HEALTH (SIHAT and AFIYAT)

HEALTH (SIHAT and AFIYAT)

fit as a fiddle Healthy, very fit, in good physical condition. There are several possible derivations of this expression, one of which holds that a properly tuned

CONCEPT OF  GOOD HEALTH

A. DEFINITION OF HEALTH

HEALTH IS A POSITIVE STATE OF BEING AND NOT JUST ABSENCE OF DISEASE.

The traditional view of health looked at it as the absence of disease. Before the development of scientific medicine, few diseases were curable. With increasing ability to cure disease we find that people may not be in optimal health and well-being even if all physical ailments were eradicated. This has led to the realization that good health is an independent entity that can be defined and handled independent of disease. Stated in other words, individuals who are disease-free may not be healthy.

COMPONENTS OF HEALTH

The components of good health are spiritual health, sihat ruhiyyat;  biological health, sihat al jasad/rahat jasadiyyat;  psychological  and mental, sihat nafsiyyat/rahat nafsiyat), and social health. Spiritual health is maintaining correct relations with the creator which in turn orders relations with other humans and with the environment. Health in the biological sense is maintaining physiological function in the optimal situation. Psychological health is being aware of and at peace with the self as well as the social environment around. Health in the social sense means harmonious functioning in the social milieu involving give and take relations. The various components of health are inter-related and closely inter-dependent such that a problem in one can easily lead to dis-equilibrium in others.

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, aadat, 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.

B. THE QUR’AN AND HEALTH

The Qur’an has used terms that refer to the general concept of holistic well-being such as raahat (7:189, 10:67, 16:6, 21:20, 25:47, 27:86, 28:72-73, 41:50, 42:48) and  raghad (2:35, 2:58, 16:112). The Qur’an describes the final perception of good health as well as its components or factors. Humans get tired (21:20) and need rest. Rest, raahat is described on as calming, sakiinat (7:189). The night is sakiinat (10:67, 27:86, 28:72-73).  Sleep is rest (25:47). Rest is needed after a day of hard work (16:6). Raahat could also be looked at as relief of distress (41:50) and as a blessing, rahmat (42:48).

C. 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.

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 and can not be summarized as indices or statistical measures.

The indices of health 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.

D. HEALTH AS AMANAT

Keeping body in good health is a responsibility, 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. Neglect of one’s health is a sin.

E. HEALTH AS A BOUNTY, NI’IMAT

Good health is a gift from Allah, ni’mat al 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

A. NUTRITION

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).

b.      ENVIRONMENT

c.      LIFE-STYLE

d.     PSYCHOLOGICAL FACTORS

e.     SPIRITUAL FACTORS

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

A. CHILDREN AND THE FAMILY

Good mental and physical health requires that children grow in a healthy family so that they can be balanced adults. A healthy family promotes the health of all its members. There is no alternative to the family for child up-bringing.

The family teaches trust, loyalty, a sense of belonging, rights and responsibilities. These are attributes needed for balanced psychological health.

The family is an economic unit

The family is the main source of primary health care

B. MUTUALLY SATISFYING SPOUSAL RELATIONS

Good, balanced, and mature marital relations are conducive to psychological and physical health. 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. The psychological and physical health of spouses and children suffer when the family breaks up on divorce more so than on death of one of the spouses.

C. THREATS TO THE FAMILY

Extra-marital sexual relations are a threat to the stability and functioning of the family. Islam has therefore prescribed several measures to prevent sexual corruption. 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).

Extreme materialism is a threat to the family. The spouses may e so busy searching for material wealth that they neglect their duties to one another and the children which eventually leads to family instability. In extreme cases greed for material goods becomes so extreme that children are seen as a burden. Throughout human history abortion, feticide, and infanticide have been practiced by parents who did not want to share their material possessions with more children.

Extreme individualism and self-interest also pose a threat to the family. Those not willing to share with others can not maintain cordial family relations. A healthy family has both give and take. There is both deposit and withdrawal from the family emotional and material savings account. Mere withdrawal without any deposit soon leads to tensions and problems.

A healthy family requires balancing rights with responsibilities. Insisting only on rights and ignoring responsibilities destroys the family unit sooner or later

The general economic and political situation in the society could also threaten the family especially the denial of basic human rights.

D. PREVENTION OF FAMILY BREAK-UP

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 law provides for custody of children in cases of family break-up. The extended family is another safety net for the family.

E. DYSFUNCTIONAL FAMILIES

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.  The causes of family dysfunction are multiple: economic pressure, a hedonistic life-style in which liberty is not tempered by responsibility.

COMMUNITY HEALTH

A.  GOOD HEALTHY COMMUNITIES

The concept of community health was not recognized widely until the last quarter century. It is however a very old concept found in the Qur’an.

The Qur’an has told us about many communities in the past as lessons for us (11:100). 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. 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).

B. BAD UNHEALTHY COMMUNITIES

The Qur’an also told of communities that were victims of collapse, 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).

C. COMMUNITY DIAGNOSIS

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.

D.  INDICATORS OF COMMUNITY HEALTH

Indicators of community health can be visualized at the individual, family, and community levels. The quality of human relations is the best overall indicator of community health. Good human relations empower any community to overcome any other adversities.

E. IMPROVEMENT OF COMMUNITY HEALTH

Community health can be improved in three ways. The beginning is having healthy individuals in the community. Then capable or designated members of the community should undertake the communally obligatory functions, iqamat al furuudh al kifaiyat. Finally the community should aim at establishing mutual cooperation and mutual complementation.

DISEASE  PREVENTION AND HEALTH PROMOTION

A. SPIRITUAL PREVENTION AT THE INDIVIDUAL LEVEL

Most diseases can be prevented using spiritual approaches. These involve aqidat, ibadat, avoiding haram and promoting halaal.

B. SPIRITUAL PREVENTION AT THE COMMUNITY LEVEL

This involves enjoining the good, amr bi al ma’aruf, and forbidding the evil, nahy ‘an al munkar.

C. PHYSICAL PREVENTION AT THE INDIVIDUAL LEVEL

Islam encourages a human to take measures to protect the body from harm by preventing disease. Thus immunization, good nutrition, personal hygiene, and dis-infection are all acceptable measures for protecting health.

D. PHYSICAL PREVENTION AT THE COMMUNITY LEVEL

This involves various measures aimed at environmental improvement

E. HEALTH PROMOTION

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.

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