description of the “spirit catches you and you fall down,” is not likely to be understood. As the little girl grows, her seizures become more frequent, and she is eventually diagnosed. She becomes known in the hospital due to her repeated multiple hospitalizations, and she is prescribed a complex anti-seizure treatment regimen at home. Her parents are unable to read the medicine bottles. They are illiterate. They also notice side effects on Lia of some of the medications that make them hesitant to administer them. Attempts are made by the hospital administration to send nurses to their home, but due to language, culture, and social barriers, the visits fail overall. Eventually, the treating physician requests that Lia be placed in foster care to ensure that she receives her medications as prescribed. This is traumatic for both the parents and Lia, who simply cannot understand how a child so loved can be taken away from them. The foster parent herself disagrees with Lia’s placement and goes out of her way to make sure the mother has time with Lia and she listens to her needs. Enter Jeanine, a social worker who becomes pivotal in the story. She is different, she sees the Hmong as human and is willing to work with their beliefs to help them navigate the medical system. With her help, Lia returns to her parents. The seizure regimen is changed to one medicine, Depakene (Valproic Acid), and the parents do their best and are overall compliant. The final critical medical incident described in the book is traumatic. Lia presents to the emergency room with status epilepticus, a high fever and diarrhea. The doctors attempt to stabilize her seizure, completely missing the fever and signs of septicemia.  This time it was not because of a language barrier, but because the physicians were so used to her seizure disorder that they overlooked the other signs. She is transferred to a larger facility where she is placed under anesthesia to control the seizures, and her condition overall stabilizes with IV antibiotics. Unfortunately, it all comes too late. Lia is brain dead. An EEG proves the condition and the parents are informed that life support will be terminated and that she will die in a few hours. The parents have very little understanding of what is going on. The father signs papers that he does not understand. He thinks that they will kill Lia in a few hours. He tries to take Lia and run, but he is restrained by security. He yanks out the naso-gastric tube because he doesn’t understand why it’s there. A spinal tap is seen as an attack on his child. Finally, the hospital discharges Lia to her home, where she is expected to die within a few days. The parents hope that she will get better with their care. Lia continues to live for decades. Scientifically, she has nothing but a functional cerebellum. And yet she responds to her mother’s presence, her sister’s presence. The family and the community take care of her. They repeatedly hold rituals asking the spirit to bring her soul back. They hold birthday parties for her. Years later, her father has passed away, and her sisters continue to care for her. The author poses hypothetical questions and answers for this unfortunate outcome of a child. Who do we blame? If Lia had been diagnosed early on, would she have fared better overall? If she had been given a single dose medical regimen early on, would the parents have been more compliant? If she hadn’t been taken from her home, would the parents have trusted the medical center more? Whose fault is it? The parents believed that the spinal tap and excess medications killed her. The doctors thought it was the parents’ long-term non-compliance before Depakene. The truth is somewhere in between. The Depakene she had been prescribed caused a drop in WBCs, which led to compromised immunity, led to a septic infection of Pseudomonas , which led to the status epilepticus. If she hadn’t had a seizure disorder she would have presented with a coma or shock… which could still have led to her brain death. And so the question becomes not who is to blame, but what can we learn? Fadiman does extensive research, interviews with doctors, managers, nurses. She goes over thousands of pages of Lia’s charts. She interviews members of the community and spends hours at Lia’s home. She poses questions about the practice of medicine in the US. Are you, as a medical staff, willing to let go of bias? To see the “other” as human? To acknowledge holistic or cultural aspects of healing? Are doctors treating the patient, or are treating the disease? What is the difference? How much is the medical community willing, in a country such as the US with hugely diverse populations, to acknowledge the degree that racism has compromised the care of others? The author questions “Cartesianism,” a Western philosophy that separates the mind (including emotions, experience, consciousness) from the body (a physical machine like entity). Is Lia a “vegetable?” as the nurse refer to her? “How can I say she is not valuable when she means so much to the people around her?” is both the question and answer. It is clear in Lia’s case, there is obvious arrogance and resentment on the part of both the doctors and nurses treating her. In the medical charts Lia and her family are described as “Mong,” “no religion,” “animals,” “stone age,” and other derogatory references. One doctor was asked how he communicates with Lia’s family and he said, “veterinary medicine.”  