1 Introduction

The Dakhla oasis is one of six depressions in the Western desert of Egypt. It lies in relative physical isolation from the rest of the country, where the population coalesces around the Nile Valley as it has since the beginning of civilisation in Egypt. The oasis has a General Hospital that covers standard medical specialties except for psychiatry: there are no mental health services in Dakhla. The first port of call for most cases of social, physical, and mental health difficulties are the healers of Dakhla, who play a crucial role in managing the wellbeing of the community. They see everything from marital discord to chronic back pain; from impotence to psychosis; from major depression to bizarre behaviour; and from conflicts at work to schizophrenia.

Whatever the nature of the complaint, the common premise underlying all consultations is the suspicion of spirit (jinn) presence or possession and/or evil-doing (sorcery) responsible for the problem. Thus, diverse and seemingly unrelated problems are considered and dealt with within the same practical and moral framework. The healer seeks to detect this evil (e.g. the spirit) and, through a range of interventions, to dispel it. From there, the hope is to restore personal function and social harmony .

In this Chapter, through an ethnographic encounter with a prominent Qur’anic healer in the Dakhla oasis, we demonstrate the interplay of personal and cultural values on the healer’s practice. On one hand, the healer is keen to preserve and continue traditional healing practices; on the other, he is keen to innovate and to develop his practices in line with his understanding of scientific concepts and procedures. We conclude by considering the implications of this for the proposed development of mental health services in communities such as the Dakhla oasis, where local healers manage the mental health of the community.

1.1 Meeting Sheikh Rayyes

I met Sheikh Rayyes in the course of an ethnographic study carried out during 2009 and 2010 in the Dakhla oasis. He works as a Qur’anic healer in the largest village of the oasis and is among the most famous and sought-after healers in the region. Just over 5 ft tall, with a penetrating gaze, a shaved head, and six digits on both feet and hands, he cuts a striking figure. Due to a congenital anomaly in his legs that was later operated upon at a hospital in Cairo, he walks with a noticeable limp. The operations left him with life-long chronic pain for which he self-administers an intravenous opiate painkiller daily.

Being in the presence of Sheikh Rayyes is unnerving, not least due to the intensity with which he converses with you. He lives in a three-storey building that he shares with his two brothers and their families as well as his wife and four children. In our meetings, we would congregate in his private room, which is also where he receives his many seekers among the possessed, ill, and unfortunate. The room is painted a bright blue and the walls are adorned with various Islamic items: verses inscribed in graceful calligraphy, several calendars with photos of the Prophet’s mosque in Medina and the Ka’aba in Mecca, a photo of Al-Aqsa mosque in Jerusalem, and several certificates indicating prizes the Sheikh had won in religious chanting and singing (inshad). In this room I spent many hours with Sheikh Rayyes. I would visit him around 9 in the evening and would stay just short of the call for the dawn prayer. We would converse about possession, sorcery, and the community, and I would observe him at work with those who seek his help.

Sheikh Rayyes, like the majority of healers in Dakhla, practices Qur’anic healing. The main task before a Qur’anic healer is to utilise the divine blessings (baraka) and power of the word of God, the Qur’an, to dispel or contain the evil that has entered in the form of the jinni. The aim is to resolve the mental, physical, or social problems that have resulted from this. Healers do so in two main ways: through the recitation (incantation) of verses (ruqya) that are thought to embody certain powers, and by preparing amulets and holy water that can be used by the person thought to be influenced by the spirit. As Sheikh Rayyes put it, “every verse, every word, every letter in the Book possesses immense baraka.”

Transferring the baraka, and therefore the healing power, inherent in the word of God to amulets and holy water is a laborious process. In order to prepare holy water, Sheikh Rayyes fills a large bowl then twirls the index finger of his right hand in the water while rapidly reading and repeating verses and invocations. This process lasts about 20 min. Next, he writes the required verses on plain white paper using ink distilled from the ground mixture of several herbs: za’faran, white musk, gazelle’s blood, and rose water. Gazelle’s blood, a herb, gives the ink an intense red colour. The paper is then placed in the bowl and the ink gradually dissolves in the water. He then transfers the holy water to several bottles, ready to be used for treatment, for protecting oneself from harm, or for general wellbeing.

1.2 Treating Fat’hi

Fat’hi was a young man who consulted Sheikh Rayyes in my presence. He had been harassed by a male jinni for 4 months. It started one evening after he had closed his shop and returned to his mud-brick dwelling . He had been living there alone after his mother’s death two years before. As he entered the house, he felt there was someone there. He washed, prayed and went to bed, while trying to ignore this unsettling feeling. The same feeling recurred day after day, always in his house, and 2 weeks later he heard his name called. This progressed from a simple call to what he described as “noise and lots of talk”. Initially, this was restricted to the house, but then it carried through with him while at work as well. In the beginning he would go for late night walks and return home only to sleep; he tried to live with it and to ignore it. But when the spirit followed him and spoke to him throughout the day, he found it impossible to work and for the few days leading to the consultation with Sheikh Rayyes he had not been able to open his shop. He had not sought any help during these months, and it was only because he could not afford to keep his shop shut, he explained, that he knew he had to do something about the problem.

On hearing this account, Sheikh Rayyes asked a number of diagnostic questions to ascertain the possibility of spirit interference . He informed him that he was right, that it was probably a jinni interfering with him. The Sheikh then moved closer to Fat’hi and in a powerful voice began reading the verses of the ruqya. These are specific verses from the Qur’an that are used to detect and dispel influences of the spirit world, and are also utilised for general healing and well-being. During this procedure Fat’hi had his eyes closed and was motionless in his chair. Sheikh Rayyes completed the verses, which took about 20 min, and after a short moment of silence asked him how he felt. Fat’hi said he felt calm and it was evident in his features that this was the case. Sheikh Rayyes then resumed further invocations and, upon completion, advised Fat’hi to spend more time observing religious practice: he should pray regularly in the mosque, read the Qur’an on a daily basis both in the morning and before going to bed, and invoke God’s name throughout the day. He then gave him two bottles of holy water and asked him to sprinkle it over his body and around the house.

