Ramadan And Over-Crowding Hospitals In Saudi-Arabia

The Holy month of Ramadan changes the daily rhythm drastically in Saudi hospitals. Basically the hospital, just like the rest of the Kingdom of Saudi Arabia, becomes alive at night and quiets down for the day during the Muslim fasting month. Read more here on how the Saudis usually visit the sick at hospitals. 

Needless to say the amount of visitors during Ramadan will at least double, especially during the last ten days. Visitors will come late and stay until early morning which is allowed because of the changed visiting hours. Visitors will bring along vast amounts of arabic foods to break the fast with like sambosa, all kinds of tiny pastries, cookies, dates, chocolates..

Large Saudi families come to the hospital to join in Iftar together with the sick family member.  It's not uncommon to find the entire family eating with their hands, on the bedsheets spread out on the floors! Saudis will generously give the nurses a taste of everything, sometimes offering huge trays full of different sweets or salty snacks.

Another peculiar thing that happens during Ramadan is handing out money to nurses. Patient or relatives might slip Riyals into the nurses pocket or openly offer money anywhere from 10 to 1000 riyals at a time. The gesture usually makes nurses feel somewhat awkward and because of cultural differences might be misinterpreted to be some form of bribing. Nurses are naturally not supposed to accept the money very few will reject it every time especially because the person offering the money will become very upset if rejected and they can be extremely pushy and just stuff the pockets with the money. The reason behind this is Saudis wanting to give 'charity' and do good deeds during Ramadan and the families wanting to show their gratitude and appreciation to the nurse.

Only a few patients will be observing the Ramadan fast, and if they do, they will also abstain from all medications including injections and intravenous drugs during daylight hours. That makes it a bit difficult to accommodate the medication regime to the fasting timetables. Basically it means that the medications normally given around 8-9 am will be given at fast breaking time around 6:30 -7 pm. The next dose will be at midnight and finally just before the morning prayer at 4 am. This can cause problems with the efficiency of treatments with antibiotics and pain killers.

For some patients it's fine to fast (health-wise) and it will not make their condition worse. Every once in a while there will be a patient who insists on fasting even if doing so will severely adversely affect their health. The patients don't want to miss out on the blessings of fasting. Some are diabetic which means their blood sugar levels will be uncontrolled and it might put the patient in risk of coma, or they will refuse insulin injections resulting in sky-high blood sugar levels. Patients with bowel problems might get complications like obstructed bowel, liver patients may suffer irreversible consequences that may even need surgery and then there is the odd patient who will even refuse to be operated on.

Toward the end of Ramadan the emergency room usually begins to fill with patients suffering from bowel obstructions, liver coma, severe dehydration and so on. Many are elderly patients needing full time hospital care meaning that the hospital will be full to its maximum capacity and often patients are left to wait for an available bed in the EMS. Patients suffering from gastrointestinal diseases and disorders, diabetes, metabolic disorders and other diet controlled conditions further crowd the ER beds making it the busiest time of the year in the hospital. Nurses and doctors are often exhausted from the workload this month brings along.

The Muslim medical personnel will often opt to work night shifts to make fasting easier or alternatively if they wish to work days they can work shorter hours. The total amount of working hours during this month for Muslim nurses, doctors and other muslim personnel is also cut down. Generally there will not be any operations other than the most urgent ones.

The patients' sitters will all usually be fasting and the hospital kitchen provides food for them as well as the fasting patients in the early morning hours. A three course 'breakfast meal' called sohoor will be distributed at 2 am well before the Fajr prayer.

The iftar meal, complete with dates, laban (buttermilk), soup, vegetables, rice and meat, dessert and juice will be distributed to the rooms at 6 pm. Even if a patient is not fasting, they will usually be up all night chatting with relatives, reading Quran or watching Arabic soap operas or the live televised show from the grand mosque in Mecca. This makes the night shifts exceptionally busy and hectic while the day shifts are slow paced and quiet.

I personally enjoy working during Ramadan, patients and relatives are in good spirits and it's nice to spend some extra time with them in the rooms having some arabic coffee and sweets. Generally the atmosphere is more laid-back and patients are not complaining as much as usual :)

P.S this post is a revised edition of a previous Blue Abaya article about Ramadan in Saudi hospitals from 2010.

