PORTLAND, Maine (AP) _ Whether it's blue or spotted or striped, the standard issue hospital gown is drafty and revealing. It's embarrassing for just about anyone who's spent a night in a medical center.
But for modest Muslim women, it's an unthinkable indignity.
``I have witnessed their misery and how bad they feel about it. They don't like it. They feel ashamed. It's very embarrassing,'' said Asha Abdulleh, a native of Kenya and a medical interpreter.
When officials at Maine Medical Center discovered many Muslim women were so ashamed they were canceling doctor visits, the hospital took action, redesigning the standard gown to provide extra coverage for patients who want it. The new hospital gowns have been available for several weeks.
``This is a great example of a challenge raised by a specific community that can ultimately benefit all patients,'' said Dana Farris Gaya, the hospital's manager of interpreter and cross-cultural services.
The problem was acute for Maine Medical because 2,000 Somali refugees have come to Portland over the past few years and most of them are treated at the hospital's international clinic. As many as three out of 10 women were skipping their appointments, said Osman Hersi, a medical interpreter at the hospital.
Tracked down at home, the women whose religion and culture require them to be covered, described to interpreters the horror of being asked to wear the revealing gowns during outpatient procedures.
Furthermore, they were publicly humiliated when they had to wait in a hallway in the radiology department.
On a recent morning after the new patient gowns were provided, Shamso Abdi appeared for her first hospital visit since arriving in Portland.
She and her husband, Aden Ali, came to the United States from Mogadishu, Somalia. They lived in a small town in Kentucky, and then Columbus, Ohio, before coming to Portland.
Abdi, who was clothed in a dress, a sarong and a hijab, a scarf wrapped around her head, said she had canceled appointments in Columbus when she had to see male doctors and wear the standard drafty gown.
The gown created by the Portland hospital is long enough to provide more coverage of a patient's legs and has extra material to ensure that a patient's backside remains covered. Underneath, there's a wraparound sarong for even more coverage.
Abdi said she was grateful to see that Maine Medical had created a patient gown with her principles in mind.
``I'm so happy they made the change. I'm so happy that they considered us,'' she said, speaking through an interpreter.
Other hospitals are responding to the needs of Muslims. In southeastern Michigan, home to 300,000 Arab-Americans, the University of Michigan Medical Center is also addressing the issue of modesty.
The hospital is thinking of posting signs on the rooms of Muslim women warning male visitors and staff to check with a nurse's station before entering, said spokeswoman Krista Hopson in Ann Arbor, Mich.
As for the gown itself, Maine Medical isn't the only hospital to try to create a more acceptable version.
Hackensack University Medical Center in New Jersey introduced vibrant colors and funky patterns five years ago. Other hospitals and garment producers have tweaked the traditional design with snaps, Velcro and other changes.
Still, the standard-issue gown will never go away entirely. In some situations, in emergency rooms for example, it's more important to put the interests of doctors and nurses ahead of the interests of patients.
But for many situations, it makes sense to keep patients happy.
Asks Dr. Nat James of the hospital's international clinic: ``Why didn't we think of this so long ago?''
The idea of changing the gown isn't completely new.
In 1999, designer Cynthia Rowley unveiled new gowns that offered a mid-calf length with a mock turtleneck and three-quarter length sleeves with snaps for women and drawstring pants, a short sleeve shirt and a matching robe for men.
That same year, Missouri state Rep. Sam Gaskill pushed a bill that would have required hospitals to provide patients with ``dignity gowns,'' covering the body from neck to knee. The bill, prompted by Gaskill's own hospital experience, never made it out of committee.