Muslim doctors in the mainstream

The challenge of multiculturalism is for the community to recognise, appreciate and accommodate cultural differences

I anticipate that this article will be published halfway through the month of Ramadan.

My experience of the Muslim world was limited until about a decade ago, when, in the Spanish city of Córdoba, I stumbled upon a symposium about Maimonides, the medieval Sephardic Jewish scholar and doctor who had a profound influence on both Islamic and Christian thinking and philosophy. At the time, I had just wandered through the Great Mosque of Córdoba, now the Cathedral of Our Lady of the Assumption. Built in the 8th century, the mosque was taken over four centuries later by Christians, who then constructed the cathedral within it.

The fate of Jews, Muslims and Christians has long been intertwined, but often the interaction has been one of conflict rather than an expression of shared cultural values.

In his book What went wrong?, about the relative decline of Islam in the 20th century, especially in the Middle East, Bernard Lewis asks:

This is a complex question that requires deep exploration of culture and history to answer.

Multiculturalism in Australian medicine

In the prevailing culture of my boyhood, opportunities for mutual understanding, if not cultural affinity, among Muslim and other people in our community were few. My closest friend, who attended the same private Anglican single-sex school that I did, admitted to a strong Jewish heritage. There were other Jews at school and then at university, and I was fortunate to sustain friendship and collegiality with them during my professional life. So, in the critical developmental period of my life, I was socialised alongside Jews. By contrast, my social contact with Muslims was minimal, and the Muslim world remained on the periphery of my early professional life.

However, over the past 20 years, the number of Muslim doctors in Australia has grown, among both local and international medical graduates. As I became more involved in the delivery of rural health services over the past decade, through my role as director of medical services of several small contiguous health services, my contact with Muslim doctors increased substantially. I quickly came to realise that in some Muslim communities, there is a culture of male doctors treating male patients, and female doctors treating female patients. Such patterns were reflected in many of the Muslim doctors' attitudes, leading to tensions. When there is no easy familiarity with cultural differences, the community tiptoes around them, fearful of accusations of racism.

At the same time, the term “multiculturalism” is bandied around as though it were an instant anodyne. However, multiculturalism must flow deep in the nation's heritage — a tradition in the mainstream — to truly exist.

Improving cultural understanding

The challenge of multiculturalism is for the community to recognise, appreciate and accommodate cultural differences. These differences are often manifest or enshrined in religious observances. In the case of Islam, the most obvious is the month of Ramadan, with its fasting between sunrise and sunset. I know young Muslim doctors who were asked by non-Muslim colleagues why they were not eating on a particular day: were they sick?

To improve cultural understanding among their colleagues, I invited two female Muslim interns to prepare a presentation on Ramadan before it commenced in 2013. This presentation was refined by one of them last year and presented again just before Ramadan, then repeated this year. On each occasion, the presentation invoked considerable interest among a predominantly non-Muslim audience. The meaning underlying ritual is central to community tolerance, just as Lent and Easter require Christian explanation.

In another instance earlier in my role as the director of medical services for these health services, a Muslim doctor with paediatric training brought to my notice the issue of circumcision and its proscription in public hospitals by the Victorian Department of Health. This policy seemed not to have taken account of Muslim sensibilities, resulting in the extreme situation of one family taking their child overseas for the procedure. Male circumcision was once common and, although less popular now, remains legal. To draw attention to this Muslim concern, I arranged for the Muslim doctor to present a Grand Round on the matter, with a senior Christian paediatrician acting as discussant. There was a diverse audience of non-Muslims, and the discussion was balanced.

The growing number of Muslim doctors in the Australian community brings mutual obligations, and it is through open communication and education that misunderstandings are resolved, particularly regarding the relationships between women and men. I have seen value in encouraging Muslim doctors to share their experiences, as occurred with the Ramadan presentation. Ramadan finishes in the Eid al-Fitr fast-breaking celebrations, which in a truly multicultural society could be marked by a public holiday.

The Ramadan presentation could be used to good effect elsewhere in the health system, and controversial areas such as male circumcision should be openly discussed. For me, the complexity of multiculturalism was brought home forcefully that day in Córdoba, on the banks of the Guadalquivir River. Gazing into the river, I could reflect that here, for a time, notwithstanding the periodic eddies, a mainstream of Muslim, Jewish and Christian cultures did coexist.