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August 4th, 2013
09:49 AM ET
For some Muslims, Ramadan fasting poses risksBy Slma Shelbayah, CNN (CNN) This Ramadan, Amina Jabbar faced a difficult decision. The University of Toronto medical student’s rotation at Sunnybrook Health Sciences Centre began around July 9, the start of the Muslim holy month. That meant working unpredictable shifts for as long as 26 hours while fasting from eating and drinking during the day. The fast-paced hospital environment was already challenging Jabbar’s ability to keep up with colleagues and patients. As a new physician, she felt more “error prone” and said fasting would increase her anxiety on the job. Ramadan requires “slowing down,” Jabbar said, an impossible task for a first-year medical resident whose job requires fast decisions and clear thinking to save lives. The 29-year-old Muslim was torn. Should she fulfill her professional duties, eating regular meals so hunger would not distract her from patients’ critical needs? Or should she honor her religious obligations by observing the fast, a practice considered a “pillar” of Islam? “I am spending 60-80 hours (at the hospital) and I don’t get to slow down for Ramadan,” Jabbar said. “It felt unfair to my colleagues and patients to tell them to slow down for me.” At the same time, Jabbar said she feared that fellow Muslims would criticize her if she didn’t fast. “There’s a certain amount of shame when we talk about people not fasting,” she said. The decision not to fast during Ramadan, the holiest month in the Muslim calendar, is somewhat taboo in the Muslim community. READ MORE: The Belief Blog Guide to Ramadan In Islam, Ramadan commemorates the time when the angel Gabriel imparted the Quran to the Prophet Mohammed. Many Muslims throughout the world commemorate the month by fasting, refraining from sex and smoking, and dedicating more time than usual to praying and reading the Quran. Some exceptions are generally allowed during Ramadan, which ends August 8. Pregnant women, travelers and sick people are not expected to observe the fast, for example. But for many other Muslims, especially first responders and others with stressful jobs, the choice of whether to fast can cause its own kind of anxiety. When Jabbar blogged about her decision not to fast, she received a mix of reactions. One Muslim accused her of looking for an “excuse” to shirk her religious duties. Some questioned her devotion to Islam, asking if she performs other required Islamic rituals such as daily prayers. “Of course I pray," Jabbar said. "I am just choosing not to fast. We have a lot of pressure to demonstrate to our community that we’re Muslim.” Imam Khalil Abdur-Rashid, head of the Iqra Mosque in Brooklyn and Muslim Chaplain of Columbia University, said that observing the fast during Ramadan is a religious obligation for every Muslim who is considered mature, mentally sane, healthy and not traveling. There are no fatwas – or religious rulings – that grant fasting exemptions for first responders, he added. But, Abdur-Rashid said, one is definitely needed. In fact, he generated one immediately after speaking with CNN. "The purpose of the fast is not to place the fasting person in the face of harm, but to teach self-restraint,” Abdur-Rashid said. “And the moment the fast becomes dangerous, or external conditions place the fasting person in harm's way," he said, "then the fasting person is not only permitted, but in many cases, religiously obliged to break their fast.” Abdur-Rashid's new fatwa may be especially valuable to Muslims like New Yorker Ahmed Sabree, who battles fires while wearing heavy equipment during the searing summer heat. Sabree, 42, said the arrival of Ramadan this July took him back to his training days with the New York Fire Department nearly eight years ago. Sabree endured intense physical drills that included racing up six-story buildings, pulling up hoses and crawling on the floor. Trainers told the budding firefighters to “hydrate, hydrate, hydrate,” Sabree recalls. He contemplated breaking the fast, at least to drink some water, and researched Islamic texts for guidance. Sabree concluded that his training, though grueling, was insufficient reason to drink water during the day. Ramadan is not just about enduring physical hardships for hardships' sake, Sabree said. Instead, the holy month has a deeply spiritual dimension. The firefighter said Ramadan's rituals offer an opportunity to “get back on track” and become more conscientious of his responsibilities to God and his fellow man. That doesn’t mean fasting is easy for Sabree, so he takes precautions to lighten the load a bit. For instance, he volunteered for the lunchtime watch shift at his firehouse in Harlem, New York, while others are eating in the kitchen, better to keep the alluring aromas of food at bay. And if a fire breaks during the time of breaking the fast, Sabree responds immediately. To the fire that is, not his stomach. “If it’s time to break the fast and there’s a fire, you gotta go,” Sabree said. “I’ll break my fast with some water and go.” READ MORE: Muslims have mixed views on TSA Ramadan advisory Deputy Chief Mike Jaafar of Wayne County in Michigan is also fasting this year. Jaafar