Cairo Magazine - The big picture

Ahmed Hosni

Every type of medicine has its specialty,” explains Quanmin Yang, an acupuncuture and acupressure therapist who doubles as a tai chi and chi kong instructor. “If someone has a headache, then the pills of Western medicine can quickly relieve the pain. The pills work on the level of the pain, they do not go beyond to try and solve the problem that caused this pain in the first place. It is like a car that breaks down before a midan. It slows the cars passing it down so they arrive at a slower speed to the midan. They slow the traffic down and you start to experience what is known as a traffic jam. Instead of hunting for the real reasons behind this traffic jam, western medicine simply removes the traffic jam. So it’s just a matter of time before the broken down car will cause a traffic jam once again. Traditional [Chinese] or even holistic medicine is comparatively slower, but takes into consideration the whole human structure.”

This characterization of “alternative” medicine is common. What is surprising, though, is the growth of its acceptance among not only people looking for remedies, but the conventional medical community as well.

“As physicians, it is our responsibility to research all the possible lines of treatment for the patient’s benefit. We cannot reject something simply because we are not familiar with it,” points out Dr. Nabil Mawsoof, professor of pain management and head of the ozone therapy unit at the National Cancer Institute at Cairo University.

The treatments that fall under the category of alternative medicine are many and varied. They range from practices like acupuncture, which has a long tradition of use as well as a certain amount of scientific backing, to more contested ideas such as color therapy and healing with crystals.

However, most fall under the range of what are known as “complementary alternative medicines” (CAM), meaning that they are meant to be taken in conjunction with normal medical treatments, not replace them. All CAM praticitioners stress the importance of going to see a medical professional if surgery required, communicable diseases involved, or when faced with any serious life-threatening illness.

In some parts of the world, “alternative” therapies are not alternative at all, but are either quite conventional or supplement to Western therapies. For example, in China a variety of choices come standard with any visit the hospital. Yang explains, “In China if I am sick I go to the hospital ... where I am asked whether I want a traditional [Chinese] treatment or a Western doctor.” After being tested, the patient can opt for anything from Chinese herbs, acupuncture, acupressure, suction cups or conventional medicine.

In Egypt, the kind of services available very much depends on where you look.

Dr. Nasser Loza, psychiatrist at Behman Hospital for Mental Health explains, “In Egypt, there are many sectors providing varying qualities health care. There is the state health service, which the ministry of health is in charge of, multiple different medical schools, the national insurance scheme or tameen sehi, which has its own facilities, not to mention a very extensive private sector. Each of these sectors is independent and they rarely communicate.”

There is, however, some acceptance in the world of conventional medicine that a complementary approach may have its benefits, or at the very least not have any drawbacks, as long as conventional treatment is continued.

Dr. Loza agrees that alternative medicine may have a place in conventional healing. “Medical services, known today as health care, have become an integral part of society in the civilized world. In my opinion, both conventional and alternative medicines are needed in today’s health care system. In fact, they complement each other.”

“Now we have started researching the use of complementary alternative medicine in conjunction with conventional medical procedures. For instance, we are using nigella sativa [known locally as Habet Al Baraka or black seeds] in association with chemotherapy at the cancer institute to determine its influence in improving the general well-being in patients receiving chemotherapy in 700 individuals. The results may take some time, but at least it’s a step away from what has become stagnant practice,” says Cairo University’s Dr. Mawsoof.

“Lets say a group of people all have panic attacks,” Dr. Loza explains. “I may respond better to medication, you might get better results with cognitive behavior therapy, a third may prefer homeopathy, for a fourth the ideal thing may be group therapy. The fact that it may work well for someone and not for someone else does not make any of these methods more right or wrong than the other.”

Growth industry

The last five years has seen a steady growth in the alternative scene in Cairo, and those in the business say that this is just the beginning.

At first, participation in alternative medicine was sparse. “We basically started taking lectures in homeopathy in ‘93 with Peter Chappell. Not many people were involved in alternative medicine back then. Now we have regular courses to teach others,” says Dr. Abdul Hai Holdjik, lecturer at AUC and practicing homeopath who manages the Society of Homeopaths website.

Hands-on healer, Linda Noorlander, has also noticed growth in the sector. “In the past year, four or five centers have started up in Cairo alone,” Noorlander says. However, she insists that there is still plenty of room for growth in the field, both in Cairo and the rest of Egypt. “For a city of 20 million, 5 or 6 centers is not much at all. There are 1,100 names on my mailing list and the numbers are increasing. I know of a couple of people in Alexandria, a few hotels that offer the more mainstream disciplines in Hurghada and Sharm Al Sheikh, plus a few private practices that run regular workshops in Dahab, Nuweiba and Ras Shaitan.”

