DEVELOPING HEALTHCARE SERVICE THROUGH WAQF FUNDS
FarahdinabintiAbdManaf
Academy of Islamic Contemporary Studies ( ACIS) , UiTM/
Department of Syari’ahLaw , Academy of Islamic Studies , University of Malaya
SitiMashitohMahmood,
UM Awqaf, University of Malaya/
Department of Syari’ahLaw , Academy of Islamic Studies , University of Malaya
Abstract
A healthy community which has fewer burdens of diseases are among the most important assets of a developing nation. Nonetheless, the increase in the cost of healthcare service today appears to become a liability to most. Other than the patients, who have to bear high medical treatment costs, the government is also facing difficulties in preparing substantial public healthcare services which are of good quality. The existence of private medical institutions as an alternative has not been able to bear the current needs, as patients have to bear costs which are too high. This paper therefore aims to suggest waqf to become the source of funds in preparing a healthcare service of good quality, which can be enjoyed by people from all walks of life at a reasonable cost.
Keywords:waqf, healthcare service,māristān, medical costs
Introduction
Healthcare service is very heterogeneous, as it consists of various things or equipment and service intended to preserve, improve and repair the physical and mental health of an individual.Healthcare service is concerned with the responsibility of health care; preventing, controlling and treating or healing diseases.From the economical perspective, healthcare affects the economical situation, and the same is vice versa; the economical situation can affect the health level of an individual or a society . For instance: Poor health conditions of an individual will affect one’s work performance and thus, the ability to enjoy a more productive life will subside. Poor health can also be a threat to others; for instance,the spreading of contagious disease that cannot be cured. The health condition of the family leader can also cause the family’s income to decrease and thus, members of the family will not get food of good quality and a much better shelter. An employee’s health level that is unsatisfactory will also affect his productivity at work. Therefore, an excellent healthcare service will benefit individuals and the society. Authorities, such as the government or the responsible parties, especially those in healthcare and the preparation of medical service to the society, are responsible for the preparation of medical service for the needs of every member of the society. The trend of the current world economic development indicates that various factors contribute to the increasing funding costs for health. The hike in health service costs also burdens the nation, especially those from the poor and low income groups, in obtaining medical treatment for chronic illnesses and any illness requiring continuous treatment. For the government, building hospitals require very high capital costs and administration costs, despite the fact that health facilities such as health centres and hospitals are necessities for the nation of various ages. Furthermore, the implementation of the waqf fund will assist the preparation of healthcare services that can meet the demands of patients, especiallyconcerning quality and cost, while taking consideration of medical expertise, accommodation, medical centres, treatment costs and medical costs.
Healthcare Service as a Basic Necessity
Preparing utilities and facilities in order to improve the level of health as well as to provide the best medical treatment for the comfort of living is an important responsibility (fardhukifayah) on all Muslims. From the Islamic perspective, the need to prepare medical service can be compared to the preparation of water supply, fire and a green field for livestock. Personal care, including life, is one of the maqasid al-syari’ah which is given great emphasis by Islam. Everyone is entitled to get free medical service. The government or ruler is also obliged to prepare substantial or sufficient service to the people, appropriate with the current economy of the nation; excellent medical service that meets the needs of the people, including providing adequate medical experts and services that every member of the society will be able to enjoy. As reminded by the prophet, peace be upon him: “Muslims share three aspects which are water, fire and a field of grass.” This hadis states that water, fire and a field of grass are collective rights (Al-Mawardy, 1993). This means, the basis is that everyone has the right to obtain and use health service free of charge; similar to education service, which should not be commercialized. In this case, waqf is envisioned as the best alternative. With the existence of a waqf system in the health service, the responsible parties will be able to implement their duties by using the contributions from the rich and wealthy. The wealthy will be able to contribute to the well being of the society according to their capabilities, where as the poor and needy will be able to receive assistance that will help fill their individual needs.
Healthcare Service in Islamic Civilisation
History has proven that the advent of Islam has brought light to human life. For example, in the golden times of the cAbbasiyyahreign, Baghdad in the east and Cordova (Qurtubah) in the west became important centres of Islamic medical institution. When Paris and London were still filled with muddy lanes and run-down huts, Baghdad, Cairo and Cordova already had hospitals complete with various facilities, and female and male assistants for patients of both genders. These hospitals or medical centres,were equipped with libraries, pharmacies, outpatient centre, separate wards for men and women, and enough medical staff consisting of doctors and nurses (Surty, 1996). There were also mobile clinics that aimed to serve the community or the public who were not able to travel to hospitals to undergo treatment, or did not have the infrastructure or time to go to the hospital for medical treatment, or those who live in rural areas (Hassan Ibrahim Hassan, 1984). These serve as evidence of how Islamic civilization has advanced civilizations of other people in the world, particularly in the field of medicine. Islamic Civilisation has also advanced well and benefit not only Muslims, but also people from the four corners of the world.