No attempt was made to provide interpreters, or to reach community leaders or to embrace any of their beliefs. The author provides a historic context for this racism. The Hmong are very proud people. They survived thousands of years by resisting assimilation.  Their history in China and the region of Laos/Cambodia/Thailand is the same. They were able to preserve their culture and heritage by “flight” where they simply move higher up in the mountains. Or they “fight” to protect their land and living.  The Hmong refugee resettlement to the US was in the aftermath of a “fight.”  In the chaotic aftermath of post WW2 and the division of the region into countries, the fight between communism and nationalism was ongoing. The Hmong had an important role as they were allies of the US forces fighting the communist forces. The author describes in detail the disturbing end to this alliance. Four airplanes took the elite of military Hmong to safety to Thailand. Everyone else (including Lia's family) had to escape Laos on foot. The road to escape is horrific. People are shot at, bombs exploded on the journey, people died of starvation and left on the side of the road to rot. Entire boats of family members drowned crossing into Thailand. In return, as some sort of reward, the Hmong were given a choice, either stay in refugee camps, or apply for asylum in the US. And so it was that the 60’s and 70’s witnessed hundreds of Hmong moving to the US. Once they arrived, they thought they would be welcomed, having stood with the US allies. Instead, they were met with hostility and suspicion. They were blamed for draining resources and accused of living off the government. They were accused of eating pets. They were seen as barbaric and backward. Life on the ground was hardly ready to accommodate any of their beliefs or style of life. They were also faced with the pressure to assimilate, something they had long rejected in order to survive. Little effort was made on the part of the government or receiving community to help them learn English, to learn driving, or any essentials. An example of this was driving tests. The Hmong developed ways of sewing the answers to the driving test on their clothes in a pattern, since they could not read the questions or answers.   The events of this book span the 70’s, 80’s, 90’s. Some things have changed for the better, and some things are the same. Hmong shamans, for example, can now take medical courses and are allowed to perform certain rituals near the beds. Many medical services have been successfully translated into Hmong language.  For other minorities, their spiritual needs can be accommodated in many hospitals. When I was sick in the hospital I had no problem requesting that a Muslim Chaplain read to me Quran and pray with me. When I was a fellow, interpreters were readily available and remote interpreters through Martii gave access to over 200 languages for any of my patients. Things that haven’t changed: bias and racism against immigrant patients or immigrants in general, still present. The pressures of assimilation and struggles to adapt to the US are challenges for any new migrants. The lack of communication between medical institutions and the population that they serve is also present in many areas. This book should be essential for anyone in the medical field. The story of Lia is one of many similar stories that we hear of. Sometimes it’s on a large scale, like entire groups receiving less quality care than others. Sometimes it’s minor like a patient misunderstanding where to pick up medications. Cultural clashes can still lead to unfortunate outcomes. Reading this book is a reminder that It is important to accommodate beliefs, involve community members, provide outreach and understanding of the diverse populations that make up our patients, and to build trust between health care workers and patients. For me, I can relate to the Hmong culture at some levels. I come from a religious background where healing is intwined with religious verses, prayers, turning to God. Seeking medicinal treatment is commanded at the same time. I come from a culture where evil eye and other paranormal are blamed for people’s illnesses. But my ancestors were the first to explore human anatomy, surgery, treatments for basic ailments and more. Never did one negate the other, both belief and medicine work in tandem to make a being whole, healthy in mind, soul and body. Humans are spiritual beings, on a human journey, and both journeys must be embraced, in my point of view. I recommend this book for anyone in the medical field, anyone who works with immigrants on a daily basis. There is a breadth of knowledge about the Hmong culture and history which was incredibly informative. Lastly, I recommend this to anyone who questions the medical bioscience culture, Cartesianism, and would like to see their patients from a different and more holistic perspective.