In Search Of The True Meaning Of Ramadan

Ramadan Mubarak to all Blue Abaya readers!
The following article was published in Saudi Gazette on Wednesday. I wrote the article because every year that I spend in Saudi Arabia during Ramadan, the more all the over consuming and madness is starting to bother me. The true, original meaning of Ramadan has been totally forgotten and it makes me feel really sad to see what is has become for some.

Most non-Muslims know this month as the time when Muslims abstain from food and drink during the daylight hours.  Before I came to KSA, admittedly, just like most non-Muslims living in western countries, I was pretty ignorant about Ramadan. I knew that this was the month when Muslims fasted from sunrise to sunset, but that was pretty much it. I had heard people saying 'them mohammedians' can eat only at night because Allah doesn't see in the dark or that Muslims need to fast only part of the day because they couldn't handle a week in row and other such nonsense. I remember wondering, what was the real reason behind the Muslim fast, but never bothered to find out the real answer. That is, until I came to the Magic Kingdom.

During my first Ramadan here I became very curious to find out more about this month as it all suddenly became much more of a reality to me. To my surprise, as Ramadan drew closer, my expat friends grew grumpier. "I hate Ramadan!" "Everything is closed, nobody is working" "Muslims skip work and leave all the work for us to do" "Whatever you do, don't stay in Saudi for Ramadan, it's just crazy" "they will arrest you if they see you drinking water during the day" etc etc etc. I did not hear a single positive comment about Ramadan. So naturally, I became somewhat weary of what Ramadan would bring along and started to dread the beginning of it along with all the other expats.

So Ramadan rolled along and the entire hospital turned upside down. Read here what Ramadan is like in a Saudi hospital. Patients ate at the strangest hours, visitors came and went in the middle of the night, Muslim working hours were cut, some Muslim employees would disappear in the middle of shifts, medicine regimes had to be changed and fasting patients could not even be administered intravenous medicines during daytime. It was all very confusing.

Despite all the weird schedule changes, I could not help noticing other changes too. There was a remarkable sense of unity, cheerfulness and a feeling of high spirits among my Muslim colleagues. The patients, if possible, became even more welcoming, friendly, and hospitable. There was a sense of elation in the air that I could not quite put my finger on, but it made me even more curious.

One day I watched all the ward clerks praying together with some nurses and doctors in the staff room where I was doing charting. I finally mustered up the confidence to ask about Ramadan, despite the fact that they were all Saudi males and I felt a little intimidated to approach them on this matter. I remember simply asking "why do you fast during Ramadan?"

I was blown away by the reply. Looking back, the way one of the men explained it to me in such a nice and respectable way was commendable, despite my seemingly super ignorant question.

He told me: "We fast to remember all those people who cannot eat and drink daily. We fast to feel their suffering, to remind ourselves of how blessed we are to have food and water. "

"We fast to feel those same pangs of hunger that our poor sisters and brothers feel daily around the world."

"We fast to become more generous, to practise self-discipline and to strive to become better Muslims and people."

His words had a profound impact on me. Somehow I had failed to see the true meaning of the fast. I started to look at it from an entirely different perspective.

I came to realize, that in reality, Ramadan is so much more than just abstaining from food and drink during the daylight hours. Basically, Muslims are supposed to abstain from all harmful acts as much as possible and concentrate on becoming a better person and Muslim. Everyone can set their own goals for Ramadan according to their life situation and abilities. While one person struggles to quit smoking, another might set as a goal to read the entire Quran during Ramadan. Some might plan to pray extra prayers every day, donate to charity or memorize a new Surah from the Quran.

So I learned from my Muslim colleagues that Ramadan is also about remembering our Creator, reading the Quran, which was sent down during the month of Ramadan, doing good deeds (out of a sincere wish to do them, not by habit or force), being kind to others, giving out Dawah (teaching, not preaching non-Muslims about Islam) and remembering the poor and the less fortunate. Ramadan is about being humble, modest and abstaining not only from food, but from extravagance, over-consuming, spending, wasting food, money and resources.

Sadly, what I see today is very disturbing in that many people in Saudi Arabia are doing the exact opposite. The true purpose has been long lost and forgotten. I see people stocking up on food and spending on groceries like crazy, cooking and baking like there is no tomorrow. Women are spending their days in the kitchen instead of focusing on their religion; some out of their own will or perhaps out of learned habit and routine, some by demands from husband and even peer pressure.