The Basic Concept of Waqf
Fiqh Scholars have defined al-waqfas al-habs, which means “hold”. Therefore, waqf is a form of wealth submission either in clear forms(sorih) or hints (kinayah), whereby the wealth is held and whatever is gained will be used for good purposes either generally or specifically. Waqif (the person who does the waqf) usually opts for a waqf or endowment which has guaranteed long benefits, such as mosque, schools and cemeteries. Mosque waqf or endowment often lasts long because administration costs and maintenance are usually born by the local community through alms and other contributions. Similarly, the fundings for school waqf depend on contributions made by the student trustees or the ruler (Chaider S. Bamualim and Irfan Abu Bakar, 2007).
The implementation of the Waqf practice is based on the hadis by IbnUmar, as narrated by Imam Muslim who recounts how Umar al-Khattab, who obtained a piece of land in Khaibar and had wanted the land which had high value to be benefitted the best way possible. Then RasulullahS.A.W (prophet) suggested that he gave the profits from the land and the source be held (waqf). Umar thus distributed the profits to the poor and family, those who fight in Allah’s path and travelers,freed servants, and feasted the guests. The waqfproperties cannot be sold, distributed or inherited (HadithNarrated by Muslim).
In Malaysia, matters pertaining to waqfhas been mentioned in the respective state enactments (Article 74(1)(2), Federal Legislation/Constitution). All waqf properties are administered and managed by Majlis Agama Islam Negeri/MAIN. Waqflands which are registered are subject to MAIN as the sole waqf wealth benefactor (State AdministrationIslamic Enactment). The reason MAIN was appointed as the sole benefactor of waqf wealth is to ensure waqf is managed and administered well, efficient until it can generate a wealth of profit that may be benefitted by the beneficiaries or for charity purposes; either predetermined or not by the person who left the waqf. What is most vital is to avoid various kinds of arising problems by appointing a dishonest private benefactor and interference from family which result in the loss of wealth and waqf status that becomes a divergence from the initial aim and against the principles of law (SitiMashitoh, 2005).
The History of Waqf in the Health Service
Health Service has existed in the Muslim Civilisation since the times of the Prophet, peace be upon him. This service portrays how Islam places importance on health care, prevention and treatment of illnesses. To treat those injured in the war, the companions of the prophet built tents in the compound of MasjidNabawi in Madinah. The companions of that time took the roles of doctors and nurses who servedregardless of time and without charge. During the reigns of Khalifah ‘Umaribn al-Khattab (13AH/634CE – 23AH/644CE), he himself joined a group of medical experts in a military expedition to Persia (W. Durrant,). Many medical institutions, better known as māristān, were built and expanded rapidly during the period of the BaniUmayyah Empire (661CE-750CE), the Abbasiyyah Empire (751CE – 1258CE) up to the period of The Turk Uthmaniyyah Empire (1299M – 1924M). All the treasure and waqf fund were then administered by the government or specified persons who had been appointed (Smith, Wilfred Cantwell, 1957). In 303 AH (716CE), Khalifah al-Muqtadir (295AH-319AH / 908CE-932CE) had asked arenown medical expert, Abu ‘Uthman Said bin Y’qub from Damasqus (Damshiq) to keep an eye on and surpervise a hospital in Baghdad, Makkah and Madinah. KhalifahMuqtadir had also founded a few new hospitals in which he had largely contributed by giving a substantial amount of endowment or waqf (Hassan Ibrahim Hassan, 1984). Medical institutions which were established and managed by Muslims were recorded by historians as the best hospitals, equipped with modern facilities at that time, as well as fast developing to other parts of the whole world including Europe (The Encyclopaedia of Americana, 1972).
The medical institution complex or māristānusually consists of a medical college, a big hospital, a university hospital, an army hospital, a women’s hospital, a mental hospital, a prison hospital, a mental hospital, a hospital for the leprosy, an emergency clinic, a mobile clinic, laboratory, pharmacy and dispensary surrounded by a herbal garden (Farahdina, 2005). Benjamin of Tudela recordedthat in 1160 EC, in the town of Baghdad, there were not less than 60 well-managed medical institutions (Ziauddin Ahmad, 2006). Maristan al-Muqtadiri in Baghdad (716 CE) and MaristanIbnTulun, in Cairo (872 CE) were amongst the most well known hospitalsduring the era of Muslim Civilisation (Surty, 1996). IbnBatutah wrote, whilst on his way to Egypt by sail:“..māristān which is located in between two castles in the area of al-Malik al MansūrQalawūnis picturesque beyond words. At this māristān, various facilities and endless supply of medication are offered....” (IbnBattutah, 2003).This situation is very different from the image given by Richard Staton, a western historians with regards to the scenario of the medical service in the West at that time:“People in the Middle Ages were haunted by illness and death... Diets were poor and food often spoiled before sale. It rarely provided the essentials for good health and nutrition. The result was that people did not live for very long... The poor living conditions particularly in the towns, encouraged the spread of diseases (ZiauddinAhmad ,2006).
