ISLAM AND POLIO
From The Lancet Infectious Diseases
Also at http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2814%2970856-4/fulltext#aff1
Fatima Riaz a, Yasir Waheed a
a Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan
Public health interventions and policies do not have a uniform response worldwide. Medical anthropologists appreciate the role of cultural epidemiology in establishing the community response and, concomitantly, the diseases fate.1 In the case of polio, which has a viable vaccine, social misconceptions and religious misinterpretations receive the most media attention as the barriers preventing the disease from tipping over into complete eradication.2
The world is battling the last wild-type polio virus in Pakistan, Afghanistan, and Nigeria—all three countries being predominantly Islamic and, in the case of the first two, neighbours. Epidemics in Somalia and Syria this past year complete the so-called Islamic pentad of polio prevalence.3 Authentic religious references need to be sought to credit or discredit the anomalous relation between Islam and polio. Islam has never shunned science or medicine; in fact, Islamic scholars during the Islamic golden age of the 8th to 15th centuries, such as Al-Razi, Ibn Sina, and Al Kindi,4 made major contributions to modern medicine.
However, vaccines have a prophylactic nature. This characteristic has caused much propaganda in some groups of Muslims who mistook this as a way of averting qadar (fate), or the will of God, while impugning on the knowledge of the unforeseen.
The concept of prevention (termed wiqaya) is not an alien one in Islam—its implications and implementations are present many times in the Quran and Hadith. Wiqaya can be sought for many things, from hell fire and punishment to jealousy and anger.5
The roles vaccination campaigns had in wiping out smallpox and greatly reducing cases of measles, rubella, mumps, and whooping cough is common knowledge.6 Islamic practices will hence, in all intents and purposes, promote vaccines for their role in preventing fatal diseases.
Containing contagious disease elements, especially with regard to endemic and epidemic diseases, is highly permissible in Islam. Furthermore, theologian Ibn Al Qayyim said: “the Prophet permitted seeking protection against contagious diseases”.7 Vaccines have some generic inflammatory side-effects, such as fever and influenza-like symptoms, but these drawbacks are negligible when the greater evil (ie, paralysis) is prevented. This principle is similar to the process of circumcising boys, in which the infant experiences pain, but later reaps many benefits.8 As Ahmad and Ibn Maajah narrated from the Prophet: “there should be no harm and no reciprocal harm”.9
Polio has an undisputed presence in endemic regions, and has an R0 of 5—7.10 With such a high R0, polio needs a prophylactic intervention to prevent it from rampaging through the community. Islamic principles clearly advocate this type of protection for the perpetual wellbeing of the world.
Trypsin, an enzyme used in the oral polio vaccine, is sometimes extracted from pork pancreas.
Although the enzyme is later washed out, this fact still sparked rumours that the vaccine is haram, or prohibited.11 Although pork is haram, trypsin categorically is not, and its quantity is so minute that, according to the Islamic principle of “when the quantity of water exceeds 2 qilla, impurities no longer affect it”, trypsin is clearly permissible.12
Many Islamic scholars and organisations have ruled in favour of the polio vaccine—eg, the Grand Sheik Tantawi of Al-Azhar University, the Grand Mufti of Saudi Arabia, and many others. Furthermore, organisations such as Darul Uloom Deoband in India, the Organisation of the Islamic Conference, the International Union for Muslim Scholars (Mufti Dr Yousuf al Qaradawi), Imam of Masjid al Aqsa (Baitul Muqadas), and Majelis Council of Ulemmas in Indonesia have also voted in favour of the vaccine. Countries that are leading examples to the Islamic world, such as Saudi Arabia, also expect all incoming immigrants for the Hajj and Umrah pilgrimages to be immunised via oral polio vaccine.13
Despite propaganda stating otherwise, no reference in the Quran or Hadith prohibits seeking a cure from a non-Muslim. The Prophet Mohammad himself sent for Harith Ibn Kulda, the doctor of the Arabs, who was not a Muslim, for medical advice.14 Islamic physicians were even known to use Indian, Greek, and Chinese medical practices if these would cure an individual from sickness. The Quran states clearly: “there is no compulsion in religion”.15
This division of the Quran is proof that Islam does not frown upon counterpart religions; thus, there is no basis for animosity or intolerance towards people of other faiths. Western medicine or medical practitioners can and should be consulted for matters pertaining to health, because the Sunnah (Practices of the Prophet Muhammad) and Hadith show no such discrimination.
Instability and terrorism in the three polio-endemic countries have successfully challenged government writ and hampered progress in health, education, and economy. Polio hot-spots in these war-ravaged states are inaccessible, inhospitable, and brewing with fundamentalism and violence.3 After 9/11, because of invasions, covert operations, and anti-West sentiment, Muslim countries are in a more precarious situation than are their counterparts. Boko Haram, TTP, and Al-Shabab are only some of the terrorist organisations hampering immunisation and killing health workers.16
Islam—derived from the Arabic word salema—means safety, purity, and peace, all of which are attained by surrendering to the Will of Allah.17 His explicit will as narrated by the Holy Prophet is as follows: “O you servants of Allah take medicine as Allah has not created a disease without creating a cure except for one and that is old age.”18 In its very name Islam has negated sickness, impurity, and distress; all features of polio and all avoidable by the timely use of the vaccine. An able-minded Muslim refusing the prophylactic is blatantly disobeying God and the sanctity with which Islam upholds life.
Polio is the present star of public health, and the world is getting frustrated by its refusal to be eradicated. With emotions running high and resources becoming thin, propaganda naturally ensues as the world tries to rationalise the viruss intractable last stand. Islam does not deserve to take the fall, because it is not against Western medicine, prophylactics, or any life-saving concoction that contains traces of pig derivatives. Religion is too wide a net to cast; there are 1·57 billion Muslims and 49 Muslim-majority countries, but only 6·1% of these are endemic for polio.19, 20 Although admittedly an exploitation of religion is present, this is because of instability and conflict—something rectifiable by working for peace in these troubled regions. Polio is global, and must be fought with global citizenship, without disparaging or stereotyping particular faiths or communities.
We declare no competing interests.
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