by Stephen Schwartz
The involvement of Muslim physicians in the London and Glasgow airport terror conspiracy on June 29-30, 2007, forced both non-Muslims and moderate Muslims to question how those trained to heal could embrace terrorism. The doctors involved in the attempt to detonate car bombs in London and blow up a passenger terminal at the Glasgow airport did not represent an isolated phenomenon. Many Muslim doctors have adopted the extremist doctrines espoused by the Muslim Brotherhood, Saudi Wahhabis, and Pakistani jihadists. Groups such as Al-Muhajiroun, a group banned but still active in Britain and famous for celebrating the 9-11 terror attacks, recruit medical students. Tablighi Jamaat, an Islamist movement prominent in Great Britain among Muslims of South Asian origin, also welcomes Muslim medical students. Medical professionals represent an elite in Muslim societies. They have moral and social standing that can influence others to stray from the observance of traditional, mainstream, and spiritual Islam toward radical ideologies.
Confluence of Mullahs and Medicine
In early Islam, there was little separation between religion and medicine. Traditional Islam promotes the concept of medical work as a service to humanity. Physical wellness and religious belief remain bound together in the popular consciousness of Muslims. It is not uncommon to use encased Qur'anic verses in amulets to cure ailments. Pocket handbooks for faith healing are printed and sold from Bosnia-Hercegovina to Indonesia. A typical such booklet, Kur'an Kao Lijek (Qur'an as healing), widely circulated in Turkey and Bosnia-Hercegovina, recommends that a sick person write the opening sura or book of the Qur'an, Al-Fatiha, on a piece of paper, dip it in water, and drink the water. Also common are small booklets correlating the ninety-nine Arabic names of God with solutions to specific ailments. One example from India reads, "Al-Hayy (The everlasting): Anyone desiring sound health should recite this name 3,000 times daily. If a sick person writes this name in a bowl with musk and rose water and then washes such inscription with water and drinks the water, he will soon be cured from his illness, Insh'allah [God willing]." The thirteenth-century Syrian theologian Ibn Qayyim al-Jawziya's At-Tibb an-Nabawi (The medicine of the Prophet), remains popular today and is available in many languages.
Among many Muslims, the concept of "the Prophet's medicine" has appeal because it avoids surgery and other expensive procedures. Clerics versed in folk medicine traditions can gain credibility with the rural and urban poor. Conversely, though, because religion and medicine are so intertwined in belief, some ordinary Muslims may consider Muslim medical doctors to be superior to mainstream clerics. The radical Islamist doctor may easily usurp religious authority from a traditional imam. Khaleel Mohammed, comparative religion professor at San Diego State University, has argued that in recent times, "Muslim leaders have not traditionally been chosen for their Islamic knowledge but for their stature in society—a medical doctor, a computer scientist."
Islamists have seized upon this dynamic to manipulate the masses. In third world countries, many people consider the medical doctor to be the only person capable of delivering real assistance. This is not limited to Muslims. In the 1960s and 1970s, Latin American leftists sent students to the Soviet Union and Cuba to study medicine. Ernesto "Che" Guevara was a medical doctor. Fidel Castro's regime continues to produce and train doctors to serve poor communities for free. Castro even extended the U.S.-based Nation of Islam an invitation to send young African-American men to Cuba for free medical training.
There is no reason why the Muslim approach to medicine should be different from that of the West. Islamic bioethics do not differ profoundly from Western bioethics. Muslim scientists and doctors translated Greek medicine into Arabic. Muslim doctors inherited the Hippocratic Oath along with other elements of Greek medicine. In 1981, though, the International Organization of Islamic Medicine, an institution set up in Kuwait with the aim of formalizing Islamic medical doctrine, issued an Islamic Code of Medical Ethics. This text includes an "Oath of the Doctor," which augmented the Hippocratic Oath with reference to the omnipotence of God, as well as the duty of the Muslim physician to observe Islamic standards of modesty in dealing with patients and to live as a Muslim publicly as well as privately.
