Egyptian American Culture

1. Egyptian American Culture Larry Purnell, PhD, RN, FAAN

2. Egyptian Overview/Heritage • The Egyptian people have a strong sense of identity with their country and demonstrate pride in coming from such an old civilization. • The Arab conquest of Egypt around 641 ad spread the Islamic and Arabic culture among the Egyptians. • This long history and the diversity of populations have influenced the value systems, beliefs, and explanatory frameworks Egyptians use in their daily lives.

3. Egyptian Overview/Heritage • More than 1 million people of Egyptian ancestry live in the United States. • The highest concentrations are in New York, Los Angeles, Washington, DC; Chicago, and San Francisco.

4. Egyptian Communication • The dominant language of Egyptians is Arabic. • The written Arabic language is the same in all Arab countries, but spoken Arabic is dialectical and does not necessarily follow proper Arabic grammar. • For Egyptians in the United States, English is the language of communication in business and contact with American society.

5. Egyptian Communication • Respect is expected when speaking with those who are older or in higher social positions. • Politeness, adab, is related to what is appropriate, expected, and socially sanctioned. • Truth and reality may be sacrificed for what is appropriate and polite. • Sharing negative news directly or asking for things directly is not polite.

6. Egyptian Communication • Egyptians tend to be in touch with their inner feelings and are highly expressive of them. • Egyptians tend to share problems and the most minute details about their lives with their trusted circle of insiders. • Because their personal space tends to be small, Egyptians stand and sit very close to each other.

7. Egyptian Communication • Men, whether strangers or acquaintances, touch each other. • Similarly, it is acceptable for women to touch each other. • Women tend to keep male friends as far away as male strangers. • Traditionally, it is unacceptable for women and men to touch each other unless they are close family members.

8. Egyptian Communication • Touch between the sexes is accepted in private and only between husbands and wives, parents and children, and adult brothers and sisters. • Devout Muslim men and women do not touch each other, even a handshake is not practiced. In these situations, a nod of the head substitutes for a physical greeting.

9. Egyptian Communication • Egyptians speak with their mouth, face, hands, and their entire bodies communicating the meaning of their language. • Their facial expressions are mirrors of their internal processes and reflections of their inner evaluations of their situations. A wide-eyed gaze to a child means “stop it now.” A wink to an adult means “watch what you are saying.”

10. Egyptian Communication • Egyptians think of those who do not maintain eye contact or who have shifty eye contact as people who should not be trusted. • Among the more traditional, women and men who are strangers may avoid eye contact out of modesty and respect for religious rules.

11. Egyptian Communication • Most older Egyptians cherish the past, whereas most younger Egyptians live in the present. • Social time takes a high priority, and engagements are not concluded because of other scheduled appointments; therefore, guests are expected to arrive 1 to 2 hours late. • However, they are punctual for business engagements and meetings.

12. Egyptian Communication • Children are given a first name; the father’s first name is used as the middle name; the last name is the family name. A person is called formally by the first name, such as Mr. William. • Respect is demonstrated in the use of titles. Older people should never be called by their first name without an adjective or title. • The accepted U.S. custom of addressing clients by their first name may be insulting to Egyptians.

13. Egyptian Family Roles and Organization • The demands of life on immigrants and nuclear families promote sharing responsibilities and decision-making. • To preserve traditional roles that contribute to a more egalitarian family organization, family roles change considerably after immigration. • The absence of an extended family results in greater fluidity in roles and participation in all family matters.

14. Egyptian Family Roles and Organization • Social status is gained through professional accomplishments, financial success, and involvement in Egyptian community affairs. • Children are treasured in the present and viewed as security for their parents’ future. During their early years, they are expected to be studious and goal-oriented, respectful, and loyal to the family.

15. Egyptian Family Roles and Organization • When children become adults, they are expected to take care of their elderly parents. • Religious beliefs and teachings forbid premarital sex and adultery for both Egyptian Muslims and Christians. • The greatest calamity that may happen in an Egyptian household is to have a daughter lose her virginity before marriage.

16. Egyptian Family Roles and Organization • This fear stems from a potential lack of marriageability of the daughter, loss of face for the father, and gossip within the community. • Egyptian children are expected to marry Egyptians. However, because many second-generation Egyptian Americans do not reside in areas with an abundance of Egyptians, cross-cultural marriages are becoming more common.

17. Egyptian Family Roles and Organization • As Egyptians grow older, they are treated with gentleness and are never made to believe that their usefulness is limited because of retirement. • Their children and extended families are obligated to care for them. • Women gain status with age and with childbearing.

