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Religion has been given a paramount importance in cultures across the globe. It has been considered an integral part of cultural beliefs system. Religion plays a significant role in shaping individuals` worldviews. However, the level of attachment with one`s own religious beliefs varies from person to person. The level of attachment with religion has a strong relationship with one`s life experiences. Certain life calamities can take one closer/away to/from religion. As religion often concerns questions related to life hereafter, individuals tend to develop an intimate relation with it whenever they face life-threatening crisis in their lives. Terminal illness is one such unfortunate life events which makes people to search for answers to questions related to death. This paper seeks to investigate the role of religion in the lives of terminally-ill people. Based on the findings of our research on three terminally-ill people, this paper will argue that people tend to turn towards religion more when they are faced with life-threatening illness. The level of religiosity of patients increases during the course of their illness in terms of their greater engagement with different religious practices (religious text and rituals etc). While the role of religion in the lives of terminally–ill people has been studied mostly from psychological perspective, this article seeks to counter the balance and tends to look into the role of religion in the lives of terminally-ill people from an anthropological point of view. This implies to investigate in what different or similar ways religion plays out its role in the lives of terminally-ill people and what kinds of meanings people attached with it.
A two months fieldwork was carried out for this article in Lahore, during which three terminally-ill patients were interviewed. Two of the research participants were cancer patients while one was a patient of AIDS. Lahore, the capital city of the province Punjab, is an important economic hub of Pakistan and hence attracts a large number of people from the surrounding areas for its better job prospects. Majority of the population is middle and lower-middle class and most of the earning people population either has government jobs or have their own small business set-ups. Like elsewhere in Pakistan, a large part of the population is Muslim with Sunnis making the bulk of them. Other sects among the Muslims in the city include Shias, Ahmadis, and a small number of Ismailis. All of these sects follow various Islamic tenets in various different ways from one another. However, our research only focused on Sunnis mainly because of their greater proportion and hence easy availability in the city. While most of the people strongly identify themselves as Muslim, it is their specific sect within Islam to which they feel much strongly. As compare to other sects, in Sunni Islam the prime importance is given to Quran and the sayings of prophet Mohammad (PBUH) in religious matters. They are required to pray at five specified times in a day. Quran is the holy book and its recitation is considered an act of great value and piety.
The Turning point
Forty-years-old Munir* was living a normal life with his wife and three children in a small house near the main market. He was happy with his life as he was able to run his family smoothly because of his government job. It was in December, 2011 when he got diagnosed with blood cancer and all of a sudden a happy life became a pipe dream for him. He could not believe what had happened to him but it was a bitter reality which he had to accept anyway. However, except his wife, he did not tell anyone about his illness. He calls his life prior to being diagnosed with cancer a “normal” life. He was not a “religious” man whom as he said “prays five times a day and recites the holy Quran”. While he was not regular in his different religious practices, he would consider religion as an important part of life. Religion was important for him in theoretical terms but not in terms of performance and practice. He considered himself to be distant from the religion prior to his illness.
Salim is fifty-five years old and lives with his wife, two daughters, and three sons. He owns a footwear shop from which he earns enough to support his family. Two of his sons also work which makes it easy to fulfill household expenses. Salim was diagnosed with lung cancer in June, 2011 and since then he has been living a fearful life as doctors have declared his cancer to be in an advance stage. Like Munir, Salim too recalls that he was not regular in his religious practices. Though he would follow religion, he never gave it the degree of importance that he started to it after being diagnosed.
Adil is forty-three and until recently worked overseas as a labor. He was abroad when doctors told him to get a diagnostic test for AIDS and unfortunately his test results were positive. Soon after being diagnosed with AIDS he decided to return home and pursue his treatment in Pakistan because of relatively cheaper treatment expenditure here. In Pakistan his family consists of his wife, two sons, parents, and a sister. However, his wife left him soon after she came to know that Adil has return with an illness which she linked, as Adil said, with his bad relations with other women abroad. Adil suspected that his wife might have left him because of her unpleasant relationships with his sister and mother as she would complain to him about his (Adil`s) mother and sister behavior towards her. In terms religious life, Adil calls himself to be distantly away from religion prior to his illness. He did not consider religion as an important part of his life and always thought of it as a fazool, useless thing. Religion became of a secondary importance to him when he went abroad nine years ago. Adil blamed the circle of his non-religious friends for him being a non-religious.
