Friday, July 24, 2009

Principles Concerning 'Infectious Disease' (al-Adwaa) In Light of the Swine Flu Drama -


- by HealthyMuslim
Key topics: Contagion • Infectious Disease


All praise is due to Allah and prayers and salutations be upon His Prophet. To proceed.
Inshaa'Allaah, this series of articles will cover some broad principles by which, as a Muslim, you can have a clearer perspective of this subject in general and with regard to the current issue of swine flu in particular.

The subject of al-adwaa (contagion, infectious disease) can be confusing when you start looking into it, so what we want to do is to start isolating the various principles and build upon them one by one inshaa'Allaah in this series of articles.

PRINCIPLE: It is from the belief of the people of Jaahiliyyah and the Disbelievers (and secular, atheistic societies) that al-adwaa (contagion, "infectious disease") is infectious by its own inherent and intrinsic nature (bit-tab'), that it infects outside of the domain of Allaah's Will (Mashee'ah), Permission (al-Idhn) and Decree (Qadr).

We first draw upon a quote from Ibn Hajar al-Asqalaanee (rahimahullaah) in his "Badhl ul-Maa'oon Fee Fadl it-Taa'oon" (Dar ul-Kutub al-Athariyyah, 1993CE) which is a book specifically dealing with the plague, as he lived during the time of outbreaks of plague in Egypt and covered the issues relating to contagion in the Sunnah (Prophetic Narrations). On page 212 of this book, after lengthy preceding discussions, he summarises the various viewpoints on contagion (what is referred to as "infectious disease"). He says:

The first: that the disease is infectious by its intrinsic, inherent nature (bi tab'ihi), and this is the saying of the disbelievers.
We will come back to this full quote in a later part in this series, at this point, we just want to document what is held in an atheistic secular society in relation to contagion ("infectious disease").

Next we have a statement from Shaykh al-Albaanee (rahimahullaah), who says in the course of discussing the issue of al-adwaa (contagion) in Silsilah as-Saheeah (no. 971):

...And know that there is no contradiction between these two hadeeths and between the hadeeths, "There is no contagion ("infectious disease")..." that have preceded (nos. 781-789), since what is intended by them is to affirm contagion. And the intent behind these hadeeths is to negate the contagion that the peple of Jaahiliyyah used to believe in, which is its transmission by itself, without looking at the (determination of the) Will of Allaah in that... How today resembles yesterday! For indeed the European doctors are in the most severe heedlessness away from Him, the Most High, due to their shirk (association of partners to Allaah) and their misguidance, and their belief in contagion ("infectious disease") upon the way of Jaahiliyyah...
We should note here that when you look at the speech of the scholars in this regard, you see that in some words they appear to be affirming contagion and in other's they are saying it is false. They are referring to two things. When they affirm, what they are referring to is the spread of disease due to Allaah's permission and will. When they are negating, and declaring contagion to be false, they are referring to what is believed by the people of Jaahiliyyah, the secular and atheistic societies and their likes, that a disease is infectious in its own right, in its inherent intrinsic nature, outside of Allaah's control, will, permission and decree, and that it moves and spreads in a population, outside of Allaah's will, decree and permission.

From Shaykh Ibn Baaz (rahimahullaah) in his treatise "al-Qawaadih fil-Aqeedah wa Wasaa'il as-Salaamah Minhaa":

And whoever claims that there is al-adwaa (contagion, infectious disease), then this is falsehood (baatil), however Allah has made mixing with some of the ill to sometimes be a means (sabab) of the disease being found in the healthy, however it does not infect (spread) by its inherent, intrinsic nature...
And Shaykh Saalih Aal us-Shaykh says in his explanation of Kitaab ut-Tawheed, on this subject:

And the people of Jaahiliyyah believe that the contagion transmits of its own accord (from person to person, or place to place) so Allaah - the Mighty and Majestic - falsified that, He falsified that belief, and he [the Messenger] - may prayers and salutations be upon him - said, "There is no contagion ("infectious disease")", meaning: that which is the effective, influencing element on its own.
Now we can bring more quotes from the Scholars, but here we just want to establish the principle here that the belief on the inherent, intrinsic infectiousness of a disease, that it infects due to its inherent nature (at-tab'), is something held by the people of Jaahiliyyah and the disbelievers.

We can bring in some speech of Shaykh Saalih al-Fawzaan just to give us a slightly wider perspective before closing this article,and so as not to cause any confusion. He says in his "I'aanat ul-Mustafeed" (Vol 2/7-8):

His (sallallaahu alaihi wasallam's) saying, "There is no contagion ("infectious disease")": What is meant by contagion (al-adwaa) is: The spread of a disease from one person to another, or from an animal to another, or from one place to another. And disease can spread from one place to another and it can spread from the ill to the healthy and from the sick animal (scabies) to the healthy. This is something that exists.
But the Messenger (sallallaahu alaihi wasallam) is not negating this, he is negating the contagion ("infectious disease") that the people of Jaahiliyyah used to believe in, that the disease spreads by itself without the decree of Allaah, the Sublime and Exalted.

