PEOPLE living in Muslim countries in 2013 had an average life expectancy at birth of 67 years — four years below the global average. The global average life expectancy today is much greater than in 1900 — then only 31 years. Under the medieval Islamic Caliphate, however, life expectancy of the general population was relatively high, above 35 years. This is greater than longevity figures estimated for medieval English aristocracy (30 years) and classical Rome (20 to 30 years).
The figures indicate a relatively high level of Muslims’ well-being under the caliphate. Many citizens then lived into their 50s and 60s after surviving infancy. What reduced these historical figures were high infant mortality rates. The rapid increase in life expectancy over the past 100 years is due to greatly reduced infant mortality from improved health and hygiene.
The longevity seen for the Islamic Civilisation was a direct outcome of Islamic teachings emphasising health and hygiene. Prophet Muhammad said in a hadith that “cleanliness is half of the faith (iman)”. He instructed the faithful to regularly clean their teeth, bathe and wear clean clothes. Abu Hurayrah narrated that the Prophet said: “It is the duty of every Muslim to take a bath (at least) once every seven days.” Consequently, historian Ibn Sa’id could comment: “Andalusian Muslims were very particular about cleanliness. The poorest man would spend his last dirham on buying soap for washing his clothes, rather than appear in the street with dirty clothes.”
Further, for Muslims, saving lives is one of the higher objectives (maqasid) of the syariah, as is emphasised in the Quran (5:32): “Anyone who slew a person — unless for murder or spreading mischief in the land — it would be as if he slew the whole people; and if anyone saved a life, it would be as if he saved the life of the whole people.” No doubt, this verse inspired Muslim physicians to achieve great advances in medical science.
Further encouragement towards good health is provided by the hadith: “Every illness has a cure, and when the proper cure is applied to the disease, it heals by Allah’s Will.” Medical knowledge grew rapidly as illustrated by the extensive tomes written by such illuminaries as ar-Razi and Ibn Sina. Code of Laws in Medicine represents Ibn Sina’s most important work. William Osler described it as “the most famous medical textbook ever written”.
Many advances claimed by Western physicians are actually derived from Muslim discoveries, e.g. the explanation of pulmonary blood circulation and vaccinations.
Other Islamic values conducive towards longevity include seeking moderation (wasatiyyah), ease (taysir), caring for aged parents, maintaining family ties and avoiding excessive consumption. The relatively high longevity of the early caliphate period is also unsurprising, when considering attributes of Islamic governance: rule of law providing for security; provision of educational institutions, clean water and sanitation; and, caring for the ill and aged. Extending public education is directly correlated with improved health. The early caliphate had the highest literacy rates amongst premodern societies. Medieval Muslim cities greatly outstripped European counterparts with their public facilities.
Water is critical for Muslims, from the necessity for clean drinking water and ablutions. The hydraulic engineer was highly regarded. Surface water was transported to cities via aqueducts and canals, while underground water was tapped using wells and qanats (underground canals). Large mosques had ablution areas and lavatories. In cities, water was carried to public fountains, and urban quarters had bathhouses. In Fustat, the first Muslim administrative capital in Egypt, water was supplied in fine houses through pipes into basins.
Advanced sanitation systems were widespread. In Fustat, even simple two- to three-room houses had latrines.
In many high-rise, multi-storey buildings, latrines were placed on each floor, with flues constructed within the walls and connected with underground canals to communal cesspits. Impressive sanitary infrastructure, comprising 1,800m of subterranean sewage channels, was present in Madinat al-Zahra, Cordoba.
Hospitals appeared in ninth-century Baghdad and spread quickly. The Nuri Hospital in 12th-century Damascus had druggists, orthopaedists, and oculists. Ibn Jubayr, a 12th-century traveller, observed them in most cities and declared that hospitals were one of “the finest proof of the glory of Islam”.
Muslims are honour-bound to care for the sick. Services and medicines were generally provided free-of-charge from waqf endowments.
The ninth-century Ahmad ibn Tufal Hospital in Cairo contained a bathhouse each for men and women, a library and a psychiatric wing. The founding constitution of the 13th-century Al-Mansuri Hospital in Cairo read: “(The hospital’s) duty is to give care to the ill, poor, men and women until they recover. It is at the service of the powerful and the weak, the poor and the rich… without demand for any form of payment, but only for the sake of God, the Provider.”
Many hospitals doubled as schools where great advances in medicine occurred. Surgeons used advanced surgical instruments. The magnificent hospitals of Damascus and Cairo inspired the crusaders. The first European hospital was established by Louis IX in Paris after his return from the Crusades around 1260.
Surprisingly, many countries today that have the lowest life expectancies are Muslim countries in Africa. These countries show high Islamicity levels in terms of praying five times daily.
However, the inculcation of Islamic Civilisation values related to achieving good health and longevity has been relatively neglected. It is high time for Muslims to re-emphasise Islamic values and teachings, so as to change the mindsets of individuals, as well as establish institutions and facilities that engender good health, vitality and spiritual well-being for all.
The writer is associate fellow with the
International Institute of Advanced Islamic Studies Malaysia