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Global Health

When Truth Speaks: Discourses of the Voice in Medicine

17 Jul, 17 | by amcfarlane

Dr Ayesha Ahmad, Global Health Humanities Correspondent, has been travelling in Afghanistan and Nepal and meeting women who’s lived experience is a conflict of chronic gender-based violence. Her initiatives are to integrate storytelling into mental health trauma interventions globally in contexts of war, oppression of women’s speech, violence towards women and girls, and writing against the backdrop of rich story-telling traditions.

Often I reflect on the stories I have listened to. At these times, I collect the way I have experienced their stories; the gazes and the silences and the image of when someone looks me in the eye and speaks. These stories come from doctors, students, patients, and from people unknown to the world because of the suffering they carry. I bring these stories together in my mind. I wonder whether practicing medicine has limits; can medicine find all of humanity? I believe medicine can, and does. I always remember some feedback I received from a lecture I once gave on conflict and health; I was told I know how to tell a story. To this day, this remains a source of strength for me. This is the humanity of medicine, of the treatment of suffering whether from the clinic or the academy; the telling of and listening of stories.

I am one of countless individuals indebted to Professor Rita Charon who is working in some context of the clinic and feels at home with the concept of narrative as foundational for medical practice. My work focuses on the written narratives in mental health trauma related to gender based violence. Alongside, Charon’s pioneering research, during my PhD I saturated myself with Jacques Derrida’s notions of discourse and the signs and symbols of how we interpret and understand our experiences. To write the phrase ‘medical practice’ begs reflection; what does practicing medicine mean? Medicine places the unknown existentialisms of our human condition into a sphere of turning narratives; we find structures among these, creating universalities of being human wherever the world tilts; our births, living, suffering, dying, and death, and then the spirit, where medical practice halts and understands that spirits cannot be treated, and are only for healing. Spirits, then, are an equaliser; whilst medical practice is the handling of humanity, a spirit solidifies the existence of the story.

In my field of global health, I bear witness to the narratives of healing from the depths of all languages; the narratives of different authenticities that speak from a truth that I have perceived in the eyes of people who I am recollecting now, one by one. As Charon describes, I am honouring their stories. Their truths are speaking.

In all the stories that I have received, though, I have held disclosures yet at the same time I face distances of darkness, spaces of unfilled voices and visibilities that remain silent and unseen. This is the tragedy I am writing about. The truths that are unspoken, yet lived.

I question my role as an academic researching, lecturing, discussing ethics consultations, writing, presenting in international conferences, collaborating with non-governmental organizations, providing medical education for students and trainee doctors, and trying to find ways to free the tightly-rolled narratives of the marginalized. Medical practice provides a mode of examination for the way our stories make us ill; the somatised symptoms of a suffering that our societies suppress; because we fear bearing witness to suffering, and the telling of a story requires justice. But when the perpetrators are our protectors then what is the role of medicine? Can medicine practice justice?

I have heard the truths of doctors who witness other doctors committing abuse and violence towards patients in countries that are born from structural poverty, colonialization and chronic humanitarian crises; I have held in my hands the transcripts of traumas from the land as well as the body from asylum seekers and refugees; I have seen the pains that languages cannot speak. In all of these the truth has spoken; these are the discourses of medicine; the signs and symbols of our suffering of humanity and the patients for the practice of medicine.

Some of our greatest contemporary writers, Elif Shafak and Adiche, warn against the reduction of our identity into a single narrative. Truth also follows a similar path; symptoms of suffering are not reducible to a single narrative, not of the body, not of the mind, not of the spirit. The narratives of a narrative-based medicine are embodied, encompassing, and excite the diversity of different discourses.

We do not need to speak every language or interpret every sign or symbol to practice medicine; rather, to honour humanity, we need to have space for the truth to speak—that is, for our voice and our visibility to be present, that is the practice of medicine.

Storytelling, Suffering, and Silence: The Landscape of Trauma in Afghanistan and Nepal

4 Jul, 17 | by amcfarlane

Dr Ayesha Ahmad, Global Health Humanities Editor, has been travelling in Afghanistan and Nepal and meeting women who’s lived experience is a conflict of chronic gender-based violence. Her initiatives are to integrate storytelling into mental health trauma interventions globally in contexts of war, oppression of women’s speech, violence towards women and girls, and writing against the backdrop of rich story-telling traditions.