When time comes for iftar, people indulge in extravagant meals and then lay around all evening snacking on deep fried, highly sweetened and unhealthy foods, watching Arabic soap operas on TV, gossiping with friends and staying up all night. Many go to shopping malls which are now open until the early morning hours for mindless shopping. Some even force their kids to stay up late or wake them in the middle of the night so that the parents don't have to get up early with them! The next day they sleep until the evening until it all starts over again at sunset.

The Prophet Muhammed (pbuh) taught Muslims by example to break the fast with simply dates and water and eat a light meal later. Pray Tawareeh prayers, then go to sleep as one normally would, get up early for night prayers and suhoor (breakfast) and go about the day working and doing things that one would normally do.

Let's not forget the true meaning of Ramadan, its purpose, and all the blessings of this month.
Break those unhealthy and binding routines and habits.

Make your Ramadan beneficial, not superficial!

Ramadan, Junk Food and Fungus Burgers

Ramadan is supposed to be the month of not only fasting but remembering those less fortunate who are not able to eat or drink clean water daily. A time for striving to be a better Muslim and person, acting modest in every way (including eating). This should definitely not be the month to indulge in fast food. Many locals and Muslim expats however have the habit of over-eating and splurging on food among other things during this month. It's like a month long pig-out fest for some.

People often opt to eat their iftar, the meal which is eaten after breaking the fast, out at restaurants for a change. Restaurants try to attract hungry customers by offering lavish iftar buffets. Fast food chains are in the game too by offering their own "Ramadan Specials". People will be out until the early hours in search of a quick meal to eat at sohoor just before the Fajr prayer is called around 4 am. There are long queues at McDonald's, Burger King, Herfy's and other fast food joints during this time.

Here is the KFC version of iftar:

The amount of fast food chains available in the Kingdom might come as a surprise to many first time visitors or to those unfamiliar with Saudi-Arabia. The majority of the most popular American chains have branches in Riyadh and Jeddah and there's junk food available at every corner. New burger joints are sprouting around Riyadh like mushrooms after rain. American diners are among the most popular restaurants in town and becoming very common. So are heart diseases, diabetes and obesity.

The popularity of fast food in the Kingdom is very unfortunate. Combined with a very sedentary and lazy lifestyle (Saudi-Arabia was recently found to be the world's third most lazy country) the effects on the public health are enormous.

There seems to be a complete lack of  health awareness and education in Saudi-Arabia. Very obese kids can be seen indulging in french fries and burgers and sipping on caffeinated drinks. Sometimes I wonder what is the future like for these kids who have been spoiled by food and most likely by maids as well. They sit with their iPad's and computers all day never lifting a finger let lone doing some physical exercise. They are like ticking time bombs.

I find it best to avoid giving my daughter fast food at all costs. Especially those fries. All those saturated fats, bad carbs and possible carcinogens are best left alone. On the very rare occasion we do go eat fast food I always try to pick out the more healthy options, if you can really even call them such! In Finland kids meals actually contain baby carrots and milk instead of fries and Coke. One fast food chain I never went to in Saudi is Hardee's. Thank God I never ate there.

Check out their "Ramadan special" the "Fungus Burger" found inside a kiddie meal the other day:

This pic was posted in a Facebook group today. Apparently a woman in Jeddah had ordered a kids meal which was delivered to her house in the early hours of sohoor time. Yes, fast food chains DELIVER to the door in Saudi-Arabia. The poor kid ate half of the rotten burger before the parents noticed the "extra flavoring". According to her Facebook, thank God the child did not suffer any food poisoning but nevertheless this is totally unacceptable and disgusting.

The woman and some of her friends had tried to post this image on the Hardee's Saudi-Arabia FB page which resulted in them being blocked from the page. The manager had offered them a new meal to compensate the damage. Ermm, no thanks buddy.

This is such a gross violation it should be reported to the health authorities so they can go and check the branch and take action against them. Junk food is already unhealthy enough!

I find this image at the same time nauseating but not at all surprising. The standard of hygiene that is practiced by some of these workers here in Saudi is below appalling. Staff at fast food places don't receive proper hygiene training and I've hardly ever seen them wear gloves or other protective clothing. I wonder how many wash their hands after going to the toilet?

