Healthcare Disparities in The Muslim World: A Human Rights Perspective

In 1946, representatives of 61 states came together and agreed on a shared vision that every human being should enjoy the highest attainable standard of health, as it is one of the fundamental rights to ensure human flourishing.^[1] The idea of health as a human right would essentially create a legal obligation on states to actualize this ideal. Accordingly, the United Nations adopted it in article 25 of the Universal Declaration of Human Rights (UDHR) in 1948.^[2] Today, almost every country in the world is committed to one human rights treaty that addresses health-related rights.^[3]

In 2020, there are 50 Muslim majority countries according to Pew Research Centre, such as Indonesia, Pakistan, Nigeria, Saudi Arabia and Uzbekistan. In many of these countries, harmful policies and practices from top to bottom continuously prevent proper access to healthcare that increases vulnerability to ill health, particularly the poor and marginalized in society.^[4] Interestingly, these “Muslim States” vindicate the idea of Sharia as a guiding principle in governance. However, in practice, one could argue that it is a perversion of the Sharia and what it stands for. Due to the brief nature of this paper, we will not go into the details regarding public health; neither will it be a historical analysis of the decline of the Muslim world.^[5] Instead, the paper will analyze the issue from a human rights perspective with a brief focus on the colonial foundations of state fragility and failure in many Muslim countries.^[6]

HISTORICAL AND POLITICAL REALITIES

According to Fadl, the problem of human rights is one of the most formidable moral challenges confronting Islam today.^[7] The idea that Islam is antithetical to the modern notion of human rights has been used implicitly and explicitly as an anti-Islam rhetoric. Fadl argues that this is due to particular historical and political realities that Muslims have had to confront, which have led to responses that are not consistent with the commitment to human rights.^[8] Consequently, it has led to an exacerbated process of moral disengagement towards human suffering, even when done in God’s name. He further highlights the reason for this depravity is due to a systematic vulgarization of Islamic norms that devalues the humanistic tradition of Islam. Thus, violations by Muslims that often made the headlines have been subsumed within the narrative in which Islam disregards the value of human rights.^[9]

Nevertheless, in our current political climate, it is crucial to study the history of modern secular human rights by looking at its origins and how it is politically employed across space and time.^[10] The fact that the idea of human rights is interlinked with the ongoing process of colonialism makes it essential to comprehend the modern discourse on human rights within the Islamic tradition. As Fadl puts it:

Colonialism and its accompanying institution of Orientalism had not only played a pivotal role in undermining the traditional institutions of Muslim learning and jurisprudence, but it had also posed a serious challenge to traditional Muslim epistemologies of knowledge and sense of moral values.^[11]

In short, Muslims did not encounter Western conceptions of human rights in the form of the UDHR; rather, they see it as part of the masters’ “civilizing mission” to spread secular enlightenment values and justify imperialistic policies in the Muslim world. This opened the doors to intractable and politicized conflicts today, which in many instances, have decimated the country’s healthcare system as a result of years of war.^[12] Whereas, on the intellectual front, it widened the schism between Islamism and secularism in many Muslim majority countries.^[13] It was also one of the main reasons why some Muslim countries abstained from signing the UDHR as these secular values fail to take into consideration the socio-religious context of non-Western countries and contravene the Sharia. Albeit, there is some truth in this statement,^[14] the Sharia is an intricate concept that should not be pigeonholed, particularly in the context of a modern nation-state.

2) SHARIA AS A CODE OF LAW

The surge of Islamic revivalism in the 20th century, brought along calls on governments to fully enforce the Sharia by making it the official law of the state.^[15] This created a huge problem as the nature of Sharia is antithetical to codification. According to An-Naim, the interpretation of Sharia by its very nature entails plurality in views about what it means and how it should be applied.^[16] In other words, it is not just about law as it represents a complex set of moral, economic, and cultural practices that deeply pervades social structures.^[17]

On the contrary, the process of codification meant reducing a plethora of opinions to a single legal ruling that demands conformity to achieve particular political objectives. This is because a key marker of a modern nation-state was the centralization and simplification of its laws for the state to supervise the legal realm actively.^[18] What followed was the process of a paradigm acculturation that was foreign to Muslim societies. It eviscerated pre-existing structures and replaced them with institutions that favoured the colonial powers. According to Hallaq, this is one of the leading causes of weak governance in the Muslim world. It not only created a moral fissure between two separate paradigms, but it also means that Muslim economies, polities, and societies are now forced to be dependent on a central power that does not necessarily serve the Muslims’ interest.^[19]

In the same context, the UDHR was conceived by the same colonial powers that continue to dominate the system of human rights. Thus, in spaces where it operates, it is fashioned to serve either the national interest of states or the financial affairs of multinational corporations. This is primarily why refugees and migrant workers do not enjoy the same protection and access to their human rights in some Muslim countries. Paradoxically, the claims of universality is ingrained in a particularity.^[20] It is an ongoing struggle that we have yet to come to accept. Having said that, how can we create an equilibrium between the two universals? One that is critical of the ontological nature of human rights but, at the same time, unconditionally committed to protecting people’s rights both individually and collectively.