The Islamic Code of Medical Ethics addresses certain issues debated by Western bioethicists, often endorsing the sanctity of life. It bans euthanasia or mercy killing, for example, declaring, "A doctor shall not take life away even when motivated by mercy." However, it distinguishes between medical ethics and Islamic law when asserting, "Human life is sacred … and should not be willfully taken except upon the indications specified in Islamic jurisprudence, all of which are outside the domain of the medical profession." Islamist clerics also forbid abortion except in cases where the mother's life is in danger. Influential Qatar-based cleric Yusuf al-Qaradawi writes in The Lawful and the Prohibited in Islam, a popular Shari‘a guide, that "Muslim jurists agree unanimously that after the fetus is fully-formed and has been given a soul, aborting it is haram [prohibited] … However, there is one exceptional situation. If, say the jurists, after the baby is completely formed, it is reliably established that the continuation of the pregnancy would necessarily result in the death of the mother, then, in accordance with the general principle of the Shari‘a, that of choosing the lesser of two evils, the abortion must be performed."
A Code of Practice for Muslims in the West, a Shi‘i manual reflecting the guidance of the Iraqi Ayatollah Ali Sistani, addresses bioethical issues in much greater detail. In a separate chapter titled "Medical Issues," the volume specifies that organ transplants, even from dogs and pigs, are permissible in that the human body will, through "rejuvenation" of the organ, purify it. The same text authorizes the use of insulin even if extracted from swine as well as "genetic engineering" to make human beings more physically attractive.
There is a creeping Islamist revision of bioethics, at least in the Sunni community. Some Muslim medical students in Britain, for example, boycott classes and leave test questions unanswered if they involve alcohol-related diseases such as those concerning cirrhosis of the liver or sexually-transmitted diseases on the pretext that both deal with conduct forbidden in their faith. Other British Islamists have refused to wash their hands when entering sterile areas in hospitals because antibacterial gel contains alcohol. No such prohibition exists in traditional Islam against the medical use of alcohol for sterilization, nor does traditional Sunni scholarship prohibit the use of insulin even when it is extracted from a pig's pancreas.
Doctors and Jihad
Few doctors involved in radical Islamist activity obtained their primary medical education from Western institutions. Part of this is the result of geography: Arab or South Asian doctors focus on maladies specific to their region. With immense rural populations and an absence of clinics with new equipment, doctors from such areas circulate among people far more easily than Western-trained medical personnel who may find the absence of proper pharmacies and laboratories a handicap. A doctor may not be indifferent to religious matters if his education is paid for by an Islamist organization.
Here, Islamist groups have been adept. While the Egyptian government has not been able to keep up with the demand for medical services, the Muslim Brotherhood and its splinter groups have filled the gap. The Muslim Brotherhood has penetrated and, at times, subsumed the Egyptian Medical Syndicate, Egypt's official medical professional association. While some dismiss the radicalization of doctors as the result of their overproduction and underemployment, such an explanation fails to explain the concurrent radicalization of doctors in countries such as Saudi Arabia and Iran, both of which have little trouble employing their doctors.
In a strategy masterminded by Ayman al-Zawahiri, who rose through the ranks of Egyptian Islamic Jihad to become Osama bin Laden's deputy, the Egyptian Islamic Jihad and Gamaa al-Islamiyya (Islamic Group) provide local health care in exchange for opportunities to recruit neighborhood youth in extremist ideology. Bin Laden replicated the strategy when, during his years of exile in the Sudan, he used his personal wealth to build schools and hospitals.
In his book Islamic Medicine, which was turned into a collection of online essays, Shahid Athar, an endocrinologist and clinical associate professor at the Indiana University School of Medicine, provides background on the environment in which the physician can become a radical Islamist. Citing from the Qur'an, he demonstrates why the gulf between medical science and religion is not as vast for many Muslims as it may appear to many Westerners. The Islamic Code of Medical Ethics states, "The physician should be in possession of a threshold-knowledge of jurisprudence, worship, and essentials of Fiqh [Islamic legal argument], enabling him to give counsel to patients seeking his guidance about health and body conditions, with a bearing on the rites of worship."
