Abu Qatadah reported: The Messenger of Allah, peace and blessings be upon him, said, “The best of what a man leaves behind are three: a righteous child who supplicates for him, ongoing charity the reward of which reaches him, and knowledge that is acted upon after him.” 
One wondrous aspect of the hadith (collection of prophetic sayings) is the impact that each phrase and sentence of the Prophet ﷺ held over the cultural ethos and motivations of generations to come. Pithy statements such as the one above will continue motivating the ahl al-rizq (people given worldly provision) to donate large sums of money to Islamic causes. Revelation itself gives rise to civilization through the encouragement of social institutions that fulfill the philanthropic mandate placed upon both moneyed and non-moneyed Muslims: As is well-known, even a smile or act of intimacy with one’s spouse can count as sadaqah. Thus, it comes as no surprise that material efforts to support the health and lives of those left behind have been given tremendous value within Islam. We learn that whoever takes a life (except as punishment), “it will be as if they killed all of humanity; and whoever saves a life, it will be as if they saved all of humanity”. 
Medieval hospitals in the Islamic world were backed by endowments (Waqf), and the impoverished were supported through charity (Sadaqah and Zakat-ul-fitr). Though the endowment system in the Islamic world was mercilessly abolished due to imperialism and the imposition of secular law, faith-inspired care occurs in modern countries such as the United States. In 1995, there were 585 faith-based hospitals in the country, a number that grew to 726 in 2016.  One in six hospital beds in America is managed by a Catholic healthcare institution.  Muslims have similarly contributed to American healthcare through smaller organizations and individual efforts, particularly in developing free clinics and sponsoring relief trips for underserved populations in the United States and abroad. The Islamic Circle of North America (ICNA) operates free clinics for uninsured patients in seven cities across the United States and has mobile clinics after Friday prayers. One study found that free Muslim-led clinics across the nation serve over 50,000 patients a year, half of whom are not believers. 
These contributions raise a question: If Muslims have the wealth, capital, talent, and – most importantly – the religious directives, to serve humanity, why are there no Muslim-owned hospital chains in areas with higher concentrations of Muslims? Why are Muslims left out of the action when it comes to large-scale movements in healthcare? For example, take the three-way proposed merger in 2013 that included a public health institution, a non-profit Jewish hospital, and Catholic Health Initiatives.  In Forbes’ 2019 list of “America’s Top Charities, no Islamic organization was to be found. Yet, a recent study in the Journal of the American Medical Association concludes that 4.5% of the total US physician workforce originates from Muslim-majority nations.  In a single year, Muslim physicians saw 5.2 million patients and Muslim pharmacists filled 9.6 million prescriptions in New York City alone. 
Several factors explain this inability of Muslims to become big players in healthcare:
1) Political culture: Diaspora Muslims have not developed a strong culture of leadership, and credentials for elected positions are often based on family ties instead of formal non-profit experience. There is a lack of understanding of what it takes to be a founder (or founding group) of a functional institution that can cultivate the productive powers of Muslims.
2) Governance: Muslims often make empty appeals to ideas such as shura (mutual consultation) and khilaafa (man being appointed as God’s earthly vicegerent) without serious effort to understand how institutions function and flourish. Ahmed Shaikh, an Islamic estate-planning attorney and credentialed critic of Muslim nonprofits, has several online articles explaining concepts such as separation of powers in the boardroom and proper handling of zakat funds.
3) Sustainability: Most Muslim organizations rely on individual donations to survive without devising plans to ensure long-term survival. 
4) Human capital: We fail to attract and retain individuals with the talent to build. A policy report by the Institute for Social Policy and Understanding debunks the ‘myth of scarcity’ regarding human capital in Muslim non-profits:
“One myth is that Islamic nonprofits do not have the financial resources to attract and retain talent. In fact, they do – but they choose to invest in physical assets rather than in human capital. Another myth is that not enough qualified professionals are interested in the sector. In fact, many are – but choose not to pursue it because of a perceived lack of professionalism.” 
Despite these challenges, there are numerous examples of groups demonstrating the “productive potential of a wide-ranging and systematic approach by Abrahamic communities to [provide] free healthcare”: 
- Increasing access to preventive health care within local Muslim communities. Since 2008, American Muslim Women Physicians Association has organized over 50 health fairs at local mosques across north Texas, providing free or low-cost preventive medicine services to over 5,000 patients.
- Strengthening school-based health care. The Jewish Renaissance Medical Center in New Jersey received a $40,000 grant in 2014 to expand primary and preventive care to children in schools.
- Addressing coverage gaps. During enrollment for the Affordable Care Act (informally known as “Obamacare”), grants were provided to faith-based community centers to provide comprehensive health care and enrollment information for the new insurance plans.
