AIDS prevention: An Islamic approach


Islamic Medicine
Staff member
AIDS prevention: An Islamic approach

The danger of transplanting culturally mismatched

AIDS prevention programs:

We have argued in the previous' chapter that the "mismatched trans- plantation" of any preventive model from one culture to another, even if it is successful in the original culture, an be as dangerous as the mismatched transplant of hu'man organs. his may utterly fail, be 'rejected' by the host culture or even lead to opposite results. From this perspective, one feels really dishearte ed to see Arab and Muslim health practitioners unenlightening y subscribing to the Western model of AIDS prevention bye dlessly repeating the 'gospel' of advising their Muslim nationals to se condoms, avoid sex with 'high risk groups', avoid using cont minated needles and syringes, and be faithful to one 'partner' In some countries, European leaflets, pamphlets and posters are simply translated into local languages and distributed to simple rural people who never inject drugs.The small minority 9f drug abuser among these villagers either drink alcohol or smoke nashish. To them, the pictures in the posters and leaflets are embarrassingly obsc ne and pornographic and the artistic messages too abstract to com rehend. As a matter of fact, some of the pictorial materials distribut d by AIDS prevention groups are seen as giving the opposite messag even in industrialised countries. By way of illustration, an Australia censor has lately been officially asked to judge whether a series of cards developed by a local council on AIDS prevention are porno raphic and should be banned. These cards had on one side picture of naked men engaging in

homosexual acts, and on the other a 'safe' sex message. The Queensland government feared that this saf sex message may turn out to be plain porn (Reuters, March, 1995).

Even in urban Muslim communities, any health workers fail to propagate their preventive mes age. Recently, one Arab television station aired a program in which n old doctor spoke about the dangers of AIDS and sexually transm tted diseases. He uncritically parroted the prevention methods o the Western Danish model and showed the viewers a condom wh ch he later inflated like a long balloon. The program drew savage a acks and sarcasm. It obviously did not serve its purpose because it s out of cultural tune!

I consequently strongly b lieve that prevention of the AIDS dilemma in Muslim countries hould not be left to alienated J Westernised WHO experts, to la y public health practitioners who t are willing to apply any 'readyma e' prevention model, or to brain- washed psychiatrists and social w rkers who are 'auto-culture blind', unable to see the merits and super or ethical values of their own religion and culture. They are so dog atically Western-minded that they equate the usefulness of values nd ideas with technological and material excellence. Thus, importi g modernity's AIDS prevention to them is as good as importing the atest laser medical technology or PET scanning. Perhaps it is this p ssive and negative attitude which prompted a former African minist r of health to strongly emphasise that, "AIDS is not just a doctor's b, siness or a nurse's business or an :' expert's business. Everybody, every here, is needed to assist in every :; way to spread the word on AIDS" Sabatier, 1988, p. 130).

As we have seen, the Western AIDS prevention model is culturally patterned according to the ew morality of the sexual revol tion and the dictates of the liberal ecularWestern society. It follows a strategy of saving what can be aved by external manipulations without tapping the inner spiritual ncentives or changing moral and ethical values. Before adopting it holesale, Muslim health practitioners, educators, social worker and other interested religious groups should have first assessed thesuccess of the Western preventive model in its native countries. Since it is failing there to the Iextent that AIDS has already beco e the prime killer of the sexually active young Americans, it will s rely be an utter failure in more , spiritually and Jslamically oriented ocieties. For prevention to attain any real success, it must develop from Islami roots. There are a number of cogent reasons for this claim. I will st te my arguments in the following discussions:

1. Faith or iman and Islamic rites: A forceful aid to AIDS prevention

a. The Islamic conception of faith in Cod: The c rnerstone of Islamic AIDS prevention:

An Islamic prevention program should make u e of the deep belief that Muslims have in the Absolute Power and ercy of Allah Ta'ala, the Almighty God who creates and controls ev rything in this uni- verse, from the tiniest electron to the largest gal xy. He knows every detail or vv'him in men's hearts. The Qur'an sta es "He knows your secrets and that which is even more hidden (in you} than your secrets" (Ta Ha (20): 7). This belief is deeply roo ed in Muslim hearts and minds whether they are saints or criminals. nd it is thisiman or faith which bestows the Muslims in many coun ries with the lowest : percentages of HIV infections (WHO statistics o AIDS). This is quite clear in Muslim countries of the Middle Eas and North Africa, Pakistan, Afghanistan, Iran and other societies o strong Islamic commitment. A successful AIDS prevention progra should make use of this deeply-rooted belief and should seek the as istance of influential Muslim preachers who know how to tap thes beliefs in changing attitudes and sexual habits in order to avoid the spread of HIV infection.

b. The spiritual benefit of prayer:

Iman is defined as that which is deeply anchor d in one's heart and is verified by one's deeds and actions. The ost essential among these verifications of Iman and Islam is the pe ormance of obligatory forms of worship and rituals. Chief among them are prayers and fasting. The practising Muslim has to offer hi five daily prayers.

Though each prayer may take only few minutes, it is a relaxing and highly spiritual and contemplative ritual which at times takes the ii faithful into a divine journey of tranquillity and closeness to God. , This experience is especially moving when mass prayers are led by an imam who beautifully chants the inimitable poetry of the verses of the Qur'an. These prayers are nicel distributed during the day and early dark hours of the night, so th t the Muslim can carry out his daily business and other responsibili ies, but after every few hours he has to extract himself from this worl of the here and now to the spiritual world. During these blessed ti es he is consciously and uncosciously reminded of his Islamic eth cal standard and moral responsibility. Prayers, properly performed, herefore, give the faithful a very strong willpower against fornication and the unsanctioned temptations of the flesh, as well as the strongth to abstain from drugs and alcohol. The Holy Qur'an states:

"Recite what is revealed of the Book to you and establish regular prayer: fo prayer restrains from shameful and unjust deeds." (AI-'Ankabut (29): 45).

c. Fasting boosts the will to change:

Fasting is another spiritually elevating obligatory form of worship. For the whole blessed month of Ramadan Muslims prevent themselves from eating, drinking and having sex al relations from dawn to sunset. To this day, fasting is regularly a served by both devout and sinful Muslims alike allover the world. Police records of theft and house : !i breaking, rape, car accidents, drunke aggression, and similar crimes ; show an obvious decline during thi month in all countries of theIslamic world.

It is during this month that many Muslims generate the necessary will and motivation to chang their lives by stopping to take alcohol, drugs or smoking or to absta n from promiscuity and opt for a tranquil life of marriage. In a study on the effica of spiritual healing to Sudanese alcohol abusers which I carried ou for the first WHO meeting on "The promotion and development o traditional medicine" which was held in Geneva (Technical R .port, Series 622, WHO, 1978), I found that almost all the alcohol busers of my sample were able to totally abstain during the fasting onth of Ramadan. Very few of them took a little alcohol during the arly nights of the , month to avert withdrawal symptoms. Many of th e who have even- tually achieved total sobriety were those who ad sustained this Ramadan abstinence for good. Towards the end o the month, many of them felt so determined not to lose their new di ine enlightenment and improved health that they found it neces ary to perform a solemn Qur'anic oath not to relapse. The writer f und that an appre- ciable number were able to resist relapsing a nu ber of years after they decided to stop alcohol intake.

Similarly, abstaining from adulteryl forni ation and sodomy can frequently be achieved during this month an an Islamicallyori- ented AIDS prevention model should make use of he spiritual wealth of Ramadan in changing sexual attitudes and im oral pathological behaviour. Hence, the combined influence of pr yer and fasting on the heart and mind of a faithful Muslim can be a powerful incentive to a clean sexual life and freedom from risky b haviour and drug intake. To build a strong will and aversion to pr miscuity is not to consider all kinds of sex as sinful or 'dirty'. A pra tising Muslim fully enjoys sex, for mere pleasure or procreation, but n doing so he fully acknowledges that he is a slave of God and is g ided by His moral rules. He is not a slave of his unruly unsatiated lu t, nor is he guided by his erogenous zones!

