MENGENAL KANKER

Asal Muasal Kanker

Kanker menjadi momok bagi semua orang, hal ini karena angka kematian akibat kanker yang sangat tinggi. Tidak hanya di Indonesia melainkan juga di berbagai Negara. Di Amerika, kanker merupakan penyebab kematian nomor dua. Pada tahun 2003 diperkirakan ada 1.334.100 kasus dengan angka kematian sebanyak 556.500 orang. Sedangkan di Eropa terdapat tiga juga kasus kanker baru tiap tahun dengan angka kematian sebesar dua juta. Angka harapan hidup penderita kanker hanya 60% dibandingkan dengan bukan penderita.

Mengapa kanker menjadi sangat menakutkan dan membahayakan? Apa sebenarnya kanker itu?

Kanker adalah suatu kondisi dimana sel telah kehilangan pengendalian dan mekanisme normalnya, sehingga mengalami pertumbuhan yang tidak normal, cepat dan tidak terkendali. Sel-sel kanker akan terus membelah diri, dan tidak mengindahkan kaidah hokum-hukum pembiakan. Kanker bisa terjadi dari berbagai jaringan dalam berbagai organ, seperti sel kulit, sel hati, sel darah, sel otak, sel lambung, sel usus, sel paru, sel saluran kencing, dan berbagai macam sel tubuh lainnya. Sejalan dengan pertumbuhan dan perkembangbiakannya, sel-sel kanker membentuk suatu massa dari jaringan ganas yang menyusup ke jaringan di dekatnya (invasif) dan bisa menyebar (metastasis) ke seluruh tubuh.

Sel-sel kanker dibentuk dari sel-sel normal dalam suatu proses rumit yang disebut transformasi , yang terdiri dari tahap inisiasi dan promosi . Pada tahap inisiasi terjadi suatu perubahan dalam bahan genetik sel yang memancing sel menjadi ganas. Perubahan dalam bahan genetik sel ini disebabkan oleh suatu agen yang disebut karsinogen, yang bisa berupa bahan kimia, virus, radiasi (penyinaran) atau sinar matahari. Tetapi tidak semua sel memiliki kepekaan yang sama terhadap suatu karsinogen. Kelainan genetik dalam sel atau bahan lainnya yang disebut promotor , menyebabkan sel lebih rentan terhadap suatu karsinogen. Bahkan gangguan fisik menahunpun bisa membuat sel menjadi lebih peka untuk mengalami suatu keganasan. Pada tahap promosi , suatu sel yang telah mengalami inisiasi akan berubah menjadi ganas. Sel yang belum melewati tahap inisiasi tidak akan terpengaruh oleh promosi. karena itu diperlukan beberapa faktor untuk terjadinya keganasan (gabungan dari sel yang peka dan suatu karsinogen). Pada saat sebuah sel menjadi ganas, sistem kekebalan tubuh sering dapat merusaknya sebelum sel ganas tersebut berlipatganda dan menjadi suatu kanker.

Namun apabila system kekebalan tubuh tidak berfungsi secara normal, maka tubuh cenderung rentan terhadap resiko kanker, seperti yang terjadi pada penderita aids, orang-orang yang menggunakan obat penekan kekebalan dan pada penyakit autoimun tertentu. Tetapi sistem kekebalan tubuh pun tidak selalu efektif, sehingga kanker kadangkala masih dapat menembus perlindungan ini meskipun sistem kekebalan berfungsi secara normal.
Pada hampir semua jenis kanker, angka keberhasilan terapi sangat berkaitan dengan stadium saat diagnosa dan pengobatan. Semakin tinggi stadium saat diagnosa, maka keberhasilan terapi akan semakin menurun dengan modalitas pengobatan yang semakin agresif.

Faktor Resiko Kanker

Telah diketahui bahwa sekumpulan faktor genetik dan lingkungan dapat meningkatkan resiko terjadinya kanker. Faktor-faktor yang dapat meningkatkan resiko tersebut antara lain adalah :

1. Riwayat Keluarga.

Riwayat keluarga adalah salah satu faktor yang paling penting mengingat kanker bisa dipengaruhi oleh kelainan genetika. Beberapa keluarga bisa jadi memiliki resiko lebih tinggi untuk menderita kanker tertentu bila dibandingkan dengan keluarga lainnya, misalnya resiko wanita untuk menderita kanker payudara meningkat 1,5-3 kali jika ibunya atau saudara perempuannya menderita kanker payudara.

Beberapa kanker payudara berhubungan dengan suatu mutasi genetik yang khas, yang lebih sering ditemukan pada beberapa kelompok etnik dan keluarga. Wanita dengan mutasi gen ini memiliki peluang sebesar 80-90% untuk menderita kanker payudara dan 40-50% untuk menderita kanker indung telur, misalnya seperti yang ditemukan pada 1% wanita yahudi ashkenazi. Kanker lainnya yang cenderung diturunkan dalam keluarga adalah kanker kulit dan kanker usus besar.

2. Kelainan Kromosom.

Misalnya seseorang dengan sindroma down , yang memiliki 3 buah kromosom 21, memiliki resiko 12-20 kali lebih tinggi untuk menderita leukemia akut.

3. Faktor Lingkungan.

Sejumlah faktor lingkungan dapat meningkatkan resiko terjadinya kanker, salah satunya yang paling penting adalah merokok. Merokok meningkatkan resiko terjadinya kanker paru-paru, mulut, laring (pita suara) dan kandung kemih. Faktor lingkungan lain misalnya pemaparan yang berlebihan dari sinar ultraviolet, terutama dari sinar matahari, menyebabkan kanker kulit.

Selain itu, radiasi ionisasi (yang merupakan karsinogenik) yang digunakan dalam sinar x, dihasilkan dari pembangkit listrik tenaga nuklir dan ledakan bom atom dan bisa menjangkau jarak yang sangat jauh, juga dapat meningkatkan resiko terjadinya kanker.

Misalnya orang yang selamat dari bom atom yang dijatuhkan di Hiroshima dan Nagasaki pada perang dunia II, memiliki resiko tinggi terhadap terjadinya leukemia. Pemaparan uranium pada pekerja tambang juga meningkatkan resiko terjadinya kanker paru-paru 10-20 tahun kemudian, dan resiko tersebut akan semakin tinggi jika para penambang juga merokok.

4. Makanan.

Makanan adalah faktor resiko penting lainnya untuk kanker, terutama kanker pada saluran pencernaan. Misalnya makan makanan yang banyak mengandung makanan yang diasap dan diasamkan (dalam bentuk acar) dapat meningkatkan resiko terjadinya kanker lambung. Peminum alkohol juga memiliki resiko yang lebih tinggi terhadap terjadinya kanker kerongkongan. Bila seseorang makan makanan yang tinggi serat, maka dapat mengurangi kemungkinan terjadinya kanker usus besar.
Mengurangi lemak sampai kurang dari 30% dari kalori total, akan mengurangi resiko terjadinya kanker usus besar, payudara dan protat.

