Hans Stevens (The Nederlands), Porto, October, 2016

Physician in a multicultural practice: “Profession, culture, religion / Le médecin dans une société multicultural: Profession, culture, religion / O médico numa sociedade multicultural; profissão, cultura e religião

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1.History of this physician

My life started in the catholic southern part of the Netherlands, just before the Second World War. At that time 50% of the population of the Netherlands was protestant, about 40 % was catholic. Especially in the private sector Protestants and Catholics were directed towards their proper community, institutions and clubs. Catholics had numerous organizations from the catholic hairdresser- school and swimming club to the catholic university. In a catholic region Catholicism did not only mean membership of a catholic parish but also being deeply embedded in the catholic way of life all over the Christian year. I tell you this in order to demonstrate the parallel with the way of life in other religions.

We believed in a holy Catholic Church. Everything, preached by the Holy Father, the bishops and the priests was sacred and not to be discussed. Criticism was not accepted. My strict catholic parents sent me to the catholic grammar school and I continued my education at the catholic university. My bride came from a strong catholic family and our children were baptised in the Catholic Church.

When I finished my medical studies my father, who was not a doctor, asked me: you are now a doctor, please tell me where in the body is located the most dangerous disease and what kind of people are the best people? The answer was: the most dangerous disease is situated high in your head, that means having big and arrogant ideas. The best kind of people are the common people. A good introduction to my practice.

2. Meeting other cultures

In 1965 I became a general practitioner, a family doctor in Arnhem, capital of a province in the eastern part of the country, a town destroyed during the battle of Arnhem in 1944 when the allied forces tried in vain to conquer the bridge on the river Rhine (“One bridge too far”). 50% of the population was protestant and 40% catholic, the average percentage in the country. I settled in a working class area and practised there during forty five years. I was faced with other religions and other cultures, which opened to me new perspectives and challenges and gave me a critical look at my church, for me a kind of personal enlightenment.

I was faced with numerous protestant patients. I discussed with protestant colleagues and I learnt that general doctrines in individual cases may need individual adjustment. I became more critical and more reticent about imposing my catholic convictions to Protestants and later to Catholics too. My attitude became: I listen to them, and I try to apply my catholic principles in so far they are reasonably applicable in the given individual situation.

In 1970 a caravan-camp was projected near my house, and I became the doctor for 500 caravan-dwellers and gipsies. They visited me twice as much as other people about their physical condition. Mental and neurotic complaints they kept inside their proper circle. After some years I was accustomed to them and they to me. After my retirement, these people are still very loyal and familiar to me.

Other migrants came from southern Europe: Sicilia and Sardinia and from Galicia in Spain. They gave no rise to big problems about integration. 50.000 people fled from Eastern Indonesia to the Netherlands, because of their endeavour to an independent state from Djakarta. In 1978 this group organised a terrorist attack, hijacking a train with a number of victims, but now forty years later they display sufficient integration. They work, are peaceful and have many pleasant connections in the Dutch society.

3. Islam

Presently most migration comes from muslim-countries. Because this immigration has more impact than the former migrations I will focus my lecture further on the history and the impact of the muslim immigration.

The Netherlands are a densely populated country: 35.000 square km and 17.000.000 inhabitants. Limiting the enormous post war increase of the population was inevitable. In the course of the seventies the first influence of birth control became visible. In the main harbours and industries arose a lack of workers and labourers. The entrepreneurs of the big companies discovered a new reservoir for workers in the less developed parts of Turkey and Morocco. These Turks and Moroccans were the forerunners of the massive immigration during the last years. The rich entrepreneurs welcomed the migrants but people of the poor quarters of the town, like my quarter, were left with migrants and refugees.

A specific group of Mediterranean medical problems were introduced, as the group of haematological problems like thalassaemia. Physicians had to pay more attention to infectious diseases, which became very rare in our country such as tuberculosis. But most problems arose in the field of communication and cultural differences.

During the last decades of the 20th century a number of problems with people from other cultures became manifest. The permanent character of this immigration lead to ideas about integration of the newcomers: migrants have to participate in the community, where they migrated to. Broadly speaking this integration was not successful.

The migrants from Turkey and Morocco came from less developed parts of their countries and in the modern western world they were faced with new aspects of culture, opposite to the values, they knew from their home country as the different position of women, the use of drugs, homosexuality, and different marriage and sexual morality. They felt uncertain about their sons and daughters and tried to keep hold of the unknown situation. They found certainty in their religion: the Islam. Islam is a strong conservative power for most of them, cherishing traditional family-life and protecting individuals and communities against the often enormous and destructive changes in the capitalist world. Rich Islamic countries provided enormous amounts of money for new mosques and for imams.

The western reaction towards the Islamic fundamentalism has always been characterized by disgust about Koran punishment as chopping of a hand in the case of theft. There is also anxiety about the intention of Muslims to conquer the world although the Koran only speaks about war to defend Islam.

The reception and support of the new migrants was insufficiently organized in the host country and the migrants got payments in such an easy way that it became very tempting to register a higher number of children than the reality in Turkey and Morocco. They tried to receive a higher family credit. This and other ways of malversation were not good for the integration of the migrants. In the Netherlands exists a high level of social securities. This is working like a magnet to people from poor countries but implies the danger of abuse, which stirred up bad feelings in the native people.

