MODERN AND ISLAMIC MEDICINE: SOME IMPLICATIONS FOR TRAINING HEALTH CARE PROFESSIONALS IN KUWAIT. by SURREYA MAHOMED B.Sc. Physio. (U.D.W.); D.T.E. (Unisa); M.Ed. (Unisa) Submitted in fulfillment of the requirements for the degree of DOCTOR OF EDUCATION in the subject COMPARATIVE EDUCATION at the UNIVERSITY OF SOUTH AFRICA PROMOTER: PROFESSOR DC BADENHORST January 1998 Student number: 429-472-6 I declare that "Modem and Islamic Medicine: Some implications for training health care professionals in Kuwait" is my own work and that all the sources I have used or quoted have been indicated and acknowledged by means of complete references. ~~k?~<.G'k-&<_f.?d r4, ell . ~'!tJr /99~ -~!:.~~························· ··················<~<· .............. SIGNATURE DATE (Mrs. S. Mahomed) 610.95367 MAHO \1\\\111\11111\ 0001708301 ii ACKNOWLEDGMENTS I wish to express my sincere thanks and gratitude to Professor DC Badenhorst, my promoter. In Professor Badenhorst I have found the qualities of a man who has insight into understanding and appreciating different cultures and traditions; he is an open-minded teacher, a reputable scholar, and an inspirational model worthy of praise. I hope many students will find during their studies, a promoter who has the qualities of Professor Badenhorst. I also wish to express my sincere thanks to Pro£ Faizah M. Al-Kharafi, Dr. Abdullatif A. Al-Bader, Dr. Hoosein Al-Mahmoud, Mr. Sayyid Yousef Al­ Rifa'i, and Mr. Abdul Wahab Al-Shaya for giving me an opportunity to interview them in order to gain additional information for this research. I wish to thank Natalie Thirion and Karlien de Beer, the librarians at Unisa for all their assistance. I am extremely grateful to my mother Zulekha Omar and my late father Adam Salehmahomed for providing me with the kind of rearing that inculcated within me the capacity to be able to compare Modem medical concepts (which I acquired through secular education) and Islamic medical concepts (which resulted from my upbringing). I also wish to express my sincere thanks to Dr. Hussein Yosry Elewa who has constantly given me courage and determination to pursue this study to the best of my ability. Most of all to my husband Ismail Hassam Patel and my sons Hassam and Yusuf for their constant patience they exercised during the preparation of this thesis. iii Finally my humble gratitude is due to the Almighty Allah, for all the strength, knowledge and direction He has given me so abundantly during my research. I seek His forgiveness for anything wrongly stated or written that maybe due to the limitation of my knowledge. And to Prophet Muhammed (P.B.U.H.) the savior of mankind from whom flows directly all that is great and good in modem life. iv A NOTE ON THE BffiLIOGRAPHY AND SYSTEM OF DOCUMENTATION The system of documentation as used in this thesis is the Harvard method (Burger, 1992:21-75), adapted in certain respects to meet the special requirements of much of the source material. v SUMMARY MODERN AND ISLAMIC MEDICINE: SOME IMPLICATIONS FOR TRAINING HEALTH CARE PROFESSIONALS IN KUWAIT The historical roots of traditional and modern Western medicine have been the same, but during the past century these systems have diverged modern medicine has became dominant, replacing traditional systems in much of the world and denigrating them as quackery. In recent years there has been a resurgence of interest in traditional systems, with a remarkable change in attitude among health care professionals in many parts of the world. There is an increasing emphasis upon the importance of health care providers familiarizing themselves with specific culture-bound syndromes and their manifestations, in order to provide quality care to culturally diverse clients seeking health care services. Thus, there is a need for a complementary relationship between traditional healing practices and modern medicine in the world, reflecting the importance of respect for cultural diversity in health planning. The research problem assumes a relation between three distinctive dimensions of reality, namely, the industrial mentality, culture, and education. These dimensions will be discussed -Hccording to the relation-axes model introduced by Wielemans and Chan (1992:19), which investigates the complexity of relationships between man and himself, man and fellowmen, man and nature, and man and the transcendental. In Kuwait the traditional healing practices will be examined according to Islamic medicine and its contribution to health care. A comparison of modem and Islamic medicine is formulated and recommendations are made for the training health care professionals in Kuwait. vi TABLE OF CONTENTS PAGE DECLARATION 11 ACKNOWLEDGMENTS lll A NOTE ON THE BffiLIOGRAPHY AND SYSTEM OF v DOCUMENTATION SUMMARY Vl TABLE OF CONTENTS vii CHAPTER ONE 1 MODERN AND ISLAMIC MEDICINE: SOME IMPLICATIONS 1 FOR TRAINING HEALTH CARE PROFESSIONALS IN KUWAIT 1. INTRODUCTION 1 1.1 Introductory orientation. 