In the Muslim nonprofit space, there has been a relatively recent shift towards long-term thinking: The Ummah Giving Circle has collected over $1.3 million that is distributed to over 50 charities, with last Ramadan’s donations focusing on domestic poverty.  The long-term goal should be to develop Muslim-led institutions that “create opportunities for faith-based institutions to engage in productive dialogue with public and private sector stakeholders”, be they professionally run masjid clinics, a national zakat foundation, or community hospital networks.  These initiatives will not only provide Muslims with an important form of social capital and bargaining power but can also lead to a virtuous cycle of wealth creation, dedicated to ensuring that Muslim patients receive culturally- and linguistically-competent care.  As explained in an article that touches upon the role of charitable endowments:
“America is suffering from a plague of rent seeking insurance companies that have hollowed out the medical profession and turned it into a vehicle for massive profits and massive suffering. Strategically placed awqaf funded by Abrahamic communities and philanthropic individuals can focus on the development of a network of free or limited payment healthcare providers that are placed within some of the most at-risk communities in America. Doctors and other healthcare professionals can be called upon to serve a portion of their time in these institutions in a missionary spirit, not to gain converts, but to save lives.” 
The raison d’etre for the existence of any Islamic institution must be predicated upon its ability to boost Muslim achievement in business, education, or healthcare. In that vein, it is counter-intuitive for Muslims to solely invest their energy in civil rights or policy causes without fermenting the same commitment to healthcare, a $4 trillion industry where immigrant Muslims in America are well-represented. Recall that BioNTech’s coronavirus vaccine was developed by a scientist couple of Muslim Turkish descent, and that many Americans receive healthcare services in some form from a Muslim. In the same way that Moses respectfully spoke truth to power in his meetings with Pharaoh, Muslims should look to the way of Umar ibn al-Khattab and his governance and administration of both Muslims and non-Muslims in the early Islamic empire.  For us today, this means better organizational capacity and effectiveness in providing easily accessible healthcare for all. As Allah سبحانه و تعالى says, “[Believers], you are the best community singled out for people: you order what is right, forbid what is wrong, and believe in God”. 
- Quran 5:32
- Statistica. “Number of faith-based hospitals in the United States from 1995 to 2016”. Accessible at: https://www.statista.com/statistics/800827/number-of-us-faith-based-hospitals/
- American Civil Liberties Union. 2013. “The Growth of Catholic Hospitals and the Threat to Reproductive Health Care”. Accessible at: http://static1.1.sqspcdn.com/static/f/816571/24079922/1387381601667/Growth-of-Catholic-Hospitals-2013.pdf?token=9NKk9ZByg%2FRMgTOZOfvGdmNyTuU%3D
- Quigley, Fran. 2019. “Muslim Health Care for All”. Foreign Policy. Accessible at: https://foreignpolicy.com/2019/06/27/muslim-health-care-for-all/
- Becker’s Hospital Review. 2013. “Hospitals With Different Religious Backings Can Still Partner, But Some Challenges Await”. Accessible at: https://www.beckershospitalreview.com/hospital-transactions-and-valuation/hospitals-with-different-religious-backings-can-still-partner-but-some-challenges-await.html
- Boulet JR, Duvivier RJ, Pinsky WW. “Prevalence of International Medical Graduates From Muslim-Majority Nations in the US Physician Workforce From 2009 to 2019”. JAMA Network Open. 2020;3(7):e209418. doi:10.1001/jamanetworkopen.2020.9418
- Institute for Social Policy and Understanding. 2018. “An Impact Report of Muslim Contributions to New York City July 2018”. Accessible at: https://www.ispu.org/wp-content/uploads/2018/07/MAP-NYC-Report-Web-3.pdf
- Institute for Social Policy and Understanding. 2019. “American Muslim Philanthropy”. Accessible at: http://www.ispu.org/wp-content/uploads/2019/07/2019_Philanthropy-Report_WEB.pdf?x39162
- Institute for Social Policy and Understanding. 2004. The Human Capital Deficit in the Islamic Nonprofit Sector. Accessible at: http://www.ispu.org/wp-content/uploads/2004/07/2004_human-capital-deficit.pdf
- al-Dakhil, Ahmed. 2020. “Building an Alliance Sacrée”. Athwart. Accessible at: https://www.athwart.org/building-an-alliance-sacree/
- Hadero, Haleluya. 2021. “Ramadan drives donations, memberships to giving circles”. The Seattle Times. Accessible at: https://www.seattletimes.com/business/ramadan-drives-donations-memberships-to-giving-circles/
- National Center for Cultural Competence. 2001. “Sharing a Legacy of Caring Partnerships between Health Care and Faith-Based Organizations”. Accessible at: https://nccc.georgetown.edu/documents/faith.pdf
- Quran 79:17-18
- Quran 3:110
Photo by Enric Moreu
About the Author: Waqas Haque is an editor for Traversing Tradition. He recently completed medical school and is a resident at New York University. Previously, he studies public health and also obtained an M.Phil. from Cambridge University. He is broadly interested in tafsir, Hanafi fiqh, drugs development, and entrepreneurship.
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