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Obesity in the Ummah – The Struggle For Wasat

obesity

Let’s talk about overeating.  It’s a touchy subject, so I’ll start.  Over the span of 13 years I gave birth to 5 children and I also gained quite a lot of weight.  I’d like to blame the extra pounds completely on my pregnancies and the stress of motherhood, but that would be disingenuous. The truth is, I became overweight primarily because I turned to food — which is supposed to be healthy fuel for my body — as a source of comfort, happiness, stress relief, and indulgence. I consistently consumed more calories than I burned off, and I ate too many foods that were high in sugar and fat, but low in nutrients.  It wasn’t that I had zero willpower; every Ramadan, I could summon up the necessary self control to fast from dawn until sunset, like billions of other Muslims. Yet somehow, for the rest of the year, I couldn’t stop myself from saying “yes” to every chocolate chip cookie I met. 

Why couldn’t I control my eating on a consistent basis? Why did my willpower go out the window as soon as Ramadan was over?  I have always understood that our deen is one of wasat, or balance, and that we should not go to extremes in anything, including how much we consume.  Our Prophet (peace and blessings be upon him) famously said, “The son of Adam does not fill any vessel worse than his stomach. It is sufficient for the son of Adam to eat a few mouthfuls, to keep him going. If he must do that (fill his stomach), then let him fill one third with food, one third with drink and one third with air.” (al-Tirmidhi). 

Was I lacking faith? Was there something inherently wrong with me that made me overindulge?  Would I ever reclaim the fit, trim body of my youth and reestablish a healthy relationship with food?   

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It turns out that Muslims like me who have struggled with overeating and/or obesity are certainly not alone.  According to a 2018 report by the World Health Organization, worldwide obesity has nearly tripled since 1975. Muslim-majority countries have the dubious distinction of leading the pack. Currently nine of the twenty most obese nations on earth are, ironically, countries where the majority of residents spend an entire month of each year fasting!  Kuwait, Jordan, Saudi Arabia, Qatar, Libya, Turkey, Egypt, Lebanon, and the United Arab Emirates all share undesirable positions among the highest ranks of the world’s fattest nations.  

One 2013 medical study claims, “Adolescent obesity has reached a critical level in the Arab countries. Therefore there is an urgent need to establish programs to prevent and control obesity among schoolchildren in these countries.” In Pakistan, the outlook is similarly grim, according to a medical review undertaken in 2016 which concludes,  “Pakistan is currently suffering from an emerging epidemic of obesity. Effective interventions are required at population level to prevent and control this emerging public health issue.”

For most Muslims who grew up in the West, unhealthy food has been around for as long as we can remember.  Those of us who are currently middle aged have been surrounded by junk food — or at least images of it — since we were born.  If we watched TV, we grew up seeing thousands of clever, seductive commercials for Coke, McDonalds, Doritos, Oreos, and dozens of other processed and highly addictive foods. We have been exposed to these temptations nearly everywhere we have gone: school cafeterias, supermarket checkout lines, shopping malls, parties, sporting events, movie theaters, and even book stores. 

Isra Hashmy sees the ramifications of this lifestyle in her position as a Board Certified Family Nurse Practitioner at Massachusetts General Hospital where she has managed the diabetic patient population in a primary care clinic. Hashmy says, “The Muslims in the West, whether born and raised or immigrated, have adopted the fast food culture. They get food from drive-thrus, donuts before work, and order pizza at night. Due to the busy, fast-paced life of living in the West, they eat out more, which means more fried foods, high fructose, saturated and trans fats.” 

obesity

“Their lifestyle,” Hashmy adds, “does not lend itself to burning all the extra calories and fat they are consuming. They sit for eight or more hours and then get into a car, sit in traffic, and go home only to eat, and go to bed soon after. The issue is there is no movement and no nutrient-dense foods.”

The problem of fast food is not limited to people in the West, Hashmy says. “Having traveled to Morocco, Turkey, Egypt, Saudi Arabia, UAE, there is a common thread among them that I’ve seen which is food delivery services are incredibly popular. Families will order food from restaurants around town to bring the food home, and now there is not even a need to go out. The lifestyle also does not help to burn the extra calories. The weather has made it such that people sleep very late, eat at late hours, and then wake up late.” 