5. Bahan Kimia.

Banyak bahan kimia yang diketahui menyebabkan kanker dan banyak pula lainnya yang dicurigai sebagai penyebab kanker. Pemaparan terhadap bahan kimia tertentu dapat meningkatkan resiko terjadinya kanker setelah beberapa tahun kemudian, misalnya pemaparan asbes bisa menyebabkan kanker paru-paru dan mesotelioma (kanker pleura ), dan kanker kulit banyak ditemukan pada pekerja cat dan pekerja yang membersihkan cerobong asap karena adanya kandungan senyawa hidrokarbon.

6. Tempat Tinggal.

Resiko terjadinya kanker juga bervariasi berdasarkan tempat tinggal seseorang. Misalnya, resiko terjadinya kanker usus besar dan payudara di Jepang rendah, tetapi resiko ini meningkat pada orang-orang Jepang yang tinggal di Amerika dan pada akhirnya akan memiliki resiko yang sama besarnya dengan penduduk Amerika lainnya. Uniknya lagi, orang Jepang memiliki angka kejadian kanker lambung yang sangat tinggi; tetapi pada orang Jepang yang lahir di Amerika angka ini lebih rendah. Variasi geografik dalam resiko kanker ini agaknya melibatkan banyak faktor, yaitu gabungan dari genetik, makanan dan lingkungan.

7. Virus.

Beberapa virus diketahui menyebabkan kanker pada manusia dan virus lainnya dicurigai sebagai penyebab kanker. Virus penyebab kanker ini disebut juga virus onkogenik. Misalnya, virus papilloma yang menyebabkan kutil genitalis agaknya merupakan salah satu penyebab kanker leher rahim pada wanita, virus sitomegalo menyebabkan sarkoma Kaposi, virus hepatitis B dan hepatitis C bisa menyebabkan kanker hati, meskipun karsinogen ataupun promotor-nya tidak diketahui.

Di Afrika, virus Epstein-Barr menyebabkan limfoma burkit, sedangkan di Cina virus ini menyebabkan kanker hidung dan tenggorokan. Jelas terlihat, bahwa beberapa faktor tambahan (lingkungan atau genetik), diperlukan untuk terjadinya kanker yang disebabkan oleh virus Epstein-Barr. Beberapa virus retro manusia, misalnya virus HIV, dapat menyebabkan limfoma dan kanker darah lainnya.

8. Infeksi.

Infeksi oleh parasit schistosoma (bilharzia) bisa menyebabkan kanker kandung kemih karena terjadinya iritasi menahun pada kandung kemih. tetapi penyebab iritasi menahun lainnya tidak menyebabkan kanker. Infeksi oleh clonorchis, yang terutama banyak ditemukan di timur jauh, bisa menyebabkan kanker pankreas dan saluran empedu.

9. Hormon.

Hormon adalah zat yang dihasilkan oleh kelenjar tubuh yang berfungs mengatur kegiatan alat-alat tubuh. Diethyl stilbestrol, suatu hormon seks buatan yang umumnya digunakan untuk menggemukkan hewan ternak, terbukti sebagai penyebab timbulnya kanker rahim, payudara, dan alat reproduksi lainnya. Pada beberapa penelitian, diketahui bahwa pemberian hormon tertentu secara berlebihan dapat menimbulkan kanker pada organ tubuh yang dipengaruhinya, seperti payudara, rahim, indung telur dan prostat. Pengaruh hormone sehingga dapat menyebabkan kanker belum dapat diketahui dengan pasti. Epidemiologi Kanker Sejalan dengan waktu, resiko kanker juga mengalami perubahan. Kanker yang tadinya sering ditemukan sekarang jarang terjadi. Misalnya di Amerika, pada tahun 1930 kanker lambung 4 kali lebih sering ditemukan daripada sekarang.

Sementara itu angka kejadian kanker paru-paru di Amerika yang pada tahun 1930 adalah 5 dari setiap 100.000 orang meningkat menjadi 114 dari setiap 100.000 pada tahun 1990, dan angka kejadian ini melambung tinggi pada wanita. Perubahan ini hampir bisa dipastikan merupakan akibat dari meningkatnya pemakaian rokok, tak terkecuali pada wanita. Merokok juga menyebabkan meningkatnya kanker mulut. Pada sebuah penelitian epidemiologik tentang penyakit kanker, diperkirakan akan terjadi peningkatan 99% penderita pada tahun 2010 di negara berkembang dibandingkan pada tahun 1985. Sedangkan di negara maju, peningkatan jumlah penderita diperkirakan hanya 38%. Hal ini menunjukkan bahwa penyakit kanker menjadi masalah yang serius di negara berkembang di masa mendatang. Di Indonesia, masalah penyakit kanker terlihat lonjakan yang luar biasa. Dalam jangka waktu 10 tahun, terlihat bahwa peringkat kanker sebagai penyebab kematian naik, dari peringkat 12 menjadi peringkat enam. Setiap tahun diperkirakan terdapat 190 ribu penderita baru dan seperlimanya akan meninggal akibat penyakit ini. Namun angka kematian akibat kanker ini sebenarnya bisa dikurangi 3-35 persen, asal dilakukan tindakan prevelensi, screening dan deteksi dini. Misalnya dengan melakukan tes pap smear bagi wanita yang telah aktif secara seksual dapat menurunkan angka kematian kanker mulut rahim. Sebagai catatan, bila seseorang wanita penderita kanker divonis bahwa penyakit kankernya masuk dalam kategori stadium satu, maka harapan hidup lima tahun ke depan akan mencapai 90 persen. Stadium dua, 65 persen, stadium tiga, 15-20 persen, dan stadium empat harapan hidupnya hanya kurang dari lima persen. Usia juga merupakan faktor yang penting dalam terjadinya kanker. Beberapa kanker, misalnya tumor wilms, leukemia limfositik akut dan limfoma burkitt, banyak menyerang usia muda. Tetapi sebagian besar kanker banyak terjadi pada usia lanjut. Kanker prostat, lambung dan usus besar, kemungkinan besar terjadi setelah usia 60 tahun. Di Amerika, lebih dari 60% dari kanker terdiagnosis pada penderita yang berusia diatas 65 tahun.secara keseluruhan, resiko terjadinya kanker di Amerika meningkat 2 kali lipat setiap 5 tahun setelah usia 25 tahun. Meningkatnya resiko kanker pada usia lanjut mungkin merupakan gabungan dari meningkatnya dan bertambah lamanya waktu pemaparan terhadap karsinogen serta makin melemahnya sistem kekebalan tubuh akibat usia.
Selalu 'Waspada' Semakin dini kanker ditemukan, semakin besar pula harapan kesembuhan. Kenalilah dan perhatikan tujuh tanda bahaya dalam WASPADA.

