Chronicle of the Middle East and North Africa

Traditional Medicine Makes a Comeback in MENA Region

Traditional medicine does not conflict with contemporary treatment; rather, it is meant to enhance it.

Traditional Medicine MENA Region
An Iraqi man mixes herbs at an ‘apothecary’ in the old al-Shurjah souk in central Baghdad on December 14, 2008. ALI YUSSEF / AFP

Dana Hourany

Samer El-Khoury was startled by the sound of rifle fire at three in the morning on a crisp December morning. El-Khoury, who lives in a little village on the high peaks of Lebanon‘s northern mountains, discovered a dog on his porch that required emergency medical attention. Its stomach and leg both had severe gunshot wounds and were at risk of infection.

The young environmental activist and animal lover, decided on an herbal concoction made from the local “tayyoun” (inula) herb instead of the veterinarian’s topical ointment recommendation, which would have set him back a hefty $25.

“It has the same antiseptic properties as the ointment and is sticky enough to be used as an effective disinfectant,” El-Khoury told Fanack. “The vet was even astonished by the results as he did not expect such a quick recovery.”

El-Khoury is among a new generation of herbalists in the country, reviving ancient medicinal practices. Traditionally, herbalism has been recognized as part of a broader Middle Eastern healing approach that includes spiritual practices, dietary regimens, mind-body practices, and physical techniques, used in combination or individually.

An amalgam of Greco-Roman, Chinese, Persian, and Ayurvedic theories, the practice of ancient Arabic medicine has survived the test of time. According to experts, today’s inflated medical costs, prescription shortages, and political upheaval have reignited people’s interest in ancestral healing techniques.

“There are many ailments that can be cured by herbs, and our bodies can benefit greatly from reconnecting with nature,” El-Khoury said.

Back to origins

Greek, Chinese, and Indian medical techniques were the primary influence on Arab physicians, who acquired their knowledge through trade and travel along the Silk Roads from the second century BCE until the mid-15th century. Professionals and enthusiasts would attend clinical lectures on basic sciences such as alchemy, pharmacognosy, anatomy, and physiology. They would then use their newly acquired knowledge to treat wounded warriors.

Multi-regional medical knowledge was compiled using translations, and materials from the Silk Roads. Scholars who had never been to China or the Indian subcontinent were therefore able to gain access to various fields of study.

As Baghdad became the center of the medical world in the middle of the ninth century C.E. where pharmacies would first be established, the discipline of pharmacology would then take off on its own and spread to the rest of the Arab world and parts of Europe. Veterinary science and general medicine would become independent disciplines that expanded during the medieval or post-classical era between 500-1450 CE.

The Qur’an and the Prophet’s Hadiths, which became more popular in the seventh century A.D., led to an expansion of the practice. According to the prophet Mohammad, Muslims have a responsibility to care for their physical and spiritual well-being.

Translated manuscripts of Pedanius Dioscorides and Galen from Greece formed the basis of further understanding of medicine in the 9th century C.E.

During this period, Arab scholars learned about herbs, explored anesthetics, and developed techniques such as distillation, crystallization, solution, and calcinations. A new class of drugs was introduced that contained camphor, senna, musk, alum, sandalwood, ambergris, mercury, aloes, and aconite.

Prominent names of that era include Al-Razi (850-923) who produced over 200 books on medicine and philosophy and was famous for his method of experimentation and observation.

He supported a holistic approach to medicine where a person’s background and relationship to the doctor were accounted for.

Other renowned scholars are Avicenna (Ibn Sina, 980-1947 CE), often labeled as the father of early modern medicine, the polymath Al-Biruni (973-1050 CE), and the botanist and pharmacist Ibn Al-Baitar (1197-1248 CE).

Learning from the ancestors

The influences of Arabic medicine are found in modern medical science. Trained physicians, hygiene rituals, medical records, and pharmacies are all features of traditional Arabic hospitals. The sites were also used for medical teachings – similar to modern day facilities.

The most sought-after medications in Morocco today, according to Loukili Hamid, a Moroccan Arabic medicine practitioner, address skin and stomach disorders.

“The gut can harbor numerous painful illnesses,” Hamid, who has been practicing traditional medicine since he was a child, told Fanack.

Since he chooses to cure low-income individuals free of charge, Hamid’s interest acts as a hobby rather than a career, yet acquiring new knowledge and remaining curious is the most challenging aspect of his practice, he says.

“There’s an undeniable rise in the demand for these ancient medicines across the Middle East but not everyone is qualified to become a professional in the field,” the practitioner said.