As I write from the heights of Nepal, my vision is engulfed by a globe of surrounding mountains. They stand majestic and solemn into the sky. Carved deep into the mountain hearts are the trails and tracks of their wanderers’ journeys and within them are the graves of the stories that they told. At dawn, the story rose, and at dusk, the story faded.

Peacefulness betrays the legacies that we could find. The stories in the mountains are resting. This is a beautiful silence. There is a freedom in their untouched and unheard voices. Because they lay with the mystery of the mountain’s strength and existence; there is a landscape of stories and a landscape of mountains.

I came here to hold the stories that cannot rest, the stories that are suspended in a silenced captivity in hidden spaces of suffering.

The tragedy of a story is when the storyteller is no longer writing the story that she is living with within her.

The stories I was graciously given were from a women’s safe house, a vast juxtaposition to the wide and open world that her ancestors believed in. Now on her horizon there is no distance to seek, no land to explore, no story being told.

One month ago, I was writing beneath a different mountain in the heart of Afghanistan, but the stories echo, timeless and boundary-less.

It is a strange role to be receiving the telling of a story. I feel an extreme privilege to be surrounded by a story that has not been opened before. When a person gifts their story, it is a journey of exploration. Finding the story of the self creates a landscape, and to bear witness is to discover an unexplored territory, a place within a person’s world that has not been seen before.

The stories that were being shared with me were secrets, secrets in the mountains just like the mountains themselves contained secrets, journeys that no longer held paths to their destination, spaces of pure untouched land.

The tragedy of the story, though, is in its silencing. The stories were like bodies that fell from hidden mass graves, their sufferings and the deaths that buried them deep in silence were marked by injustice, brutality, violence, and isolation.

Even in the speaking of the story, the words that were falling heavy into the air were betrayed by a wounded silence. The story-teller must bear their self to tell their story, but in the diminishing of their identity as a human being, I could feel their burdens, the weight of a wish to be held as a person in their worlds. Underneath these moments where the women became their own storytellers, they were story-sufferers, suffocated by a silenced self and voice.

During the telling of their story, time felt different. Time did not pass by. There was a suspension of the time that had been lost from their lives because of violence; those moments that placed them in the grave whilst still alive and stole their breath away.

Their story became our journey. They travelled with me, we became wanderers through a language that was not ours. We wanted to speak of beauty, of dreams, of hope, but the narrative that had been sewn into their skin told a more sombre tale. Still, we continued, we took each step together through this tough terrain and we found a path through as she held her words like a fence that guided us to a space where she could kneel and touch the ground, and find her land of freedom.

I will carry their words, such precious cargo, from these mountains, cradles and graves, from the women, the silenced storytellers of Afghanistan and Nepal to the front-lines for justice.

There is silence in the mountains. Yet, silence comes from somewhere, from the winds and the valleys across their distance. Silence sounds beautiful when the silence is part of freedom, but being silenced means solitude and stagnancy. A story that cannot travel is a mountain that does not reach the sun.

The suffering of the silenced mountain story-tellers continues; there is silence, but not the absence of a voice or words, there are shadows but not the absence of self, and there are the graves of untold stories, but the mountain and her story-tellers exist together and the stories will wait their time to be told.

Global Humanities: Talking Taboo

12 Dec, 16 | by cquigley

When Talking is Taboo

by Ayesha Ahmad


In this piece, I want to talk about what it was like to be a panellist at a recent event strategically entitled “Talking Taboo” at the School of Oriental and African Studies.

I spoke for ten minutes; ten minutes that represented a life time.

I began the introduction to my research on investigating trauma therapeutic interventions using traditional story-telling for gender-based violence related trauma with a few scribbles of notes in front of me about mental health, conflict, culture, and violence. I do not usually take a script for my talks; I want to communicate and convey with authenticity and I can only reach this in the present moment. But for this talk I made key points to reduce my words into points, and my points into a skeleton for the much larger body of work I was representing.

However, just after I began to speak something stopped me in my tracks. I became acutely aware that I, myself, was talking as a woman with all the identities that my freedom beholds, in a public space that was being shared across the globe by a live-streamed video, which at one point reached over 1000 viewers.

I sat next to three other panellists, all of whom were there with their lifetimes, at a table used for the education of students from all genders, ethnicities, religions, geographies, languages, and histories, with their greatest teacher being that of equality.