PUBLIC SPHERE AND THE COMMON GOOD

The modern nation-state is here to stay, and we would probably not see it morphing in the next few decades. Moreover, with the emergence of nation-states, Muslims should recognize that we no longer need a theology of empire that idealizes a bifurcated world. What is required is not a revival of Islam or a legal reform for that matter. We need a systemic reform in Muslim spaces that can mediate between paradoxes to advance a common good and ensure human flourishing.^[21] For this to happen, a distinct public sphere needs to be established where individuals could engage in civic reasoning to deliberate on the common good and how it can be translated into society.^[22] As a result, this public sphere can impede the growth of both despotism and fanaticism, which are common trends in Muslim societies today.^[23] Therefore, at the state level, the service of the public good should be the ultimate priority of a government, and it should be tested at the level of human dignity.^[24] In this way, Muslims can embrace a more sophisticated view of the Sharia that is essentially humanistic without feeling conflicted with their multiple identities.^[25]

CONCLUSION

External forces that have destabilized socio-political infrastructures and consequently set the path for internal despotism have mainly produced the disparities we see in many parts of the Muslim world today. This paper argues for a systemic reform in Muslim polities in providing a stable environment for the advancement of a common good and restore a dignity deficit that Muslim spaces are confronting today. Moreover, it is imperative to incorporate an ethical orientation of the Sharia that essentially pursues the preservation of religion, life, intellect, wealth, progeny and dignity. It is in this light that governments should build their healthcare system. One that celebrates human dignity and actualizes human flourishing.

Like a mosaic, each member of society plays a vital role in struggling for a healthcare system that is committed to human rights in which the same treatment is available to all, an economic system that puts human needs first before profit; a moral economy^[26] that is committed to goodness, fairness, and justice.^[27]

Allahu A’lam

Footnote

[1] World Health Organization. (1995). Constitution Of The World Health Organization. Retrieved 21 April 2020, from https://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1

[2] United Nations. (1948). Universal Declaration of Human Rights. Retrieved 21 April 2020, from https://www.un.org/en/universaldeclaration-human-rights/

[3] Human Rights Watch. (n.d) Health. Retrieved 21 April 2020, from https://www.hrw.org/topic/health

[4] Razzak, J. A., Khan, U. R., Azam, I., Nasrullah, M., Pasha, O., Malik, M., & Ghaffar, A. (2011). Disparités en matière de santé entre pays musulmans et non musulmans. Eastern Mediterranean Health Journal, 17(9), 654-664.

[5] Please refer to Kuru (2019) to understand in detail the historical origins of authoritarianism in the Muslim world that has mainly caused underdevelopment in Muslim states today. In brief, Kuru contends that the shift from a mercantile to a feudal economy and the co-option of the Ulema (orthodox Muslim scholars) by military states systematically undermined intellectual and economic productivity in the Muslim world over centuries. In order to solve this disparity, Kuru calls for a socioeconomic and political reform that necessitates the existence of a creative intellectual class and an independent bourgeoisie who can balance the power of the Ulema and state authorities (p.235). It draws similarities with the paper’s recommendation to establish a public sphere for a common good.

[6] Tusalem, R.F. (2016). The Colonial Foundations of State Fragility and Failure. Polity, 48, 445-495.

[7] Fadl, K. (2002). The Human Rights Commitment in Modern Islam. In J. Runzo, N. Martin & A. Sharma, Human Rights and Responsibilities in the World Religions. Oxford: Oxford University Press.

[8] Ibid. [9] Ibid.

[10] Soubani, N. (2017). Does Islam Need Saving? An Analysis of Human Rights. Retrieved from https://yaqeeninstitute.org/en/noursoubani/does-islam-need-saving-an-analysis-of- human-rights/

[11] Fadl, K. (2002) p.117.

