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COMMUNITY HEALTH IN ISLAMIC PERSPECTIVES
Dr. Ahmed Aroua
ALGERIA

INTRODUCTION

At the "Second International Meeting on Islamic Medicine", we had presented a paper entitled "Islamic perspectives on philosophy and policy of health". We should like to recall briefly some points.

1. The integral meaning of the health, covering:

1. body health,
2. mental health,
3. moral health,
4. spiritual health

2. Health is influenced by three kinds of factors:

1. constitutional factors (biological and inherited make up)
2. environmental factors including:
   * physical environment (soil, water, air, climates)
   * biological environment (plants, animals, microorganisms; organic materials)
   * social environment (human, economical, cultural and moral) spiritual and political environment
3. behaviour factors

3. As Islamic physicians defined it, "the medicine is a science that studies the human body in state of health or disease, in order to protect health or restore it when altered" (Ibn Sina). This definition indicates the two purposes of medicine.

1. treatment of diseases (by medical means)
2. protecting and promoting health and welfare (by preventive medicine and by improving the factors that influence health)

4. Health care in its global meaning intervenes at the level of the mentioned factors:

1. constitutional factors (activity of health services)
2. environmental factors (public services in various sectors concerned by physical, biological and social environment)
3. behaviour factors (depending of personal education and consciousness in the fields of health care, culture, morale,..)
   

COMMUNITY HEALTH IN ISLAMIC CIVILIZATION

The aims of health policy are to protect and promote human health through its physical, mental and spiritual components, and the individual health and welfare are closely related to the health and welfare of the whole community, as a holy hadith said:

So, Islam is worth more than any others, in taking care of community health by preserving it or restoring it when altered.

Islamic civilization as religion, culture, moral and social institutions have early contributed to promote health and wellbeing to all members of the community and even beyond it.

Islamic civilization created many general and specialized hospitals, medical services and assisting institutions. It set up libraries, community homes, and developed science teaching, including natural and medical sciences, in addition to the other public institutions which aims to achieve and promote economical, moral and spiritual conditions of society. Here are the main qualities that distinguish the community health in Islamic civilization:

1. Wellbeing is an existential purpose covering both the land of living and the Next World.
2. Health in its complete meaning include corporal, mental, moral and spiritual dimensions of man.
3. The practical aims of the medicine are: the treatment of diseases, and the protection and promotion of health.
4. Health care is a social function based on the communitarian solidarity that involves both public and individual responsibility.
5. Personal health is closely linked to social and environmental conditions of health.
6. Health services are not lucrative enterprises but social service that must be covered by governmental or communitarian resources.
7. Fundamental teaching include religious education and general culture meanwhile teaching of medicine is delivered both in theoretical way such as medical schools and in practical way such as hospitals.

However, we have to notice some weak points:

8. The ignorance of the primary causes of diseases, mainly the infectious ones.
9. Consequently, absence of a medicine really acting against infectious diseases.
10. The absence of a central planned and well-established policy of health services.

ISLAMIC WORLD DECLINE AND THE BEGINNING OF THE OCCIDENTAL RENAISSANCE

After centuries of a shining civilization, Islamic world came into dark period of decline, because it drew away from its moral sources. It dropped the rope that protected it from error. Thus it not only fell apart into tribes nations and parties fighting against each other, but faced problems of internal conflicts, epidemics, famines, which were causes of more weakness. Then Islamic civilization degenerated and vanished away with its sciences, arts, industries, social and central institutions. Medicine put away its scientific book and turned into primary and superstitious popular medicine.

Meanwhile, Occidental peoples started competing with Islamic world. They drew sciences and knowledges from Islamic sources while the same sources had vanished in Islamic world. Nevertheless, the Occidental civilization in its Middle Age period, had to face three fundamental crises:

1. An ideological crisis that opposed dogmatic theology to the new discoveries in natural sciences.
2. A sociological conflict opposing the different social classes.
3. A moral crisis that opposed the materialistic aims of life to the moral and spiritual values.