We were all carrying our convictions, the motivations that took us through each day and into an audience that the very faces of those we cannot forget could never be a part of. We were there as the embodied memories of women who now were buried.

I saw that table as a grave. I felt like my blood was alive and speaking the words that others had bled.

As my words started to take flight I suddenly became acutely conscious of my voice. I was speaking and being listened to. I was heard. My voice was not silent. My words were alive.

I remember looking around the room as I reflected on my realisation; on how we were gathered to talk about the taboos enwrapped in a knot of culture and tradition and religion, and to unpick these meant being vulnerable to our own lives, and being open to our bodies and minds being unravelled and deconstructed.

I invited the audience to reflect on the act of a woman talking as being taboo.

The room echoed with murmurs of “yes” and as I looked around and saw woman after woman nodding their heads, both those in cloth and without cloth, I stayed silent for a moment.

The silence was full; it was full with a book of lived experiences; the pages of which were present in the eyes that I saw as I tried to find my narrative again.

Taboos mean that there are words unspoken, stories that are marginalised and symbolise injustice and violation. A story, though, is an exchange of your world with mine. There is a landscape of the mind in the way we critique our lives.

When I spoke of the taboo of talking, my talk became a story.

As an academic I present in conferences and universities and hospitals all around the world.

Yet, in that moment so many stories embraced the space surrounding me. I was in a lecture theatre in a London university, yet a different landscape emerged that was so different from anywhere that I had spoken before.

My words reached a silence; a silence that had been forced. When we cannot talk, our words become buried. Words, when they are buried, gain an illusion of absence, but they are not absent. They are present as heavy as the soil beneath the ground. Our buried stories are our land. To talk, then, is to have ownership of our territory.

I consider there to be two injustices at play. The first is when the ways we can talk become acts that lead to persecution. Banning education for girls, prohibiting women from reciting poetry, restricting public places for women to converse, censoring publications of women’s sufferings are forms of genocide—a genocide of creativity, of stories, and ultimately of lives.

The other is to reduce silenced women as being voiceless. I consider the rhetoric of giving voice to the voiceless as perverse. Voices may be silenced, but never absent. Even in the act of silencing, the story remains. Being silent is not being story-less.

Talking as a taboo means that the modes and narratives for talking are taken away. Talking about a silenced woman as voiceless is taking her voice away.

I continued my talk but I felt that the story had been told. I was presenting on story-telling but to an audience of the greatest story-thinkers.

Culture becomes strong when concepts are part of societal structures. Thus, stories, and poems, and songs, are still surviving through conflicts and migration and changing generations.

The taboos though are not cultural elements; these taboos are the modes of weakening a culture as they cause the telling of a story to decay. The memory of who you are will never be passed on.

As I listened to the other panellists and the songs that followed, it became clear that this event was a unique and special space for creating a legacy.

There was hope; hope that talking taboos leads to telling truths. There was conviction that telling truths tackles taboos. There was indeed, danger, as well. The continuation of violence against women; their concepts, bodies, minds, beliefs, words, stories–and ultimately the voice of the woman was being threatened by the dismantling of silencing.

During that night, I witnessed true bravery, and genuineness of the human spirit and strength.

The ground beneath us becomes even more solid when we are standing on the bodies of the women who were killed before they told their story. These stories become the land before us; the soil is a book and we will keep walking until our steps have told every taboo.

I commend the organisers, the participants, the audience and even the individuals who could not bear the weight of the truth of talking taboos being brought into an academic space by women who are free to be educated and to talk. And, that night, we talked. We talked and through our words, we tackled taboo.


Link to the video of Talking Taboo:

Global Humanities: On Being Invisible

8 Dec, 16 | by cquigley


Ines Ongenda – A Personal Reflection


In September 2015 I started a Master of Science in Global Health and Development at a leading UK institution. My background was in biological sciences and I was your typical aspiring medical doctor who had a strong interest in global health and wanted to explore and learn more about the field and whether I could fit in there.

Two weeks in and I wanted to quit the programme. I felt inadequate, ignorant and with nothing to bring to the table. Nothing to say. Nothing to share. Nothing to give. I was embraced by a group of African students who were all brilliant and experienced. Those were individuals who not only walk the talk but were grasping this opportunity with both hands. It was humbling. Not only because it was my first time studying with so many people from my continent but also with many from different countries within it. They were my rock and nudged me to stay and to make the most of this opportunity. I am not sure I did, but I recently completed my degree.

