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Lecture to 1st year medical students, Kulliyah of Medicine, International Islamic University, Kuantan on 14th November 1998 by Prof Dr Omar Hasan Kasule, Sr.
CONCEPT OF GOOD HEALTH
Definition of health: Health is a positive state of being and not just absence of disease. The components of good health are spiritual (sihat ruhiyyat), biological (sihat al jasad, rahat jasadiyyat), psychological, and mental (sihat nafsiyyat, rahat nafsiyat), and social. Islam looks at health in a holistic sense. If any part of the body is sick the whole body is sick. Similarly a person who is spiritually sick will sooner or later also become physically sick. The reverse is also true unless the iman is very strong. Health is relative and subjective. It varies by age, place, norms, gender, iman & tawakkul. A physical state that is healthy in an elderly person may not be so in a younger one. The conventions and norms (adat) of what is good health varies from place to place and even in the same place may vary from era to era. The subjective feeling of good health varies by gender, females generally being more worried about disease than males. Those with strong iman and trust in Allah (tawakkul) may feel subjectively healthier than those who do not have these attributes.
The Qur'an and health: The Qur'an has used terms that refer to the general concept of holistic well-being such as raahat (7:163, 7:189, 10:67, 16:6, 21:20, 25:47, 27:86, 28:72-73, 41:50, 42:48), raghad (2:35, 2:58, 16:112).
Measurement of health: Attempts have been made to measure health. Several indices of the quality of life have been defined and have been used. Statistical parameters have been used to measure health. They however are limited in that they indicate only the final state of health and do not take into account the intermediate stages. They also can not measure the intangible spiritual and mental components of good health. The best index would be one that includes both spiritual and physical parameters. Such an Islamic index has not yet been constructed to our knowledge. This index would also include criteria that reflect relations with Allah, with the self, with other humans, and with the environment. There are measurable statistical indicators of good health. They are useful for a group of persons. For the individual, the assessment of health is very individualized.
Health as an amanat: Keeping body in good health is an amanat. The Muslim must keep his body physically fit to be able to undertake the functions of istikhlaf and isti’mar. Poor health not only deprives society of the contributions of an individual but also creates a burden for others.
Good health is a gift from Allah (ni’mat aol sihat wa al faragh KS p. 106). Humans must be grateful to Allah for the gift of good health. This gratitude is in the form of worshipping Him and doing good things. Humans tend to take Allah’s gifts for granted and are therefore not grateful. They only understand the gifts when they are taken away. An ordinary person may not understand or appreciate the value of good health when in good health. On falling sick, the value of good health is understood and is appreciated but most often for a limited time. Everything is forgotten as soon as the illness is over.
DETERMINANTS OF HEALTH
The state of health of a person is determined by many factors: nutrition,. exposure to environmental risk factors, lifestyle, behavior, and iman. Diet is at the root of many diseases (MB#913,933). The prophet taught control of appetite. He never ate never ate to fill his belly (MB #1889). A believer eats in one belly but a non-believer feeds in 7 bellies (MB#1893). Drinking alcohol is dangerous to health and nullifies iman (MB #1931).