The Muslim Brotherhood, for its part, argues that repudiation of Western secularism does not automatically mean a rejection of science and of new discoveries. Sayyid Qutb (1906-66), the leading intellectual behind the Egyptian Muslim Brotherhood, encouraged Muslims to acquire knowledge and to study hard sciences such as chemistry, physics, and mathematics although he forbade the pursuit of some fields—such as economics and evolution—that he deemed outside the context of Qur'anic precepts. Qutb and his intellectual successors have drawn from classical Islam to argue that rationality and critical reason have a prominent role in Qur'anic thought.
Rather than simply bless the study of modern scientific fields developed in the West, many Islamists seek a broader reconciliation between Islam and science. Sa‘id Nursi (1877-1960), a Turkish Islamist inspired by Sufism, sought to reconcile science and religion in Risale-i Nur (Treatise on light) which, while never completed, is nevertheless widely published. Sometimes, such trends contradict the findings of hard science. As Islamism has increased in Turkey, so too has creationism. Harun Yahya, a businessman and Islamist ideologue born Adnan Oktar in Ankara in 1956, widely produces and disseminates glossy and expensive volumes questioning Darwinism and intertwining it with anti-Freemasonry and other conspiratorial arguments popular in Islamist publications. In 2007, he sent free copies of a huge, multicolored, two-volume Atlas of Creation to journals in every major country in which he argued the creationist case.
The late Mahmoud Abu Saud, a leading Egyptian Islamist ideologue who resided for many years in the United States, contributed an essay on "The Role of a Muslim Doctor" to Athar's volume in which he argued that the "doctor has a big say and great weight in influencing his patients and in righteously guiding their orientation. Besides, he should be actively involved in propagating true Islam among Muslims and non-Muslims ... The best missionary service to be rendered by a medical doctor is to behave at the time in accordance with his Islamic teachings, to declare his conviction, and to feel proud of it."
Extremist Commitment in Iran
The role of scientifically-trained elites in furthering extremist ideology is also visible in Iran. Both before and after the 1979 Islamic Revolution, the most influential Iranian political and student movements originated at the medical, technical, and engineering schools. While doctors are perhaps the most influential tier in society in the Arab world, in Iran, engineers share the stratum. Medical and engineering programs attract both the most gifted students and those with ambitions for broader roles in society. Iran has officially encouraged modern medical education beginning with the 1911 Medical Law, which required physicians to study and train in modern medicine. Initially, this did less to improve education and more to de-legitimize Islamic folk healers.
In the absence of organized party politics, students segregated themselves into competing political factions. They soon transformed universities into a stage for confrontation between monarchists and religious radicals. After the shah's departure, Islamist factions embracing authoritarianism, populism, and or Marxism confronted each other although subsequent revolutionary purges limited religious discourse to trends supporting the Supreme Leader's personal role. Members of the Mujahideen-e-Khalq (MKO) and other smaller groups that engaged in terrorism and armed combat were disproportionately drawn from medical and technical schools. Ervand Abrahamian's The Iranian Mojahedin tabulates MKO "martyrs" for the period 1981-85: Of a claimed total of 8,968, almost a third were identified as "modern middle class." In that category, 1,653 were college students while forty-seven fell into the combined group of doctors, veterinarians, and dentists. Three unnamed individuals classified as "prominent mojahedin" among the "martyrs" were doctors, veterinarians, or dentists.
