* Jasmine Collin from [Love Parenting UAE](https://www.loveparentinguae.com/), Nabta Health’s hypnotherapy partner, takes us through her guide to all things Hypnobirthing. * Learn how Hypnobirthing supports natural birth, reducing pain and creating an optimal environment during labour. * Nabta’s aim to empower women to reach their health goals as naturally as possible is very much in line with Jasmine’s approach and the benefits of hypnotherapy in labour. * Book Jasmine’s popular online Hypnobirthing course [here.](https://nabtahealth.com/product/the-love-birthing-hypnobirthing-course/) You may have heard of hypnobirthing due to its increasing popularity with expecting parents and [celebrities such as Jessica Alba and Angelina Jolie.](https://www.madeformums.com/pregnancy/celebrity-mums-who-used-hypnotherapy-in-labour/) It’s even been suggested that royal family members, Kate Middleton and Meghan Markle used it to prepare for their births – but what exactly is it and why are so many women turning to Hypnobirthing? **What is Hypnobirthing?** Hypnobirthing is a childbirth preparation method taken as a set of weekly classes either in groups or privately, any time between 20-35 weeks of pregnancy. There are lots of styles of Hypnobirthing available today but they all originate from the Mongan Method, which is over 30 years old. There are also online Hypnobirthing classes available too There are a lot of [misconceptions as to what Hypnobirthing](https://www.loveparentinguae.com/single-post/2019/10/07/why-there-is-no-such-thing-as-a-hypnobirth) is and the type of person who chooses it. Many think it’s just for hippy types wanting a home or [water birth](https://nabtahealth.com/glossary/water-birth/) or those seemingly crazy women who want to do it without pain relief, but the truth is, all women can use it to have a calmer more positive birth experience, no matter what birth they choose or what path it takes. **What is the aim of Hypnobirthing?** One of the aims of Hypnobirthing is to support and increase the likelihood of physiological birth with the least amount of chemicals and interventions wherever possible. However if drugs or medical interventions are truly needed it enables the couple to remain calm and make informed evidence based decisions for themselves and their baby. #### **What are the benefits of natural physiological birth?** Studies have shown us that women and babies who have natural physiological births benefit from better health outcomes, adjustment to life outside the womb, emotional satisfaction with the birth experience and being able to cope well with the transition to motherhood. Read more about [physiological birth](http://www.birthtools.org/What-Is-Physiologic-Birth) and its benefits for families and society as a whole. Hypnobirthing promotes births that mirror nature as closely as possible so that babies and families can get off to the best start possible. #### **What if natural birth is not possible?** Unfortunately, natural physiological birth is not always possible in our current birth culture. There are a large number of influencing factors that we can’t control and birth can be quite unpredictable. So it’s important to acknowledge the wide range of birthing styles, combinations of drugs, interventions and different experiences that can happen, so we can fully prepare couples for all eventualities. The great news is that the knowledge and techniques learnt in Hypnobirthing classes are applicable in all situations and in all types of birth. In fact the tools can be even more useful in assisted births like C- sections, epidurals and inductions etc. because they keep the mother and baby calm during potentially more stressful events. #### **Real Hypnobirthing stories** Here are a few birth stories from parents who had all types of birthing experiences and how Hypnobirthing helped them through. [The induction for](https://babyandchild.ae/uae-birth-guide/article/1523/labour-was-more-powerful-and-beautiful-than-i-could-have-imagined) [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) one [The induction and low](https://www.jasminecollin.com/single-post/2019/05/06/Taylors-Birth---A-calm-positive-tale-of-thrombocytopenia-induction-low-fluid-and-more) [amniotic fluid](https://nabtahealth.com/glossary/amniotic-fluid/) one [The planned gentle C-section one](https://www.jasminecollin.com/single-post/2017/04/16/Hanis-Birth---A-Family-Centred-Cesarean) [The one with no progress](https://www.jasminecollin.com/single-post/2017/05/04/Charleys-Birth) [The big baby one](https://babyandchild.ae/uae-birth-guide/birth-stories/article/1372/how-hypnobirthing-helped-me-give-birth-to-my-5kg-baby-drug-free) [The unplanned C-section one](https://www.jasminecollin.com/single-post/2015/05/10/10-Healthy-Foods-That-Calm-DeStress) [The VBA2C (Vaginal Birth after 2 C sections) one](https://www.jasminecollin.com/single-post/2017/04/23/Marsels-Birth---A-VBA2C-Story) [The planned vaginal](https://www.jasminecollin.com/single-post/2017/08/13/Phoenix-Willows-Breech-Birth) [breech](https://nabtahealth.com/glossary/breech/) one [The unplanned vaginal](https://www.jasminecollin.com/single-post/2017/01/26/Georges-Breech-Birth) [breech](https://nabtahealth.com/glossary/breech/) one As you can read in the birth stories, Hypnobirthing can benefit mothers and babies in all situations – but it’s not just them that benefit. Let’s not forget the partners. These days’ partners are not just welcome in the delivery room; they are expected to support the mother during labour and birth. However, without adequate training this can throw them into an environment and situation that they are not adequately prepared for. In Hypnobirthing classes partners gain invaluable knowledge and skills that they can apply in the birthing room to ensure a positive birth experience for the mother, baby and themselves. And the benefits don’t just stop in the birthing room. Lots of couples continue to use the tools for relaxing the mind and body long after the birth is over. Read- [7 surprising reasons to do Hypnobirthing that have nothing to do with birth](http://www.loveparentinguae.com/single-post/2017/08/02/7-Surprising-Reasons-To-Do-Hypnobirthing-Classes-That-Have-Nothing-To-Do-With-Birth) #### **So how does Hypnobirthing work exactly?** **During pregnancy** It empowers couples with the knowledge and belief that women’s bodies are designed to grow and birth their babies and that childbirth is a natural physiological process. It promotes healthy nutrition and physical exercise in pregnancy as being key factors in having a safe and easier birth as well sharing top tips on how to get the baby into the optimal position for birthing. Like any big physical event such as running a marathon or climbing a mountain, it’s not just physical preparation that makes the difference. Yes, physical fitness plays a big part, but a positive mindset and being emotional fit is just as important, and this is where Hypnobirthing comes in. Hypnobirthing de-hypnotises couples from all the negative information and fear that they’ve been conditioned with all their lives and updates their mindset through guided visualisations, affirmations and fear release work, all while they are very deeply relaxed or ‘in hypnosis’. Being in a natural state of hypnosis, promotes deep relaxation and being open to suggestion, so during pregnancy we can give the mind set an upgrade by accessing the sub conscious mind and reprograming it with more positive beliefs, thoughts and feelings about birth. When pregnant woman are calm and feel fully supported, their babies, who are literally swimming in their emotions, also feel the benefits. During classes there is also a focus on pre birth family bonding and this helps couples to adjust to their new roles and embrace early parenthood more easily. #### **Hypnobirthing during labour & birth** When a woman goes into labour with less fear and more understanding of how her body works and what it’s doing at each stage she can accept it more easily and experience it in a more positive way. When she relaxes and welcomes the sensations, rather than fighting them, they can then become easier to manage. Practically speaking Hypnobirthing teaches couples how to maximize the normal physiological birth process by creating the optimal environment for birth. Humans are biologically programmed in the same way that all mammals are and our birth environment needs are very similar. All mammals birth more easily in safe, warm, dark, private, quiet and undisturbed settings where there is no rush and no feeling of being watched or observed. In this ideal setting the perfect and natural combination of birthing hormones can be released and labour can progress. If however there is any sense of a potential threat or disturbance, our fight or flight response can release hormones that will slow or even stop labour. Even a bright light or a cold room is enough to slow down labour. It’s not always possible to control the external environment though, for example when driving to the hospital or in a typical hospital room, where it’s normally bright, busy and rushed, with lots of observation, disturbances and possible fear triggers. Hypnobirthing