Cultural Competency - Multicultural Health Generalizations: Muslim
Islamic Health Care Beliefs
- Information for Health Care Providers When Dealing with a Muslim Patient
- Guidelines for Health Care Providers Interacting with Muslim Patients and their Families
- Islamic Beliefs and Practices Affecting Health Care
- Culturally Sensitive Care of the Muslim Patient
Islamic Fasting During Ramadan
- About Ramadan
- Ramadan, the holiest of the four holy months, is the ninth month of the Islamic Lunar calendar; beginning approximately October 4, 2005, and concluding around November 2, 2005.
- Ramadan begins with the sighting of the new moon, after which all physically mature and healthy Muslims are obliged to abstain from all food, drink, gum chewing, any kind of tobacco use, and any kind of sexual contact between dawn and sunset.
- However, that is merely the physical component of the fast; the spiritual aspects of the fast include refraining from gossiping, lying, slandering and all traits of bad character. All obscene and irreligious sights and sounds are also to be avoided. Purity of thought and action is paramount.
- The month of Ramadan is a time for spiritual reflection, prayer, doing good deeds and spending time with family and friends. The fasting is intended to help teach Muslims self-discipline, self-restraint and generosity. It also reminds them of the suffering of the poor, who may rarely get to eat well.
- It is common to have one meal (known as the Suhoor), just before sunrise and another (known as the Iftar), directly after sunset. Because Ramadan is a time to spend with friends and family, the fast will often be broken by different Muslim families coming together to share in an evening meal.
- Fasting is not required for children but often by the early teenage years, fasting begins for at least part of the day (Ali, 1996).
- Fasting and Health
- Women who are menstruating, pregnant, or lactating, as well as sick individuals and travelers, are exempt from fasting (Ali, 1996). These individuals, however, are required to fast at another time during the year.
- Long periods of fasting from both food and drink, alternating with feasting, can be challenging for those with a chronic illness such as diabetes. If at all possible, health care providers should work with patients to adapt their treatment plans with the fasting schedule.
- If it is not therapeutic for the hospitalized Muslim patient to fast, it is helpful if the healthcare provider can explain such reasons. To the devout Muslim, the fast may be more important than the treatment plan. Hence, it can be beneficial to find a workable compromise.
Sources: 1) Lawrence, P. and Rozmus, C., 2001. Culturally Sensitive Care of the Muslim Patient. Journal of Transcultural Nursing 12, 3, 228-233. 2) http://www.ramadan.co.uk/index1.php?page=others.htm (disabled link - redirected to http://www.ramadan.co.uk/index1.php?page=resource.htm)
Muslims and Death & Dying
- Death and dying can be extremely important spiritual times for Muslim patients.
- Some Muslims may prefer to face Mecca (approximately northeast from Ann Arbor) and may appreciate the company of family and friends who recite prayers and verses from the Qur'an (the Muslim holy book).
- After a Muslim patient dies, burial should take place as soon as possible.
- Family and/or community members may want to prepare the body by washing it and then wrapping the body in unsewn white cloth.
- Post-mortem examinations are discouraged - unless required by law.
- Most scholars, however, approve of the transplantation of organs from the deceased - with family permission.
Source: Sheikh, A. and Gatrad, A.R. (2000). Caring for Muslim Patients. Radcliff Medical Press: Abingdon, Oxon.
Muslims and Fasting
- During the sacred month of Ramadan (this year beginning approximately October 15), Muslims traditionally abstain from food, drink and sexual activity from sunrise to sunset.
- At sunset, this fast is broken by drinking water, eating three dates, and performing special 'taraweeh' prayers after the daily night prayer.
- Fasting serves various purposes:
- While hungry and thirsty, Muslims are reminded of the suffering and poor.
- While abstaining from sexual activity, the body and mind are symbolically cleansed.
- Since not all fasting Muslim patients will mention their ritual, healthcare providers may want to offer a discussion of how to fast safely and successfully.
- Those who cannot fast due to chronic illness, such as diabetes, necessitating frequent medications or are too weak to fast give to charity instead of fasting.
- Women who are pregnant, breast-feeding or menstruating do not fast.
Source: M. Amir Ali, Ph.D. The Institute of Islamic Information & Education Chicago, Illinois
http://www.iiie.net/Articles/tabid/54/TID/24/cid/1/Default.aspx
Female Modesty as an Islamic Practice
- As defined in the Quran, conservative Muslim women dress to show no more than their faces and hands to anyone other than very close relatives.
