Via Black Triangle, I'm made aware of another example of religious fundamentalism interfering with sound health care:
A MUSLIM doctors' leader has provoked an outcry by urging British Muslims not to vaccinate their children against diseases such as measles, mumps and rubella because it is "un-Islamic".
Dr Abdul Majid Katme, head of the Islamic Medical Association, is telling Muslims that almost all vaccines contain products derived from animal and human tissue, which make them "haram", or unlawful for Muslims to take.
Islam permits only the consumption of halal products, where the animal has had its throat cut and bled to death while God's name is invoked.
Islam also forbids the eating of any pig meat, which Katme says is another reason why vaccines should be avoided, as some contain or have been made using pork-based gelatine.
His warning has been criticised by the Department of Health and the British Medical Association, who said Katme risked increasing infections ranging from flu and measles to polio and diphtheria in Muslim communities.
Katme, a psychiatrist who has worked in the National Health Service for 15 years, wields influence as the head of one of only two national Islamic medical organisations as well as being a member of the Muslim Council of Britain. Moderate Muslims are concerned at the potential impact because other Islamic doctors will have to confirm vaccines are derived from animal and human products.
There is already evidence of lower than average vaccination rates in Muslim areas, reducing the prospect of the "herd immunity" needed to curb infectious diseases such as measles, mumps and rubella.
Katme's appeal reflects a global movement by some hardline Islamic leaders who are telling followers to refuse vaccines from the West.
OK, so this physician has interpreted the Koran and thinks that its teachings make vaccines containing these ingredients against his religion? That's bad enough, but for a physician he sure exhibits magical thinking, so much so that I wonder what medical school he graduated from:
Katme said he was bringing the message to Britain after analysing the products used for the manufacture of the vaccines. He claimed that Muslims must allow their children to develop their own immune system naturally rather than rely on vaccines.He argued that leading "Islamically healthy lives" would be enough to ward off illnesses and diseases.
"You see, God created us perfect and with a very strong defence system. If you breast-feed your child for two years -- as the Koran says -- and you eat Koranic food like olives and black seed, and you do ablution each time you pray, then you will have a strong defence system," he said.
"Many vaccines, especially those given to children, are full of haram substances -- human parts, gelatine from pork, alcohol, animal/monkey parts, all coming from the West who do not have knowledge of halal or haram. It is forbidden in Islam to have any of these haram substances in our bodies."
"Islamically healthy lives"? Oh, yes, because Muslims were so much more healthy and resistant to disease hundreds of years ago, before vaccines were developed for common and often deadly diseases like smallpox and childhood diseases like rubella and the importance of modern sanitation was understood. Epidemics were never a problem, right? Again, what medical school did Dr. Katme graduate from?
As Anthony Cox mentioned, although this is less paranoid and conspiratorial, Dr. Katme's "warning" reminds me of the Nigerian polio scare, where Imams scare people into not being vaccinated by claiming that vaccination is a U.S. plot against Muslims. What really infuriates me about stuff like this is that people like Dr. Katme are not just endangering themselves; they are endangering others who may not share their faith and their belief that the components of vaccines are against their religion in some way. By decreasing the number of people vaccinated, they decrease the "herd immunity" that protects the unvaccinated and those for whom the vaccine didn't work. (Remember, no vaccine is 100% effective; almost nothing in medicine is.)
Of course, we shouldn't let ourselves become smug or superior over this. There's plenty antivaccination wingnuttery in the West. . It's not just Muslims. As Anthony, Skeptico, and I have pointed out, we have our own brand of religious or "spiritual" irrationality right here in the good ol' USA that drives antivaccination loons, be it Christians who claim that vaccination is against God's will and that "the abortion industry contributes to vaccine manufacturing" or New Age spiritualists who seem to think that "healthy living" (whatever that means) will protect them from infectious disease and that vaccines are somehow "unnatural." What's particularly amusing (well, it would be if it weren't so sad) is to watch one religion blame another for vaccination, as in this screed in which vaccination is referred to as the Vatican's "medical inquisition," taking a swipe at evolution along the way:
Erasmus Darwin (another doctor) was the grandfather of ape-man Charles Darwin. Since Jenner claimed that humans and animals shared the same diseases, the next step was to promulgate the idea that they had a common ancestor.
Darwin was the father of another fable called the theory of evolution. He STOLE it from the Egyptians and never paid a penny in royalty fees. This is what Darwin said about Jenner and his vaccination:
"Dr Erasmus Darwin, the famous author of Zoonomia, wrote to Jenner on the 24th of February, 1802 (a few weeks before this death): "In a little time it may occur that the christening and vaccination of children may always be performed on the same day." (Jenner and Vaccination, Dr. Creighton, p. 188). (Editor's note: christening means sprinkling babies with water to make them Christians).