skills are crucial in these less than optimal settings because they enable the mother to create a calm and resourceful internal mental state. Using her practiced breathing, visualisations, affirmations and hypnosis she can bring her body and mind into a deep state of relaxation as if she were in the ideal environment. The body cannot tell the difference between real and imagined, so she can use this mind-body hack to convince her body that it’s a safe space and a good time to be birthing her baby. The body then continues releasing the perfect cocktail of hormones for a quicker, easier and more natural birth. #### But what about the pain? A birthing mother automatically reduces pain by being calmer and less frightened of the birth, and in calm, safe settings the birthing body naturally produces [endorphins](https://nabtahealth.com/glossary/endorphins/), our own natural pain relief, to help us cope with the intense physical sensations. In addition, Hypnobirthing mums can use hypnosis to disrupt and change the way that their brain processes pain signals. They also learn mental coping strategies and physical comfort tools to deal with any discomfort that they feel. All these factors make it less likely that they will need pain relieving drugs or unnecessary interventions and they tend to have more straightforward and quicker labours. Of course if a woman is struggling then there is a selection of pain relieving drugs that the hospital can offer. The aim of Hypnobirthing however is to ensure the couple have a complete toolbox of skills and techniques that they can utilize before getting to that point, so that it can be delayed or avoided all together. But, no matter how a baby is born or whatever interventions or drugs are used, the most important elements for every birthing mother are that: * She feels calm, safe, and supported throughout. * She feels that she did her best and gave it all she had. * She feels treated with dignity and respect. * And she was able to make her own informed choices about her baby, body and birth, every step of the way. These are the key ingredients to a positive birth experience and what Hypnobirthing is all about. Surely every mother and her family deserves this birth experience…not just the hippies. \_\_\_\_\_ Jasmine Collin is a mother of two, a qualified Hypnotherapist, NLP Practitioner, Childbirth Educator and Doula who specialises in Hypnobirthing and Parenting Originally from the UK she is the longest running teacher in the UAE and has been teaching her award winning ‘Love Birthing’ classes since 2009. She is the co founder of Love Parenting UAE, winner of the 2018 Time Out Kids Award for ‘Special recognition for pre and post natal care’ and is dedicated to helping couples have calmer, more positive births so that they can ‘Love Birthing’ no matter what kind of birth they choose or what path birth takes. For more information contact: [\[email protected\]](/cdn-cgi/l/email-protection) You can book Jasmine’s popular online Hypnobirthing services on the [Nabta Women’s Health Shop.](https://nabtahealth.com/product/the-love-birthing-hypnobirthing-course/) \_\_\_ Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) Get in [touch](/cdn-cgi/l/email-protection#acd5cdc0c0cdecc2cdced8cdc4c9cdc0d8c482cfc3c1) if you have any questions about this article or any aspect of women’s health. We’re here for you.
My job at Nabta Health involves me researching a range of [women’s health issues](https://nabtahealth.com/); covering everything from [puberty](https://nabtahealth.com/glossary/puberty/) to the [](https://nabtahealth.com/articles/effects-of-menopause-on-the-body/)[menopause](https://nabtahealth.com/glossary/menopause/), [infertility](https://nabtahealth.com/glossary/infertility/) to pregnancy, adapting to becoming a parent and exploring the many challenges that come with the role. As a mum of two in her mid-30s, these topics not only interest me, but many of them are relevant to my day-to-day life. I can fully appreciate the demands and challenges of being a woman, a wife and a mother. I try to write about topics that interest me, in a way that resonates with women today. This article is slightly different; I wanted to step away from presenting the facts and figures and tell a more personal story. This is my account of what, to date, has been one of the biggest challenges I have faced as a parent. **How it Began** ---------------- Emily was our first baby and, as first time parents, we had a tendency to worry, often about the smallest things; was she grumpier than normal and if so could this be a sign of something serious; did she have a temperature, were we keeping her bedroom cool enough; were her legs bending in a peculiar way? I am sure we were not the first parents to have our health visitor (we were in the UK at the time, where it was normal to be assigned a named health visitor after the birth of a baby) on speed dial and we will certainly not be the last. Each of our concerns was soon replaced with something else; until, that is, Emily reached about 18 months of age and we started to notice her doing something strange with her eyes; we called it ‘the eye thing’. Her eyes would flicker backwards and she would lose concentration for seconds at a time. Worryingly, it was happening frequently, perhaps as often as 30 times a day. In contrast to our other concerns, this was not something we rushed to find an answer to. We definitely should have looked into it sooner, but we were scared and desperate to avoid finding out there was genuinely something wrong. Instead, we turned a blind eye, thinking that if we ignored it and if nobody else picked up on it, then it was not really a problem. A month after Emily turned two, we moved from the UK to Dubai. My husband became convinced that we should take her to a doctor, even more so after she fell over inexplicably and bumped her head. He said it happened when her eyes flickered and she lost concentration, I said she was just a clumsy child. Naturally I had googled her symptoms and I could not find a website that gave me an answer I liked. It rapidly became apparent that the most likely explanation was absence seizures, but I was determined to find excuses for why it couldn’t possibly be that. For a start, a lot of websites said that each seizure would last up to 10 seconds; Emily’s lapses in concentration were mere seconds. Furthermore, she was young, only just two, and most children are diagnosed at the age of four, or older. As a couple, my husband and I continued to disagree about what we should do, but with his daughter’s health and wellbeing at stake, my husband was determined we should see someone and it was an argument I was never going to win. Finally, I agreed to see a doctor. We visited a lovely [paediatrician](https://nabtahealth.com/glossary/paediatrician/), who suggested we see a child neurologist. She gave us some recommendations and I insisted my husband call to make the appointment. I took her to see the neurologist on a weekday afternoon, just before Christmas 2016. Upon hearing what the symptoms were, the doctor did little to alleviate my fears; an EEG would confirm it, but he suspected childhood epilepsy in the form of absence seizures. I took an instant dislike to him and sobbed in the car on the way home. Suddenly a stranger was telling me that my perfect baby, my greatest achievement, was no longer perfect. In hindsight, I cannot stress enough how wrong it was to think this way; of course she was still perfect. A medical diagnosis should never ever determine the way you see your child. **The Diagnosis** ----------------- An EEG was scheduled. We should have sleep deprived Emily so that they could perform it whilst she slept. Absence seizures are a lot more common during [periods of sleep](https://nabtahealth.com/articles/i-keep-bleeding-between-periods-is-this-normal/), than wakefulness. Plus, I am not sure that many toddlers would tolerate having multiple electrodes stuck to their head and having to sit still for over 45 minutes. This first time we went through the procedure it was not well explained to us. We had not been told to sleep deprive her, so we arrived at the clinic at 9am and were told to make her have a nap. Emily resisted quite vehemently, even after being given a sedative. In the end, I sat rocking her as she screamed herself to sleep, with tears rolling down my own cheeks. I was about 20 weeks pregnant at the time, so probably feeling a little emotionally unstable myself. Once asleep, the technician covered her scalp in electrodes and hooked her up to a monitor. We watched as each wire produced a trace. We didn’t know what we were looking for, but the rapid scribbling of the pen every so often did not fill us with confidence. As she slept, we were googling EEG traces, trying to map the ones Emily was producing to those on the phone screen in front of us. Our attempts to self-diagnose did not go well (although I never learnt my lesson and for each subsequent [EEG](https://www.mayoclinic.org/tests-procedures/eeg), I would spend a significant proportion of the time trying to determine what a ‘normal’ trace looked like and if it matched the one my