The US and the Arab American Brain Drain By: Dr. Hoda Z.M. Amer, co-founder, Treasurer of American Board Certified Doctors for Egypt (ABCDE) July 2025   My father immigrated to the US in the 1970’s. At the time, there was peak of Arab immigrants fleeing from a region devastated by numerous wars and political instability through the 60’s and 70’s. A large number of those Arab immigrants were doctors, engineers, or scientists, AKA “white collar” immigrants. They came to pursue the American Dream . The American Dream  for people like them and my dad, may he rest in peace, was not about financial security, a nice house in the suburbs, a nice car. It wasn’t even about the disposable diapers that had made their debut in US markets a decade earlier. It was more than that. Their American Dream  was to be able to think, explore, produce, work hard and to achieve their potential. It was a chance to delve into scientific concepts with resources they only dreamed of in their own countries. It was a chance to be rewarded for hard work, rather than reprimanded or taken down. It was a freedom of intelligent expression, debate, exploration. The American “Doctor’s” Dream  for them was about scientific and medical aspirations and ambitions. The US was like no other country in that regard. My father worked hard. Back then there were no 100-hour work day limits for residents and fellows, and he worked those hours diligently. The first medical journal article he published a few months before I was born was in an emerging field, the field of oncology. It collaborated with another emerging field, that of clinical neurophysiology. My father would go on to publish over 80 publications in the field of oncology over his lifetime. He was the 42 nd  member of the American Association of Cancer Research (AACR), which now has over 50000 members worldwide. His journey was not without challenges. My father’s immigrant background constantly made him feel that he should work harder than his non-immigrant counterparts, and he did. His colleagues would go home in the evening, he would stay long hours reviewing articles and newer treatment modalities. His colleagues would follow a 15-minute rule with patients, while he would stay up to the hour. His colleagues’ patient clinical summaries were a paragraph, my father’s would be pages on pages of clinical history and treatment recommendations. He was kind, modest, taking time to comfort and listen to his patients, something that others did not. The fact is, my father’s story is not unique. Every year the US welcomes thousands of international and foreign medical graduates (FMGs) into residency programs nationwide. Through J-waiver programs many go on to serve rural and underserved areas that would otherwise be unfilled. FMGs enter the US medical system after an arduous long - and expensive - process of equivalency exams known as United States Medical Licensing Exam (USMLE), which by the way is the same exam administered to US medical graduates. Each exam costs over 600$. Travel costs, housing, application fees through the electronic match system known as ERAS all add to the price tag. When the non-profit I co-founded, the American Board-Certified Doctors for Egypt (ABCDE), began providing grants to Egyptian residency applicants it was for a reason; the average monthly salary of a middle-class Egyptian is not more than 300$/month - not even a quarter of the price they would need to attempt the US training pathway. More importantly however, it was and is not about the money, though obviously that was/is a challenge. I read their applications and personal statements, and I see the other sacrifices they made and continue to make, sacrifices that cannot be measured by price tags. They leave countries, homes, families, languages… just like my father did years ago, for the American “ Doctor’s” Dream . The prospective medical training and research in the US was well worth the abovementioned sacrifices and challenges. Ivy League schools are ranked in the top 10 worldwide for medical training programs. Worldwide rankings for the best hospitals include US based institutions like Mayo Clinic and Cleveland Clinic. Medical research, again, universities like Harvard and Johns Hopkins top the list. A quick PubMed  search will show the most cited articles are overwhelmingly from the US. When COVID broke out, it was the research done by Penn State University doctorates that paved the way to life saving vaccines, for which they received the Nobel Prize. This reflection of “greatness” was seen worldwide, whether through GAVI programs to vaccinate poorer countries, or collaboration between the Centers for Disease Control (CDC) and World Health Organization (WHO) to eradicate small pox, polio, etc. The number of US medical patents for diagnostic machines and ground breaking technology was/is unparalleled by any country, with the exception of China close behind, all of which is exported worldwide. Medical research and practice are fields that have historically welcomed immigrants of all backgrounds. You didn’t need to be a certain height, skin tone, accent to join an esteemed program and succeed (obviously racism and prejudices and biases do exist, as in any other field, just not to the same degree). A list of Nobel Prize winners in Medicine and Physiology from the US, will show the majority are 1 st  or 2 nd  generation immigrants or of minority background. The US has always been known as the destination the world’s best and brightest. What other countries refer to as a “brain drain,” for the US has always been a “brain gain.”   