18. Egyptian Family Roles and Organization • Many older people have a morbid fear of being forced to move into a nursing home. • Many consider returning to their home country to avoid the humiliation of aging in America. • Divorce is not considered a stigma but an unfortunate situation and one in which the children pay the greatest price.

19. Egyptian Family Roles and Organization • Communal and same-sex families are a concept that does not exist in Egyptian societies. • Same-sex relationships are rarely disclosed. • To be gay or lesbian is considered immoral and is not accepted by any Arab or Middle Eastern religions. • To discover a gay son or lesbian daughter is akin to a catastrophic event for Egyptian Americans.

20. ClickerCheck An older Egyptian man comes to the Emergency Department with acute abdominal pain. He is unable to speak English. What language will you request from the language line? a. Spanish. b. Arabic. c. Farsi. d. Urdu.

21. Correct Answer Correct answer: B Although the patient’s language is not know at this point, most Egyptians speak Arabic.

22. Egyptian Workforce Issues • Egyptian expect detailed and careful explanation of all aspects of their job. • Egyptians are inclined to an oral tradition; therefore, the need to document in writing what can be shared verbally seems foreign to Egyptian American nurses. • Egyptians are usually punctual and follow work rules and procedures.

23. Egyptian Workforce Issues • For Egyptians, the work environment is their social environment. • The emphasis on privacy and separating work and social life expected in American work settings seems artificial to Egyptian Americans.

24. Egyptian Biocultural Ecology • Most Egyptians have olive skin tones; some are fair-skinned; and others are dark-skinned. • Northern Egyptians exhibit a fairer complexion than most other Egyptians. • Southern Egyptians (Nubians) are generally black, with very fine facial features.

25. Egyptian Biocultural Ecology • Egyptians health concerns, primarily from environmental cause from the Nile and lifestyles include schistosomiasis, filariasis, trachoma, typhoid and paratyphoid fevers, streptococcal disease, rheumatic fever, tuberculosis, cardiovascular disease, and thalassemia. • Some evidence indicates that Egyptians are poor metabolizers of beta blockers.

26. Egyptian High-Risk Health Behaviors • Although some Egyptian Americans may overindulge in alcohol, the teachings of Islam prohibit its use. • Many who drink alcohol tend to do so socially and in limited quantities. • Exercise is not part of the daily lives among most Egyptians in America.

27. Egyptian High-Risk Health Behaviors • Overeating food delicacies that are high in fat, sodium, and sugar; sedentary lifestyles; and an entertainment style based on eating contribute to obesity and immobility. • Egyptians are at risk for stomach and intestinal problems, which include heartburn, flatulence, constipation, hemorrhoids, and fecal impaction. These conditions result from limited roughage, lack of fluids, and rapid consumption of food.

28. Egyptian High-Risk Health Behaviors • Pap smears and mammograms tend to be new preventive health practices for Egyptians. • Pap smears for unmarried women are discouraged and are considered totally unacceptable in unmarried females due to the value of virginity until marriage. • Gynecologic examinations are given only to married women, usually during the check-up for a first pregnancy.

29. Egyptian Nutrition • Food is an important component of Egyptian social life and represents friendship, generosity, and nurturing. • The more food a person eats, the greater the potential expectation for health. • Thus, children tend to be overfed. Food is also associated with the ability of the head of the family to provide for family members.

30. Egyptian Nutrition • Egyptians prefer not to drink water or fluids with meals because they believe that fluid displaces the volume that could be used for food, decreasing their appetite for solid nutrients. • Some believe that fluids dilute the stomach “juices,” making digestion difficult and causing indigestion.

31. Egyptian Nutrition • Most Egyptians consider meat dishes as main dishes, complemented by vegetables and rice. • Preferred meats are lamb, chicken, beef, and veal. • They drink strong tea with hot milk or mint leaves with several teaspoons of sugar several times a day. Those who prefer tea without milk drink it with mint leaves. • Coffee, a habit acquired from Turkish rule is thick, strong, and served in small demitasse cups with or without sugar.

32. Egyptian Nutrition • Hostesses insist on giving guests excessive amounts of food and act insulted if guests refuse the food. • Those who understand the ritual may insist on refusal or may take the food and not eat it. • Completely emptying the plate may be seen as an indication that the guest did not have enough to eat.

33. Egyptian Nutrition • Whether in Egypt or in America, devout Muslims do not consume pork or drink alcohol. • Egyptians do not mix hot and cold or sweet and sour foods at the same meal. • Egyptian Christians fast for a varied number of days for several major religious celebrations. For them, fasting constitutes not eating any animal products.

34. Egyptian Nutrition • Many rituals are revived during the month of Ramadan. • Fasting during Ramadan precludes taking anything by mouth or intravenously and abstaining from sexual activities during the day. • Most Egyptian Muslims eat only well-cooked meat and do not touch rare meat.