daughter was producing. I never did work it out). In the end, the doctor barely needed to look at the traces to present us with his diagnosis. Epilepsy. It was official, not really a surprise and not by any means a tragedy, but upsetting enough. She would need medication to control the seizures. The doctor started her on Depakine, also known as sodium valproate. He told us that the easier we found it to control her seizures, the greater the chance of her outgrowing the condition. The lower doses of the drug did not help; we did see an improvement as the dosage increased, but if she was tired or poorly her eyes would start flickering backwards again. We were seeing the doctor every few weeks in an attempt to optimise the dose. Finally we got to the highest dose, if this failed we would have to start from the beginning with a different drug, but fortunately this was not necessary. Taking the maximum dose the doctor would allow, Emily stopped having visible seizures. Six months later we went for another EEG to see if she was also seizure-free whilst asleep. This time we were better prepared. My husband kept her up until past midnight and I got her up at 4am. We made it an adventure. The benefit to living in Dubai is that the good weather allows for a 5am play at the park. Attempting to make her sleep on demand was still not a great experience, the sedative seemed to have little effect and by this stage I also had a six month old to manage by myself as my husband had work that day. It was the day before my birthday and genuinely the best present I could have got came when the technician told me (off the record) that the traces looked clear to her. The doctor confirmed this and said we continue as we were doing and after two years of being seizure-free we would attempt to wean her off the medication. **The Next Two Years** ---------------------- We were lucky because Emily is a well behaved child and never once objected to taking her medicine. It became as routine as brushing her teeth and life proceeded as normal for the next 18 months, with occasional check-ups and, fortunately, no setbacks. I even started to quite like her doctor. During her routine appointment in early 2019, the doctor said it was time to consider taking her off the medication. Despite his reassurances that over 85% of children with this form of epilepsy outgrow it and despite the fact that I had so desperately not wanted her to be given a label; suddenly when faced with the prospect of taking away the stability of the medication, which had essentially been acting as a comfort blanket, my husband and I were both quite anxious. First though, another EEG to confirm that she really was still seizure-free. To be completely honest, I am not sure what results I was hoping for at this stage. A clear EEG would mean we would have to try weaning her off the medication. This prospect was so unnerving that I really do not think I considered what the alternative would mean. Another night of sleep deprivation; this time we had the technique down to a fine [art](https://nabtahealth.com/glossary/art/). A midnight walk around the neighbourhood with torches, followed by some 4am scone making. Never one to be left out, our youngest, by now almost two years old, decided to join us for our baking session! No sedative needed this time, she still cried herself to sleep in my arms, but I remained dry eyed. A week later I visited the doctor for the results. By this time I trusted him implicitly and would not hesitate to recommend him to others. A highly skilled expert in his field, I firmly believe we received the best care we could have done. My animosity from two years previous had long since disappeared. The EEG was clear. We had about 6 weeks before we would reach the vital two year mark, but after that it would be time to start reducing the dose. Grateful for the six week breathing space, it was difficult to know how to feel at this stage. On April 1st we started dropping the dose and after 5 weeks Emily took her medicine for, what was hopefully going to be, the last time. **Today** --------- This brings us to the present day. The doctor has told us that the next six months are critical; this is the time when she is most likely to relapse. If she remains seizure-free until November he will discharge her. The first few weeks were anxiety-ridden for both of us, we obsessed over every little fall she had, and we watched her like hawks. I told her teacher at school, but then dreaded pick up time, in case the teacher had bad news for me. Every week that passes is easier though. My husband is more pragmatic than me; when I sought answers for what we would do if the seizures came back, he said we’d put her back on medication and try again in a year. There is an 85-90% chance she will remain seizure-free. Those are pretty good odds and if the worst does happen, at least we know what the process is now and we know we have controlled her epilepsy before and will do so again. I wanted to write about my own experience, not least because I find writing in itself to be highly therapeutic, but also to reach out to others going through a similar experience. I am exceptionally blessed to have two happy, healthy children and I consider myself truly fortunate that this has been our biggest parenting hurdle to date. Perhaps at times I over thought it, or over-reacted; maybe I should have been tougher and spent more time being grateful that it wasn’t anything more serious. But this is what parenting is; it is wanting to protect your children with every single part of your being, it is feeling like whatever choices you make and however you manage a situation, you are doing it in a way that is wrong; It is crying with your children and for them. It is hard, but my goodness, it is worth it!
‘Hybrid Healthcare’ is the term coined by [Sophie Smith](https://www.linkedin.com/in/sophie-louise-smith/), founder of women’s hybrid health platform [Nabta Health](https://nabtahealth.com/), to define a new model of healthcare where traditional care systems are integrated with digital health solutions to revolutionise the future of global healthcare. In [“Hybrid Healthcare”](https://link.springer.com/book/10.1007/978-3-031-04836-4#about-this-book), the book of the same name recently published by [Springer Nature](https://www.springernature.com/gp), authors Smith and [Dr Mussaad Al-Razouki](https://www.linkedin.com/in/razouki/?originalSubdomain=kw) discuss how established clinical techniques, combined with new-age digital systems, will democratise healthcare, empowering patients and providing a more efficient, accessible and holistic healthcare experience. “The intersection of the traditional healthcare system with new digital technologies will enable the rise of a robust hybrid healthcare ecosystem; one that encourages accountability, efficiency and cost-effectiveness through its three pillars of patient centricity, augmented intelligence, and decentralisation.” #### _Digital and traditional healthcare professionals must adopt a hybrid approach_ Successful hybrid care models recognise that face-to-face, in-person healthcare isn’t going anywhere. The disruption of physician-led traditional care delivery mechanisms can be a win-win for patient and system. The authors argue that the digital health entrepreneurs willing to work alongside traditional clinical pathways stand the best chance of successfully addressing the many healthcare challenges of the 21st century. #### _Hybrid healthcare builds on pandemic sector shake-up_ The concept of hybrid healthcare may seem familiar, even obvious now, as we emerge from several years of the global Covid-19 pandemic. In reality, the concept envisioned by Nabta Health in 2018 was accelerated due to necessity during the Covid-19 pandemic. The healthcare system was forced to adapt at speed, adopting telehealth and remote care models to support patients during lengthy lockdowns. And with shifts in patient expectations, healthcare providers are emerging into a post-pandemic world where they are forced to offer a more patient-centric, patient-led care service. Blended in-person and virtual care. The pandemic has fast-forwarded disruption across the global healthcare sector. The future of healthcare is hybrid healthcare. #### _Embracing the next generation model of hybrid healthcare_ The book [“Hybrid Healthcare”](https://link.springer.com/book/10.1007/978-3-031-04836-4#about-this-book) is a deep dive into the potential of this exciting and rapidly growing sector. It looks at the role for virtual and electronic tools, including digital diagnostics, electronic medical records, and online health marketplaces. It discusses the possibilities for artificial intelligence, blockchain, robotic surgery, and cloud biology. And it introduces existing examples of successful hybrid healthcare solutions. As Smith says, “Hybrid healthcare has the ability to take on the challenges of a rapidly growing, increasingly unhealthy global population by exponentially increasing its base and pace of delivery using the power of digital technologies, data collection, and analytics. “We must work together, digital and traditional, if we are to survive.”