Today we begin to witness a the “reverse brain drain…” I see young physicians questioning their plans to go to the US for residency training. I see international renown scholars declining invitations to speak at events. I see entire events being cancelled. For many researchers I see the devastation of years of hard work being frozen, their employees and lab support being turned away. I see physicians and researchers scrambling to find employment in Germany, England, or Canada. Some are even returning to their countries of origin such as China. The biotech industry, an industry I have worked in, has always been the link between researchers and biomedical or biotechnology start-ups and pharma companies. These companies now face an uncertain future and dwindling investments. For medical researchers, the changing current environment is not just the loss of financial security after a whopping 2.7 million in f unding cuts  from the NIH. It’s more than that. It is medical journals receiving threatening letters  from the Justice Department. It’s the ACGME, the largest body responsible for assessing and credentialing residency programs being questioned  about their Diversity/Equity/Inclusion standards and policies. We see researchers and visitors and scholars being harassed at the airports or even prevented from entering the US. PhD students and scholars being intimidated, imprisoned. There is a genuine fear of intimidation. Gone is the feeling of intellectual freedom, gone is a restriction – free, politics - free science. The practice of medicine has also changed. For years and lifetimes physicians had been respected, honored, looked up as saviors.  All of a sudden, we face in our clinics contempt, disregard for science and data, and a preference towards disinformation. This disinformation can be deadly as we recently saw with the death of children by measles, a completely preventable disease.  It can be wasteful like searching for a cause to connect autism and vaccines which has been debunked time and again. Data essential for the prevention, treatment, and management of diseases, and to challenge the basic disinformation, has been deleted .  The loss of DEI research will also eventually have devastating and costly consequences. Minority health issues simply cannot be isolated from majority health issues. Both are intertwined, intersect and overlap and follow the natural process of disease spread and progression. A perfect example is that of the AIDs epidemic in the 80’s. What was first though of as a disease that only affects LGBTQ, was soon found to affect heterosexuals, children, mothers, transfusion receivers, etc. Without the research there would not be the treatment and management options for HIV today. When DEI restrictions include studies on women’s health you are effectively undermining the health of more than half of the population. Mental health of minorities reflects on the mental health and community health as a whole.  DEI studies are needed and essential to develop screening programs, treatment programs, and early interventions to prevent long term health issues that would otherwise be costly on an already strained medical system. Examples of these programs include maternity and birth clinics for minorities with poor perinatal outcomes. RSV clinics for Alaskan natives who are more susceptible to the virus.  Breast cancer screening for Ashkenazi Jews… We can go on and on. The US already ranks poorly in healthcare coverage, and there are currently over 20 million Americans without coverage. And now there is the prospect of cutting Medicare and Medicaid, adding another 120 million and more Americans threatened with no health care coverage. How exactly are physicians expected to be able to treat patients with no coverage? Other than disease or death, what alternatives do the uninsured exactly have? In 2020 the editors of the New England Journal of Medicine published an editorial titled, “ Dying in a Leadership Vacuum .” In this editorial they attributed much of the 200000 deaths of Americans from COVID-19 to an administration that relied on incompetence, uninformed “opinion leaders” and weak inappropriate government policies. In 2025, we see a continuation of that same government, with an extended outreach and unprecedented capacity to impose ideology and to weaponize the medical and research fields for their own political gain. In short, the US is on a trajectory that is anything but “great,” anything but “healthy,” and will soon join other countries in experiencing its own “brain drain” as exceptional physicians and researchers choose other countries in which to practice medicine and achieve their potentials…   Dr. Hoda Z. Amer, Author, Pathologist, Treasurer of ABCDE, Hilliard OH.     Copy of a book in the Arab American Museum in Dearborn, MI, by Dr. Rashid Abdou, a Yemeni-American surgeon who immigrated to the US at the age of 15, and became one of the first of his village to receive higher education. His career spanned 50 years, including establishing the Joanie Abdu Comprehensive Breast Care Center in Youngstown, OH, named after his late wife. Plaques in the Arab American Museum in Dearborn: Above: honoring Dr. Abdallah Najjar, a Lebanese American. He was known for his international work on eradicating malaria, and for founding the Office of International Services at the CDC. Below: honoring Dr. Ahmed Zewail, Egyptian American Physicist who received the Nobel Prize in 1999. His work influenced the medical field in numerous ways including 4D electromicroscopy, physics of medicine, and nanomedical drug development.     Excerpt from “Oncology News” in 1978, with a photo of my father, Dr. Magid Amer and his study of metastatic disease and brain scans. My father would go on to publish over 80 journal articles in the field of oncology.