[12] Human Rights Watch. (2020). When Health Care Is Decimated By War: COVID-19 in the Middle East and North Africa. Retrieved 21 April 2020, from https://www.hrw.org/news/2020/04/16/when-health-care-decimated-war-COVID-19-middle-east-andnorth-africa

[13] Quraishi-Landes, A. (2015) The Sharia Problem with Sharia Legislation. Ohio North University Law Review, Vol. 41, p. 545, 2015; Univ. of Wisconsin Legal Studies Research Paper No. 1361. Available at SSRN: https://ssrn.com/abstract=2652896

[14] UNESCO. (2019). Abdullahi Ahmed An-Na’im: On human rights, the secular state and Sharia today. Retrieved 21 April 2020, from https://en.unesco.org/courier/2019-1/abdullahi-ahmed-naimhuman-rights-secular-state-and-sharia-today

[15] Rahman, N. (2018). Shariah Revivalism in Singapore. In N. Saat (Ed.), Islam in Southeast Asia: Negotiating Modernity (pp. 195-230). ISEAS–Yusof Ishak Institute.

[16] Erdman, S. (2015). Emory Professor Explains The Varied Views On Sharia Law. Retrieved 21 April 2020, from https://www.wabe.org/emory-professor-explains-varied-views-sharia-law/

[17] Hallaq, W. (2009) An Introduction to Islamic Law (p.163). Cambridge: Cambridge University Press.

[18] Alkiek, T. (2019). Shari’ah: From Diverse Legal Discourse to Colonial Misrepresentation. Retrieved from https://yaqeeninstitute.org/tesneem-alkiek/shariah-from-diverse-legal-discourse-tocolonial-misrepresentation/#ftnt3

[19] Hallaq, W. (2013) The Impossible State Islam, Politics and Modernity’s Moral Predicament (pp.155-156). New York: Columbia University Press.

[20] Asad, T., An-Na’im, A. (2009) Religion, Law and the Politics of Human Rights(p.2). Retrieved from https://tif.ssrc.org/2009/11/09/religion-law-and-human-rights/

[21] Traditionally, newspapers, magazines and forums were crucial platforms for discussion and the exchange of ideas. Today, the public sphere has been structured through cyber technology and has the capacity to transcend boundaries and mobilize people in a manner that was previously deemed impossible (Moosa, 2019).

[22] Habermas, J. (1991) The Structural Transformation of the Public Sphere An Inquiry into a Category of Bourgeois Society (trans.).Massachusetts: The MIT Press.

[23] Although Habermas’ notion was shaped along the lines of secular post-enlightenment reasoning, religion, particularly Islam, has a lot to offer in this marketplace of ideas.

[24] Moosa, E.(2019) Morality In the Public Sphere:Islamic Ethics and the Common Good (p.13). Singapore: Muis Academy.

[25] Nasir, N. (2020) Preserving The Sanctity of The Sharia – Why Must We Reject Extremists’ Claims? Retreived from https://muslim.sg/articles/do-we-reallyunderstand-sharia-muslim-sg?type=articles

[26] Moral economy might be defined as a kind of inquiry focussing on how economic activities of all kinds are influenced and structured by moral dispositions, values and norms, and how in turn these are reinforced, shaped, compromised or overridden by economic pressures (Booth, 1994).

[27] Esack, F., & Chiddy, S. (2009). Islam and AIDS: Between Scorn, Pity and Justice (pp. 6-7). Oxford: Oneworld.

Bibliography

Asad, T., An-Na’im, A. (2009) Religion, Law and the Politics of Human Rights(p.2). Retrieved from https://tif.ssrc.org/2009/11/09/religion-law-and-human-rights/

Alkiek, T. (2019). Shari’ah: From Diverse Legal Discourse to Colonial Misrepresentation. Retrieved from https://yaqeeninstitute.org/tesneem-alkiek/shariah-from-diverse-legaldiscourse-to-colonial-misrepresentation/#ftnt3

Booth, W. (1994). On the Idea of the Moral Economy. The American Political Science Review, 88(3), 653-667. doi:10.2307/2944801

Esack, F., & Chiddy, S. (2009). Islam and AIDS: Between Scorn, Pity and Justice (pp. 6-7). Oxford: Oneworld.

Erdman, S. (2015). Emory Professor Explains The Varied Views On Sharia Law. Retrieved 21 April 2020, from https://www.wabe.org/emory-professor-explains-varied-views-sharia-law/

Fadl, K. (2002). The Human Rights Commitment in Modern Islam. In J. Runzo, N. Martin & A. Sharma, Human Rights and Responsibilities in the World Religions. Oxford: Oxford University Press.