Bed bugs which are tiny insects from the genus climex can be found in any household as they can be transferred through clothes, luggage or even public transport. They feed on human blood mostly at night. Their bites can result in a number of health impacts including [skin rashes](https://nabtahealth.com/articles/getting-started-with-nabta-health-your-101-guide-to-skin-and-hair/), psychological effects and [allergic symptoms](https://nabtahealth.com/articles/healthy-eating-for-your-milk-allergic-child/) that can range from mild to serious. A scenario that is replicated in various households grappling with this problem. #### **The health impact of bed bugs** Bed bug bites cause hives and blisters, accompanied by mild to severe itching and burning on the affected area of the skin. A great source of distress and discomfort. Being primarily nocturnal, their bites can cause loss of sleep, fatigue and anxiety. Directly impacting an individual’s productivity, mental state and social life in the long run. Staying awake and concentrating on tasks becomes an uphill task especially for children who come from these households. Scenarios involving people isolating from family and friends due to embarrassment and mental anguish associated with having bed bugs in their homes are common psychosocial effects following bed bug infestation. While they are not known to cause any serious illnesses, secondary [skin infections](https://nabtahealth.com/articles/fungal-infections-in-infants/) may occur largely as a result of scratching the bites and introducing germs to the wound. But with proper monitoring, this can be avoided. Other people have reported varied levels of allergic reactions which can also be handled with proper medical attention. Constant spraying of affected areas with pesticides or incorrect use of pesticides in a bid to get rid of the bed bugs can also pose a potential health risk to the people around. And it’s recommended that proper guidelines be adhered to when exterminating these insects. #### **How AKI is trying to help** Angamiza Kunguni Initiative (AKI) is a female led Non-Profit Organization (NPO) that deals with eradication of bed bugs among the under privileged members of the society. I am the founder and I was inspired to start this project after experiencing first hand the effects of bed bug infestation while studying at the University. These included sleepless nights, allergic skin reactions and poor grades during examinations. With lack of proper information or access to the right pesticides, I strived to find lasting solutions to this menace. So far, AKI has worked with a number of households in which they have carried out fumigation using environmentally friendly pesticides and successfully combated the issue. Stigma is also an issue that arises as bedbug infestation is associated with certain levels of poverty or poor hygiene. A notion that AKI seeks to demystify. In 2019, AKI was nominated for the Zuri awards “Young achiever of the year”. Currently the demand for the services of AKI has far exceeded available resources. For us, the journey has just begun and we are excited about the possibility of reaching more households countrywide. #### **About Winnie** My name is Winnie Mwangi. I am passionate about charity and giving back to the community. Moved by the plight of less privileged members of the society who have been affected by bedbugs, I founded AKI 5years ago. My main aim is seeing a bed bug free society and children scoring better grades in school. A dream I’m hopeful will become a reality someday. ##### How I met Nabta’s CEO Sophie: I signed up as a mentee for the [Cherie Blair Foundation](https://cherieblairfoundation.org/) having done research on foundations that support women in business especially in Africa. I was matched with Sophie in 2019 and she guided me on how to run the Initiative. In March 2020, I was declared redundant at my place of work due to the [Covid-19](https://nabtahealth.com/covid-19-questions-and-answers/) pandemic. I talked to Sophie about my situation and she suggested I join Nabta Health as an intern. I’m currently the head of Nabta Health local presence here in Kenya and I remain grateful to Sophie for all the support, favours and guiding me on the right path. #### **A word from Nabta’s CEO Sophie Smith** I signed up as a mentor for the Cherie Blair Foundation for Women after speaking to Cherie Blair about Nabta and learning about the work she was doing to support women in emerging markets. Winnie and I were matched as mentee/mentor in 2019. Initially, I was advising Winnie on her NPO, the Angamiza Kunguni Initiative (AKI), which was focused on eradicating bed bugs in Kenyan households. Then, when Winnie was made redundant at the start of the Covid-19 pandemic, I suggested that she joined us at Nabta. Winnie is now heading up our local presence in Kenya and has done a fabulous job of improving the visibility and formatting of the content on our platform. I remain extremely grateful for the Cherie Blair Foundation for Women and the opportunity to meet amazing women like Winnie.
[First published](https://qscience.nature.com/article/74/the-lack-of-physical-exercise-in-arab-states) by **Antonio Guillem Fernandez, Alamy** | 31 July 2015. Republished by Nabta, 23 Nov 2021 * A lack of exercise has been an ongoing problem across the Middle East. * Between obstacles and opportunities for exercise, most Arabs still do not get enough physical activity. * Common barriers to physical exercise include a lack of time and health conditions. * The result is a growing trend towards obesity in the region. Obesity is a growing healthcare problem worldwide, and especially throughout the Middle East. The fast adoption of a Western lifestyle, among other factors, has led to reduced physical activity and an increase in the consumption of sugars and saturated fats. The [World Health Organization (WHO)](https://www.who.int/news-room/fact-sheets/detail/physical-activity#:~:text=living%20with%20disability%3A-,should%20do%20at%20least%20150%E2%80%93300%20minutes%20of%20moderate%2Dintensity,intensity%20activity%20throughout%20the%20week) recommends that healthy adults should have at least 150 minutes of moderate exercise per week. According to recent studies, however, only 40% of men and 27% of women in the Gulf Cooperation Council countries reported being physically active for that amount of time. In Qatar, nearly half of 18- to 19-year-olds have insufficient levels of physical activity, and this rate increases substantially with age. [Epidemiologists](https://www.researchgate.net/publication/259461510_Barriers_and_Facilitators_Influencing_the_Physical_Activity_of_Arabic_Adults_A_Literature_Review) Kathleen Benjamin and Tam Truong Donnelly of the University of Calgary in Qatar reviewed the relevant literature in order to identify the factors that promote physical activity among Arab adults, and those that act as barriers to it1. They searched several large databases for relevant English-language studies, using keywords and phrases such as “physical activity,” “exercise,” “Middle East,” “challenges,” and “enablers,” and found 47 articles, and then eliminated 32 of these, because they did not include data on Arab adults, or because they did not focus on the barriers and facilitators of physical activity. From their review of the remaining 14 articles, Benjamin and Donnelly find that the two most commonly reported barriers to physical exercise were lack of time, largely due to competing factors such as household chores, childcare, and extra office care, and the presence of health conditions such as heart disease, osteoarthritis and asthma. Other participants reported lack of interest or motivation, fear of injury, and excessive internet usage as major barriers to physical activity. Some of the reported barriers are related to cultural and social norms. Traditionally, women in some Muslim-majority countries need to be accompanied by a male relative when outdoors. This, together with their expected role in the home and the traditional dress many wear in public to preserve their modesty, further reduces Arab women’s opportunities for exercise. Other major reasons for lack of activity included the lack of appropriate facilities, and the hot weather in the region. The most common facilitators of physical activity were the presence of a health condition or heath scare, such as a heart attack, which motivated people to become more active. Religion was also cited as another major facilitator, with several people contending that the Quran also encourages physical activity. \_\_\_ If you are concerned you may have high [cholesterol](https://nabtahealth.com/glossary/cholesterol/), get tested in the privacy of your own home by ordering a [cholesterol](https://nabtahealth.com/glossary/cholesterol/) blood test [here.](https://nabtahealth.com/product/pcos-test/) Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) [Get in touch](/cdn-cgi/l/email-protection#6d485f5d140c01010c2d030c0f190c05080c011905430e0200) if you have any questions about this article or any aspect of women’s health. We’re here for you.
In 1995, Gary Chapman, an American pastor with a Masters in Anthropology and a Ph.D. in Religious Education, published a book titled “The Five Love Languages”. In this book, Chapman outlines five ways to express and experience love that he calls “_love languages_“. These five languages are as follows: * Gift giving, * Quality time, * Words of affirmation, * Acts of service (devotion), and * Physical touch. The theory of the book is simple: we all have a primary “love language” – a way in which we best understand and like to experience love. Be it through touch (hugs, kisses) or words of affirmation (being told “I love you”, “thank you”, “you’re doing a great job”). Once we have identified our primary love language, we can rank the remaining languages by importance; potentially we have a love language that is a very close second, potentially we have one that does not matter to us at all. By identifying your love languages, you can establish what it is that your husband does on a regular (or less regular) basis that make you feel good or “loved” – be it leaving work early to spend an extra hour with you and the children at home (quality time), or surprising you in the middle of the day with a bunch of flowers (gift giving), or making the bed in the morning instead of leaving it to you (an act of service). Conversely, you can also identify the things he does with loving intentions that do not make you feel good, and either (a) allow them to continue, acknowledging the fact that the loving intentions are there, or (b) encourage him to try other things instead. Having identified your love languages, the first step should be to communicate these to your husband, and to get him thinking about his. Once he understands the concept of the five love languages, you can actively encourage him everytime he “speaks” to you in yours. Similarly, by identifying your husband’s love languages, you can invest more time in these and less time doing things that may seem very loving to you, but which your husband does not in fact register as “love”. Of course, that’s the theory. In practice, things are never so simple. Take me, for example. My primary love language is acts of service, meaning I feel most loved when people do things for me. They don’t have to be big things; lately, I most appreciate it when my husband takes the baby from me for ten minutes, which gives me time to wash my hair or respond to an email without being interrupted. Before I had Oliver, it could have been anything from buying me lunch to meeting me at the train station to offering to carry my bag. As long as it was a deed, something done, not said, I was – I am – happy. In terms of the remaining languages, they are probably ranked from top to bottom: physical touch, quality time, words of affirmation, and gift giving. Which is all well and good, except that my husband’s primary love languages are words of affirmation and gift giving… What this means is that in order for my husband to feel loved, I have to do things that feel least like love to me. Telling him I love him is easy, but affirming him, thanking him (often, earnestly) is so contrary to my nature that I almost have to set a reminder on my phone to remember to do it. And for my husband, acts of service is bottom of his list, so in order for me to feel loved, he has to do something that is fundamentally contrary to his nature as well. Luckily, we’ve had the discussion about love languages; he knows mine and I know his. This knowledge has, without a doubt, helped me not only to understand my husband better, but to love him more, and more effectively, as a result. So much so that when he brings me a bunch of flowers but neglects to do the washing up, I know he’s loving me in his language and I can be (almost) genuinely grateful instead of wanting to kill him. And when I bring my husband coffee in bed and go thirty minutes out of my way to collect him from work but forget to tell him how wonderful he is, he can remind himself that I’m just loving him in my way and not be tempted to look for affirmation elsewhere. My advice to all women on the subject of love languages is this: it’s always much easier to change your own behaviour and mindset than it is to change another person’s. As a wise colleague once told me, “In relationships, we can only do our 50%.” “Not feeling appreciated” is one of the top complaints most women have of their marriage. But only one in four men say they feel actively affirmed by their wives. Or, to put it another way, 75% of men do not feel actively affirmed by their wives. Identifying each other’s love languages is a great place to start in order to rectify the situation. I guarantee you that if you remember to love your husband using his languages, and encourage him to do the same for you, you will both feel more appreciated and affirmed. If you would like to know more about the five love languages, download our app, or follow us on Facebook, Twitter and Instagram (@NabtaHealth) for our daily hints and tips on all things woman.
