On June 26, a group of Muslim medical students at Thiruvananthapuram Medical College approached the principal, Dr Linette J. Morris, seeking permission to wear long scrub jackets and surgical hoods inside the operating theatre. Due to infection control policies, sterile operating theatres have strict restrictions on what people can wear.
The 'bare-below-the-elbow' policy followed in operating theatres in India requires healthcare workers to wear short sleeves and avoid wearing wrist jewellery. The students raised concerns about the surgical practices for maintaining sterility, which could conflict with their commitment to "modesty" as required by their religion. They demanded an alternative arrangement in the form of long-sleeved scrub jackets to cover their hands and surgical hoods since they were not allowed to wear hijabs inside the operating theatre. They also pointed out the challenges faced by hijab-wearing Muslim women in finding a balance between complying with religious attire and maintaining modesty while following hospital and operating room regulations.
The college principal reportedly spoke to the students about the practical difficulties they may face while scrubbing up for leading or assisting a procedure. Incidentally, the medical college is planning a meeting of surgeons and infection control experts to discuss the issue.
It appears that the balance between inclusivity and sterility requirements in the operating theatre has been a topic of discussion in the western world as well. Last September, Rewan Abdelwahab, a medical student at Mayo Clinic Alix School of Medicine, published a commentary in the Mayo Clinic Proceedings advocating for a change in policies to make clothing guidelines in the operating room more inclusive. She wrote the commentary after experiencing personal difficulties due to operating room regulations regarding attire.
In 2019, a study titled "I decided not to go into surgery due to dress code" was published in BMJ Open. The study involved 84 female medical practitioners from different ethnicities and various geographical locations. It found that the majority of participants agreed that wearing a headscarf was important for themselves and their religious beliefs (94.1%). However, over half of the participants (51.5%) encountered problems when attempting to wear a headscarf in the theatre. Some women reported feeling embarrassed (23.4%), anxious (37.1%), and bullied (36.5%). Additionally, over 53% of respondents stated that their religious requirement to cover their arms was not respected. The study suggested that female Muslims working in the National Health Service (NHS) of the UK faced challenges when wearing a headscarf in the theatre and complying with the "bare below the elbows" policy.
In 2019, the Royal Derby Hospital in the UK became the first hospital to introduce disposable sterile hijabs (headscarves) after a Malaysian Muslim doctor, Farah Roslan, introduced the idea. Roslan, who was a medical student at Royal Derby, came up with this solution after facing situations where she had to leave the operating theatre multiple times due to infection control norms.
The medical students at Thiruvananthapuram Medical College appear to be inspired by Dr Deena Kishwai, a Chicago-based obstetrician and gynaecologist resident physician, who is leading a movement for policy changes to create a more inclusive environment for hijab-wearing Muslim women in the healthcare segment. On the home page of her website hijabintheor.com, Kishwai mentions the “possible solutions” to accommodate hijab-clad health workers in operating theatres as follows:
“Long sleeve scrub jackets should be made easily accessible in OR locker rooms for hijab-wearing women to wear over their scrubs until scrubbing in and donning sterile attire. Especially since no outside clothing is allowed, it would be most comfortable to have this on since long sleeves cannot be worn under scrubs. Similarly, surgical hoods should be made readily available in the OR locker rooms so that women who wear hijab can easily cover their hijab and remain compliant with sterile code and procedures.”
