Islam places the responsibility of practicing religion on the individual and, as a result, it is important that health cares providers discuss religious observance needs with are mainly ablution and bathing, prayer, dietary needs and chaplaincy services.

1. Ablution and Bathing

• Before prayer, a Muslim is required to perform ablution with water. Washing with water is also required after urination or defecation. A full bath is required after seminal discharge or after menstruation and post-natal bleeding.
• If washing with water or having a bath is not medically advisable or possible, an alternative method of purification, called Tayammum, can be performed. In Tayammum, the patient strikes the palms of both hands on any unbaked earthly matter (e.g. stone or sand) and symbolically washes in two simple steps.

2. Prayer

Muslims are required to pray five times a day. Those who are cognitively incapacitated are exempted. Women at the time of post-natal discharge and during menstruation are also exempted.

Prayers are said while facing Mecca. Prayers are usually performed on a prayer mat and include various movements such as bowing, prostrating and sitting. It is not necessary for an ill patient to make all the usual prayer movements.Therefore, prayers can be performed in bed or while seated. Those who are not physically or medically restricted to bed could be provided with a space to pray in a secluded, clean and quiet place.

A hospital chapel may be used provided there are no religious icons present.

3. Dietary Needs

Muslims are required to follow a halal diet. Halal means lawful and is used to designate food which is permitted in Islam.

Not permitted: pork and any other pork product (e.g. bacon, ham, gelatin); meat and derivatives not killed ritually; alcohol.

Permitted: Meat and derivatives that have been killed ritually (halal meat); fish; eggs; vegetarian foods.

Patients can request halal food in most of the hospitals. Where halal menu options are available, patients may need reassurance that the food is halal and can be confidently consumed.

Utensils which have been used in the preparation of pork products or non-halal dishes should not be used to prepare food for a Muslim patient.

Muslims are required to wash their hands before and after meals. Bed-bound patients may require portable hand washing facilities.

Muslims will prefer to use their right hand for eating and drinking. If health care providers are required to feed a Muslim patient, the use of the right hand is preferred if they are required to touch the food, but either hand is acceptable if utensils are used.

4. Administration of Medicines

Some medicines may not be suitable for Muslim patients because they contain alcohol or are of porcine or nonhalal origin. Health care providers should inform patients about the origins of their proposed medication if it is derived from animals and no suitable synthetic alternative exists. Patients should be encouraged to make informed decisions regarding their treatment.

5. Medical Examination

Modesty is very important in Islam. Muslim men and women may be shy about being naked and very reluctant to expose their bodies to a stranger. Some Muslim patients may not wish to have physical contact with, or expose their bodies to, the opposite sex.

Muslims (both men and women) may be accustomed to being examined by a health care provider of their own gender, and if possible, this should be arranged. In the event of this not being possible, health care providers should show sensitivity and understanding for modesty concerns. Women may be especially reluctant to be examined by a male health care provider for sexual or reproductive health matters.

Health care providers should explain the need for more invasive examinations, particularly when the request for a same-sex clinician cannot be accommodated.

6. Hygiene

Islam places great emphasis on hygiene, in both physical and spiritual terms. Muslims must maintain a level of ritual cleanliness before prayer. Muslims must also follow a number of other hygiene related rules including:

• washing with water after urination or defecation
• the removal of armpit and pubic hair
• keeping nostrils clean
• keeping fingernails trimmed and clean.
• Toilets should be equipped with a small water container to assist with washing

A beaker of water should be made available to a bed-bound Muslim patient whenever they use a bed pan.

7. Maternity Services

As soon as a child is born, a Muslim father may wish to recite a prayer call into the baby’s right ear followed by a second prayer call into the left ear. This will not take more than five minutes and, unless the newborn requires immediate medical attention, health care providers should allow this to take place.

Another rite which is performed shortly after birth involves placing a chewed/softened date on the palate of the infant. If dates are not available, honey or something sweet may be used as a substitute.

Muslims are required to bury the placenta (which is considered part of the human body and therefore sacred) after birth. If there are clinical reasons for not providing the placenta to the parents, this should be explained.

Circumcision is performed on all male children. The timing of this varies but it must be done before puberty.

A fetus after the age of 120 days is regarded as a viable baby. If a miscarriage, an intra-uterine death after 120 days, or stillbirth occurs, Muslim parents may wish to bury the baby.

The removal of the new-born’s hair soon after birth is practiced by many Muslims. This is usually done seven days after birth. This can be performed at a later date (every seven days) if the baby requires a prolonged stay in hospital.

All other rituals for newborns can be delayed and are usually performed at home. For babies requiring a prolonged stay in hospital, communication with the parents about other rites and practices is important.

8. Foster Care and Adoption

Foster care and adoption, especially of orphans, is encouraged in Islam. However, under Islam, the child must always retain the family name of the biological family. Breastfeeding Islam requires mothers to breastfeed their children for two years. If a woman breastfeeds a child aged two years or less, the relationship between the woman and that child is considered to be like mother and child.

The woman’s biological children are also considered brother or sister to the breastfed child. However, the relationship between the child and its biological mother is not changed. Because of this, Muslim women may be reluctant to donate breast milk or to have their child fed from a milk bank.

9. Community Health Services Home Visits

If a home visit is required, it is advisable for health care providers to be modestly dressed to avoid embarrassment.

As Muslims often pray on carpeted areas, health care providers should ask if shoes should be removed before entering a carpeted area.

10. Visiting Arrangements

Visiting the sick is an important part of a Muslim’s duties and is required by Islam. It is considered a communal obligation and a virtue to visit the sick.

Muslim patients may have large numbers of visitors, including those from outside their immediate family.

Health care providers should discuss with the patient, or their family, the possibility of large numbers of visitors and the impact this may have on rest or care requirements, or other patients.