BMJ 2006;333 (21 October), doi:10.1136/bmj.333.7573.0-e
Editor's choice
Messages from the Middle East
BMJ readers, our surveys suggest, don't like theme issues. But we offer few apologies for this one on the Middle East. In a globalised world regions can ill afford to ignore each other's health problems. As tension and distrust between Islamic countries and the West mounts, we hope this issue will promote awareness of the challenges the region faces and help promote rational debate and collaboration among doctors and policy makers—in and outside it. We share Samer Jabbour's optimistic view (p 837) that action to improve health may help spur the social and political change which many of this week's contributors call for. Few of the health problems described are new; what is new is the acceptance that tackling them requires action outside, as well as inside, the health arena. "For many people in the region, health improvement must start somewhere else—with education, equality, and security"(p 815).
When we put out our call for papers we put no proscriptive definition of the term Middle East, and there are several to chose from (see figure). Of the 150 or so submissions, of which we could, as usual, accept only a handful, most fitted best in the Analysis and Comment section and Letters pages; hence the unusual balance of this fully open access issue.
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Improving health depends on political will as much as resources, Bhutta argues (p 839). Of the current 1.4 million deaths among children under 5 in the Eastern Mediterranean Region close to 60% could be saved by implementing simple, cost effective community based interventions. Social change is crucial too, above all to provide women with more freedom and choice, not least to get sexual and reproductive health services. Gender equity is high on the agenda of next week's meeting of the Global Forum for Health Research in Cairo (www.globalforumhealth.org).
In a list of obstacles to health in the region (p 859) spending hugely more on defence than on health and research and development must rank high. The legacy of this investment can be seen in the rubble of Lebanon (p 848), the appalling death toll among civilians in Iraq (p 821), and the tented camps of Darfur (p 846). International action is as important here as it is in tackling common health problems from rising rates of non-communicable disease to the threat of avian flu (p 856).
We learnt a lot from putting this issue together, not least about the difficulty of avoiding causing offence. We have repeatedly been accused of anti-Zionism. We also met hatred, from the unprintable response of one Arab reviewer to a request to review a paper from a US author and the Lebanese professor who would not write for us because the issue contains Israeli voices. But we have felt the warmth, inspiration, and fortitude of many more. As editors we weekly brace ourselves for highly critical online rapid responses (and braced we are, gentle reader, although "we come not to offend"). Some of this week's contributors risk bullets.
Tessa Richards, assistant editor1, Christiane Rehwagen, editorial registrar
1 (trichards{at}bmj.com)
The external advisers for this issue were Mohamed Abdur Rab, Zulfiqar Bhutta, and Abdul Ghaffar.
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Relevant Articles
- Health in the Middle East
- Wasim Maziak
BMJ 2006 333: 815-816.[Extract] [Full Text] [PDF]
- NHS chief admits to errors in costing of pay reform
- Adrian O'Dowd
BMJ 2006 333: 821.[Extract] [Full Text] [PDF]
- Can action on health achieve political and social reform?
- Samer Jabbour, Abbas El-Zein, Iman Nuwayhid, and Rita Giacaman
BMJ 2006 333: 837-839.[Full Text] [PDF]
- Child health and survival in the Eastern Mediterranean region
- Zulfiqar A Bhutta, Asim Belgaumi, Mohammad Abdur Rab, Zein Karrar, Mohamed Khashaba, and Nezha Mouane
BMJ 2006 333: 839-842.[Full Text] [PDF]
- Darfur—dependent population at risk of another catastrophe
- Remco van de Pas
BMJ 2006 333: 846-847.[Full Text] [PDF]
- Can Lebanon conjure a public health phoenix from the ashes?
- Abla-Mehio Sibai and Kasturi Sen
BMJ 2006 333: 848.[Full Text] [PDF]
- Regional collaboration in the Middle East to deal with H5N1 avian flu
- Alex Leventhal, Assad Ramlawi, Adel Belbiesi, and Ran D Balicer
BMJ 2006 333: 856-858.[Full Text] [PDF]
- Obstacles to health in the Arab world
- J Makhoul and F El-Barbir
BMJ 2006 333: 859.[Extract] [Full Text] [PDF]
Rapid Responses:
Read all Rapid Responses
- Re: Messages from the Middle East
- Dr. Rajesh Chauhan
bmj.com, 21 Oct 2006 [Full text] - Apologies!
- Josef Alawneh
bmj.com, 24 Oct 2006 [Full text] - Spreading the culture of death?
- Anne M Williams
bmj.com, 24 Oct 2006 [Full text] - Middle East;definitions-surely joking?
- Keith R Sumner
bmj.com, 26 Oct 2006 [Full text] - Middle East? WHO's Eastern Mediterranean? What, what, what
- JK Anand
bmj.com, 26 Oct 2006 [Full text] - Ending Hatred and Intolerance is How to Improve Health in the Middle East
- John R. Cohn
bmj.com, 31 Oct 2006 [Full text]
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