“Oftentimes, the information is passed along by older practitioners who supervise the newcomers or have documented their findings in books that are not available in libraries. My ancestors recorded their trials and errors in journals that I found when I was very young,” he continued.

Hamid claims that among the difficult diseases he was able to treat in his area of specialty were skin malignancies.

In Syria’s northwestern city of Idlib, Fadi El-Khatib and his Iraqi business partner, Bassem whose names have been changed for privacy concerns, told Fanack that people in their region have grown frustrated with modern medicine.

“Our goal is to give patients something that provides a semblance of stability. Frequent hospital visits and reliance on prescription drugs have pushed people to seek something that yields better results or comfort at the very least. This is where we come in,” El-Khatib said.

Seeking stability in times of unrest

A Chinese doctor who once lived in Syria gave El-Khatib his informal training six years ago. What initially began as an introduction to herbalism developed into a wide range of different therapies, including, among many others, cupping, East Asian massages, and aromatherapy.

“According to the common proverb, an herb that doesn’t help you won’t hurt you,” the practitioner stated, “and I entered this field for that reason. Without running the risk of maybe hurting people, I wanted to do good.”

Over a decade of crises and deteriorating economic conditions have caused a severe humanitarian disaster in Idlib. People are forced to rely on food baskets or are compelled to beg on the streets.

The conflict has greatly harmed El-Khatib’s practice because many of his prior facilities were destroyed and supplies were in short supply.

Fortunately, as the turmoil calmed in recent years, he has been able to reestablish his practice. He is however still wary of potential developments.

Although he claims that traditional medicine follows an all-inclusive approach, he personally focuses on orthopedics.

“We do not deny the importance of modern medicine but we provide a solution when the latter does not.”

His cupping expert partner, Bassem, emphasizes the significance of this age-old practice, which was endorsed by the Prophet, who was believed to have said, “Indeed in cupping (hijamah) there is a cure,” according to Jabir ibn Abdullah [Saheeh Muslim hadith No: 5706].

What is cupping?

Blood is drawn from the body during hijamah (cupping) in order to allow for the circulation of replenished, healthier blood. In Islam, cupping is used to treat a wide variety of diseases and dates back thousands of years when the Chinese, Babylonians, and ancient Egyptians were chief practitioners.

The cupper burns a little piece of paper or cotton within the vessel to rarefy the air in order to cling the cupping vessel to the skin. The vessel must then adhere to the skin for three to ten minutes. A razor blade or other sharp object is used to make a small incision in the skin to remove it. This process is repeated as necessary.

Other traditional practices include apothecaries, also known as “attar” stores, which are still operating in some parts of the Middle East but are in danger of disappearing. They sell fragrances, medications, and salves that treat illnesses using plant and animal organs.

In these stores, mixtures containing hedgehog spines, seahorse, and ostrich eggshells are sold for as little as $3. “The most highly demanded products are aphrodisiacs. For sexual energy,” Issam Al-Berjawi, an attar from Lebanon told The National.

Mind, Body, Spirit

There are facilities in Lebanon where alternative medicine, which incorporates East Asian and Middle Eastern traditions, is taught and practiced.

Hassan Jaafar is an author, gynecologist, and practitioner of alternative medicine. He founded the “Lebanese Center of Alternative Medicine” in 2000. The number of patients has increased ever since, he told Fanack.

“Nowadays, patients visit their usual doctors with the pressure of mounting medical bills and potentially bad news. This results in a decline in both their physical and mental wellbeing,” he said.

The doctor claims that over time, he has observed an increase in young women who experience migraines, sexual dysfunction, glandular disorders, and menstrual cycle disturbances. However, the alarming increase in psychiatric disorders has only become more common throughout the recent years of crisis, he said.

More than 80% of the population in Lebanon descended into poverty as a result of the 2019 financial meltdown, and the value of the local currency is still falling in proportion to the US dollar.

“For those who are psychologically and mentally ill, we employ a hypnosis technique where we free the subconscious mind from the underlying issue,” he said.

Jaafar claims that this tradition is similar to the one practiced in Islam where ruqyah or “healing invocations” are used by reciting verses from the Qur’an to soothe mental disturbances.

“They’re treating the subconscious mind. For the religious mind, faith in scripture is needed. For the secular mind, a more scientific approach is required,” Jaafar said.

According to El-Khatib, the ruqyah, which he uses on patients with mental health issues, solely has a soothing effect on the patient.

Both practitioners concur that traditional medicine emphasizes a flexible approach to ailments, where treatments and formulations are regularly modified to meet contemporary demands without putting financial gain first.

Supplies are generally accessible, and reasonably priced. Most significantly, traditional medicine does not conflict with contemporary treatment; rather, it is meant to enhance it, they said.

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