Let there be no compulsion in religion.

Sura 2 - Al-Baqara (MADINA) : Verse 256
لَآ إِكۡرَاهَ فِى ٱلدِّينِ‌ۖ
“Let there be no compulsion in religion.”
This rather startling directive appears in the Qur’an right after the Verse of the throne, which extols the virtues of Allah ST. In Qura’nic rhetoric the word “La” is used to convey to the reader the notion “without doubt” or “let there be no doubt.” Other well known instances when a verse starts with “La” are the Muslim confessional statement “La ilaha illal lah”, variously translated as there is no god but God or Ggod is one. The rest of the verse goes on to state that there is no reason for compulsion because with the advent of Islam “the Truth stands out clear from Error.” The verse concludes “whoever rejects Evil and believes in God (in Arabic Allah) has grasped the most trustworthy hand-hold that never breaks. And Allah is all hearing and all knowing.”
Even those who are skeptical of Islam’s value in modern world would be startled by this extraordinary verse. It set the stage for a dramatic change in the history of religions from coercion and forced conversions to an appeal to the heart and mind of individuals. There was active proselytization but through persuasion not coercion. The word used by those Muslims who are active in proselytization is dawa, which means to invite, to reason and to ponder over the message and its meaning.
This simple and emphatic edict was responsible for a paradigm shift in the way minorities were protected and respected and allowed to live in peace and dignity in the Muslim world.
There were exceptions of an occasional ruler who violated these rules. While visiting Istanbul I saw a dramatic example of an aberration from this norm. The Hagia Sophia, one of the oldest and largest churches, was converted in to a Masjid by Suleiman the magnificent. The king, I learned, rode in to the Church on his horse and declared that it be converted to a Masjid forthwith. He probably forgot how the Khalifa Umar would not pray in a church, even at the invitation of the cardinal of the city of Jerusalem, for the fear that his followers may turn it into a Masjid.
There are many monuments, too numerous to recount, of Muslim tolerance and broad mindedness. The most dramatic is Jerusalem itself.
Some of this history has been distorted by Muslim haters and Islamophobes.
Some is being shredded by ignorant Muslim mobs like those who rioted against Copts in Egypt.
Some is being misinterpreted and mangled by faux Imams.
In a handful of conservative societies this edict of “no compulsion” runs up against another edict that exhorts Muslims to uphold right and prevent wrong; “Amar bil maruf wa nahi anl munkar.” These societies, basing their actions on the interpretations of the ignorant Imam, have taken upon themselves the right to enforce practice of religion as they see is the correct way. Hence the religious police in Saudi Arabia and Afghanistan, and to a lesser extent in Iran, will go around checking proper attire and performance of rituals.
Religion cannot be forced down anyone’s throat. You cannot win over hearts by coercion. When compelled to convert Muslims in ancient Spain simply went underground and became crypto Muslims. Same happened recently to Muslims in communist Russia. Human nature will react against coercion. Persuasion is more difficult tool and requires both patience and leading by example. The effect however can be long lasting.
There is a deeper understanding of the “Amar bil maruf” edict, which is understood to mean freedom to criticize authority, to demand transparency and accountability and fight for human rights and civil rights of all people but minorities in particular.
In a famous hadith Prophet Muhammad is reported as saying; "The best Jihad is to say what is just (or truth) in the face of a tyrant" (Abu Daud, Tirmidhi, Nisai and Ibn Majah).
Still another hadith goes farther suggesting the responsibility is with all of us; "When people see a tyrant and do not stop his excesses (his cruelty), it is not inconceivable that God sends a common punishment on them." (Abu Daud and Tirmidhi)
I have often imagined if a modern Muslim majority state that practiced governance by these principles then it would be an inspiration to all and may even have a positive influence on other nations. The only nation that gives me some hope is Turkey, the same nation that has Hagia Sophia, which under Erdogan is turning into a nation that we can be proud of. Erdogan has brought a culture of religious tolerance to Turkey and has tried to neutralize its illiberal secularism. He is the only Muslim head of state that has raised a voice against human rights violations in parts of the Muslim world. His and his party’s position is still precarious but there is always hope.

