Sikhs

Background

Sikhism was established in northern India approximately five hundred years ago by Guru Nanak.1 During a period of time when there were conflicts between Muslim’s and Hindus, Nanak had a divine experience. He reported that he had been in communion with God – the Ultimate Reality or Divine One.2  God, according to Nanak, had called him to be a guru – a “spiritual preceptor.”3 For the remainder of his lifetime, Guru Nanak traveled to countries such as India , Iraq , and Arabia preaching a message of “equality between all religions, love between all men, faith in the one eternal, infinite God who has no rival, is not limited by time and can go anywhere.”4 There were nine other gurus that followed Guru Nanak. The last, Guru Gobind Singh, ended the line of personal gurus and passed the succession of the voice of God to the Sikh holy book.2

There are several sects within the Sikhism with some practices that differ from those of “orthodox” Sikhs. Sikhs who have undergone the sacred ceremony called amrit (a baptism ceremony) are called Khalsa. Today, Sikhism is the fifth largest religion with approximately twenty million Sikhs worldwide. There is a growing population in the United States and other areas of North America . The word “Sikh” means disciple or follower.5 The most important religious center for Sikhs is the Golden Temple (Harmandir Sahib) located at Amritsar in Punjab .6

Religious Representatives

• There is no formal priesthood in Sikhism. Each Sikh has a sacred duty to impart knowledge of the religion to others.7 Members of the family and community are expected to visit a Sikh who is hospitalized.

Religious Beliefs

• Religious book: Guru Granth Sahib (sometimes called the Adi Granth).

• Religious place of worship: Gurdwara (or Gurudwara), which means “door to enlightenment.” A Gurdwara may be a large temple-like building, a smaller more informal building, or a single room in a private home.2

• There is one God who is above all things and can be known through meditation. God should be worshipped daily.

• A person can be released from the cycle of birth, life, death and rebirth (reincarnation) and live forever united with God, by living his or her life in a manner that is God-like.8

• All persons have equal status in God’s eyes.

• The word, Khalsa means “pure ones.” Sikhs who have undergone the Khalsa baptism ceremony adhere to the Khalsa Code of Conduct, which defines social practices, ethical rules of conduct, acceptance of the teachings of the Gurus, and wearing of five physical articles of faith (or five Ks) as follows:

  • Kes (also referred to as Kesh, kais, kesa): Uncut hair, including body and facial hair. Hair on the head is worn in a topknot.4 All Sikhs, particularly in Western countries, do not adhere to this practice.3

  • Kangha: A comb carried as a symbol of hygiene, to keep the hair neat and to hold the topknot in place. Bald Sikhs also wear a kangha.3

  • Kara: A steel or iron bangle worn on the right wrist as a sign of loyalty to the Guru, as a reminder to the wearer to restrain his or her actions, and to remember God at all times.3, 5

  • Kirpan: A sword, often a short one, approximately four inches in length or a smaller steel replica. The kirpan is typically worn underneath the clothing and symbolizes defense for all that is just.3

  • Kachha: Knee-length pants tied with a drawstring, generally worn as an undergarment, symbolizing sexual restraint.3

• Men who are members of the Khalsa must wear a turban. However, the turban is not one of the five Ks. Women are not required to wear a turban, but may do so if desired. A scarf instead of a turban is acceptable for women.7  The turban is a method of keeping the hair neat and tidy. It consists of a lengthy piece of cloth and is generally tied as an inverted V over the forehead. The color, shape of the turban, and the manner in which it is tied, can indicate a Sikh’s age, geographical origin and/or political preference. A keski, or small under-turban about one-fourth the size of the outer turban, may be worn only when not in public.3

Special Celebrations/Religious Observations

• There is no fixed day of worship for Sikhs. Persons may gather at any time for worship.6, 7

• Sikhs celebrate a number of festivals, which follow the lunar calendar. Gurpurbs are celebrations of important events in Sikh history. Three gurpurbs celebrated by Sikhs everywhere are the commemoration of the birth of Guru Nanak (November), the birth of Guru Gobind Singh (December/January), and the martyrdom of Guru Arjan (May/June).7

• Baisakhi: Celebrates the formation of the first Khalsa. Generally, falls during April.11

• Divali: Also called the Festival of Light, generally falls in October or November. This festival symbolizes peace and joy.