At the time, when I looked around me, the cohort was incredibly diverse: people with different nationalities, different languages, different religions, and different professionals at different stages in their careers etc., but very few felt like frauds. From those I approached, there was excitement and awe, people being inspired by their fellow students, people eager to grasp that different perspectives and people eager to share their own, to confront their ideas.

I looked at other students who “only” held bachelor degrees and came straight from those undergraduate studies, like I did. I talked to them to understand their position and very few echoes my sentiments. At that time, I did not think much of it. I felt like a fraud, I did not want to talk during lectures or tutorials. I wanted to be one with the walls and be invisible. It was something that had always been true in my upbringing as a daughter of a Congolese (DRC) father and a Burundian mother. I was taught to not make waves. I was told to always be very discrete. This was in sharp contrast to those from other nationalities. Most Americans students were bold and outspoken, happy to share their opinion, unapologetic in their way of presenting themselves and their ideas. The first few weeks, they truly dominated the narrative.

Only recently have I been interested in asking myself: why? Why is it that my upbringing does not foster that confidence? Why is it that the cultures I grew up in do not reward that free spiritedness I encountered in my Americans counterpart? I specifically do not want to make a generalisation to the entire continent. As we were often joking with other members of the diaspora, Africa is a continent not a country, there is no one Africa. My experience as a half Congolese, half Burundian former political refugee partly raised in France is of course different from that of a Yoruba from Nigeria.

To answer those questions, one of the components could be religion, or should I say superstition. In my culture, one does not make himself known/seen too much because one must fear jealousy, and gossip. One does not want his life spread out in front of others and risk spoiling it. What is the link with Global Health? I was not supposed to share my opinion as it might attract ridicule. What if people questioned my legitimacy? After all, I was just at 24-year-old who flew from genocide in Burundi as a small child. What does she know? What is her authority in these matters? This crucial idea of legitimacy. This idea that only people with a vast amount of experience, people who are legitimate due to their achievements, can speak out loud. The idea that only the one who “knows” can talk probably hindered my ability to learn. This led me to dismiss my own opinions, my own ideas. I took it as a given that they knew what was right and that I was as a result wrong in my own thoughts and views. My opinion was not valid because I did not have that a true global health background.

As the year progressed and I was ready to work on my thesis, I truly went against a wall. Every idea that I dismissed where the ones that my supervisor nudged me to stick with. Any opinions, any criticism that I had, I had to develop and research. It started to weigh on me that I was the only mixed Congolese and Burundian of my program. I was the only one able to share my perspective and to tell my story. I was the only ‘me’.

Global Health Humanities to me is about my coming into my own truth. It is about respecting my origins and looking at them as an asset and not as a point to dismiss because it is not the ‘right’ background. Global Health Humanities is about exploring my own humanity, my own identity in order to better raise my voice, and thus carry the torch for sharing this story, ultimately our story. Global Health Humanities represents a window that will serve to ensure that we no longer need to be ‘mindful’ of other cultures, but can instead truly integrate those cultures and facilitate an authentic sharing of stories.

This process is ongoing, and progress is being made – there are increasing opportunities for sharing stories through art (from writers to musicians and filmmakers), through the businesses that are being created from fashion brands to travel companies to magazines and healthcare startups), and through research.

Africa is rising.

Global Humanities: Writing as a form of protest

15 Nov, 16 | by cquigley

Ayesha Ahmad


‘Daughters of Rabia’ is a social media blog with over 50,000 viewers a week. The blog is a dashboard containing narratives of different forms – poems, essays, and short stories – from women, and sometimes men, in Afghanistan about the challenges they face often in the shadows of being silenced and shielded from the view of the rest of the world.

Each word is an act of protest; an echo of resistance and a triumph of knowledge that although voices may be quiet, the mind is alive and speaking out against injustice and violence towards the body as well as towards the spirit of humanity.

The question I ask here, then, is why is writing as a form of protest remaining such a strong tradition in our global culture?

The below image details an inscription, or rather, the signature of a determined artist to finish their poem once the war ends.


“When this war ends, I will return to my poem”

I think that our stories are our hope. If we can create our words during a time of destruction or decay or death either in terms of an ill society or an ill body, then there is a pathway to a legacy.