Javeed Akhter.

Should the term Allah used exclusively by Muslims?

A recent decision by the supreme court in far away Malaysia has relevance to our discourse in the US. The court ruled to allow Christians to use the word Allah in their worship. The reason for the court challenge was the fear that some Christians were using the word Allah in a surreptitious attempt to proselytize Muslims. The Christians disagreed saying the word simply means God in Arabic and the high court in Malaysia agreed. It is worth remembering Malaysia is an overwhelmingly Muslim majority country (approximately 60% Muslim and about 9-10% Christian) that practices a pluralistic, inclusive version of Islam.
The Malaysian court’s decision is bolstered by the fact that Arabic language Bible uses the word Allah for God. Adjectives like insha-Allah (God willing) masha-Allah (an appreciative appellation of God’s will), subhan-Allah (God be praised) are commonly used by both Muslim and non-Muslim Arabs. Outside the Arab world the term Allah and its derivatives are used only by Muslims that may have been part of the reason for the court challenge.
There are references in the Qur’an that clearly allude to the fact that Allah is a pre-Islamic term. Referring to the self serving use of God by pre-Islamic Arabs the Qur’an states, “---- then comes a stormy wind and the waves come to them from all sides, and they think they are being overwhelmed: they cry unto Allah, sincerely offering (their) duty unto Him, saying "If Thou dost deliver us from this, we shall truly show our gratitude!" (10:22)” In fact early on Allah did not appear to be the Qur’an’s favored term for God. “Rahman”, meaning the “Compassionate”, was used so often that observers felt it would be the chosen term.
Scholars have speculated that the word Allah may be the combination of “al” and “Ilah’ or “the God.” The confessional statement Muslims use in declaring their faith “La Ilaha Illal-Lah” is most frequently translated as “there is no God but Allah” or “there is no God but God.” The difficulty with the first translation is that it implies, unintentionally, that there is an exclusive God for Muslims. Nothing could be farther from the concept of God in Islam. God, Muslims are taught, is universal. He is God of all humanity, the Creator and Nourisher of the universe. The rationale for a universal God formulation is to achieve unity of mankind through a unified God, but not necessarily the same faith. The second formulation “There is no God but God” though powerful in Arabic, sounds inane as most literal translations are. Some argue that intellectually God may be defined only in negative terms, as whose attributes are beyond mind's eye and whose non existence is inconceivable; therefore the “no God but God” makes sense. A better translation would be the simple statement “God is One.”
Nevertheless the Arabic word Allah is well suited to the stringently monotheistic concept of God in Islam. The word has no plural to it, nor does it have a gender. In Islam one can never ask the question “is God female?”
Muslims talk about the ninety nine names of Allah (Asma-ul-hasana) that is meant to represent the numerous attributes of perfection. Scholars have wondered if there is a hundredth hidden name that holds the mystery of existence.
Much misunderstanding remains in the use of the word Allah and how to accurately translate it, but the Malaysian high court’s decision has cleared the air a bit and struck a blow for common sense.

Jihad and Jihadists:

Use of the term Jihadist an example of electronic and print graffiti.

With the recent flurry of cases of young Muslim Americans who were allegedly planning to engage in Jihad, like the five young men from Virginia who were detained for questioning in Pakistan and other cases, there has been extensive use of the term Jihadist to describe these individuals. Electronic and print media use the term Jihadist with abandon many a time link it with the phrase Islamic terrorist. From reporters, “Recruits in jihadist training camps “ (Katharine Houreld, Associated Press), to politicians, “ground zero for Jihadist terrorist plots”, (U. S. Rep. Mark Kirk), to op-ed writers and commentary on the electronic media, “Whenever a jihadist volunteers for martyrdom” (Charles Krauthammer) everyone is in to using the term to mean an unreasonable, faith driven extremist, the so called dead-ender. The word Jihadist does not exist in Muslim lexicon. Jihad does.