Periksakan diri lebih lanjut ke dokter bila ada salah satu tanda di bawah ini yang tidak sembuh dalam beberapa minggu.

Tanda-tanda yang harus diperhatikan dan disingkat menjadi WASPADA adalah :

W : Waktu buang air besar atau kecil ada perubahan kebiasaan atau gangguan.
A : Alat pencernaan terganggu dan susah menelan.
S : Suara serak atau batuk yang tak sembuh-sembuh.
P : Payudara atau di tempat lain ada benjolan.
A : Andeng-andeng (tahi lalat) yang berubah sifatnya, menjadi semakin besar dan gatal.
D : Darah atau lendir yang abnormal keluar dari tubuh.
A : Adanya koreng atau borok yang tak kunjung sembuh.

Pada stadium dini, kanker tumbuh tanpa menimbulkan keluhan ataupun gejala. Hal ini sering menyebabkan orang yang sudah terkena kanker tidak menyadarinya. Bila sudah timbul gejala atau memberi keluhan, biasanya penyakit sudah berlanjut. Oleh sebab itu, bila teraba ada benjolan atau kelainan lain seperti ditemukan dalam WASPADA walaupun rasanya tidak mengganggu, perlu diwaspadai dan dicurigai sebagai kanker sampai terbukti kalau hal itu bukan kanker.

Penghematan Sumber Daya Alam

Sumber Daya Alam (SDA) adalah segala sasuatu yang ada di alam ini yang dapat digunakan untuk berbagai keperluan kehidupan manusia. SDA dapat memiliki berbagai macam bentuk, seperti SDA pertanian, SDA pertambangan, dll. Kebanyakan dari SDA itu merupakan SDA yang tidak dapat diperbaharui. Ini menandakan bahwa jika kita terus menerus menggunakan SDA secara berlebihan maka SDA tersebut akan cepat habis. Tetapi yang menjadi fenomena baru sekarang adalah terjadinya kelangkaan SDA air, padahal air merupakan SDA yang dapat diperbaharui. Kelangkaan air bersih bisa kita lihat di daerah gunung Kidul. Warga di sana sangat kesulitan mencari air bersih. Hal ini juga terjadi di beberapa tempat lain dikarenakan adanya pencemaran pada air sehingga air tidak dapat digunakan untuk kehidupan. Selain kelangkaan air bersih, masih banyak lagi kelangkaan SDA lain yang terjadi seperti munyak tanah, gas LPG, dll. Untuk menghindari kelangkaan SDA yang setiap waktunya semakin banyak, kita harus pintar-pintar menghemat. Jangan karena merasa air itu murah dan tidak perlu bayar (yang menggunakan sumur, kalau make PAM bayar), msks kita menggunakannya dengan berlebihan. Keran air terus menyala padahal sedang tidak menggunakan air. Tentunya itusangat boros bukan? Begitu juga dengan penggunaan bahan bakar minyak. Kita sebaiknya memilih kendaraan umum karena dengan menggunakan kendaraan umum, secara tidak langsung, kita ikut menghemat SDA. Penghematan SDA sangat penting karena suatu saat nanti, kita akan mewariskan bumi ini pada anak, cucu, atau cicit kita. Jika kita tidak menghemat dan menghabiskannya sekarang, anak cucu cicit kita yang akan menderita pada kehidupannya nanti. Mereka akan kesulitan untuk memenuhi kebutuhan hidupnya. Kita harus menyadari bahwa kita hidup sekarang ini bukan untuk menggunakan SDA, kita hidup untuk menjaga agar SDA ini tetap dapat digunakan oleh anak cucu kita yang aklan mewarisi bumi ini.

Untuk menghemat SDA sebenarnya tidak sulit, hanya sekali lagi yang perlu diutamakan adalah niat. Jika kita memang berniat untuk menghemat, kita akan melakukannya. Tetapi jika kita malasa dan tidak ada niat, kita akan menggunakannya secara boros. Ini bergantung dari dirri kita sendiri. Untuk menumbuhkan niat diperlukan kesadaran. Untuk menumbuhkan kesadaran perlu adanya pendidikan. Jika kita mendidik anak-anak kita yang masih kecil untuk berhemat SDA, maka kelak pada saat dewasa nanti anak-anak itu akan memiliki kesadaran akan pentingnya berhemat.

Pencairan Es Di Bumi

Pada permukaan gletser di Greenland, terdapat celah-celah yang mencapai dasar gletser. Es yang mencair akan menjadi air dan masuk ke celah-celah gletser ini. Air yang masuk ke celah-celah ini kemudian membeku. Air yang membeku memiliki volume yang lebih besar daripada saat bentuk cair sehingga air yang membeku ini mendorong es disekitarnya dan membuat gletser di Greenland pecah.

Antartika dikhawatirkan mencair
seluruhnya karena Global
Warming

Para ilmuwan merasa kesulitan untuk mencegah hal ini karena untuk menghentikan pencairan ini, maka harus menghentikan pemanasan global. Untuk itu dunia sedang mengusahakan pengurangan emisi gas buang dari perindustrian terutama dari negara-negara maju. Selain di Greenland, Antartika juga semakin terancam oleh pemanasan global. Proses pencairan es di Antartika berlangsung lebih cepat karena seluruh permukaan antartika merupakan es tidak seperti di Greenland.

Hal ini menyebabkan bertambahnya kecepatan pencairan dikarenakan sifat es yang lainnya, yaitu es lebih mudah bergerak di atas permukaan cair dibandingkan di atas permukaan padat. Di Greenland, gletser berada di atas permukaan padat, tetapi di antartika es langsung berada di atas air. Es yang berada di atas air mengalami gerakan yang lebih cepat dibandingkan es yang berada di atas permukaan padat. Ini menambah faktor yang menyebabkan es pecah. Jika es di antartika pecah, maka balok es raksasa akan terapung di laut dan mengalami pencairan lebih cepat karena volumenya lebih kecil.

Kurang Tidur & Resiko Kanker !

Olahraga secara rutin dapat mengurangi resiko kanker pada perempuan, tapi manfaat itu bisa luput jika perempuan tersebut tidur terlalu sedikit, kata beberapa peneliti AS, Senin (17/11). Studi yang melibatkan 5.968 perempuan di Maryland mengkonfirmasi temuan sebelumnya, bahwa orang yang melakukan kegiatan fisik rutin menghadapi resiko lebih kecil untuk terserang kanker.

Tetapi ketika para peneliti itu meneliti perempuan yang berusia 18 hingga 65 tahun yang rajin berolah raga setiap pekan, mereka mendapati bahwa tidur tampaknya memainkan peran penting dalam resiko kanker.
Orang yang tidur kurang dari tujuh jam setiap malam menghadapi resiko 47 persen untuk terserang kanker dibandingkan dengan mereka yang tidur lebih banyak di antara perempuan yang aktif secara fisik, demikian laporan para peneliti itu dalam pertemuan American Association for Cancer Research.

