The Culture of Pakistani Sunni Muslims

Verbal Communication

Verbal

Communication style with people outside the family and close friends is generally formal and indirect as they often seek to avoid offending or burdening the individual

In the case of a male healthcare provider and a female patient, verbal communication should include the husband or male relative

Non Verbal Communication

Non

Verbal

The left hand is used for removal of dirt or cleaning, so one should gesture, touch people, or offer items using the right hand or both hands together

It can be considered rude to maintain direct eye contact with an elferly person or someone of the opposite sex

They do not require as much personal space as other cultures, however, one should still avoid the intimate zone of space unless necessary

Abortion

Abortion

A fetus is considered alive after 120 days gestation and abortion is not permitted after this time unless the pregnancy constitutes a serious threat to the life of the mother. Abortion is permitted prior to 120 days under certain circumstances. For example, in the case of fetal abnormalities, when there is a serious health risk for the mother, or when pregnancy has occurred as a result of rape. Abortion is never permitted on the basis of family planning.

Reproduction

Reproduction

Muslims are permitted to use temporary contraceptive methods under certain conditions. However, permanent contraceptive methods such as vasectomy and tubal ligation are only allowed where the woman’s health is at risk from additional pregnancies.

The use of assisted reproductive technologies is generally permitted in Islam. However, there are some techniques and practices that are not permitted:

• the use of donor sperm is strictly prohibited

• the use of sperm that has been cryopreserved is prohibited if the father has died

• surrogacy is not permitted.

Mental Health

Mental

Health

Mental health can be a taboo topic and many Muslims may try to deny the presence of mental illnesses.

For providers of mental health services, it is important to understand the particular religious practices of a Muslim patient. For example, the repetitive movements of daily prayer are not a sign of compulsive behavior but are rather part of the prayer ritual itself. Fasting during Ramadan is not necessarily a sign of disordered eating.

Medical Procedures

Medical Procedures

Blood transfusions and donations are acceptable

A fasting person may take the following medications/ treatments without breaking their fast:

• injections and blood tests

• medications absorbed through the skin

• gargling (as long as no liquid is swallowed)

The following will break the fast:

• ear and nose drops

• suppositories and pessaries

• inhaled medications

There is a cultural fear and demonization of addiction, which may result in hyper-monitoring of pain medication suggestions after being discharged

Birth

At the time of birth, there is a special prayer recited immediately in the baby’s ear.

Boys are circumcised as per religious obligation.

In the case that a baby needs to remain in the hospital for over a week after birth, it is good to know that a baby’s head is shaved 7 days after birth.

Family

Family is typically very involved and multi-generational. It is very normal for people to live with their parents well into adulthood along with their own spouses and children. It is normal for many people to crowd the patient during visiting hours. It is very unlikely that a patient will be left alone.

Decisions are usually deferred to elders. For example, even if a spouse is present, it would be normal for an elder or parent to give their opinion, or for a family to discuss things together. In the case of children, the eldest is usually responsible. Overall, decisions are usually discussed as a group and not taken by one person.

Death

Death

Islam considers human life sacred and suicide and euthanasia are forbidden. However, if a patient is suffering from a terminal condition and has been assessed as having no hope of recovery, it is permitted to stop medical treatment.

After death, it is extremely important religiously for the body to be released as soon as possible for burial, so much so that families are likely to refuse autopsy. Autopsies are considered disrespectful to the human body, which is seen as sacred. Most Muslim communities have their own funeral homes to avoid the excessive practices that take place in western funeral homes. Family will typically view the deceased person’s face briefly and wish to bury them as soon as possible.

Organ donation is generally avoided. Some may donate internal organs but avoid anything that alters the form of the body. Ex. limbs, skin, eyes, etc

Foods to Avoid

Foods to Avoid

Pork and alcohol are strictly forbidden. Most won’t eat other meat unless it’s Halal (Muslim version of Kosher)

Gelatin is also avoided due to it being an animal product, therefore medications in a gel capsule are avoided.

Alcohol-based medications are debated, so it is best to inform the patient and ask their comfort level.

Cultural Foods

Cultural Foods

South Asians have a high risk of heart disease, diabetes, excess body fat, fatigue and a number of other health conditions, mainly due to genetic factors and their high-carbohydrate lifestyle

Rice and meat are eaten almost every day. Unlike some nearby cultures, Pakistanis aren’t a vegetable-focused culture. When educating a patient on lifestyle changes to promote health in cases of diabetes or hypertension, many Pakistanis find it difficult to find healthy alternatives that don’t erase their cultural food. This usually results in a lack of lifestyle changes. It also can be very difficult to be one person in the home changing their eating habits while the rest of the household is still eating their regular food, especially considering that families live together and eat together.