says Ramadan is “kind of a cool time,” but he doesn’t mean temperature. In fact, for the last several years, Ramadan has fallen during the hottest summer months. The holy month is calculated by a lunar, rather than fixed calendar, so it rotates from year to year. “Unfortunately, I can’t adjust my schedule in the profession I am in. This year is going to be a tough one,” Jaafar said. He is expected to keep the same long hours and fulfill the same duties as his fellow officers. But there are some perks to celebrating Ramadan in Michigan, home to the largest concentration of American Muslims in the United States. When the holy month comes around, fasting isn’t much of a foreign concept, even for those not Muslim. This understanding translates into small workarounds for Jaafar. Sometimes, if he begins his workday early enough, he is able to finish in time to get home for dinner. “My hours can be flexible, and usually I can break my fast with family,” Jaafar said. He uses this time to visit his mother every day and to attend the mosque with his children. As for Jabbar, the medical resident is trying to make up for not fasting through other spiritually fulfilling options, such as praying and helping heal her patients. “Spirituality has to become part of my clinical practice, because I spend so much time of my life there,” she said. But Jabbar said she still misses the slowing down that Ramadan's daytime fasting requires. "I am trying to make it up in terms of remembrance," of God, she said. "It doesn’t always feel sufficient."
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"As for Jabbar, the medical resident is trying to make up for not fasting through other spiritually fulfilling options, such as praying and helping heal her patients."
One would think that if prayer actually worked, there would be no need for hospitals or doctors. It amazes me that someone who goes through all the scientific education and training, involved in medical school, can be so intimidated by ancient nonsense.
For my rotations I have personally preferred to do the busy rotations instead of lighter one because then the day goes faster and I do not have enough time to feel hunger.
As far as fuzzy – even some of the senior non-fasting resident's action or some of the non-fasting attending's decisions are fuzzy. Depneds on their level of knowledge and interest to see patient.
I am not sure who is lying here but with ACGME rules I am not aware of a program who is making its Interns or Residents to work for 26 hours. If you do not beleive me do google search with ACGEME duty hours
Being a resident physician myself I can understand what Amina Jabbar is going through. Fasting can be tough esp when the hours are long during summer time and fasting cannot and should not be used as an excuse to not be able to work. Every individual is different and while some of us are able to work 30 hours in a row while fasting without affecting patient care there are others who simply don't have the physical and mental strength to be able to accomplish that. We just need to be sure whether or not we are choosing not to fast because we are finding that it affects patient care and not because it feels inconvenient/difficult. Fasting was never meant to be easy...
My advice for Amina Jabbar and other residents like here is to request the chief residents in advance to assign one to a lighter rotation during Ramadan. That's what I have done throughout residency and it has helped a lot.
For those who are commenting that you need to choose between your profession and religion I disagree. Saving lives of patients in a hospital or of people in a burning house is bound to earn a lot of thawab too and is not a mere worldly task. Can you honestly say that Allah would reward one more for fasting than saving the life of a child in a burning building? If my fasting is going to result in someone's death that I'm sure Allah would rather have me not fast at that point in time and He wouldn't punish me.
At the end of the day it's a personal decision to fast. Allah knows our intentions and if our intentions are sincere and if we were to miss/skip a fast we can always make up for it later on. Innamal aamaal o binneyaat.
Censorship test...
New Interns are already dangerous to patients when they're not under the additional stress of not eating and drinking. When you add in the additional stresses on the doctor's body, do you truly believe that they will not be putting patients at risk? When I go to the hospital, I expect my doctor to be on top of his or her game.
but isn't it weird also to force someone to work for long shifts like 26 hours.. i think this is the problem and not the fasting
Agreed. This article is in overall poorly researched, written and is biased.
I am sorry, but if my employee in the hospital was fasting, I would tell them to take some vacation time, or unpaid leave. Someone could die from a mistake. I have seen people not eat for a few hours start to get 'fuzzy' at making decisions.
Maybe working 26 hours can make you a bit fuzzy all by itself?
If you really believe that you should make your name and hospital name public. Lets see how far you get by trying to limit the employment of practicing Jews, Muslims and Buddhists.
