1) Can you briefly outline the history and main objectives of the Medical Advisory Board (MAB)?
1. In mid seventies when I was a medical students, I received several requests from our community in East Africa to help them with their treatment when they came to UK. I felt ill-equipped to do so. The need kept on increasing and as soon as I qualified as a doctor in 1977 I was able to do more. However, it seemed to me that the services needed to be better organised. Since the need of our community was from patients from all over the world I felt it appropriate that it be done by the World Federation. I had also started to participate in World Federation’s Haj Medical Mission. It was then felt appropriate that such activities be consolidated under one board - Medical Advisory Board (MAB).
The board was then officially formed in 1979 and its objectives approved by the World Federation conference as: a. Treatment of patients from all over the world; b. Haj Medical Mission; c. Help doctors and other health care professionals; d. Health education of our community in terms of specific projects e.g. Govandi, Patna, etc; health education literature, articles, lectures,etc.;e.Screening programmes; f. Help other jamaats’ medical committees with their own work and projects; g. Fulfill health needs of our communities world wide as and when they occur.
2) You have been the honorary Chairman of MAB since it was inaugurated in 1979. This by no means is a small achievement and God bless you for the many hours you have spent towards community service. However don’t you think that the community needs to restrict the period of one’s Chairmanship primarily to encourage others to come forward to take such positions with out fear of being tied down to the post year in, year out?
2. I have been the honorary Chairman of MAB since it was inaugurated in 1979. In principle, you are right that the community needs to restrict the period of one’s chairmanship primarily to encourage others to come forward to take such positions without fear of being tied down to the post year in year out. However, our community is amazingly indifferent to this concept. It feels comfortable to let people do the work as long as they are generally satisfied with their performance. Before every triennial conference of the World Federation I have attended (6 since 1979) I have expressed a wish to the office bearers and to the delegates that a new chairman of MAB be appointed for the reasons mentioned above.
People simply don’t come forward and the President of the World Federation is left with no choice but to make do with "old tired-me". I have tried extremely hard to encourage fellow doctors and other health care professionals to take up the chairmanship but I have not succeeded. Let alone the Chairmanship, I find great reluctance in the professionals in our community to work for the community. In the last few years, things have improved and I now have a very good team but it was indeed a struggle to find people willing to work for the community.
What I am not prepared to do is to just follow the principle and withdraw from MAB when no adequate provision has been made to ensure that the work continues. I think It would be wrong to do so and the community needs to think very hard about introducing rules which it then can not fulfill. What is the point of restricting the chairmanship to one or two or three terms when the community is not prepared to come up with the workers/leaders when their time is up? To do so would be suicidal and self destructive.
3) Is the MAB subsidised by donors and the World Federation (WF) or is it self-financed?
3. MAB belongs to the World Federation. It is part of the WF. It is one of the boards of WF just like Islamic Education Board, Zaynabia Child Sponsorship Scheme, etc. The Chairman is appointed by the President of W F. It is funded by the WF.
4) Other than by way of arranging health care, in what ways does the MAB spread its assistance to individuals and organisations world-wide?
4. Besides what I have already mentioned, our work involves sending vital medical literature in terms of journals and books to other health care professionals, helping fellow human beings in distress (a lot of our efforts and funds are used to send medicines to the Iraqi refugees stranded in camps in Iran-Iraq border), advising our community in health related problems, producing health/medical literature pertaining to the specific needs of our communities and generally being available to the community with out any charge or breach of confidentiality. We also take it as our job to alert and educate the community of its health and medical problems e.g. HIV and AIDs.
5) Would it be of advantage to commercialise the running of MAB whereby the Board would be run by full-time paid professionals?
5. We already employ paid workers in our secretariat. However, the scope of our work and the work-load is increasing and we are considering employing paid health care workers.
6) Our health is our first wealth but yet we often leave ourselves vulnerable to diseases. To what extent does carelessness contribute to our ailments?
6. A lot. I could tell you of dozens of tragic cases which have ended up in disaster because of carelessness. There are cases of Aids, Cancers, and other serious diseases which have been ignored until it is too late. Patients are then come to us when it is too late.