Should we make a parallel between words dying or our bodies dying and the words we convey during illness, perhaps there is a sense that words signal our breath; the stories that become of our words are the times that our hearts have beaten through our tales; our traumas.

It would be hopeful for medical and health professionals to relate to the initiative of writing as a form of protest. Sometimes silence reaches the most deep of wounds, and when such silence emerges as a voice, there is a power, a blood in the veins of all the intricate ways in which we, and our sufferings, are connected.

Daughters of Rabia (Persian): in English, Free Women Writers:


Global Humanities – Finding New Narratives

19 Sep, 16 | by cquigley


Conflict, Culture, and the Clinic: Finding new narratives

Ayesha Ahmad


In a recent publication “Syria Speaks”, the book volume is a collection of various forms of narrative that have been born in conflict. In reflection, there is a line that says: “War ignites people’s anger, and acts against culture, which is the work of the mind and the imagination”.

I find this interesting because culture becomes a force, a current of an ocean that is our imagination—our creativity, whereas war personifies all ways of life ending—killing, being killed, dying, and seeing others die.

Conflict is not culture. Rather, conflict unearths the skeleton of our human condition at the same time as burying the flesh from the bodies that are returned to the ground.

The ground, or land, is the bedrock of a conflict. The soil is separated and territories are disputed. The fragmentation of the land is a replica of the falling down of humanity. Pieces of the land are fenced away, boundaries that keep people apart from their footsteps.

I recall a passage in a story of four seasons in an Afghan village, recounting the lives of women weaving carpets; their hands moving in ways their grandmothers patterned the stories of their lives into colors and shapes.

The book, The World is a Carpet by Anna Badkhen, features a character called Amanullah. I was captured by the description of Amanullah walking “the trail by heart, steering from a memory that wasn’t even his own but had double-helixed down the bloodstream of generations of men who had travelled this footpath for millennia. A memory that was the very essence of peregrination, a flawless distillation of our ancestral restlessness”.

Our lives mirror our memories, and we carry our cultures; sometimes as treasures and sometimes as burdens.

I wonder about medicine. I wonder about a horizon where those walking from ancient paths like Amanullah entered new landscapes. I wonder about the doctor who encounters the Amanullah’s reaching Europe as refugees; what is the body when the body is without land?

If culture is our embodiment of the soil of our cradle, then medicine must confront culture in the clinical setting, as a form of sight, of hearing, of tasting, of feeling and of expression.

Our “travelling cultures” (Ahmad, 2014) must not be forgotten. In the examination of the toll of such journeys, medicine is challenged with new boundaries of healing and of humanity.

The question that emerges and I leave open for thought is “can doctors find a new narrative for culture in the clinic that inherently holds hope for the suffering?”



Ahmad, A. (2014), Do Motives Matter in Male Circumcision? ‘Conscientious Objection’ Against the Circumcision of a Muslim Child with a Blood Disorder. Bioethics, 28: 67–75.

Global Humanities – A Refugee in the Clinic

15 Aug, 16 | by cquigley


“You see a war zone, I see my home”


Ayesha Ahmad


“In my land”, you say. I trail away from your story into my own exploration; I am wondering about your possession—about your land, what it means for your to be yours, or what it means for you that my land is mine, and not yours.

In hospitals all over Europe, doctors are practicing medicine on the frontline. The patients are seen as refugees, or asylum seekers, or undocumented migrants; categories that are formed to describe who the person is in relation to their status to the land they are in.

When the phrase “in my land” is embedded in a story of war and displacement, a question is begged: how is a doctor to receive a story of a refugee?

The idea of “my country” represents the host of an individual’s existence. There, in their, and our land, the familiarity that we use to navigate our physical, mental, emotional, and existential worlds can be found.

The language, then, between the patient and the doctor, each from foreign lands to one another, is a script from their books; their poems, scriptures, and literature.

Perhaps in this context of travelling cultures and exploring stories, the need for doctors to understand and respond to stories is the way to close the frontiers between the doctor and the patient, and between the clinic and the home.

Boundaries diminish humanity; they separate ‘you’ from ‘I’.

“My country was such a nice place”, you say when you talk to me about how things were for you. “I am here now, but there, there is my Motherland. Once she was vibrant, but now, now she is like a body in a grave”.

Land, like a person, can become ill. As a victim of violence, a country personifies trauma. The soil, then, is felt like blood in those who are cradled in their births, and deaths, in their land.

