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A Western Muslim's Guide to Hijrah

Part IV: Standards of Living and Health Care

Lower Costs of Living Often Mean Lower Standards of Living

One thing people crow about when they talk about hijrah is the lower cost of living. It’s like a bonus in their minds. Not only are you living in a place where they make adhan, but the cost of living is so much lower than the West! However, very often, with a lower cost of living comes a lower standard of living. Not always, but in many cases. Sometimes the lower standards are quite bearable — no dishwashers or dryers, for example. Sometimes, however, you have to give up a lot, including luxuries like Western food products, the internet, land line phones, flushing toilets, electricity, and running and / or clean water. Are you prepared to give this stuff up? You may think you can do it for the sake of Allah, but when you’re on day 97 of no running water, making wudhu with amoeba-infested water you had to haul from a well or pay a truck to deliver, you might very well find yourself at the end of your emotional and diyni rope. It may be particularly had on you if you are from an urban or suburban background. Yes, without a doubt there is rough living in some of America’s cities and even in her suburbs and rural areas. But all over the country, we have running water, 24 hours of electricity, and many other things. So you really need to think if you can live in an area like that, or if you’ll have to stick to city living.

A few years ago, there was a lot of noise among some Western Muslims about making hijrah to a mountain region of an Arab country that was, largely, beyond the control of the central government. Quite a few people did pick up and go; I knew some of them. What they found was a village where, yes, there were da’iyees and a markaz and people did tend to adhere to the minhaj that they agreed with. What they also found was that they were living in cement and mud huts with dirt floors and no real roofs (they had some sort of screen cover that you could overlay another cover on if it rained) (those who could afford it had rough cement floors), no electricity (car batteries were used), no running water, no clean water, no prepared or processed foods, no hospital, no clinic, no local doctor, no bus, no taxis, no medicine, no school. They were hundreds of miles away from the capital, dozens of miles away from the nearest doctor, dozens and dozens from a hospital or clinic. There were one or two tiny shops where people could purchase necessary food and home things: rice, soap, vegetables. Remember my friend with the typhoid? Yeah.

Now some people thrive in this. They can handle it, and it enhances their faith. Others don’t. It doesn’t make you a better Muslim if you can, and a worse Muslim if you can’t. If you’re thinking of moving to a place like this, perhaps you should do a “dry run” before you commit — if you can afford it. If you can’t afford to go visit the place for two weeks or a month, try it out in your home. I’m serious. Stop using electricity. Use your running water for a few hours a week, putting it in buckets and then using it from there. Do your laundry this way with the cheapest powdered soap you can find, and then air dry it. Don’t use your fan or central air or central heating. Sleep on the floor… on cheap, thin foam mattresses. Just try it out. And before you go, make sure you have an out. Whether it’s a plan to move to a city or a return ticket home, make sure you have a way out. Not every place is like this, of course, but if you’re thinking of going to a place like that because Markaz Such and Such is there, you should at least try roughing it at home before you spend thousands of dollars to go somewhere you can’t hack. If you can't do it at home, where "roughing it" will still be legions easier than it will in the real situation, then you need to think of another plan.

For others, going to a Muslim country will mean they live in relative luxury. You can afford a much bigger place, a car, servants, and other amenities that you might not have back home. Don’t get caught up in that. Are you going there to have a villa with marble floors, or are you going for the sake of your diyn and your children’s diyn? I’ve seen people get caught up in the fact that they’re suddenly in the upper class, with the money and the means to do things that were unavailable to them in the States and that are unavailable to most of the people in their chosen country. Don’t be one of these people.

For still others, particularly those traveling to rural or more underdeveloped places, you’ll be living somewhere in between the luxury of many expats and the “off the grid” living of some muhajirun. For example, you may find many houses made of cement. Water does not run 24 hours a day, 7 days a week, and may not be safe to drink. Electricity may go on and off throughout the day (or, more usually, in the night). Internet, other than dial-up, may not be available, or may not be available on a regular basis. There may not be central heating or flush toilets. Little things like this, for some people, can really add up to one huge fitnah / obstacle.

You also need to look at the crime rate in the country / city you'd like to move to. I'm not talking about terrorist incidents, although those certainly can be a concern, but petty crime, robberies, murders, assaults, and so forth. Frankly, there are some cities in Muslim lands that are crime ridden. As a foreigner you may find yourself targeted as well.

So sit down as a husband and wife, or with your parents, friends, whoever if you are single, and honestly look at what the standard of living is going to be like and if you can handle it. (Remember, if you can afford it, I highly recommend that you visit your chosen land first). Can you live without your DVR? Can you live without cable internet? Can you deal with having to purchase drinkable water several times a week? Can you deal with having to buy water to wash with from a truck? Can you live without grape jelly for your sandwiches, or corn tortillas, or Dr. Pepper? I think that, after some difficulties, many people find that they can live without these things. However, others find that it’s too hard (although I think that can be an issue of transference: transferring their homesickness for other things on to tangible material items like grape jelly).

Health Care Matters

I mentioned “clean drinking water” and “running water” a few times. That’s a big one that people from the West may not think about. I know that I think about it all the time because we have to, and we live in a very modernized capital city. Drinking non-purified water (non-bottled) in many countries will have you doubled over with the runs at best or flat on your back in the hospital with dysentery at worst. In some countries, lead and arsenic in the water is a real concern. Regardless of which country you go to, you will probably experience a few weeks of stomach trouble, even with only purified water to drink. That’s normal, and also happens to people from other countries who visit the United States. It’s just a difference in what organisms our systems are used to. The best thing to do is let your system work it out. Taking anti-diarrheal medicines does not eliminate the problem, it only stops your body from getting it out. In some places, you may not be able to eat fruits or vegetables that don’t grow on trees or can’t be skinned.

