Days of the Hajj

On the day of the Feast of Sacrifice (Eid al-Adha), celebrated by Muslims as part of the annual Hajj pilgrimage, I was working in the emergency department at the King Faisal Specialist Hospital and Research Centre, in Riyadh, Saudi Arabia. I treated a young man who had sliced open his left forefinger as he assisted in the slaughter of a goat that evening. I explored his wound and fortunately found no damage to his extensor tendon. As I closed the wound he told me a little more about the ritual of animal sacrifice.

The year 2000 — 1420 in the Hijra calendar — marked the implementation by the Saudi government of the Sacrificial Meat Project arranged by the Islamic Development Bank. The project included the construction of several giant slaughterhouses to ensure that animals (usually cows, sheep and camels) are sacrificed according to Shariah (Islamic law) and health requirements. In former times individuals had to kill the animal and then burn it. Today, people can pay a sum (usually a few hundred riyals — about a hundred dollars) to purchase an animal and have it killed, butchered and the meat packaged and frozen for distribution to Muslims in need around the world.

This year 2 million Muslims, including a few thousand Canadians, converged on the holy cities of Mecca and Mina to perform the religious rites of the Hajj. Some of these rites, which are observed during the first 10 days of the Dhul-Hijjah (the last month of the Islamic calendar), include wearing simple, unsewn white garments, standing on the plain of Arafat (at the foot of Mount Arafat, where the Prophet Muhammad delivered his final sermon), circumambulating the Holy Kaaba at the Grand Mosque in Mecca, stoning the Jamrat Al-Aqaba (throwing 7 pebbles at a stone pillar representing Satan) and sacrificing animals on the Feast of Sacrifice (commemorating Prophet Ibrahim's obedience to God and readiness to sacrifice his son, Ismail).

On the first day of the Hajj an unconscious middle-aged man was brought by car to the emergency department and was whisked into one of the resuscitation rooms. While we set to work, a translator gathered a history from the patient's brother: the man had begun to feel unwell an hour earlier and had lost consciousness about half an hour later. We quickly determined that the man's condition was grave: he had no pulse or blood pressure and was not breathing. He was still warm, but in reality he was dead. Because of his relatively young age and the somewhat unclear history of sudden loss of consciousness we continued our efforts to revive him.

During the flurry of activity in the room, the translator extracted a little more of the man's medical history. He had diabetes. He'd previously had a stroke. His brother described some additional neurological problem. Did he have any heart problems? Possibly... Yes, he took a lot of medication, but no, they didn't have his pills with them. We continued CPR, blew oxygen into his lungs and injected epinephrine into his blood stream, none of which made any difference. During these 20 minutes other members of his family arrived in the room and lined up against one wall, silently watching us do our work. After half an hour we stopped, and I thanked the various staff around the bedside for their efforts.

With the help of a translator I then turned my attention to the man's family. We don't have a designated quiet room in the emergency department for discussion of catastrophic events. A 3-way conversation ensued among his 4 brothers, an uncle, the translator and me. I discovered that the first day of Hajj is a good day to die. Not as auspicious as the Feast of Sacrifice, but a good day nonetheless. One of his brothers stepped forward and introduced himself to me as a muttawah, a member of the religious police. He explained that if his brother was a good man he would be with Allah in Paradise today, and if he were a bad man he would be burning in the hot place. The brother did not venture an opinion one way or the other about where his brother had gone; he made no presumptions about his fate. I said to the brother, through the translator, that I hoped the deceased was a good man and that he would be in Heaven today. Afterward the translator told me that the policeman found my remark amusing, although I wasn't entirely sure why. The male relatives then, one by one, went to the head of the bed, kissed the deceased man on the forehead and quickly left the room.

About an hour and a half later a nurse approached me. Another uncle had arrived and wanted to know if his nephew was really dead. Since the man's body was still warm, were we sure that he was dead? I went back into the room with the uncle and a translator, carefully pulled back the sheet covering the patient's head, paused, put my stethoscope on his chest, listened for a few seconds, slowly removed the instrument and turned to the translator with the message that yes, he was dead. The uncle appeared satisfied with my assessment (and not particularly grief-stricken) and rejoined the other members of the family.

Walking back to my apartment at the end of my shift, I thought again of the remarks of the policeman brother and his response to my hope for his brother. As I understand it, hoping for something is all right, but that hope is unlikely to change the outcome — as an article of the Muslim faith, it is best to trust in Allah, the all-powerful and all-merciful. Which is why statements Muslims make about doing something in the future often end with the expression inshallah (with the will of Allah). For example, this weekend I'll be going to Dammam on the Persian Gulf Coast inshallah, or today my patient could be in Paradise inshallah.

A few days later a colleague returned from Canada to Riyadh. Knowing my newspaper reading habits, he had brought with him an airline copy of The Globe and Mail published on the final day of the Hajj. I paged through its international section looking for some report of the pilgrimage and the Eid holidays, celebrated by an estimated one billion Muslims around the globe. I found a brief essay on St. Patrick's Day but nothing about the Hajj. And then I noticed a 6 cm х 10 cm black and white photo captioned “Feast of Sacrifice.” It showed 2 Indonesian men and 1 woman in a crowd pushed up against a fence, faces contorted and hands outstretched through the bars of the fence, one grasping hand almost touching the camera. The brief text (with no additional explanation): “Indonesian Muslims clamour at the gates of Jakarta's largest mosque yesterday, hoping to get meat given to the poor as part of the Eid al-Adha festival. Cows and goats are slaughtered there.”

Sitting in my living room in Riyadh recalling a recent radio program on the Broadcasting Service of the Kingdom of Saudi Arabia about the demonization of Muslims in the aftermath of the Egypt Air Crash, I was dismayed by the photo. It's hard to know exactly what an average Albertan sitting at a table in my favourite café at home in Lethbridge would make of such an extreme image. Not that the photo demonized Muslims; it didn't. With so little context, it didn't do much of anything other than portray 3 (presumably poor) dark-skinned people purportedly clamouring for fresh meat. Could those 60 cm² of prime newsprint have been better used to enlighten readers about a major religious holiday celebrated in Canada and around the globe? Perhaps next year the paper will run a short essay on the Feast of Sacrifice and a sensational photo from Mrs. Murphy's pub in Dublin inshallah.

Figure. Tens of thousands of Muslims circumambulate the Holy Kaaba at the Grand Mosque in Mecca as part of the annual pilgrimage, or Hajj, in Saudi Arabia. Photo by: Canapress/Kamran Jebreili