Application and training of Al-Fashdu therapy for healing and reducing the use of chemical drugs

Al-Fashdu therapy is an Islamic-based alternative treatment that is one of the community's options for dealing with health problems. In addition to reducing disease, this therapy is inexpensive because it does not use chemical drugs. This Community Service aims to introduce treatment using the Al-Fashdu method to residents of RT 06 RW 05,


INTRODUCTION
Health is an important thing for life. The World Health Organization (WHO) defines health as a perfect condition in a person both physically, mentally and socially, not only free from disability, but also economically and socially productive. Therefore, everyone certainly wants to live a happy healthy life and always want to look healthy and fit. However, this cannot be felt when a person has an illness. The development of the current era raises many risks of degenerative diseases. Degenerative diseases are health conditions that cause tissues or organs to deteriorate over time. These diseases are caused by the aging process, or get worse during the aging process, due to genetic problems and lifestyle choices (Budiman, 2022). In Indonesia, degenerative diseases can be in the form of high blood pressure, blood sugar, heart disease, cholesterol, rheumatism, etc., which are mostly experienced by people in the elderly (over 60 years old).
In general, medical treatment is the main choice to cure illness. However, some people did not choose medical treatment because they do not experience significant healing (Fanani & Dewi, 2014;Rayner et al., 2009). Medical treatment is also tends to cost a lot for some people (Kasmawati & Muharram, 2019;Triratnawati, 2010). This causes some people to choose and use alternative medicine. Alternative medicine is non-medical treatment where the equipment and materials used are not aligned with medical treatment standards. Alternative medicine is also not carried out by professional health workers such as doctors (Firmansyah, 2017). This form of health service is usually referred to as complementary and alternative medicines (CAMs). Although there is no strong scientific evidence that alternative medicine can cure disease, alternative medicine has benefits including helping to relieve side effects from medical treatment, providing comfort, and reducing worries about health conditions (Arista, 2021;Firmansyah, 2017).
As a predominantly Muslim country, one of the alternative treatments that is widely used by people in Indonesia is Islamic medicine known as Al-Fashdu therapy. Al-Fashdu, or in medical terms called phlebotomy, is a treatment recommended by the Prophet Muhammad in which blood is removed from the vein at the chosen point. Pulse checking also carried out to ensure that the patient really can be treated with the Al-Fashdu method (Sofyan, 2020). Al-Fasdhu's method of therapy is to remove deoxygenated blood from the body which contains residue from metabolism in the form of bad cholesterol, excess sugar levels, uric acid, and is excreted through blood vessels (not all vessels contain deoxygenated blood). A therapist must know the procedure as well as the place and point of the source of the disease. The deoxygenated blood is called Al-Fasdhu which is believed to be able to treat physical ailments (Habibah et al., 2020). The treatment technique is by means of a small puncture using a special and sterile needle, so it is safe from disease transmission and is not dangerous (Rahman et al., 2018).
The way Al-Fashdu works is almost the same as cupping (bekam), both of which remove blockages and deoxygenated blood (toxins/poisons of the body). The difference is, Al-Fashdu removes blockages and body toxins through the veins or large blood vessels, while cupping removes blockages and body toxins through capillaries or small blood vessels (Al-Muhasibi, 2021). Al-Fashdu is very effective in reducing cholesterol, uric acid, blood sugar, high blood pressure, itching, and other harmful substances that mix with the blood in the blood vessels (Adminrumah, 2021). Al-Fashdu therapy is not only for people with old age, teenagers can also do this kind of treatment. In addition, if it is done regularly every month, the impact that occurs is that the skin will be cleaner and brighter, because blood circulation is always replaced by removing old blood.
Residents of RT 06 RW 05, Perum Lembah Harapan, Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya, often complain of back pain, knee pain, high cholesterol, diabetes, itching, dizziness, and others. Residents also complained that the effects of medical treatment they received were not significantly affect them, besides that, they also complained that medical treatment required a lot of money.
Based on the pre-survey conducted by the community service team, it is known that most residents do not know about and have not used alternative medicine, especially Al-Fashdu therapy. Residents also do not know the benefits and positive effects of this therapy for health. Therefore, the Yos Soedarso University community service team introduced Al-Fashdu therapy to residents. This community service program aims to socialize, apply, and provide training on Al-Fashdu medication to cure disease and reduce consumption of chemical drugs.