Both christening and vaccination are inventions of that old Serpent the devil!!
Nobody except old Beelzebub himself has sent more souls to hell than this ape-man. His grandfather and Jenner laid the foundation of the MAD idea of turning the FABLE of evilution into a scientific FACT.
They also make a big deal out of how Louis Pasteur, inventor of the rabies vaccine, was a devout Catholic.
The animated GIF from the website included in my quote above is just the perfect wingnut touch to let the writer's antivaccination/anti-evolution freak flag fly, don't you think? And, of course, the irony is hard to miss, given that in some strains of conservative Catholicism, it has been a major concern that some vaccines are grown in cell lines originally derived from fetuses many years ago but that it is also position of the Catholic Church that "there would seem to be no proper grounds for refusing immunization against dangerous contagious disease, for example, rubella, especially in light of the concern that we should all have for the health of our children, public health, and the common good."
In the case of Islam, fortunately, Dr. Katme doesn't seem to be in the mainstream of Muslim thought, just as Christian fundamentalists such as the ones I cited above who consider vaccines to be against the Bible are outside the mainstream of Christian thought. Even the Catholic Church, the foremost opponent of abortion in the world, reluctantly supports the use of even vaccines against rubella until such a time that new vaccines that are not produced using cell lines derived from an aborted fetus, as does Dr. Shuja Shafi, a spokesman for the Health and Medical Committee of the Muslim Council of Britain, who says: "In terms of ingredients in vaccines, there are so many things that are probably Haram, but in the absence of an alternative we are allowed to take it for the sake of our health."
Sounds a lot like the Catholic position on this matter, doesn't it?
As Anthony points out, Iran, of all places, has a consistently high level of vaccination against common childhood diseases (92-99%, depending on the specific vaccine), a level comparable to that of the U.S., even though it is basically a Muslim theocracy. Religious beliefs do not necessarily have to conflict with protecting children against infectious disease; unfortunately, in the case of Dr. Katme, whose words carry more weight among British Muslims because he is a physician, they do. When religious fundamentalism infects the brain of a physician, this sort of dangerous idiocy is all too often the result.
for a physician he sure exhibits magical thinking, so much so that I wonder what medical school he graduated from:
According to this article in a Pakistani newspaper, he isn't a physician at all. He's a psychiatrist. I was unable to find anything on where he went to school, but I'm guessing it wasn't anywhere in the West.
Since when were psychiatrist's not physicians? Psychologists are not -- but psychiatrists most definitely are.
If it wasn't for the fact that it was that these practicioners of the woo are going to be hurting their children...well, I'd encourage them not to use the evil evil scientific medicine.
Anti-vaccination dogma wrapped in religious extremism? Say it ain't so!
You can express your concerns or questions to him directly; his email is at the bottom of this document (which outlines the IMA's goals and seems mostly reasonable, with a few exceptions): http://72.14.203.104/search?q=cache:n-sET8e9Nk8J:www.islamicmedicine.or…
Vaccines are unnatural. Deadly nightshade is natural. Let me think where I should put my loyalties. . . .
i've always wondered about how a physician should approach his patients concerning the risks of vaccination. i mean, if the herd immunization rate is high enough, then shouldnt a physician advise an individual patient not to be vaccinated? as long as everyone else is vaccinated then dont the possible side effects of vaccination (including the muslim worry about damnation?) outweigh the benefits of vaccination?
mike
Once again we see the old idea that disease is the wages of sin. We in the West are hardly innocent of that notion: most of us vastly overestimate the amount of disease that could be prevented through lifestyle change (we assume that the risk differentials associated with smoking and cancer/cardiovascular disease are typical of most lifestyle factors, whereas in fact they're much larger).
mike... or doc tom:
So if herd immunity is high, it may be okay to not vaccinate. BUT... as has been shown in Nigeria and northern India ... AND in Indiana, USA if enough people say "Oh, no! No vaccine for me because I'm special!" then there is no herd immunity.
In the UK herd immunity to mumps and measles has been eroded enough to bring those diseases back with some tragic consequences. And in Indiana:
http://www.alertnet.org/thenews/newsdesk/N21417880.htm
i've always wondered about how a physician should approach his patients concerning the risks of vaccination. i mean, if the herd immunization rate is high enough, then shouldnt a physician advise an individual patient not to be vaccinated? as long as everyone else is vaccinated then dont the possible side effects of vaccination (including the muslim worry about damnation?) outweigh the benefits of vaccination?
No. Because herd immunity is not a static entity - it is constantly changing through births, deaths, immigration, etc. Just because the impact of a disease is low now doesn't mean it will remain low. Sporadic outbreaks of measles in the U.S. illustrate that A.) herd immunity stops the progression of most diseases and B.) such diseases are truly a "plane ride" away.