It is really lamentable to see Muslim AID practitioners, who possess such a wealth of spiritual self-preventio , yet do not make use of it in their prevention programs, echoin instead a failing Western model and parroting the gospel of c ndoms and clean syringes. They remind me of the famous verse f an ancient Arab poem which describes persons who are blind t their own cultural treasures as camels in a hot desert who suffer and die from thirst el ! while large skins of water are loaded on their backs. I am sure if daily prayers and Ramadan were observed by Westerners the way they are I observed in the Islamic world today, we would have had hundreds 0, upon hundreds of serious studies and research into their usefulness in AIDS prevention and in solving the problems of drug addiction. This is particularly saddening when one sees that the modern Muslim youth are coming back to Islamic values with forceful devotion. Prayers and fasting have another supporting aspect to the immune system. The steady spiritual invigoration, serenity and peace of mind they create in the practising Muslim is indeed an enhancing factor to his or her immune system. Modern research in psychosomatic and holistic medicine has repeatedly confirmed this relationship between mind and body to the extent that it has become one of the established , facts of modern medicine.

Another very interesting finding about the physiological bene- fits of fasting in the month of Ramadan which is quite pertinent to our discussion of AIDS prevention was reported by Dr. Usama Qandil of the Medical School of the prestigious Harvard University. Professor , Qandil found that the challenge that the human body faces when the fasting person suddenly stops the intake of food and water from dawn to sunset each day for a whole month causes the immune system to counter attack this condition with an upsurge in the activity of the very cells which are depleted by the AIDS virus.

Professor Qandil and his co-workers performed a number of remarkable studies comparing the influence of fasting on the immune systems of cancer patients suffering from immune deficiency. In one group, he compared the natural killer-cell count and their efficiency in attacking cancer cells just before the group embarked on fasting, as compared with their efficiency on the twenty-first day: of Ramadan and the twenty-eighth day of the month. The result was : indubitable. Fasting greatly increased the measured activity of these ; killer cells. The statistically computed difference was highly signifi-'\ cant (p<O.O2). It is of interest to note that Dr. Qandil found no difference of significance between the activity of the killer cells in healthy fasting Muslims as compared with a control of healthy non-Muslims.

Dr. Qandil also meticulously compared the ratio of other cells of the immune system in both healthy and immune subjects includ- ing a sample of those who fasted in the month of Ramadan and those who did not. He must have been astonished to find an upsurge in the ratio of the T-cells, and only in those who fasted. The statistical significance of this ratio was a staggering 0.0009. And of these cells, the helperT-cells had the highest increase. As we have explained earlier, these helper T-cells are unequivocally the most important group of cells in,the immune'system since, like the field marshal of an army, they control other cells of the immune system and organise the bat- tle against invading germs. By now we must be well acquainted with the fact that the AIDS virus and its collaborators are a killer because they target these T-cells. (Saudia monthly magazine, Ah/an Wasah/an, February 1996 issue, p. 73).

d. Promotion of AIDS prevention through hajj and 'umrah:

A third pillar of Islam and iman that can be very helpful in develop- ing Islamically oriented AIDS prevention is pilgrimage, or thehajj. Every year, millions upon millions of Muslims travel to Makkah to perform the holy rites of thehajj and 'Umrahah and to Madinah to visit the holy grave of the Prophet Muhammad and to pray in his blessed Mosque. The Prophet Muhammad, may the peace of God be upon him, is the only messenger of God whose blessed place of bur- ial is,authenticated without any shred of doubt. Thehajj is an annu- al holy occasion in which more than two million Muslims every year voluntarily pay for their transportation and other expensive needs to visit the holy Ka'bah, carry out specified rituals and congregate in the blessed valley of 'Arafah. All the pilgrims aggregate in this vast valley from noon to sunset to engage in prayer, glorifying Almighty God and begging Him for forgiveness and blessings. In spite of the hardships of overcrowding, high temperature, barren desert and hot black mountains radiating heat like giant stoves, the experience of the hajj is so moving and spiritually invigorating that most pilgrims return to their countries with completely different attitudes and spiritual orientations. Many are able to stop taking drugs and pledge to uphold their daily prayers and other religious obligations. In some Muslim societies, the esteemed title of "Hajj" (and "Hajjah" for a woman) is bestowed upon the person who performs this commandment. This , would generally impede such a person from engaging in fornication, drug intake or similar base practices associated with irreligious and good-for-nothing people, practices in which he might have indulged before his pilmirage,

A few decades ago, a large number of those coming to the hajj were the elderly who wished to carry out this obligatory commandment before their death. With the powerful wave of contemporary ; Islamic revivalism, the picture is completely reversed. About 85% of 1; the pilgrims are now young men and women. Though these young :: Muslims are not travelling to visit the breathtaking beauty of the lakes : of Switzerland nor to enjoy the happy-go-lucky life of Las Vegas, and though they are aware of the difficult camping life in the hot Arabian sand and the hazards of camp fires, sunstroke and suffocation due to overcrowding, they are still willing to pay to perform their religious duty.

The number of youthful applicants to the hajj and 'umrah is skyrocketing. Srnce the seventies, the government of Saudi Arabia found it necessary to limit the increasing number of pilgrims, specifying a quota for each Islamic country according to its population, and preventing those who have already performed the pilgrimage from doing so for a second time before the lapse of a specified number of years. Accordingly, ministries of pilmirage in many Islamic countries have found themselves compelled to select the lucky ones by casting lots. The number of overseas pilgrims added to those from inside Saudi Arabia exceeded two and half million at the last hajj occasion .

Unlike the hajj, the'umrah and visits to the grave of the Prophet and his .holy mosque can be performed at an time during the year, but then again, the huge numbers of those wi hing to visit Makkah, particularly during the holy month of Rama an have necessitated Saudi restrictions. I performed the "umrah during the Ramadan of 1996. As I stood to say my late night mass pra er, it was clear to me that there was hardly any place for more p ople inside the vast mosque with its huge multi-storey edifice. It wa just like the hajj. The number of people who attended the blessed night prayer of the twenty"seventh of Ramadan exceeded one millio .From where I was playing, I intentionally tried to spot old people like myself whose hair had whitened or greyed. It was a difficult task, since by far the great majority were the black-headed youth. ' How is it that an international Muslim mmah facing such a lethal pandemic as AIDS fails to make use of th hajj and the 'umrah in launching an Islamically oriented awarenes and prevention campaign? How is it that the ministries of health, outh or social affairs in all Muslim countries fail to utilise this u ique opportunity to address millions upon millions of these young eople who are at the highest risk of infection? These young pilgrims do not cost anybody anything. On the contrary, some governments ake money by forcing pilgrims to pay hajj and 'umrah taxes and y increasing the fares for air travel to Saudi Arabia during hajj time.

Millions every year could have beco e aware of the AIDS issue and how best to deal with it from an Isla ic point of view. The message could have been given in all the di erent languages spoken in the various Muslim countries, so that it ould be widely propagated by these pilgrims when they return to t eir home countries. It is lamentable that other than the usual very li ited Islamic preaching by professional scholars, this great occas on is only used as a floor for political quarrels and boisterous rallies.

e. The Muslim youth: The spearhead of Islamic revivalism:

From what we have just said about thehajj it will be evident that the Western model, which was mainly develop d to preserve the sexual revolution, will be clearly rejected by the gr at majority. of the sexually active Muslim youth to whom AIDS pre ntion is supposed to be directed. Whether we like it or not, Islam a a religion and an ethical way of life is returning with a forceful socio-cultural and spiritual tidal wave which is changing the social nd political face of the land of Islam. This great revival has paradoxi ally been brought about by the young; by those who were supposed to have been 'liberated' from their religi9us and traditional values an who have accordingly been more vulnerable to HIV infection. ,

In almost all Muslim and Arab cou tries, Islamic organised groups have completely dominated studen , workers, lawyers and doctors unions. Scores of young females w o were brought up by westernised modern Muslim mothers are i I sisting on wearing the hijab (Islamic dress), at times against the wishes of their elders and the threats of their governments. This is cle rly exemplified by the refusal of veiled Muslim girls in France to fo sake their Islamic dress in the face of the unfair and prejudiced deci ion of the French minister of education at that time to expel any female Muslim student who came to school wearing Islamic attire.

