?.. by Dr Mir Baiz Khan
In the month of July this year, I happened to be in Chitral when construction on the Aga Khan Diagnostic Centre began. It is located in the heart of the Chitral Town and in close vicinity of the Town Hospital. For the past four decades, health facilities have increased and improved; there are government hospitals in upper and lower Chitral and health centers of the Aga Khan Health Services in many of its villages. These facilities serve the Chitrali community in treating known communicable and non-communicable diseases within their capacity. However, there is no medical institution with highly advanced technology in Chitral where diseases are diagnosed before they become life threatening or chronic ruining the quality of life and making it dependent on family members as long as it continues to linger on.
The sad fact is that very small number of families in Chitral can afford to take their family members to down country hospitals staffed with specialized diagnostic facilities; they are so expensive that the income of the predominant majority of Chitrali households cannot afford the expenses of travelling and staying in the cities even for a short period of time. What this means is that they don?t act until and unless serious illness of the individuals in the family becomes chronic or manifests suddenly. In such situations either the disease has advanced to an irreversible level or the patient has reached at the terminal point and, in all likelihood, dies either before or after reaching the hospital in the city. Many of these illnesses can be diagnosed within the curable time which can be treated in local hospital or have enough time to seek help for treatment or surgery in city specialized health facilities. More importantly, many at risk individuals can undergo regular monitoring of their conditions. For example, expectant mothers need the assurance that their health and their babies? health is not at risk before the delivery.
In Islam, respect for human life is of utmost sanctity; in that saving one life is like saving the complete human race. This is what the noble Qur?an teaches us: ?he who saves a soul, it is as if he saved the whole of mankind? (?? ???? ?????????? ???????????? ??????????????? ?????????). Following this Quranic guidance and many other verses which speak to the need of helping the sick and saving life, Muslim thinkers and physicians from the very beginning undertook upon themselves to advance medical science and find treatment to numerous illnesses. As professor Seyyed Hossein Nasr informs us in his book Science and Civilization in Islam: ?
The wise man or h?ak?m, who has been throughout Islam?s history the central figure in the propagation and transmission of the sciences, has usually also been a physician. The relationship between the two is in fact so close that both the sage and the physician are called h?ak?m; many of the best-known philosophers and scientists in Islam, such as Avicenna and Averroes, were also physicians, and made their livelihood through the practice of the medical art.
It is in this tradition that the sayings of the Prophet, peace be on him and his family, dealing with health, sickness, hygiene, and other questions pertaining to the field of medicine were collected and systematized. This body of Prophetic sayings became known as Medicine of the Prophet (t?ibb al-Nab?). Professor Nasr informs us that the collection of Prophetic traditions of Bukh?r? which is one of the most authoritative sources of its kind, consists of two books in which 80 chapters consist of the Prophet?s sayings about illness, its treatment, the sick, etc. The Medicine of the Prophet became the first book to be studied by the medical student, before he undertook the task of mastering the usual compendia of medical science.
From Muslim perspective, this task was not just an activity of interest and career, it was a deep commitment to the Faith, Islam. Muslim physicians carried on the tradition with full realization that they were dealing with the most delicate and difficult matters, that is, the human life. They never claimed full credit of their efforts to themselves in which they left no stone unturned. They acknowledge, as part of their Faith that their successes ultimately depended on the Divine help. For example, Abu Ali ibn Sina (Avicenna) gives details of diagnostic analysis of cases and in one examples he says that ?in the inspection of the urine, the observing of its colours and sediments, and the deducing of some special condition from each colour are no easy matters; for all these indications depend on Divine help and Royal patronage.? Treating patients was not just an activity that was at times perilous to the life of the patient, it was at times equally dangerous to the physician himself. Muhammad ibn Zakariyya Razi, a towering figure in early development of medicine in Islamic history and about whom another Muslim thinker Hamid al-Din al Kirmani in his book Al-Aqwal al-dhahabiyya says that he was in his field ?like a competent rider who gallops alone in the field.?
