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'It impacted the relationship with my culture': When culture, cuisine and a chronic illness combine

Jude Soussan is on a mission to help people understand Coeliac disease (SBS).jpg

Jude Soussan is on a mission to help people understand Coeliac disease Source: SBS News

Coeliac disease affects one in seventy Australians, according to the Wesley Research Institute. But when food is integral to cultural identity, the impacts of this autoimmune disease — especially on multicultural and diasporic communities in Australia — can extend beyond the physical, affecting mental health. Jude Soussan is a young person of Lebanese heritage in Perth, Western Australia, and has used her diagnosis to help educate others about what it means to live with coeliac disease in the diaspora, using creativity. She hopes that, with time, communities can better understand how to accommodate chronic illness.


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TRANSCRIPT

For Lebanese youth Jude, growing up in Australia meant favourite memories filled with early mornings, the sound of Fairouz — the beloved Lebanese singer — and the smell of mana’eesh, baked flatbread topped with za’atar, an aromatic Middle Eastern spice blend.

"I grew up eating a lot of Lebanese dishes that contained gluten. Mana’eesh was a big, big, big part because we used to have it for breakfast all the time. It was my top favourite."

At age nine, she discovered her love for cooking. Traditional foods became a bridge to her heritage in the diaspora, and when she was visiting family in Lebanon, she saw that food brought together communities.

But everything changed after a diagnosis found she was allergic to what she loved most.

"Coeliac disease has kind of affected my connection to my Lebanese culture because of the amount of foods that I no longer can eat. I found out at the age of 15, so I am currently 23, turning 24 this year. I didn't stop it right away. I was like, "Oh, I'll keep gluten as a treat and only have it on weekends." And then my body just fully couldn't cope anymore. It's to the point where I can't even have contamination."

She began exploring alternatives and substitutes, however she began to see that food was central to her culture, and the gap in awareness about the condition, including contamination, made it difficult for her to connect with her community.

"There was a lot of celebratory desserts that I can no longer eat that would happen during like Eid. The biggest difficulty is just trying to find other people in the community that share the same issue. Even when I did go back to Lebanon, because gluten is not really a well-known thing, not just in Lebanon, but in the Arab community, it was just quite stressful because it's a lot to explain. So I did feel quite disconnected. Sitting with family at a table filled with food and I can only eat a couple things and I can't dip Lebanese bread in hummus anymore, that sort of thing."

Coeliac disease impacts nearly 400,000 people in Australia according to the Wesley Research Institute. Only twenty per cent of people are diagnosed, and many find out later in life — by which point the health impacts can be more serious and long-lasting.

Coeliac Australia explains the condition means the intolerance to gluten triggers an autoimmune response affecting the lining of the small intestine, where nutrients are absorbed.

That means the body's immune defence reacts to gluten by attacking itself. Currently, the only treatment for coeliac disease is a strict gluten free diet.

Dr Nema Hayba is a nutrition expert at the University of New South Wales, and says navigating the condition has improved with time, especially for people from multicultural communities.

She says for Arab cultures - including Lebanese - gluten is a primary inclusion.

"I think 20 years ago, a coeliac diagnosis could be isolating and that's because of how prevalent wheat is in our diets in general. And then there's certain cultural dishes that are quite indispensable or the inclusion of wheat or in our version, cracked wheat like burghul (bulgar) is essential to that dish. With the right guidance and navigating something like coeliac disease can be achieved"

For many people from diverse backgrounds like Jude, food is rooted in culture, going beyond only nutrition.

As a result, without the correct guidance, coeliac can be quite isolating, impacting both physical and mental health.

"Eating food is not just about nutrition and fueling up. It's a big part of who we are, a big part of connection and social cohesion. Special months and events such as Ramadan and Eid. We almost eat like a buffet type of style where there's a main food put on the table and we all take pieces from that, as opposed to other cultures who have a plate set up in the beginning. It can be awkward at first, but I think with the right communication and the right tools, it can be navigated well."

Dr Teresa Davis, Associate professor and Co-convenor of the Australian Food, Culture and Society Network at the University of Sydney echoes the sentiment around food and culture, describing it as a major pillar in developing cultural identity, and most uniquely for multicultural communities in the diaspora, portable.

"So as a migrant, carrying your food traditions and cultural practices around food is one of the ways of holding on to home, if you will, when you're in a new place or in a sometimes hostile new environment, if you're forced to move, as is with many displaced people. But also it's a source of comfort because it's the familiar. It's something that you've known forever, you've known as a child you've grown up with."

While Jude’s love of cooking grew, she also had to adjust to the limits that came with coeliac disease. Along the way, she discovered another passion — theatre — and quickly fell in love with it. After seeing a few performances, she began to wonder if it could be a way to share her experiences with others in her community.

Now, Jude writes, directs and performs her own productions, making audiences laugh, and filling their stomachs with gluten-free Lebanese food she cooks on stage; her latest production is called mil’aqa, meaning spoon in Arabic, where she plays the role of a Lebanese aunty who she describes as having a lot more wisdom.

"I didn’t know that milk and cream came from wheat, and the cows are making bread.”

She found that using humour allowed her to connect with audiences, but her ability to make people laugh stemmed from coping mechanisms, growing up with Israel's attacks on Lebanon.

“People who come from places or like countries that has dealt with a lot of hardship and colonisation, you tend to have a sort of resilience to you that bleeds into becoming quite humorous. Its like the whole thing of if I don’t laugh, I’ll cry. That sort of idea. So having coeliac disease, it’s a lot better to absorb it and communicate it and educate it to people in a funny way.”

The productions have helped start conversations around being Lebanese and coeliac. She creates foods known to Arab audiences, but demonstrates how they can be adjusted to being coeliac friendly.

She says by weaving in nostalgic elements, she hopes Arab and other multicultural communities in Australia can relate — and create spaces where culture and cuisine can still be shared, even with dietary adjustments.

"People coming from the Levant region, so like Palestinians, Lebanese, Jordanians, or Syrians, I think they found that they could connect to the story even if they didn't have coeliac disease. It was just nostalgic, you're listening to Fairuz music and to most Arab children, we all kind of grew up listening to Fairuz. And then for people who have coeliac, even though they weren't Arab, they still related to where I spoke about silly interactions I have with people or the way people misjudge coeliac disease.

For people from multicultural communities having trouble navigating the diagnosis, Dr Hayba says the journey can feel quite isolating, and having a dietician who understands the cultural role of food, can make it a lot more manageable.

"That dietician doesn't have to come from the same ethnic background as you, but just has to have experience in your cuisine and in your culture. So someone who's culturally responsive and can meet you where you're at, that can really help you in that transition. But with the right tools and knowledge, it can be something that can be managed. You just need to have the right people in your corner.”


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