I have seen a few years of bigotry leading to people making "fuzzy" decisions.
She shouldn't fast at all. If she is jeopardizing other people health and hers. God is great he will forgive her.
It's not a big deal.
"At the same time, Jabbar said she feared that fellow Muslims would criticize her if she didn’t fast. “There’s a certain amount of shame when we talk about people not fasting,” she said."
As a muslim when I heard this, I feel we are responsible for sending misleading information to other non-muslim, and not any other people. As a muslim or followers of any other religions, it is your choice to to go to mosque or church regularly or not and same for fasting. If this world is your priority then why complain or care about what other people say in your community about you. But as real muslim or followers of any other religion, you will always find way to fulfill your religious duties and life balance in this world. I have been in this country for long time and none of my jobs became an issue in Ramadan. You just have to find a way to complete your religious duties either by communicating with your management, rescheduling your training etc.This is the beauty of this country that everyone has religious freedom and most people respect that.
Muhammad was a false prophet
Professor and Dr.
It's a safe bet you are neither.
Observer
Professor and Dr.
It's a safe bet you are neither.
Vegas Chucawgo politics, blind observer??
Boo Leann
A stupid Dr. I might add.
muhammad brought the book that cites jesus more than 200 times when his own name is cited just 5 times, if he was false he would be asking people to worship him, but you do not know nothing about islam except what jewish news network tells you, by the way jews don't believe in jesus, but you seem not have any problem with that and you use the old testament which is the jews book( like lewis black talks about in his excellent show) which is also the book of the people who don't believe in jesus.
its no ones business whether she fasts or not, this is between Allah and her. As for putting the lives of others in harms way, she needs to make that choice. if she thinks fasting would effect her then she needs to weigh this herself. Does she want this world or does she want the here after, because that is what Islam is, preparing for the hereafter. Making it seem like an issue is just to get 15 minutes of fame. She can make all these decisions in the comfort of her privacy. She has to answer to no one but Allah so why bring out these issues? decide for yourself and live with your decision. End of story.
Another religion of works for their so called God, Some fast, some don't, and those that do boast of their accomplishments thinking God is pleased with them more.
"For the kingdom of God is not a matter of eating and drinking, but of righteousness, peace and joy in the Holy Spirit", Romans 14:17.
If you are in a profession, which forces to you choose between discharging your duty your creator and discharging your duties, you should evaluate if the profession is a right one. It is your God who gave you the resources and smarts to become a physician. And you reward him by not following him.
There are hundreds of thousands of doctors around the world, who fast and perform their duties very well. Probably the difficult to exercise your faith is merely an impediment that is specific to YOUR mind.
Proud Atheist here. Glad I don't have to spend all my time doing religious stuff like this!
I am not Muslim. I think that, if you are in a profession where your weakness or incapacity brought on by the fast could affect the life or death of another person, then the fast needs to be rethought. I doubt Allah had in mind putting others in danger as a requirement of Islam.
What answer are we going to give Allah when we meet him, sorry my world business kept me away from religious obseravances, Allah never enforces hardship on us, its us who enforces hardship on us, Fasting is a blessing, a person who misses a fast without a valid reason, ask the reason from a practicing scholar, that person if he o she fast for 2 month straight wont even get blessing of fasting on Ramadhan, Allah blessing, its also healthy to fast, doctors dont undersand religion, Allah is all above us May Allah guide us to practice Islam is the correct manner told to us by our beloved Propher ( May Allah peace be upon him )
said Mahadi, 925 CE.
I think with the Dr's situation, i think she is doing the right thing if she fasts she is not thinking clearly. Doctors take the oath to not harm others. Islam is a peaceful religion also claiming not to harm others . i don't think Allah would mind. here this lady is doing Allah's doing tending and caring for the sick (this has to be a calling from Allah otherwise i don't know what she is doing it for) then why come down on her ? she is doing what is expected of her keeping up with her prayers. she herself said "I am trying to make it up in terms of remembrance," of God, she said. "It doesn't always feel sufficient." so she knows what she is doing but she is conscious of her surroundings. I think there is a line of religion and life and she is working to balance it out. the lady is a doctors and you do not want a doctor to pass out or to make irrational decisions that can kill a person. Maybe because I am a christian and I do believe in fasting so I understand the devotion the spiritual cleanliness after a fast but even christian god says do this in remembrance of me and as often as possible, so i know it isn't about cutting corners but is SHE really cutting corners??? you cant expect her to run around a hospital 80 hours a week and fast and make good decisions without any fuels in her body. I bet you anything the people who are criticizing her for not being muslim enough are also the first to sue her for malpractice. You cant please people. Just do whats right for you and your god lady! and may god bless your hands for doing this job!