And yet, East or West, not all people are obese.  Why is this? Do some people just have stronger willpower?  A higher level of imaan?  Good genes?

Though weight loss programs have been trying to unlock that secret for nearly six decades (one of the first, and most famous, Weight Watchers, was founded in 1963), obesity is still on the rise in most parts of the world.  Every year new trends tap into the weight loss niche and promise results, but few seem to deliver lasting solutions. Some fads are difficult to follow and others have questionable health benefits. For people hoping to lose weight, it can be very hard to know which plan will actually work, and which one will be sustainable in the long run.  There are also stigmas attached with being overweight that make some people afraid to seek help for their problem.  

In an article called “Are physicians biased against overweight patients?,” author Rita Rubin, MA, asserts, “A 2015 review of literature on weight bias in healthcare found considerable evidence that negative attitudes and stereotypes about people with obesity influence physicians’ judgment, behavior, patient perceptions and even decision-making. Research has found doctors show less respect for overweight patients, spend less time with them in the exam room and feel justified to address excess weight ‘every chance they get.’”

Hashmy believes that Muslims face some additional challenges: “One stigma I find in Muslims who want to lose weight is they feel they are being vain, and it’s not in the religion to care about looks. A lot of education is needed to let them see, this is basic health. This is not about being vain, it’s about taking care of yourself, which is a requirement of our deen.”

Shabana Haxton, a Registered Nurse, Certified Diabetes Educator, and Certified Cognitive Behavioral Therapist who works with patients with diabetes as well as bariatric surgery candidates, agrees that Muslims might have to overcome some extra obstacles.  In her profession she has worked with numerous Muslim clients who want and need to lose weight. “I believe emotional eating is very common in our community,” Haxton says. “We show love via food. If you go to someone’s house and do not eat a lot, it is an insult to the host. The host keeps putting food on your plate, etc.”

It’s clear that Muslims tend to love and treasure their native cuisine.  Whether it’s biryani, maqlooba, kebab, bastilla, roti, or shawarma, the traditional food of a Muslim’s heritage is usually cherished, shared, and enjoyed with gusto.  While Allah SWT has forbidden recreational drugs and alcohol, most foods are halal. Therefore at almost every Muslim celebration — from Eid and iftaar parties to weddings to aqeeqas — food is always present, in abundance, taking center stage.  With cultures that celebrate primarily with food, plus a religious tradition that might seem to downplay the importance of physical appearance, plus the other stigmas that overweight people in general face, Muslims are in a particular bind.  What is the first step they should take, if they need to lose weight?

Hashmy suggests, “My first advice is to switch your meals. Generally, most people have their biggest meal at night, at dinner. I tell them to make lunch their biggest meal and dinner something lighter. Due to the fact that they are most likely less active at night, there is a greater chance of burning the calories consumed from lunch than a dinner they had at 9:00 pm or later.”

Haxton asserts that first — and crucially — overweight people must “Admit that they have a problem. Seek help. Over-consumption of food is not just a physical problem. It is a biological, social and emotional problem. Until we all get to the root of the problem we will not be able to succeed.”  She warns, “If we do lose weight by a fad diet, it will come back because the root cause is not fixed.” 

My own experience confirms Haxton’s opinion.  Over the years I’ve tried several diets, but none addressed the core issues — my addiction to sugar and my emotional dependence on food.  Alhamdullilah, last May, a friend told me about a book that would change my life and my way of thinking about food: Bright Line Eating:  The Science of Living Happy, Thin, and Free by Susan Peirce Thompson, Ph.D.  

Bright Line Eating (known as BLE) is based on the science of addiction and was developed by Thompson, a former professor of Brain and Cognitive Sciences who focused her doctoral studies on the elusive topic of weight loss.  In her book, Thompson describes how sugar and flour act like drugs in our brain, causing some people — particularly those who are highly susceptible — to be addicted to them in the same way others are hooked on heroin or cocaine. Thompson lists concrete steps we can take to overcome food addiction and to reclaim our health. Her four “Bright Lines” are clear boundaries we must not cross, and by following them diligently we rewire our brain to help us eat in a healthier way, with less cravings, less stress, and less reliance on fickle willpower.    