7) In addition to prevention, what primary positive attitudes would you recommend as being conducive to good health?
7. In addition to prevention, I would advise our community to treat their bodies with as much respect as they give to other belongings like cars or televisions. If one’s car needs attention, one would take it to a person who knows about cars and how to repair them. We would not advise the engineer what to do because he is supposed to be an expert. We would not interfere with what he is doing to car. In the same context, our community needs to develop some respect for the health care professionals. Instead of going to see quacks or changing doctors frequently or telling the doctor what to do (this is very common in East Africa) the community should accept advice without questioning it or contradicting it.
8) According to the statistics availed by you, the number of overseas patients visiting UK in 1996 was 299. This indicates a drop from the 1995 figure of 416 patients. Is this downward trend attributable to any reason like more patients going to India for treatment because of lower costs or probably because of better health-care facilities overseas?
8. You are right. There is a drop in the number of patients coming to us for their treatment if you compare 1996 figures with 1995 figures. This downtrend may be due to more patients going to places like India, South Africa, Kenya, etc. where treatment is cheaper than UK and of good quality. We encourage this move. However, I don’t think the drop is of any significance. We have seen this is variation in the past.
9) What is your opinion of medical facilities provided in India?
9. Medical facilities in India are good. Except in cases where some new treatments and technologies are required for treatment of cancer or IVF, we would like to encourage people to go to India. The CHB has organised a very good set up which would benefit all.
10) Considering the high costs involved for patients seeking medical treatment overseas, complemented by the fact that you receive most patients from East Africa (over 50% come from Tanzania), would it not be prudent and cost effective to creat a local infra-structure to cater for medical treatment? This would mean investing in equipment, manpower and property but would provide our brothers in Africa with a cheaper alternative.
10. I agree wholeheartedly with you. We have been advocating this approach for some time. Perhaps it is tame to think along this line more seriously.
11) Do you receive patients who come from overseas for treatment of ailments which can easily be cured in their place of domicile? If so, can you mention the type of treatments for which patients don’t necessarily have to travel overseas for treatment?
11. Yes - indeed. The cases include appendicectomy, cataract surgery, circumcision, male and female sterilisation, general body checks, simple gyenaecological procedures, etc. These can easily and competently be carried out in the country of such patients’ domicile. However, when the treatment is being paid for by the patient, we can not refuse them the facilities of MAB.
12) What are the main killer-diseases facing the community and any suggestions on how to protect ourselves from these?
12. Heart disease, Cancers, Accidents and HIV and AIDs. We should do all we can to prevent heart disease e.g. eat less fat and cholesterol, control our weight, stop smoking, take regular exercise, get conditions like high blood pressure and diabetes adequately treated and adopt less stressful life. It is better to be happy, healthy and have less money than to be unhappy, rich and die prematurely. I see too many premature deaths in men in our community who are striving extremely hard to become very rich fast.
The number of deaths in our community due to cancers (of lung, liver, breasts, ovary, bowel, etc) is rising fast. This is a fact borne by figures. Some of our doctors are doing research into the causes. It is felt that affluence leading to over indulgence in luxury foods like meat may be the cause of this unfortunate increase in cancer incidences in our community.
It is very sad that so many young people die in the prime of their life due to road traffic accidents. Many are seriously injured crippling them for the rest of their lives. All of us know of at least one person killed or seriously injured in an accident. The solution is obvious. Take care. Avoid haste. Make do without unnecessary risks.
What can I say about HIV and AIDS that has not been said. We were the first to raise our voice in the community about the impending calamity but people decided to ignore it. Some of our own doctors ignored the writing on the wall and denied that the community has this problem. The affluence in our community and with it, sexual promiscuity has added to the risk of catching HIV. Some of the practices of using used needles in injections and giving contaminated blood during blood transfusion has indeed added to the problems. The community must take urgent action to promote preventative measures. One way to stop the spread of AIDs is to introduce compulsory blood testing before marriage. This should also include thalassaemia testing to prevent children from being born with this very serious disease.
