Patient care for Muslims a new need

The Rev. Esther Bowen unfurls a Muslim prayer rug -- its brilliant teal a sharp contrast to the muted tones of the small hospital chapel -- that she says she hopes will bring comfort to Muslim patients and their families at Quincy Medical Center.

The prayer rug, on which Muslims kneel to pray five times a day, and a nearby copy of the holy book, the Koran, are part of the nascent efforts Quincy and other hospitals south of Boston are making to accommodate the medical and pastoral needs of a small but growing body of Muslim patients.

''It's more and more on our radar that this is important," said Thomas Barber, the hospital's chief of medicine. ''The Muslim population in the South Shore is growing."

At Quincy, 119 patients identified themselves as Muslim upon admission to the emergency room in the second half of 2005, up from just four in the second half of 2004.

Estimates of how many Muslims live in greater Boston range from 10,000 to 70,000. Hospitals and caregivers must get up to speed on requirements of observant patients, said Asif Razvi, chief of vascular surgery at St. Elizabeth's Medical Center in Boston and imam at a mosque in Wayland.

''Not every hospital is sensitive to those issues," Razvi said.

Special services required by some Muslim patients, Razvi said, include dietary restrictions, assigning female doctors to female patients, and burial practices.

Under Islam, only specially prepared, or halal, meats are permitted, so many Muslims simply ask for vegetarian meals while they are in the hospital.

Alcohol and pork are also forbidden under Islam -- meaning some patients might need alternatives to common cough medicines that contain alcohol, or to heparin, a frequently used blood thinner usually made from pork.

Razvi said many Muslim women who observe the hijab -- wearing a veil and modest clothing -- may require female doctors because they wouldn't want to be seen unveiled or touched by men outside their immediate family.

Muslims who are seriously ill or disabled are exempt from some religious rules.

Those who are too sick to go without food and water during the month of Ramadan, for example, can make up fasts later.

The sick and disabled also can pray sitting or lying down instead of performing the more physically demanding prayers that entail kneeling and standing. They also might forgo the ritual washing with water that precedes prayer, called wudhu, using dust instead.

Many area hospitals, like Quincy, are still on a learning curve. The hospital has trained medical and other staff in ''cultural competency" -- meaning everyone from nurses to file clerks gets information on how to care for people of diverse cultures.

But Barber is considering putting together a special panel of Arab or Muslim doctors to advise other doctors and staff.

Allen So, director of the hospital's interpreter and outreach services, often includes cultural or religious background information on a patient's medical information chart to increase awareness among medical staff.

Barber said most of the accommodations Quincy has made so far have had to do with gender. He said it is fortunate that more than half of the hospital-employed doctors at Quincy are women, and some are Muslim.

One is internist Saima Khan, a native of Kenya who lives in Milton. Khan, like many Muslims, fasts during Ramadan, and has helped patients keep their fast as well.

One Muslim patient, hospitalized for an infection during Ramadan, received only intravenous antibiotics, instead of typical intravenous fluids that would be considered food. ''They would give her an appropriate dinner at time of opening the fast," Khan said.

Representatives of some area hospitals said they haven't had many requests for special medical care, but they want to make sure their pastoral services make Muslim patients comfortable.

Charles Webb, director of pastoral care at South Shore Hospital, a 234-bed facility in South Weymouth, said the hospital does not have a prayer rug, but it does have an Arabic-language Koran he received after attending a seminar on Islam last year.

In a hospital where the bulk of patients are Catholic, none of the patients have used the book yet, but Webb is looking forward to the day one does.

''I think demographics are changing in the South Shore," said Webb, a Catholic deacon. Last year, just 33 of more than 24,000 inpatients at South Shore identified themselves as Muslim.

''We're probably seeing very low numbers," said Webb, ''but we have a moral obligation to be prepared to serve."

Globe correspondent Kay Lazar contributed to this report.