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When 60 people met on Monday 25th August 2014 at Royal Children’s Hospital to talk about “Bagels, Baklava and Doner Kebabs”, you could have been forgiven for thinking they were chefs mixing foods and cultures. In fact, they were pastoral carers. They were talking about the mix of faiths and cultures in their work in hospitals, prisons and other centres.

Addressing a number of Victoria’s pastoral care workers about religious diversity in August were (from left):
Lina Ayoubi (Muslim); Jo Silver (Jewish); Jasbir Singh Suropada (Sikh); Bhakta Dasa (Hindu); Hojun Futen (Buddhist); Daniel Bellils (Greek Orthodox).

The sub-title of their meeting,  was “religious and cultural diversity in spiritual care”. Food and drink did have a place in the discussions, of course.  These can have an important role in people’s faith practices.

But the meeting went beyond food.  It focused on spiritual care from the perspective of six faith communities – Buddhist, Hindu, Islamic, Jewish, Orthodox Christian and Sikh.

That had its share of surprises as well as exploring both the differences and the common concerns that faiths bring to human care – including food and drink.

“The five precepts of Buddhism include a vow to abstain from intoxicants, which could apply, for example, to patients taking morphine,” said Hojun Futen, a Buddhist monk and coordinator of healthcare chaplaincy for the Buddhist Council of Victoria.

“Many Hindus are strict vegetarians,” said Bhakta Dasa, a minister of the Hindu faith in the Hare Krishna movement who oversees Hindu pastoral care and chaplaincy throughout Melbourne.  “Any medicines with animal origins may need to be discussed with Hindu patients.”

Kosher food may be needed for Jews:  “Some Orthodox Jewish people will accept only kosher prepared and wrapped food,” said Jo Silver, project manager at the Jewish Community Council of Victoria (JCCV) and chair of its pastoral care steering committee.

The meeting was organised by the Victorian branch of Spiritual Care Australia (SCA), the national body for practitioners in chaplaincy, pastoral care and spiritual services.

“Pastoral and spiritual caregivers need to develop their cultural competence so they can be aware of people’s needs across the spectrum they serve,” said Paul Hammat, SCA vice-president and a member of the organising group.

“Awareness of difference and the variety of preferences or needs is an important step towards appropriately catering for these spiritual and physical needs."

A report from Spiritual Health Victoria (until recently known as Healthcare Chaplaincy Council Victoria, or HCCVI) summed up the task this way: “When faced with significant illness, change or loss, many people require more than just attention to their physical needs.  Spiritual care provides a supportive, compassionate presence for people in times of need, helping them on their journey toward healing".

“Spiritual care is an inclusive term describing a range of services including spiritual support, pastoral care, faith-based chaplaincy, religious services and other rituals.  We are very conscious of the increasingly multicultural and multifaith nature of our communities.”

The Rev. Stephen Delbridge, coordinator of health chaplains for the Anglican diocese of Melbourne, said “Bagels, Baklava and Doner Kebabs” had “certainly shown the common human concern that people of different faiths have, and participants were keen to hear the various perspectives”.

“Australia’s multicultural, multifaith society requires a lot of understanding from those of us who provide spiritual support and pastoral care,” he said.

That understanding includes a variety of faith practices.  Prayer, for example, is important for many patients in hospital.  Muslims pray five times a day to “feed the soul”.  In contrast, there are no set times for Hindus, but most prefer morning prayers, according to Mr Bhakta Dasa.

Orthodox Christians take another approach.  “Prayers are never the creation of an individual but always expressions of the church,” said Daniel Bellis, coordinator of hospital chaplaincy for seven Orthodox Churches.  And those praying don’t join with non-Orthodox people.

They may also pray to an icon for their spiritual support – or a miracle.  “An icon is more than a picture or artwork.  It’s a window through which we can gain a glimpse of divinity,” said Mr Bellis, whose chaplaincy serves members of the Greek, Antiochian, Russian, Serbian, Bulgarian, Romanian and Ukrainian Orthodox Churches.

Religious events also have their place in people’s lives.  Some find their health affected by missing a special occasion.  As the pamphlet “Caring for Jewish Patients” points out, “Jewish festivals focus heavily on the family and community, so patients may feel very isolated and low-spirited at these times.”

Another sensitive point is the sacred texts of a person’s faith, such as the Sikh scriptures – all 1430 pages of them.

Jasbir Singh Suropada, vice-chairman of the Sikh Interfaith Council of Victoria, explained that some patients have a small selection of scriptures, and that must be respected, too.  “Ask permission before you touch it,” he warned.  And cover your head with a scarf if you’re reading those scriptures.

