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Features: June/July 2015

Summer: Seasonal Safety Issues

Summer safety issues include heat-related illnesses, sun exposure, water safety concerns, and use of fireworks or concern about fire.  Extremely hot weather can cause sickness or even death. Read more...

Ramadan 2015

Fasting Holiday: Consider Medical & Scheduling Implications for Some Patients

Ramadan will last for 30 days until Friday, July 17th.  Many Muslims, including many in the local community, will follow dates established by the sighting of the moon in Muslim countries such as Saudi Arabia. Ending dates may therefore vary. Ramadan is the ninth month of the year in the Islamic calendar.

Clinical Considerations: During Ramadan, Muslims will abstain from food and drink from sunrise to sunset. In northern locations like Seattle, the days this year will be long, around 15 hours.

There can be medical and scheduling implications of fasting for some patients. For those who fast, the diurnal pattern of caloric intake is obviously reversed and diabetic schedules will have to be adjusted to accommodate this significant change. Sometime in the month prior to Ramadan a discussion between provider and patient should take place to plan medication schedules. Blood draws, anticoagulation, breastfeeding regimens, TID regimens, surgeries and other procedures may also merit special consideration during Ramadan. Senior doctors might consider bringing this to the attention of new interns who may not be in the habit of thinking about Ramadan when prescribing medication, scheduling procedures, and arranging follow-up on discharge from the hospital.

Health care settings might consider providing support for patients to maintain their religious practices. Islamic patients are more likely to keep their clinic appointment if they know a room is available to maintain their prayer times during their month long Ramadan observance. Eid-al-Fitr is a day of celebration marking the end of Ramadan, and clinics may want to take steps to avoid scheduling possible no-shows on this day in particular. Throughout Ramadan, Muslims gather as family and community in the evenings to break their fast. Inpatients may receive an increasing number of visitors during this month.

Fasting Exemptions and Extra Fasting: Based on the Quran, those who are sick, on a journey, or women who are menstruating, pregnant or nursing are permitted to break the fast and make up an equal number of days later in the year: [2:185]. Such persons as the sick elderly and chronically ill for whom fasting is unreasonably strenuous are required to feed at least one poor person for every day in Ramadan for which he or she has missed fasting, and are then not expected to make up the fast later. There are provisions made for paying back missed fasting days as practical aspect of the faith. It can be useful for providers to remind patients of this option; it sometimes allows one to negotiate important compromises. Muslim patients may still choose to fast because, to most, Ramadan is believed to be the most blessed and spiritually-beneficial month of the Islamic year.

Some people will choose to fast an additional 6 days after Ramadan, beginning the day after Eid-al-Fitr (celebration marking the end of Ramadan). This extra fasting is accepted by some Somali scholars as the equivalent of fasting for one entire year, while other Islamic scholars may say it is equal to 60 months (one day being equivalent to ten months). This type of fasting is called sunnah fasting.

See also:

Recent Features

Migrant Children Health

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Welcome to EthnoMed

EthnoMed contains information about cultural beliefs, medical issues and related topics pertinent to the health care of immigrants to Seattle or the US, many of whom are refugees fleeing war-torn parts of the world.

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Ebola Resources

The risk of an Ebola outbreak in the U.S. is very minimal, but there are some resources and factsheets about Ebola in other languages and formats to help provide accurate information. Below are several resources that provide audio messages, pictoral factsheets and translated brochures about the Ebola virus.

Centers for Disease Control

Washington State Department of Health

Public Health-Seattle King County

Torture Resources

Resources for clinicians and advocates around issues of torture, often related to warfare and political repression.  Includes information about Northwest Health and Human Rights (NWHHR) coalition serving refugees, asylum seekers, and immigrants in Washington State.  Visit Caring for Survivors of Torture page for additional information.

Scams Targeting Refugees and Immigrants

The U.S. Citizenship and Immigration Services (USCIS) and Federal Trade Commission (FTC) provide information about common immigration services scams and other kinds of scams targeting refugees and immigrants. To find information about recent scams, tools and education about avoiding scams, and to learn what victims should do if targeted, read more...