I urge you to remember, however, that diarrhea is one of the leading causes of death in children, particularly those under five, in the so-called “third world.” You must be very careful with your children, especially younger ones. Every year, somewhere between 5 and 8 million people die of infectious diarrhea, many of them children. Although for many travelers it simply indicates a period of adjusting to the food and water, for others it can be a life or death situation. The lack of clean drinking water is often the culprit.

Most Muslim countries do not have the standards of health care that Canadians, Britons, Australians, Americans, and others are used to. Fortunately, in most major cities in the Muslim world, you can find doctors who speak English and / or French and who trained in North America, Europe, or the Caribbean. You can find private hospitals, many catering to the rich and the military, that can provide a satisfactory level of care. In many cases, the cost of going to the physician will be more affordable. For the most part, HMOs and health insurance are pretty much unknowns. You pay doctors out of your pocket. There is health insurance in some of these countries; it comes from employers, and I’m not sure how it works. I only know that not everyone has it, even if they have a good job. This is something you really, really need to check out before you make a decision; if health insurance will not be available to you, you need to make sure that you’ll have money in your budget for the doctor, dentist, clinic, hospital, and medications.

Two very important things you need to consider in relation to your health (besides water and food concerns) are your teeth and childbirth. I have some friends who made hijrah to a rural area, hundreds of miles from the capital, in a less developed country when their older son was 2 and lived there until he was about 6. When they returned, his teeth were brown, crooked, really skinny looking, in the wrong positions, and the enamel was worn away. Not only is childhood tooth decay bad for them now (it can affect how they eat and decaying teeth are generally bad for your health), but it can affect their adult teeth later. The water, which you probably can’t drink, may not be fluoridated. There is a chance that the drinking water you purchase will not be. In addition, sugar (in the form of juices and candies) is readily available and cheap in many places. In Jordan, for example, the school snack bars often sell nothing but sugary drinks and candy. Now, if you live in one of the more developed countries and / or in the capital city, you can easily buy things like Crest or Close Up (which have fluoride), but if you don’t, it may be hard to find. You’re going to want to know a dentist that you and your kids can go to (perhaps an ortho as well) for regular check ups and for emergencies. If you choose to live in a rural or isolated area, this is even more urgent.

The second issue I urge you think about carefully is childbirth. I have heard horror stories from women who made hijrah (and women who are locals) that would make you never want to have a child anywhere. Personally speaking, for me, if it came to it, I would return to the United States to have a child. Labor and delivery, especially in state run hospitals, is not the same as it is in the West. In some places, midwives aren’t the nice, cozy, granola crunching ladies with nursing degrees we all love, but ignorant women who don’t even know about washing hands to get rid of bacteria. I’m not making this up. I have known women who have had these types of experiences with midwives and home birth in the Muslim world.

In some places, childbirth philosophy is about where it was in the US forty years ago: shaving, enemas, and twilight sleep. Birth plans are unknown. You are probably generally expected to do what the doctor and nurse tell you. I have heard stories of things I personally consider outright abuse by hospital staff, particularly nurses, of women in labor. You may not get an epidural or any sort of pain relief. Your husband may not be allowed to enter the room with you and provide his love and support. Water birth and other things are not easy to come by. In some countries, home birth is illegal. Having a bad or even traumatic birth experience can have a severe emotional, mental, and spiritual impact on a woman and / or her husband. Minimize any unforeseen emergencies by making sure you know what the birth culture is like in your country of choice and preparing for it.

In other places, you will find doctors, nurses, and midwives who are educated about different birth philosophies and supportive of things like water birth, walking in labor, home birth, and so forth. If you think that you may live over here permanently, if you think you might be having children here, then you need to know what it’s like where you are, and decide if you will be able to afford to return to the West to have your children, if it comes to that.

Another health issue you need to consider is contagious diseases. Throughout the “Global South,” to varying degrees, diseases like dengue fever, yellow fever, cholera, typhus, typhoid fever, malaria, hep A, B, and C, diphtheria, dysentery, parasitic diseases, TB, and many other scary things ending in -itis are endemic. I’ve heard stomach churning stories from ex-muhajirun and muhajirun about doctors and nurses reusing needles, as though HIV and hepatitis are not a concern. Not too long ago, in a well publicized story, a young muhajira died of malaria while fleeing fighting. The region she was in, which she had traveled to because she and her husband believed it was an “Islamic state,” has no infrastructure and almost no decent health care to speak of. She traveled for the sake of Allah and died protecting her diyn, her family, and her life, of a fever and contagion, so we can say and hope that she died as a martyr. May Allah receive her among their ranks in Jennah. But her story should also make us aware that just as the locals are vulnerable, so too are we vulnerable to diseases long gone or unknown in our Western countries.

If your health is damaged, or the health and well being of your children is damaged, you may find your ability to remain in a land you otherwise love is compromised. You could spiral into a depression, and begin to forget why you came there in the first place: fisibillah. So make sure that you do a thorough investigation of health care options and the standard of living where you want to go, and make sure you’re ready to handle it. Even if you’re living in a villa, it is natural that you will have a rough adjustment period, you’ll be homesick, you’ll have stomach cramps, and things won’t be like you thought they would. But if you plan carefully and deliberately, even if it takes you months or years, you can minimize or avoid any damage to yourself, your spouse, and your kids, the type that comes through rushing headlong saying, “Allah will take care of me!”

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