Because we care:
Only for the eyes of our sister and brother Muslims:
From the studies of Armstrong, Rushdie, Hirsi Ali, Richardson and Bayhaqi--–
The Five Steps To Deprogram 1400 Years of Islamic Myths:
( –The Steps take less than two minutes to finish- simply amazing, two minutes to bring peace and rationality to over one billion lost souls- Priceless!!!)
Are you ready?
Using "The 77 Branches of Islamic "faith" a collection compiled by Imam Bayhaqi as a starting point. In it, he explains the essential virtues that reflect true "faith" (iman) through related Qur’anic verses and Prophetic sayings." i.e. a nice summary of the Koran and Islamic beliefs.
The First Five of the 77 Branches:
"1. Belief in Allah"
aka as God, Yahweh, Zeus, Jehovah, Mother Nature, etc. should be added to your self-cleansing neurons.
"2. To believe that everything other than Allah was non-existent. Thereafter, Allah Most High created these things and subsequently they came into existence."
Evolution and the Big Bang or the "Gi-b G-nab" (when the universe starts to recycle) are more plausible and the "akas" for Allah should be included if you continue to be a "crea-tionist".
"3. To believe in the existence of angels."
A major item for neuron cleansing. Angels/de-vils are the mythical creations of ancient civilizations, e.g. Hitt-ites, to explain/define natural events, contacts with their gods, big birds, sudden winds, protectors during the dark nights, etc. No "pretty/ug-ly wingy thingies" ever visited or talked to Mohammed, Jesus, Mary or Joseph or Joe Smith. Today we would classify angels as f–airies and "tin–ker be-lls". Modern de-vils are classified as the de-mons of the de-mented.
"4. To believe that all the heavenly books that were sent to the different prophets are true. However, apart from the Quran, all other books are not valid anymore."
Another major item to delete. There are no books written in the spirit state of Heaven (if there is one) just as there are no angels to write/publish/distribute them. The Koran, OT, NT etc. are simply books written by humans for humans.
Prophets were invented by ancient scribes typically to keep the un-educated masses in line. Today we call them for-tune tellers.
Prophecies are also invali-dated by the natural/God/Allah gifts of Free Will and Future.
"5. To believe that all the prophets are true. However, we are commanded to follow the Prophet Muhammad (peace and blessings
be upon him) alone."
Mohammed spent thirty days "fasting" (the Ramadan legend) in a hot cave before his first contact with Allah aka God etc. via a "pretty wingy thingy". Common sense demands a neuron deletion of #5. #5 is also the major source of Islamic vi-olence i.e. turning Mohammed's "fast, hunger-driven" hallu-cinations into horrible reality for unbelievers.
Walk these Five Steps and we guarantee a complete recovery from your Islamic ways!!!!
Unfortunately, there are not many Muslim commentators/readers on this blog so the "two-minute" cure is not getting to those who need it. If you have a Muslim friend, send him a copy and help save the world.
Analogous steps are available at your request for deprogramming the myths of Christianity, Judaism, Buddhism, Hinduism and Paganism..
From Google Translate:
من الدراسات من أرمسترونغ، رشدي، هيرسي علي، ريتشاردسون والبيهقي --–
في خمس خطوات لأبطل تأثير 1400 سنة من الأساطير الإسلامية:
(-خطوات اتخاذ أقل من دقيقتين لإنهاء-ببساطة مدهشة، دقيقتين لإحلال السلام والعقلانية إلى أكثر من مليار فقدت النفوس لا تقدر بثمن!)
هل أنت مستعد؟
استخدام "الفروع الإسلامية 77 من" الإيمان "مجموعة الإمام البيهقي المترجمة كنقطة انطلاق. في ذلك، وهو ما يفسر الفضائل الأساسية التي تعكس صحيح" الإيمان "(إيمان) من خلال الآيات القرآنية ذات الصلة، وأحاديث نبوية." أي ملخص لطيفة من المعتقدات القرآن والإسلامية.
