They aren't all first cousins: Bedouin marriage and health policies in Lebanon

Abstract

Objective. Fertility and consanguineous marriages among the Bedouin tribes of the Middle East have long generated interest particularly around health outcomes and social relations. In particular, Bedouin in Lebanon have increasingly embraced the Lebanese national bio-medical health system in the past two decades, while Lebanese policy-makers' responses continue to be minimal and ill-informed. This paper investigates the mismatch between policy-makers' formulations of Bedouin consanguineous marriages and the Bedouins's actual reproductive practices and discusses the implications of these formulations on the Bedouins's access to health services.

Design. The findings are drawn from the data collected as part of the Bedouin Health Project, an EU-funded five-year study (2005–2010), aiming at assessing access to reproductive and child health care among the Bedouin in Lebanon. The data was collected from 6 clusters representing the main Bedouin informal and unrecognized settlements in the Bekaa Valley of Lebanon. The data consists of 111 socioeconomic questionnaires with Bedouin women users of local public, private, and nongovernmental reproductive and child health-focused clinics, in addition to 40 in-depth interviews with Bedouin women across the clusters and 17 semi-structured interviews with policy-makers.

Results. The findings suggest a gap between the perceptions of policy-makers and the incidence of consanguineous marriages and reproductive practices among the Bedouin. While there was no national data available for the Bedouin populations, policy-makers relied on a constructed ‘Bedouin reproductive profile’ that portrayed them as ‘a problematic health group’. The national policy formulation of the Bedouin reproductive profile has an exclusionary impact on the Bedouin population as they are ignored from any targeted health policies or provided with politically motivated palliative care provision.

Conclusion. These findings highlight the importance of addressing stereotyping and discrimination among health practitioners and policy-makers, as a crucial part of improving the overall marriage and reproductive health practices of the Bedouin.

Keywords:

• Bedouin
• health policies
• discrimination
• reproductive health practices
• policy-makers
• health practitioners

Acknowledgements

The findings in this paper were drawn from a research project funded by the European Commission.

Key messages

1. In the absence of national data on margnialised social groups such as the Bedouin in Lebanon, policy makers need to directly collect data from the communities in order to formulate inclusive maternal and child health policies.

2. Well informed national health policies are key to reducing stereotyping and discrimination among health practitioners and policy-makers and constitute a crucial part in improving the overall marriage and reproductive health practices of the Bedouin in Lebanon.

Notes

1. The Bedouin of Lebanon in our sample preferred to be called ‘Arab as they considered the term bedu to be derogatory; Bedouin in Syria and Jordan preferred the term bedu.

2. Many informants told stories of harassment by police and government officials and non-Bedouin locals. Many times, Bedouin tents were burned and pulled down, grazing land was increasingly hard to find as land was fenced off as private property and access to it denied

3. The major sub-tribal groups or ‘ashayir identified in this study with informal settlements in the Bekaa are the Hruuk, Faour, Haramisha and Al Fadl [Al-Fadl]; Bu ‘Eed, ‘Eedeen [Hassanna]; Mawali; Ls'Ouways; Shgeef; and Luhayb. Most of these groups have gradually built up informal settlements at the base of the Anti-Lebanon Mountain Range over the past three decades. The most recent is the Mawali settlement between Anjar and Kfar Zabad. These places exist as geographical entities (generally on the borders of municipal districts) but not as legislative ones; they do not exist on Lebanese government maps. Al-Fa‘our, al-Mecherfeh, al-Jarrmeesha, al-‘Umariyya, al-Zas'imiyya, al-Jarrahiyya, and Bahsaasa, for example, are all unofficial Bedouin settlements; they lack basic infrastructure, they have no sanitation networks, piped water, electric networks, and roads. In addition, they lack basic public services such as schooling and health care.

4. This nationality was extended to Bedouin men and women as bachelors and spinsters. Without married status, they are unable to pass on their citizenship to their children. Many were already married with large families in 1994 when they accepted to be registered as ‘single’. However, 15 years down the line with their nationality status on hold, their children are now Maqtumeen al Qayd, or without nationality.

5. However, there is little data available on the applied effectiveness of this measure in deterring cousin marriages.

6. Many politicians are extending political patronage to Bedouin communities in the Bekaa on the basis of their Sunni voting power; the Bedouin have been embracing sectarian identity as a composite and extension of their Bedouin one.