Muhammad ibn Zakariyya Razi was once received a message from the Samanid Amir, Mansur inb Nuh of Bukhara asking him to come to his court to treat him for an ailment which had grown chronic and the court physicians had failed to cure the disease. Zakariyya Razi sent his book Kitab al-Mansuri to the Amir through a messenger by the name Ere saying: ?I am this book and by this book thou cast attain thine object, so that there is no need of me.? When the book reached the Amir, his ailment had worsened. He sent a thousand dinars and one of his own private horses with instruction to his official to show every kindness to the physician, but, if he still refused to come, then to bind his hands and feet and place him in the boat and bring him across the Oxus River. This is what happened. When he was ferried across the river, his hands and feet were released. He was actually scared of being drowned.
Having tried his best, he found no improvement in the Amir?s condition. He, then, decided to treat him psycho-emotionally. He asked the Amir that he was going to try a different method and for that the Amir needed to sacrifice two strong and fast animals, one a horse and the other a mule. The Amir agreed. The next day he took the Amir to the bath of J?-yi-M?liy?n, outside the palace. The horse and the
servant at the door of the bath. He brought the King into the middle chamber of the hot bath and his entourage were not allowed to accompany him. Zakariyya Razi poured over the Amir lukewarm water, after which he prepared a drink, tasted it himself, and then gave it to him to drink. And he kept him there till such time as the humours in his joints had undergone coction. Then he himself went out and came back with his clothes on and taking a knife in his hand. He stood for a while insulting the Amir by saying, ?O such-and-such, you did order your people to bind and cast me into the boat and to threaten my life. If I do not destroy you as a punishment for this, I am no true son of Zakariyya.? The Amir was furious and rose from his place to his knees. Muhammad ibn Zakariyyia, drawing his knife, threatened him even more, until the Amir, partly from anger, partly from fear, completely rose to his feet.
When Muhammad Zakariyyia saw the Amir on his feet, he turned round and went out from the bath, and both he and his servant mounted, the one the one the horse, the other on the mule, and they took off towards the Oxus. At the time of the afternoon prayer they crossed the river, and halted nowhere till they reached Merv, the town of Ibn Zakariyya. From Merv he wrote a letter to the Amir, saying, ?May the life of the King be prolonged in health of body and effective command! I your servant undertook the treatment and did all that was possible. The treatment of the disease by ordinary means would have been a protracted affair. I therefore abandoned it in favour of psychical treatment.? When Inb Zakariyya?s servant arrived, riding the mule and leading the horse, at the court of the Amir of Bukhara he presented the letter to Amir. Reading the letter, the Amir was astonished and sent ibn Zakariyya generous honorarium and gifts.
These Qur?anic and Prophetic tradition inspired physicians were people of faith and integrity, but, they needed Royal patronage in advancing the science of medicine and treatment. Many rulers, generous wealthy families and individuals in the countries of Muslim domain supported the learning and research in all facets of human life and made many breakthroughs in the sciences of their time. For instance, the first important treatise on the eye was the Note-Book of the Oculists of ?Ali ibn ?Isa of Baghdad, composed at the end of the fourth/tenth century, and followed shortly by the Book of Selections on the Treatment of the Eye of Ammar al-Mausili who was the eye surgeon in the Fatimid Egypt during the Fatimid Imam-Caliph al-Hakim whose court was also the scene of the activities of al-Hasan ibn al-Hasan ibn al-Haytham who was the greatest of the Muslim opticians, and who also made many studies on the structure and illnesses of the eye, especially related to the problem of vision. Another renowned physician in the Fatimid Egypt was Ibn al-Jazzar who produced many books, one of them is tibb al-fuqara? wa?l-masakin, the intended purpose of which was to treat the patients of poor classes who needed medical treatment but could not afford unnecessarily expensive rare and important drugs and the costly fees of physicians.
It is in this Muslim intellectual and humanistic tradition of service to humanity that the Aga Khan Diagnostic Centre Chitral will offer the much needed service to thousands of Chitralis, saving them of the enormous costs of taking their family members to down country hospitals and diagnostic facilities and more importantly saving the ailing individuals from either facing untimely death or being paralysed from otherwise curable diseases. I was glad to be in Chitral at the time of the ground breaking of this much needed health institution took place. .. Dr MB Khan, 06 Sep 2019