In the social and political arena, irres ective of the final out- comes, Islamic revival amongst the young s showing itself everywhere; whether it is the triumph of the Muja ideen in Afghanistan or the unexpected successes of the Islamists in t e recent Jordanian and Algerian free elections; the stone throwing lestinian children, the jihad of the reintroduction of Islamic law in Sudan and Pakistan, or the return of old customs like polygamy and earded youth; one will find the young Muslim men and women to b the spearhead in each and every sphere of these revolutionary move ents. For the first time in recent history, the gulf between the old an the young in Muslim countries is showing itself in a reverse fashi n. It is the young who crowd the mosques and adhere to Islamic adition, at times with uncompromising vigour.

Paradoxically, this Islamic reviv,lism amongst the youth is most forceful in Muslim countries that were modernised according to Western standards. Western powers exported the values and modern technology of modernity to colonised Muslim countries with the firm expectation that this would secularise them. The result was just the opposite. The more modernised the Muslim society, the stronger would be its Islamic dedication and the Western technology import- ed to modernise, to become the tools for Islamic propagation. This phenomenon serves as a good example of the culture blind and eth- nocentric way Westerners generally perceive other cultures. Just because the church in the Middle Ages presented an ugly, barbarous picture of religion, and just as the Enlightenment and the scientific revolution blended in Western modernity to bring about secularisa- tion, the same results should be expected in any other corner of the world even if religion in that corner has brought about enlightenment to its followers. This is beautifully elucidated by John L. Esposito (lslam-The straight path (Oxford University Press, 1988)). He says:

The history of modern Islam has challenged many presuppositions and expectations. The prevailing wisdom was that modernization required the separation of religion from public life, as modernizing societies' progressively and inevitably became secularized. The very process of modernization, which includes the impact of reason, science, and technology, was seen as encouraging and enhancing this secularization process...lslamic revivalism:..has countered and discredited such a uniform, evolutionary view of histori- cal change and development. Revivalism has l, been most visible in countries where modern ism had been strongest. Moreover, technology and modern education have often been used to reinforce rather than undermine belief and practice (p. 176).

In this kind of atmo.sphere, whether we like it or not, it should be unwise to set up AIDS prevention strategies along Western lines or to speak freely to Muslim youth about being homosexual, bisexual or lesbian, and to advise using condoms with prostitutes, or to speak about sexually active, unwed mothers who infect their babies with HIV as though one is talking about preferences in foods or drinks. It should be noted here that it is not the open talk about sexual matters between real or hypothetically married couples which is offensive. The Islamic literature, as we have already noted, tackles the hetero- sexual problems between married couples in the most frank manner. It is the implied or direct reference to what Muslims consider as immoral or perverted sexual relations which can be embarrassing.

Of course, one should not expect that all those who refuse a Western-style prevention plan of AIDS are not themselves promiscuous. There is always a difference between the spoken ideals and the actual practice of the individual. However, such persons, unlike their Western counterparts, feel guilty about their sexual misbehaviour and look forward to the day in which they will repent and go straight. Most of my Arab and Musl im patients, from Pakistan to Morocco, find it difficult to confess their unlawful sexual relations. When they finally do, they are often tearful, or at least repentant. Virginity and chastity are still highly held virtues, particularly in females, whereas any unsanctioned sexual relation is still considered sinful. This value judgement is generally accepted in any Muslim culture whether it is actually practised or not. Any wise group of professionals who are to plan for AIDS prevention in Arab and Muslim countries where the Muslim youth had already been influenced by revivalist movements . should take this Islamic orientation inio serious consideration. They should ponder the relevant information about AIDS, what to give and how to give it, what psychospiritual attitudes to foster, and what behaviour changes to expect, as these are all influenced by this primary aspect.

2. Islamic prevention' and divine retribution

The Western psyche greatly resent the idea of God's retribution, for obvious historical and psychological reasons which we have already detailed. Western secularisation denies the authority of divine sanc- tification and perceives its sanctions and punishments as being opposed to human freedom and dignity and to humanism which strongly believes that man is the measure of all things.

I will give a few unambiguous examples from the writings of Bertrand Russel, the eminent British philosopher, one of the most influential thinkers of the Western world and the recipient of the Order of Merit and the Nobel Prize for literature. He condemns Christ because he appealed to fear and retribution by believing in hell! He asserts that Socrates was a wiser man who deserves more respect because he does not take the line of indignation. "You find ," him (Socrates} quite bland and urbane toward the people who would not listen to him" (1957, p. 17}. In mocking religious punishment and ":,'l retribution, picturing preachers as hypocrites, Russel tells the story of a parson who terribly frightened his congregation with tales of future , catastrophes awaiting sinners and with pronouncements of the imminence of the second coming of Christ. However, Russel narrates, frightened worshippers were much consoled when they found him planting trees in his garden! (1957}.

More importantly, religious retribution is firmly associated in the Western mind with such repugnant acts of the church as the burn- ing of innocent women accused of having sexual relations with the devil, and the execution of and cruelty to scientists who opposed the views of the church. One must agree that these acts were barbaric, irrational, and antagonistic to science, the new religion of modernity. Therefore, it is only natural to find that this attitude of repugnance towards retribution has, since the Enlightenment, completely com- manded the white man's temperament like a chronic, hardened pho bia.

This attitude of revul ion towards the inhumane history of the church and subsequently any form of retribution can be emotionally oveRgeneralised to aim st all forms of punishment and to all religions. This cannot be expr ssed in stronger and clearer words than those lucidly stated by Russel:

"You find this curio s fact, that the more intense has been the religion of ny period and the more profound has been the dogma ic belief, the greater has been the cruelty and the wor has been the state of affairs. In the so-called ages of aith, when men really did believe the Christian religio in all its completeness, there was the Inquisition, with ts tortures; there were millions of unfortunate women urned as witches; and there was every kind of cruelty practised upon all sorts of people in the name of religi n" (Russel, 1957, p. 20).

As he fluently continues, R ssel begins to generalise his wrath to all forms of organised religions of the world:

"You find as you loo around the world that every sin- gle bit of progress to ard the dimjnution of war, every step toward better tr atment of the colored races, or every mitigation of s avery, every moral progress that there has been in t e world, has been consistently opposed by the orga ized churches of the world II (pp. 20 & 21). !

By organised churches of th world, Bertrand Russel obviously refers to all 'organised' religions and not only to Christianity, since in another part of his article, 'Why I am not a Christian , he clearly ascribes these negative attrib tes to all religions. In another article in the same book, Russel defia tiy denounces all religions by writing, "My own view of religion is hat of Lucretius. I regard it as a disease born of fear and as a source of untold misery to human race" ( p. 24). Though Bertrand Russel may not be so typical in his atheistic fanaticism, this biased, narrow-minded approach of seeing all reli- gions through the tunnel- vision of medieval Catholicism is unfortu- I nately the general rule among the majority of Western scholars. They are too obsessed with the history of the Dark Ages with its Catholic I ferociousness, its inquisitions and punishments of pioneer scientists to see any value in retribution or to appreciate other religions which brought about progress, peace, justice and human development to their converts. Any well-informed Muslim will be astonished by Russel's denouncement of religion; simply because, to use his rhetoric, "every step toward the treatment of coloured races, every moral progress and every "bit of progress in humane feel ingll was initiated and fostered by Islam and its civilisation in a primitive Arab nation of undisciplined Bedouins. That is why the modern Muslim AIDS prevention practitioner in the Islamic world should be quite aware of the roots of the modern "don't moralisell, Western attitude towards religion and the consequent cringing of Western AIDS experts at the use of religious aspects in their AIDS prevention programs.

