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Proactive Medicine: Reflections from Madinah

As a community, our focus on treatment comes primarily at the point a patient becomes ill. Few of us take precautions to look after ourselves to prevent illness from occurring; often delaying any change in diet, exercise or routines till after symptoms arise. In fact, for many people, even though they are aware of their genetic vulnerability to certain illnesses, precautions are rarely taken until after the signs of the illnesses emerge.

“Many black and south Asian people know about the higher prevalence of diabetes and high blood pressure in their communities, but they don’t realise the direct link between these conditions and kidney failure,” says Kidney Research UK’s Neerja Jain[1].

This attitude to healthcare extends to the field of ethics, an area severely underdeveloped but desperately needed within the Muslim community in the UK. Although each of us is aware of our likelihood to visit a hospital at some point in our life – whether for treatment or other care such as child birth – we have little to no resources to help us navigate the tricky ethical situations which can quite easily arise during our visits. Moreover, with an estimated 20% of medical school graduates coming from South-East Asian backgrounds[2], what resources exist to help them understand their day to day practice in light of their religious and ethical beliefs? Examples of the types of questions people may face include:

  • At what point can we turn a machine off for a dying patient?
  • Can doctors sign cremation forms?
  • Can we give and receive organs?

Each of these require a detailed level of research to understand the complex issues at play, something which is difficult to produce to a high quality within a short timeframe. This means patients often struggle to find the information they need to help make their decision at their time of need, delaying the whole process and causing a lot of trauma to the patient’s family. A significant part of medicine and public health is also reliant on the information the wider public have around a treatment and their proactive approach to healthcare. Issues such as organ donation require proactive education of society well before the case arises as a patient is unable to receive an organ without there being donors to give.

The need for this work is not restricted to the UK, but within any country with a Muslim population. On 9th November 2014, the CIM were invited to attend a conference in Madinah entitled ‘Meet the Healthcare Leaders’, organised by the Madinah Institute for Leadership and Entrepreneurship (MILE). The conference was the final day of a week training course for hospital directors within Saudi Arabia, and the CIM was invited to participate in the discussions and inform them of our experience in the UK.

Alongside discussions around the infrastructural and financial development of the healthcare system in Saudi Arabia, proactive care was a common theme in the conference. Dr Walid Fitaihi from the International Medical Centre spoke about the need to deal more holistically with a patient’s healthcare needs. Throughout his presentation, he asserted the need to deal with the underlying issues confronting patients at the primary level before they present themselves at hospitals. His talk was aided by the former Minister of Health in Saudi Arabia Prof. Tawfik Khoja, describing the need for a more proactive approach to healthcare to help curb the significant expense the kingdom has on healthcare treatment. The Minister also complemented the work of the CIM, praising it as a leading example for the work that needs to be done within the community. Mr Graeme Robertson from Schneider Electric described a research piece run by their company looking into the importance of indirect remedies for patient care placed. They discovered that 28% of a patient’s recovery is based on the quality of the environment they are in,[3] part of which he agreed included the ethical dilemmas for the patient’s to be at ease.

Following the conference, we were invited by one of the leading hospitals within Madinah to present about the work of the CIM to its medical staff, focusing specifically on our work within mental health. During the session, we discussed the day to day relevance of ethics within their practice and the importance of being aware of such issues. Examples were given to highlight the common occurrence of ethics never odd or even

  • How should religious people respond to the prevalent aetiology of depression?
  • What affect can the Unseen world have on our mental wellbeing?
  • How have Muslim scholars treated the different faculties of mind and soul in the past? Are these classifications outdated?

There is a clear and urgent need for the work within ethics to begin. The financial benefits are obvious, and the potential benefit that can be gained is significant for many generations to come. The aim of the CIM is to begin to develop the material around these issues, conducting the research around each of these issues to ensure the material is available when needed. This proactive approach to medicine brings a much needed shift in cultural attitudes towards treatment, improving outcomes of treatment for patients as a result. Our hope is to build the infrastructure, networks and finances to sustain the research and development of the field for many years to come.

By Talha Ghannam, CEO of The Centre for Islam and Medicine

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[1] http://www.nhs.uk/Livewell/Kidneyhealth/Pages/BlackandAsiankidneyhealth.aspx

[2] Country of training and ethnic origin of UK doctors: database and survey studies; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC516656/pdf/bmj32900597.pdf seen 9th October 2014

[3] https://www.youtube.com/watch?v=1wPhrQ6eFNk

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