During this first period, and for many centuries, the Occidental Civilization did not show any interest to the community health, except for the marginal charity houses run by religious institutions.

COMMUNITY HEALTH IN THE CONTEMPORARY OCCIDENTAL WORLD

Community health in its modern meaning appeared only in the XXth century with the radical social changes. The interest given to community health is due to an ambiguous motivation where the personal aspiration to health joined the business interest in preserving the active and productive manpower.

For this reason, the policy of community health reflects the ideological and moral contradictions existing both in the liberal and the socialistic systems. This will be illustrated by a comparative study between a liberal system represented by USA and a socialist system represented by USSR.

REMARKS
Remark 1.
Here is a brief comparison of the different advantages and disadvantages in both systems.

Remark 2

The comparison between the health system in USA and in USSR represents two extreme politics. In fact, many states in the world, pick up from the two systems, according to their ideological option and their social and economical conditions. So, the private and the public sectors are coexisting in various proportions in the most European and third world countries.

ISLAMIC PERSPECTIVES IN COMMUNITY HEALTH

Can we imagine an Islamic point of view in community health policy in comparison with liberal and socialist systems?

In its Islamic meaning, community health is based on three methodological criteria:

- Fidelity to the Islamic doctrinal, moral and external civilizations.
- Broadmindedness with regards to the external civilizations.
- The ljtihad or effort to historical adaptation and advancement of sciences and technology.

1. As for the fidelity to the Islamic sources, it is based on the following principles:

- The integral meaning of the health including physical, mental, moral and spiritual dimensions of the man.
- Policy of health involves:
* curative medicine using medical means,
* preventive medicine that protect health by medical and hygiene means,
* general prevention acting at the level of health factors in environment

- Health care is at the same time, a personal and a public responsibility involving the governmental and the community institutions.
- Community health is not a commercial enterprise, but a social service.
- Each member of the community has equal right to health, wellbeing and happiness

2. As far as scientific and cultural broadmindedness is concerned, it means oversight on the scientific, technological, economical and social achievements performed by other peoples, in order to acquire knowledge with regards to what fit in with moral Islamic principles and with the common good of people.

3. . As for the Ijtihad, it means the development of scientific researches, creative technology, and planned strategy to promote the human being in all the fields of health, education, and social development.

Remarks

We only mentioned general ideas in Islamic community health perspectives. Various ways to approach medical and samitarian problems in the modern Islamic society are possible, with regards to historical, economical and sociological conditions of each country. For example, the proportion between public and private health services may be different. Educational programmes and methodology of teaching are evaluative. The permanent objectives are to promote the general level of community health by improving health services environmental health and the citizen's consciousness.

CONCLUSION

Community health policy in its Islamic perspectives, is characterized by:

1. The global meaning of the health which include physical, mental, moral and spiritual dimensions of the man.
2. The practical objectives of health, which are to promote both preventive and curative health services and improve the external factors that influence the health.
3. Health and educational institutions are not lucrative enterprises, but community services.
4. Moral and spiritual virtues can't be set aside of the medical profession.

REFERENCES

1. 1982
2. 1981 SNED

3.

4. 1974
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6. "Sante Publique, Sante de la Communaute S.I.M.E.P". p. 293-319.
7. "Les trois systemses mondiaux de prestation medicale: tendances, perspectives". Milton Terris in Forum de la Sante Vol. 1 & 2.
8. DR. MAHER M. HATHOUT, "Islamic Health System and Integrated approach", II^nd Islamic Conference of Islamic Medicine.
9. HAKIM MOHAMMAD SAID, "Thoughts of the future of Islamic Medicine". II^nd International Conference of Islamic Medicine.
10. DR. OMAR S. ALFI, "Islamic Health System in U.S.A", II^nd International Conference of Islamic Medicine.