The Cultural Beliefs in UAE
This paper discusses about the cultural beliefs of people at UAE. It mainly focuses on people who all are suffering from diabetes and fast during the month of Ramadan. Gibbs cycle has been used to explain the overall situation of the behavior of diabetic patients towards their health. The later part of the paper discusses on personal experience with the recommendations to deal with the patients in order to maintain their sugar levels at the time of fasting. The goal of studying this topic is to explore the knowledge about the importance of spirituality in treating the patients and maintaining their health. The paper also includes the summary of the interview that has been conducted with the non-Arabic nurse so that clear view can be acquired about their strategies to deal with the local patients.
The United Arab Emirates is the country that has around 96% of its population as Muslims. It is the cultural duty of all the adult Muslims to fast in the holy month of Islam that is, Ramadan (Clarke, 2017). Fasting results in decrease of glucose level, that ultimately falls down the insulin and this affects the health of the diabetic patients (Pasha & Aljabri, 2014).Therefore, fasting is not allowed for the diabetic patients. If the facts and figures have been considered, it has been estimated that 20% of the total diabetic patients in UAE prefer to fast during the month of Ramadan. Even after having awareness that fasting is not good for health, they prefer to fast as they are very much attached to their culture and the cultural practices. If worldwide data is considered, it has been estimated that 50 million Muslim people having diabetes fast for a month every year without concerning about their health issues (Deeb, et.al., 2017). Assessing the entire situation, it has been analyzed that it is very much essential to assist the Diabetic patients in UAE about the effects of fasting on their health and advising them for the same.
This paper focuses on Gibbs reflective cycle. I have used this cycle to evaluate and assess my experiences regarding fasting in the holy month of Ramadan and its effect on the diabetic patients. Gibbs model helps in assessing the situation and evaluating the personal reflection about that (Edgar, 2016). It dissociates the whole scenario into six parts that starts with description, feeling, evaluation, analysis, and conclusion and action plan. Explaining all the steps of the Gibbs model provides the related aspects of the situations. It not only helps in providing the reflection of the person about the situation but also describes the future recommendation to handle that particular situation.
Gibbs Reflective Cycle and Personal Experience
This is the initial phase that discusses the actual situation which has been experienced by me related to the topic. It is the time when I was doing my internship at khalifa hospital. I was assisting the doctor who was specialized in curing diabetes. It was the time of Ramadan and one of the patients came to the doctor explaining that he is facing the issues of weakness and dehydration. After examining him, the doctor asked him if he is fasting or not and he shook his head in approval that he is doing fast. The doctor got angry and he asked the patient to stop fasting as he is diabetic and fasting is affecting her sugar levels that is very bad for his health (RNW Media, 2017).The patient denied to the idea of ceasing the fast and asked doctor to help him maintaining his sugar level as he cannot stop fasting for a month. This idea suggests that it is very much obligatory for the people that follow Islamic religion to fast during Ramadan as they believe that it is a sin if someone with this religion is not fasting during the season of Ramadan (Vakili, Niazi & Rezaie, 2016). When I interrupted the patient and tried to explain him that health is more important, he totally resisted to understand.
After this incident, I felt that it is very important to teach people about the importance of their health. This situation made me realize that most of the people that follow the culture of Islam people do not consider their health over their cultural beliefs (EL-Hadded, 2017). I felt the need of helping these people with the provision of some sort of advice like diet charts and medical help so that they can maintain their sugar levels at the time of fasting. Pharmacology professor, Lind Jaber suggests that it is not only the empty stomach that affect the health of the diabetic patients but breaking the fast at night and overeating at that time also fluctuates the sugar level of the blood(Rouhani & Azadbakht, 2014). Keeping this mind, I realized that it is the learning stage and helping these people is very much required to keep them safe from the hazardous consequences of fasting.
According the incident, I realized that I have not made enough efforts to explain the overall situation to the patient. I should have shown him the practical process that occurs in the body during fasting. This may affect his understanding in a better way. He resisted understanding the situation because, he was so much attached with this cultural belief that he did not wanted to understand the science behind his illness.
Recommendations to Deal with Diabetic Patients
My interruption between the conversation of the doctor and the patient was needed at that time. This is because it is my duty to make the people understand that their health should be the preferred choice for them (Cruz, Alshammari, Alotaibi & Colet, 2017). It is very important to convey the knowledge of associated risks to the patients so that they can realize the importance of balancing their diet at the time of fasting. (Lovering, 2013) has provided the crescent of care model for nursing that explains the involvement of spirituality and cultural beliefs in care and wellbeing of the Islamic people. This model suggests that nurses have to make the balance between the cultural belief of the patients as well as their health and to do so they have to take care of them accordingly. In case if diabetic patients, nurses have to make efforts in maintaining the health of these people at the time of Ramadan along with giving respect to their beliefs.