الخمسة الأولى من الفروع 77:
"1. الإيمان بالله"
كما يعرف أيضا باسم الله، الرب، زيوس، الرب، الطبيعة الأم، وما إلى ذلك يجب أن تضاف إلى الخلايا العصبية التطهير الذاتي الخاص.
"2. إلى الاعتقاد بأن كل شيء غيرها مما كان الله غير موجود. بعد ذلك، الله سبحانه وتعالى خلق هذه الأشياء، وبعد ذلك جاءوا إلى حيز الوجود."
التطور والانفجار الكبير أو "غي ب G-NAB" (عند بدء الكون لإعادة تدوير) هي أكثر ترجيحا وينبغي أن تدرج في "المندرجة" في سبيل الله إذا كنت لا تزال تشكل "بجمعية العقارات، tionist".
"3. إلى الاعتقاد في وجود الملائكة."
A بندا رئيسيا لتطهير الخلايا العصبية. الملائكة / دي VILS هي الإبداعات الأسطورية من الحضارات القديمة، على سبيل المثال HITT خائبي، لشرح / تعريف الأحداث الطبيعية، والاتصالات مع آلهتهم، والطيور الكبيرة، والرياح المفاجئة، وحماة خلال الليالي المظلمة، وما إلى ذلك لا "ثينجيس افسح المجال ل جميلة / UG-LY" بزيارة أي وقت مضى أو تحدثت إلى محمد، يسوع، مريم أو يوسف أو جو سميث. اليوم سوف نصنف الملائكة كما F-airies و "القصدير كير تكون LLS". تصنف الحديثة دو VILS مثل دي مونس هيئة اجتثاث mented.
"4. إلى الاعتقاد بأن جميع الكتب السماوية التي تم إرسالها إلى الأنبياء مختلفة صحيحا. ومع ذلك، وبصرف النظر عن القرآن، كل الكتب الأخرى ليست صالحة بعد الآن."
ومن البنود الرئيسية في حذفها. لا يوجد كتب في ولاية روح السماء (إذا كان هناك واحد) فقط حيث لم تعد هناك ملائكة لكتابة / نشر / توزيعها. القرآن، OT، NT وما هي ببساطة الكتب التي كتبت من قبل البشر للبشر.
اخترعت الأنبياء من قبل الكتبة القديمة عادة للحفاظ على الجماهير غير المتعلمة في الخط. اليوم ونحن ندعو لهم فرز الأصوات للتناغم.
النبوءات كما invali مؤرخة من قبل الطبيعية / الله / الله الهدايا من الإرادة الحرة والمستقبل.
"5. إلى الاعتقاد بأن جميع الأنبياء صحيحا. ومع ذلك، ونحن مأمورون اتباع النبي محمد (عليه الصلاة والسلام
صلى الله عليه وسلم) وحده ".
قضى محمد ثلاثين يوما "الصيام" (أسطورة رمضان) في كهف الساخن قبل أول اتصال له مع الله الملقب الخ الله عبر "ممتزوجات افسح المجال ل جميلة". الحس السليم يتطلب حذف الخلايا العصبية من # 5. # 5 هو أيضا المصدر الرئيسي للالاسلامي VI-olence أي تحول محمد "سريع، يحركها الجوع" hallu-cinations إلى واقع فظيع لغير المؤمنين.
المشي هذه خمس خطوات، ونحن نضمن الانتعاش الكامل من الطرق الإسلامية الخاصة بك!!
للأسف، لا توجد العديد من المعلقين مسلم / القراء على هذا بلوق لذلك "مدة دقيقتين" العلاج هو عدم الحصول على لأولئك الذين في حاجة إليها. إذا كان لديك صديق مسلم، ترسل له نسخة وتساعد في إنقاذ العالم.
تتوفر خطوات مماثلة في طلبك للحصول على deprogramming الأساطير المسيحية واليهودية والبوذية والهندوسية والوثنية
If she were a TRUE muslim, there would be no problem. She'd be sitting at home with the children (having gotten 'married' at age 13 or so) and would not even be out in public during the day unless completely covered and attended by a male relative. Of course, being a medical student is beside the point because true muslims don't believe in educating women.