• Naming Ceremony: Religious ceremony performed in the Gurdwara, during which a newborn receives his or her name. The ceremony is one of thanksgiving for the birth of the child.8

• Sikhs who have been initiated into the Khalsa take the name Singh for men (meaning “lion’) or Kaur for women (meaning “princess”). 11

Health Beliefs

• All humans suffer. Suffering stems from two sources—failure to appreciate God’s creation and failure to control the mind.8

• Alcoholic beverages, narcotics, tobacco are avoided by most.

• The five Ks are worn at all times, even during hospitalization, illness at home, or when washing. Consult patient/family before removing any of these items.14

• Women may consider themselves unclean during menstruation.

Kinship/Social Factors

• Sikhs may have a large extended family, which includes all members of the Sikh community. Elders are valued and cared for by the family.

• Men and women have equal status. However, women are expected to cover their legs.15 Women may wear loose trousers called salvars and a shirt that reaches to the knees.2

• Provide same-sex caregivers, including physicians, particularly for women. Protect modesty, leaving the body covered as much as possible.

• Eye contact may be avoided between children and adults, men and women.

• Family members are likely to stay with a relative who is hospitalized. Allow participation in care as much as possible.

Birth/Children

• Children are considered a gift from God. The father will wish to whisper the Mul Mantra (guru Nanak’s first poetical statement) into the newborn’s ear as soon as possible following birth.8, 9

• The mother may be secluded for a period of thirteen to forty days following delivery. This is considered a period of impurity.3, 14

• Birth Control: Acceptable

• Artificial Insemination: Permitted if sperm is from husband.

• Elective Pregnancy Termination: Generally unacceptable.

• Children’s hair will be left uncut. Boys may undergo a ceremony of turban-typing in the gurdwara at 10–12 years of age. From this point forward, the turban should be treated with the same care and symbolism as with adults. Teenage boys will not shave.2

Dietary Considerations

• Many Sikhs are vegetarians. Alcohol is prohibited.

• During hospitalization, family members may bring karah parshad (a special food that has been blessed) to the ill relative. If at all possible, the hospitalized person should be allowed to have a small piece of the food, even if on a restricted diet.14

Death

• Scriptures will be read and hymns changed during the last hours of a Sikh’s life.

• Hope, rather than sadness, should characterize the death of a Sikh.8 Expressions of grief for one who has lived a happy and long life are limited or not seen at all. It is believed that crying, etc. will interfere with a peaceful departure of the dying person. Expressions of grief may be more liberal with a person dies early in life or from some unnatural cause.2, 11

• The family will likely wish to prepare the relative’s body following death. This involves washing and dressing the deceased by wrapping in a white shroud, leaving the five Ks in place. The head will be wrapped in a turban.14 If no family is available, the head of the deceased should be kept covered. All hair should be left untrimmed. The face should be cleaned and the eyes and mouth closed. Limbs should be straightened and the body covered with a solid white sheet. The five Ks should be left in place.16

• Sikhs are generally cremated within twenty-four hours of death, if possible. Stillborns and neonates may be buried.15

• Autopsy: Acceptable, but generally not desirable unless required by law.16

• Organ Transplant/Donation: Acceptable 16

Other Considerations

• Baths are taken daily at dawn, followed by meditation and prayer. Additional prayers are offered in the evening and before going to sleep. Plan care to incorporate these practices. Provide privacy.17

• Cutting/shaving of hair should be avoided. Consult patient/family, except under extreme emergencies, explaining medical reasons, etc.

• If the kachha must be removed for medical examinations or childbirth, discuss keeping them around one leg instead of removing them.14

• If the turban must be removed, the majority of Sikh men will want their head and hair covered with a cloth. The turban should be handled with care and held using two hands. Leave the turban near the patient, if possible. It should not be placed in a bag with other clothing or allowed to touch the floor.14

• If there is space in the home, a copy of the Adi Granth will be placed in a separate room. The holy text will be opened during the morning and put to rest after sunset each day.17

• Blood Transfusions: Acceptable 16

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