Despite its limited presence over the last decade, Noorlander found that holistic medicine was still a relatively unknown treatment option in Cairo when she started Insight-Inside Complementary Healing Center in Mohandiseen three years ago. “You had to do an enormous amount of work to spread your name and to make people aware of the possibilities,” she remembers.

Noorlander, however, found a receptive clientele in Cairo. Given the challenge of educating people about alternative health options, she says she “expected to have mainly a foreigner-based range of clients, being exposed to the possibilities from their home countries, but in actuality Egyptians formed about 80 percent when we started. Now it’s more balanced with an equal number of both locals and foreigners in the different workshops we provide.”

Sama (not her real name), who has tried Egyptian healing, new-style or “vortex” healing, magnetism and color therapy, says that in addition to her private sessions, it’s always refreshing to go to one of the group workshops, where the number of people present allows you to “see the world through different eyes.” She finds that going to alternative healing workshops helps her work through problems in her life.

May the force be with you

For the medical consumer, the range of services now available in Cairo is actually quite impressive. From the relatively mainstream practices of homeopathy and acupuncture to approaches that sound, to the uninitiated, more than a little wacky—such as crystal therapy—in-the-know Cairenes can now also get acupressure, herbology, reiki, jin shin jyutsu, Egyptian healing, color therapy, ozone therapy and biogeometry therapy.

One of the more widely-available alternative medical practices in Egypt is homeopathy. The basic (and still contested by the conventional medical community) principle of homeopathy is that a plant or mineral extract can have a potent effect on the body after it has been diluted to that point that it’s presence has become undetectable by conventional means. Homeopathy is common enough that Egypt now has a Society of Homeopaths. Homeopathy, like many alternative medicines, sells itself on not having any harmful side-effects, unlike traditional treatment. Some critics point out that this reflects the neutral value of the water, not its potency.

Clients and practitioners believe that the remedies are significantly more than “just water.” One client, who asked to remain anonymous, paid LE150 per session to receive treatment from two different homeopaths in Cairo. She described being asked lots of questions by one, while the other made his diagnosis more “intuitively.” The two homeopaths gave her opposite diagnoses and treatment options. While she eventually found that one of them worked for her, her experience may point to the lack of government oversight in homeopathy. It is not known if her homeopaths were certified by the Society of Homeopaths in Cairo.

Reiki, jin shin jyutsu and Egyptian healing, which fall under the general heading of “hands-on healing,” are three up-and-coming practices that might gain more acceptance in the future. They ostensibly work with the energy around an individual and aim to achieve a balance between the individual and his or her surroundings. This is done by placing the hands on or near the individual’s body (hence “hands-on”) and the practitioner claims to channel energy where it is needed.

“I like to think of it like kick-starting a car. Our bodies are wise and have the knowledge of how to make use of this abundant healing energy. That’s where the therapist comes in. They are just a vessel or a conduit that relays this healing energy to the client,” explains hands-on healer Rana Shoukry. “The clients start to be in harmony with their respective situations not merely ‘dis-ease’ free.”

Hands-on healing is done in Egypt at a number of places, including Insight-Inside and by Shoukry, Maha Corcoran and Leslie Zehr.

Rana Shoukry practices holistic medicine, especially hands-on healing, out of her home in Zamalek.

Ahmed Hosni

Closely related to hands-on healing is crystal therapy. Crystal therapy is also based on the theory of directing energy. Crystals are often set on the client’s body at specific points or in specific patterns in ways that are supposed to “release negative energy” or “bring light and healing.”

There are practitioners of crystal therapy here in Egypt, but the demand is miniscule still. “In England it’s quite a well-known discipline, though here in Cairo it is still pretty much obscure,” Corcoran explains. However, she contends that crystal healing can sometimes be easier for clients to understand because it is logical to use a crystal as a healing tool and because the effects can be stronger. “In comparison to hands-on healing, crystals can sometimes propagate a much more intense reaction after the healing session. Crystals focus the energy much more and therefore the effects may be more intense.”

Another relatively-unknown alternative medical practice available in Cairo is color therapy. Color therapy claims that auras—the electromagnetic field around each person—have different colors, each of which has a different frequency and therefore a different effect on health and well-being. Practitioners believe that you can look at a person’s aura, see what colors they are lacking, and expose them to that color to bring their bodies into balance. This is often done by shining colored lights on patients for set periods of time.