This reminds me of a BAAK branch in the D.Q Kindy plaza, which had no running water in the entire restaurant at one point. Yes, you read correctly, no running water. I guess that answers the previous question and also why my friends got a severe food poisoning after eating there.

Another recent incident I recall was with Chili's here in Riyadh. It was shut down for a while after the authorities found oh just a few TONS of expired meat and cheese in their kitchen. Chili's is now open again and remains one of the most popular restaurants in Riyadh.

A while back there was a video circulating of a McDonald's restaurant in Medinah Saudi-Arabia that claimed to show lettuce being washed in the washing machine in the backroom. It was never totally clear if the video was a staged fabrication or not. After the incident the McDonald's Arabia page issued a statement saying the video was fabricated and that they don't handle lettuce in such a way in their restaurants. They even said they have an "Open Door" program:

“McDonald’s prides itself on its transparency. With our Open Door Program, we open our doors and welcome you to tour our kitchen to take a close look at the quality standards of our products and procedures. This is an open invitation for those interested in learning more about our kitchen at any point in time,” 

I was immediately interested and contacted them by email as requested to book an appointment. But why by appointment only, and why only certain locations? I thought they had nothing to hide? Photography was mentioned to be strictly forbidden. I still wanted to check it out. I waited a week for a reply then emailed them again. In total I sent four emails requesting for the Open Door tour without ever receiving a response. I guess they thought issuing the statement was enough and that nobody would actually be interested or bothered to come and look.

So what exactly goes on in the kitchen's of Saudi-Arabia's fast food joints? It remains a mystery.
Will you take the risk?

Ramadan- Favorite Month For Saudi Religious Police

Ramadan, the busiest season of the year for the members of the Commission for the Promotion of Virtue and Prevention of Vice (CPVPV) aka Saudi religious police force. I like to refer to them
more familiarly as the muttawa.

DISCLAIMER: This entire post is written in a sarcastic tone, tongue in cheek. For those readers that suffer from over-sensitivity and lack sense of humour, I recommend you don't read any further, because you might get offended :)

During Ramadan malls all over Riyadh will fill up with Saudis shopping until they drop (which would be around 3 am). What a better opportunity for the moral cops to get some serious moral enforcement done! If you don't know what Saudi religious police are read more here and find out some of my previous encounters with them here and here.

New toys for the bearded boys
Before the Holy Month the muttawa have been busy preparing their fleet of white GMC Suburbans in anticipation of making many new arrests. CPVPV recently received some (about 53 million dollars) bribery ahem sorry support money from the royal family and they were able to pimp their 600 rides with hi-tech anti-immorality gadgets. The GMC's now contain laptops, scanners, fax and copy machines and I bet a coffee machine and a plasma TV too.

Why is Ramadan such a fruitful time for muttawa?
Firstly because the pure numbers of immodestly dressed women and men at malls nearly triple compared to normal months. Uncovered faces, male-leggings (meggins), pink shirts on men, shorts, flashy abayas, high heels, t-shirts with the highest button left unbuttoned.

You name it- surely the muttawa will find it.

During daytime the religious police will be on the look out to catch foreigners secretly taking a sip of water or chewing gum in public places which is viewed as forbidden during Ramadan daylight hours (but only in Saudi-Arabia!)

Ramadan also enables easier entry to malls for single men who are normally unable to enter malls without a female (guardian). They might try to sneak into crowded malls by infiltrating into groups of women as fake brothers.

Special opportunities 
Food courts are another place of interest for the religious police since lots of haram mixing happens if the food court counters are not separated by screens. Women tend to remove their veils partially when eating in the closed family sections. This poses great potential for eager officers who've specialized in terrorizing dining females.

Women's clothing stores might have hidden dressing rooms in the back rooms and if found the muttawa have really hit the jackpot!
Another point of interest for muttawa are mirrors. Some shops for women's clothing actually hide mirrors behind the racks.

Religious cops are also keen to check on the abaya shops for anything with too much color or bling-bling on it. In other words, anything other than ALL BLACK is a big no-no. There is no point of going to the abaya shops when the CPVPV members are present at the mall (if looking for anything else than the standard all black version). Abaya salesmen are clever enough though and often manage to trick the muttawa by hiding the flashy abayas and scarves. Even the catalogs for the embroidery and sequins have magically disappeared.