Prayers: an essential component**
Munir sees praying five times a day an integral of part of Islam. Ever since he got the illness, Munir always makes sure that he does not miss any prayer. Hearing about his illness the first thing he did was to go to a nearby mosque and offer nafl, extra (optional) prayer. He said that he knew that his life would never become like before. He stayed in the mosque until the zuhr, afternoon prayers and all of that time he just kept on praying and asking Allah for his pardon. To Munir, it is not just parying five times a day rather it is all about praying from the core of one`s heart. Also, he thinks that praying at home does not bring that much sawab, reward which a prayer offered in the mosque does. Munir would rarely, generally only on Friday, go to the mosque nearby his home. Before his illness, going to mosque and saying prayer was one of the hardest things for Munir to do. He would spend his lunch and zuhr prayer break in talking to his colleagues at his job place. Some of his colleagues were regular in prayers and they would offer their zuhr prayer during the prayer break. Though Munir would sometimes offer his prayer at office, he never went to mosque during his prayer break, except on Fridays. However, this has changed ever since his being diagnosed with cancer and now he finds going to mosque a source of great satisfaction. Pehle masjid jane ka dil nahi karta tha lekin ab masjid se bahar dil nahi lagta, earlier I would find it hard to go to mosque but now I do not feel good outside the mosque, he says. Now he is one of his colleagues who regularly go to mosque for offering prayers. He prefers to remain in mosque rather than talking with his colleagues. Praying at mosque is not only a source of comfort for Munir but it also helps him to spend his whole day in a scheduled way. His life has become more productive with it as he is able now to manage different tasks more wisely. Earlier he would not be able to carry out his daily tasks according to schedule, he would often lag behind in completion of different tasks but now it is completely different for him.
Salim, too, has started offering prayer more regularly as compare to earlier when he was not diagnosed with the disease. Although he prefers offering prayer at mosque to home, he is not punctual in going to mosque. Ever since his illness, Salim tries not to miss any prayer and to go to mosque as often as possible. But sometimes it is not just possible for him to go to mosque especially for isha, evening prayer because of the mosque being away from his home. It is not just offering the prayer which has been increased for Salim, the pattern of offering the prayer has also changed for him. As compare to earlier, now he prays for a longer time. He says, the more time he spends on praying the more he becomes oblivious of his illness. Also, he has started telling his children to pray regularly and often takes his youngest son to mosque with him. With going to mosque Salim has developed a new habit of attending bayaans, religious sermons which are often given at after maghreb prayer. Attending these sermons is a way for him to learn about Islam, es se bohat si nai cheezon ka pata chal jata hai, it (sermon) helps in getting know a lot of new things (about Islam). After being aware of different new things, Salim tries to incorporate those things in his life. He tries to follow what has been said in the sermon. However, his not being punctual in going to mosque makes it impossible for him to attend every session of the sermons and hence he has bought Fazail-e-Amal, a book which contains sayings of the prophet Mohammad (PBUH) concerning different religious matters. One of his sons reads excerpts from the book each night at home while all the family members are present to listen to it.
For Adil, his attitude towards prayers has not been changed much since his illness. He considers himself not a religious man who “spends most of his time in mosque”. Owing to his life abroad where he had friends circle consisting of both Muslims and non-Muslims and where his Muslim friends never cared about offering prayers, Adil too had never offered his prayer abroad. Even after his illness he did not feel the urge to pray. It was not until his return to Pakistan that he started offering prayer regularly. Most of the times, Adil prays at home but sometimes he goes to mosque when his parents ask him to do so. He thinks of prayers to be of no good. Offering prayer does not offer him any comfort and most of the times he just go to mosque because his parents have asked him to go.
Search for deeper meaning
People faced with an unfortunate life event are more likely to use religious scripture as a way of comfort and feeling better about their life (Koenig 2002). Religious scripture being consider a divinely thing gives people the hope that it may help them in their trouble. Munir regularly recites the holy Quran. He gives a paramount importance to Quran and considers it a great source of knowledge for people. Although he gives importance to the whole Quran, he recites certain selected verses from the Quran on daily basis. He has made it his routine to recite the ninety-nine names of God twice a day, in the morning and at night before he goes to sleep. However, he further gives more preference to certain names of God over others. He has memorized certain Quranic verses which he reads on daily basis. About the selection of certain verses he said that he chooses the verses with meanings which he thinks suit his purpose, mein woh ayats hifz krta hun jes ki maani muhje sahi lage, I only memorized those verses the meaning of which seem relevant to me. Similarly, Munir has memorized certain names of the God which he thinks have meanings relevant to his illness. His memorized names of God included names like Al-Mohyee (the life giver), Al-Momeet (the life taker), and Al- Razzaq (the provider). However, when asked why he recites the name Al-Razzaq, as its meaning does not concern illness, he replied that as his children are too young and he is the sole breadwinner of his family he wants God to provide for his family after his death. Along with this, Munir has also memorized certain Quranic verses which he recites whenever he finds time for it. Again, his reason for choosing certain Quranic verses was the relevance of their meanings with the purpose for which he would recite those verses. Among the Quranic verses he had memorized Sura-e-Mulk, which he thinks would protect him in his grave.