Farouq, S. (2018) Human Dignity in the Islamic Bioethical Discourse on HIV/AIDS (Masters), Qatar: Hamad Bin Khalifa University.

Habermas, J. (1991) The Structural Transformation of the Public Sphere An Inquiry into a Category of Bourgeois Society (trans.).Massachusetts: The MIT Press.

Hallaq, W. (2009) An Introduction to Islamic Law(p.163). Cambridge: Cambridge University Press.

Hallaq, W. (2013) The Impossible State Islam, Politics and Modernity’s Moral Predicament (pp.155-156). New York: Columbia University Press.

Hussin, I., Brown, N., & Yavari, N. (2014). The Impossible State: A Discussion of Wael Hallaq’s “Islam, Politics, and Modernity’s Moral Predicament”. Perspectives on Politics, 12(2), 461-467. Retrieved April 22, 2020, from www.jstor.org/stable/43279923

Human Rights Watch. (2020). When Health Care Is Decimated By War: COVID-19 in the Middle East and North Africa. Retrieved 21 April 2020, from https://www.hrw.org/news/2020/04/16/when-health-care-decimated-war-COVID-19-middle-east-and-north-africa

Human Rights Watch. (n.d) Health. Retrieved 21 April 2020, from https://www.hrw.org/topic/health

Kuru, A. (2019). Islam, authoritarianism, and underdevelopment: A global and historical comparison. Cambridge: Cambridge University Press.

Moosa, E. (2019) Morality In the Public Sphere:Islamic Ethics and the Common Good (p.13). Singapore: Muis Academy.

Rahman, N. (2018). Shariah Revivalism in Singapore. In N. Saat (Ed.), Islam in Southeast Asia: Negotiating Modernity (pp. 195-230). ISEAS–Yusof Ishak Institute.

Nasir, N. (2020) Preserving The Sanctity of The Sharia – Why Must We Reject Extremists’ Claims? Retreived from https://muslim.sg/articles/do-we-really-understand-sharia-muslimsg?type=articles

Quraishi-Landes, A. (2015) The Sharia Problem with Sharia Legislation. Ohio North University Law Review, Vol. 41, p. 545, 2015; Univ. of Wisconsin Legal Studies Research Paper No. 1361. Available at SSRN: https://ssrn.com/abstract=2652896

Quraishi-Landes, A. (2017) How to Create an Islamic Government-not an Islamic State. Retreived 21 April 2020, from https://www.middleeasteye.net/opinion/how-create-islamicgovernment-not-islamic-state

Qureshi, A. (2020). Reforming Modernity: Ethics and the New Human in the Philosophy of Abdurrahman Taha – The Bookslamist. Retrieved 22 April 2020, from http://thebookslamist.com/2020/01/06/reforming-modernity/?fbclid=IwAR3XR6tDjCMMRc4guLYq0wZytAmOPys9elAkqYuNy2Tz0J9Y38EtDroFE_A

Razzak, J. A., Khan, U. R., Azam, I., Nasrullah, M., Pasha, O., Malik, M., & Ghaffar, A. (2011). Disparités en matière de santé entre pays musulmans et non musulmans. Eastern Mediterranean Health Journal, 17(9), 654-664.

Soubani, N.(2017). Does Islam Need Saving? An Analysis of Human Rights. Retrieved from https://yaqeeninstitute.org/en/nour-soubani/does-islam-need-saving-an-analysis-of- humanrights/

Tusalem, R.F. (2016). The Colonial Foundations of State Fragility and Failure. Polity, 48, 445-495.

United Nations. (1948). Universal Declaration of Human Rights. Retrieved 21 April 2020, from https://www.un.org/en/universal-declaration-human-rights/

UNESCO. (2019). Abdullahi Ahmed An-Na’im: On human rights, the secular state and Sharia today. Retrieved 21 April 2020, from https://en.unesco.org/courier/2019-1/abdullahi-ahmednaim-human-rights-secular-state-and-sharia-today

World Health Organization. (1995). Constitution Of The World Health Organization. Retrieved 21 April 2020, from https://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1

Yavari, N. (2014). A Discussion of Wael Hallaq’s Islam, Politics, and Modernity’s Moral Predicament. Perspectives on Politics, 12(2), 466-467. doi:10.1017/S153759271400098X

SOCIETY ETHICS KEHIDUPAN MUSLIM MASYARAKAT PERSPEKTIF ISLAM MUSLIM WORLD HEALTH MEDICAL CONTEMPORARY ISSUES MEDICINE ISLAMIC PERSPECTIVE UMAT ISLAM MUSLIM LIFE