There is a strong relation between iman, character, behavior and health. Iman cures diseases of the heart such as jealousy, hasad and rancour, hiqd, that lead to violence in the person or those around him. These diseases may manifest physically as psycho-somatic illnesses or may manifest more dramatically such as homicide (MB #522, 523) or bodily injury. Addiction to alcohol, or drugs is a reflection of weak iman. It leads to many physical and psychological disease
FAMILY HEALTH
Good mental and physical health requires that children grow in a healthy family so that they can be balanced adults. A family is a source of calmness and tranquility (25;33). A spouse is a source of psychological balance, sakinat (30:21). Islam has enacted several measures to ensure family health. Marriage is encouraged (MB#1828, 1829, 1830) as a basis for family formation. Islam recognizes no alternative family arrangements. Religion is the basis for selection of a spouse (2:221, MB #1835). For the family institution to be stable, temporary lust-driven sexual relations are forbidden (MB#1844). To ensure stability of the marital relation, marriage must be contracted by mutual consent without force (MB# 1848, 1849, 1850). Good treatment of the spouses is ordered (MB #1858). There are preventive measures against family break-up such as adultery. Men and women are not allowed to be in situations that may lead to sexual corruption (MB#1868). Adultery is strictly forbidden ( p 544 3:24-25, 5:5, 17:32, 24:2-3, 2:68, 60:12). There are many measures to preserve marriage, ihsan al zawaaj (4:24-25, 5:5, 24:4, 24:23). There are procedures for resolving marital disputes (p 547 4:34-35, 4:128-130, 24:6, 33:4, 58:1, 66:1-5). Divorce is the worst of legal measures; it is however allowed when there is no other alternative. Even in cases of divorce the process is structured in such a away that reconciliation is possible (p 749 2:227232, 2:236-237, 2:241, 33:28, 33:49, 65:4, 65:6, 66:5). The parents especially the father are responsible for the material welfare of the family, nafaqat (2:233, MB #1884, 1886).
The number of dysfunctional families is increasing. Many children are living in single-parent families. Dysfunctional families are not healthy in the physical and psychological sense. This will have long-term impact on the children.
COMMUNITY HEALTH
The Qur'an has told us about many communities in the past as lessons for us (11:100). Some of them were blessed and lived in peace and plenty (2:58, 7:96, 7;161, 16:112). Makka was described as a city of peace and general welfare (2:126, 14:35). Good, al balad al taib (7:58, 34:15) and safe, al balad al amiin (95:3) are adjectives that the Qur'an has used about some communities. The Qur'an also told of communities that collapsed, khiraab (p 941 2:259, 27:34), those that were punished by famine (p 942 7:94-95, 16:112, 65:8-9), or were destroyed by Allah, ihlaak (p 940-1 6:131, 7:4, 7:96-98, 11:102, 11:117, 1:4, 17:16, 17;58, 18:59, 21:95, 22:45, 22:48, 25:40, 26:208, 27:56-58, 28:58-59, 29:31, 29;34, 46:27, 47:13). The physical destruction was due to moral deviations like batar (p 941 16:112, 17:16, 28:58, 34:34, 43:23), transgression, dhulm (p 941 4:57, 11:102, 18:59, 21:11, 22:45, 22:48, 28:59), and corruption, fasaad (p 941-942 6:123, 7:82, 7;88, 7;96, 17:16, 18:77, 21:74, 27:56, 28:58, 34:34, 43:23). No community is destroyed or is punished until it receives a warning from Allah (6:92, 6:131, 12;109, 25:51, 26:208, 28:59, 34:34, 36:13, 42:7, 34:23).
Community diagnosis is identifying and describing health problems in a community with a view to initiating public health interventions. Many communities in both developed and developing countries are dysfunctional. They are unhealthy in the physical and social or mental sense. The reasons underlying community ill-health are the same as the Qur'an mentioned above. Social injustice is responsible for the conditions of poverty and deprivation that lead to malnutrition and infectious disease. Immorality and sexual promiscuity encourage the spread of sexually-transmitted diseases. Over-indulgence leads to over-nutrition that is associated with coronary heart disease. Alcohol and drug addiction lead to a lot of long-term mental problems.
DISEASE PREVENTION AND HEALTH PROMOTION
Islam encourages a human to take measures to protect the body from harm by preventing disease. Thus immunization, good sanitation, and disinfection are all acceptable measures for protecting health. There are activities that Islam encourages to promote health. They essentially put the body in the best state to withstand disease and illness. These include diet, exercise, and recreation. Health promotion involves pro-active measures that make health better. These include exercise, good nutrition, adequate rest, mental calmness, tranquility of a family life (sakiinat). Iman and spiritual calmness, tama'ninat, contribute to health promotion.