Another thing to remember is that herd immunity is designed to protect two groups of people - those who cannot be vaccinated due to known contradindications or those for whom the vaccine just doesn't work. As long as the percentage of people who otherwise opt-out remain low, the herd immunity threshold is rarely breeched.
Well...historically the idea of not eating pork, frequent washing and sticking foods that were known to be 'safe' would have prevented many an illness simply due to lowered cross-contamination and avoidance of food-bound parasites. So there is a grain of truth in his idea.
Except that the rest of it is bunk. Those were provisions to keep people safe thousands of years ago, but the present is new and fresh bundle of twigs so I'm afraid I can't award partial points for historical thinking.
So there is a grain of truth in his idea.
Not really. Plenty of cultures without those taboos and practices managed to be just as healthy.
with respect, both anonimouse and HCN (hydrogen cyanide?), respond to my argument with impact on other people...people presumably with whom i dont have a doctor patient relationship, or possible ramifications if too many physicians adopt the same policy...which i would argue is unrelated to a specific dr-pt relationship. i think that still leaves open the question of if it is unethical for a doctor to tell a patient in an area where herd immunity is high to avoid an immunization if the risk of side effects is worrisome to the patient.
i , of course, agree with your practical viewpoints. but would you advise a side effect worried celibate woman to get an HPV vaccine? if the vaccine protects the patient only in asmuch as it protects the herd, is advising to be vaccinateds at all at odds with prima non nocere? or in other words, is our duty to public health at odds with our duty to a patient?
mike
p.s. HCN, "mike" will be fine, i use doc tom as a handle because mike is too common a name and generally leads to confusion on open threads. although here it doesnt seem to be an issue.
"...we have our own brand of religious or "spiritual" irrationality right here in the good ol' USA that drives antivaccination loons, be it Christians who claim that vaccination is against God's will and that "the abortion industry contributes to vaccine manufacturing" or New Age spiritualists who seem to think that "healthy living" (whatever that means) will protect them from infectious disease and that vaccines are somehow "unnatural.""
Whenever I encounter the smug selfishness of the latter, it puts me to mind of dear Redd Foxx's wisdom - "Health nuts are going to feel stupid someday, lying in hospitals dying of nothing."
mike (it is perhaps the most common English male name),
True it is something in regards to a SINGLE doctor-patient relationship when it comes to vaccines. There are certain patients that have a real reason to skip certain vaccines. Some have actual allergies, and other issues (one of my kids has never been vaccinated for pertussis due to a seizure disorder, hence my desire to increase herd immunity for that). I don't know about HPV for a celibate woman, because how does that really work? What if there is a change of heart... or worse the celibate woman is a victim of violence (perhaps the solution is to vaccinate all men?).
BUT... Dr. Katme was saying that the MMR was inappropriate for ALL Muslims. That leaves are large population that can become susceptible to an outbreak fairly quickly. All it takes is one person to get on an airport in India or Romania to contact the unvaccinated group. This is what happened in Indiana. One young woman infected over 30 others (and several were hospitalized). That is how 9 children died in Philadelphia in the early 1990s.
This is, of course, why polio returned to Nigeria and India. It is part of whole swaths of folks not getting vaccinated, so that they go back to the "good ol' days" of rampant infectious diseases.
Dr. Paul Offit had an opinion piece last week in the Wall Street Journal titled "Fatal Exemption". To read it requires a subscription, but I was able to use my public library card to read it online. Here is one important paragraph:
"The finding that lower immunization rates caused higher rates of disease shouldn't be surprising. In 1991 a massive epidemic of measles in Philadelphia centered on a group that chose not to immunize its children; as a consequence nine children died from measles. In the late 1990s, severe outbreaks of pertussis occurred in Colorado and Washington among children whose parents feared pertussis vaccine. And in 2005 a 17-year-old unvaccinated girl, unknowingly having brought measles with her from Romania, attended a church gathering of 500 people in Indiana and caused the largest outbreak of measles in the U.S. in 10 years -- an outbreak limited to children whose parents had chosen not to vaccinate them. These events showed that, for contagious diseases like measles and pertussis, it's hard for unvaccinated children to successfully hide among herds of vaccinated children."
Also, there is a video presentation which shows how much exemptions have grown over the past decade:
http://researchchannel.org/prog/displayevent.aspx?rID=5170&fID=345
And yes, these are my initials, but I am still a Perfectly Poisonous Person (who likes alliteration)
doctor tom,
As a physician, I would hope you understand that timely vaccination is part of the accepted standard of care for children. Your duty as a physician is to provide the accepted standard of care, which generally attempts to balance the rights of the patient against public health concerns.