“Kami kira itu sangat menarik dan membangkitkan rasa ingin tahu. Ini seperti pertama kali melakukan penelitian. Itu bukan sesuatu yang telah dikaji secara luas,” kata Jame McClain dari National Cancer Institute, bagian dari National Institute of Health pemerintah, dalam suatu wawancara telepon.

McClain, yang memimpin studi tersebut, mengatakan tidak jelas bagaimana sesungguhnya tidur terlalu sedikit mungkin membuat orang lebih rentan terhadap kanker. “Tidur secara cukup telah lama berhubungan dengan kesehatan,” kata McClain.

U.S. Centers for Disease Control and Prevention (CDC) menyebut kurang tidur sebagai masalah kesehatan masyarakat yang tak diperhatikan, dan menyatakan orang Amerika kian kurang tidur. CDC menyatakan persentase orang dewasa yang melaporkan tidur selama enam jam atau kurang per malam meningkat dari 1985 hingga 2006.
Para ahli mengenai tidur mengatakan kekurangan tidur kronis berkaitan dengan kegemukan, diabetes, tekanan darah tinggi, stroke, penyakit jantung dan pembuluh darah, depresi, menghisap rokok dan minum secara berlebihan.

Selain itu, penelitian telah memperlihatkan bahwa orang yang berolah raga secara rutin menghadapi resiko lebih rendah kanker payudara, usus besar dan jenis kanker lain. Banyak ahli berpendapat dampak olah raga pada tingkat hormon tubuh, fungsi kekebalan dan berat tubuh mungkin memainkan peran penting.

Gregg Ends Bid for Commerce Job

Senator Judd Gregg withdrew his nomination for commerce secretary during a news conference on Capitol Hill on Thursday.

WASHINGTON — Senator Judd Gregg of New Hampshire abruptly withdrew Thursday as the nominee for commerce secretary, saying he had “irresolvable conflicts” with President Obama over his economic stimulus plan and a concern over what many fellow Republicans believe is the politicization of the 2010 census.

The departure of Mr. Gregg is the latest setback to a White House that has struggled to fill several top positions and to fulfill Mr. Obama’s pledge of building a bipartisan administration. He is the third prospective cabinet secretary — the second for the Commerce Department — to remove his name from consideration.

“I’m a fiscal conservative, as everybody knows, a fairly strong one,” Mr. Gregg told reporters at a news conference in the Capitol. “And it just became clear to me that it would be very difficult, day in and day out, to serve in this cabinet or any cabinet.”

“It was my mistake, obviously, to say yes,” he added.

But the political fallout is left to the White House, which now has a string of appointees who have stepped aside over vetting problems, unpaid taxes or philosophical differences with Mr. Obama. Since the president took office last month, not a week has passed without the White House responding to a personnel crisis.

Mr. Gregg said he alerted Mr. Obama to his decision “several days ago,” but administration officials said the senator’s withdrawal had taken them off guard.

The White House sought to contain the political fallout, issuing a terse statement and pointing out that Mr. Gregg had said he would “support, embrace and move forward with the president’s agenda.”

Mr. Obama, traveling in Illinois, told reporters that he had spoken to Mr. Gregg on Wednesday but that he did not know he planned to withdraw until Thursday. He said that the senator had had a “change of heart” and that he intended to keep his pledge of a bipartisan cabinet.

“I am going to keep working at this,” said Mr. Obama, adding that the American people were “desperate” for Democrats and Republicans to work together.

Mr. Gregg would have been the third Republican in the cabinet. The others are Defense Secretary Robert M. Gates and Transportation Secretary Ray LaHood.

Senator Judd Gregg withdrew from consideration to be Commerce Secretary during a press conference on Capitol Hill on Thursday.

The appearance by Mr. Gregg at his news conference in the Capitol was one of the few he had made in public all week. Senators assumed that he was preparing for his confirmation hearings, but he was huddled with his wife, Kathy, and a small circle of advisers trying to determine how he could undo his decision last week to join the Obama administration.

Mr. Gregg did not vote on the administration’s $789 billion economic stimulus plan the first time it came up in the Senate. He declined to tell reporters on Thursday how he would vote when the bill came up for final passage, but he expressed his disagreement with the policy by criticizing the plan in his withdrawal statement.

“It has become apparent during this process,” Mr. Gregg said, “that this will not work for me, as I have found that on issues such as the stimulus package and the census, there are irresolvable conflicts for me.”

“We are functioning,” he added, “from a different set of views on many critical items of policy.”

The White House signaled last week that it would exert greater control over the Census Bureau, in part because of a concern among minority groups over Mr. Gregg’s leading the Commerce Department. Then, in response to complaints by Republicans, the administration said that it would work closely with the director of the census, but that the census would not be under the direction of the White House.

The Senate majority leader, Harry Reid, Democrat of Nevada, had recommended Mr. Gregg for commerce secretary. The White House accepted Mr. Reid’s suggestion, in part, because the president had said he wanted his cabinet to be filled with a variety of viewpoints.

Senator Judd Gregg withdrew his nomination for commerce secretary during a news conference on Capitol Hill on Thursday.

Mr. Gregg praised Mr. Obama for this in his news conference. “He has been a person who has reached out and aggressively reached out, across the aisle,” the senator said. “And I immensely respect that, and I immensely respect him.”

The roster of fallen cabinet nominees also includes Tom Daschle, who stepped aside last week as the nominee for health and human services secretary because of questions about unpaid taxes, and Gov. Bill Richardson of New Mexico, who withdrew from consideration as commerce secretary because of an investigation into state contracts.

Senator Judd Gregg with President Obama and Vice President Biden at the White House on Feb. 3, when his nomination was announced.

Mr. Obama’s choice for chief performance officer, Nancy Killefer, pulled her name from consideration because of unpaid payroll taxes for a household employee. Gen. Anthony C. Zinni was offered the position of ambassador to Iraq, but the opportunity was retracted.

Mr. Gregg will remain in the Senate and said he would help Mr. Obama accomplish some pieces of his agenda, like reworking Social Security. “I do believe, genuinely, that I can be even more effective for this presidency in the Senate,” Mr. Gregg said.

Mr. Gregg added that he would not seek re-election to a fourth term in 2010, making him the fifth Republican senator to announce plans to retire next year.

Rahm Emanuel, the White House chief of staff who had been a strong proponent of Mr. Gregg’s nomination, sought to play down his decision to withdraw. “It is better that it happened now,” Mr. Emanuel said, “than when you have someone in the government.”

Among the responsibilities facing the next commerce secretary is oversight of the government’s multibillion-dollar rescue of the Detroit automakers Chrysler and General Motors.