This negative attitude is further strengthened by the tendency of the modern Western mind, as Professor Dr. Syed Muhammad Naquib al-Attas asserts, to dichotomize things into opposite extremes of what he dubs the lIeither or II disposition. Things are either objective or subjective, values are either profane or sacred, governments are either secular or theocratic, economy is either capitalistic or socialistic, sex is either for pleasure or procreation, and people are either white or coloured.

To apply this categorisational approach to the AIDS crisis, one should either ~elieve that epidemics are divine retribution and be considered an unscientific, ignorant reactionary who wants to reinstate the ethically barbarous and inhuman authority of the church, or one can be perceived as a progressive, rational person should one strongly believe that epidemics have their natural courses and God has nothing to do with their aetiology or spread. Listen, for a good illustration of this dichotomous Western mentality, to Lipson in his book, The ethical crisis of civilization. To him one must either give credence to the "nonsensical" belief that AIDS is a retribution sent by God and therefore can only be alleviated by prayer alone, or you totally abandon this medieval mentality and look to scientists for a cure. You cannot believe that AIDS is sent by God and at the same time pray for Him to guide some of His white-coated slaves in labo- ratories to discover a cure. Lipson states:

" the 1990s is claiming its victims on every continent. When one hears about the scientific research now being conducted in laboratories to dis- cover the cause of AIDS and therefrom develop a cure, one is struck by the contrast with what happened in the fourteenth century when the Black Death decimated western Europe...ln today's world many persons still seek advice from astrologers and presumably would give credence to this sort of nonsense; while others consider AIDS to be a punishment sent by God and curable therefore only by prayer. But apart from such surviving examples of medieval mentality, in the tem- per of our times the great majority prefer to look to white-coated medical researchers for rational analysis of a physical problem" (1993, p. 234).

Similar rhetoric is strongly reiterated by almost all authors on AIDS. We have already quoted Masters, Johnson and Kolodny's sarcastic remark ridiculing the belief in God's retribution to the modern sexual revolution. They state:

"And unless one believes that God had a particular gripe with the peoples of central Africa, (the postulated origin of AIDS) it is hard to look at AIDS as a form of divine retribution with a moralistic twist" (1988, p. 17).

The same message is also echoed by the Western media and its audio-visual material on AIDS. For example, in a long video program on AIDS aired in 1989 over the American Discovery channel titled, On the brink: An AIDS chronicle, one of the well-known guest scientists unequivocally stated the following in an emotionally toned oration which I have put down word for word:

"God does not have much to do with it (AIDS). I do not think that He is punishing (a) specific group. On the contrary, society is forced to take stock of minority groups such as drug users and homosexuals and recognize their importance in society. AIDS makes us realize that we need to review the relationships between our social groups."

Scholarly magazines, journals and books ride the same sarcastic wave. See, for example, the comic strip reproduced from the book, Strip AIDS U.s.A.., in which God himself is shown sending a lightning bolt to burn to ashes a priest holding a Bible because he was giving a harsh retributive message to a young man with AIDS (Robbins, 1989).

Another cartoon reproduced by the famous magazine Psychology today show a couple responding angrily with statements like "Are you crazy?", "Are you kidding?, or "You are sick" to some- one saying that "Lung cancer is God's punishment on smokers", "And diabetes is God's punishment on sweet eaters", "And heart disease is God's punishment on joggers" and "And hunger is God's punishment on Ethiopians"; but when he said AIDS is God's punishment to homosexuals, the couple enthusiastically agreed, saying, "You said it! You better believe it! Serves 'em right!" Uanuary, 1986 issue).


Islamic Medicine
Staff member
This unique attribute has even encouraged a tiny minority of religious and immorally motivated Western thinkers to bravely stand up against the ! vast promiscuous majority. They have taken advantage of the AIDS scare and dared to preach a return to Christian ethical values condemning sodomy and fornication while asserting chastity. A few cardinals and priests were able to announce that homosexuality is an abomination and to remind people about the destruction of the biblical cities of Sodom and Gomorra. They rightly declared that AIDS cannot be healed without a total revision of sexual permissiveness and promiscuity. This, however, was only "a shout in the wilderness" as the Arabic saying goes, since the modern sexual revolution retali- ated with its uncompromising, unbeatable assault.

However, in totally refusing the conception of God's retribu- tion, Western modernity finds itself in a real dilemma. Westerners do not want to be outright atheists and declare that there is no retribution because there is, after all, no God to punish or to reward. At the same time, God and religion are closely related in their minds with the church and its ugly past, the defeat of which has earned them freedom and a new god of science and technology. Thus, they want to have an impotent God "in whom they trust", as the motto in the American dollar bill reads. A God who does not interfere in their new, secularised morality. A God who does not mind if the humans He created accept Him as their real creator and obey His commandments, or worship themselves or a new secular god of technology instead. A form of an Aristotelian God who created the universe as its "First Mover" and then left His creation unattended to in order to contemplate in His divine, eternal mind. He has nothing to do with the detailed problems of man, whether he sins or does good, whether he suffers from sickness or enjoys health. As an example of this worldview, listen to Manuel (1984) speaking about medieval sci- entists who believed in God:

"But once they accepted God as an Original Creator or Prime Mover, the scientists did not have further need for His intervention into the workings of the laws of the universe which were destined to go on functioning in the same way forever" (p. 26)

By submitting to this forceful conception of a helpless, amoral god, some Western churches have compromised their Christian com- mandments to give religious ethical credence to Western modernity's new morality, to the extent of publicly appointing homosexual priests and joining homosexual men or lesbian women in 'holy' matrimony. , I believe that such Christian institutions are doing a lot of moral harm to their societies. By succumbing to the tidal wave of the sexual revolution and its moral abandon, they have actually confused many good and ethically committed Christians, not only in Europe and America, but also in other parts of the world. This is particularly confusing to millions upon millions of Christians living in traditional societies in which all practised religions condemn promiscuity and sodomy. By bowing to the loose morality of the sexual revolution, these Western religious institutions have taken a constricted, nationalistic stand, and have committed a serious offence to Christianity asan international religion. They should not have conceded; theyshould have remained as a religious, moral.,conscious minority or 'superego' to their ethically degenerating peoples, since to declare straightforward atheism is better than to hypocritically uphold a disabled, helpless and paralysed god.

It is unfortunate that some Muslim scholars have joined the , band wagon of totally refusing the concept of Divine retribution and i punishment of any wrongdoing in this world. For example, Professor Hashim Kamali of the Faculty of Law in the International Islamic University in Malaysia has not only accepted this position, but has also tried to find justification for it in Islamic literature in a manner which contradicts clear Qur'anic Verses and Ahadith of the Prophet, chief among them is the Hadith we just quoted on God's punishment to rampant fornication. He has even stated that if God has decreed that there is life after death and a day of judgement, then punishing wrongdoers for their sins in this world would be a contradiction! Listen to his own words from a paper titled, "islamic responses to some AI DS related issues", that he wrote for the Preparatory National Consultation for the Colloquium on Islam and HIV/AIDS organised by the AIDS National Council of Malaysia:

The Qu'ran provides conclusive evidence that there will be life after death and a day of judgement to determine the question of reward and punishment for 'what the people have done in their worldly life. Life in this world is seen as a testing ground and a prepa- ration for what is to follow in the hereafter. This is an absolutely indispensable framework within which religious guidance and accountability acquires its basic meaning and purpose. But then to say that God hastens that process, as it were, and metes out pun- ishment in this life, and selects some people for this purpose to the exclusion of others is tantamount to contradiction. and neglect of the whole structure of rei igion, and the basic terms of what God refers to as His universal norms (p4 of his paper).