A couple of comments --
Jess: Many of the prohibitions of the Old Testament (e.g. not eating pork or shellfish, dealing with human waste) were taken as bein "good standards to preserve health" -- and to a certain extent, but *only* to a certain extent, they were. The irony kicks in when you look at stories like one that hit the news recently, confirming that the Dead Sea Scrolls were very likely to have been in the possession of the Essenes at Qumran -- identified because the Essene's "hygeinic" methods of dealing with human waste, and washing, left them with a far higher parasitic and pathogenic load than just about any other population in the area (and they had a very high adult mortality, as well). Read more detail about it at http://www.msnbc.msn.com/id/15689591/ .
More generally, re: vaccinations -- I live near Aberdeen, Scotland. Recently a close friend of ours with a 14-month-old daughter took her for the MMR jab. Within a day of the jab she had developed a fever of about 40degC and had had two small seizures. They rushed her to hospital, where they were met largely with indifference, and an unsympathetic nurse handed them a pamphlet (one they should have been given BEFORE the jab was given!) warning them of possible side effects of the MMR jab. What really upset them was the blase attitude of "oh, there's nothing really wrong" -- they felt like, their child had been given something which affected her badly, and they just got blown off. Fortunately their daughter was all right after a few days, but they felt that the only "care" they were given was the pamphlet and advice to bathe her in cool water, and that was it.
They are sensible, steady people, not terribly sympathetic to either woo or scaremongering, and they had never had any second thoughts about vaccinations. They still understand that vaccination is far better than no vaccination in terms of disease, and will continue on course with further vaccinations. However, it's obvious to everyone (except, perhaps, the local health providers) that this sort of thing is hardly conducive to convincing more people to take up vaccines again with confidence in their medical system. It was the complete indifference which ticked them off (and us!) more than anything else. And that kind of story does grow legs, as well.
Now, for something to really make Orac scream....the triumph of woo in the UK.
Had he seen http://uk.news.yahoo.com/26012007/344/faith-healers-option.html , yet?
"More than half of people would turn to therapists such as faith healers rather than endure long NHS waiting lists, according to a new poll.
And more than two thirds (67%) believe in the psychic powers of mediums and clairvoyants, 54% in ghosts, and 41% in an intelligent life on another planet, the poll found.
Seven out of 10 people questioned could name a paranormal expert, compared with one in 10 who could name a nationally acclaimed doctor.
Regionally, 72% of those in Scotland said they would turn to an alternative therapist to get better, followed by 66% of those in Wales and 45% of Londoners."
Whee.
luna,
Some doctors suck. That's a given. And I do believe that the fact that some doctors suck and some drug companies do questionable things for profit breeds anti-vax (and general woo) sentiment. It can be hard to get past that fact. But I know objectively that vaccine benefits outweigh the risks.
anonimouse: I know that. You know that. Most people know that. But perception can be just as important as -- or more important than -- fact, when it comes to determining human behavior, and the immediate perception that doctors are indifferent to the harm vaccines can do (even if very small harm) fuels behavior more than the very dim and distant perception that diseases can kill children. We have a couple of generations which have grown up without losing childhood friends to measles or whooping cough, so these things have receded to something of a fairy tale in their minds -- whereas arrogant indifference of those in authority is something that evokes a visceral reaction in most people.
So, my point -- in order to get people to vax more, the immediate perception of the uncaring medical profession HAS to be addressed, at a local and immediate level.
Granulus, I'm not at all saying its the be all and end all, I'm saying I see where he might have gotten the idea. Hygenic practices aid in health.
Luna, I have read that :) I was speaking in generalities but I appreciate your comments.
I had vaccinations when I was a child. But I am of two minds at present. Now that I am lacto-vegetarian I am leaning away from vaccinations since they use eggs to manufacture them. It is a tricky balance. I am also leery of the dairy industry. Now I am much healthier since I am vegetarian.
Before we jump to conclusions about the Muslim guy's response, we should remember the story of the Native People of the Americas. Millions of the indigenous populations "dropped dead like flies" from diseases that were brought to the Americas by the European Settlers from Europe. The Native Americans did not have immunity from these diseases.
Okay, sunlite, you made an obtuse point. I don't know what point, but you made a point.
Do you think a measles or Hib virus, or even a tetanus bacterium gives a damn about what you eat? Tetanus, otherwise known as "lock-jaw" is just as nasty to vegans and omnivores as it is to others (and it is also not a subject to herd immunity).
Incredible, every time I think that I have seen the worst, something else comes along. Now riddle me this: What happens when all of these unvaccinated kids come back to the UK from their summer trip to Karachi. Maybe the conspiracy here should be that the Muslim doctor wants the UK kids to get sick.