13) After being prescribed antidotes by a doctor for a particular disease, say a common Flu, patients often resort to self-medication when they contract the same virus again presuming they will be medically advised to take the same dosage. What is your opinion on self-medication?
13. Self medication is good provided there is adequate previous experience and not done for too long without consulting a doctor - say 2-3 days. This is so because most diseases in the human body are self limiting and the body’s immune system is able to overcome it. The patient must consult a doctor if there is no improvement or if the condition deteriorates. It should restrict to simple medications like paracetamol or cough linctuses and NOT antibiotics, steroids, etc.
14) In your address at the Dar Medical Convention you said the problem of infertility can be adequately handled for almost all situations. What are the new methods to cure infertility and are all such methods allowable by Islamic Sharia?
14. The new methods include artificial insemination of husbands sperms, fertilization of the ovum outside the womb and then re-implanting it, fertilization of ovum whereby husband’s sperms are specially cultured when he can not produce any, etc. As long as the gametes involve husband and wife and no outside donation of gametes is involved, the Sheria allows it.
15) With AIDS, previously we were complacent believing that our youths upheld high moral values. Then cases cropped up and we had to accept that we are equally vulnerable. Based on your evaluation at the Medical Convention, the community could be having between 0.5% to 1% carriers world-wide. The Community’s attitude towards AIDS is now geared towards creating awareness but the element of ‘urgency’ is missing. Don’t you think we need to be more pragmatic and down-to-earth in our approach even if this means causing alarm?
15. I do. The community has to recognise its needs and priorities. When we first talked about this problem, there was an uproar. We were accused of creating panic and asked to tone down our message. I hope it is not too late.
16) Talking of a pragmatic fight against contracting the disease, what are the best measures? What is your view of compulsory screening before marriage and of sex education to our adolescents?
16. I think we have no choice but to introduce these measures.
17) HIV carriers are often blamed for their misdemeanours. However not all carriers contract it through illicit sex. Do you have a percentage of how many carriers carry the virus through no fault of theirs?
17. You are of course right. Not all HIV carriers have become infected due to illicit sex. Many have been infected by being given infected blood or receiving injection by a dirty needle.
18) It is said that "as a man thinketh in his heart, so he is". Irrational or negative thinking often leaves one more vulnerable to diseases thereby accentuating the need for Counseling. To what extent is Counseling undertaken for patients being treated through the MAB? Considering the fact that many of the sick need spiritual healing, do we involve Alims in such Counseling?
18. Not much formally. You are right. Counseling is very important. It can indeed affect the outcome of treatments. Informal counseling of course goes on all the time by our doctors and volunteers. However we must think of providing formal counseling and involve our alims.
19) Many patients seek particular dates, doctors or hospitals following an Istikhara thereby leading to inconveniences in arrangements. What is your view with regard to the Istikhara-medical connection?
19. This is a very difficult area to comment on. I do not accept that istekhara should be used to rule our life the way some people in our community are using it . They actually use istekhara to decide whether to do istekhara or not. Surely this is not right and can not happen in the twentieth century. If and when the decision is so much in balance that one simply can not decide, perhaps istekhara can be justified. Surely it is common sense that Allah (SWT) does not want us to conduct our life on in this manner. Surely He wants us to use our intellect.
20) In what way do you publicise the activities of the MAB by way of literature, videos, Internet? You may also wish to mention on what progress has been made to update the community doctors’ directory.
20. Over the years, we have tried to publicise our activities as much as possible. We feel we are fairly well known in our communities in the world. However, we need to do more. Our reports are circulated in WF’s executive council meetings and in triennial meetings. We are on the Internet on the WF page (address is http://www.dircon.co.uk/worldfed/). Our 3rd edition of the directory of health care professionals in our community is going to be issued soon.
21) Finally can you outline the main long-term objectives of MAB?
21 My visit to Dar es salaam has been fruitful. At the Medical Convention my contribution was to introduce difficult health issues affecting our communities in Africa and making people think of them very seriously. At least my visit has started people talking about our problems openly. We have finally broken the ice. It is time to discuss our problems openly without fear or pretense and then TAKE ACTION. We need to listen to the professionals who know the problems of our communities. Otherwise we are doomed. .