We should not waste space and time to refute such a stand since every lay reader of the Holy Qu'ran, let alone the scholars, knows that it is full of Verses that clearly speak of collective and individu- alised punishment in this world for ominous sins which people commit. The Holy Qu'ran tells us in many Verses that when the punishment is directed to a whole group, as in the case of Thamud and 'ad, the believers who live in the same community are always saved from this collective punishment. So, God does not only punish for sins in this world, but that He also "selects some people the exclusion of others". However, for the non-Muslim readers of this book I shall quote the following Verses from the Qu'ran concerning punishment in this world to the people of Pharaoh to substantiate what I have asserted :

" We punished the people of Pharaoh with years of drought and shortness of crops, that they may receive Ii admonition". We sent on them flood, locusts, lice, frogs and blood: Signs openly self-explained: but they were steeped in arrogance, a people given to sins. \; And when the plague (punishment) fell on them, they ~ said, "a Moses! On our behalf call upon your Lord in I virtue of His promise to you: If you will remove the j~ plague from us, we shall truly believe ...But when We removed the plague from them ...they broke their word" .(Surah No 7, Verses 130 & 133-135)

Professor Kamali then goes on to prove his point with respect to AIDS by repeating the often mentioned argument of Western writers who reject the idea that AIDS is a punishment by referring to innocent children who get the virus. He stated the following in the abovementioned paper:

"To say that AIDS is God's punishment inflicted for . the failing of one's conduct would imply that God inflicts this punishment on the gui)ty and the innocent (drug users and babies e.g.) all alike. Such an asser- tion clearly violates the Qu'ranic dictum that 'good and evil can never be equal to one anoter'." (p.6).

It seems to me that Professor Kamali has taken this argument as it is ; from a Western source. Westerners who say that AIDS is a punishment are talking about promiscuous homosexuals and bisexuals who are still considered as immoral by many people who also blame them for the mutation of the AIDS virus. Intake of drugs on the other hand is not rated as such. So Westerners who speak against the belief that AIDS is a punishment would argue that babies and drug users have committed no punishable sin for which they should pay by being infected by HIV. In the above quotation that I have copied from his paper, Professor Kamali gives the same example of babies and drug users to prove that AIDS cannot be a punishment. The claim that alcohol and drug users are as innocent as babies is definitely a con- tention that Professor Kamali would not subscribe to in spite of writ- ing it to support his argument! Injecting drugs, as we have men- tioned, is as bad or even worse than drinking alcohol and is consid- ered as one of the very grave sins alkaba'ir.

I believe that scholars who write against the Divine retributive aspects of disease and other calamities confuse the concepts of pain and deprivation with that of punishment. All kinds of punish:. ment must carry some form of painful experiences, but not every kind of painful experience is a punishment. Furthermore, all rewards bestowed by God on the chosen devoted Muslims are pleasurable; but not every pleasurable experience is a proof of God's pleasure with the person concerned. Quite often it may be the contrary. If all the pains and pleasures are distributed by God to adults and children on a simple fixed schedule then this world would seize to be a resting place for humanity. We have more to say about this issue in the following pages.

b. The Islamic conception of retribution:

The AIDS prevention practitioner in the Muslim world should be aware of this Christian psycho-historical dynamic of divine retribution in relation to the AIDS epidemic. He should be aware that this whole issue is quite alien to Muslim societies. In the length and breadth of their history, the Muslims have not experienced the moral dictatorship of a church nor the barbarous executions and inquisitions. In fact, Islam portrays a very optimistic, merciful and rational conception of divine retribution. The Holy Qur'an clearly states that God's punishment in this world is meant to ward off more, serious future pains and agonies, and to coerce the sinful to repent and , secure God's forgiveness:

"And indeed We will make them taste the penalty (and pain) of this life prior to supreme penalty, in order that they may repent and return" (AI-Sajdah (32):21).

Also, human anguish is a Divine test to wipe out sins and to elevate the spiritual position of the suffering person. As the Prophet Muhammad, peace be upon him, said, there is always a reward to the Muslim from God for even the slightest pain he incurs, even if it is the prick of a thorn (AI-Bukhari). Furthermore, the Islamic Shari'ah has its specified penalties and severe punishments for theft, fornica- tion, murder and similar crimes. If modern man can give the state the right to punish those who break the law with a penalty that can take away the life of the offender, it will indeed be most impertinent and " arrogant not to give this right to God. It is of interest in this respect to mention that the United States topped the world's list of executions " .during the year 1995. The number of prisoners put to death in 24states was 56. About 3,000 convicts nationwide are at present still t awaiting execution. ( AFP, December 31, 1995). "

These Islamic teachings about God's retribution within the Divine conceptualisation of His mercy give Muslims a deep belief that any misfortune befalling an individual is God's work for some j" sins he has committed or because Allah wants to test and reward t, him. Divine retribution and punishment are accordingly always conceived within the context of God's mercy, wisdom and justice.

Thus, the general belief about the AIDS pandemic is that of divine retribution for the immoral homosexual revolution of the West and its aping in other countries. This belief is firmly rooted in the Muslim mind because every child in his early school years must have been thrilled by the Qur'anic story of the Prophet Lot (pbuh) and what God did to his homosexual people. This is further ratified and explained in the most accurate and detailed exposition by a famous saying of the Prophet Muhammad (pbuh) in which he speaks as though he miraculously describes the contemporary dilemma of the AIDS pandemic. The famoushadith quoted and authenticated by Ibn Majah and other ancient hadith scholars is translated as follows:

"If ahishah or fornication and all kinds of sinful sexual intercourse become rampant and openly ,practised without inhibition in any group or nation, Allah will punish them with new epidemics (ta'un) and new diseases which were not known to their forefathers and earlier generations.

This great hadith clearly implies the concept of mutation in the ; Prophet's use of the words "new diseases"-al-jadidah. The Prophet also states that these diseases will take epidemic proportions. This is explained by the Arabic word ta'un which specifically means plague but is used generally in Arabic to stand for any epidemic. It is interesting to note that today, AIDS is dubbed the "plague of the twentieth century". Thehadith does not associate the new epidemic with fornication as such, but with rampant fornication which is practised publicly and without shame and guilt.

If fornication is practised without any shame, then it would become public and the whole environment would be an aggregate of seductive cues enticing people to fornicate. Promiscuity would then be performed in the most uncontrolled manner and 'pioneers' who have had enough of the permitted public forms of fornication will .excavate new sexual grounds and novel forms of deviant practices. This, as we have mentioned earlier, may facilitate the development of previously harmless germs into lethal microbes. We have already discussed how new researches are radically changing the orthodox Darwinian conception of mutation as an unguided random process and that micro-organisms can change their gene construction in amuch faster rate according to the demands of new environmentalconditions. From this, one can rightly infer (as already discussed) how semen from different men ejaculated into the filthy, faecallybefouled rectum of a promiscuous, receiving homosexual, causing f his body to secret auto-antibodies to these foreign ejaculates, can disturb the physical environment, creating new biological needs for microscopic organisms and causing them to mutate into murderous germs. Thus, publicity of fornication in any group is an obvious sign of the absence of shame and guilt leading to excessive, rampant promiscuity in that group, which can in turn be an etiological factor in gene mutations in bacteria and viruses leading to new venereal diseases. Professor Opendra Narayan of the Johns Hopkins Medical School has openly indicted the excessively rampant promiscuity of the early homosexual group for the development of HIV/AIDS. He describes them as follows:
"These people have sex twenty to thirty times a night A man comes along and goes from anus to anus and in a single night will act as a mosquito transferring infected cells on his penis. When this is practised for a year, with a man having three thousand sexual intercourses, one can readily understand this massive epidemic that is currently upon us" (As quot- ed by Leo Bersani in AIDS:Cultural analysis cultural activism, 1991, p. 197).