It is no exaggeration to say that Bright Line Eating has transformed my life.  I now understand why I overindulged for many years, and why the temptation to eat unhealthy foods was so great. “Moderation” is nearly impossible for an addict. One bite of an addictive food makes your brain crave more.  I had gained weight not because I was weak, lazy, or uncommitted to my faith or my health. It was because of the two drug-like substances — sugar and flour that were making my brain beg me for the next “hit.” 

Alhamdulillah, as of this writing I have followed Bright Line Eating for nearly eight months. In that time I have lost a substantial amount of weight, healed many weight-related health problems, and improved my relationship with food so that I no longer feel desperate for unhealthy options. I now enthusiastically recommend Thompson’s book to everyone who questions me about my very visible, very positive transformation.

To my overweight brothers and sisters, I send encouragement and hope.  There are solutions to your problems, professionals who are willing to help with compassion and knowledge, and weight loss plans that do work. Do not feel that you are a weak Muslim or an unworthy person if you struggle with overeating.  Scientists and doctors are still discovering what causes unhealthy eating patterns, and they increasingly realize that obesity is not due to laziness or any other character flaw.  If you are struggling with your weight, know that your Creator gave you a body as an amanah and that seeking help to improve your health is a sign of gratitude to Him.  

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For over a decade, Laura El Alam has been a frequent contributor to various Islamic magazines. In her work she frequently addresses issues related to converts' experiences, women's right in Islam, racism, and Muslim-American identity. You can follow her on Facebook at her page The Common Sense Convert and read her blog on her website Sea Glass Writing & Editing.

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#Life

Mental Health & COVID-19: Light, Guidance, & Much Love | Part 1

Insha’Allah, you and your loved ones are safe & healthy. May Allah swt protect us all from COVID-19, Ya Hafidh, and open the way for our spiritual growth, Ya Fattah Ya Rabb. No doubt, we are living in very challenges times, and many in our community are suffering. As such, my intention for this two-part series is to provide some beneficial perspectives and practical strategies that will make your emotional journey safer & easier, insha’Allah.

And a journey it surely is. We are on a very long hike up a very steep mountain. And we have only two choices about HOW we approach this challenge: unskillfully or skillfully. If we wear flip-flops, and fail to pack water and snacks, we will have a very difficult time reaching the summit. And if we do, we will be in very bad shape. If we wear good socks, sturdy hiking boots, and our backpack is well-stocked, not only are we likely to reach the summit, but reach it in great shape. This is what I want for our beloved community, insha’Allah.

As Muslims, it is crucial to remember that the ultimate summit is the hereafter. Truly, Allah subḥānahu wa ta'āla (glorified and exalted be He) is our goal and pleasing Him is our aim. Truly, everything we do or fail to do here has an impact there. For many people, this haqq is much more difficult to remember and actualize when their day-to-day challenges are daunting. This is why historically and traditionally, in times of crisis, Muslims have always sought the nasiha of wise elders. Imam Muhasibi, the father of Islamic Psychology, developed this crucial, beautiful science in response to the human needs of his students. Sadly, the loss of these teachings as a widespread living tradition has contributed in large part to the widespread mental-health problems that have been plaguing our community for a very long time, which have now been exacerbated by COVID-19.

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Here’s a good metaphor. The science of nutrition teaches us about our body, the properties of different foods, what to avoid to prevent disease, and the vital nutrients we MUST ingest to attain optimum physical health. Likewise, the science of mental health teaches us about our heart and mind, the impact of specific activities, what to avoid to prevent disease, and the vital psychological nutrients we MUST ingest to attain optimum mental health. Lack of knowledge about Islamic Psychology and the absence of the vital psychological nutrients have taken a huge toll on our community. The stories I hear would probably shock you. They would certainly break your heart. Especially the stories of our young people, who are my top priority. Insha’Allah, the wake-up call of COVID-19 propels us to reclaim en masse this lost part of our spiritual heritage, so we can reclaim our vitality and nobility as the Ummah of Muhammad ṣallallāhu 'alayhi wa sallam (peace and blessings of Allāh be upon him).