For hundreds of years, Moslems, Christians, Jews lived together as neighbors. I was blessed to visit an area of Old Cairo known as The Religions Complex . Its an area that breathes history. Its cobblestones, artifices, pillars go back to the Roman age. We visited Amr Ibn El As mosque, the oldest mosque in Africa. We visited the Hanging Church, where Jesus AS and Meriem (Mary) AS hid. We also visited Ben Ezra Synagogue, recently renovated. It is a fascinating area and witness to how politics can divide, but a love for God can unite. At the end of the day, we are all neighbors. Visit to Amr Ibn el As mosque Some of the columns are Roman pillars The churches and caverns where Meriem (Mary) and Jesus AS hid from prosecution. You can see some of the pillars are Roman pillars. Ben Ezra Synagogue was closed for many years for renovations. The Geniza was taken out of Egypt by a Cambridge scholar. It is currently being digitized for distribution, or so I understood. Test your knowledge with this worksheet.

Did you know that over 2 million birds migrate through Egypt every year? From Europe and Asia these birds seasonally take the route through Egypt. Some birds decide to make Egypt their home, and seem to settle in quite well. If you'd like to go birdwatching on the Nile I totally recommed Dayma . They are a conservation group that also cares about raising awareness. They provide binoculars so you don't have to worry about bringing any. This is my favorite Facebook Group : . #birdwatching #ecotourism #NileRiver #Dayma Birdwatching on the Nile Can you guess what bird this came from? Clue: It has an important role in the story of the Prophet Soliman, AS. It is a migratory bird but many live in Egypt.

Dr. Hoda Zeinab Amer at 57357 in 2012

I nternational Day of Zero Tolerance for Female Genital Mutilation Feb. 6 It is estimated that over 200 million women/girls have undergone female genital mutilation. The overwhelming majority are in African nations, particularly the region of Sudan, Djibouti, Egypt. FGM has been banned by the three Abrahmaic faiths and by numerous forms of legistlation worldwide. Here I summarize the detrimental health effects of FGM, and the long term consequences. Background: FGM is the "cutting" or removal of all or part of the female clitoris. The clitoris is the main pathway and concentration point for nerves and erectile tissue. All types of FGM/C even minimal cutting or nicking or pricking of the clitoris, interrupts this natural pathway and leading to a difficulty in achieving orgasm, which is the peak of sexual pleasure. The clitoris is a natural “hood” above the urethral opening (the opening that releases urine) that protects this area from bacteria or other diseases and trauma during intercourse. Its natural protective function is damaged in FGM/C/C of all types. Medical Complications: Sexual Complications: During sexual intercourse FGM/C leads to bleeding . This is because the area that has been cut is replaced by scar tissue that is thinner, weaker, and leads to weaker vessels that bleed and tear easily during or after intercourse. Painful intercourse (dyspareunia) : The narrowing of the vulval opening by either reactive scarring from the cut or by the intentional narrowing performed in FGM/C, leads to difficulty in penetration and pain. c. Vulvar pain:  damage to the ends of the nerves present in the sensitive area of the clitoris/labia leads to hypersensitive nerve pathways and sharp pain, extending to other areas of the vulva. d. Urinary incontinence:  Pressure on the exposed urethral opening leads to inadvertent loss of urine during sexual relations, which can be distressing and embarrassing for the woman. e. Husbands/ partners : the penis can often become injured due to the excessive scarring or narrow opening caused by FGM/C, up to 15% of males complain of erectile dysfunction and other sexual disorders. f. The lack of sexual pleasure can cause anxiety between couples since the woman will often avoid sexual intercourse for fear of pain and bleeding, and men may avoid it for fear of causing her discomfort, or