Even practitioners admit that color therapy can be a little challenging. “Color therapy requires a special kind of sophisticated patient, not everyone is receptive to the idea that colors can influence positive physiological effects,” says Dr. Ali Bayoumi, a professor of internal medicine in the faculty of medicine at Cairo University. According to practitioner Katriona Shawqy, patients don’t usually come to her seeking color therapy. However, she says, over the course of treatment, color therapy is often integrated with other treatments. She estimates that she sees between 20 and 25 clients a week and uses some aspect of color therapy with less than half of them.

Local knowledge

While early demand may have come largely from the local market, it has taken time for local expertise to catch up. It now seems, however, that this expertise is being developed.

Perhaps the most important sign that Egypt is opening up to alternative medicine is the appearance of training facilities. Dr. Bayoumi, as well as teaching internal medicine at Cairo University, heads their new complementary medical unit and is chairman of the Egyptian Society of Complementary Medicine (ESCM). “We are trying, through Cairo University and the Egyptian Society of Complementary Medicine, to train new practitioners through courses held in Egypt. ESCM has arranged up to 16 training courses in safe modalities such as acupuncture, manual therapy, homeopathy and Hijama, or cupping.”

Dr. Bayoumi hopes that by training qualified doctors in alternative medicine, they can produce health care workers who will use alternative practices to complement Western medicine, getting the best of both. He explains that “the damage done to [the reputation of] complementary medicine is by non-medical practitioners … who just want money and don’t care about the patient.”

So far, about 400 students have been trained through the ESCM training courses, which were run in cooperation with Cairo University. According to Dr. Bayoumi, training courses are scheduled whenever enough students have expressed interest. Although Cairo University started to offer some courses in complementary medicine about four years ago, Bayoumi stresses that “complementary medicine is not officially recognized in Egypt.”

Before Cairo University and ESCM started offering classes, Egyptians were often introduced to alternative medicine by chance and had to go abroad to study it. Amina Sabry, psychologist and practicing homeopath, says her first experience with alternative medicine came after she had a baby 17 years ago. She was given a choice between gynecological surgery or a shot at homeopathy. She chose to try homeopathy and says, “My condition improved markedly. I was very interested in the idea so I read more and then enrolled in correspondence classes and then later went to college in the U.S. My fascination was that you no longer had to withstand the harmful side-effects of medication and that there was no need to prolong treatment.”

Hands-on healer Shoukry’s first experience with alternative medicine came when she visited her cousin in Santa Fe in 1996. At the time she felt like a “physical and emotional wreck.” She was coaxed by a nagging cousin to get acupuncture treatment. The results? “Blew my mind,” describes Shoukry, “I awoke the next day to a feeling of well being that I had not imagined possible. Since then I saw no reason not to try to feel that way all the time.”

This incident prompted a trip to the library to learn more about what she had experienced and resulted in a two-year academic study at the International Institute of Chinese Medicine in Santa Fe. Further study and practice in jin shin jyutsu would follow.

Sabry says she has seen definite changes in the way alternative medicine is viewed in Egypt over the last 17 years. “When I first came across homeopathy in ‘88 it was a definite taboo to tell people, you only told your best friend and then only in whispers. Now it’s a lot more open.”

Both Shoukry and Sabry practice alternative medicine in Cairo now. Shoukry does hands-on healing out of her home in Zamalek, seeing four or five clients per day. Sabry practices homeopathy at the Digla Medical Center in Maadi.

Home grown cures

Not all alternatives, however, are learned in the West. Egypt has a wealth of traditional knowledge to offer as well, and part of the exploration of alternative and complementary therapies is an appreciation of the resources to be found right here on the doorstep.

The attar [traditional herbalist] is one of the first places people go looking for a simple solution to a health problem. Mahmoud Seada, 27, owner of Sayed Seada Al Attar and Sons says, “My most popular concoctions are those for bronchitis, kidney stones and infections. Everyone is returning to the use of traditional and natural remedies…. The people have grown sick of the chemicals in their medication that fix one thing and screw up 10 others.”

Seada’s popular concoctions include his remedies for the respiratory tract (coughing, dyspnea, infections and pain), the urinary tract (kidney infections and stones), the gastro-intestinal tract (diarrhea, constipation, flatulence and nausea), the colon and, of course, cosmetics and skin.

Seada recommends Habet Al Baraka (black seeds) first thing in the morning, to clean out your lungs. He says that when taken with honey, it ensures renewed strength and vitality (for more on black seeds, see page 23).