A patient’s faith can also cause tension for treatment.  As a Buddhist pamphlet on health care points out, “stabilising and developing the mind” is a key part of that faith.  But it may mean “lessening or termination of drug regimes that cloud the mind or dull the consciousness of the patient”.  People “may attempt to use meditation as an alternative to pain medications”.

And initiated members of the Sikh faith never cut or shave their hair, either on the head and elsewhere on the body.  “Consult the patient or the family before shaving any hair from a patient’s body [for medical reasons],” said Mr Suropada.

Pastoral carers need some familiarity not only with the many differences in belief and practice among the faiths.  They also need to be aware that each faith has its own variations.  Any of these can affect a person’s well-being.

“Like every other religion, there’s a variety of practices and convictions [in Islam].  Each patient has their own culture on top of Islam,” said Lina Ayoubi, hospital and prison pastoral care coordinator at the Islamic Council of Victoria. 

“Judaism is very cultural, a way of life, and very much what you associate with.  There’s an accepted way of doing everything, but nothing is absolute.  And religious practices are a very personal kind of thing,” said Ms Silver.

Hinduism:  “There’s much diversity and no central, authoritative document.  It’s difficult to provide definitive rules that apply to all Hindu patients.  There’s complete freedom to practise religion as each person chooses,” said Bhakta Dasa.

So, “What sort of Hindu are you?” was an important question to discuss with the patient, he said – an approach endorsed by people from all the other faith traditions.  Patients and families are the best authorities on their own religious needs.

Buddhism comes in three main forms:  Theravada (south-east Asia), Mahayana (northern and eastern Asia) and Vajrayana (based in Tibet).  The last of these is the main practice for Western converts, Mr Futen explained.

Appreciating the different traditions “is important in terms of what Buddhist images you hand to patients”, he said.

Alongside all these differences, there is strong interfaith agreement about the value of human life, and that religious rules can be bent or ignored in order to preserve life.

Jo Silver:  “Whatever must be done to save a life, must be done.  Life comes first [for Jews].  If it’s Shabbat and a family doesn’t use the phone [during Shabbat, from Friday evening to Saturday night], but someone’s life is at risk, they’ll use the phone.”

Lina Ayoubi:  “Maintaining life is priority number one [for Muslims].  If it means breaking a rule [of faith] to save life, do it!” she said – even if that meant drinking alcohol or eating pork.  “Life is the most important.”

There’s less agreement among faiths when it comes to understanding disease and death.

As an Orthodox Christian presentation put it to pastoral carers earlier this year, “illness, suffering and death are not natural human states, [but] are the result of the sin of disobedience”.

In contrast, Mr Futen said Buddhism understood that “life is suffering”.  A Buddhist pamphlet on healthcare principles puts it this way: “Suffering is inherent in birth; everything born will experience the sufferings of old age, sickness and death.”

For Muslims, “the time of death, we believe, is ordained by God”, said Ms Ayoubi.  As it approaches, a common practice is to move the person’s bed so that it faces Mecca.

When a person dies, it’s a matter of contacting the mosque as soon as possible.  “To give the [dead] person their best wish, we bury them within eight hours – and certainly within 24 hours,” said Ms Ayoubi.  “In an Islamic country, that can be within four hours.”

In the Jewish community, too, burial is swift – preferably within 24 hours of death.

The Buddhist pamphlet says:  “Death is a particularly sensitive transition because states of mind at this time affect rebirth.”  It also advises that there may be a request “to refrain from grieving around the dying person after they have medically passed away”.

Buddhist funerals vary according to the traditions of the faith, but the most common form is cremation, usually seven days after death.

It’s a big agenda for pastoral care practitioners:  from understanding different approaches to disease and death through to appreciating the ‘denominations’ of Buddhism, a Muslim’s need to face Mecca, what an icon can mean to an Orthodox Christian, and being careful about contact with Sikh scriptures.

If that’s not enough, they can also find that different faiths have their own views on the place of pastoral care practitioners.

In Hinduism, for example, “pastoral care is usually left up to the family”, said Bhakta Dasa.  “Basically, a pastoral care worker should refer everything back to the [Hindu patient’s] family.  The family is critical.”

Jo Silver said some Jewish families might not always welcome chaplaincy or pastoral care, which could be “seen as being Christian” – but that hasn’t stopped the Jewish Community Council from setting up its pastoral care steering committee and moving to appoint a coordinator.

“Pastoral care has not only been taken up in the faith communities, but they clearly want to work with each other,” said Harriet Ziegler, a Uniting Church member who is coordinator of pastoral care at Epworth Eastern Hospital in the Melbourne suburb of Box Hill.

“I think we are increasingly committed to the wisdom expressed in the Sikh faith:  ‘If you cannot see God in all, you cannot see God at all,’” she said.

Bruce Best