Senator John D. Rockefeller IV, a West Virginia Democrat who is the chairman of the Commerce Committee, said he wished that Mr. Gregg had “thought through the implications of his nomination more thoroughly before accepting this post.”

Later in the day, Mr. Gregg said the census had been “only a slight issue” in his decision to withdraw. But the census has been a major issue between Republicans and Democrats for years, and Mr. Gregg has been involved in the dispute. A decade ago, he resisted efforts by President Bill Clinton to increase financing for the 2000 census.

In recent days, Republicans have been upset by suspicions that the Obama administration sought to assert more direct control over the census, a prospect they called troubling given that the president’s chief of staff, Mr. Emanuel, is a former Democratic congressman who helped his party win a majority in the House.

“We respectfully request that you reconsider and reverse your administration’s plans to transfer control of the Census Bureau and the 2010 census to the White House staff,” the House Republican leader, John A. Boehner of Ohio, wrote Thursday in a letter to the president.

The census has huge implications social and political. It is used to distribute federal money to states and cities based on population, and to redraw Congressional districts — determining how many seats in the House that growing states will pick up at the expense of states with relatively stagnant populations.

White House officials said they did not have any leading contenders for commerce secretary. It could be difficult, they feared, to attract a strong candidate who would be the third person selected for the post.

The administration did have one key position filled Thursday when the Senate, by voice vote, confirmed Leon E. Panetta to run the Central Intelligence Agency.

Jackie Calmes and David Stout contributed reporting from Washington, and Helene Cooper from East Peoria, Ill.

By : Jeff Zeleny Published on : February 12, 2009

A version of this article appeared in print on February 13, 2009, on page A1 of the New York edition.

Re-Published By : The Author

How does Allergic Rhinitis related to Otitis Media with Effusion (OME)

Otitis media is an inflammation that occurs in the middle ear. Middle ear space contains fluid that could be easily infected and the infected middle ear is called otitis media with effusion. The cause of the chronic OME (otitis media with effusion) for most of the allergic rhinitis patients is mainly due to the IgE-mediated allergies. IgE-mediated allergy is the allergy that happens when IgE antibody (one type of the white blood cell) binds with the mast cell. IgE antibody is being produced by the plasma cell when foreign particular from outside of the body entering into the blood through nasal mucosal surface. Once the IgE antibody binds with the mast cell around the nose, histamine is secreted from this cell and it is the main chemical that causes itching and hypersensitive of the nose. According to the publication by a group of scentists, 50% of the children who had chronic OME also had nasal allergy [Acta Otolaryngol (Stockh) 1988;458(suppl):41-7]. Effects of the seasonal allergic rhinitis to the Eustachian tube function and middle ear pressure had been studied by a few groups of medical scientists. According to one of the studies, Eustachian tube of the pollen allergic patients become obstructed increases from 15% to 60% from the starting to the maximum of the pollen exposure. [Ann Allergy 1990;65:206-10]. In one of the studies, ragweed pollen , which is a seasonal pollen, was let it exposed to a group of people. What had been discovered is that it will cause immune reactions in the Eustachian tube and nose [Am J Rhinol 1988;2:155-61.].Apart from this study, the other study reported that house-dust mite, which was a perennial allergen, also caused Eustachian tube obstruction [ ArchOtolaryngol Head Neck Surg 1986;112:840-]. In the same study, they found out that 55% of the adults, who had nasal allergy, experienced the development of the Eustachian tube dysfunction when this group of adult was exposed to house-dust mite. In the following study, new thing that had been found out was Eustachian tube obstruction happened more frequently for the patients who had allergic rhinitis. [J. Allergy Clin Immunol 1987;79:27-31]. In allergen provocation studies, scientist found out that nasal obstruction usually occurred before the development of the Eustachian tube obstruction. In allergen provocation study, individuals who took part in this study were exposed to allergen to provoke their nasal allergy symptom. In this study, researchers also discovered that various of inflammatory mediators such as histamine have been detected in middle ear effusions of the children who had OME [Arch Otolaryngol Head Neck Surg 1988;114:1131-3]. If Eustachian tube obstruction that was caused by perennial exposure to allergen such as house-dust mite was left it untreated for quite a sometime, it could form middle ear disease, especially, when priming phenomenon occurs in the Eustachian tube. Priming phenomenon happens when mucosa in the organ responds to lower doses of allergen with repeated exposure. Allergic rhinitis could have priming phenomenon too when the mucosa in the nasal passage responds to low amount of allergen that has been inhaled through the nostril. For the Eustachian tube obstruction that was caused by seasonal exposure to allergen such as ragweed pollen, its physiologic hyperresponsiveness could extend beyond the ragweed season.

Studies show that half of the newly occurrence otitis media are diagnosed immediately after patient had been infected by viral URTI (virus that causes flu and common cold). By using traditional standard culture techniques, it is quite rare that viruses could be isolated from the middle ear effusions in the patient with otitis media. However, with the newly developed PCR-based molecular analysis, viruses in the middle ear effusions could be detected and discovered that 53% of the middle ear effusions are positive for viruses [J Infect Dis 1995;172:1348-51]. An experimental, which was carried out by infecting real human with rhinovirus-39, had been carried out in Children’s Hospital of Pittsburgh to study the effect of this virus to the middle ear pressure and Eustachian tube. Result of this experiment showed a substantial increase of Eustachian tube dysfunction and also abnormal middle ear in approximately 30% of the people who had been infected in this study. However, all these people who had been infected by this virus had less possibility to develop an otitis media disease. In another study, where influenza A virus was intranasally inoculated to a group of peoples, 59% of the inoculated people experienced the development of middle ear under pressure and only 25% of these people developed otitis media [J Infect Dis 1995;172:1348-51]. In this study, one of the inoculated people developed middle ear under pressure followed by purulent otitis media. This patient middle ear effusion was taken for PCR analysis and it showed positive result for both influenza A and Streptococcus Pneumoniae. Streptococcus Pneumoniae is some kind of spherical, Gram-positive, alpha-hemolytic bacterium and it is a member of the genus Streptococcus. In this group of inoculated people, 80% of them who had infected by this virus experienced the development of Eustachian tube dysfunction and 80% of them had middle ear under pressure [Ann Otol Rhinol Laryngol 1994;103:59-69]. With this group of infected people, five of them had developed OME on the 4th day after the viral exposure. One of the patients had dizziness and vertigo symptoms, which is mainly due to the inner ear malfunction. All these studies support the causes of otitis media by URTIs virus and causes of otitis media starting from the development of Eustachian tube obstruction and abnormal middle ear pressure. In the recent publication about the study of a group of children with acute otitis media, micro-organisms in the fluids of the middle ears of the children were isolated by the investigator of this study. They found out that 65% of the fluid samples that had been collected contained both bacteria and viruses. These results show that virus infection in the middle ear creates an environmental that is suitable for the breeding of bacteria. [N Engl J Med 1999;340:260-4].