The word Jihad, which has the letters JHD and the as its root, and its derivatives jahada and jaahada, appear numerous times in the Qur’an and are used to describe “Striving for God with the effort which is His right.” A literal translation of the word Jihad would be “struggle” but the phrase that would capture the spirit of the word would be “a noble struggle.”

For ordinary piety minded Muslims all through the ages, the concept of Jihad is quite straightforward, and can be illustrated by the following anecdote. Once when Muslim soldiers were returning from a military engagement, their commander made the statement that "We are going from a lesser Jihad to a greater Jihad". The soldiers were surprised, I suspect dismayed, and asked which military engagement they were headed for next. The commander replied that by "the greater Jihad" he meant Jihad or struggle against one's inner self (Nafs).

Jihad is to strive for the highest possible goals, struggle against injustice and practice self denial and self control to achieve moral purity. That is how Muslims understood the word and applied it in their personal, social, political and military lives.

There are Muslim apologists who argue that Jihad does not mean “Holy war.” They are right in the sense that it more accurately means “just war.” Violence is to be used in self defense, in a limited manner, and as the absolute last resort and with no loss or injury to innocent life. Nevertheless the history of Muslim rule is replete with examples of those who attempted to sanctify their wars of personal aggrandizement as wars for a noble cause by labeling them Jihad. A few even named their war departments as the “departments of Jihad.”

Those who consider Jihad as a "fight against the whole world", including other Muslims who do not subscribe to a group’s incoherent and exclusivist understanding of Islam, like the al-Qaeda, seriously misunderstand it; they corrupt the concept.

Those who have no use for it in public life and define it strictly as a way of improving self; they diminish the concept.

Then they are those who understand it as a difficult but noble struggle to be conducted with patience, wisdom and with peaceful means, these are most Muslims, they comprehend the proper concept.

This “jihad of the new age” is to fight for rights, justice and dignity in “the realm of ideas, media, and communication,” such as the internet, video, and satellite television is in essence activism. It may used to influence politics and policy, feed the hungry and provide health care for the needy or write a blog.

Those who use the terms Jihad and Jihadist in a derogatory fashion, divorced of its original meaning, its historical and theological context and all of its nuances are either ignorant or lazy or both. Some are bigoted and are indulging in Muslim bashing.

Javeed Akhter, a physician, is founding member of a Chicago based Muslim American think tank “The International Strategy and Policy Institute.”

An Attitude of Gratitude

Javeed Akhter

If we reflect upon it for a minute there is lots we all have to be thankful for. Much of it we take for granted; our life, health, children, knowledge and so on.

Islam strives to make people lose this complacency and be aware of their good fortunes. In the Qur'anic chapter titled Rahaman the flamboyant recurring refrain “and which of thy Lord’s favors will you deny?” is a direct allusion to the human flaw of taking things for granted.

Though not unique, the teaching that one should be thankful in every circumstance and strive to attain an attitude of gratitude, is central to Islamic way of thinking.

Gratitude may be expressed in many ways, like charity, and Sadaqa but above all by good deeds; by giving without expecting thanks in return.

A consequence of being thankful is optimism. It is an antidote to pessimism and depression.

Dr. Robert A. Emmons of the UC Davis has done interesting research on gratitude and its relation to happiness. Some of his findings were summarized in an op-ed in the Chicago Tribune recently. Those who kept gratitude journals and lists, felt better about their lives as a whole, and were more optimistic than those who recorded hassles or neutral life events. They were more likely to have made progress toward important personal goals (academic, interpersonal and health-based) over a two-month period compared with control groups. Young adult subjects self reported higher levels of positive states like enthusiasm, determination, attentiveness and energy. They were more likely to have helped someone with a personal problem or having offered emotional support to another.

In summary Emmons' research shows that inculcating and practicing gratitude resulted in higher reported levels of optimism, alertness, energy, enthusiasm and determination.

Salat, the Muslim prayer, is a gratitude exercise performed many times a day; sajada, prostration, is the ultimate symbol of gratitude.