To continue with the metaphor. Working one-on-one with an experienced nutritionist is very different than reading a book about nutrition. With the former, your nutritional program is specifically tailored to your particular problems, challenges, habits, and temperament. The same is true when it comes to mental health. So I must manage your expectations honestly and honorably by saying that it is not possible for me to do in two articles for the general public what I do one-on-one in my private practice as a psychotherapist, life-coach, and spiritual mentor. Truly, there is a palpable, powerful, fitrah-based alchemy that can only happen when two human hearts link-up in real time. That said, in the same way that reading and learning about nutrition is very beneficial, so too reading and learning about mental health, especially now.

Working Skillfully with Difficult Emotions

No doubt, COVID-19 has unleashed a wide range of very difficult emotions. People are struggling with tremendous anxiety, uncertainty, fear, sadness, loneliness, depression, helplessness, hopelessness, anger, frustration, confusion, grief, despair, and in some cases, a full-blown crisis of faith. So let me explain a little bit about emotions and how to work with them skillfully  

One of the foundational principles of cognitive-behavioral psychology is called ‘reframing.’

It is the process of deliberately thinking differently about our situation. Reframing it. The fact is, the lens through which we view our circumstances makes all the difference in the world insofar as how we feel. Thoughts are like the front wheels of the car and feelings are like the back wheels. We must be in the driver seat, steering intentionally. Whichever way the front wheels turn, the back wheels follow. So paying attention to our thoughts moment by moment, and making sure they are aligned with the Qur’an and Sunnah, is crucial. The mind is a like a muscle that MUST be trained through specific exercises, and our tradition is rich in the techniques for doing so. Truly, we must hit the spiritual gym regularly. The heavy lifting of muhasiba (self-reckoning) and muraqaba (mindfulness/meditation) are not optional. If these are not already a consistent part of your spiritual practice, NOW is the time to take them up. You will be so happy you did!

Here’s a good metaphor. If you are a longtime couch potato, even a flight of stairs leaves you huffing and puffing. If you are in good shape, you’re able to jog around the block easily. If you’re in great shape, you’re able to leap over the hurdles like a gazelle. For many, COVID-19 has been like asking a couch potato to run a marathon. So we need to get in the best spiritual shape possible as quickly as possible. To that end:

The Centering Exercise 

Every time you notice that you are feeling sad, anxious, fearful, angry, hopeless, helpless, impatient, frustrated, confused, or depressed, here’s what to do.  

  • Turn off your devices and put them in another room.
  • Close your door and put a “Please do not disturb.” sign on the doorknob. Lay down.
  • Close your eyes. Turn your attention to your heart. Remember the Hadith Qudsi, “Heaven and earth cannot contain me but the heart of my faithful believer is where I reside.” Truly, Allah is closer than our jugular vein. (50:16)
  • Take some slow-deep breaths. On the out-breath, silently recite “La illaha.” On the in-breath, silently recite “il Allah.” After a few minutes, notice the shift in your state. Notice the deep connection between ‘self’ and ‘breath’, not just experientially, but also etymologically. They both derive from the same Arabic root, transliterated nfs.   
  • When you are centered, mentally review what you had been thinking about that gave rise to the difficult emotions.  Then do a ‘search and replace,’ deliberately and intentionally replacing your dark thoughts with the Light of The Qur’an or Hadith. Here is one example: Search: “I’ll never get through this.” Replace: “Allah never burdens a person with more than he is well able to bear.” (2:286)

As individuals, we each have our own particular dark thoughts. NOW is the BEST time to fix them. I lovingly encourage you to get a blank journal, so that each time you do The Centering Exercise, you can make note of what you observed, what you learned about yourself. Write down each dark thought and then write down each Rx of Light from The Qur’an or Sunnah. Having a personal journal gives you a concrete means of reinforcing your new thought patterns. 

We know from our neuroscience that the human brain possesses ‘neuroplasticity’, which is the capacity to be shaped, molded, changed. As such, the more often you do The Centering Exercise, the more your thinking patterns will change. This is how Allah subḥānahu wa ta'āla (glorified and exalted be He) created us, mash’Allah! It’s really quite amazing to realize that the Qur’an we’ve been given provides Light upon Light from The Lord of The Worlds. And the Sunnah is that Light fully actualized to perfection, mash’Allah. The fact is, no matter how dark a room may be, if we light just one candle, it illuminates the space. Mash’Allah!