1.3 Sheikh Rayyes Innovates

Several weeks after this consultation on one of my regular visits to Sheikh Rayyes, I found him more excited than usual. His face drew the expression of someone who had come upon something significant. He told me that he had conceived a new, modern treatment for spirit influence that could help people like Fat’hi. He said:

You know how many of the jinn, when they speak through a possessed person, say they are lodged inside the person's body? And do you remember how some of them say they are in the blood or mixed with the blood? Now what if we dissolve the verses into distilled water from the pharmacy and then inject the patient with this holy water? This way the baraka will target the jinn in the blood directly and will be more effective. What do you think?

Immediately and prior to any reflection, I was alarmed by this suggestion. My main concern was that it might not be safe to inject water in which several herbs had been dissolved, not knowing, for instance, the potential for allergic reactions or the impact of residue on arteries and veins; it was a risky practice. When I pointed this out to the Sheikh he thought about it for a moment and said: “No problem then. I don’t have to prepare the water this way, I can just read the Qur’an over it”.

2 Values Arising

From a mental health perspective in the context of the Dakhla oasis, Sheikh Rayyes is consulted for and manages a range of mental health conditions. The case of Fat’hi is a clear example. In pursuing his practice, Sheikh Rayyes is keen to continue his tradition. Qur’anic healing has its roots in pre-Islamic ‘magico-religious’ remedies including incantation to the many gods in the Arabian Peninsula. Prophet Muhammad had adopted these incantations and purified them of illegitimate polytheistic elements. Sheikh Rayyes is part of this tradition. Additionally, Sheikh Rayyes values innovation. During our meetings, I found his mind to be active, always looking for ways to improve his practice. For example, in order to maximise the baraka of the verses, he would sometimes prepare amulets by writing the Qur’anic verses in separate letters, a method he borrowed from sorcerers who prepare talismans and amulets in this way in order to increase their power. His suggestion to inject holy water into a vein is another attempt at innovation, which in this case resulted in a potentially dangerous practice.

What inspired Sheikh Rayyes’ to arrive at this idea? We can reasonably surmise that this had something to do with the fact that he self-administers an intravenous opiate on a daily basis, and so is accustomed to the power injected substances can have on one’s mental and physical state. He might also have been inspired by my presence, which in my capacity as a medical doctor led to many discussions on mental health practice and psychotropic medication. Overlying this is a serious worry about society’s tendency to perceive Qur’anic healers as charlatans or as engaged in backward, unscientific practices. Sheikh Rayyes was aware of these accusations, which can be heard in the coffee shops of Dakhla, and are voiced in various media by doctors, intellectuals, and orthodox religious figures. Accordingly, he was anxious to validate and modernise his practice, and the obvious way to do so was to borrow from the prestige of ‘science’ and ‘medicine’ by emulating what he thought of as scientific concepts and practices.

3 The Influences of Culture

How does ‘science’ have this legitimating value for Sheikh Rayyes and the community more broadly? To answer this question, we need to understand the various attitudes to science in the context of the challenges of modernity to more traditional concepts and practices.

This challenge can be heard in the Egyptian Media and is voiced by intellectuals and prominent psychiatrists, all of whom share a tendency to portray the ‘supernatural’ beliefs upheld by rural and low-income Egyptians as backwards and a sign of ignorance. Consider, for example, Galal Nasr, a prominent journalist and writer in Al-Ahram weekly: ‘our [the Egyptians] very capacity for reasoning seems to have disintegrated, while our infatuation with myth and the unseen world seems to be on the rise… We have so many schools and universities, and yet here we are entering the twenty-first century with a firm belief in ghosts. We are infatuated with jinn, beholden to the darkness of the irrational, and hungry for fables’ (15–21 March 2007). The negative portrayal of rural and low-income Egyptians’ beliefs is part of the official discourse on modernisation with its emphasis on the value of education and national development: rural and low-income Egyptians are lacking in the first and therefore a hindrance to the second, so the discourse goes.

With this background in place, attitudes concerning science are ambivalent to say the least. On one hand, we find arguments that science is just one part of the package of ‘westernisation’, a package that many in the community feel the need to resist in that it brings with it ‘corrupt’ lifestyle and family values. On the other hand, there are attempts to partake in the prestige of science by emulating its procedures and borrowing its discourse, often in a superficial manner. For example, you find every now and again attempts to justify a problematic procedure (e.g. culling the pigs in the wake of swine flu) or a questionable discovery (a machine that cures HIV) by citing ‘science’ as a grand justificatory category.

The suggestion offered by Sheikh Rayyes can be understood within this web of attitudes as an attempt to partake in scientific method and concepts.

4 Conclusions

The development of mental health services in communities such as the Dakhla Oasis requires the cooperation of the community and, crucially, the cooperation of local healers. Healers like Sheikh Rayyes manage the mental health of the community and are almost always the first port of call for a wide range of problems. In order to be able to enlist the cooperation of local healers, it is necessary to understand the values they are keen to promote and the cultural influences on their thought and practice. As we saw in the case study discussed in this chapter, the interplay between traditional practices and scientific concepts and methods, in the context of ambivalent cultural discourses around science and Qur’anic healing, resulted in a potentially dangerous innovation. By understanding these processes through ethnography, it becomes possible for future cooperation between traditional healers and mental health services to lead innovation in a more positive direction.