**I was a late starter. Late to [puberty](https://nabtahealth.com/glossary/puberty/), late to make-up (I still don’t really wear any), late to the appreciation of nice bath products. Late to hidden meanings in films, late to appointments. An ugly, awkward teenager with blocky braces and rimless glasses that didn’t suit me.** **My mother only told me how babies were made when I was eleven years old. Nowadays, children in the UK learn about the facts of life much sooner – sometimes as young as four of five, which seems to me to be a desecration of childhood innocence, but each to his own. It’s less relevant for this part of the world. Even at eleven years old, I wasn’t really ready to hear the truth; it would be another couple of years before I got my head around it. I maintain to this day that my mother sabotaged me.** **As it transpired, I was to be a late starter in terms of almost everything that made me a “woman”. Including my period, which arrived a couple of months after my sixteenth birthday and then proceeded to be wildly irregular for the first ten years of my adult life. The average age of menstruation is twelve and a bit years, so sixteen is late by any standards. Late enough, in fact, that about six months previously my father (who is a doctor) had suggested, slightly awkwardly, that I might like to go and get myself checked out. I politely declined.** **I don’t remember much about my first period except that it happened so quickly I wasn’t really sure it had happened at all. I do remember thinking, “Is this it? What’s all the fuss about?” Of course, by the time my second period had come and gone – lasting a full seven days, heavy, and accompanied by the tell-tale cramps and emotional maelstrom – I had drastically altered my opinion.** **It was the irregularity of my cycle that prompted me, long before such things were fashionable, to download a period-tracking app and start trying to understand exactly how the thing worked. I never got as far as taking my temperature every day, but I did monitor a whole range of physical symptoms, including when my period started and how heavy it was on particular days.** **Just this – the simple fact of tracking my period – made me feel much more in control. I could see, for example, that although my periods felt like they came and went with reckless abandon, there was a pattern to them. My cycles were longer – the shortest around 31 days and the longest somewhere between 50 and 55 days – but on average, they tended to be between 31 and 34 days. I started buying sanitary items in advance; I took them with me on holiday. I stopped worrying.** **By the time the moment arrived for me to start thinking about marriage and babies, I felt pretty sure that I knew what I was doing. My periods were starting to settle down and I was using the Billings Method of Natural Family Planning (NFP) to accurately predict when I was fertile.** **None of this would have been possible without my period tracking app. If I could have changed one thing about it, it would have been to make the daily logs a little bit more comprehensive and accessible. At the time, the user experience was pretty unfriendly. I could also have done with a gentle reminder the day before my period started so that I remembered to take the necessary items with me if I went out. After you have children, of course, the signs associated with fertility change.** **My objective with [Nabta](https://nabtahealth.com/) Fertility is to create a product that caters for all ages and stages in life – whether you’re just entering [puberty](https://nabtahealth.com/glossary/puberty/) and need a guide to navigate its ups and downs, or you’re looking to start a family and would like to plan the next step effectively. Or if the reproductive phase of your life is coming to an end, and you need a support system to see you through the transition.** **That is what we are; that is what Nabta hopes to be. A guide, a support, a friend. A community to learn from, a small group of peers to confide in, a vast cavern of information to mine. [Nabta’s story](https://nabtahealth.com/) is my story, but my story is also every woman’s story.** **That, I think, is the real beauty of it.**
It is two years to the day since Nabta was founded. March 21st 2017. An historic day. Not only Nabta’s birthday, but Mother’s Day in the Gulf, my co-founder’s birthday, and the day my son was due (in the end, he arrived 11 days late on the 1st April). I thought I would mark this moment by reflecting, in a very specific way that has nothing to do with being asked to write an article by P&G on exactly the same topic, on the reality of being a woman in women’s health in the Middle East. **The reality of being a woman** -------------------------------- The first reality is this: when people ask you to explain what you’re doing, still the first question is often, “What is it like to be a woman doing X?” rather than, “What is it like to do X?”. If you throw a baby in a carrier or an advanced pregnancy into the bargain, this question is usually accompanied by a healthy dose of concern. With the #MeToo and other movements, I expect it won’t be long before the question of being a woman ceases to exist in many parts of the world, but for now at least, in a region that historically has some of the worst stats for female inclusion and empowerment, it’s here to stay. **The reality of a healthcare system driven by commercial benefit** The second reality is that combining two novel (and to a greater or lesser extent, taboo) concepts – hybrid healthcare, and women’s health – into a single bid for change, prompts mixed reactions; from investors, from members of the healthcare ecosystem, and even, occasionally, from other women. The MENA healthcare market is one of the fastest growing in the world. Take the UAE, for example, where the healthcare sector is expected to grow by 60% in just five years – from $17BN in 2016 to over $28BN by 2021. Much of this growth, as defined by the UAE 2021 Vision National Agenda, will be fueled by investments in preventive medicine to address the issue of Non-Communicable Diseases (NCDs), such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are, “the leading global cause of death and are responsible for 70% of deaths worldwide” (WHO, 2017). With this in mind, you’d have thought that a platform such as Nabta, designed specifically to facilitate preventive and personalised medicine by seamlessly integrating virtual care components such as mobile technologies, smart medical devices and tests, and machine learning, into traditional care pathways, would be an easy sell. Not so. Not when that platform is (1) built by women, (2) focused on women’s health, and (3) forced to compete with a healthcare ecosystem that is underpinned by commercial benefit, driven by investments into traditional “brick and mortar” setups, and a good three to five years away from understanding the concept of value-based care. **The reality of investment opportunities for women (or the lack thereof)** The third reality of being a woman in women’s health in the Middle East (and anywhere else for that matter) is that the amount of capital invested in female-led startups is significantly lower than the amount invested in male or co-led startups. In 2018, all female founders in the U.S. put together raised $10BN less than one cigarette company, Juul, took in by itself – just 2.2% of the total $130BN invested. This is despite the fact that (1) the female economy is considered to be the largest and fastest growing in the world – worth more, at circa. $23TN, than the GDPs of China and India combined, and (2) in a study by the Boston Consulting Group, it was found that female-founded or co-founded startups generated, on average, higher revenues per dollar invested than their male-founded counterparts. Although many of the MENA region’s top publications like to highlight the fact that female entrepreneurship is on the rise, the reality in terms of access to capital is very different. Ticket sizes from funds that claim to focus exclusively on female-founded or co-founded startups are significantly smaller than the average – ranging in size from $10K to $50K at the seed stage (versus $50K to $250K). And even the capital that is available is not equipped to support startups that do not follow the popular eCommerce / marketplace / software-only models, i.e. startups that have even a whiff of an R&D budget baked into their projections. **But realities change** The fourth and final reality is perhaps the most important: realities change, and they change because we change them. By persisting in the face of adversity; by refusing to allow statistics to get us down; by not being too proud to admit where we have been wrong and allowing our business models to pivot and evolve to support the real need we are trying to address, we can alter reality. Perhaps it will take women of our generation three years to close a funding round where it should take one; perhaps we will always feel that we are on the hard end of negotiations concerning valuation and investment terms; perhaps we will get tired of being patronised, ignored and knocked back down, and choose other paths and vocations. But there is value in the fight. Do not underestimate the impact your voice can have. Do not hesitate because people call you “crazy”, “delusional” or dismiss you out of hand simply for being a woman. In the words of Nike’s recent, amazing, “[Dream Crazier](https://www.youtube.com/watch?v=whpJ19RJ4JY)” advert: “So if they want to call you crazy? Fine. Show them what crazy can do.” **Sources:** * https://gulfnews.com/uae/health/uae-health-care-market-to-grow-to-dh103b-by-2021-according-to-new-study-1.2002656 * https://apps.who.int/iris/bitstream/handle/10665/258940/9789241513029-eng.pdf;jsessionid=C4C2CAEB2F25C6DC856AD047A965F4D8?sequence=1 * http://fortune.com/2019/01/28/funding-female-founders-2018/ * https://hbr.org/2009/09/the-female-economy * https://www.ft.com/content/a18196c6-ba62-11e8-8dfd-2f1cbc7ee27c