4. What is Islam?

Islam is a complete way of life with prescriptions and guidelines about religion, economy, commercial ethics and tax rates. About jurisprudence and punishment. About weights and measures. About politics, war and peace. About marriage, family, family life, succession and sexual relations inside the marriage. About care to animals and cattle. About clothing, way of greeting and hospitality.

According to Islam there is one eternal, charitable and almighty God: Allah. He is the Lord, everything, everybody and all mankind, belongs to him. He created the world and the end of the universe will come when he decides. The ending of the world will be followed by the Day of Judgement, when all people will rise from death and will be called to account. Then they will be sent to hell or to paradise for ever.

Allah announced this to all mankind by the way of a number of prophets, from Adam to the last prophet, Mohammed. The final message from Allah was given to the last prophet Mohammed and was written down in the Koran, which describes everything what people have to know and to do, in order to enter the paradise. The Koran is supposed to be dictated by Allah. The spreading of Islam has been based always upon the power and the simplicity of this religious conviction with emphasis upon punishment and reward in the hereafter. Therefor it is understandable why poor people in the Third World look for consolation and thinks of paradise after death.

5 The columns of Islam

The five ”Columns” of Islam are laying at the basis of the muslim way of life. I will mention shortly the main items:

1. There is no God but Allah. Muslims do not accept that Christians are seeing their prophet (Jesus) as the son of God. Allah is almighty. The Christian God is more a God of love.

2. The prophets are the unfallable envoys of Allah. Mohammed is the most important and also the last prophet. The last prophet has the last word. All the prophets are ending successful. Therefore Jesus cannot have died on the cross and was taken from the cross. Later Jesus will come back to the world.
3. Every uslim has to accept the Koran as the literal and unfallable word of Allah. Thora and Bible comprehend the words of Allah too, but in Thora and Bible errors have crept in. Islam accept the majority of the Thora and the Gospel, but in the case of difference with the Koran, the Koran will have the priority.
4. Muslims living above the economical bare minimum must pay a kind of tax in order to alleviate the needs of the poor. The Koran forbids a bureaucracy to collect these taxes. Everybody pays from his sense of duty but that is open to different interpretation.

5. Muslims have to fast during Ramadan. Ramadan implies no eating, no drinking, no smoking and no sexual intercourse from sun rise to sunset. Viewed in the light of promoting health care, Ramadan gives more physical problems than the Christian Lent.
6. Jihad, the saint war. Muslims must have the zeal permanently to help a Muslim brother who is hampered to put Islam in practice. But most Muslims are no terrorist. The terrorist Muslims do not realize how poignant and dangerous their actions will influence the atmosphere between Islam and other people and religions.

6. Meeting Muslims

I will tell you two stories.

In our home a cleaning woman worked during twelve years. She started at the age of 28, was a Muslim woman from rural Turkey. She divorced, and lived together with a sun (12 years old) and a daughter (6 years). During the evening she studied child care and by self-education she received all certificates. She got a job and continued also working in our home. She was well-integrated in our society. She always assisted our house-parties and got much appreciation from our guests. Her son Mehmet came and helped me every Saturday cleaning my car and working in my garden. I often discussed with him and many years later he thanked me for having a share in his education. We spoke about Muslim tradition too and he gave me much information about the Muslim way of life. Unfortunately his school results were poor and he got a job under his intellectual level at the age of 22. In spite of his Dutch way of life, on the work floor Mehmet was called disdainfully: “You, Turk”. He felt being not accepted. He came and told me that he wanted to return to Turkey, together with a Dutch friend. This friend converted to Islam, grew a beard and changed his name from Alexander to Samir. On the way to Turkey they would visit some mosques. I got some mistrust about radicalism. Fortunately Mehmet got a bride and a good job in Turkey and did not radicalize. His mother and sister lost the father figure in the family. The daughter got psychotic and the only therapy seemed following her brother Mehmet to Turkey. Mother was left alone. Later she returned to rural Turkey too. A well started but finally unsuccessful integration.

Another story.

An aged Turk asked me to visit him at home because of pneumonia. He apologized that he asked me coming to him. I replied: “Do not worry, in the Netherlands we have an innocent proverb: when the mountain cannot come to Mohammed, Mohammed will go the mountain.” He answered: Doctor, do not say ever more the name of our prophet”. I apologized and we were friends again. Two weeks later a young Moroccan consulted me because of low belly pain at the right side. During the medical examination I touched the painful spot and he jumped up and cried: “Jesus Christ”. I answered: “I do not continue the consultation. I am not permitted to say the name of your prophet, and you cry the name of my prophet.” He startled and said: “Everybody in this country speaks so, but I apologize”. My answer: “OK, we continue this consultation”. This was a lesson for me, we, Christians have to speak with more respect the name of our prophet, our teacher. We may learn from Islam being more respectful.

7. Some conclusions

1. A compromise between Islam and Christianity is not possible without elementary change and adaptation of the present-day theology of both religions. Islam up to now did not accept the Enlightenment. Christianity has to consider Islam as equivalent and has to reflect on its principles.

2. Cultural differences between the Christian churches have to be respected but a growing unity of the Christian churches is a must. A divided Christian world cannot be a partner in dialogue with Islam. In speaking about re-evangelization this voice is hardly heard. Re-evangelization cannot mean a return to the former tracks.
3. The rich Europe may not expect that the migration stream from poor countries outside Europe will diminish. At best the stream will be regulated.
4. The future for our children and grandchildren has to be a future of respectful living together, giving the idea of being welcome to a well-regulated number of immigrating people. We have not to be pessimistic, most immigration in history ended well.