Current Issues on Healthcare Service in Malaysia
The healthcare system of this country consists of a network of public and private healthcare service. The public network system of healthcare service is the pivot to the nation’s healthcare system. Its infrastructure is available nation wide, and it offers service to everyone irrespective of rank. The Malaysian Ministry of Health has tried carrying out its social duties to the nation, especially in terms of offering facilities to those who are financially less fortunate at a minimum cost. For instance, free medical treatment is offered to government servants at all government hospitals and a minimum fee of only RM1 per person is charged for each medical treatment at the newly introduced 1 Malaysia Clinics. Nonetheless, the medical healthcare in Malaysia is facing a variety of challenging issues that may affect the level of performance and sustainability such as factors concerning labour shortage, high workload and also congestion in public healthcare facilities (MMH Strategic Plan ,2011-2015).
The existence of private healthcare services offers the society the option to obtain healthcare service from other than what is provided by the government. Besides that, it complements government facilities. However, private healthcare services which are mostly concentrated in urban areas are also challenging as it acts as an attraction to the professional workforce, causing them to leave the public sector. This is due to the fact that private sectors are mainly based on financial profits. Other than that, the underprivileged also have limitations in obtaining service from the private sector. In the end, the healthcare service offered by the private sector targets those who can afford it or have their own healthcare payment protections (insurance), either paid individually or offered by their employers (al-Junid, 2000).
Another issue is the excalating medical costs for chronic illnesses, especially those involving surgery. Research shows that there has been an increase in cases of cronic illness in Malaysia. For instance, the statistics revealed by PusatSumberTransplanNasional (National Transplant Resource Centre) indicates that one in 10 people in this country, of all ages, have the tendency to develop cronic kidney problems. In fact, 18,347 of the 18,384 cronic patients awaiting organ donations in this country are kidney patients (themalaysianinsider.com). The total number of new patients with kidney problems in need of dialysis treatment has more than doubled within the period of 10 years, from 2,375 people in 2002 to 5,201 people in 2011 (freedomtolive.com.my). The main cause of death in 2012 are complications associated with cardiovascular, which was recorded as more than 25% of the recorded number of deaths, followed by diseases linked to respiratory (18.46%), infection or parasite (17.81%) and cancer 11.87% (Malaysia Ministry of Health, 2012).
A uniform guideline to ensure the quality of primer service either in the government or private healthcare service needs to be set up. Through this, the responsibility to educate, treat and help patients reach an optimum level of controlled chronic illness can be shared. A Malay proverb often says: to bend bamboo, start when young (melenturbuluh, biarlahdarirebungnya). With this spirit, primary education has become an important step in shaping a healthy and active generation in the future. The prevention of illnesses can not happen without education. Therefore, it is vital to expose healthcare awareness from the very beginning, whilst stressing its significance. The community must be well equipped with medical knowledge to the extent that they are able to treat a few minor ailments on their own, taught the importance of preventing chronic diseases as well as ways of identifying warning signals or symptoms when faced with an ailment or situation. Programmes such as personal hygiene, healthy diet and health and safety training are handy for children and teenagers to learn in order to become independent adults. This process of awareness will definitely take a long time but it will result in an everlasting generation practising a healthy way of life. It is not sufficient for our education system to only be able to produce ‘robots’ that are merely able to count and measure, but ideally, they should be born healthy and aware about their bodies and health so that they become a community who is civil and healthy. A healthy nation is a productive nation; a productive nation is a nation who will generate more rapid economic growth for the country ( Afif , 2013).
WaqfIn Malaysia Healthcare Services
In Malaysia, Johor Corporation has pioneered waqf system in healthcare and medical services. Corporate responsibility division coordinates and monitors corporate responsibility (CR) activities of Johor Corporation which are carried out directly through its non-profit organisations comprising of Waqaf an-Nur Corporation Berhad and Yayasan Johor Corporation as well as indirectly through its group of companies.Through collaboration with Waqaf An-Nur Corporation Berhad and KPJ Healthcare Berhad, Johor Corporation has to date developed 21 units of KlinikWaqaf An-Nur (KWAN) nationwide and a Hospital Waqaf An-Nur (HWAN) in PasirGudang, Johor. The outpatient treatments are offered at KWAN for the public from all walks of life and backgrounds with a minimum fee of RM5 only. As at December 2016, a total of 1,398,524 treatments were carried out by KWAN, of which 11% (111,881) treatments were delivered to non-Muslim patients. The clinics also equipped with 66 dialysis machines that served a total of 307 kidney patients( JCorp, 2016 Annual Report).