While the revolution curtailed the opportunity for most Iranian doctors and engineers to exchange opinions with their counterparts outside the country, they retained their predominant role in society. Several doctors assumed high positions in the Islamic Republic. ‘Ali Akbar Velayati, foreign minister between 1981 and 1997 and current foreign affairs advisor to the Supreme Leader, is a pediatrician by training and conducted post-doctoral training at Johns Hopkins University. Abbas Sheibani, a hard-line Islamist currently on the Tehran city council and a former minister of agriculture, also segued from medicine into Islamist politics. Similarly, Hossein Shariatmadari, editor of the hard-line Iranian official daily Kayhan and an aide to Supreme Leader ‘Ali Khamenei, was a medical student before his arrest and imprisonment by the shah's regime. Many others were engineers. The confluence of medical doctors or engineers and Islamism in Iran may reflect the weakness of liberal principles in society. The absence of liberalism, often conflated with Westernization, let alone hostility to both liberalism and the West, has created a vacuum that other ideologies seek to fill. While the shah sought to promote Persian nationalism, his flight ceded the battle to Islamism and Marxism. Khomeini's Islamism won. Commitment to Islamism in Iran offers doctors and engineers an opportunity to achieve a fast political and social rise.
Are Doctors the Ultimate Jihadis?
Among jihadists, doctors can transcend rivalries. The doctor can move more freely with less security. Doctors may also augment Islamist jihad with their knowledge of chemistry and perhaps pharmacology. They may serve to purchase sensitive supplies, including volatile chemicals for use in explosives or drugs.
When confronting moderate Muslims or peoples of other faiths, Islamist doctors also have an advantage. In countries beset by Islamist violence, many citizens perceive those fighting jihad to be disfranchised illiterates responding to the appeal of craftier bigots. This was a major theme of the 1994 Egyptian satirical film, Al-Irhabi (The terrorist). For Islamist organizations seeking to overcome such stereotypes, what better way to penetrate a village than to send a much needed doctor?
The same strategy has replicated itself in disaster relief operations conducted by radical Islamist organizations. After a 7.6 Richter scale earthquake in Pakistani Kashmir on October 8, 2005, Pakistani Islamist organizations helped to provide homeless victims with hot food, clothes, and other supplies. At least seventeen Islamist organizations banned by President Pervez Musharraf's government undertook relief and reconstruction work in the aftermath of the earthquake. The Daily Telegraph reported that "Islamic groups are widely regarded as having provided the most efficient aid operations in some areas after the Pakistan earthquake struck in Kashmir and the North West Frontier Province."  These Islamist and jihadist organizations also aided refugee camp management, running thirty-seven out of the seventy-three organized camps in and around the regional capital of Muzaffarabad, and Islamists had a presence in every other affected Pakistani district.
Such medical outreach aids the Islamist cause in multiple ways. Not only can doctors proselytize, but they can also funnel or launder humanitarian donations to terrorists. Funds collected by the radical Sunni Lashkar-e-Taiba group for relief in the aftermath of the 2005 Kashmir earthquake were diverted to the use of the conspirators in the 2006 Heathrow airport terrorist plot. The diversion of medical aid charities occurs in the United States as well. The U.S Treasury Department's Office of Terrorism and Financial Development has designated the Holy Land Foundation for Relief and Development, which often solicited funds for medical relief, to be a provider of "millions of dollars in financial and logistical support to Hamas." The Treasury Department also designated the Global Relief Foundation, headquartered in Bridgeview, Illinois, as a terror supporter because of its role in raising money for Al-Qaeda.
Jihadi Doctors in the West
The involvement of medical doctors in the British bomb plots has raised several questions about how the phenomenon of jihadi doctors spread to the West. British authorities asked both whether the Muslim doctors involved in the London-Glasgow conspiracy were the exception or the rule and, if unreflective of mainstream Muslim doctors, whether their radicalization occurred before or after they arrived in Great Britain.