Muttawa field trips
Just the other day the Saudi religious police force were having a blast at one their favorite hangouts Granada Mall, known to locals as "Gharnaata Moll". As my husband and I entered I noted the presence of not one but two CPVPV vehicles parked outside the entrance. I made a remark to my husband betting we will run into them inside the mall. I counted a staggering seven muttawa apprentices in addition to the Big Boss donning the black cape (bisht), all accompanied by one or two security officers. They were armed as if going into war.

We actually went to this mall specifically to check out the Saudi Cancer Society Photo Exhibition held there. Funny how they allowed that btw.

I took some pictures of the expo and before I could say "maashallah" I spotted the muttawa.

The commission members didn't seem to have any interest in the exhibition itself (although images of living things and art by Saudi women were on display and there was no segregation of sexes) but instead they were going in and out of stores checking for above mentioned forbidden things.

The bearded bullies enter a kids clothing shop 
The store we were in was packed with women and children when the joyous mood suddenly changed to silence and wary looks when a religious police officer entered with a mall security guy.

The bearded threat naturally did the most important thing first and went around telling all women to cover (all had niqab on). He then picked out one of the salesmen and took him to the back room with the visibly awkward mall security officer. Everyone in the store was quiet and the atmosphere was like being in a horror movie, will he return alive?

After they emerged (the clerk looked very pale) the commission officer approached my husband. He started interrogating him; name, family, tribe, workplace and so on. The muttawa had an issue with my husband's shorts, which were below the knee length and should be OK, but nevertheless were deemed inappropriate. The muttawa told my husband to immediately leave the mall! 
My husband did not take him seriously but politely promised not to wear them next time.

During this grilling session the security guy stood nearby looking extremely squirmy and embarrassed trying to motion for the commission member to leave to the store.

The muttawa ignored his request and then shifted his interest to me, asking my husband: "Why doesn't your wife have a niqab (face veil) on? Her face is exposed!" My husband replied: "What she is wearing is fine. What is your problem?"

The muttawa replied "Saudi men should keep their jewels hidden."
Hehehe. How nice to be called a jewel ;) And what was this exposed jewel doing during all this? Laughing to herself and snapping a pic of this silly situation.

So what happened to the salesman they harassed? The highest button on his T-shirt had been open and muttawa had given him a long lecture about it in the back room.

Interesting to see what the priorities of the CPVPV members seem to be during this Holy month.

The different sides to Ramadan in Saudi

Ramadan is here and Muslims all over the world will be fasting this month. Saudi-Arabia turns into a much more accommodating place for fasting people to live during the holy month. There are many exceptions in everyday life that enable easier days of fasting, especially for Saudis.

Other fasting Muslims on the other hand and the millions of non-muslims working in Saudi-Arabia might not live this month as smoothly as the Saudis do. Ramadan in Saudi is certainly a very different experience for a Saudi, a muslim and a non-muslim.

I wrote some previous posts about Ramadan in the Kingdom here and one on hospitals and Ramadan here.

Less work, more spending
There are millions of non-muslims living and working in Saudi-Arabia that are greatly affected by the holy month.
Almost all opening hours of business will change, stores will open only from late afternoon up until 2 am. This of course means heavy traffic in the evenings and not much to do during the day for the people that aren't fasting. Schools start later for Muslims and there are less working hours for Muslim employees. Researches have found that the productivity in Muslim countries decreases almost by 50- 80% during Ramadan but on the other hand markets grow due to increased spending and giving charity.

Who does the work during Ramadan?
At the workplace the non-muslim employees are discriminated against in many ways. Starting with working hours, non-muslims work like in any other month while the Muslims work less total days and have shorter hours.
Muslims might take more breaks during the day, arrive late or leave early. This is not frowned upon as long as they are Saudis. Other nationalities even if fasting, will be expected to abide strictly to the working hours.
In the hospital where I worked only the Saudi employees were allowed to leave the workplace during prayer times. Sometimes an employee might have been absent for an hour during prayertime. Especially the male employees seemed to do this because they would go out to the hospital mosque unlike the female employees who prayed in empty rooms.

The untouchables
All this this might add up to the Saudi employee spending almost half less time at the workplace than the other employees during Ramadan.

Or at least that is how it seems to those left behind at the workplace to do the job while the Saudis are gone.

