Ramadan is the most holy month in the Islamic calendar. According to the Islamic faith, the Quran, the holy book of Islam, was recited to the prophet Mohamad during the month of Ramadan. Ramadan is a month in which people give thanks for the good things in their life (including food and drink) and to empathize with those less fortunate. It is a month to practice patience and offer prayers.

It’s important for all healthcare leaders to understand how the celebration of Ramadan impacts their patients, as well as vaccine distribution. Also, as we work to build equity and inclusion in the healthcare workforce, ACHE of MA’s Diversity & Inclusion Committee is pleased to share this educational list on how to communicate and recognize the holiday with their colleagues.

Details

• Muslims around the world fast from dawn to sunset. Fasting includes food, drinks of any kind (including water), medications, etc.
• According to Islam, all adult Muslims are obligated to fast, with some exceptions for people who are travelling, pregnant, or sick, and a few other exceptions.
• Due to fasting, the daily schedule for Muslims may be altered. Iftar (breakfast) is at sunset, which is around 7:20ish Eastern Time. To prepare for fasting, some Muslims wake up early to have a light meal (Sohour) before dawn.

Date and Duration

• This year, Ramadan starts on April 13^th. The Islamic calendar (Hijri) is about 11 days shorter than the Gregoric calendar, and the start and end of the month are determined by the position and shape of the moon in the sky.
• Ramadan goes for 29 or 30 days, and it ends with a three-day feast called Eid.
• The daily meal that Muslims have after fasting is called Iftar. Usually, the family prepares different kinds of food and gathers around the meal. Iftar is a reason for families to visit each other and have the Iftar meal together.
• Adult Muslims usually gather to participate in a group prayer (Taraweeh) after Iftar

Impact on Patients

• Some patients may need to adjust their medication schedule to accommodate fasting
• Some patients may request scheduling accommodations: for example-they might ask for the early appointment so they can go back home afterwards to rest.
• Patients may have fewer visitors during Ramadan.
• Patients might request to postpone appointments until after Ramadan.
• No-show rates may be higher during Ramadan.

Impact on Vaccine

• According to some Muslim Scholars, anything that enters the body during the fasting hours in Ramadan is not allowed (food, drinks, medication, injections, etc). However, the vast majority of scholars agree that vaccination does not lead to violating the fasting rules. As we are going through the COVID vaccination process, some Muslims might postpone their vaccination until after Ramadan. It would be helpful to remind patients/ people who will postpone the vaccine for this reason that vaccination does not violate fasting rules and you could direct them towards the chaplaincy of the hospital or towards the Muslim leaders in the community to discuss that.

Impact on Staff

• Muslim staff might request change of shifts and prefer to work during the evening when they can eat and drink. If you can accommodate that, please do.
• Muslim staff might request time off during Ramadan or Eid.

Impact of COVID on Ramadan

• Due to Covid, Muslim families are unable to gather for Iftar and the group prayer that follows.

Nice Gestures

• Acknowledge Ramadan if you know you have a colleague who is fasting. The proper terminology to use is: Ramadan Kareem, or Ramadan Mobarak (meaning have a blessed Ramadan).
• A message from leadership acknowledging and offering well wishes for Ramadan is appropriate.
• When possible, avoid eating and drinking in front of your fasting colleague.
• Often times, when Ramadan comes up in a conversation the natural response is: ‘’I could not do that” or “that would be so difficult” or “fasting without drinking or water is unhealthy’’. Although this is a natural response, try to avoid saying it. Instead, you can say: ‘’I hope your fasting goes smooth and easy’’.
• Understand that fasting may affect a colleague or patient’s mood.