Parents, once you get the hang of The Centering Exercise, please please teach it to your children! Insha’Allah, make it the new normal in your household, transforming discord and upset into harmony and peace.

Say “Ameen!”

Divine Reminders

Insofar as reframing COVID-19 in the broader sense, I offer you this lens, this Divine Reminder, with much love. May it shift your state from embittered to empowered. My beloved sisters and brothers, Allah subḥānahu wa ta'āla (glorified and exalted be He) is our Rabb, our Teacher, and COVID-19 is the Test we’ve all been given. Every single human being on the planet. We all woke up one day, walked into the classroom of Life, and got handed a pop quiz. The purpose of which is to show us the places where we weren’t prepared. This is great! Because the trumpet is absolutely going to sound, and we surely want to be ready. As long as we’re breathing, we have time to prepare. This is great!

Say “Ameen!” 

Beloved ones, we have the incredible privilege of being students of The One Who Knows Everything, including The Future and The Unseen.  It is very bad adab to question the teaching methods of our Teacher or to complain that we don’t like the Test.

This was the fatal mistake of Bani Israel that we are reminded 17x/day not to emulate. On the contrary, what we want to be asking ourselves is: “What must I do to pass this Test with flying colors, to ace this Exam?” Our beautiful Qur’an teaches us: “Not without purpose did We create heaven and earth and all between.” (38:27)  This pandemic is not some random event. It has a divine purpose. There is deep meaning in it. 

There is also enormous rahmah in it. Our beautiful Qur’an teaches us: “…My mercy embraces everything.” (7:156) The Divine Physician has dispensed this bitter medicine to heal us. To heal the whole world from its longstanding imbalances and injustices. Surely, it is no accident, the timing of COVID-19 vis-à-vis the murder of George Floyd and the global response it has galvanized.  Surely, every human being wants to and deserves to breathe.

COVID-19 is a wake-up call for the whole world. Ours to do as students is to be fully present in each moment, to practice mindfulness (muraqaba), so we can be deeply receptive to the Lessons we are meant to learn (muhasiba). Indeed, Allah will not change the condition of a people until they change what is in themselves.” (13:11) Beloved ones, NOW is the time for global tawbah (repentance). As the Ummah of Muhammad ṣallallāhu 'alayhi wa sallam (peace and blessings of Allāh be upon him), this is our Divine Assignment, individually, collectively, institutionally. 

My vision and personal commitment is that we wind up stronger and better-than-ever on the other side of this, insha’Allah. I can say this with great confidence because first and foremost, I know that COVID-19 or no COVID-19, Allah subḥānahu wa ta'āla (glorified and exalted be He) is not out of business! The presence of The Presence, the power of the Names & Attributes, are as robust as ever. 

We are being summoned to recognize our hubris and turn our hearts in humility toward The One Who Is In Charge, The One Who Calls The Shots, to The One Whose Decree we surrender. Humbly. Readily. Insha’Allah, NOW is the time to actualize the last part of Hadith Jibreel about qadr. The fact is, what’s happening around us is what’s happening, and this is always in the hands of Allah subḥānahu wa ta'āla (glorified and exalted be He). HOW we respond to what’s happening is entirely up to us.

What I want for our community is the best possible response, the most skillful and beautiful response, the response that will be of maximum benefit here & hereafter, insha’Allah.

I can also say this with great confidence because time and again, working with Muslim refugees who have been through horrific trauma, I have seen with my own eyes how absolutely amazing human beings are. How resilient. How courageous. How creative. How capable of transforming sorrow into joy, lemons into lemonade, compost into roses. This is what I want for you, my beloved sisters and brothers.

No doubt, on any long and arduous journey, in addition to having the right equipment and supplies, having an experienced trail-guide makes all the difference. There is dangerous terrain you want to avoid, and beautiful vistas you don’t want to miss. In my experience over decades, I have observed that human beings thrive when we are given the right tools and the loving encouragement to master them.  So let me give you now some very practical guidelines to help you navigate skillfully, so you can extract from these precious days of your life what is meaningful & transformational. 

Practical Strategies

When it comes to protecting our physical health from the pandemic, there are certain steps we MUST take. Likewise with our mental health. As such, here are some practical strategies, culled from thousands of pages of research and decades of experience. My focus is on parents, whose job has never been more difficult. And with the new school year right around the corner, this guidance is extremely timely. 

