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Some communities have peripheral zones inhabited by persons with a different culture than the majority of the general population, such as the Aboriginals in Australia, the Native Americans in the U.S. and Canada, the Eskimos in Lapland, and the Bedouins in Israel. These citizens are not receiving the same medical or rehabilitation services as the citizens of the metropolitan areas due to the fact that health and welfare programs are not adapted to their unique needs. At the Soroka University Medical Center in Beer-Sheva, Israel, the health and rehabilitation services have a very large and heterogeneous catch-up population serving most of the south of Israel. The purpose of this study was to look at the utilization and the number of appointments for child rehabilitation services by the Bedouin population compared to the general population in the south of Israel at the Zusman Child Development Center (CDC). The records of appointments to the CDC between the years 1995-1999 inclusive were studied and we randomly chose to limit the study to January, April, July, and October of each year, and randomly chose the daily records of nine therapists, three from each discipline (occupational therapy [OT], physical therapy [PT], and speech and language therapy [SLT]). There were 8,504 appointments during these 4 months of the years 1995-1999, 2,255 of which were for Bedouin and 6,249 for Jewish children. Noncompliance with therapy appointments (NCTA) for the same period for both the Bedouins (31%) and Jewish children (26%), with a significant difference between the two populations, was noted. Of all the Jewish childrens' appointments, the percentage of all three services was similar: 33% to PT, 38% to OT, and 29% to SLT, but for the Bedouin children, the percentage between the three services was significantly different: 62% to PT, 34% to OT, and 3% to SLT. These results seem to indicate that the Bedouin families prefer the PT and OT over the SLT. Our results enhanced the need for planning a model for supplying health services adapted to clients coming from different cultures. According to this model, we need to take into consideration the cultural differences, the accessibility to rehabilitation services, and the economical impact on the family; all in all, to give a better solution to the patient with special needs.

The Use of Developmental Rehabilitation Services. Comparison between Bedouins and Jews in the South of Israel