The non-muslim employees might feel they are forced to do most of the work because the fasting colleagues are resting. The fasting workers are exempt from the physically heaviest chores.
No one dares to complain about a Saudi colleague, they have a sort of untouchable status at the workplace.

Forbidden Eating
Another phenomenon that might make Ramadan a less pleasant experience for those not fasting is the expectation that all non-muslims must eat and drink in secrecy during the daylight hours. At the hospital for example even keeping water bottles visible was viewed as almost criminal activity. I think it's silly that kind of culture exists that everyone else must change their normal daily routines so that the fasting Muslims won't get offended by the sight of food. I have witnessed how this behavior made some people feel humiliated and it doesn't exactly indicate religous tolerance either.

The toughest Ramadan?
What about the housemaids and drivers? Their month must be the toughest of all especially if they happen to be fasting. The maids are of course the ones having to take care and feed the children during the daytime while the fasting mothers are sleeping through the day. In the afternoons the maids are preparing the food for the family and likely guests too. Evenings and nights they cater to and clean up after the iftar parties. Some families even send their maids to their relatives houses for extra work. When do they have the chance to sleep?

The drivers don't have it mush easier. Their working hours become longer and they might be forced to skip their night sleep because of family members needing rides to shopping malls or friends houses in the middle of the night.
Naturally there are also Saudi families like my husbands that give their maids extra money or gifts and more free-time during this month.

In any case Ramadan is an exceptional month and an ordeal for everyone living in the Kingdom. For some it may be like a nightmare while to others an enjoyable nightly party.

Excuse me! I'm a VIP and Need Service NOW!

During Ramadan night time shopping the other day I ran into this rather irritating phenomenon of Very Important People aka unbelievably impatient Saudi women. Unfortunately typical in Saudi-Arabia. I hate it when some people disrespect others especially based on nationality, imagining themselves superior and treating them in a very demeaning way.

These VIP's are women that can be found continuously shouting "excuse me" in high pitched demanding voices to waiters, shop assistants, cashiers, or whoever they want service from. Seems like they have not heard of such things as "patience" "courtesy" or "respect". These women behave like they are the only people in the world.

Everything has to happen NOW. Immediately. Pronto. YALLA!

Waiting in line is also an unknown concept to them. What line? There is other people here?

The poor victims are usually Filipinos, Indians or other Asian nationalities trying their best to please the demanding Saudi women.

These hopelessly impatient women might not know any other word of English but rest assured will master "excuse me" from early childhood by which they will call all "servants".
Usually the VIP women will be wearing niqab. That way she remains anonymous which enables her to act like a spoiled kid in public. No one will recognize her, after all.

Last night I was at the food court of the shopping mall, it was closing time around 2 am. Because of the gender segregation even the counters of the food stands are divided by screens. The place I wanted to order food from was packed with VIPs shouting in a chorus on the women's side.

The male side was empty so I decided to order from there. The friendly Filipino guy came and took my order, all the while the women continued their aimless racket. He was running around like crazy doing his best trying to get the important women served. I felt sorry for him, he was sweating but he still managed to keep calm and smiling.

Perhaps the women didn't realize that pizza doesn't actually cook any faster however many times they shout excuse me to the guy making it.

What just topped off my irritatation was when they all stuffed themselves next to me in the men's section trying to push themselves into the front as if I wasn't even standing there. The shouting continued and the Filipino worker ran faster.

Then a little girl VIP started shouting to the guy in a very disrespectful tone hurry, hurry! The mother was standing right next to her and didn't say a thing. So I told the girl, the poor guy is doing his best. It's not nice to shout at him because he can't make the food any faster. We must all wait in line.
Her reply: But I've been waiting at least FIVE minutes!

FYI Pizza nor any other type of food does not cook in less than five minutes, unless you want yours raw of course.

Thats all. Just had to let it out.

Ramadan in a Saudi hospital

The Holy month of Ramadan changes the daily rhythm drastically in Saudi hospitals. Basically the hospital becomes alive at night and quiets down for the day.
Read here how the Saudis usually visit the sick in hospitals. Needless to say the amount of visitors during Ramadan will at least double, especially during the last ten days. Visitors will come late and stay until early morning. They will bring along vast amounts of arabic foods to break the fast with like sambosa, all kinds of tiny pastries, cookies, dates, chocolates..