for fear of his own discomfort. There is an increased rate of divorce in couples where women have undergone FGM/C, with sexual displeasure cited as a common factor. Repeated Urinary Infections and Menstrual Difficulties:   a. Retention of urine:  nearly 30% of women who have undergone FGM/C complain of urinary difficulties. For some, urination takes almost 15 minutes to complete because of the scarring. For fear of pain some women will try to retain the urine, which can lead to urinary retention. b. Repeated infections and scarring at the urethral meatus also lead to urinary retention, and even renal failure. c. Urinary fistulas:  One of the worst urinary complications of FGM/C happens during pregnancy, when the head of the baby puts pressure on the wall of the lower pelvic outlet, that pressure leads to the wall falling apart since its nerves and vascularity have been destroyed in FGM/C, and leads to a vesicovaginal fistula. It is basically an opening between the vagina and urinary bladder. This fistula is one of the worst things a woman can live with as the urine continuously falls through the vagina without end. d. Menstruation is debilitating  for these women, as the muscles are weakened, the blood causes pressure on the scarred tissue, and the disrupted flow leads to gathering of the blood in the pelvis. This is painful and difficult for them to function normally. Extended periods can keep her from prayer for a longer time Keloids and Scars and Genital Infection. All types of FGM/C interrupt the natural skin barrier. The body responds by making scar tissue that is weaker, thinner, has easily broken blood vessels. a. STD’s:  Women who have undergone FGM/C have higher rates of catching sexually transmitted infections including Trichomonas, Herpes, Syphillis, etc. Blood transmitted diseases such as Hepatitis C and HIV are also easily transmitted into the weakened and broken blood vessels. This is traumatic in the cases of sexual assault, and in cases where the partner has been unfaithful.   b. Cancer Cervix:  HPV is particularly dangerous because it is a sexually transmitted disease that leads to Cancer Cervix. Women who are victims of FGM/C have higher rates of Cancer Cervix. c . Infertility:  Repeated genital infections by bacteria can lead to Pelvic Inflammatory Disease, which can lead to infertility. d. Skin cysts and keloids:  exaggerated scarring response is common in women of African background. When this scarring occurs in the genital area it leads to large disfiguring and ugly scars.  Cysts made of degenerated skin layers get infected and cause abscesses.    Difficulty of Preventive Care The key prevention of cancer cervix is early detection by pap smears and molecular testing of samples, with or without biopsies, to treat the pre-invasive stage. Lack of screening for cancer cervix and other diseases : women who have undergone FGM/C are more hesitant to be assessed gynecologically, for fear of of pain.  The colposcopic examination is also challenging in FGM/C victims because of the narrowing of the vagina. Pre-invasive lesions are missed, and instead, victims of FGM/C present at later stages of Cancer Cervix. These are often complicated by other infections or conditions that are also missed without a thorough examination. Birth Trauma and Harm to the Baby and Mother When the cut of FGM/C is made, the body tries to heal by scarring and creating new smaller vessels. This scarring is thinner and weaker than the normal skin and connective tissue. a. “Elasticity” or the capacity of the birthing canal to expand and allow the release of the baby is also destroyed by FGM/C. b. Blood loss:  Tearing of this area during childbirth leads to excessive blood loss. c. Perineal tears:  Up to 65% have extensive perineal tears due to the scarring. These tears can take months to heal. d. Obstruction of Labour : The baby cannot get through the birth canal, leading to still birth, distressed or asphyxiated babies, and harm to the mother due to prolonged labor. Psychological Trauma Having their genitalia cut as children or young women leads