METHODS
Implementation of this community service program for 4 (four) days in July 2022. The community service team consists of 3 lecturers and 5 students from Yos Soedarso University Surabaya and 22 | 201 | Application and training of Al-Fashdu therapy for healing and reducing the use of chemical drugs Anindya Prastiwi Setiawati, Masliyah Masliyah, Eva Sundari therapists from Healthy Smart Indonesia (HSI). 75 partners involved in this activity, mostly consisting of housewives, retirees, and active employees/entrepreneurs who mostly have complaints of diseases such as high blood sugar, high blood pressure, high cholesterol, rheumatism, itching, dizziness, and others.
Methods in community service are designed to implement predetermined goals which include planning, work sequences, and evaluation to get the results that are as expected. The stages carried out in carrying out this service include: (1) Survey stages to obtain primary data about the condition and health status of partners; (2) The preparatory stage, is a series of activities that include finding or collecting and studying all forms of activities that can support in achieving the goals to be achieved. This preparatory stage includes finding a location, looking for therapists, setting a time for implementation; (3) Requesting permit stage. This stage is carried out by submitting permits to carry out activities to related parties; (4) Data collection stage. At this stage, data and information are collected from Partners who will take part in training and treatment; (5) Socialization stage. This stage is carried out by providing material by means of lectures using power point and LCD; (6) Stages of application or treatment. Treatment is carried out directly to partners by the Therapeutic Team and supervised by health workers; (7) Training stage. This stage is carried out by providing training and direct assistance to partners on how to carry out Al-Fashdu therapy; (8) Evaluation stage. This stage is carried out by providing a list of questions to partners to identify their knowledge and understanding of the implementation of the Al-Fashdu therapy program. The stages of implementing the community service program are shown in Figure 1. out in carrying out this service include: (1) Survey stages to obtain primary data about the condition and health status of partners; (2) The preparatory stage, is a series of activities that include finding or collecting and studying all forms of activities that can support in achieving the goals to be achieved. This preparatory stage includes finding a location, looking for therapists, setting a time for implementation; (3) Requesting permit stage. This stage is carried out by submitting permits to carry out activities to related parties; (4) Data collection stage. At this stage, data and information are collected from Partners who will take part in training and treatment; (5) Socialization stage. This stage is carried out by providing material by means of lectures using power point and LCD; (6) Stages of application or treatment. Treatment is carried out directly to partners by the Therapeutic Team and supervised by health workers; (7) Training stage. This stage is carried out by providing training and direct assistance to partners on how to carry out Al-Fashdu therapy; (8) Evaluation stage. This stage is carried out by providing a list of questions to partners to identify their knowledge and understanding of the implementation of the Al-Fashdu therapy program. The stages of implementing the community service program are shown in Figure 1.

RESULTS AND DISCUSSION
This community service program is carried out at RT 06 RW 05, Perum Lembah Harapan, Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya, which is located about 9 Km from the Yos Soedarso University Surabaya campus. This residential location is quite strategic and is inhabited by many residents with various professional and occupational statuses. Most of the livelihoods are entrepreneurs/self-employed people aged between 45-60 years, with a total of more than 50 family heads.

Socialization Stage
The socialization was carried out on July 20 2022 at Balai RT 06 Perum Lembah Harapan, Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya City. Socialization is implemented in the provision of material about alternative medicine which aims to provide knowledge and understanding of alternative Islamic medicine (Thibbun Nabawi). The material and implementation are shown in detail in Table 1.