- Some Muslim women abstain from shaking hands with men they do not know.
- Same gender care is an effective way to ensure female modesty. Therefore, Muslim women might require a female provider.
- Modesty in the examination room can be achieved by:
- Providing a long-sleeved gown, ankle-length robe, or bath blanket to conservatively cover the body.
- Asking permission of Muslim women before examining any covered body part, and allowing them to pull clothing aside as necessary (i.e. hijab/headscarf).
- Being understanding if husbands or relatives are present for support.
Sources: "Islam". Ethnic Resource Guide, 3rd. Edition, Copyright Fall 1999. p.73. Workforce Development and Diversity Strategies Division, Corporate Human Resources, Henry Ford Health System.
Culture Sensitive Prenatal Care for a Muslim Woman. Sigma Theta Tau International, Nursing Honor Society. (Online). (2004, Aug. 30) (disabled)
Alternate source: Maqsood, Ruqaiyyah Waris. Thoughts on Modesty. Islam For Today.
http://www.islamfortoday.com/ruqaiyyah05.htm
Contraceptive Usage according to Islamic Practice
Contraceptive use is a topic about which some Muslims disagree. Many Muslim scholars approve of family planning because contraception is not expressly forbidden in the Qur'an. In fact, prolonged breastfeeding is encouraged by some scholars to delay conception. It is also recognized in the Qur'an that some friends of the Prophet practiced coitus interruptus. Therefore, it is reasoned that if contraception were inappropriate, it would have been expressly forbidden in the Qur'an (Libbus & Kridli, 1997, as cited in Lawrence, P. et al, 2001). However, other Muslim scholars believe that contraception is forbidden in Islam. The command to "procreate and abound in number" is cited as proof of this prohibition. Some scholars believe that children are God's gift and that procreation is the primary objective of marriage. These scholars would also argue that only God can decide the number of children that a couple will have (Libbus & Kridli, 1997, as cited in Lawrence, P. et al, 2001). This example of varying practices and beliefs within the same culture is a reminder that cultures are not homogeneous, and therefore, such generalizations can be used as a starting point to learn the practicing beliefs of each patient.
Source: Lawrence, P. and Rozmus, C., 2001. Culturally Sensitive Care of the Muslim Patient. Journal of Transcultural Nursing 12, 3, 228-233.
Muslim Birth Customs
Muslim birth customs are deeply symbolic and serve to remind new
parents that a fresh chapter is about to unfold. The following are only
four of many Muslim birth customs.
- Adhan - A call to prayer including two pronouncements:
- It is only proper that the first word a baby hears is the name
of his creator, 'Allah'. - Followed by the Declaration of Faith, 'There is no deity but
Allah; Muhammad is the Messenger of Allah'. - Both of these fundamental pronouncements serve as the pivot around which the life of a Muslim rotates, hence their symbolic significance at birth.
- The father whispers the Adhan into the baby's right ear,
serving as a reminder that the father also has a key responsibility in the months and years ahead. - Ideally, the Adhan should be completed as soon as possible after birth.
- Iqamah - A second call to prayer performed shortly after the Adhan; 'Our stay on earth is short' - the equivalent of the few minutes separating the Adhan from the Iqamah, 'so life then should be spent wisely and diligently, and not wasted'.
- Tahneek - Performed soon after birth and preferably before being
fed, a small piece of softened date is gently rubbed onto the infant's
upper palate. - Where dates are not easily available, substitutes such as honey are used.
- A respected member of the family often performs this custom with the hope that some of his positive qualities will be imparted onto the infant.
- Taweez - A black string with a small pouch containing a prayer,
tied around the baby's wrist or neck. - This is particularly common among Muslims from the Indian
subcontinent, with many believing that it protects the baby from ill health.
Source: Caring for Muslim patients: Birth customs: meaning and significance. Primary Care Online.
http:www.primarycareonline.co.uk/humaneffect/muslim/chap3.htm (disabled) (2003, Mar. 31).
Alternate sources: Gathrad, AR, A. Sheikh. Muslim Birth Customs. Arch Dis Child Fetal Neonatal Ed 2001;84:F6-F8 (January). (Online). http://fn.bmjjournals.com/cgi/content/full/84/1/F6#SEC2
Amjad, Moiz. (2000, Dec. 18) General Muslim Customs & Traditions. Understanding Islam. (Online).
http://www.understanding-islam.com/related/text.asp?type=article&aid=35&sscatid=177