Accordingly, the danger of new sexual epidemics is only triggered by rampant fornication and not by the limited promiscuity expected to be practised in any average, morally clean society. It should be emphasised at this juncture that Islamic Shari'ah laws are not intended to completely eradicate fornication and other major sins. No human society can be saved from such sexual misconduct. The main " aim of Islamic law is to prevent its publicity and the seductive behaviour that leads to it, thus limiting it to a small minority of those who timidIy and secretly do it in the darkness of their homes. And though the unishment for fornication is very severe, proving it in a Shari'ah cou is almost next to impossible. The accused will not be punished unl ss he or she is seen performing actual penetrative sexual inter- cou e by four persons. Accordingly, unless the fornicator is per- for ing openly or in a very careless manner, he will not be endanger d. The aim of the Shari'ah is therefore to purge the environment so t at, with the help of the spiritual guidance of the Qur'an and the Sun, ah of the Prophet, the society, particularly its young generations, will igradually perceive fornication as an ugly, immoral practice.

Consequently, a Muslim can clearly see God's mercy in des roying the highly promiscuous homosexual people of Sodom. As we, aid in chapter three, the Holy Qur'an describes them as the first peo' le to practice sodomy. We add here that they are described as pu lic fornicators, looking at each other in shameless transgression:

"And Lut said to his people:
"Do you commit lewdness such as no people in creation ever committed before you?
For you practise your lusts on men in preference to women. You are indeed a people transgressing beyond bounds" (AI-A'raf (7): 80-81)
"And Lut said to his people:
Do you do what is shameful while you watch (one another)?" (AI-Naml (27): 54).

Ac ording to the quoted blessedhadith, the people of Sodom prac tised what might have developed into a new epidemic; probably an AI Slike virus. Destroying the transgressors before they developed
the disease and infected the comparatively primitive and thin populati n of the earth at that time was indeed a highly merciful divine ac on. It is like the decision of the surgeon to amputate a patient's serously infected limb.

Thus, though the Prophet's hadith is accepted by Muslims a miraculous prophecy, it can be explained in terms of modern scientific discourse. That being the case, the only cure for such epidemics, according to Islam, is a radical change in sexual behavio A return to traditional religious values which view sexual enjoyme as one of God's greatest gifts for which humanity should be gratef by purging it of the deviance of sodomy and fornication. A return ethical values that reinstate the family institution to its rightful thro and rebuild a society in which the deviant few homosexuals a promiscuous can only practice their sinful behaviour in the secre of shame and guilt. If such a radical change is not brought abo venereal epidemics will not be eliminated. And though the Prophet stated in another famoushadith (quoted by Ibn Majah) that God h not created a disease without creating its medical cure, thus pred} ing that a cure or vaccine for AIDS is forthcoming, another new epidemic will surely befall the rampant and publicly fornicating so eties if they do not change their immoral sexual abandon.

In fact, a new strain of HIV is already surfacing in one of t countries with one of the highest rates of prostitution in the worl According to the journal Science, as quoted by AFP (March 2, 199 this new strain, which is heterosexually much more infectious th the HIV prevalent in the United States, was found in Thailand. new virus, identified now as HIV-E, survives better in female genit tissues and thrives in the cells lining the mouth, vagina and cervi Scientists are worried about its possible spread since it increases t risks of heterosexual intercourse. Another new dangerous strain the AIDS virus has also appeared in Honduras. It is reported that t strong strain (HIV sub-type B) is also especially dangerous to worn (Reuters, February 5, 1996).

Accordingly, though we should be optimistic that a cure vaccine for HIV will surely be discovered sooner or later, as stated the Prophet's sayings, new epidemics will certainly surface if rampa fornication leading to mutations persists. If modernity's sexual rev lution continues its uninhibited practices, it should be prepared the next epidemic; but is it really prepared? laurie Garret, in a chap- lerl indicatively titled, "The next epidemic", has this to say about this issue:

"The world was caught off guard by the immunodeficiency virus; will it be better equipped to handle the next emerging virus? lederberg has concluded that the answer is a resounding "No" " (Mann et al.1992, p. 837).

If one is to predict from prevalent sexual behaviour, one would expect that a new discovery of a cure for AIDS will immediately be followed by a surge of heedless promiscuity. like the recoiling of a compressed metal spring, whatever caution that was developed over Ihe years for fear of HIV infection will disappear in the thrill of beat- in& the virus. Some experts are even worried that the development of the new combination or cocktail therapy, which is not really a cure, m y cause those overly optimistic to revert to pre-AIDS abandon. In the closing ceremony of the Vancouver International AIDS C nference in which this new cocktail therapy was unveiled, Pr fessor David Cooper, the director of the National Centre in HIV Ep demiology, is quoted by the Australian daily, The Sydney Herald of uly 13, 1996, as posing the following warning in the form of a question:

"if infectivity is shown to be lower in the presence of
a low viral load, will this lead to an abandonment of
safer personal behaviours and a surge of recidivism
in sexual and injecting practices?"

In a similar vein, current Malaysian minister of health, Chua Jui Meng, warned the public by declaring, "Don't believe the AIDS cure Story". He was disturbed by the overly optimistic reports that scientists have found a cure for AIDS. The minister continued that if the combination' of drugs were used, within one or two weeks the level of HIV in the body would come down very fast; however, HIV level will increase if a person stops taking the drug. "We do not want to create a false sense of security in people and cause them to relax in their behaviour, particularly in relation to sexual activities and drug addiction" (The Malaysian dailyThe Sun, July 26, 1996).

From these warnings, one should appreciate the wisdom of Islamic teachings of instilling self-restraint against fornication and prohibition of drug intake by using positive rewards and retribution. Islamic literature is very rich in verses from the Holy Qur'an and other sayings of the Prophet (pubh) and his disciples which speak about fornication and sodomy in the most repulsive and terrifying ! manner. Using this literature can work as a spiritual agent in building the emotional component of attitudes in a way which will be accepted, appreciated and respected by the great majority of Muslims, whether they are committed to Islam or not.

As a matter of fact, this belief in God's retribution within the context of His mercy and justice is a widely held doctrine among Muslims. When a large group ofArab-Muslim chi'dren were asked to freely draw and paint pictures about AIDS to be exhibited in the International AIDS Congress in Kuwait in the eighties, more than 90% of their drawings depicted this divine retributive concept. Most of them painted indisposed, bony, dying persons, or skeletons with : holy Qur'anic and blessed Hadith captions, or simply stating in their 'own words that this is the result of fornication and drug abuse. I think that this belief is the main reason why, up to now, the lowest rates of AIDS infection in the world are in Arab and committed Muslim soci- eties. Whether a practitioner of AIDS prevention in the Islamic world believes in Islam or not, he should make use of such beliefs if he real- ly intends to succeed in his mission.

One final and very important point about the Islamic concept[ of retribution is the difference between perceiving punishment or test' to a deserving group or a society as compared to the perception of the individual or specific person in that society. When dealing with individuals in a state of distress such as an illness or catastrophe, even with those who were sinners or criminals, Islam very forcefully preaches mercy, brotherly love, sympathy and an optimistic attitude. Visiting sick people, praying for them and raising their morale and hopes for improvement is one of the deeds very highly recommend- ed by Islam in the blessed ahadith and practices of the Prophet Muhammad (pbuh). Failing to care for the sick incurs the displeasure of God. In the well-known hadith qudsi narrated by the Prophet (pbuh), quoted by Abu Hurayrah, and authenticated by al-Bukhari, God says in the Hereafter the following moving words to one Muslim who had not cared for a sick acquaintance during his lifetime on earth :

"Allah, the Lord of Honour and Glory, will say in the Day ofJudgement: O Son of Adam! I was sick and you did not visit me! The man will submit and say: my Lord! How is it that I visit You and You are the Sustainer of the universe? And God will reply, "Didn't you know that My servant so and so was sick and you did not bother to visit him? Didn't you realize that if you had visited him you would have found Me with him?" (Adapted from the translation of S. M. Madni Abbasi, Riyad al-Salihin ).