So al-adwaa (contagion) is: The spread of disease from one place to another because of the nearness of the healthy to the diseased, and the one who decrees it is Allaah, the Most High. For a healthy person can be close to an ill person and nothing will afflict him, and he may sometimes be close and he will be afflicted (with the illness). And so the cause is that it goes back to Allaah, if He wills, the Sublime and Exalted, the illness will spread (to the other person) and if He wills, then it will not spread.

So the mere nearness of the ill person to the healthy person, or going to a place where a disease has broken out, this is a sabab (a means). As for the effect (ta'atthur), then it is in the Hand of Allaah, the Sublime and Exalted. For a person can enter into a land where a disease has broken out, and he will not be afflicted, an ill person may pass by a healthy person and (the latter will) not be affected. An ill person may sleep next to the healthy person and he (the latter) will not be afflicted. Sometimes, he may. But what is the separating matter between the two situations?

That this goes back to Allaah, the Most High's Will (Mashee'ah).

As for the people of Jaahiliyyah, they don't differentiate, rather to them: Everyone who comes close to an illness, or everyone who comes close to an ill person - that he will be afflicted. And they don't ascribe this to Allaah's ordainment (qadaa) and decree (qadar), and nor do they place reliance upon Allaah, the Sublime and Exalted, and they exaggerate in omens (at-tashaa'um and at-tiyarah) and in the spread of contagion ("infectious disease") and they do actions that are laughable.

So what we find here is that the phenomenon of disease spreading is something that is observable and witnessed. So clearly this outwardly observable phenomenon is not being negated, it does take place. However, this is not because of the "infectiousness" of the disease or this being inherent and intrinsic to it (bi tab'ihi). Further, the mixing between people can sometimes be a sabab, a means. The decisive factor in the spread of the disease is actually Allaah's will, His permission, His decree. This is what the affair return's back to. From this understanding a range of other issues branch off which inshaa'Allaah will be covered in later articles.

What we should note here is that there are a number of viewpoints amongst the Salaf

There are those who say that there is no such thing as contagion ("infectious disease") at all, and that any spread of disease is because Allaah creates that disease afresh in each individual. We will be documenting this view later inshaa'Allaah. For now we'll just mention what has been summarised by Ibn Hajar al-Asqalaanee in the aforementioned book (p.213), and which in his view is the most correct view:
The fourth: That disease is not infectious by its inherent nature at all (aslan, fundamentally). Rather, to whichever person a disease occurs, then that is due to Allaah's, the Sublime and Exalted, creating of that in him afresh. For this reason, many who are afflicated with a disease - about which it is said that it is "infectious" - are observed where a healthy person mixes with them often and nothing afflicts him at all, and many who have not mixed at all with the one with the disease are observed, yet the disease (still) afflicts that person (nevertheless). And all of that occurs from the decree (taqdeer) of Allaah...
So here it is explained that because it is often observed that there are many who have never mixed with those with the disease, and who still catch the disease - this shows that the mixing on its own is not the sabab (means), rather it is purely from Allaah's decree and will that other people get the disease, since whether a person mixes with an ill person or not, they still get the disease.

And others from the Salaf say that Allaah has made the mixing between two people to sometimes be a means (sabab), but that the actual effect is under the control of Allaah's will, permission and decree..
These views have arisen out of the necessity to provide an explanation for the apparent contradiction between the hadeeths that negate contagion (such as "there is no contagion") and those that appear to affirm it (such as "flee from the leper"). So you have different ways of reconciling. We will go into that in more detail inshaa'Allaah in future articles.

Summary

The people of Jaahiliyyah, and atheistic, secular societies believe that a disease is "infectious" by its own inherent, intrinsic nature (bi tab'ihi), and that the spread of disease is outside of Allaah's will, permission and decree. When you read much of the language in the scientific documents, in the reporting and in the general coverage of "infectious disease", and in many of the health leaflets on "infectious diseases" and especially when there is an outbreak of some disease (large or small) you come across an abundance of language indicating this.
Here is just one example from the Washington Post from 2nd May 2009:

Mexican Officials Say Flu's Ability to Spread May Be Low. Mexican health officials studying the new influenza virus said Friday they have found that its ability to spread from person to person may be fairly low, raising hopes that the extreme measures taken here -- the shutting down of all nonessential commerce and government -- can contain its spread... In an obscure government building in the south of this city, dozens of experts in public health gathered in a "war room" to monitor on computer screens the spread of swine flu around the country. While it is far too early to answer with any certitude the most pressing questions -- how infectious and lethal is the virus? -- they offered some preliminary assessments
And another example:

...they've determined that the virus is capable of human-to-human transmission...
And another example from the LA Times, 30th April 2009:

The swine virus does appear able to spread easily among humans, which persuaded the WHO to boost its influenza pandemic alert level to phase 5, indicating that a worldwide outbreak of infection is very likely.
The capability, and ability in the transmission, is attributed to the virus in this type of language being used.