to lifelong psychological effects. The extensive scarring and disfigurement is also a source of constant stress and a reminder of the trauma. The lack of sexual pleasure causes self esteem, guilt, and emotional distress. Did you know that up to 80% of women who are victims of FGM/C have anxiety disorders and up to 30% have post- traumatic stress disorder? Death Many girls bleed to death when they are cut. Other women bleed to death during childbirth. Some women fight infections all their life, and succumb to septicemia, which they die from, or complications of renal failure due to obstruction. Female Cutting Versus Male Circumcision There is a gross misunderstanding in that male circumcision is similar to female genital mutilation. I hope that this table will clarify the main differences. Male Circumcision Female Genital Cutting or Genital Mutilation recommended in some religions Not recommended in ANY religion Excess skin removed Organ removed or damaged Most sensitive area responsible for sexual pleasure remains as is (dorsum of penis) Most sensitive area responsible for sexual pleasure REMOVED or DAMAGED (clitoris/hood/labia). Decreased rates of infections and transmission of STDs Increased rates of infections and transmission of STDs Decreased lifelong risk of penile cancer Increased lifelong risk of Cervical Cancer   Seeking Treatment: For women who have undergone FGM/C treatment defibulation can be a relief. The scars are removed, and the labia is reconstructed.  This leaves the vulva open permitting a free flow of urine and menstrual blood and allows for a more comfortable sexual intercourse. Pelvic Floor exercises and physiotherapy can help return the muscles and anatomy to normal function.  Almost all women who undergo defibulation describe relief of urinary and sexual functions and can even experience orgasm. Pediatric surgeons and obstetric uro-gynecologists can provide this treatment. Seeking psychological help to resolve issues of PTSD, anxiety and to help navigate the healing process is available. Couples therapy for spouses can provide support and healing. The earlier treatment is sought the better the outcome with regards to marital relationships, childbirth, and urinary function. A Few Last Words: …If you are a woman who was a victim of FGM/C, you can get treatment and support your sisters to seek treatment, and you can stand up against FGM/C for your daughters. You do not have to stay the way you are, or accept the cultural norms that destroy not build. …If you are a man, your role is valuable. Many women agree to FGM/C because you ask them to. You will be happier, and your marriage relationship and sexual relationship improved.  Stand up against this harmful practice and protect your daughters and future wife from FGM/C. Encourage the women in your family to seek treatment. We can all work as a community to protect our young girls from this vicious practice, and help our community heal. I wish - A Poem About FGM, For The Girl Generation By Sahra Ahmed Koshin, Garowe, Puntland, Somalia. “I wish to overcome. This emptiness of fear. The incompleteness of life. The lingering search for my innocence. The memories of the painful cut. The fierce grip and my tremble under your gaze. The masking of my face and my soul. The mishandling of my body. The pains never expressed and the scars forever inflicted. I wish to overcome this feeling of brokenness, of incompleteness...”   "I want to tell the parent that mutilation is very harmful to your daughter, you didn’t protect her by it  [instead] you destroyed her marriage relationship " Victim of FGM, Cairo, Egypt     Thank you, Dr. Hoda Amer, MD, FCAP Previous Project Leader, Muslims Against FGM/C, an initiative by MyProject USA Treasurer, American Board Certified Doctors for Egypt   Sign the Petition Against FGM Here References and Useful Resources:   1.       Vella, M. & Argo, Antonina & Costanzo, Angela & Tarantino, Lucia & Milone, Livio & Pavone, Carlo. (2015). Female genital mutilations: genito-urinary complications and ethical-legal aspects. Urologia. 10.5301/uro.5000115. Link here . 