Such popular local resources have provided one of the most widespread alternatives to the conventional treatment of Hepatitis C, or HCV. HCV was spread to the otherwise healthy population of Egyptians when syringes were re-used in bilharzia vaccination campaigns between 1930 and 1950. Experts estimate that approximately 25 percent of the adult population of Egypt now carries the virus.

The interferon treatment conventionally employed to treat HCV is very expensive, costing between LE2,000 and LE3,000 per month, and many with the disease now take Al Haba Al Safra (the yellow seed) as an alternative.

The popularity of this treatment was amply demonstrated when the government restricted imports three years ago and the remedy’s prices sky-rocketed with small portions selling on the black market for LE150–250 per ounce. Sheer demand caused the government to review its position and allow the remedy back on the market nine months later. It can now be found at any attar for a more reasonable LE10–15 per ounce.

However, pharmacist George Shawqy does not put much stock in alternative treatments for HCV, calling it a “bad tradition in Egypt.” He says that many people will go and try alternative medicine but that “finally, they go to the doctor and take their [orthodox] medicine.”

Certification

The Society of Homeopaths, based here in Egypt, tries to ensure that patients see qualified practitioners. They require a minimum of E.U. standards for members. “We require a minimum of 750 hours of theoretical study and lectures coupled with a minimum of 250 hours of clinical practice with patients under the direct supervision of a trusted certified instructor,” explains Dr. Holdjik.

The Society of Homeopaths grant certificates to practitioners who meet their requirements and keep a database of qualified homeopaths on a website (www.h2rc2.com) that is overseen by Dr. Holdjik.

By laying down a fixed standard, alternative healers hope to weed out frauds, protect clients and avoid bad media harmful effecting the collective reputation of CAM therapists. “I personally verify the diplomas and documentation of any instructor before they are allowed to work with people in my center,” emphasizes Noorlander.

There are some unconfirmed rumors that homeopaths may acquire licenses to practice in Egypt. However, the Ministry of Health could not be reached for comment and Dr. Holdjik says this is news to him. “Officials, though, are allowing us to make a contribution to the health field as ‘consultants,’ as long as we make no claim to ‘cure’ anyone. Healing people, officially remains a claim exclusive to medical practitioners.”

One of the risks to practitioners of government regulation is amply demonstrated by the several cases in the last five years of homeopaths being accused of fraud. When the government tested remedies being sold for LE100 per vial and found them indistinguishable from water, the sellers ended up in court.

However, the risks of no regulation may be much greater. Dr. Bayoumi insists that government oversight could ensure patient safety, as well as safe-guarding the reputation of alternative and complementary medicine. “Any drug not approved by the Ministry of Health should not be given to patients. This is the case with herbal street medicines sold by the attar. There is no data of the ingredients, no knowledge therefore of possible negative interactions, the purity [of the constituents], the culture where it was grown and lastly the date of production or the expiry date.” He does say, though, that the one exception to this should be homeopathy, because remedies are so diluted that they are not harmful.

No cure-all

For the time being, despite growing acceptance of some alternative therapies in the medical establishment, most non-conventional treatments remain out of reach for the majority of the population.

“We offer discounts and group rates, yet still it’s sad that it’s only accessible to a small piece of the population, even though instructors receive only a small fraction of what they would normally receive in Europe,” says Noorlander.

Treatment at Noorlander’s Insight-Inside costs LE150 for an hour and a half session of hands-on healing. Shoukry is a bit more expensive than that at LE250 per session, but she says that she offers discounts, especially for students and younger clients. “I never let anyone leave without getting treatment,” she says.

Sama, who uses alternative medicine, has found the prices prohibitive. “These therapies are rather limited at present to a small sector of society,” she says. “I’ve taken friends to try out different types of therapies that I felt they may need.

A wide variety of herbs are available from your local seed merchant.

Ahmed Hosni

Though they were amazed and felt great afterwards, sadly few were able to cope with the financial demands. In terms of affordability, they [alternative therapies] are not accessible to many. I only hope that more good therapists become more readily available and then hopefully the prices would become more competitive.”

The high cost and uncertain benefits, as well as official resistance, have inhibited growth. “It’s still very much an underground scene,” says Shoukry.

But it may be an underground scene whose time has come. “At the same time as the quality of medical education is going downhill, we need to present these complementary alternative methods in a scientific light that can be grasped by our academics that they may learn of the possibilities and even expand on them,” says Dr. Mawsoof. “Conventional or chemical medicine has reached its peak, leaving many diseases uncured. Maybe it is time that alternatives were considered.”