Based on the information that had been collected from a few recent publications of the studies of the relationships of the allergic rhinitis to the OME (otitis media with effusion), we could conclude that allergic rhinitis or common cold/flu will cause Eustachian tube obstruction and middle ear pressure. When the situation becomes uncontrollable, otitis media with effusion will develop and this may could permanent hearing impairment. Therefore, allergic rhinitis and common cold/flu should be treated immediately without any delay. This is because these common illnesses may become serious and develop to chronic sinusitis disease and otitis media with effusions, which is quite difficult to cure.

Published By : Remy A Singal

3 Positive Steps to discover the purpose of life

If your life is not as passionate as you would have liked it to be, if you lack the zest and energy for living, it is because of the lack of an underlying principle around which one’s life should be organized.

The process of discovering this underlying principle may be the most powerful thing you will ever do yourself, because it will give your life a direction, a purpose. It will provide you with the clarity and focus, that could awaken the unbelievable forces hidden somewhere deep inside you.

In this article we will discuss the concept of life and its underlying principle. We will be going through a step by step procedure, exploring your feelings and options, and by the end of this article, you should have a fairly solid tool you could immediately employ in your life, to give it a meaningful direction.

There are three steps to the process of discovering the purpose of your life:

Understanding the principle of choice
Creating your underlying principle
Aligning your life with the underlying principle

Understanding the principle of choice :

Norman Vincent Peale has this to say about the power of choice. “The greatest power we have is the power of choice. It is an actual fact, that if you have been groping under unhappiness, you can choose to be joyous, instead. And, by effort, lift yourself into joy. If you tend to be fearful, you can overcome that misery by choosing to have courage. The whole trend and the quality of anyone’s life is determined by the choice that are made”.

Choosing is the most important activity of your mind, because by making a choice, you are proclaiming your desires to your subconscious mind. Once the subconscious mind get to know your desires, it is going to do anything to manifest them in your life. The choices you make in your life become your goal. And, if you are sincere in pursuing them, there is no reason why you should not accomplish them.

Indecision, on the other hand, not only creates frustration and anxiety, but can also confuse the subconscious mind about what you want. But it is important that the choices you make are made by you, in accordance with your true desires, purposes and aptitude. A lot us of let others make choices for us, or make our choices according to what we think is ‘correct’, even if that means that we go against our wishes. What is right for someone is may not be right for you, and the way to know this is listening to what your heart says.

So, begin with, make a list of things which interests you; things which you have always enjoyed, which makes you feel better, which inspires you to surge ahead, no matter what obstacles you face. Do you like doing something creative, or something artistic? Do you enjoy nature, do you like the sea? Do you enjoy helping others? Do you get pleasure out of making a difference in other people’s life?

What ever it is that interests you, go ahead and make a list under the following headlines:

Things you love to do:

______________________________________

What is it that you love in this thing and why? How you could do this for money, and make a living out of it?

__________________

__________________

Creating Your Underlying Principle :

The next step is to examine the list you just made and find out if there is any recurring them. Maybe, it is the contribution that keeps coming up, or an effect to seek or give love, or helping your parents cope with old age. Whatever it is try to identify the central them of the things you love to do, and try to put it in a short and precise statement. This will be your ‘Mission Statement’. It may even be a quote by a famous person, or a philosophy that has influenced you. Of course, as you grow up, this statement could evolve, but its soul will remain the same. Now, write down your Mission Statement.

Aligning your LIFE with the Underlying Principle :

The final step in this journey is to map your path to your ultimate purpose. Make the little changes in your lifestyle that would accommodate this principle in your life. LIVE this principle each and every day. It might take a few days, but you will certainly feel the difference in your enthusiasm for life. If you realize that you love being amidst nature, plan out your holiday. Maybe an outing with your children could be enough to recoup with your energy. On the other hand, you might even want to change your job, or start a new business, that is more in line with your mission.

Remember – “Do what you love, and money will follow”.

Try it now..!

How Hypnotherapy Helps With Stress And Anxiety


Stress can be defined as a state we experience when there is a mismatch between perceived demands and our perceived ability to cope. Stress can also be defined as an adaptive response by a body to change in the environment. Stress response evolved to enable humans to deal with life-threatening dangers or stressors such as being confronted with a wild animal or perhaps a hostile human. Situations like this required action – the activation of stress response to wither stay and …

Stress can be defined as a state we experience when there is a mismatch between perceived demands and our perceived ability to cope. Stress can also be defined as an adaptive response by a body to change in the environment. Stress response evolved to enable humans to deal with life-threatening dangers or stressors such as being confronted with a wild animal or perhaps a hostile human. Situations like this required action – the activation of stress response to wither stay and fight or to run away.

Today we hopefully won’t have to face the same dangers as our ancestors but the stress response to demanding situations we face is still with us and our mind and body still prepare for fight or flight when confronted with this equivalent of the wild animal. This is where the problem may begin as activation of the fight or flight response with no physical outlet, such as if we are stuck in a traffic jam and can’t fight it or flee it, or maybe an unfair confrontation in the workplace where once again the response for action may be triggered but we cant vent it by fighting or running away without consequences we would rather avoid. Perhaps both of these events and more are experienced on the same day, perhaps every day, and the stress builds within us until it can damage our health if a solution is not found

Stress isn’t always bad – the stress response was designed to help and protect us and some people even place themselves in stressful situations they know they can handle for excitement and ‘the rush’ as it is often called.

We all experience stress in different ways depending upon our personality type, conditioning and possible training also.

When we face a stressor but perceive we have the ability to deal with it successfully a feeling of success and achievement can be gained. Getting the balance right between good stress to motivate us and encourage us to grow, and our ability to cope with the stress is possibly the key to remaining healthy, positive and active in whatever arena of life we find ourselves.

Our ability to cope with stress can be affected by our diet and the intake of good substances that out body needs to remain strong and flexible and to repair itself when needed. Also we should avoid anything that could cause us to be more stressed or weaker such as drugs, alcohol, smoking etc.

Finally, stress can be external, some event or situation that is causing stress, or internal, attitudes or emotions that lead to stress (anxiety, guilt, low self esteem, fear, etc).

What is the Fight/Flight Response? Why do we still have it ?

The ‘Fight or Flight Response’ is a physiological reaction and is the body’s response to a stressor.

Changes in hormones prepare a person to either stay and deal with a stressor or to take flight/run away. This immediate state of alarm is when the body prepares to take action, and in this state a person will be extremely alert to their surroundings but also very anxious and possibly unable to concentrate.

The body will slow down systems not vital in responding to the stressor, such as the digestive system, which is why a person in a fight or flight situation may have a dry mouth and a nervous/upset stomach. The body will make other preparations such as improved cooling for the body as more energy is used and this will result in perspiration.