Different stages of gratitude are recognized: The first level is gratitude for the favors one has received I life. A higher state is attained when one is grateful even if a wish is unfulfilled. Here one sees the blessing veiled in difficulty.

The Qur’anic verses from Fajr (89.15, 16) allude to both of these states; it considers both good and bad fortune as equal trials.

As for man, whenever his Lord tries him by honoring him, and is gracious unto him, he says: My Lord honors me. (15)
But whenever He tries him by straitening his means of life, he says: My Lord despises me. (16)

People who realize good fortune is as much of a trial as is difficulty and those who remain thankful, even in the face of hardship, have achieved an uncommon level of spirituality. They have attained the much coveted inner peace, the nirvana, the serenity of soul, the tranquility of heart that we all desire. The challenge is to remain content, even in adversity.

As a wise man once noted “A heart filled with thankfulness has no room for self-pity or despair.”

The Fort Hood Tragedy:

Need for Patience.

A major tragedy, like the horrific violent act by Major Hasan, brings to the best and the worst in people.

Even before we learned any of the details of the incident or the bio of the killer politicians like Joseph Lieberman were calling it the greatest act of Islamic terrorism since 9/11. Lieberman, who is in charge of homeland security, plans to launch an investigation even though he has pre judged the conclusions. Lieberman is joined in his shrill rhetoric by many in the media and a slew of right wing pundits.

Experts tell us that an act like this is multi-factorial in origin. It is becoming increasingly clear that Major Hasan’s actions may have been partially because he either was mentally ill or snapped under the stress of his personal circumstances. There are indications that he was increasingly ambivalent in fighting other Muslims. But it is not clear how much he was motivated by religious zeal. If he was then he has clearly a wrong and twisted understanding of Islam.

It is reported that he became increasingly reclusive after his parent’s death. His supervisors during the residency program worried about his becoming “psychotic.” It is hard to understand why they did not demand a psych evaluation. But we still do not know all the details. We need to wait till the army’s investigation is complete. This is not to condone or justify his actions or turn him into a victim; it is to understand what happened and learn from it.

Even a psychiatrist may have an incipient mental illness that is exacerbated by the stress of his work. This may be especially true if the work involves dealing with human tragedy like PTSD ad infinitum. Others in the army in positions similar to Hasan should be examined for warning signs of stress.

Not uncommonly a sudden and swift breakdown is the first overt sign of a mental illness. All too frequently early symptoms of a mental illness may be misconstrued as personality trait of being introverted or having poor social skills. The person suffering from mental illness, almost invariably, does not recognize that he is in trouble. Often family or close friends may not pick up on clues of an impending breakdown. Major Hasan appears to be a man who had few friends and a meager social support network.

There are contradictory reports that Hasan was stereotyped and even harassed. It would not be surprising if some stereotyping goes on in large institution like the army. A question to be looked at carefully is how the armed forces deal with stereotyping of minority groups like women, blacks, gays, Muslims and others.

It is important that a professional and unbiased analysis of all the factors involved be carried out. The army appears to be doing just that. The investigation should not be tarnished by the grandstanding of politicians or Islamophobes.

The words of General George Casey Jr., the Army chief of staff, provide much needed dose of sanity and objectivity when he pointed out that Hasan may have just “snapped” and cautioned against speculation about the soldier’s faith might “cause a backlash against some of our Muslim soldiers.” General Casey pointed out correctly that “it would be a shame if our (army’s) diversity became a casualty as well” of the tragedy. Casey’s words are wise and apply to our civil society as well. We are a nation committed to the ideals of fairness, justice, tolerance and above all E pluribus ununm.

Javeed Akhter, a physician, is founding member of a Chicago based Muslim American think tank “The International Strategy and Policy Institute.”
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Dalit Children forced to clean toilets at school.

Dalit Children forced to clean toilets at school.

