Understanding Ramadan helps Penn State Health care for Muslim patients

Religious beliefs and practices are frequently a critical component of people’s lives. As an organization committed to an inclusive environment with a vision and mission that call for culturally responsive health care, Penn State Health asks its health care professionals to understand the importance of supporting our Muslim patients who observe Ramadan.

This holy month of fasting, reflection and prayer begins on the evening of April 12 and ends on the evening of May 12. The annual observance of Ramadan is considered one of the Five Pillars of Islam.

During Ramadan, Muslims eat a breakfast-style meal called suhoor before sunrise and then do not eat or drink for the rest of the day until sunset, when the fast is broken with the iftar meal. This meal generally consists of dates and water but, depending on the culture, can include other light foods such as soup, appetizers or fruit.

All Muslims who have reached puberty are expected to fast. If the fasting would create a hardship, such as people who are sick, traveling, women who are pregnant or experiencing their monthly cycle, an individual can request a religious exemption. Older individuals who are too weak or ill to fast are also exempt. Although children do not need to fast, it is not unusual for youth who are at least 7 years old to engage in limited fasting, such as half days or weekends, as a training for future fasting.

Clinical staff should follow these guidelines when treating Muslim patients who observe Ramadan:

1. Clearly communicate to the patient the requirements for receiving the best medical care. Talk to them at the beginning of their treatment about their preferences and options concerning their observance of Ramadan. For example, if the patient needs a feeding tube, explore whether there is an option for that to take place prior to sunup and/or after sundown.
2. Advise food services staff of the patient’s observance of Ramadan and that food should only be delivered before sunup or after sundown. In that way, the patient does not have to repeatedly refuse food during the fasting hours.
3. For Muslims with uncontrolled diabetes, recommend against fasting, but if they desire to do so, suggest that they divide up their quantities of healthy foods before sunrise and after sundown and not eat one large meal each time.
4. Encourage Muslim patients who are fasting to drink plenty of fluids prior to sunrise and after sundown to avoid dehydration.

For additional information, see the following:

• Ramadan fact sheet, Tanenbaum Center for Interreligious Understanding
• Diabetes during Ramadan, WellShare International
• Safe Ramadan Practices in the Context of COVID-19, World Health Organization, April 15, 2020
• What Providers Need To Know About Ramadan – YouTube video
• Mini-symposium: Ramadan Fasting and the Medical Patient: An Overview for Clinicians, Salem A. Beshyah*, Waseem Fathalla, Abdulkarim Saleh, Abdulrazzak Al Kaddour, Mohamed Noshi, Husni Al Hateethi, Nameer Al-Saadawi, Hussein Elsiesi, Numan Amir, Mohamed Almarzouqi, Ali Khalil, Mahmoud Benbarka, Urooj Ahmed, Huda Ezzeddin Mustafa, Wael Al-Mahmeed.

Penn State Health’s Office for Diversity, Equity and Inclusion partnered with Tanenbaum Center for Interreligious Understanding to better understand how to care for patients of various religions.

For more information about diversity and inclusion at the health system, contact Penn State Health’s Office for Diversity, Equity and Inclusion at diversity@pennstatehealth.psu.edu or 717-531-1012.

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