RESULTS AND DISCUSSION
This community service program is carried out at RT 06 RW 05, Perum Lembah Harapan, Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya, which is located about 9 Km from the Yos Soedarso University Surabaya campus. This residential location is quite strategic and is inhabited by many residents with various professional and occupational statuses. Most of the livelihoods are entrepreneurs/selfemployed people aged between 45-60 years, with a total of more than 50 family heads. out in carrying out this service include: (1) Survey stages to obtain primary data about the condition and health status of partners; (2) The preparatory stage, is a series of activities that include finding or collecting and studying all forms of activities that can support in achieving the goals to be achieved. This preparatory stage includes finding a location, looking for therapists, setting a time for implementation; (3) Requesting permit stage. This stage is carried out by submitting permits to carry out activities to related parties; (4) Data collection stage. At this stage, data and information are collected from Partners who will take part in training and treatment; (5) Socialization stage. This stage is carried out by providing material by means of lectures using power point and LCD; (6) Stages of application or treatment. Treatment is carried out directly to partners by the Therapeutic Team and supervised by health workers; (7) Training stage. This stage is carried out by providing training and direct assistance to partners on how to carry out Al-Fashdu therapy; (8) Evaluation stage. This stage is carried out by providing a list of questions to partners to identify their knowledge and understanding of the implementation of the Al-Fashdu therapy program. The stages of implementing the community service program are shown in Figure 1.

RESULTS AND DISCUSSION
This community service program is carried out at RT 06 RW 05, Perum Lembah Harapan, Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya, which is located about 9 Km from the Yos Soedarso University Surabaya campus. This residential location is quite strategic and is inhabited by many residents with various professional and occupational statuses. Most of the livelihoods are entrepreneurs/self-employed people aged between 45-60 years, with a total of more than 50 family heads.

Socialization Stage
The socialization was carried out on July 20 2022 at Balai RT 06 Perum Lembah Harapan, Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya City. Socialization is implemented in the provision of material about alternative medicine which aims to provide knowledge and understanding of alternative Islamic medicine (Thibbun Nabawi). The material and implementation are shown in detail in Table 1. The material was given to the residents of RT 06 Lidah Wetan Village, Lakarsantri Subdistrict, Surabaya, carried out by a team of therapists from Healthy Smart Indonesia (HSI) and accompanied by a community service team which was held at the Yos Soedarso University Surabaya campus. The team of therapists from Healthy Smart Indonesia gave a brief explanation about treatment using the Al-Fashdu method, and diseases that can be treated with Al-Fashdu therapy. The material also contains rules before and after doing Al-Fashdu.
This socialization was attended by the Head of RT 06, community leaders, the community service team at Yos Soedarso University Surabaya, and a team of therapists from Healthy Smart Indonesia (HSI). Socialization is also given to provide an in-depth understanding of the Al-Fashdu therapy method which is still the pros and cons in society. Several substantive questions about Al-Fashdu therapy were submitted by partners and received good responses from the speakers. Based on the results of socialization, question/answer, and discussion, the benefits of Al-Fashdu therapy are lowering cholesterol, being able to balance iron, lowering high blood pressure, cleaning the lymph system, improving health, maintaining and improving body health, improving blood circulation , maintaining spinal health, helping the spinal cord in producing new red blood cells, and reducing consumption of drugs derived from chemicals, this condition will result in a decrease in the quality of red blood cells and can trigger damage to the function of other organs. This is in accordance with the opinion expressed by Ahmad (2021), based on information from Islamic religious leaders that Al Fashdu therapy is beneficial in preventing and improving the condition of the body by: (1) Regulating toxins in the body that are not needed must be removed so that all organs can work properly. Several organs will be encouraged to work more effectively through Fashdu therapy because it is very effective in removing toxins from the body; (2) Stimulates the spinal cord. By forcing the body to produce new red blood cells in this Fashdu way, the body has the opportunity to make new, healthier cells as well as the bone marrow has the opportunity to produce new red blood cells; (3) Avoid complications. After a patient is diagnosed with certain blood conditions, the patient will be advised to undergo drug disposal via the Al-Fashdu method. Although side effects have not manifested, complications can still be avoided with early treatment; (4) Improve blood flow. Activities such as smoking, high-sugar diets, cell phone radiation, radio frequency and other electromagnetic waves will make blood hypercoagulable which has the potential to raise the risk of blood clots and strokes. To improve this blood flow, one of the best ways that can be done is with Fashdu so that deoxygenated and thick | 203 | Application and training of Al-Fashdu therapy for healing and reducing the use of chemical drugs Anindya Prastiwi Setiawati, Masliyah Masliyah, Eva Sundari blood can come out so that new red blood production can increase; (5) Addressing medical conditions that can cause abnormalities in the blood, for example hemochromatosis and polycythemia, whereby Fashdu therapy will change the composition of the blood so that symptoms of disease conditions can be improved; (6) Balancing iron so that it does not occur such as weakness, fatigue or heart failure. This excess iron can be treated with Al-Fashdu so that it does not cause complications such as problems with the pancreas, liver and also reproduction; (7) Improving the overall health of the body due to the removal of unnecessary accumulated poisons, excess lipids and also crystals will be excreted from the body along with the blood; (8) Cleansing the lymphatics and circulation. The Fashdu method is very good for people with hypertension because Fashdu can significantly reduce blood pressure and cholesterol levels in the body; (9) Gives the spleen a chance to rest. The spleen is the main organ whose job is to filter blood so that old red blood cells can be removed.