Large Saudi families come to the hospital to join in Iftar together with the sick family member.  It's not uncommon to find the family eating on the sheets on the floors! Saudis will generously give the nurses a taste of everything, sometimes offering huge trays full of different sweets or salty snacks.

Another peculiar thing that happens during Ramadan is handing out money to nurses. Patient or relatives might slip money into the nurses pocket or openly offer money anywhere from 10 to 1000 riyals at a time. The gesture usually makes nurses feel somewhat awkward and because of cultural differences might be misinterpreted to be some form of bribing. Nurses are naturally not supposed to accept the money very few will reject. The person offering the money will become very upset if the offer is rejected and they can become pushy and just stuff the pockets with the money! The reason behind this is Saudi families wanting to show their gratitude and appreciation to the nurse.

Only few patients will be observing the Ramadan fast, and they will also abstain from all medications including injections and intravenous drugs during daylight hours. That makes it a bit difficult to accommodate the medication regime to the fasting timetables. Basically it means that the medications normally given around 8-9 am will be given at fast breaking time around 6:30pm. The next dose will be at midnight and finally just before the morning prayer at 4 am.

For some patients it's fine to fast and it will not make their condition worse. Every once in a while there will be a patient who insists on fasting even if doing so will severely adversely affect their health. The patients don't want to miss out on the blessings of fasting. Some are diabetic which means their blood sugar levels will be uncontrolled and it might put the patient in risk of coma, or they will refuse insulin injections resulting in sky-high blood sugar levels. Patients with bowel problems might get complications like obstructed bowel, may even need surgery and then there is the odd patient who will even refuse to be operated on.

Toward the end of Ramadan the emergency room usually begins to fill with patients with bowel obstructions. Many are elderly patients needing full time hospital care. Patients suffering from gastrointestinal diseases and disorders, diabetes, metabolic disorders and other diet controlled conditions further crowd the ER beds making it the busiest time of the year in the hospital. Nurses and doctors are often exhausted from the workload this month brings along.

The Muslim nurses will often opt to work night shifts to make fasting easier or alternatively if they wish to work days they can work shorter hours. The total amount of working hours during this month for Muslim nurses and other muslim personnel is also cut down. Generally there will not be any operations other than the most urgent ones.

The patients' sitters will all usually be fasting and the hospital kitchen provides food for them and the fasting patients in the early morning hours. A three course 'breakfast meal' called sohoor will be distributed at 2 am well before the Fajr prayer.

 The iftar meal will be distributed to the rooms at 6 pm. Even though a patient is not fasting they will be up all night chatting with relatives, reading Quran or watching Arabic soap operas or the live televised show from the grand mosque in Mecca.

I personally enjoy working during Ramadan, patients and relatives are in good spirits and it's nice to spend some extra time with them in the rooms having some arabic coffee and sweets. Generally the atmosphere is more laid-back and patients are not complaining as much as usual :)

The Magic Month in the Kingdom

Ramadan is a very special month to Muslims all over the world. In case you are not sure what Ramadan means to Muslims and why Muslims fast check out this link.
The crecent moon has been sighted and the fasting has started this morning.

Ramadan in Saudi-Arabia is a very different experience from any other country, even other arab Muslim countries. Fasting is taken dead seriously and the whole nation accomodates to make fasting easier.Spirits are high, every Muslim supports one another. The whole country changes radically for a month. For some expats it seems to be a nightmarish experience. But again I think it all comes down to attitudes and what one makes of it. I personally think it's a privilage to be able to experience it.

For expats it might appear something like this:

