Cholera Outbreak: Guidelines in Light of Islām
What You Need to Know About Cholera
As at 24 May 2023, the Gauteng Department of Health has confirmed at least 22 cases of cholera and 15 deaths in the region, with numbers set to increase. The National Institute of Communicable Diseases (NICD) has provided detailed answers to frequently asked questions (FAQs) about the disease. A summary is provided below. The full-length document can be accessed at the following link https://www.nicd.ac.za/wp-content/uploads/2023/02/Cholera-FAQ_February-2023.pdf).
- What is Cholera?
Cholera is a diarrhoeal disease caused by the bacterium Vibrio cholerae. It can cause large outbreaks and epidemics, usually in developing countries with poor water, sanitation, and hygiene infrastructures.
- How does Cholera affect a person?
The incubation period ranges from a few hours to 5 days, and symptoms range from mild diarrhoea to severe dehydration. The disease can be fatal if untreated.
- Who is at risk of contracting Cholera?
People who do not have access to clean and safe water and improved sanitation are at the highest risk of contracting cholera.
- How is Cholera spread?
Cholera is spread through the consumption of contaminated water or food. Water can be contaminated at its source, during storage or during use. Vegetables fertilized with human faeces or fish sourced from contaminated water can also cause infection. Similarly, if contaminated water or faeces come into contact with hands that are used to handle food, the disease can also be transmitted.
- How is Cholera treated?
The mainstay of treatment is rehydration, which replaces lost body fluids. Mild cases can be managed with oral rehydration, while moderate and severely ill patients need to be admitted to a hospital for intravenous fluid rehydration. Antibiotics are recommended for patients with moderate or severe dehydration. If you suspect that you have contracted cholera, you should visit your doctor immediately.
- How do we prevent the spread of Cholera?
Early detection and treatment of patients, coupled with health education, are the best control measures during an outbreak. Hand washing is essential for all healthcare workers and the community. Providing potable water and improved sanitation, along with health education, can prevent the spread of cholera. Cholera vaccines are also used in outbreak situations.
- What precautions should people take?
The community should be informed about sources of contamination and ways to avoid infection. Hand washing is vital in all community and health facility settings. Attention to sanitation can markedly reduce the risk of transmission of cholera as well as other diarrhoeal diseases. This is especially true where a lack of improved sanitation may lead to contamination of water sources.
High priority should be given to observing the basic principles of sanitary human waste disposal and particularly the protection of water sources from faecal contamination.
- Use safe water. If people are concerned about the quality of water they use for drinking and cooking, it is recommended to treat the water first by boiling it (place water in a clean container and bring to a boil for 1 minute) or treating it with household bleach (add 1 teaspoon of household bleach (containing 3 to 5% chlorine concentration) to 20 litres of water, mix well and leave it to stand for at least 30 minutes before use). Water should be stored and covered in clean containers.
- Because contaminated food may also be a source of cholera infection, attention to food safety is an essential preventive measure in order to prevent faecal contamination of food by food handlers. Street vendors and communal food sources will require particular attention through health education, since they pose a special risk.
The Muslim Approach
- Correct Belief
First and foremost, the correct belief to hold is that sickness and cure are from Allāh SWT. Any intervention or treatment that is utilised will only be effective by the Will of Allāh SWT.
Allāh SWT states, “… and you do not will, except that Allāh SWT, the Lord of the universe, wills”. [al-Takwīr 29] Likewise, Rasūlullāh SAW said, “For every illness, there is a cure. When a medicine counteracts the disease, then a person is cured by the will of Allāh SWT”. [Muslim 2204]
- Cleanliness & Hygiene – An Essential of Faith
Cleanliness is the main strategy through which cholera can be avoided. Islām emphasises cleanliness through different verses of the Qur’ān as well as through the Aḥādīth and rulings of Fiqh.
Allāh SWT praised the people of Qūbā for their use of water when purifying themselves after answering the call of nature. Allāh SWT states, “In (the Masjid of Qūbā) are men who love to purify (themselves) and Allāh SWT loves those who purify.” [al-Taubah 108] When Rasūlullāh SAW enquired about their hygienic practices, the people of Qūbā informed him that they would purify themselves with water after having answered the call of nature. Rasūlullāh SAW advised that they continue to use water and himself then also adopted this practice. [Rūḥ al-Ma’ānī 6/29]
Rasūlullāh SAW said, “Cleanliness is half of faith.” [Muslim 223]
Cleaning the private parts thoroughly with water (Istinjā) when answering the call of nature is necessary.
- Rasūlullāh SAW would always use water when answering the call of nature. [Ibn Mājah 354]
- Rasūlullāh SAW prohibited urinating where a person bathes or makes Wudhu. [Abū Dāwūd 1/259]
- Rasūlullāh SAW advised, “Seek protection from three actions that attracts the curse (of people): Urinating/defecating in the waterways, on the walkways and under the shade of trees.” [Abū Dāwūd 26]
Washing the hands after eating is a blessing and a means of protection against harm from animals and diseases.
- Rasūlullāh SAW states that the one who is harmed by anything after having gone to sleep without washing the traces of food from his hands would only have himself to blame. [Abū Dāwūd 3852; Badhl al-Majhūd 11/575; Mirqāt al-Mafātīḥ 7/2714]
- Rasūlullāh SAW said, “The blessings of food are in washing the hands before and after eating it.” [Abū Dāwūd 3761]
Washing the hands when awakening from sleep in order to eliminate impurities and germs.
- Rasūlullāh SAW advised that a person who intends to wash himself upon awakening from his sleep should not submerge his hands directly into the water container until he first washes his hands separately. [Muslim 278]
Safeguarding food against contamination and disease.
- Rasūlullāh SAW commanded that food and beverage containers be covered during the night. [Bukhārī 3316]
Covering of food should be done along with taking the name of Allāh SWT as it would serve as a means of protection from different harms, including epidemic diseases that descend during the evening. [Mirqāt al-Mafātīḥ 7/2760]
- Rasūlullāh SAW commanded that if food had fallen to the floor, it should be picked up and should be cleaned before eating it. [Muslim 2033]
The Hadith serves to prove that food must be clean before it’s consumed.
- Intention to Emulate the Sunnah
The practice of good personal hygiene should be done with the intention of emulating the lifestyle of Rasūlullāh SAW, as he was sent to the Ummah as a guide in all matters that also includes the preservation of our health and maintenance of personal and social hygiene. By the will of Allāh SWT, these practices will become a means of reward in this world and the Hereafter.
May Allāh SWT keep everyone safe and healthy.