Islam is a world religion that originated in the Middle East in the seventh century CE* It is practised by about a fifth of the world's population. Muslims believe there is only one God (Allah) and Muhammad is his prophet. Although Muslims revere Muhammad they do not worship him. Muslims believe that everything and everyone depends on Allah. All Muslims of whatever race are members of one community known as the ummah.
Muslims are guided to follow Allah's will by obeying their holy book, the Qur'an, and also by following the example set by Muhammad.
Every Muslim must perform duties known as the 'five pillars of Islam'. These are:
Most Muslim patients have a positive attitude towards healthcare staff and are willing to seek medical help and advice when sick.
One of the most important religious practices for Muslims is daily prayer (Salat). They pray five times a day. The times are broadly as follows:
Muslims welcome privacy or a quiet space during prayer times, and they must face towards Makkah (Qibla, to the south-east in the UK). The section on washing and toilet covers hygiene needs relating to this practice.
Muslims will eat only permitted food (halal) and will not eat or drink anything that is considered forbidden (haram). Halal food requires that Allah's name is invoked at the time the animal is killed. Lamb, beef, goat and chicken, for example, are halal as long as a Muslim kills them and offers a prayer. Fish and eggs are also halal.
All products from pork, carrion and blood are forbidden (haram), as are all types of alcohol. In Britain Muslims buy their meat from a Muslim butcher whenever possible. A Muslim does not eat generally available meat or food that contains animal fats, in case it contains pork fat or fat from other animals not ritually slaughtered.
Fish and eggs must be kept strictly separate from meat during preparation. Unless absolutely sure that all food is halal, when away from home many Muslims will follow a vegetarian diet. Pakistanis and Arabs like their food well seasoned and spiced, and may find bland food unpalatable.
Muslims fast during the month of Ramadan (the date varies each year). At this time Muslims will not eat or drink between dawn and sunset. The sick, infirm or very old need not fast. Fasting is also excused during menstruation, for 40 days after childbirth, while breastfeeding or during a long journey. However, some Muslims will choose to fast even if ill and you should try to accommodate this. This means providing adequate and acceptable meals during the hours of darkness and, wherever possible, adjusting medication to fit in with the fast. If the doctor says a patient should eat and drink more, you should explain to the patient that this is part of the medicine to assist recovery. It is important to recognise that a decision to fast is based on different priorities, not on ignorance or being unco-operative.
Muslims attach great importance to cleanliness. They must have running water (from a tap or poured from a jug) in toilets, as they consider toilet paper inadequate; if a bedpan has to be used a container of clean water should accompany it. Muslims prefer to wash in free-flowing water, and cannot accept the idea of sitting in a bath. Ablution before each prayer is necessary. The worshipper washes their hands and face, rinses their mouth, cleans their nostrils, washes their arms up to the elbows, wets the hands and runs them through the hair, cleans inside and behind the ears and lastly washes their feet up to the ankles – each of these three times. After menstruation women must wash their whole bodies. It is regarded as unclean to eat or perform religious ceremonies using the same hand that is used for toileting purposes.
Generally a Muslim woman is not allowed to be examined or surrounded by male members of medical staff. It is always preferable that a female member of the medical staff is present. In certain cases a Muslim woman may not agree to be examined or treated at all by a male staff member. In Islam free mixing of sexes is prohibited and there should be no physical contact between a woman and any man except her husband. Muslims should be accommodated in mixed wards only in emergencies. A Muslim woman may find it difficult to accept an X-ray gown because it is short.
Many Muslim women wear a headscarf when out in public (the hijab) and some Muslim women will also choose to be fully covered with only their eyes and hands showing (burka). You should show sensitivity to the needs of Muslim women to dress appropriately.
A dying Muslim will wish to lie on their right side facing Makkah (the Qibla). Familiar people can give comfort by reading to the patient verses from the Qur'an. It is an important religious duty to visit the sick and dying, so a large number of visitors may arrive at all hours.
Should a baby die at or after four months of pregnancy or soon after birth, he or she will be named, washed, shrouded and buried in the usual manner. If the foetus dies before four months of pregnancy, then it should be wrapped in a clean cloth and buried.
It is customary among Pakistanis and Arabs to express their emotion freely when a relative dies. Whenever possible you should give them privacy to do so; and explain gently but firmly the need to avoid disturbing other patients by their mourning.
The next of kin will want to arrange to wash the body before burial. In Islam the body must be buried as quickly as possible (cremation is forbidden). A postmortem must be avoided if legally possible, as this is not allowed and causes considerable distress; organs should all be buried with the body.
Some Muslim women will refuse to be examined internally before giving birth and may be reluctant to be attended by a male obstetrician unless in an emergency. When a Muslim child is born, as soon as possible a member of the family must recite in the baby's ear a prayer that normally lasts a minute or two (Azaan). A Muslim boy must be circumcised as soon as possible. It is not a religious requirement for girls to be circumcised.
Strictly speaking an orthodox Muslim would not approve of family-planning devices. In practice individuals vary widely in their attitudes; information about facilities should be given, but no pressure exerted. Any discussion should be in strict confidence, and never in front of visiting relatives or friends.
There are no particular issues relating to blood transfusions, but although organ donation has been permitted it is a complicated issue for Muslims and will often be met with reluctance. The decision would lie with the individual and their family in consultation with their local religious leader.