As the sun sets over London this Ramadan, Budoor Al Budoor, an intensive care specialist working in the city, ends the daily fast in a hospital break room. She eats alone at the start of her shift before another night tending to patients acutely ill with coronavirus.
With mosques shuttered during Ramadan this year and extended families separated by coronavirus lockdowns, the religious holiday is markedly different for most Muslims.
For UAE doctors thousands of miles from home battling the coronavirus, Ramadan is characterised by hardship and isolation but also the opportunity for spiritual reflection.
"I think working in Ramadan by itself has its own virtue and doing what I do has been a spiritual experience in these days especially," the 32-year-old clinical fellow at King's College Hospital told The National.
“These are not ordinary times and what I am doing ultimately might be hard. I might be losing patients sometimes. But there are lots of people who are getting better. I just feel like I have been graced to be able to do this during this time.”
In the midst of the public health emergency that has gripped the world, Dr Al Budoor said concentrating on the task at hand and the support of her colleagues helped her get through the worst of the crisis.
“We are pulling together and doing the work because we are all sharing the same feelings of anxiety,” she explained. “It definitely did boost morale. It really felt like we were all in it together.”
However, the disease is cruel. It can strike down otherwise healthy people unexpectedly and because of social distancing often patients die alone or with only medical workers for comfort.
“It's worse because these patients are literally gone too soon,” Dr Al Budoor explained. “You have to call [the family] when the patient is at their worst, is dead or dying, that's difficult. We try hard not to let anyone die alone.
“Usually we give them their privacy, we allow the family to be there. But because of the infection we really can't do that. The risk of infection is really, really weighing on all of us.
As well as dealing with the high death rates Dr Al Budoor has had to care for colleagues in the ICU, taken ill with the coronavirus.
“There are a few now that are still critical but generally it has been tough. When it is one of your colleagues it is not a pleasant thing to go through,” she said.
Dr Al Budoor is in touch with her family in Dubai in a daily basis. Her brother, also a doctor, is tending to patients in the UAE and although he is nearby is self-isolating from the family to stop transmission of the disease.
The space that would normally be filled with family, food and entertainment is replaced this year, she explained, with introspection. “With that cultural aspect gone this has become one of the most spiritual Ramadans I have had,” she said.
Dr Abdullah Alhelali, 30, who began training as a resident doctor, at Regensberg Psychiatric Hospital in Germany two years ago said the first few days of the difficult Ramadan away from home had made him appreciate the smaller things.
“Not only are you living through the whole coronavirus situation but also the situation of not being home in Ramadan. This makes me much more appreciative for my family and being together with the family and the precious moments that we take for granted sometimes,” he said.
The small moments he recalled were those like travelling with his mother to buy Indian samosa before iftar.
“I miss this time of driving the car with my mother to buy samosa for iftar. This half an hour with my mother during ramadan alone, driving in a car to bring samosa and then the smell of it in the car as we drove back home that's one of the things I miss about home,” he said.
In the face of the coronavirus crisis, Regensberg hospital has changed significantly. Patients who have contracted Covid-19 are cared for on separate wards and only the most severe psychiatric cases are being admitted.
“The patients we admit are severe cases of depression and anxiety and schizophrenia or addiction so they all need help and they couldn't deal with it alone at home,” he explained.
Many of Dr Ahelali’s lectures and training sessions have been cancelled and in the evenings he breaks his fast alone, socially distanced from the other Muslims on his course.
“It has been difficult the first couple of days. But I think as the month goes by I will be more accepting of the situation,” said.
Seeing his family on social media means Dr Ahelali has been more keenly aware of what he is missing. He said he knew an essential ingredient of Ramadan was absent without family and community nearby.
“In the age of social media, you see what your family is eating and what your family is doing and the rituals that you used to be part of at home,” he said. “The taste of Ramadan comes when you come together and you share this meal together at the end of the fasting day. At home when you come for iftar it is not about coming to eat it is about coming for this meal and feeling grounded and being at home.”