The fight or flight response is a very old and very basic response and has been with us for a very long time. It was originally a response to danger that would prepare our ancestors to fight the wild beast or the enemy who might suddenly threaten or confront them, or to take flight and literally run away from the danger.

This response is triggered when we send a message of alarm to a part of the brain called the hypothalamus. This area of the brain will then send a signal to the glands to release adrenaline, cortisol and endorphin into the blood stream. Increased levels of adrenaline increase heart rate and blood flow which in turn brings extra oxygen and glucose to the muscles. Cortisol causes an increase in amino-acids and sugars in the blood. Amino-acids are crucial for the repair and recovery of damaged tissues which may occur under stress and the blood sugar adds to the availability of glucose (fuel) for the body.

The release of endorphin, which is a morphine like substance only more powerful, provides the body’s natural tranquilizing system. Pain is blocked and a feeling of euphoria may be experienced, both helping to get the body through the situation it may find itself in due to stress.

We still have this response, as it is still necessary to prepare and protect us in times of alarm, such as being involved in an emergency situation of any kind, or being confronted with any form of potentially life threatening danger.

Once the initial stages of this fight or flight response are over, a person will have a psychological reaction to the stressor which will be based upon many variables including, personality type, conditioning, age, physical and mental ability, and their knowledge relevant to the situation to be dealt with.

It is very often the resulting symptoms of this fight or flight response kicking in that we tend to call a panic attack. what actually happens is that we may be in a situation where we can’t fight or flight, such as a meeting or on a train, and so we become more and more anxious and may feel as though we will pass out, or be sick, or any one of a number of responses. What often happens then,is we find we have a desperate need to urinate, and that is another way the subconscious mind will sometimes attempt to gain our attention and force us to leave the arena in which we find ourselves at the time. It is normally the feeling of not being able to escape, and knowing that we might have this strong feeling to fight or flight that causes much of the anxiety and expectation of problems for most people who find they need help to overcome their problem.

Also, many people….no…that should be most people who suffer from panic attacks and anxiety will normally have the need for some Obsessive compulsive actions in their life…it can often be a type of coping, or controlling strategy.

Why hypnotherapy is totally different from any other form of therapy ?

Hypnotherapy is different from any other form of therapy because of the way in which the therapy part happens while one is in hypnosis. Put another way, hypnotherapy is a very effective combination of hypnosis, a trance or altered state of mind and deep relaxation, and the chosen therapy, which might be for example; suggestion therapy, regression, ego states therapy, neuro-linguistic-programming or hypnoanalysis.

Hypnosis allows an individual to enter a state of deep relaxation which in itself is a very useful therapy for combating stress. It also allows one to become calm and focused, as all parts of the mind work together and concentrate on solving the problem at hand, and therefore making the very best use of the chosen therapy as it is applied.

Why it is so helpful in cases of stress, anxiety and panic attacks ?

Hypnosis is a state in which the conscious critical faculty is temporarily suspended or distracted and in which all parts of the mind work in harmony for the good of the whole being.

When in hypnosis an individual can become very relaxed and at the same time very aware and ‘sharp’, mentally focused.

For the computer literate, I would liken hypnosis to the ‘safe mode’ on a computer, where if a part of the system is acting up or malfunctioning, placing the system in safe mode allows for investigation and repair to be carried out safely while minimising the risk to the normal operating systems. In some sports it would be like a ‘time-out’, where all parts of the team come together briefly to review the current state of play, to identify where poor choices may have affected the outcomes and to choose a new strategy to move forward with.

In the normal hurly burly of life we seldom have time to take a time out, or to go into safe mode to pull together our resources and to calmly take stock and plan our best way forward. Hypnosis then, is a safe, relaxing state in which we can let go the tensions in and around us for a short period, and in which, if we desire it, a skilled therapist can guide us through the stages of investigation, discovery, planning and repair we may need.

Hypnotherapy therefore provides relaxation (and clients of good therapists learn self-hypnosis so they can find this deep relaxation for themselves) and is therefore useful at even this basic level, as a kind of first aid. The good therapist will help the client to find any repressed emotions, triggers and false instincts from the past that are a kind of out-of-date, erroneous, or maybe just no longer wanted or needed programming, that loops around once triggered to cause us much anxiety and feelings of panic, but we often don’t know why. Following this, the wonderful power of hypnotic suggestion, and Neuro-Linguistic programming techniques will be used to provide new and efficient programming to support moves forward into a much more positive life with a better outlook on everything..

Some Arab Women Find Freedom in the Skies



Flight attendants at a graduation ceremony last year in Abu Dhabi, the United Arab Emirates.

ABU DHABI, United Arab Emirates — Marwa Abdel Aziz Fathi giggled self-consciously as she looked down at the new wing-shaped brooch on the left breast pocket of her crisp gray uniform, then around the room at the dozens of other Etihad flight attendants all chatting and eating canapés around her.

It was graduation day at Etihad Training Academy, where the national airline of the United Arab Emirates holds a seven-week training course for new flight attendants. Downstairs are the cavernous classrooms where Ms. Fathi and other trainees rehearsed meal service plans in life-size mockups of planes and trained in the swimming pool, where they learned how to evacuate passengers in the event of an emergency landing over water.

Despite her obvious pride, Ms. Fathi, a 22-year-old from Egypt, was amazed to find herself here.

“I never in my life thought I’d work abroad,” said Ms. Fathi, who was a university student in Cairo when she began noticing newspaper advertisements recruiting young Egyptians to work at airlines based in the Persian Gulf. “My family thought I was crazy. But then some families don’t let you leave at all.”

A decade ago, unmarried Arab women like Ms. Fathi, working outside their home countries, were rare. But just as young men from poor Arab nations flocked to the oil-rich Persian Gulf states for jobs, more young women are doing so, sociologists say, though no official statistics are kept on how many.

Flight attendants have become the public face of the new mobility for some young Arab women, just as they were the face of new freedoms for women in the United States in the 1950s and 1960s. They have become a subject of social anxiety and fascination in much the same way.

The dormitory here where the Etihad flight attendants live after training looks much like the city’s many 1970s-style office blocks, its windows iridescent like gasoline on a puddle. But there are three security guards on the ground floor, a logbook for sign-ins and strict rules. Anyone who tries to sneak a man back to one of the simply furnished two-bedroom suites that the women share may be dismissed, even deported.

In the midst of an Islamic revival across the Arab world that is largely being led by young people, gulf states like Abu Dhabi — which offer freedoms and opportunities nearly unimaginable elsewhere in the Middle East — have become an unlikely place of refuge for some young Arab women. And many say that the experience of living independently and working hard for high salaries has forever changed their ambitions and their beliefs about themselves, though it can also lead to a painful sense of alienation from their home countries and their families.