Munir searches for the deeper meaning of whatever he recites. For him it is the meaning of the text which makes him decide on what is to recite and what is not to. As mentioned earlier, Munir looks for such verses which he thinks have some significance and could help him through his illness. After being diagnosed with cancer he bought a copy of the Quran with Urdu translation and started to recite it with translation ever since then. He does not pickup random verses from the Quran.Whenever someone suggests him a verse from the Quran to recite the first thing he does is to look for its meaning and if he feels that the meaning of the suggested verse suits his purpose he adopts it. Ever since he has started reciting the Quran with translation, Munir has never felt the need to seek help of religious scholars for interpreting to him what has written in the Quran. Munir does not prefer translation of the Quran merely for the sake of selecting verses from the Quran for wazifa, repetitive recitation, but he prefers it also for understanding what has God asked people to do. He tries to regulate his life according to the teaching of the Quran. He also has a tafseer, an elaborated interpretation of the Quranic verses. He uses it whenever he finds any difficulty in the meaning and hence he thinks of himself as a person who does not need to consult maulis, Islamic religious scholars for an issue which he can resolve by himself through his interpretation guide.
Embodying the text
The religious text is engaged with not only through recitation but also through embodying it through wearing amulets. Although Salim was not Quran literate, he uses different Quranic verses in the form of wearing amulets. Wrapped in black leather, Salim wears two amulets attached to a single thread hanging down through his neck. Unaware of the amulets` text, let alone its meaning, Salim has a strong belief that whatever he is wearing is of great significance. He claims, es ka bohat faida hai, mein acha mehsoos krta hun, it has an advantage, and I feel good with it. He says that had the amulets not of any good to him he would have thrown it. Salim believes that God never makes things harder for people; rather He provides comfort so that people could not complain of the difficulty of the din, religion (Islam). Salim talks of Amulets` advantage in terms of its being easy to carry and that one can have it all the times. One does not need to recite it or something it is just to be worn. For Salim, the efficacy of Amulets lies both in its being sacredness (the use of sacred Quranic text in it) and its presence with the person all the times. He does not seem to be much concerned with the meaning of his amulets` text. Rather he considers that all the verses of the Quran are equally sacred and important. To him, one can never prefer certain verses to others. That`s why he thinks of his amulets in terms of the whole Quran, ye Quran-e-pak ki trha hai, these (amulets) are akin to the holy Quran.
Apart from wearing amulets, Salim also keeps Surah-e-Yasin in his chest-pocket. Although he cannot read it by himself, he often asks his daughter or son to read it to him loudly at night before going to sleep. In order uphold the sanctity of the amulets and Surah-e-Yasin, Salim puts them at some higher place while going to sleep. However, he has memorized certain short kalmats, verses, which he recites at specific times as told by people who have suggested those verse to him. Still, because of his unwariness with the Quran, he does not believe in himself to able to read those verses in the way in which they need to be recited. Owing to that, he prefers wearing amulets and keeping the Yasin in his pocket. He keeps the Yasin in his chest-pocket because he thinks that it’s the ‘heart’ of the Quran so one needs to keep it near his heart.
Medicines vs. the sarkar`s company
Salim regularly visits a local saint, which he calls with the name of Sakar. Whenever he finds time he visits Sarkar`s where he sits with him for hours. Salim came to know about Sarkar three months ago through one of his friends. At first he would visit Sarkar`s once in a week but later on he got too close to him and started visiting him more often. Sarkar lives nearby so it is not an issue for Salim to meet him. Sarkar has a great influence on Salim`s life and he (Salim) thinks of Sarkar as a leader and guide to him. The Sarkar`s company provides so much solace to Salim that he sometimes abandons his medicines because they do not give him that much satisfaction which the Sarkar`s company does. Salim says that he does not find the degree of comfort in medicines which he finds in the Sarkar`s company. When asked if Sarkar has asked him not to use medicines Salim said that he (Sarkar) would never ask him what to do and what not to do. It bothers Salim`s family a lot when he does not eat medicines. But to Salim, medicines are meant to provide comfort which he finds in the Shah Jee`s company rather than the medicines.