So the point being here, that in the language used in atheistic, secular societies (and likewise in the educational and medical establishments), diseases are noun-entities that are "disease-causing" in and of themselves, and they are then spoken of as having inherent and intrinsic properties and abilities, such as "infectiousness", "capability of transmission" and so on. And this language is widespread - and it affects the way people think and perceive of the situation, and its a reminder of what was said by Shaykh al-Albaanee (rahimahullaah):

...How today resembles yesterday! For indeed the European doctors are in the most severe heedlessness away from Him, the Most High, due to their shirk (association of partners to Allaah) and their misguidance, and their belief in contagion ("infectious disease") upon the way of Jaahiliyyah...
The spread of disease, however, is an observable phenomenon. The mixing between people can be a means (sabab), and the control and power over it's effect lies only with Allaah, the Sublime and Exalted. Since Allaah is the Creator of the asbaab (ways and means) and the musabbabaat (the resulting effects). However, as Allaah is the Creator He can prevent the asbaab (means) from being tied to their musabbabaat (effects). Further, some of the ways and means are strongly, or inextricably tied to their effects, so the sabab (say drinking water) always leads to its effect (removing thirst), and other ways and means are loosely tied to their effects (say planting a seed may not always lead to the plant and its fruits, or a man having intercourse with this wife, may not always lead to a child) - since there may be additional asbaab (means) that are required also, as well as the absence of preventative barriers for the musabbabaat (effects) to be seen. So ultimately, Allaah has power over everything.
The above is one explanation, namely the mixing between the people is a sabab (means) that is under the control of Allaah, and it can lead to the transmission of disease from one person to another, but this is purely by Allaah's will and decree.

The other explanation from the Salaf is that there is no such thing as "infectious disease" (al-adwaa), at all, and that Allaah creates the disease in each individual afresh. This will be documented in more detail in a later article inshaa'Allaah.

It is permissible for a person to keep away from a person with a disease or from a land where a disease has broken out, out of the principle of not subjecting oneself to potential harm, and keeping away from the asbaab (ways, means) that can lead to harm. And in this regard there is the hadeeth of Umar not advancing to the place where plague had broken out - this will be covered on its own in more detail in a future article inshaa'Allaah. So not subjecting oneself to harm is a general principle, so it applies to things like a person not climbing down a well that is deep, or climbing up a tree, or a building where there is a danger of falling, because this is subjecting oneself unnecessarily to potential harm, and so keeping away from a person with a disease that can spread (by Allaah's will and decree), or from a land where a disease has broken out, is permissible, since the mixing with such people, or going to such a land is from the asbaab (means) that can lead to potential harm. The Prophet (sallallaahu alayhi wasallam) forbade going to a land where a disease has broken out and from fleeing from a land where a disease has broken out with the intent of fleeing from the disease. And some of the scholars have explained that the one who has strong faith and reliance upon Allaah can go to a land where a disease has broken out, but that those of weak faith should avoid this in case their aqeedah becomes corrupt.
Shaykh Saalih al-Fawzaan said in I'aanat ul-Mustafeed (2/8):
So his saying "There is no contagion", meaning, upon the manner that the people of Jaahiliyyah believed in it. As for contagion (the spread of disease) occurring by the permission of Allaah, then this is an affair that occurs, and for this reason the Prophet (sallallaahu alayhi wasallam) prohibited from mixing with the leper, and he (sallallaahu alayhi wasallam) prohibited from approaching a land where disease has broken out, and he he prohibited whoever was in the land in which the disease broke out from leaving that land, and the one who was outside was not to enter into it, because these are asbaab (ways and means) that lead to the spread of disease, and to prevent them is to adopt the protective ways and means, and proceeding towards (such a land) is throwing oneself to destruction. And Allaah prohibited from that, except for the one whose faith and his reliance upon Allaah, the Most High, is strong, for such a one can proceed to the affected land, and can mix with the diseased and he will not be afflicted, because he is relying upon Allaah, the Sublime and Exalted, however this is only for the people of strong faith. As for the people of weak faith, then they are to remain far from these places in case they are affected and then their aqeedah becomes evil
.
It is also permissible for a person to mix with a person with a disease out of reliance upon Allaah (tawakkul), upon the belief that Allaah is the one who controls everything. These two actions are both validated in the Sunnah, and explained by the Scholars.
On a closing note, in the Time Magazine from 27th April 2009:
How to Deal with Swine Flu: Heeding the Mistakes of 1976. In February 1976, an outbreak of swine flu struck Fort Dix Army base in New Jersey, killing a 19-year-old private and infecting hundreds of soldiers. Concerned that the U.S. was on the verge of a devastating epidemic, President Gerald Ford ordered a nationwide vaccination program at a cost of $135 million (some $500 million in today's money). Within weeks, reports surfaced of people developing Guillain-Barré syndrome, a paralyzing nerve disease that can be caused by the vaccine. By April, more than 30 people had died of the condition. Facing protests, federal officials abruptly canceled the program on Dec. 16. The epidemic failed to materialize.

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