At almost any hour of the day or night, there are a dozen or more young women with identical rolling suitcases waiting in the lobby of their dormitory to be picked up for work on Etihad flights. Though several are still drowsily applying makeup — and the more steady-handed have perfected a back-of-the-bus toilette that takes exactly the length of their usual ride to Abu Dhabi International Airport — they are uniformly well ironed and blow-dried. Those with longer hair wear black hair-ties wrapped around meticulously hair-netted ponytails. They wear jaunty little caps with attached gauzy scarves that hint at hijab, the head coverings worn by many Muslim women. Like college students during exams, all of them gripe good-naturedly about how little they have slept.

There are exclamations of congratulation and commiseration as the women learn friends’ assignments. Most coveted are long-haul routes to places like Toronto and Sydney, Australia, where layovers may last many days, hotels are comfortable and per diem allowances from the airline to cover food and incidentals are generous. Short-haul flights to places like Khartoum, Sudan, are dreaded: more than four hours of work, followed by refueling, a new load of passengers, an exhausting late-night return flight to Abu Dhabi and the shuttle bus back to the dormitory tower with its vigilant guards.

Upstairs, scrubbed of their thick, professional makeup, most of the women look a decade younger. They seem to subsist on snack food: toast made, Arabic-style, by waving flaps of pita over an open flame; slivers of cheap, oversalted Bulgarian cheese; the Lebanese date-filled cookies called ajweh; pillowy rolls from a local Cinnabon outlet that one young Syrian flight attendant proclaimed herself addicted to (an expression she used with self-conscious delight, a badge of newfound worldliness).


They watch bootlegged DVDs — “Desperate Housewives,” “Sex and the City” — bought on layovers in Bangladesh and Indonesia. They drift along the tiled floors between their rooms in velour sweatpants and fuzzy slippers, and they keep their voices low: someone is always trying to catch a wink of sleep before her flight.




A Lonely Existence

It is a hushed, lonely and fluorescent-lighted existence, and it is leavened mostly by nights out dancing. Despite the increasing numbers of women moving to the gulf countries, the labor migration patterns of the last 20 years have left the Emirates with a male-female ratio that is more skewed than anywhere else in the world; in the 15-to-64 age group, there are more than 2.7 men for every woman.

Etihad flight attendants are such popular additions to Abu Dhabi’s modest hotel bar scene that their presence is encouraged by frequent “Ladies’ Nights” and cabin-crew-only drink discounts. It is almost impossible for an unveiled woman in her 20s to go to a mall or grocery store in Abu Dhabi without being asked regularly, by grinning strangers, if she is a stewardess.

One evening last fall, an Egyptian flight attendant for Etihad with dyed blond hair and five-inch platform heels led a friend — a 23-year-old Tunisian woman wearing a sparkly white belt who said that she had come to the Emirates hoping to find work as a seamstress — up to the entrance of the Sax nightclub at the Royal Meridien Hotel.

Just inside, in the bar area, several young Emirates men in white dishdashas were dancing jerkily to deafening club music.

Clutching her friend by the elbow, the Egyptian woman indicated one of the bouncers. “Isn’t he just so yummy?” she shrieked. The bouncer, who had plainly heard, ignored her, and the women filed past. Despite appearances, explained the Egyptian flight attendant — who asked not to be named because she was not authorized by Etihad to speak to the news media — sex and dating are very fraught matters for most of the young Arab women who come to work in the Emirates.

Some young women cope with their new lives away from home by becoming almost nunlike, keeping to themselves and remaining very observant Muslims, she said, while others quickly find themselves in the arms of unsuitable men. “With the Arabic girls who come to work here, you get two types,” the Egyptian woman said. “They’re either very closed up and scared and they don’t do anything, or else they’re not really thinking about flying — they’re just here to get their freedom. They’re really naughty and crazy.”

Treated Like a Heroine


Rania Abou Youssef, 26, a flight attendant for the Dubai-based airline, Emirates, said that when she went home to Alexandria, Egypt, her female cousins treated her like a heroine. “I’ve been doing this for four years,” she said, “and still they’re always asking, ‘Where did you go and what was it like and where are the photographs?’ ”

Many of the young Arab women working in the Persian Gulf take delight in their status as pioneers, role models for their friends and younger female relatives. Young women brought up in a culture that highly values community, they have learned to see themselves as individuals.

For many families, allowing a daughter to work, much less to travel overseas unaccompanied, may call her virtue into question and threaten her marriage prospects. Yet this culture is changing, said Musa Shteiwi, a sociologist at Jordan University in Amman. “We’re noticing more and more single women going to the gulf these days,” he said. “It’s still not exactly common, but over the last four or five years it’s become quite an observable phenomenon.”

Unemployment levels across the Arab world remain high. As the networks of Arab expatriates in the gulf countries become stronger and as cellphones and expanding Internet access make overseas communication more affordable, some families have grown more comfortable with the idea of allowing daughters to work here. Some gulf-based employers now say they tailor recruitment procedures for young women with Arab family values in mind. They may hire groups of women from a particular town or region, for example, so the women can support one another once in the gulf. “A lot of girls do this now because this has a reputation for being very safe,” said Enas Hassan, an Iraqi flight attendant for Emirates. “The families have a sense of security. They know that if their girls start flying they won’t be thrown into the wide world without protection.”

A Feeling of Displacement

Yet not everyone can make peace with life in the United Arab Emirates, the young flight attendants say. Even the landscape — block after sterile block of hotels and office buildings with small shops and takeout restaurants on their lower floors — can contribute to a feeling of displacement. Nearly all year long, for most of the day, the sunlight is bright white, so harsh that it obliterates all contrast. Despite vigilant watering, even the palm trees on roadsides look grayish and embattled.

Some of the young women tell stories of fellow flight attendants who have simply slipped onto planes to their home countries and run away, without giving notice to the airline.

The most successful Arab flight attendants, they say, are often those whose circumstances have already placed them somehow at the margins of their home societies: young immigrant women who are supporting their families after the death of a male breadwinner, for example, and a handful of young widows and divorced women who are eventually permitted to work overseas after their prospects of remarriage have dimmed.

Far more than other jobs they might find in the gulf, flying makes it difficult for Muslim women to fulfill religious duties like praying five times a day and fasting during Ramadan, the Egyptian attendant noted. She said she hoped to wear the hijab one day, “just not yet.” A sense of disconnection from their religion can add to feelings of alienation from conservative Muslim communities back home. Young women whose work in the gulf supports an extended family often find, to their surprise and chagrin, that work has made them unsuitable for life within that family.

“A very good Syrian friend of mine decided to resign from the airline and go back home,” the Egyptian flight attendant said. “But she can’t tolerate living in a family house anymore. Her parents love her brother and put him first, and she’s never allowed out alone, even if it’s just to go and have a coffee.”

“It becomes very difficult to go home again,” she said.

A version of this article appeared in print on December 22, 2008, on page A1 of the New York edition.

Published By : KATHERINE ZOEPF