And although the Prophet, in a number of famous sayings, has warned against mixing with people with infectious diseases, e.g., 'thehadith commanding Muslims who live in a city or country in :which there is an outbreak of plague not to flee and for those outside 'of it not to enter it, he has also warned against unreasonable fear nom infection which prevents a Muslim from caring for a sick brother or sister.

Another important aspect of visiting the sick and caring for them is for the faithful Muslim to ask them for du'a' or to pray for "
him or her. Since the afflicted person is being tested by God, then his;illness or disease will purify him of his sins and his prayers would 1 accordingly be more inclined to be fulfilled. The Prophet (pbuh} illustrates this purging of sins because of sickness by the tree which sheds;, its dry leafs (thishadith is authenticated by al-Bukhari}. Thus, the more: serious the sickness, the purer will the patient Muslim be. These teachings are indeed a much needed consolation for the sick and a
very useful instructive scheme for the counsellors of AIDS patients; and HIV-positives in Muslim countries.

3. Islam as a way of life guards against AIDS

a. Islam's balanced attitude to sex shields society from retaliatory sexual revolutions:

We have already detailed how AIDS is an astonishingly retributive syndrome for two of the main corrupting evils of modernity. These are, its sexual revolution, and its attitude towards drug and alcohol : intake. Contrary to this is the position of Islam as a way of life in relation to AIDS. In this section, I would like to discuss some of the teachings of Islam which, if followed, will guard against HIV and ; other sexually transmitted diseases. The discussion will mainly elucidate what Islam says and not what contemporary Muslims, do since" this aspect will be dealt with in coming chapters.

Islam, like Judeo-Christian religions, strongly bans adultery" sodomy, and other forms of fornication. However, unlike these reigions, Islam does not look at sex as an evil, unavoidable pleasure for procreation. As we have already explained, this extreme, Catholic belief about sex, particularly towards women, was probably the main, factor behind the counter revolution of unrestrained sexualliberalism in the West. In all spheres of social life, history tells us that human correction of extreme dogma can only shift the pendulum to an opposite extreme.

Islam, in the verses of the Holy Qur'an the blessed hadith of the Prophet Muhammad and his deeds, and the biography of his Companions and those who followed them, onour the pleasure of sex as a great gift from God and a source of His pleasure and reward if practised in the sanctioned manner. The Prophet emphatically asserts, "There is no monasticism or rahbaniy in Islam" (al-Bukhari & al- Tabari). Pleasure and procrJation are not ontradictory. They are two sides of the same divine coin of grace. M slims, accordingly, do not harbour conflicts regarding this issue.

While European women were tortured by "sharp instruments...thrust betwixt every nail of their ingers and toes" (R. Cavendish, 1970, p. 854) in orddr to confess s ual relations with the devil and consequently be pul)licly burned, and while they were openly discouraged from enjoyi!ng sex, Musli women used to ask the Prophet (pbuh) about the positions they c uld take when having intercourse with their husbands. Muslim wo en in Madina were influenced by the strong Jewish belief that th rear entry in sexual intercourse is immoral and similar to animal opulation, and that it will bring about a deformed child. They preac ed that the best posi- tion is the side-to-side. When a husband from ecca wanted to have a rear entry with his wife from Madinah, she r fused, and later openly consulted the Prophet Muhammad (pbuh) about the issue. The answer came in the form of a revelation in t e Holy Qur'an in the second chapter commemoratin~ forever the high standard of this Islamic sexual injunction:

"Your wives are (like) your tilth; so app ach your tilth when or how you wishl but do som good act for yourselves beforehand! (i.e., forepl 'I and good words)" (AI-Baqarah (2)1: 223)

Thus, the Holy Qur'an invalidated the Jewish myth and portrayed the fact that once the semen is ejac;ulated and c nception takes place, the position of the couple has nothing to do w th the development of the future baby. Moreover, the oly Qur'an advises husbands to be gentle and to do the necessary in roductory foreplay before the actual intercourse. The Prophet expla ned this by saying that the husband should not "come to his famil the way a mule approaches its female". "Come to his family" is a polite way of saying have sexual intercourse with his wife. The mule hurriedly rides to get its pleasure; the refined Muslim husband, f Ilowing this prophetic injunction, should think about the pleasure f his wife. Thus, Islam, as early as the seventh century, had not o Iy accepted the sexual pleasure of women, but it had also made it revealed injunction.

After the induiring lady h ard this revelation, the Prophet told her that she could[ have any for of intercourse with her husband provided they totally avoid anal intercourse at all times and vaginal intercourse during her menstrua ion. Not only that, but the Prophet asserted that giving sexual enjoy ent to the wife is a religious obligation on the husb,and (al-Bukha i). Sexual relations between spouses was also considfred a good deed for which the spouse will secure the pleasure of God. The Prop et of Islam declared this to a large group of Muslims ho came to ask him about ways in which they could get divine rewards. Hence, sex, practised with spouses in the proper Islamic fasnion, can be source of spirituality and worship. An AIDS prevention campaign hat makes use of these balanced moral beliefs can obviously acco plish more changes in attitudes as it taps spiritually and psychologi ally familiar roots.

Islamic recbrded literatur is full of teachings and anecdotes about happy marriages and 10 ing relationships between faithful Muslim spouses. The Holy Qur' n asseverates God's mercy in creating spouses for the two sexes to rovide them with love, mercy and tranquillity:

"And among His signs s that He created for you ~ates fro~l,amo~g yours Ives, so that you may dwell In tranqulll,ty wIth them and He has put love and mercy between your hea s. Verily in that are signs for those who reflect." (A/-Rum (30): 21).

These teachings and examples of gratifying love, spiritual peacefulness, and unwavering trust is still experienced in the life of many simpIe and rural Muslims. They really fully enjoy each others' relations since their sexual urge is not satiated by promiscuity; their hearts are not tormented by fear and suspicion of being infected by their spouses; their minds are not pestered by thoughts of comparing th' ir mates with other sex partners; their brains are not eclipsed by sexusually dampening drugs and alcohol; and their heterosexual desire is not confused by gay preferences. They stand side by side as th y humbly offer their five daily prayers in peaceful, pleasurable bli s, and they lie side by side as they delight in the bounty of the fie h. Both are great gifts from Almighty God. There is no conflict between the spiritual and the physical; between body and soul; between pleasure and procreation; between the here and now and the he eafter. I have lived for many years amongst such happy people in Gazira State in Sudan, more intimately with the people of Ruf a Town. I have, accordingly, felt much pity and sympathy for many of my Western and unhappy Westernised patients who were referred to me because of marital and sexual dilemmas caused by modern it 's lifestyle.

b. Islam strictly prohibits homosexuality; adultery; anal intercou se and vaginal sex during menstruation:

Also, unlike other religions, detailed Islamic teachings regarding sexual matters surprisingly protect from HIV infection and other sexually transmitted diseases. For example, Islam strongly prohibits t o kinds of sexual relations between spouses. These are vaginal sex a! intercourse during menstruation, and anal intercourse at all times. o show how ugly it is, the Prophet dubs anal intercourse with the w fe as the "minor sodomy", in Arabic, al-Iutiyya assughra (hadith quoted by Ahmad ibn Hanbal). A number of other Prophetic traditions speak about this repulsive practice as one of the great st of sins.