1 1.2 DEFINITION' OF TERMS 3 1.2.1 Definition ofthe term "modernization" 3 1.2.2 Definition of the term "medicine" 4 1.2.2.1 Traditional definition of "medicine" 4 1.2.2.2 Modem definition ofthe term "medicine" 4 1.2.3 Interpretation of the term "Islamic medicine" 6 vii PAGE 1.3 THE FACTORS THAT LED TO TIDS STUDY 7 1.3.1 Need to define health and illness, and need to understand how 7 how people perceive their pain, and whether they communicate this pain to health care professionals. 1.3.2 Reasons for the neglect of Islamic medical education in the 8 in training of health care professionals in Kuwait. 1.3.3 Need to review historical background of Islamic scholars. 9 1.3.4 Need to review modem medicine in terms oflslamic medicine. 9 1.3.5 Need to offer answers to world problems related to health care. 10 1.3.6 Need to evaluate the concept of "modernization." 10 1.3.7 Need to evaluate the premature importation of Modem 11 Tertiary-Care-Orientated approach to health care delivery system. 1.3.8 Need to evaluate the process of "modernization." 12 1.3.9 Need to reflect on the relationship between man and the 13 transcendental. 1.4 THE PURPOSE OF THE STUDY 13 1.5 SUBSIDIARY OBJECTIVES OF TIDS RESEARCH 14 1.6 THEAIMOFTHESTUDY 15 1.7 THE STRATEGIES FOR EXPLORING THE PROBLEM 15 1.8 MOTIVATION FOR USING WIELEMANS AND CHAN'S 16 MODEL viii PAGE 1.9 THE METHODS USED IN THE STUDY 17 1.10 LIMITATION OF THE STUDY 19 1.11 THE STUDY PROGRAMME 19 CHAPTER TWO 21 HEALTH AND ILLNESS IN CONTEXT WITH PARTICULAR 21 REFERENCE TO THE MODERN (WESTERN) VIEW OF MEDICINE AND ITS IMPLICATIONS FOR THE SYSTEM OF TRAINING HEALTH CARE PROFESSIONALS 2.1 INTRODUCTION 21 2.2 THE RELATION-AXES MODEL 24 2.2.1 Industrialization and "Industrial Mentality". 25 2.2.1.1 Modernization Theory 25 2.2.1.1.1 Primary carriers of modernity 26 (a) Technological production 26 (b) Bureaucratization 27 2.2.1.1.2 Secondary carriers of modernity 28 (a) Mass education 28 2.2.2 Acculturation, Culture, Cultural Identity and Core Values. 29 2.2.2.1 Acculturation. 29 ix PAGE 2.2.2.2 Concept of culture. 29 2.2.2.3 Cultural identity. 31 2.2.2.4 Core values. 34 2.2.3. Educational Socialization and Core Curriculum. 35 2.3 THE FOUR RELATION AXES 37 2.3.1 THE RELATION BETWEEN MAN AND mMSELF 37 2.3.1.1 Health. 38 2.3.1.1.1 Defmition ofthe term "health." 38 2.3 .1.2 The concept of culture as it is related to pain. 41 2.3.1.2.1 Private pain. 42 2.3 .1.2.2 Public pain. 43 2.3.1.2.3 The presentation of public pain. 46 2.3.2. MAN AND NATURE/ENVIRONMENT 47 2.3.2.1. Disease. ·~ 48 2.3.2.2. Diagnosis. 49 2.3.2.3. Modern Birth culture. 52 2.3.2.4. The origin of Western birth culture. 54 2.3.2.5. Culture related to fertility and infertility. 55 2.3.2.6. Culture related to contraception, abortion and infanticide. 57 X PAGE 2.3.3 THE RELATION BETWEEN MAN AND FELLOWMEN 58 2.3.3.1. Treatment. 59 2.3.3.1.1 Medical pluralism in the Western countries. 59 (a) The popular sector. 59 ( b ) The folk sector. 62 (c) The professional sector. 67 · ( d ) Fifty facts from the World Health Report. 68 2.3.3.1.2 Metaphors of illness. 72 2.3.3.1.3 Comparison ofthe medical systems. 73 2.3.4 MAN AND THE TRANSCENDENTAL 75 2.3.4.1 Definition of Spirituality and Spiritual Health. 76 2.4 CRITICS OF THE MODERN MEDICAL SYSTEMS 79 2.5 CONCLUSION 82 CHAPTER THREE 85 HEALTH AND ILLNESS IN CONTEXT WIT PARTICULAR 85 REFERENCE TO ISLAMIC MEDICINE, MORE SPECIFICALLY KUWAIT, AND IT'S IMPLICATIONS FOR THE TRAINING OF HEALTH CARE PROFESSIONALS 3.1 INTRODUCTION 85 xi PAGE 3.1.1 The meaning of Islam. 87 3.1.2 What does the word Islam mean? 87 3.1.3 What is Islamic Medicine? 89 3.2 GENERAL INFORMATION ABOUT KUWAIT 91 3.2.1 The State ofKuwait. 91 3 .2.1.1 Location and area. 91 3.2.1.2 Kuwait's Islands. 93 3.2.1.3 Amir ofKuwait. 95 3.2.1.4 Crown Prince. 96 3.3 THE IDSTORY OF KUWAIT. 97 3.3.1 The rulers of Kuwait. 99 3.3.2 Public Authority for Civil Information. 101 3.3.2.1 The Civil Identity Card. 101 3.3.3 Religion. 101 3.3 .4 Mosques. 102 3.4 KUWAIT AFTER THE OIL BOOM.