Translating the relationship between the land and the body takes time. The transcription takes place using the instrument of reflection to tell a story of “what is in my body now is what I have lived”.

“My body is my land, and my land is my body”.

To treat this severing in the clinic setting, new words and new concepts to add to the body the language of the land are needed.

Bringing forth narratives of a land’s literature and lyrics is a way to represent the person who becomes the patient. The clinic setting marks such a unique centre for the meeting point of cultures—medicine with poetry, storytelling, and narratives that otherwise would remain ‘the Other’ as marginalised and defined by boundaries.

As the humanitarian crises of war and forced displacement dispels and unfolds into the home of doctors, the opportunity to make medicine richer is before us. There is no greater practice for listening skills than to hear a language contain a different land, and an unfamiliar body.

There is new terrain on the horizon for the clinical encounter; new lands to be explored and new narratives to share as the doctor-patient relationship continues to learn how to heal.

“You see a war zone, but I see my home”. As the patient leaves, let us hope that we all see the same place.


Ayesha Ahmad, Global Humanities Editor

The Screening Room: a review of the Lebanese film Ghadi

18 May, 16 | by cquigley

Ghadi New Poster

Music overcoming disability –  Ghadi, Lebanon, 2013, directed by Amin Dora

Reviewed by Dr Reem Gaafar, a Sudanese doctor, writer, filmmaker and graphic designer


A special screening will take place at the Polish Cultural Centre, 238 King Street, Hammersmith, London W6 0RF, Sapphire Room, 2nd Floor, at 8pm Friday 3rd June 2016. To book tickets

To buy copies of the film, please email


Ghadi, a 2013 film from Lebanon tells a poignant story: In a small town called Al Mshakal, there lived a young boy named Leba. Leba had a stutter, and was subjected to bullying and humiliation from his schoolmates, until a mysterious music teacher, Mr. Fawzi moved into town with his piano as well as nightly Mozart recitals. Using music lessons and improvised speech therapy, Mr. Fawzi helped Leba grow out of his stutter. Years later, Leba becomes a music teacher himself. His music attracts his childhood crush Lara into his classroom, and one Sunday afternoon, into his life. Their happy marriage is crowned with two beautiful daughters, but the family’s blissful life is disturbed by the obtrusive local community urging Leba and Lara to try for a baby son. The so-called caring community lived on gossip and backbiting with dishonesty flowing through the cobbled streets like a dark, murky river.

Eventually, a baby boy is conceived, but to the couple’s distress he is expected to be born with special needs. Leba has serious concerns: should the child be born or not? Is it fair to bring such a child into the world? He seeks advice from Mr. Fawzi, his childhood teacher and friend. Mortified by Leba’s doubts, Mr. Fawzi advises him to name the child immediately, to give him a presence, an existence, and the right to live. A few months later, Ghadi is born with Trisomy 21 (Down’s syndrome) becoming the most handsome boy in the neighborhood.

In today’s world of modern technology and advanced medicine, it has become relatively common for a couple to face the impending reality of bringing a ‘different’ child into the world. Basic ultrasound, amniocentesis and chorionic villous sampling can detect as early as 10 weeks a child with congenital and chromosomal anomalies, genetic disorders of metabolism, and various growth abnormalities. First trimester screening for Down’s syndrome has become routine in the developed world (Huang et al, 2015), and screening for anomalies at 18-20 weeks is becoming regular practice in the developing world. The course of action that follows the discovery of an aberration, however, is not at all globally agreed upon.

Many factors – religious, legal, educational, social and others influence the expecting couples’ decision to undertake the screening procedures in the first place, and to continue or terminate the pregnancy. Studies suggest that health professionals are more likely to lean towards termination of abnormal pregnancies than the general lay person (Drake, Reid and Marteau, 1996, Norup, M, 1998), and that a third of women who have a sibling with Down’s syndrome would consider termination if their prenatal screening proved they were carrying a child with chromosomal aneuploidy (Bryant, Hewison and Green, 2004). However, some individuals remain uncertain about terminating a fetus with Down’s syndrome compared to other conditions such as spina bifida and hemophilia (Bell and Stoneman, 2000). Some parents and/or health professionals think it is justified to not provide children with Downs’ syndrome the necessary medical and social care they need. Some families hand over the responsibility of these children’s care to public health systems through adoption (Julian-Reyniar et al, 1995).