The overall situation and the incident conclude that I have to handle the situation patiently. A nurse working there has been interviewed to get the proper idea of the situation. The nurse was working there for 3 years from now. She suggested that she has learnt some of the words in Arabic so that it will be easy for her to communicate with the Arabic patients. The first solution that has been used by them is to assess the reports of the patients before 1-2months of Ramadan (Burnard & Gill, 2014). According to the assessment, the medical advice has been given to the particular patients regarding their diet charts, meal time and the amount of meal taken by them. Educational counseling is another important and effective solution to this issue. After assessing her answers, I realized that she has good knowledge of the importance of nursing in Islamic culture but she did not have any idea about the basic beliefs of the Islamic people for fasting in Ramadan. According to the humanity concern, she suggested that involvement of family helps in dealing with the patients. She has also mentioned about the problems she has to face at the time of dealing with these patients. The main problem is lack of knowledge about the local culture. Overall interview suggests that the non-Arabic nurse should be provided with the training of local culture.
Interview:
- How long has the nurse been working in the Middle East?
It has been 3 years that the nurse is working in Khalifa Hospital.
- Does the nurse speak Arabic? Do they know any of the words that would be used for daily assessment such as pain, voiding, eating etc.? If not, how do they communicate with patients?
The Importance of Nursing in Islamic Culture
Nurse does not speak Arabic but she has learnt some of the basic terms in Arabic that can help her in making daily conversations with the local people.
- What does the nurse understand about the 5 pillars of Islam?
She explained that she knows about the names of the 5 pillars that are there in Islam but she does not have any idea about these pillars in details. She also said that she knows bit more about fasting as the pillar because now a day she is dealing with the patients having problems due to fasting.
- What role do they see the family has in the healing process?
She explained that n only medical treatment but the support from the family also helps in curing the diseases.
- What do they understand about traditional alternative health practices? Do they agree with the patient’s right to use these? Are they congruent with their own beliefs?
She said that she has no idea about the traditional health practices.
- What other barriers does the nurse identify when providing care to Arabic and especially National patients?
The major barrier that she has mentioned was about the communication and lack of the cultural knowledge.
To resolve this issue in future, I will definitely propose the khalifa hospital to conduct a workshop for the people having diabetes before the month of Ramadan that assist the patients regarding the issue by providing them assistance. For Arab patients, the heath is very much related to their spiritual beliefs and thus they cannot prefer their health over their culture and beliefs (Dogan, 2013). The Health Authority of Abu Dhabi is the authority that regulates all the medical related profession including the profession of nurses. It provides the framework to the nurses working in Arab states to involve the cultural aspects of the Islam in health practices (Emirates 24|7, 2017). This also helps in better treatment of the people and nurses can easily make the patients understand about the importance of health if they involve spirituality in the process. The Abu Dhabi Health Services Company (SEHA) is the organization that provides the reports and the guidelines that helps in treating the patients at the heath care centers (Ramezani, Ahmadi, Mohammadi & Kazemnejad, 2014).
Several recommendations have been made in order to handle and treat the people at the time of Ramadan who are suffering from diabetes. It has been recommended that measuring the sugar level at daily and regular basis at the time of fasting helps the patients to make the records and know about the patterns in which their sugar level is falling or increasing (McFarland, 2014). This requires teaching the patients about these tactics and heath care centers should take initiative in providing such knowledge to the patients. This ultimately needs to train the staff of the heath care centers to involve spirituality in their process of treating the parents at the time of Ramadan (Smyth, 2017).
Interview with a Nurse
Conclusion
To conclude, it has been determined that UAE is the place where people are very much attached to the culture. They prefer to follow their beliefs rather than taking care of their health. This suggests that the medical practitioners have to involve spirituality in their process of treating the patients at the time of fasting or in the month of Ramadan. In addition, It is important to know that nurses suffering from insisting of patients with some disease to fast but in another hand intact for an important personal commitment to the patient that should be clearly in light of guidelines for religious exception and taking of consideration of the associated risks in reference with health care professionals.
References
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Vakili, R., Niazi, Z., & Rezaie, P. (2016). Type 1 diabetes and Ramadan fasting: A narrative review. Journal of Fasting and Health, 4(1), 22-24.
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