Really? Do you know every Muslim? To say that "true Muslims don't believe in educating women" is showing your ignorance. I have female Muslim friends who are PhDs, their friends are PhDs, have other doctorates, and are some incredibly educated Muslim women. some choose to wear the hijab, some do not. Gah. WHY do people have to just stand around and flail their hands claiming to know all about "true Muslims." Ignorance can be so depressing.
o Islam gives women almost no rights and treats them like fodder for the male species as so bluntly noted by Aya-an Hi-rsi Ali in her autobiography, In-fidel.
"Thus begins the extraordinary story of a woman born into a family of desert nomads, circu-mcised as a child, educated by radical imams in Kenya and Saudi Arabia, taught to believe that if she uncovered her hair, terrible tragedies would ensue. It's a story that, with a few different twists, really could have led to a wretched life and a lonely death, as her grandmother warned. But instead, Hi-rsi Ali escaped – and transformed herself into an internationally renowned spokeswoman for the rights of Muslim women."
ref: Washington Post book review.
some excerpts:
"Some of the Saudi women in our neighborhood were regularly be-aten by their husbands. You could hear them at night. Their scre-ams resounded across the courtyards. "No! Please! By Allah!"
"The Pakistanis were Muslims but they too had cas-tes. The Untou-chable girls, both Indian and Pakistani were darker skin. The others would not play with them because they were unt-ouchable. We thought that was funny because of course they were tou-chable: we to-uched them see? but also hor-rifying to think of yourself as un-touchable, des-picable to the human race."
"Between October 2004 and May 2005, eleven Muslim girls were ki-lled by their families in just two regions (there are 20 regions in Holland). After that, people stopped telling me I was exa-ggerating."
"The kind on thinking I saw in Saudi Arabia and among the Brotherhood of Kenya and Som-alia, is incompatible with human rights and liberal values. It preserves the feu-dal mind-set based on tr-ibal concepts of honor and shame. It rests on self-deception, hypro-cricy, and double standards. It relies on the technologial advances of the West while pretending to ignore their origin in Western thinking. This mind-set makes the transition to modernity very painful for all who practice Islam".
More on the treatment of females in Islam:
Islam’s widespread practice of amputating the cli-to-ris and sometimes part or even all of the vul-va from the ge-n-ita-lia of Muslim women, affirmed in a had-ith by Mohammed himself, most likely also traces back to the founder’s deliberate abuse of se-x to lure pagan males into his cu-lt. The more the male s-ex drive is purposefully aro-used, the more the female s-ex urge may have to be proportionately suppressed, lest org-iastic he-ll begin to spread.
Consider then what frequently happens when even a modestly clothed young Western woman walks alone in broad daylight down a street in, for example, a non-Westernized area of a city in Pakistan. Muslim men around her can see her face, hair and neck—maybe even her ankles. Some of them perceive that much exposure as intent on her part to a-rouse them. The fact that she is not accompanied by a male relative confirms their susp-icions. Knowing that she, a Western woman, has not been subjected to that cruel amputation which Islam forces upon millions of Muslim women, some males may even imagine that she must feel s-exual desire for them.
They tend also to perceive themselves as not responsible to exercise decent social restraint. Rather she is responsible not to tempt them! Whatever lewd thing Muslim men around her say, do or feel as a result is regarded as her fault alone. . . .
During a major upheaval in Indonesia in the late 1990s, s-ex-crazed Muslim men gang-ra-ped dozens of Chinese women in shops, homes and even in the streets, shouting in Arabic, “Allahu Akbar!” (God is great!)*
I once worked with someone who insisted on fasting during Ramadan. Unfortunately he was diabetic and fasting often sent him into convulsions. Given the risk to his health, wasn't he prohibited from fasting?
Only people in good health with no medical issues are supposed to fast. For example even healthy travelers have the valid option of making up the fast after Ramadan.
The Jews seem to have a more pragmatic approach to this sort of thing - they have a practice of exceptions so their observances won't let their customs interfere with the safety of the community. Its one thing to follow custom but you have to temper this with reason. For example, I was on a cruise recently to Alaska. The ship had a lot of Muslim staff who were getting a bit strained towards sundown because summer in Alaska does rather long days (~10pM to ~4am). (A pragmatic religion would simply define a 'day' as something like 6am to 6pm and leave it at that.)
Once you get very far north people use the timing of a closer region. Islam is a very pragmatic religion. There are no priests in Islam, everyone is supposed to be active in regular life and in their religious observances.
If fasting poses potential risks to others, to my knowledge fasting wouldn't be necessary, but the fasts would have to be made up on another date (such as when the individual is free to fast).