* Cyclical Vomiting Syndrome (CVS) sufferer, Rebecca Griffiths gives us an overview on the illness. * Patients with CVS experience severe vomiting, unrelenting nausea and lethargy, with no apparent cause. * CVS is very rare and difficult to diagnose with no known cure or treatment. About Cyclical Vomiting Syndrome -------------------------------- I’m a patient who suffers from CVS. It is a rare condition that mainly affects infants and children but occasionally develops in mid-late twenties. It is characterized by recurrent, prolonged attacks of severe vomiting, unrelenting nausea and lethargy, with no apparent cause. During an episode, vomiting persists at frequent intervals, 5-6 times or more per hour at the peak, for periods ranging from hours to 10 days or more (CVSA UK). The episodes are completely debilitating and tend to be similar to each other in symptoms and duration: my episodes always last for 5 days. The sufferer is generally in good health between episodes which makes it very difficult to diagnose and the exact cause is unknown (NORD). With traditional face-to-face appointments, it is very unlikely that a doctor/consultant will witness the acute symptoms of CVS as a patient is very unlikely to attend if they are mid-episode. I am always hospitalised. Other symptoms can include pallor (looking white/grey or ‘like a ghost’), sufferers may feel the need to drink a lot (so that the body can dilute the stomach acid), feel so unwell that they are unable to move or talk and may also feel the need to induce vomiting (make themselves sick) as the body incorrectly believes that emptying the stomach will stop the vomiting (NORD). I know I used to do this when I was first diagnosed but soon learnt that it didn’t help. Why the delay in diagnosis? --------------------------- It is very tricky to diagnose as there is no known cause, no diagnostics/tests and nausea and vomiting is a common symptom of lots of childhood illnesses. Young women in particular are often either treated as hypochondriacs or misdiagnosed with an eating disorder. Other mis-diagnoses include Gastroparesis (in my case as I’m also a T1 Diabetic). The condition is now viewed globally as neurological ([Cyclic Vomiting Syndrome – NORD (National Organization for Rare Disorders)](https://rarediseases.org/rare-diseases/cyclic-vomiting-syndrome/) but despite this, almost all sufferers are treated by a [gastroenterologist](https://nabtahealth.com/glossary/gastroenterologist/) which causes further delay to diagnosis and potential treatment. In reality, patients either have to rely on ‘pot luck’ on seeing a doctor who has come across it before or frantically search online for someone they think will be able to help. In almost all cases that I have come across, information is primarily found using social media (private groups) accessed by the adult patient or relative of a child-sufferer. As there is so little official research into the condition, patients and their families almost entirely rely on others in these groups to find ways of reducing/terminating episodes as well as making a note of any known ‘triggers’ to an episode as well as any medication that works for others that they can suggest to their doctor. One of my main triggers is adrenalin. If I’m looking forward to something, the chances of me being able to do it are minimal as the excitement triggers my vomiting. What else can trigger an episode of CVS? ---------------------------------------- There is so little known about CVS, however, patients who have kept a symptom diary can often identify specific triggers. As aforementioned, one of mine is adrenalin but I can also identify triggers such as eating foods containing MSG and several female patients I know have severe disruption to their regular menstrual cycle, often not having had periods since they suffered their first episode. This points to a hormonal element in adult patients. Lack of sleep is almost always a trigger in both children and adults and is most likely to trigger an episode an hour or two before they would usually wake up in the morning (NORD). In severe cases like mine, often the only way to find relief is by using sedation and often if I’m in a ‘deep sleep’, sedation (in a hospital setting) can terminate an episode. What is the treatment for Cyclical Vomiting Syndrome? Is there a cure? ---------------------------------------------------------------------- There is no known cure and no real treatment that works across the board. Patients find medications that help them through trial and error. As most patients are treated by a [gastroenterologist](https://nabtahealth.com/glossary/gastroenterologist/), mainstream anti-emetics are used with little effect. Those who are treated by neurologists tend to be treated with anti-[migraine](https://nabtahealth.com/glossary/migraine/) medications which seem to be more effective. There are currently a few medications being trialed across the world for CVS but as it is a rare condition and there’s a limited number of end users, there is little incentive for pharmaceuticals to find/develop potential medications specifically for use in CVS. NHS England suggest that patients are given ‘supportive care’ including plenty of fresh air/ventilation, low lighting or a dark room, gentle music and a calm atmosphere although from personal experience I know that this is very hard to achieve due to the fact that patients are usually treated in busy bays with other patients, bright lights, lack of windows and lots of noise. Scalding hot baths/showers (or as hot as sufferers can handle) is also reported to help (NHS England). 5th March, is International Cyclical Vomiting Awareness Day. Venues across the world are lit up in blue in the evening, including Niagra Falls in North America. It is hoped that with increased awareness, more patients will be correctly diagnosed and more research conducted to find a treatment and maybe one day, a cure. ### Key CVS Facts: * It mainly affects children between the ages of 3-7 years * It is estimated that as many as 2% of babies and children suffer from CVS at some point in their childhood. Many children simply ‘grow out of it’ (NORD) * For sufferers diagnosed in their twenties and thirties, episodes are life-long. * Episodes can last for hours to over a week and the defining feature is severe vomiting and unrelenting nausea which is often worse than the physical vomiting * In-between episodes, sufferers are often [asymptomatic](https://nabtahealth.com/glossary/asymptomatic/). * In adults, it primarily affects women — Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) [Get in touch](https://nabtahealth.com/contact/) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** Nord ([rare disease.org](http://raredisease.org/)) Rare Disease UK CVSA UK CVSA US NHS England
**I’m writing this as a non-Muslim Brit based out of Dubai. This is worth noting because inevitably my observations (although first-hand) will bear the marks of a person who has been raised in an increasingly liberal, sectarian society. Also worth noting is the fact that, compared to other countries in the Middle East, the United Arab Emirates is _extremely_ accommodating of Western practices, largely on account of there being nine foreign residents to every one Emirati.** **That said, I am also the mother of a four-month-old, breastfed baby boy, and I have spent most of the past year in the Middle East. My husband and I moved to Dubai last year shortly after we got married; I spoke at a HealthTech conference in Kuwait when I was five months pregnant; we traveled** together as tourists to Egypt and Oman in my seventh month. Our shared love of Arab culture has taken us to Syria, Morocco, Bahrain, Lebanon, Jordan, Tunisia, **and back.** **And it occurs to me, on the eve of the final day of World Breastfeeding Week 2017, that there are a few things worth mentioning about breastfeeding in the Middle East and North Africa (“MENA”), specifically the differences between “breastfeeding in theory” and “[breastfeeding in practice](https://www.sciencedirect.com/topics/nursing-and-health-professions/breastfeeding-practice)”.** **Opinions regarding “breastfeeding in theory” are pretty uniform across the region. The global public health recommendation of breastfeeding a child exclusively for the first six months of its life is widely accepted, on the basis that it provides the child with “optimal nutrition for growth and development together with significant immunological protection”. The dramatic rise in recent years of nutrition-related chronic diseases such as diabetes, obesity and heart disease among the local population has prompted governments across the Middle East – in the UAE, Kuwait, and Lebanon – to call for the active promotion of breast milk over formula. Among Muslims, breastfeeding is an expectation of parents and the Quran recommends that children should be breastfed until the age of two. Indeed, this particular aspect of Quranic teaching was recently enshrined in law in the UAE in 2014.** **“[Breastfeeding in practice](https://nabtahealth.com/articles/is-breastfeeding-overrated/)”, however, is a different story. A recent study of Emirati women found that less than 50% of mothers exclusively breastfeed their children by one month of age. Those unfamiliar with the region could be forgiven for assuming that the main reason for this is the fact that breastfeeding in public (i.e. in front of men) is strictly forbidden according to traditional Islamic teaching, which states that a woman is not allowed to expose any part of her body in public except her head, hands, and feet. Women can breastfeed in front of other women, but even then should do so with modesty and discretion. Surely then, most women who introduce +formula, solids, or other liquids to their child’s diet in the first six months do so for the sake of practicality? So as not to be perpetually harassed or wrong-footed in public?