Even hardened cynics would be shocked by the story reported in an English language Indian weekly Outlook that dalit children are routinely forced to clean toilets in schools in Gujarat. This was not an expose by the news weekly but an account of a conference held at Sabarmati Ashram founded by Gandhi. "The children were at the ashram to share their 'experiences' with a fact-finding panel, tales of being forced to clean toilets and mop floors in school, of horrific discrimination by their upper-caste schoolmates and teachers. They came to the podium in line, district by district, took the mike to tell their stories," said the report.
The story added that "All these kids work for a pittance, cleaning manure pits, dragging dead animals, helping their parents to sweep streets, mop floors, clear garbage, clean toilets. In schools they are forced to do this for free. In the evenings the children accompany their parents to collect leftovers from the homes their mothers work in. It's known as "baasi" or stale food."
A recent novel "A Fine Balance" by Rohinton Mistry weaves in the plight of the dalits in a compelling narrative not meant for the faint of heart. Relentless, graphic and depressingly matter of fact, Mistry's novel leaves the reader's emotions in tatters. The reality of these children in Gujarat's schools is even more emotionally wrenching. It appears to be wide spread and raises few if any eyebrows.
The caste system is the most severe indictment of traditional Hinduism, which otherwise has much humanism in it. I do not know how caste system can be rationalized leave alone justified. My Hindu acquaintances and friends I suspect are largely uncomfortable with this part of their faith.
This is not to say that other faiths in India do not practice discrimination based on caste. Eighty percent of Christians who are of dalit background complain of the higher Christian castes monopolizing the Church hierarchy. Muslim society in India is guilty of its own social ills. One reason for the revered reformer Ambedkar's conversion to Buddhism, and not Islam, as a way out of the dalit black hole was the discrimination by Muslims of a group amongst them, the so called Arzals. He criticized Muslims for sugarcoating their sectarian caste system with euphemisms like "brotherhood".
I have not been witness to caste based discrimination among Muslims. This may be because I have lived in an urban and not a rural environment. But I have seen pervasive 'servant' abuse in India that is really another form of class discrimination. Servants, many of them children, are not allowed to eat at the same table or sit at the same level. Sometimes I have seen waiters in restaurants verbally abused as are chauffeurs. Many as a result of years of discrimination have a painfully obsequious attitude toward those perceived as belonging to a higher class.
In spite of its many social ills it would be fair to state that Islam has done a better job at getting rid of stratification based on race and caste. Who among Muslims has not heard the statement in Prophet Muhammad's last speech when he said that we should stratify people not on the basis of race but their righteous behavior.
India needs to act forcefully and quickly to exorcise it's demon of the caste system. The laws are there but they need to be enforced. There are hopeful changes in the political arena as witnessed by the election of a dalit leader Mayawati as Chief Minister of the large and important state of Uttar Pradesh. Yet much more needs to be done.
India's hopes for reform lie in its strong English language press, which has good record as a watch dog, and a large intelligentsia with a growing tradition of standing up for human rights.
Javeed Akhter, a physician, is founding member of a Chicago based Muslim American think tank "The International Strategy and Policy Institute."

Health Care Reform.

Reforming healthcare while ignoring the physicians.

If physicians, who after all drive healthcare, were asked how they would reform the system, they may come up with somewhat different set of proposals that are being debated.

High on the list would be stringent transformation of the health insurance industry, malpractice reform and reeducation of physicians in giving up defensive medicine in favor of practice based on evidence based guidelines. This would truly improve the health care system and arguably attain substantial cost savings.

Physicians would debunk the myth that US has the best health care system in the world that should be left alone. It is also not as bad as some statistics tend to show. US physicians are well trained, Hospitals are equipped with star wars technology, medical and surgical protocols are exemplary and followed by the rest of the world. If criteria like life expectancy, infant and child mortality and cost effective care are used as parameters US is lower than many developed countries. No Canadian or Brit or French would like to migrate to the US for health care; unless they could afford it.