Social pressure
Adil is not so keen about being more religious. He does not want to be in mosque all the times, neither does he want to recite or wear any kind of amulets. For all of his life he has never been enthusiastic about religion. But despite all of what have been said, his orientation towards religion has been increased since his illness. He has been going to mosque more frequently now and tries to stay in mosque as long as he can. Now he recites the Quran, which he said he had read for the first time since completing his Quranic education from a local mauli, Islamic religious scholar. But he does all of this because his parents and neighbors expect it from him. He adheres to religious matters to escape people`s criticism because, due to his serious illness, the surrounding people expect him to be more religious, offering prayers and reciting the Quran. By adhering to religion, Adil also escapes the unwanted comments of people about his character, nemaze shemaze parhne se ye hota hai ke log ye nahi samajhte k mujhe AIDS es leye huwa hai ke mein parhezgar nahi hun, because of offering prayers people don`t think of my being inflicted with AIDS as due to my impiety (unreligious). However, whatever may be the reason behind his being more religious now, Adil thinks that religion does provide him some kind satisfaction and by following religion he feels more like a member of his community. But still, the level of satisfaction that he gets from being religious is not of significant amount. That is why he says that if he were living somewhere else where people would not expect him to be religious he would have not cared about it (religion) as much as he does now.
Re-visiting the role of religion
After being diagnosed with their diseases, the orientation of all the informants towards religion has been increased. But despite the fact that all of the three informants have the same socio-economic and religious background their attitude towards religion is profoundly different from one another. Each one of the informants puts to fore a different religious aspect. One (Munir) emphasizes on the personal relation to religion. He does not need religious scholars to interpret to him what has been written in the Quran. To Munir every person should learn by him/herself. He adheres to such religious practices which are of individual nature, such as reciting the Quran and memorizing different Quranic verses for the sake of reciting them at different specific times. He translates the Quran by himself and always checks the relevance of different Quranic verses to his illness. The other (Salim) emphasizes on embodiment of the Quranic text without any concern for its meaning. Also, Salim seems to be giving more importance to religious authorities. He sees Sarkar as a guiding persona for him. Unlike Munir, Salim is more likely to follow on what other people suggest to him. He believes that his own knowledge about Islam is not enough to decide on his own about following different religious matters.
The case of Adil provides a very different attitude towards religion. Despite the fact that he follows religion to escape people`s criticism; it, however, would be difficult to say that his terminal-illness has not any effect on his relation with religion (McGrath 2003). Neither can we say that Adil has developed negative attitude towards religion after being diagnosed with AIDS (Lavery et al 2009). However, it is important to point out that in the case of Adil religion provides him with a sense of being member of his community. By adhering to religion, Adil makes sure that he has been seen as a “good” member of the society. Still, when asked if he would have followed religion in the same way if he were not inflicted with AIDA, Adil answer was in negative. This provides us with a clue that his terminal-illness and religiosity has a positive link.
All of the three informants related religiosity with hope, overall satisfaction, and psychological well-being (Heo 2009 and Jones 2004). The fact that people terminal illness are faced with the fear of looming death leads one to think that the positive relation between religiosity and terminal illness is due that fear (Hoelter et al 1979). From our findings, however, we can conclude that none of the informants seems to explicitly link religiosity with the fear of death. Munir, says mujhe maut se darr nahi hai, I don`t fear death. Similarly, Salim considers his illness a message from God. To Salim, God has inflicted him with illness because He wants him (Salim) to know the real purpose of his life. And to him the real purpose of life is to worship God and make Him happy. However, choosing certain verses of the Quran by Munir with their meanings concerning life, death, and illness, it can be stated that fear of death does play an important motivational force for being more religious.
In conclusion, the meaning and understanding of religion varies from individual to individual. Every person tends to emphasize that aspect of religion which s/he thinks would be of certain importance to her/him. Religion provides people with a tool to make sense of their own lives. However, it would be an exaggeration to term religion as an important aspect of terminally-ill people lives. Terminally-ill people`s attitude towards religion varies just like the “healthy” people`s attitude towards religion. It would not be right to say that terminally-ill people have the same kind of motivation, that is, their illness and fear of death, behind their being more religious. Like other people, terminally-ill people might have been following religion for a lot of different reasons, which may include their personal motivation (like in the case of Munir and Salim) or a social pressure (like Adil in this case).
Written By: Waleed Khan (LUMS)