Boundaries: Set clear boundaries regarding where and when devices can be used. This applies to everyone in the household, kids and parents alike. Parents, as your elder who loves you, I am reminding you that YOU are the CEO of your home. YOU are the policy maker. YOU are in charge. NOT your kids or their devices. So take charge!

  • No devices for kids 0-3. These guidelines are from the American Pediatric Association. 
  • No devices at the dinner table* or in the bedrooms.
  • No devices until after Fajr. Better yet, after breakfast.
  • All devices put away 1-2 hours before bedtime. Plugged in in the kitchen to recharge.
  • Limit on-line entertainment and socializing to 1 hour/day MAX.
  • Schedule tech fasts ½ day weekly, and 1-2 full days monthly, on a weekend.
  • An occasional family-time movie is fine on the weekend. Choose something meaningful, uplifting, thought-provoking, heart-opening. Pop some popcorn. Make tea. Engage in a special time afterward to really talk together about your experience. *Getting in the habit of real-time-face-to-face conversations is crucial. If you start when your kids are young, it will lay a strong foundation for their teenage years, when they desperately need wise, trustworthy, caring adults who really know how to listen from the heart.

Nature: Spending time in nature is the very best thing you can do for yourself and with your family. There are reams of data about the stress-reducing effects of being outdoors, especially in the woods. There are also reams of data about the benefits of exercise, not only for physical health, but for mental health. Given all the extra sitting everyone is doing during COVID-19, regular exercise is not optional. 

Furthermore, if your kids are schooling from home and you are working from home, everyone will surely need some breathing room, some physical and emotional space from one another, some time every day in solitude, unplugged from their devices. Spending alone-time in nature is the perfect solution. 

For family-time activities, unplug from your devices and enjoy these delightful experiences. They will engender tremendous awe (khushu’) and deepen your heart-connection with your Rabb, The One Who Created you and all the beauty around you. Subhan’Allah.

  • Take a 15-30 minute family-walk every night after dinner before homework.
  • Go hiking, biking, rollerblading, kayaking, kite-flying, or camping on the weekend.   
  • Set up bird feeders in your yard. Learn their names and identify their songs.
  • Go out nightly to look at the stars. Learn the names of the constellations.
  • Watch as many sunrises & sunsets, moonrises & moonsets as you can. 

As Muslims, our worship is guided by the natural cycles Allah put in place. The sun is our clock. It tells us when to pray. The moon is our calendar. It tells us when the new month begins. Sighting the moon is an act of worship, mash’Allah.

Divine Reminders

Our beautiful Qur’an teaches:“We will show them Our Signs (ayat) in the universe and in their own selves, until it becomes clear to them that this (the Qur’an) is the truth.” (Fussilat 41:53)

In this ayah, we are taught the two beautiful gateways into the sacred: the macrocosm of the universe, and the microcosm of the self. Both of these gateways open into the direct experience of Allah’s presence. 

As Muslims, we have been invited to spend time in this dunya in the company of The One Who is Love (al-Wadud). The One Who is Strength (al-Aziz). The One Who is Peace (as-Salaam). And on & on. What could be more beneficial during this time of crisis? Alas, calling upon our Rabb by His most Beautiful Names, with urgency & sincerity, is one of the Lessons we must learn from COVID-19.  My prayer for our community is that people do not squander the opportunity to connect in a deep, meaningful, intimate way heart-to-heart with Allah because they can’t put their phone down or turn their computer off. Insha’Allah, I will address the subject of digital addiction in the second article, as it plays a huge role when it comes to mental health issues.

Closing Du’a

Ya Habibi Ya Allah. Please grant us oceans of fortitude and mountains of strength Ya Sabur Ya Aziz. May we be dutiful beautiful students who strive with all our might in jihad al akbar to pass this test with flying colors, to ace this exam. May we, the Ummah of Muhammad ṣallallāhu 'alayhi wa sallam (peace and blessings of Allāh be upon him), love one another like he loves us, and strengthen one another every step of the way. May we wind up stronger and better-than-ever on the other side of COVID-19, reclaiming the standard of Insan Kamil as the Index by which we measure our lives. Ya Dhal Jalali wal Ikram.

Say “Ameen!” 

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