Early Muslim scholars and jurists, for example I n Qayyim al-Jawziyyah, in his Zad al-Ma 'ad, detailed the psychological and medical reasons for this forceful injunction. As confirmed y the modern , behavioural point of view, these early Muslim schola s rightly indicate that anal intercourse with the wife is indeed minor sodomy since " it can gradually lead a man to full-fledged homosexua ity. This is so, as they say, because of the identical anatomy of females and males in this respect. A husband who gets used to anal interc urse with his wife may easily shift to boys and beardless men. Seco dly, they criticise the husband who engages in anal sex not only fo being a notorious sinner but also for his selfishness in pursuing his own pleasure and denying his wife her Islamic rights to sexual s tisfaction and procreation. The human rectum, as they assert, is o viously more harmful and is not created by God for such a functio .Finally, they remind such husbands that God prohibited vaginal in ercourse during the wife's monthly period because it is harmful to both partners. The Holy Qur'an explicitly forbids vaginal sex during the wife's monthly flow and calls it a hurt or a pollution:

"They ask you concerning women's course ~Say: They are a hurt and a pollution: So keep awa from women in their courses, and do not approac them (by actual intercourse) until they are clean. Bu~ when they have purified themselves, you may approach them in any manner, time or place ordained for you by God. For God loves those who turn to Him constantly and he loves those who keep themselv s pure and clean" (AI-Baqarah (2): 222).

During this monthly period, spouses are permitte to sexually enjoy each other by any other means than vaginal intercourse.

Modern medicine tells us that both of thes practices are unhealthy and positively related to HIV infection. Anal intercourse is now too obvious to dwell upon. Vaginal intercourse during Ihe female's monthly period was found to be more conducive to HIV infection because the menstrual flow mixes blood with cervical vaginal secretions, providing an optimum environment for the virus ejaculated by the male partner. This can also increase the chances of infection of males since it was established that the AIDS virus is found in both the menstrual blood and the cervical secretionslof infected females (Daniels, 1986).

c. Islam strictly prohibits the intake of alcohol and drugs

We have already discussed the dangers of alcohol in facilitating the spread of AIDS. Alcoholic beverages are unrestricted drinks or adults in many parts of the world. As we mentioned in an chapter, more than 80% of the world's alcohol is consumed i in Western countries. Alcohol 'dissolves' moral restraints so that, a~er a few drinks, people will not remember to use condoms or to avoid risk groups. Drugs are even worse, since their intake by injection can directly infect. Another serious outcome of alcohol and drugs is th ir immunosuppressive properties, which some scientists believe is t e true cause of HIV infection. They support the view that the AIDS vi us can be a real danger only when the immune system has already be~n weakened by other suppressants of the immune system. This has already been elucidated elsewhere.

d. Islam sternly bars the intake of khaml:; an Arabic word whith literally means any substance which 'covers' or curtails the mind. That is, any substance which intoxicates its user, whether it is taktn as a drink, inhaled, eaten, smoked, or taken in any other way. Fpr this reason, no practising Muslim would take khamr, and even among the general population, modern Muslims have the lowest rate of alcohol abuse and the highest rate of abstinence with respect to II kinds of intoxicants.

d. The Islamic tradition of male circumcision: A helpful practice against AIDS and other STDs:

" Another Islamic injunction which is inhibitive to HIV infection is the Sunnah of male circumcision. Islam considers this practice as one of the great traditions inherited from our honourable Prophet Ibrahimi., peace be upon him. Uncircumcised men are at a greater risk of contracting AIDS and other STDs, like genital herpes and syphilis, thani circumcised men. In AIDS and such diseases, the virus will find its;way into the victims bloodstream through any tiny break or abrasion in the penis. The inner lining of the erect penis in an uncircumcised ;male can represent as much as 50% of the surface of the shaft. This will indeed increase the chances of a break in the exposed soft skin, and augment the risk of infection (Daniel, 1986).

For this reason, it was found that AIDS is less spread lamong) African tribes which observe male circumcision in comparison to' tribes in which circumcision is not performed. This may also be due to the fact that it is mainly the Muslims in Africa who strictly observe;, male circumcision, and the comparison between these tribes may:. therefore also be viewed as a Muslim and non-Muslim collation." However, there is evidence of the fact that even among non-Muslim, African tribes, circumcision proves its value with respect to HIVi infection. In an unpublished study conducted by the Islamic Medical Association of South Africa, it was found that the African Xhosa tribe; in which male circumcision is an observed practice, have less spread of AIDS than that of the Zulus, who do not circumcise. Both tribes'; are not Muslim, and they live in similar environmental conditions.

It may be of interest to note that more and more Westerners are now opting for male circumcision. The Guardian, as quloted by the Malaysian newspaperNew Straits Times of September 8, 1991, reported evidence given by American urologist Aaron j. Fink tha uncircumcised men are at a greater risk not only of contracting AIDS but also cancer of the penis, herpes, and syphilis. Furthermore, wives and female partners of circumcised men run far less risk of cervical cancer, which is a very rare disease among Muslim and orthodox Jewish women.

The Guardian stated that many Britons ask for circumcision because their wives and partners complain that "they do not wash properly" causing them to develop various infections. Of pertinence 10 this issue is the recent poll carried out in Britain by Research Associates on 1,000 adults and reported by Reuters in June 1995. The results showed that 1 in 10 British men do not change their underpants for 3 days while 1 in 100 continue wearing them for a week. Also, one in 4 of the sample confessed to regularly going without a bath or a shower for 3 days. This would certainly be much more harmful to uncircumcised men in more humid and warm countries!

e. The benefits of ghusl al-janaba :

A third, beneficial Islamic teaching related to washing and cleanli- ness is the Qur'anic injunction of ghusl al-janaba, or the thorou&h washing of the genitals and the whole body after sexual intercourse. This is a compulsory command without which a Muslim cannbt pray, read the Holy Qur'an, or even stay in the Mosque. In the famoushadith authenticated by Ahmad ibn Hanbal, Muslim and al-Tirmidhi, the Prophet Muhammad (pbuh) was quoted to have Commanded that the Muslim couple should perform the washing of ghusl not only after actual sexual intercourse but even if their unclothed genitals touch in an act of copulation. Many Muslim couples take Ihis compulsory shower and brisk genital-washing immediately after copulation, and before retiring. It makes them feel spiritually cleaner. Thus, the young sexually active practising Muslim, who usually , copulates about 3 to 5 times per week, cannot go without this obl!galory washing. It is of interest to note that in general, even non-practising promiscuous Muslims who do not say their prayers still regularly perform this ghusl practice, even after fornication! They feel 'dirty' and susceptible to evil if they do not wash.

If one feels too lazy to perform ghusl one is advised by a Prophetic teaching quoted by the Prophet's wife 'A'ishah,and authenticated by al-Bukhari, to wash one's genitals thoroughly even if sexual intercourse is to be resumed. As is known, the HIV is aivery weak virus, and such meticulous washing is sure to be of help. Modern researchers in the field of sexually transmitted diseases (e.g., M. Hart, 1971) have attested to the value of washing the genitals after inter- course as a simple practice that protects against sexually transmitted diseases.

A final point that I wish to document in this sectioh is that of ; izalat al-atha, or literally, the removal of harmful substances from the body or on it. It has been advised by some leading Muslim jurists that couples should urinate after sexual intercourse and before taking their janaba shower. Evacuating the bladder is not only a removal of a harmful substance but an essential practice before ghusl and ablution, since urination nullifies ablution and a Muslim needs to perform ablution again if he wishes to pray, read the Holy Qur'an or go to bed in a spiritually clean condition.

This teaching is also verified by modern research Qn sexually transmitted diseases. It was found to be particularly helpflJl to men. Urine is acidic and as such, urination after coitus was disfovered to be helpful in killing or washing away infectious microbes. Modern researchers advise men not only to urinate after coitus, but even to wash the glans of the penis with urine! (S. Rathus, 1983).

These are some of the important Islamic conception~ and practices which I believe can be of help in designing an Islan1lically oriented form of AIDS prevention. Some scholars may think of other items, or reformat what I have expounded in ways more pertinent to different Islamic countries. However, whatever the form, any Islamic AIDS prevention scheme may stimulate resistance because of the implicit clash between background, cultural and religions aspects. Other obstacles may arise as a result of internal problems in various Muslim countries.