2.       Behrendt A, Moritz S. Posttraumatic stress disorder and memory problems after female genital mutilation. Am J Psychiatry. 2005;162(5):1000-1002. doi:10.1176/appi.ajp.162.5.1000. 3.       A.R. Sharfi, M.A. Elmegboul, A.A. Abdella. The continuing challenge of female genital mutilation in Sudan. African Journal of Urology, Volume 19, Issue 3, 2013, Pages 136-140,ISSN 1110-5704, https://doi.org/10.1016/j.afju.2013.06.002 . 4.       Khayat MH. Health as a Human Right in Islam. WHO Regional Office for Eastern Mediterranean. Cairo, Egypt. 2004. https://applications.emro.who.int/dsaf/dsa217.pdf 5.       Varol N, Turkmani S, Black K, Hall J, Dawson A. The role of men in abandonment of female genital mutilation: a systematic review. BMC Public Health. 2015;15:1034. Published 2015 Oct 8. doi:10.1186/s12889-015-2373-2 6.       Esho, T., Kimani, S., Nyamongo, I.  et al.  The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.  Reprod Health   14,  164 (2017). https://doi.org/10.1186/s12978-017-0433-z   7.       Osterman, A.L., Winer, R.L., Gottlieb, G.S., Sy, M.‐P., Ba, S., Dembele, B., Toure, P., Dem, A., Seydi, M., Sall, F., Sow, P.S., Kiviat, N.B. and Hawes, S.E. (2019), Female genital mutilation and noninvasive cervical abnormalities and invasive cervical cancer in Senegal, West Africa: A retrospective study. Int. J. Cancer, 144: 1302-1312. doi:10.1002/ijc.31829 8.       Ogah J, Kolawole O, Awelimobor D. High risk human papilloma virus (HPV) common among a cohort of women with female genital mutilation.  Afr Health Sci . 2019;19(4):2985-2992. doi:10.4314/ahs.v19i4.19 9.       Sara Johnsdotter, Birgitta Essén. Cultural change after migration: Circumcision of girls in Western migrant communities. Best Practice & Research Clinical Obstetrics & Gynaecology,Volume 32, 2016, Pages 15-25, ISSN 1521-6934, https://doi.org/10.1016/j.bpobgyn.2015.10.012

This novel "Velvet" is the next in a series of books about Palestine I've read and would like to share with you. It takes place in a refugee camp in Jordan and is about "Hawaa" which translates to "Eve" in English. It is beautifully written with detailed descriptions so real you can feel, hear, smell the life in the camp, down to the dew drops on an early morning, and the sewage and foul odors. The book has a circular timeline, beginning as she buys a beautiful tea set for the home she dreams of, then goes back in time to her childhood as she cooks, cleans, learns to sew (velvet representing love and desire), and she protects her brother from the abuse of her father. The book continues throughout her marriage life, divorced life, and past the point of buying teacups, to a violent and despairing end at the hands of the same brother she once protected. It's heartbreaking in scenes, angering in scenes, beautiful and hopeful in scenes. Domestic violence is rampant, sexual violence, political violence interwines with struggles of poverty and exile and womenhood. Hawaa survives it with a practical, down to earth attitude of passive aggression mixed with hope. I found it a difficult book to read, and even more difficult to put down. By Huzama Habayeb, translated from Arabic. I recommend this as a realistic depiction of life (and death) in refugee camps. #hoopoebooks   #aucbookstore   #PalestinianVoices   #booksaboutpalestine   #booksaboutisrael   #booksintranslation #hodaZbookreviews

The Woman from Tantoura, is an amazing read. It reads like a memoir, the story of Ruqayyah, expelled from her village city in Palestine, as she witnesses the murder of her father and 2 brothers and numerous other men in the village. It follows the life of her and her children from Lebanon to Egypt, to Jordan, to Greece as they try to keep their identity and home alive. She is a witness to the horror of the Sabra and Shatila massacres. A great book for anyone trying to understand the current genocide and it's early beginnings in 1936. Definitely recommend, Hoopoe books, author the late Radwa Ashour #aucpress   #palestinevoices #hodazbookreviews     #booksaboutisrael   #booksaboutpalestine   #endtheoccupation