[caption id="attachment_13303" align="alignleft" width="120"]Joe Lam, PhD[/caption]The crucial first step in dealing with many ailments is for a patient to feel comfortable enough to approach a doctor. Without that, patients may not seek treatment. Then the results can be deadly. Consequently, building trust between patient and doctor is of paramount importance. When a doctor and patient are from different cultures, however, that fragile relationship could become even more delicate.
It was with this in mind that Dr. Joe Lam, Managing Director for Elsevier Health Sciences in Southeast Asia, set about developing the world's first Muslim health-care app. Lam had worked for many years with Great Britain's National Health Service, where he saw many patients from Muslim countries who had trouble accepting certain medical practices.
"As time went on it seemed obvious to me that there was a need for something that would help doctors bridge that gap," said Dr. Lam, who is based in Singapore.
Whether it's understanding the correct times to administer diabetes medicine during the Ramadan fast or knowing who can be a donor for a life-saving organ transplant, cultural knowledge is essential for non-Muslim doctors dealing with Muslim patients.
The Care of Muslim Patients app provides answers on such issues for the 70% of doctors who, according to a survey carried out in Southeast Asia, say they need more information on cultural understanding when caring for their Muslim patients.[note color="#f1f9fc" position="left" width=400 margin=10 align="alignright"]
Top 3 concerns of non-Muslim doctors treating Muslim patients
- Unsure of cultural practices (30%)
- Communicating Diagnosis and treatment (23%)
- Physical examination guidelines and protocols (21%)
Source: Islamic Healthcare Survey of physicians in Southeast Asia, conducted by Elsevier[/note]
The one-of-a-kind app features 26 chapters on topics such as "Medical Dilemmas," "Etiquette in Treating Muslim Patients" and "Medical and Cultural Issues," providing practical advice on potentially difficult issues for health-care providers not knowledgeable about the faith and its practices. It was created through a collaboration among authors, reviewers, editors and Islamic scholars from a variety of cultural and academic backgrounds.
To ensure that the information in the app was accurate, Elsevier looked for an organization with a history of reliably serving Muslim patients. It turned to the Federation of Islamic Medical Associations (FIMA).
"FIMA is a global association, which acts as an umbrella organization bringing together Islamic medical associations around the world, so that made it the obvious choice for us," Dr. Lam said.[caption id="attachment_13308" align="alignleft" width="250"]
Dr. Joe Lam with Deputy Director General of Health (Research and Medical Support) from the Ministry of Health Malaysia – Ybhg Dato' Dr Maimunah Abdul Hamid at the Federation of Islamic Medical Associations (FIMA) convention[/caption]Indeed, FIMA's worldwide reach was crucial when it came to ensuring the viability of the app not just as a cultural guide book, but as a tool for dispensing effective healthcare. For each specific cultural issue, a medically acceptable alternative was needed.
"The challenge was to identify the gap between cultural sensitivities and medical guidelines, and then bridge it," Lam said.
For some procedures, that could seem impossible. Resuscitation, for example, can be an invasive experience for any patient and crosses the boundary for many Muslim patients. Yet, there are no practical alternatives. What, then, does the app suggest?
"Communication," said Lam, "The route you have to take in a situation like that is for the doctor to explain all the elements of the procedure, and then the patient can make an informed decision about what they're comfortable with."
In other instances, solutions came not from the medical establishment, but from Islamic scholars. One issue faced by patients who are pregnant is how to approach Ramadan and the health issues that can result from fasting.
For this, Lam and his team consulted doctors and experts in the Muslim faith, who revealed that – although not widely known – the rules for pregnant women, and indeed anyone sick or unfit, were more flexible. They would be permitted to eat during Ramadan.
The app is important to any practitioners not steeped in Islamic beliefs who work with Muslim patients, said Professor Abdul Rashid Abdul Rahman, Editor of the app and the immediate Past President of the Islamic Medical Association of Malaysia.
"It represents a global effort in bridging the gap for better understanding of the needs of Muslim patients," he said, reflecting on a process that saw cultural experts and medical practitioners pool their resources to create this new tool.
As well as text chapters, the app uses case studies and videos to illustrate the Muslim viewpoint on health and healing, and the do's and don'ts of treating Muslim patients.
Dr. Parvaiz Malik, the President of FIMA, said the app will better equip medical practitioners and health-care leaders to care for Muslim patients. Nonetheless, there is still one cultural gulf that remains to be crossed.
"Not everyone uses Apple," sighed Lam of the iPad app. "We've had a lot of people saying 'When is it coming out on Android, or some other platform?' But we're working on that.
[caption id="attachment_13316" align="alignright" width="110"]Ian Evans[/caption]
Ian Evans is Communications Business Partner in Elsevier's Global Academic & Customer Relations division, based in Oxford. He worked with Dr. Joe Lam and Marketing Manager Uma Lin of Elsevier Health Sciences to write this article.