** **In fact, the reasons given as to why most women do not exclusively breastfeed beyond the age of one month relate more to a lack of proper postnatal support and the failure of employers to accommodate breastfeeding mothers in the workplace. Pre-lacteal or “top up” feeds given in hospital around the time of birth, convenience when returning to work or study, and subsequent pregnancies are among the top reasons listed for discarding breastfeeding early on. Interestingly, socio-demographic factors such as the age of the woman at the time of marriage or birth, family size, and domestic help were not found to be particularly influential.** **I have breastfed my son in underground car parks, in public toilets, in the darkened corners of abandoned cafes, and on a speedboat to avoid causing offense in public. On these occasions, my discretion has been more to do with my own personal preference than enforcement by any third party. I have also breastfed openly in malls, restaurants, and on the beach – always using a breastfeeding cover, always with the maximum amount of care and attention to the people moving around me – and only once have I ever encountered a serious objection, and that was on a cramped plane flying from Barcelona to Dubai, where the fact that we were mid-takeoff and the toilets were out-of-action meant discretion wasn’t really an option.** **It is apparent, therefore, that what MENA needs is not a lively campaign to protect women’s right to breastfeed in public, as suggested in some Western media outlets in recent months – for most local women, it is a non-issue, and for ex-pats such as myself, respect for cultural norms should take precedent. Instead, local governments should proactively advertise the medicinal [benefits of breastfeeding](https://nabtahealth.com/articles/benefits-of-breastfeeding-for-the-mother/), for both the mother and the child, and oversee the introduction of proper postnatal support – be it longer maternity leave (in Dubai, maternity leave is still just 55 days, of which 45 are paid), information packs specifically targeting mothers in the postpartum period, the introduction of postnatal home visits, and the obligatory provision of proper breastfeeding facilities in public places, including the workplace.**
* The Diabetes epidemic currently affects 37 million people in The Middle East. * Type 2 Diabetes, which is related to lifestyle factors, is prevalent across the MENA region. * The impact of this Diabetes epidemic is huge, with over 350,000 diabetes related deaths each year. * The ratio of Type 2 to Type 1 Diabetes sufferers is 10:1. * Simple, sustainable changes to diet and lifestyle are key to overcoming the epidemic. News sources, [including the BBC](https://www.bbc.com/news/health-35959554), have reported a “disturbing” rise in the number of children and teenagers being treated for Type 2 Diabetes in the UK. Of those treated, three quarters were obese, with the youngest aged between five and nine. The early onset of Type 2 Diabetes is a trend that can be seen all over the world, and nowhere more so than in the Middle East #### **How Bad Is The Type 2 Diabetes Problem?** According to the World Health Organisation and IMF, diabetes currently affects 37 million people in the region, or 1 in 10 adults. It is the fifth largest killer in MENA after cardiovascular disease, stroke, pneumonia and road traffic accidents. Of these, at least two – cardiovascular disease and stroke – are secondary consequences of diabetes. Although Egypt, as the most populous state in the region, has the largest number of people with diabetes – 7.6 million in total – the epidemic is proportionately higher in the Gulf, affecting 24% of the population in Saudi Arabia, 23% in Kuwait and 19% in the UAE. This figure is set to double or even triple in some parts of the region, such as the UAE, by 2035. The economic impact of this is huge. In 2014, there were 363,000 diabetes-related deaths, over half in under-60s. In ordinary circumstances, these citizens should have been part of a healthy working population. The annual spend on diabetes, which is already a whopping $16.8 billion, is set to increase to $24.7 billion by 2035 with the potential to bankrupt many healthcare systems. But that is not the real tragedy. The real tragedy is that the ratio of Type 2 to Type 1 Diabetes sufferers is 10:1. Or to put it another way, that almost 10 in every 11 cases are preventable. At least 90% of the $500 billion spent every year on treating diabetes does not need to be spent on treating diabetes and could be spent instead on researching and treating less preventable diseases. #### **Solving The Diabetes Epidemic** So what can be done? Fortunately, the answer is simple, and it starts with a change of lifestyle and approach that focuses on sugar rather than calorie consumption. Type 2 Diabetes can be understood as an intolerance to sugar, whereby the body is unable to remove excess sugar from the blood leading to high blood glucose levels. Over time, high blood glucose levels cause complications such as retinopathy, heart disease and stroke. When we eat sugar, whether it is natural, added or complex, it is converted by our bodies into glucose. Therefore, the key to controlling Type 2 Diabetes is to minimise the total sugar burden from all three of these sources. To illustrate this point, consider two typical breakfast options. The first breakfast is one that is typically consumed in the UK – it contains bran flakes and skimmed fresh milk, a slice of wholegrain toast and a glass of apple juice. The second option is a three egg cheese and mushroom omelet and a full fat milk coffee. Most health-conscious individuals would believe that the first breakfast with its wholegrains, fibre, fruit juice and low fat dairy is the healthier choice. However, when you consider the amount of sugar that is in each one, the results are quite surprising. The first breakfast contains 16.3 teaspoons of sugar and the second less than 1. Nutrition experts say that no more than 5% of daily calories should come from sugar – this equates to 7 teaspoons. So in fact, the first breakfast equals almost two whole days’ sugar allowance. With sugar hidden in the most seemingly healthy foods, it is hardly surprising then that even for a health-conscious individual, the sugar burden can quickly accumulate. There have been a number of systematic reviews to evaluate the outcomes of a traditional calorie-restricted, low fat diet against a reduced carbohydrate approach. The outcome of these reviews indicates that on a low carb diet, people lose more weight and improve their [cholesterol](https://nabtahealth.com/glossary/cholesterol/) and systolic blood pressure. Moreover, there is a lower attrition rate for people in low carb groups indicating that if it was down to patient choice rather than public health guidelines to choose a treatment pathway, people would be more likely to maintain a low carb lifestyle than a calorie restricted one. #### **Finding A Solution to Diabetes** Diabetes.co.uk is the largest and most engaged diabetes community in the world. It provides a vital support network and discussion forum for nearly 10% of the diabetes population. Diabetes.co.uk has spent the past 3 years developing a series of evidence-based digital health interventions that have been proven to positively affect patient health outcomes. The Low Carb Program is the world’s first completely accessible education program for people with Type 2 Diabetes. It focuses on simple, sustainable changes to diet that are grounded in a person’s goals, as well as their family, social and working lives. Over the course of ten weeks, the Low Carb Program guides users through a series of lessons, supported by a multi-platform app, videos, print-outs, practical action points and 24/7 online support. The ultimate aim of the Low Carb Program is to reduce [HbA1c](https://nabtahealth.com/glossary/hba1c/), the 90-day average of blood glucose level, which is used as a marker of diabetes control. A 1% reduction in [HbA1c](https://nabtahealth.com/glossary/hba1c/) reduces someone’s risk of amputation by 43%, [cataracts](https://nabtahealth.com/glossary/cataracts/) by 16%, and heart failure by 19%. The program has been a runaway success. To date, the combined weight loss of the 150,000 people who have participated in the Low Carb Program stands at 1.8 million kilograms or an average of 12kg per person. The [HbA1c](https://nabtahealth.com/glossary/hba1c/) of people who complete the program has dropped so much that 35% can be technically classed as no longer having Type 2 Diabetes, while one in five are able to stop taking at least one diabetes related medication. **In Conclusion…** The message is simple: eating sugar, in whatever form, raises blood glucose levels and high blood glucose levels cause complications. By eating less added sugar and consuming more real food, not only can we stop the Type 2 Diabetes epidemic but we can actually reverse it. Consider this: if the 33.6 million diabetes sufferers in MENA were put on the Low Carb Program tomorrow, by early 2018, 11.7 million of them could be in diabetes remission, saving the region billions per annum in medication alone. Diabetes is killing the Middle East, but it needn’t be. It’s time for local governments to acknowledge what needs to be done; to invest proper time and money in evidence-based educational programs, and start fighting back. \_\_\_ If you are concerned you may have Diabetes, get tested in the privacy of your own home by ordering an [HbA1c](https://nabtahealth.com/glossary/hba1c/) blood test [here.](https://nabtahealth.com/product/hba1c-test/) Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) [Get in touch](/cdn-cgi/l/email-protection#f7d2c5c78e969b9b96b799969583969f92969b839fd994989a) if you have any questions about this article or any aspect of women’s health. We’re here for you.