35. Egyptian Pregnancy and Childbearing Practices • Although Egyptians in America may practice family planning and birth control, these practices are not used before conceiving the first child. • A couple is not complete until they have a child. • Pregnancy brings women a sense of security and their husbands’ and in-laws’ respect. • Giving birth, particularly to a son, considerably strengthens the status and power of women.

36. ClickerCheck A genetic condition common among Egyptians is • Tuberculosis • Filarisis. • Thalassemia • Hemophilia.

37. Correct Answer Correct answer: C Thalassemia is a common genetic condition among Egyptians. Filarisis and tuberculosis are not genetic.

38. Egyptian Pregnancy and Childbearing Practices • Women are expected to curtail physical activities during pregnancy for fear of miscarriage. • Women are also advised to eat more because they are feeding two. • Some women have waham (strong cravings) for certain foods. If these foods are not consumed, babies may be born with the imprint of the needed foods.

39. Egyptian Pregnancy and Childbearing Practices • When a woman goes into labor with only her husband in attendance, it is considered an emergency. • Acculturated Egyptian men want to be included in the birthing experience, which may offend Egyptian newcomers. • The cold and hot theory for health and illness may prevent women from bathing during the postpartum period. Bathing or hair-washing could expose them to colds and chills.

40. Egyptian Pregnancy and Childbearing Practices • The postpartum period lasts 40 days during which new mothers are expected to rest, eat well, be confined to the house with their babies, and not engage in any sexual activities. • They are usually cared for by family members and are not expected to have any demands put on them. Chicken and chicken soup help women during their postpartum transition.

41. Egyptian Death Rituals • Most Egyptians react vigorously and dramatically to the loss of a family member, expressing their grief outwardly. • Wailing and public crying occur on first learning of death. • This public reaction is an expected demonstration of their grief for the deceased.

42. Egyptian Death Rituals • Older people speak calmly about their own impending death. • Egyptians with a strong religious foundation do not fear the nearness of death; they consider it a journey to another world that is believed to be better. • Egyptian Muslims and Christians believe in an afterlife and expect rewards for good deeds accomplished in their first life.

43. Egyptian Death Rituals • Among Muslims, Islam calls for burial of the deceased as soon as possible. • The burial ritual includes cleaning the body and wrapping it in a white cotton wrap. • Verses from the Qur’an are read, and a special prayer is recited at the mosque before the body is buried underground in a simple tomb.

44. Egyptian Spirituality • On the night of the burial, friends and family gather to give their condolences and respect to the grieving family. • Some Muslim families insist on having the deceased buried in Egypt. • Forty days after the burial, another mourning ritual takes place in the home of the deceased’s family. Family members listen while passages from the Qur’an are read by a religious man to console the family. • A ritual also takes place on the anniversary of the death.

45. Egyptian Spirituality • Prayers, even for the nondevout Muslim or Christian, are significant during times of illness. • Egyptians may bring the Qur’an or their Bible to their hospital beds and usually put it under the pillow or on the bedside table. • Prayers may be recited by the individual, in groups for Muslims, or in religious settings such as mosques or churches.

46. Egyptian Spirituality • Muslims who can afford the expense and are in good health make the pilgrimage to Mecca sometime during their lifetime. • The journey is thought to provide Muslims with a source of inner fulfillment. • Before praying, Muslims must engage in a purification ritual, which consists of washing every exposed body part.

47. Egyptian Spirituality • Prayer, required five times daily, consists of elaborate bending and kneeling movements in systematic ways, increasing a person’s range of movements, limbering stretches, and meditative poses. • Religion and prayers are believed to provide protection from illnesses.

48. Egyptian Health-care Practices • Egyptian health care is influenced by ancient Greek, or unani, medicine, and by humoral systems. • The principles behind the humoral system are based on dividing many aspects of life into four: the year into four seasons; matter into fire, air, earth, and water; the body into black phlegm, black bile, yellow bile, and blood; and the environment into hot, cold, moist, and dry.

49. Egyptian Health-care Practices • Egyptians believe that cold and moist environments cause illnesses by changing from cold to hot or vice versa; the opposite humor is used for treating the illness. • Egyptians believe that suddenly being presented with bad news without preparation causes illness. • Although a person’s mental and physical health is intricately interwoven, treatment sought from the health-care system is focused on physical or biomedical treatment.

50. Egyptian Health-care Practices • Once in the health-care system, they prefer immediate, personalized attention. • They value tests and prescriptions for their illnesses and follow medical regimens and prescriptions carefully. • The family expects and prefers to be involved in all health-care decisions.