Treatment Stage with Al-Fashdu Method
After the socialization and delivery of material, it has been continued with the implementation of treatment for residents on July 24, 2022 which starts around 08.00-16.00. The enthusiasm of the residents was quite high, as the day progressed, more and more residents came for treatment. About 75 participants were followed, of which almost 60% were aged 50 years and over with complaints of knee pain, back pain, cholesterol, neck stiffness, and others. This community service is carried out professionally by a team of therapists who are certified as therapists, and carried out in accordance with predetermined Standard Operating Procedures, including patients before being treated are always measured for blood pressure (tension), and this is to determine the patient's condition and to determine therapy what should be done. In addition to tension, tongue analysis was also carried out on the patient. Treatment with the Al-Fashdu method is the main treatment without chemical drugs. This treatment applies to the general public, not specifically for Muslims. After receiving Al-Fashdu therapy, patients or participants can feel the effects, including necks that feel stiff or heavy, after the therapy has disappeared, there are also those who feel a significant impact, namely participants whose cholesterol tall to his feet which were initially a bit heavy to walk, after being treated for light feet and can be used to walk. In addition to Al-Fashdu's treatment, the therapist team also introduced End of Age Medicine (PAZ) to residents.
After the implementation of the activities by the Yos Soedarso University community service team, currently many residents in Perum Lembah Harapan RT 06 and its surroundings routinely carry out treatment using the Al-Fashdu method by contacting the therapists directly.

Treatment Stage with Al-Fashdu Method
After the socialization and delivery of material, it has been continued with the implementation of treatment for residents on July 24, 2022 which starts around 08.00-16.00. The enthusiasm of the residents was quite high, as the day progressed, more and more residents came for treatment. About 75 participants were followed, of which almost 60% were aged 50 years and over with complaints of knee pain, back pain, cholesterol, neck stiffness, and others. This community service is carried out professionally by a team of therapists who are certified as therapists, and carried out in accordance with predetermined Standard Operating Procedures, including patients before being treated are always measured for blood pressure (tension), and this is to determine the patient's condition and to determine therapy what should be done. In addition to tension, tongue analysis was also carried out on the patient. Treatment with the Al-Fashdu method is the main treatment without chemical drugs. This treatment applies to the general public, not specifically for Muslims. After receiving Al-Fashdu therapy, patients or participants can feel the effects, including necks that feel stiff or heavy, after the therapy has disappeared, there are also those who feel a significant impact, namely participants whose cholesterol tall to his feet which were initially a bit heavy to walk, after being treated for light feet and can be used to walk. In addition to Al-Fashdu's treatment, the therapist team also introduced End of Age Medicine (PAZ) to residents.
After the implementation of the activities by the Yos Soedarso University community service team, currently many residents in Perum Lembah Harapan RT 06 and its surroundings routinely carry out treatment using the Al-Fashdu method by contacting the therapists directly. Volume 8, No 1, February 2023: 199-207 therapy has disappeared, there are also those who feel a significant impact, namely participants whose cholesterol tall to his feet which were initially a bit heavy to walk, after being treated for light feet and can be used to walk. In addition to Al-Fashdu's treatment, the therapist team also introduced End of Age Medicine (PAZ) to residents.

ABDIMAS: Jurnal Pengabdian Masyarakat Universitas Merdeka Malang
After the implementation of the activities by the Yos Soedarso University community service team, currently many residents in Perum Lembah Harapan RT 06 and its surroundings routinely carry out treatment using the Al-Fashdu method by contacting the therapists directly.