The answers are discomforting. The London-Glasgow group does not appear exceptional. The radical Deobandi sect with roots in India and Pakistan, the equally extreme Wahhabi movement with its base in Saudi Arabia, and the Muslim Brotherhood, whose origins lie in Egypt, have each made inroads into British society. Each has targeted outreach efforts to doctors, engineers, and lawyers. Deobandism and its missionary offshoot, the Tablighi Jamaat, flourish in urban communities in Britain among the educated and affluent. Radicalization of elite professionals is more a product of the ideological conflicts within Islam itself than of social conditions or political issues in Britain. Not all physicians join radical movements, but their presence in these movements, according to anecdotal reports in the Muslim community, exceeds what might be expected if their only motivation were foreign policy grievance. Such anecdotal evidence suggests that radical Islamists target them for recruitment. The West should expect many more examples of Islamist doctors to appear in the future.
The problem is compounded for immigrants studying in the West and their progeny by the manner in which U.S. and European universities teach medicine. Because they focus primarily on hard science, Muslims can go through the courses with very little exposure to the arts and humanities and, therefore, not have their sometimes simplistic views of religion challenged. In Britain, where medicine is an undergraduate field, the chance that Muslim doctors will receive any college-level training in humanities is slim.
Such an educational milieu allows radical Islam to present itself as a rational and modern expression of faith, suitable for a scientifically-trained professional. A radical interpretation of Islam is uncomplicated, requiring little real study or reflection, and can often, therefore, be more attractive to professionals who must dedicate their lives to hours of medical memorization.
In the United States, doctors with Islamist leanings are increasingly active in the promotion of radical interpretations. In 2003, the federal government charged Rafil Dhafir, an oncologist from Syracuse, New York, and three other persons with conspiring to violate sanctions by transferring funds to Saddam Hussein's Iraq. Convicted two years later, he is now serving twenty-two years.
In Toledo, Ohio, Islamist doctors spearheaded the takeover of a once-progressive mosque that had preached respect for other faiths. They began by promoting the writings of Qutb and Abu al-A'la Mawdudi, founder of the Islamist Jamaat-i Islami in India and Pakistan, and ended by organizing a vote to oust the mosque's moderate leadership. A former congregant at the mosque said, "What surprised me was that this takeover scheme was masterminded by Muslim physicians." He suggested that the majority of Muslim medical doctors in the region had embraced radical ideology.
When the doctors took over the mosque, they temporarily succeeded in removing an American flag from the premises although three converts to Islam demanded it be returned to a place of honor. Islamic religious instruction at the mosque became saturated with extremism; one religious teacher called for the beheading of U.S. military personnel in Iraq. Congregants who criticized such radicalism and the substitution of politics for theology were branded as "Zionist, neoconservative spies helping the U.S. authorities in the destruction of Islam." In February 2006, the FBI arrested an alleged cell of three terrorists in Toledo.
In a similar case in California, a prominent member of Masjid Abu Bakr, the largest Sunni mosque in San Diego, conducts religious courses imbued with radical interpretations and offers discounted dental services to his students, an attractive perk to immigrant Muslims who may not be wealthy.
Perhaps the most famous Islamist doctors in California are the Egyptian-born brothers Maher and Hassan Hathout, who have been prominent in the Islamic Center of Southern California, as well as such organizations as the Muslim Public Affairs Council (MPAC), a Saudi-funded Islamist front group. Maher is a retired cardiologist while Hassan is an obstetrician and gynecologist.
Too often, the conduct of extremist Muslim doctors is rationalized as a protest against deprivation and corruption in Muslim majority states or a reaction to the humiliation of Palestinians and Iraqis at the hands of Israel, Western Europe, or the United States. While popular, there is little evidence to support such analysis.
The radicalization of Muslim doctors is more systematic. They occupy a superior stratum of their society and, as such, are targeted by radical ideologues. How then can medical professionals and governments in the West respond to this challenge? Vetting of Muslim doctors for radicalism may prove ineffective and will doubtless raise civil liberty concerns. More possible would be closer monitoring of radical Islamist groups in order to counter incitement and preempt violence. Radicalization of Muslim doctors is only a symptom, however. Until the West pressures Muslim governments—especially Saudi Arabia, the United Arab Emirates, and Pakistan—to stop their financial support and that of their citizens for radical ideological groups, Islamists will erode not only medical ethics but other aspects of Western liberalism.