Lecture for 1st year
medical students April 2001 by Professor Omar Hasan Kasule Sr.
1.0 CONCEPT OF GOOD HEALTH
A. Definition Of Health
B. The Qur'an And Health
C. Measurement Of Health
D. Health As Amanat
E. Health As A Bounty, Ni'imat
2.0 DETERMINANTS OF HEALTH
3.0 FAMILY HEALTH
A. Children And The Family
B. Mutually Satisfying Spousal Relations
C. Threats To The Family
D. Prevention Of Family Break-Up
E. Dysfunctional Families
4.0 COMMUNITY HEALTH
Good Healthy Communities
B. Bad Unhealthy Communities
C. Community Diagnosis
Indicators Of Community Health
E. Improvement Of Community Health
5.0 HEALTH PROMOTION
A. Spiritual Promotion at the Individual Level
B. Spiritual Promotion at the Community Level
C. Physical Promotion at the Individual Level
D. Physical Promotion at the Community Level
E. General Health Promotion
1.0 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
COMPONENTS OF HEALTH
Four components: The components of good health are spiritual health, sihat ruhiyyat; physical 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 that 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 disequilibria in others.
Holistic outlook: Islam looks at health in a holistic sense. If any part of the body is sick the whole body
is sick, mathal al jasad al waahid idha ishtaka minhu ‘udhuwun tadaa’a
lahu saairu al jasad bi al sahar wa al humma. If a member of a family is sick the rest of the family are affected emotionally
and psychologically. Any sickness in the community will sooner or later have some negative impact on all the members. The
holistic outlook also means that physical, emotional, psychological, and spiritual health are considered together. 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, and state of iman or 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 vary 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,
tawakku, may feel subjectively healthier than those who do not have these
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 () 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). Cure, shifa, was mentioned in several verses of the Qur’an (p. 637 3:49, 5:110, 9:14,
10:57, 16:69, 17:82, 26:80, 41:44). It is restoration of health after disease either mental/psychological (, , 17:82, 41:44) or physical (, 5:110, 16:69).
C. MEASUREMENT OF HEALTH
Health is often assessed subjectively using terms such as ‘good health’, ‘healthy’, ‘poor
health’ and ‘unhealthy’. Attempts have been made to measure health more objectively based on the ‘disease
model’ which defines health is absence of disease. Several indices of the quality of life have been defined and have
been used or have been described before. Statistical parameters have been used to measure health. There are measurable statistical
indicators of good health. They are useful for a group of persons since they describe the average or the range of the normal.
For the individual, the assessment of health is very individualized and cannot 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 cannot 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. It is e religious obligation, fardh,
for the sick to seek treatment. It is also obligatory to undertake disease-preventing measures such as dietary regulation,
general and oral hygiene, avoiding violence, avoiding diseases of the qalb that precede mental illness, or in general avoiding
anything that impairs good health.
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.
2.0 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).
The environment is the source of food and water that are necessities of life. Fertile soils give crops and food
(p 95 32:27, 36:33-36, 80:24-31). The environment is also the source of water an essential of life described in various forms
by the Qur’an as maau ghadhaq (p 1055 72:16), maau ma’iin (p 1055 23:50, 67:30), maau mubaarak (p 1055 50:9),
and maau ‘adhab (p1055 25:53, 35:12, 56:68-70, 77:27), maau maalih (p 1055 25:53, 35:12, 56:70), and maau ghawra (18:14).
The elements of the weather like heat and cold have direct effects on health. The environment also harbors many pathogens
that cause disease in humans. Some habitats may not be healthy for some people for example the companions of the prophet found
the climate of Madina unhealthy, ‘adam mula’amat jaw al Madina li al sihhat (KS501) and many suffered from fever
(KS501). The habitat also determines the character and behavior of people for example those who live in desert areas adopt
a nomadic life-style with a militaristic aggressive tendency whereas those who live in forested regions are sedentary and
are less aggressive.
The life style that people choose affects physical and mental health. The Qur’an has described several life-styles
that are injurious to health such as taraf (p233 11:116, 17:16, 21:13, 23:33,
23:64-67, 34:34-35, 43:23, 56:45), israaf (p 103 6:141, 7:31, 17:29, 25:67),
fasaad (p 895-896 5:32-33, 7:86, 7:103, 10:91, 12:73-75, 13:25, 16:88, 27:14,
30:41, 38:28, 47:22-23, 89:12-13).
Personality and behavior are perhaps the most important determinants of health. The Qur’an has described
several negative personality types and behaviors. Humans have been described as fakhuur
(), dhaluum (), ‘ajuul
(), qatuur (17:100), khasiim (36:77), haluu’u (70:19-21), jazuu’u
(70:19-21), and kanuud (100:6-8).
There is a strong relation between iman, character, behavior and health. Humans suffer from diseases of the heart,
amraadh al qalb (p 958 , , , , 24:50, 33:12, 33:60, 47:20, 74:31).
Among these diseases are lahaw (21:3), ghaflat (), ghill (), ghaidh (3:118-119), kibr (40:35), and nifaaq (2:8-10). Some of these diseases such as jealousy,
hasad and rancour, hiqd,that lead to violence in the person or those around
him Iman cures diseases of the heart. These diseases may manifest physically as psychosomatic 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 diseases
3.0 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, and 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). The Law prescribes 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 be 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, parents
who did not want to share their material possessions with more children have practiced feticide, and infanticide.
Extreme individualism and self-interest also pose a threat to the family. Those not willing to share with
others cannot 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. Harassed parents cannot be good fathers or mothers. War and poverty cause dislocation, instability,
and break-up of families
D. PREVENTION OF FAMILY BREAK-UP
There are many measures to preserve marriage, ihsan al zawaaj (-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 fathers 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 an additional
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 and decline of moral and religious values in the society.
4.0 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 (, 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 (, 7:96, 7:161, 16:112). Makka was described as a city of peace and general welfare (2:126, ).
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
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.
5.0 HEALTH PROMOTION
A. SPIRITAL PROMOTION AT THE INDIVIDUAL LEVEL
Most diseases can be prevented using spiritual approaches. These involve aqiidat, ibadat, avoiding haram and promoting
B. SPIRITUAL PROMOTION AT THE COMMUNITY LEVEL
This involves enjoining the good, amr bi al ma'aruf, and forbidding the evil, nahy 'an al munkar.
C. PHYSICAL PROMOTION 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 disinfection are all acceptable measures for protecting health.
D. PHYSICAL PROMOTION THE COMMUNITY LEVEL
This involves various measures aimed at environmental improvement
E. GENERAL HEALTH PROMOTION
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; and tranquility of a family life, sakiinat.
Iman and spiritual calmness, tama'ninat, contribute to health promotion.