Al-Fashdu Therapy Training and Assistance Stage
The next series of community service activities is to provide Al-Fashdu treatment training by the HSI therapist team, with the hope that the trainees will be able to carry out therapy independently for themselves or their families. Implementation of the training on September 2, 2022 at the Yos Soedarso University campus. Presentation of material by the HSI therapist team which contains the understanding of Al-Fashdu therapy, types of diseases that can be cured with Al-Fashdu therapy, rules before and after Al-Fashdu, how to analyze the patient's tongue, and about how to determine or look

Al-Fashdu Therapy Training and Assistance Stage
The next series of community service activities is to provide Al-Fashdu treatment training by the HSI therapist team, with the hope that the trainees will be able to carry out therapy independently for themselves or their families. Implementation of the training on September 2, 2022 at the Yos Soedarso University campus. Presentation of material by the HSI therapist team which contains the understanding of Al-Fashdu therapy, types of diseases that can be cured with Al-Fashdu therapy, rules before and after Al-Fashdu, how to analyze the patient's tongue, and about how to determine or look for veins. As for the patients who are prohibited from receiving Al-Fashdu therapy, namely: Hemophilia, Anemia, Hypotension, Hypoglycemia, too thin, weak, too fat so it is difficult to find the veins, Hepatitis (not recommended), and too old. Furthermore, the introduction of Al-Fashdu equipment, namely tourniquet, kidney tray, G18 syringes, 95% alcohol, plaster, and gloves. Followed by how to look for veins either on the hands or on the feet, how to install a tourniquet, how to install and inject a needle into the vein. After that all participants must be able and dare to do Al-Fashdu on themselves.
for veins. As for the patients who are prohibited from receiving Al-Fashdu therapy, namely: Hemophilia, Anemia, Hypotension, Hypoglycemia, too thin, weak, too fat so it is difficult to find the veins, Hepatitis (not recommended), and too old. Furthermore, the introduction of Al-Fashdu equipment, namely tourniquet, kidney tray, G18 syringes, 95% alcohol, plaster, and gloves. Followed by how to look for veins either on the hands or on the feet, how to install a tourniquet, how to install and inject a needle into the vein. After that all participants must be able and dare to do Al-Fashdu on themselves.

Evaluation Stage
There are 2 methods of evaluation carried out, namely direct interviews that produce citizen testimonials and using a list of questions for training participants. The interview method was carried out by directly asking residents who had taken treatment using the Al-Fashdu method. Inquiry via WhatsApp about whether there are any impacts or effects felt after the Al-Fashdu therapy. The very encouraging thing is that once the implementation of Al-Fashdu therapy was finished, testimonies from patients or participants felt a positive impact on their health, including a neck that felt stiff or heavy after being treated had disappeared, residents who had high cholesterol levels decreased and were able to walk back, the body becomes healthier, no dizziness, no itching, and can sleep better.
Evaluation was carried out on Al-Fashdu therapy training participants using a list of questions. This evaluation was carried out by the community service team to measure the extent of the participants' knowledge and understanding of Al-Fashdu therapy. The evaluation results are presented in Table 2.