* If you have Type 1 or Type 2 Diabetes, controlling your diet and hydration is a key part of your ongoing care and treatment. * Nabta Health is pleased to be partnering with Diapoint ME to provide care and support to women with diabetes. * The following nutrition and hydration guide is provided by Pam Durant from Diapoint ME and is useful for anyone, not just diabetics. When coping with [diabetes](https://nabtahealth.com/a-guide-to-type-1-diabetes/), eating a healthy and balanced diet and maintaining hydration is important to achieve good health, a healthy body weight and to help you feel your best. A healthy and balanced diet is about eating a wide variety of foods from all the food groups and in the right proportions. Try to choose a variety of different foods from the five main food groups to get a wide range of nutrients: * Fruit and Vegetables * Carbohydrates like potatoes, bread, rice, pasta and other starchy carbohydrates. * Beans, pulses, fish, eggs, meat and other proteins. * Dairy (milk, yogurt, cheese) & Alternatives * Fats & Oils (e.g. spreads and olive oil) #### **What is a portion size?** * 80g of preferably fresh, or canned or frozen fruit and vegetables * 30g of dried fruit – which should be kept to mealtimes * 150ml glass of a low sugar smoothie * 1 piece of fruit such as a small apple, banana, pear or similar-sized fruit * A slice of pineapple or melon is also one portion * Three heaped tablespoons of vegetables is also one portion. A useful way to improve your portion control is to start using a [digital food scale](https://www.diapointshop.com/products/nutricook-digital-kitchen-scale-eko-by-nutribullet?_pos=1&_sid=b99bf54e9&_ss=r) when planning your meals. #### Diabetes nutrition and hydration: **fruits & vegetables** Aim to include five portions of fresh fruits and vegetables a day. They are the best source of vitamins and minerals and fibre, and should make up over a third of the food you eat each day. #### How much **starchy foods and carbohydrate**s for a diabetic? Starchy foods should make up just over a third of everything you eat. Make sure to go for wholegrain or wholemeal varieties of starchy foods, such as brown rice, wholewheat pasta, and brown, whole meal or higher fibre bread. You can learn more about rice and carbohydrates in this article [here](https://www.diapointme.com/rice-and-carbohydrates/). #### Protein Many people often think that meat is the primary source of protein to stay healthy. We are happy to say that protein can be found in a variety of foods – not just meat. Beans, pulses, fish, eggs, meat and other sources of protein are essential for the body to grow and repair itself. These foods are also good sources of a range of vitamins and minerals. While meat is a good source of protein, vitamins and minerals, including [iron](https://nabtahealth.com/glossary/iron/), [zinc](https://nabtahealth.com/glossary/zinc/) and B vitamins, we prefer to be as plant based as possible. Try to eat as little red and processed meats as possible. If you do eat meat, choose lean cuts of meat and skinless poultry whenever possible. Eggs and fish are also great sources of protein, and contain many vitamins and minerals. Oily fish is particularly rich in omega-3 fatty acids. Aim to eat at least two portions of fish a week, including one portion of oily fish to get all those wholesome omegas. Pulses, including beans, peas and lentils, are naturally very low in fat and high in fibre, protein, vitamins and minerals. Nuts are high in fibre, and unsalted nuts make a good snack. But they do still contain high levels of fat, so eat them in moderation. #### **Which milk, dairy and alternatives** for a diabetic? Milk and dairy foods, such as cheese and yoghurt, are good sources of protein. They contain calcium, which helps keep your bones healthy. Go for lower fat and lower sugar products whenever possible. There are many vegan alternatives now for dairy products. Read the labels to avoid substitutes that are over processed or have too much added sugars. #### **How much fats and oils?** Some fat in the diet is essential, but try to avoid eating too much saturated fat and remember to avoid trans fats completely. Trans fats are made through a chemical process of the hydrogenation of oils. They are most commonly found in things like vegetable shortening, some margarines, crackers, cookies, and snack foods. It is so important to eat fats that are healthy. Yes, there are healthy fats like the monounsaturated fats found in olives, peanuts, sesames, avocados and olives. If you have a new diabetes diagnosis and you are unsure of how to manage this change in your life, a [Nutrition for Diabetes Management Health Coaching Session](https://www.diapointshop.com/products/nutrition-for-diabetes-management-health-coaching-session-90-minutes?_pos=1&_sid=7fec2d09d&_ss=r&variant=39596980240493) can help. We will guide you to manage your nutrition and understand the fundamental principles of managing diabetes nutrition. Diabetes and Hydration ---------------------- Getting enough water everyday is important for your overall health #### **Water Helps Your Body** * Regulate it’s temperature * Prevent [constipation](https://nabtahealth.com/glossary/constipation/) * Improve digestion * Lubricate joints and prevent pains * Maintain spinal cord health * Get rid of wastes and toxins * It even helps maintain blood sugars [According to the CDC](https://www.cdc.gov/pcd/issues/2013/12_0248.htm), drinking enough water daily can improve skin complexion and blood pressure. Sufficient hydration can also support weight loss goals. These are just a few of the reasons you need to make a habit of proper daily hydration! #### **Tips To Drink More Water** If you are often on the road, you should always take a water bottle with you. Invest in a large metal water bottle and fill that before you leave for work in the morning. If you get the right brand, the water will stay cool all day. Avoid plastic bottles (even reusable ones) because not only are they bad for the environment, they are bad for us too. As plastic heats up, it releases harmful particles into your water that you will end up drinking. Also, during work hours, you should always keep a water bottle near you that you can easily access and drink from regularly. If that is not an option, you must remember to drink lots of water during breaks. Keep a personal water bottle and make a habit of keeping it near you even when relaxing in front of the TV at home. Ensure you maintain your hydration include making a habit of drinking water first thing in the morning because our bodies lose hydration in our sleep. Also, remember to drink some water before and during meals. Some beverages like herbal tea can also help maintain hydration, but just water is always the best way. Aim to drink two liters of water daily. Written by Pam Durant, [Diapoint Me](https://www.diapointme.com/) \_\_\_ Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) [Get in touch](/cdn-cgi/l/email-protection#c5e0f7f5bca4a9a9a485aba4a7b1a4ada0a4a9b1adeba6aaa8) if you have any questions about this article or any aspect of women’s health. We’re here for you.