The main problem our healthcare is the huge rich/poor, rural/urban and inner city/suburb divide. There are North side Hospitals in Chicago that are so well appointed they rival five star Hotels and others in the South side that look like they are in a poor country in a different continent. The healthcare system suffers from an ethical deficit not a dearth of god medicine. No system that leaves millions of its citizens unprotected can be called a good system
The insurance industry makeover must include simplifying rules reducing phone calls and paper work that accounts for 7% of healthcare expenses. Many physician practices have one or more associates devoting their time simply dealing with paper work generated by many and confusing rules. For hospitals this administrative load is exponentially greater. Avarice of insurance companies has resulted in a diabolically complex system with multiple and confusing plans.

There are in network and out of network options to consider (your favorite physician may be out of network and therefore out of reach) and pre authorization even for PPO plans is common place. Current insurance plans may accurately be described as schemes that have more to do with increasing corporate profit and less with providing health care.

The “pre existing condition” clause and loss of coverage when individuals move to a different job are other examples of egregious Insurance behavior that health care reform proposals aim to eliminate and are universally embraced by care givers and care receivers alike.

Insurance companies, if they wish to do business, should be mandated to offer a simple, economical, no questions asked, basic plan. This frill free plan would provide for catastrophic coverage, hospitalizations and routine preventive care. The premiums for this type of plan may be subsidized by the federal government. This along with expanded Medicare eligibility and appropriate funding of Medicaid would eliminate the need for the “Public Option.” Expanded coverage would result in timely health maintenance, fewer visits to emergency room with significant cost savings.

Malpractice reform is a necessity not a luxury. The current malpractice system is corrosive, penalizes the caregivers directly and the patients indirectly. It is common to hear in discussions among physicians phrases like “It is not indicated medically but for medico-legal reasons it would be prudent to run the test.” That is not good medicine. Physicians are not suggesting getting rid of malpractice system but making it fair and balanced. Freedom from the ever present terror of the malpractice suit would allow the physicians to practice medicine the way it should be.

At the very end of the speech on health care reform to the joint session of Congress President Obama mentioned the words physicians had been waiting eagerly to hear; “malpractice reform.” But the statements that followed left many scratching their heads in puzzlement as there were few specifics mentioned; “move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.” It seemed like a gesture to appease rather than a commitment to do anything substantive.

President Obama remarked “I don't believe malpractice reform is a silver bullet” and added, “I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.” President Obama is right malpractice reform is not a silver bullet and may not result in much direct cost saving but it will result in an assurance to the care receivers that they may not be subjected to excessive tests and much needed peace of mind for the care givers. What is distressing is that the malpractice issue has been reduced to largely economic question when it is primarily a matter that affects physicians as humans with feelings and vulnerabilities. There is no other country in the world where physicians practice their craft under GREATER DURESS than in the US. People tend to forget that a malpractice suit not only threatens their livelihood and life savings but cause untold emotional stress. Many experienced physicians have retired early or moved from sates like Illinois to states like Indiana that have instituted reasonable malpractice reform that we can learn form and improve upon. President Obama may have talked to many doctors but has he listened to any?

As a part of reform physicians would be retrained to practicing Evidence Based Medicine, and not defensive medicine; this arguably would result in large cost savings. Educating physicians in moving away from defensive medicine that is partly driven by fear of a malpractice suit, partly bad habits inculcated over years and partly patient expectation of a perfect outcome is a cultural shift of seismic proportions.

But it can be done.

Increasingly carefully crafted evidence based guidelines are published by societies in the discipline. Physicians would argue evaluating their performance on practicing Evidence Based Medicine rather than outcomes alone as suggested by President Obama is a better option. Outcomes depend on many and complex variables and would be problematic to use as the only way of judging good care. Caregivers who take on patients with higher acuity and complexity may have lower outcomes. Physicians and hospitals may start screening for patients with lesser acuity. Another part of the education process would be encouraging patients to enquire about guidelines in place in a practice or hospital for managing a particular illness and how is their efficacy being assessed.

Americans are compassionate group and have an admirable history of caring for their neighbors and regardless of party affiliation. They have seen too many horror stories of friends and family whose lives have fallen apart because of a serious or chronic illness; I know they will support a sensible and compassionate health care reform. But successful reform depends on listening to physician concerns.

Javeed Akhter, a physician practicing in the Chicago area, is a free lance writer.