Team:BGU Israel/Human Practice/Bedouins

Some groups are at higher risk of developing type 2 diabetes, and the metabolic syndrome, than others. All over the world, groups of indigenous people are far more likely to develop the disease due to a rapid urbanization process and the adoption of modern lifestyle. The Bedouins in Israel provide us with a no different story.
Populations of Indigenous people all over the world have shifted from traditional to modern-western lifestyle that includes less physical outdoor work, and increased consumption of industrial foods. This, in addition to low socio-economic background, leads to today findings – indigenous people, such as the Aborigines in Australia, suffer type 2 diabetes far more than any other group.



The Bedouins are an ancient indigenous subgroup within the Arab minority in Israel with cultural, historical, social and political uniqueness, mostly located in the Negev desert (southern Israel), very close to Ben-Gurion University. The Bedouin community has changed drastically, once nomad tribes, now living in concrete houses in concrete cities. Urbanization and adopting modern lifestyle pushed Bedouins to change their diet almost entirely, and abandon the nomad way of life, leaving grazing and agricultural work to a more convenient city lifestyle. By meeting with Dr. Abu Rabia, the first Bedouin doctor in southern Israel who was a tremendous source of knowledge, we have learned that this "convenience" led to a terrible yet amazing fact – in 1960, type 2 diabetes almost did not exist amongst the hard physical working Bedouins, while in 2002 findings show that the presence of the disease in the Bedouin community is significantly higher than in the Jewish sector and twice as much as any other peripheral group. In only 40 years, the Bedouins climbed all the way from the bottom, up to the top of the infamous list of type 2 diabetes risk groups.

Awareness is key, yet hard to find in the Bedouin community. We can see how lack of awareness is reflected in many Bedouin day-to-day habits, and by that, could drastically affect the failure of prevention and development of type 2 diabetes. Until recently, being diabetic was actually considered shameful in the Bedouin community. As a result, people actively avoided taking proper treatment. From a religious perspective, Bedouin women tend to stay at home, and avoid being seen in any open-air activity, even a casual stroll in the streets. These cultural-religious habits and others add to the risk of developing the disease, which with the proper awareness could improve the prevention and eventually lower the number of type 2 diabetes cases amongst Bedouins. But even when Bedouin diabetics do go to clinics to get medical care, many of them still refuse being treated with insulin, mostly due to the perceived shame of that act.
The Inner Doctor treatment (like genetic engineering) is an advanced, more difficult to understand and accept by the patient. Providing the Inner Doctor solution could be much complicated in a community that rejects a basic insulin treatment, or fails to understand the daily lifestyle that could lead to diabetes, all due to lack of information and awareness. Therefore, we understood that this fundamental obstacle has to be removed in order to have the Bedouin more open and willing to use our solution, more aware of the implications of diabetes and what causes it, and by that, take an action, first towards prevention, and second, by getting the right treatment if needed. This is the complete solution of the Inner Doctor.

We organized a seminar for 40 Bedouin students in medical professions, which received the knowledge and motivation to start taking action and raise awareness for Diabetes in their communities. The lectures we organized gave tools and inspired them to keep learning about this subject, and we also handed out brochures in Arabic for them to share within their social networks and communities. To make an everlasting effect, together with the Dean of Students Prof. Moshe Kaspi we successfully established scholarships (up to 70% of tuition) for 8 students who would volunteer in Diabetes Clinics in their communities: helping, treating and guiding patients, while learning themselves and gaining experience in the process. We also met with the CEO of the diabetes association in Israel Mr. Moti Peralmuter and arranged a scholarship: a position for a Bedouin student as the branch manager of the association in the southern Negev.

Finally, we met with the Director of BGU's School of Pharmacy in the Faculty of Health Sciences Prof. Riad Agbaria who was very enthusiastic about the seminar and said he would organize a similar one next year.  We received amazing feedback from the participants who learned so much and were extremely satisfied. We got great support from everyone who volunteered to help: university faculty members, medical professionals whether a Doctor, nutritionist, or a nurse, they all came and supported the cause on their day off. There was also a patient who came to tell his personal story dealing with Diabetes, and we couldn't have done it without a nursing student who helped make this day happened.

Balanced nutrition is a key factor in keeping a healthy lifestyle and inhibiting diseases, especially when talking about type 2 diabetes. In addition to our bio-engineered Inner Doctor, we set goals for a more complete solution. One that will include a treatment, but just as important, awareness for prevention steps of diabetes. With the corporation of the Israeli Diabetes Association and a local clinic in Rahat, we have organized a healthy cooking workshop and early detection glucose tests for Bedouins spouses. Rahat is the largest Bedouin city in the world, and above all reflects the massive Bedouin urbanization process. The women who attended the occasion all have at least one diabetic relative under their care.

During the workshop they got plenty of great tips on how to cook and consume healthily. With completion of the workshop, they all had the opportunity to be checked and diagnose their glucose level. It is important to understand that early diagnose is crucial, since once you get type 2 diabetes you cannot go back. 
A major goal for this day was to create a strong link between the clinic in Rahat and the Israeli Diabetes Association. That was gladly achieved as this day was announced to be an annual event from now on, which will continue promoting healthy cooking and early diagnose awareness long time after the iGEM 2014 competition will end.

It was important to us to learn about the Bedouin society and understand the causes for the high rate of diabetics in the community when compared to other sectors. Therefore, we have consulted with experts within the society itself and mapped the barriers for making a real change. We discovered a major problem of awareness, and lack of motivation to take action and save lives.

All the events that we organize had a goal of dealing with these barriers and set the ground for a more open-minded treatment (like our Inner Doctor) that might be implemented in the future. We wanted to avoid one-time events, and for that we involved potential partners along the way, who will be willing to continue the cooperation and execute more events long after the competition.