Physicians who regularly treat Muslim patients offer the following advice for psychiatrists and others who may see these patients:
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For Muslims, going to hospital is a family affair. It is not unusual for a patient about to undergo major surgery to be accompanied by a dozen or more relatives.
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Some Muslims may tend to be passive in the presence of authority figures. Women may defer to their husbands and usually ask their advice before making a decision.
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Husbands often need to be present and do most of the talking, describing symptoms and discussing treatment options. Another family member or friend may sometimes fill this role.
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When seeking personal information, explain why you need it.
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As an ice-breaker, consider engaging in small talk to gain the patient's trust.
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Ask about having a family spokesperson rather than communicating only with the patient.
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Control the tendency to be “frank” when communicating a grave diagnosis or a poor prognosis.
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Since the Koran forbids premarital sex, some women may be unwilling to undergo medical procedures such as pelvic examinations and Pap smears, if the procedures could damage the hymen.
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A woman is exempt from daily prayers and from fasting during menstrual periods and 40 days after childbirth. She is also exempt from fasting during pregnancy and when nursing if there is any threat to her or her baby's health. If fasting is obligatory during the month of Ramadan, missed days can be made up later when it is more convenient.
Adnan Hammad, Ph.D., director of the Arab Community Center for Economic and Social Services (ACCESS) in Dearborn, Mich. (see article above), gives this advice to health care providers when treating a Middle-Eastern woman:“ Even if she doesn't understand English, talk to her, make a rapport between you and her, look into her eyes, and make communication.”
Maya Hammoud, M.D., director of the Middle Eastern Women's Health Program at the University of Michigan Health System, said health care workers have recently begun to pay more attention to Middle-Eastern patients.
Physicians now say to themselves, “Wait a minute—there is a different population that we need to understand here,” she said.“ There is still a lot that they do not know. But they know a little bit more” than they did a few years ago.
Some hospitals use innovative ways to make Muslim women feel more at ease during their stay. When Muslim women said they felt uncomfortable about men walking into their rooms when they were not properly covered, the University of Michigan Hospital gave patients a sign to place on their door requesting people to knock and wait for an answer before entering.
In another example, Maine Medical Center in Portland ordered new hospital gowns when its staff found Muslim women were so embarrassed with the skimpy ones that they had to wear that they would cancel their medical appointments. More than 2,000 Somali refugees now live in Portland. The ankle-length gowns completely cover the patient's back and buttocks; underneath is a wraparound sarong.