On the other hand, advances in medicine and technology are allowing everyone, including the disabled, to live longer and healthier lives. Disability activists are now calling for women to resist the pressure to abort a disabled fetus, believing that such acts oppress the rights of the disabled, as well as adversely affecting all women (Saxton, M. and Davis, L., 2013).

While prenatal screening is being increasingly offered in the Middle East, the attitudes of both lay people and doctors are still unknown concerning abortion in general, and aborting a potentially-disabled fetus in particular. It is to be expected that these attitudes are based on cultural and religious beliefs and the laws that govern them. The Middle East and North Africa (MENA) region is predominantly Muslim, and the local laws rely heavily on the different interpretations of Islamic ruling in this matter, as well as on those laws inherited from colonial times. Abortion laws range from liberal to very restrictive, but the position of selective abortion relating to Down’s syndrome is not at all clear. Only Tunisia and Turkey have laws that allow abortion without restriction based on underlying reason (Dabash, R and Roudi-Fahmi, F, 2008, Hessini, L, 2007).

Ghadi spends his days and nights at the family’s home singing his peculiar songs, irritating the neighbourhood even more than Mr. Fawzi’s Mozart recitals used to. Eventually, Leba is faced with an ultimatum: either to send Ghadi to a specialist institution, or face the prospect of eviction with his family from their hometown. Desperate for a way out, Leba, helped by the village outcasts, succeeds in conjuring an elaborate plan to convince everyone that Ghadi is an ‘angel’ who can grant local people their wishes and punish them for their sins. In an unexpected twist of events, the townsfolk transform into honest, law-abiding citizens in fear of the wrath of ‘Ghadi, the angel’.

The film suggests that in spite of Leba’s initial apprehension and the community’s rejection of Ghadi, the pro-life decision for children with special needs ultimately turns out to be the correct and rewarding decision for all. Down’s syndrome is now officially recognized globally with a whole week dedicated annually to increasing awareness.

Special thanks to Amin Dora and Elyssa Skaff for kindly facilitating this review.

Address for correspondence:


Bell, M. and Stoneman, Z.  (2000). Reactions to Prenatal Testing: Reflection of Religiosity and Attitudes Toward Abortion and People With Disabilities. American Journal on Mental Retardation: January 2000, Vol. 105, No. 1, pp. 1-13.

Bryant, L., Hewison, JD and Green, M., (2005). Attitudes towards prenatal diagnosis and termination in women who have a sibling with Down’s syndrome. Journal of Reproductive and Infant Psychology, Volume 23Issue 2, 2005, pg. 181 – 198, DOI: 10.1080/02646830500129214

Dabash, R and Roudi-Fahmi, F., (2008). Abortion in the Middle East and North Africa. Population Reference Bureau, USA. Online, available at

Drake, H., Reid, M. and Marteau, T. (1996). Attitudes towards termination for fetal abnormality: comparisons in three European countries. Clinical Genetics, 49: 134–140. doi: 10.1111/j.1399-0004.1996.tb03272.x

Hessini, L., 2007. Abortion and Islam: policies and practice in the Middle-East and North Africa. Reproductive Health Matters, vol. 15, no. 29, pg. 74-84

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Ayesha Ahmad: ‘Lahore is an Illusion, Lahore is Everywhere’

27 Mar, 16 | by Ayesha Ahmad

The mango tree faded many shadows ago, its fruit became stones and the branches became a skeleton. Yet, the roots remained, and they embrace the soil in the womb of the earth.


This was the cradle of my family’s birth.

Now, blood is watering Lahore’s gardens.

In sorrow, I remembered these words given to me a few days ago by my father.

 ‘Lahore is an illusion, Lahore is everywhere’

I wondered about them for sometime afterwards and I did not realise the gift that these words were to become.


Ayesha Ahmad: Introduction to Global Humanities—Through Creation, Violence Will Die

15 Mar, 16 | by Ayesha Ahmad

Against the backdrop of violence, I have been examining through my research the qualities of our human condition that perpetuate both our survival and our spirit.

As an introduction to an ongoing series on Global Humanities, I will be discussing ways we can counter the dominant narrative of violence.

Our globalised world, or rather, the collective ‘Other’, is met through encounters from suffering—the patients that enter our clinical settings, the individuals that sacrifice their lives to reach the shores of safety, and the images that we only ever see from afar of stories that breathe suffering.


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