Evaluation Stage
There are 2 methods of evaluation carried out, namely direct interviews that produce citizen testimonials and using a list of questions for training participants. The interview method was carried out by directly asking residents who had taken treatment using the Al-Fashdu method. Inquiry via WhatsApp about whether there are any impacts or effects felt after the Al-Fashdu therapy. The very encouraging thing is that once the implementation of Al-Fashdu therapy was finished, testimonies from patients or participants felt a positive impact on their health, including a neck that felt stiff or heavy after being | 205 | Application and training of Al-Fashdu therapy for healing and reducing the use of chemical drugs Anindya Prastiwi Setiawati, Masliyah Masliyah, Eva Sundari treated had disappeared, residents who had high cholesterol levels decreased and were able to walk back, the body becomes healthier, no dizziness, no itching, and can sleep better.
Evaluation was carried out on Al-Fashdu therapy training participants using a list of questions. This evaluation was carried out by the community service team to measure the extent of the participants' knowledge and understanding of Al-Fashdu therapy. The evaluation results are presented in Table 2.  sufferers with answers somewhat agreeing 40%, using treatment with the Al-Fashdu method regularly with answers agreeing 40 %, believing that the Al-Fashdu method of treatment can reduce the consumption of chemical drugs with the answers strongly agreeing 60%, doing Al-Fashdu therapy independently for themselves with answers somewhat agreeing 50%, and doing Al-Fashdu therapy independently to other sufferers with answers somewhat agreeing 40% but strongly disagreeing 30% and disagreeing 30%, this indicates that residents still tend to be hesitant to perform Al-Fashdu treatment on other people, because they still do not have sufficient experience and are not professional in carrying out the treatment process. In general, the community service program carried out by the Yos Soedarso University Community Service Team has been carried out in accordance with the goals and targets of the program. Partners benefit from participating in training and treatment with the Al-Fashdu method. Some of the obstacles include that people's understanding of alternative medicine using the Al-Fashdu method is still lacking, moreover there are many hoaxes circulating that are not true (Dida et al., 2020), there are people's doubts that this alternative treatment does not meet the medical requirements it should, and there is no valid argument in the Qur'an about the Al-Fashdu method which can cure physical ailments (Habibah et al., 2020) Based on Table 2, the results of the training showed that the participants had knowledge of the understanding of alternative Islamic medicine, especially with the Al-Fashdu method with 50% strongly agree answers, knowledge of methods, tools, sequences, and treatment procedures with the Al-Fashdu method with agreed answers 60%, understanding of the benefits of Al-Fashdu therapy with answers that strongly agree 40%, understanding that Al-Fashdu method of treatment cannot be given to some sufferers with answers somewhat agreeing 40%, using treatment with the Al-Fashdu method regularly with answers agreeing 40 %, believing that the Al-Fashdu method of treatment can reduce the consumption of chemical drugs with the answers strongly agreeing 60%, doing Al-Fashdu therapy independently for themselves with answers somewhat agreeing 50%, and doing Al-Fashdu therapy independently to | 206 | ABDIMAS: Jurnal Pengabdian Masyarakat Universitas Merdeka Malang Volume 8, No 1, February 2023: 199-207 other sufferers with answers somewhat agreeing 40% but strongly disagreeing 30% and disagreeing 30%, this indicates that residents still tend to be hesitant to perform Al-Fashdu treatment on other people, because they still do not have sufficient experience and are not professional in carrying out the treatment process.
In general, the community service program carried out by the Yos Soedarso University Community Service Team has been carried out in accordance with the goals and targets of the program. Partners benefit from participating in training and treatment with the Al-Fashdu method. Some of the obstacles include that people's understanding of alternative medicine using the Al-Fashdu method is still lacking, moreover there are many hoaxes circulating that are not true (Dida et al., 2020), there are people's doubts that this alternative treatment does not meet the medical requirements it should, and there is no valid argument in the Qur'an about the Al-Fashdu method which can cure physical ailments (Habibah et al., 2020).

CONCLUSION AND RECOMMENDATIONS
The community service program was carried out by the Yos Soedarso University Surabaya community service team along with the Al-Fashdu medical therapist team from Healthy Smart Indonesia (HSI). The aim of this program is to provide socialization, training, and treatment of the Al-Fashdu method for 75 residents of RT 06 Lidah Wetan Village, Lakarsantri District, Surabaya. Based on the results of the community service program, it shows that the community has good knowledge and understanding of the Al-Fashdu method, the community obtains health benefits after receiving Al-Fashdu therapy, and the community can take advantage of this alternative treatment to reduce consumption of chemical drugs. However, some people are still hesitant to provide the Al-Fashdu method of treatment for others because of their lack of experience and not being professional in carrying out the treatment process.
The limitation in implementing this community service program is that Al-Fashdu treatment itself is still not widely known, so there are still doubts in the community. In addition, there are also limited time and place for implementation as well as limitations on program socialization. For this reason, suggestions for further service workers need to do more open socialization, especially by using online media or social media, collaborating with the health office to add facilities and increase public trust, as well as increase the number of partners to receive training on alternative Islamic medicine.