During Ramadan Saudis turn entirely into nocturnal beings, the daily rhythym reverses itself. Shops will open only in the late afternoon or after sunset and close around 2 am. Riyadh is like a phantom city until sunset arrives.
After the last prayer of the day Ishaa, thousands and thousands of huge SUV's packed with the entire Saudi family start making their ways to their relatives houses or shoppingmalls. Slowly they begin crawling into the streets eventually stopping the traffic altogether.
When they finally reach the malls the women will go out looking for Ramadan sales. Everyone will be busy finding nice clothes to wear for Ramadan.
Tailors get packed with women and men having custom-made thobes and jallabiyas ready for Eid clebrations.
Restaurants and food courts fill with families and screaming children throughout the night. Everyone including the smallest children will be stuffing themselves before they begin fasting. Some indulge in KFC and McDonalds megameals followed by a box of Cinnabons until they cannot move anymore.
Special night prayers also known as Taraweeh prayers are called out from the thousands of mosques around the city. They can be heard as a discordant symphony throughout the night.
Dental offices will be busy until 3 am with fasting patients that cannot be treated during the daytime.
Finally the streets congest once again with families hurrying home before Fajr prayer, which at this time of year is around 4 am.
After that, nothing. Absolute silence on the streets of Riyadh until it all starts over again the following day.
At home some will stay up until the morning chatting and watching tv, finally falling asleep when the sun comes up.
This was a bit aggrevated version of Ramadan in the Kingdom but many although of course not all Saudis do unfortunately spend it like this.
Read here how Ramadan is ideally spent.

For an "outsider" the experience may seem somewhat absurd and incomprehensible. First timers are usually either extremely irritated or fascinated.
What irritates non-Muslims is of course that they cannot do anything during the days since everything is closed and when the stores do open they are fully packed. But this is also the time that consuming any kind of fluid or food in public during the daylight hours becomes a horrendous crime.
Non-Muslims drinking publicly might openly be shouted at and at least glared down by angry Muslims. Basically non-Muslims are forced to hide all evidence of consuming.
If the Muttawa spots someone publicly drinking they might be in big trouble for disgracing the Holy month and might even end up in jail.

I personally think this is quite ridiculous and blowing things out of proportion. I don't mind if someone eats spaghetti bolognese in front of me when I'm fasting! I can always go somewhere else, look away or just not care. After all fasting is about self discipline too. I don't see why some Muslims will get offended by this. It's not like the non-muslims are doing it on purpose to offend anyone although I'm not saying that might rarely occur.
Sure people should be sensitive but this kind of dramatising and exaggeration is in my view unnecessary. Why does respecting other cultures and religions only seem to work in one direction in Saudi-Arabia? Religious tolerance should work both ways.
For example in the hospital all the staff's water bottles have to be hidden out of public sight, they are stored behind closed doors or bathrooms where staff has to go to secretly have a sip. Fasting Saudi employees will generally have very flexible working hours, arriving late, leaving early and taking hour long breaks while non-Saudi Muslims will not have all these luxuries and they are expected to be just fine with it.

I bet when some of these same hypersensitive Saudis go abroad they will forget about tolerance of all other religions altogether..

Anyways Ramadan Mubarak everyone!

Security alert during Ramadan

I just learned that the US embassy and consulates around KSA have issued a high alert security warning. The Finnish embassy has not sent any info about this so I thought it's better to post this just in case to spread the word.
The following information was published for U.S citizens to practise caution during Ramadan. This of course applies to all westerners because to extremists western looking people are potential Americans in other words targets.
Although Ramadan is supposed to be the month of good deeds and actions for Muslims, sadly terrorists might think it is the perfect time commit these awful crimes "in the name of God"and double their rewards. Islam teaches that during the Holy month, all good deeds are doubly rewarded by God. Naturally these sick people would see killing Americans as a good deed.

The following statement was issued:
We have received credible information that an unidentified extremist
in Saudi Arabia may be planning to attack Westerners working and living in
al-Qasim, Saudi Arabia. The timing and method of potential attacks are
currently unknown. The U.S. Embassy in Riyadh, Consulate General Dhahran
and Consulate General Jeddah remind U.S. citizens to exercise prudence and
enhanced security awareness at all times.


Most personnel experience relatively few security concerns; however,
situations can change suddenly. Regardless of where you are, it is always
advisable to keep your security and situational awareness levels high.


Please follow these good security practices:
Do not be time and place predictable. Vary your routes and times to and from
work. Do not frequent the same shops with regularity;
Know where you are going and have a plan of what to do in the event you
encounter demonstrations or violence;
Identify safe areas (for example police stations, hospitals, Saudi
Government buildings) in your area and how to get to them quickly;
Avoid crowds or large gatherings when traveling in public;
Tell co-workers or neighbors where youre going and when you intend to
return;
Minimize your profile while in public;
Always carry a cell phone and make sure you have emergency numbers
pre-programmed into your phone.

I wish everyone a peaceful and happy Ramadan despite these evil peoples efforts to ruin it. Inshallah they will be stopped before any harm is done.