Businesses in Ramadan: strange hours but similar problems for UAE hospitals

Most health problems during the holy month at Burjeel day surgery centre are related to fasting and medication, doctors have said

Abu Dhabi, U.A.E., May 31, 2018.STORY BRIEF: how hospitals deal with the influx of patients during Ramadan and the problems they face.  (L-R) Dr Fadi Baladi, medical director of the Burjeel day surgery centre in Abu Dhabi, Michael Ghani, director of operations. 
Victor Besa / The National
Reporter: Nick Webster
Section:  National
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At the time of day when most people are relaxing and breaking their fast, doctors at the city's clinics are just getting started.

And while no day is the same in medicine, hospitals are seeing more patients with diabetes or asthma coming to them with fasting related health problems.

Many health related issues during Ramadan are due to medication, with patients unsure of taking their prescribed treatments during periods of fasting, or at the wrong time of day.

The effects can be devastating, with medical staff at the Burjeel Day Surgery Centre on Al Reem Island recording a spike in hospital admissions either first thing in the morning, or later at night.

“We see a lot of problems with the timing of medication taken by our patients that cause problems during fasting hours - because of that, relapses are common,” said Dr Fadi Baladi, medical director of the surgery.

“Because of the nature of the diseases we are treating related to fasting, we do see problems related to gastro intestinal conditions and dehydration in the heat.

“With asthma patients, we have seen some who are worried about breaking their fast by using their inhaler.

“A patient has come into the hospital because her asthma has become a problem.

“When I asked her about the medication, she told me she was taking her daily dose in just four or five hours, rather than the stipulated 24-hour cycle. This was causing a problem.

“Patients with diabetes are also having the same problems by postponing their insulin and this is dangerous.”

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Most admissions come from a minority of the hospitals patient community, as 70 per cent are expatriates and non-Muslims, staff have said.

Those with diabetes are most at risk from fasting, and should check with their doctor it is safe to do so.

Insulin injections to control type one diabetes often need to be administered 12 hours apart, but doctors said some who are fasting fail to do this and end up in hospital.

“We wouldn’t usually see these patients during the rest of the year, it is only during Ramadan that they have problems with their medication control,” Dr Baladi said.

“Anyone receiving injections, inhalers or pills should continue – even doing some health tests is difficult during Ramadan.

“Some wait until iftar, and then choose not to come until the day after so it creates a problem.

“We have extra staff in later at night, and transportation for them can be difficult late at night but we try to help as much as possible.”

Patients who continue to take blood glucose lowering medication during the daylight hours of fasting, may increase their risk of hypoglycaemia, or low blood sugar level.

This can result in dizziness, confusion, seizures or even death in extreme cases.

Those with diabetes taking insulin should not stop treatment as it could lead to diabetic ketoacidosis, a dangerous short-term complication which can lead to diabetic coma.

Michael Ghani, director of operations at Burjeel Day Surgery Centre in Abu Dhabi, said all steps are taken to ensure services are available to patients when they’re needed.

“Most of the time, patients are fasting during the day so they so not want to see their doctor,” he said.

“We’ve decided to make our specialists available from 8.30pm-11.30pm. Normally we are working from 9am until 10pm, but it is usually very quiet during the daytime.

“There is a hotline people can use and although we modify the staffing schedule, it is pretty much business as usual.”