Gender, sickness, and healing in rural Egypt: ethnography in historical context

SOHEIR A. MORSY, Gender, sickness, and healing in rural Egxpt: ethnograph.v in historical context, Conflict and Social Change series, Boulder and Oxford, Westview Press, 1993, pp. xiv, 235, £30.00 (0-8133-8166-5). Dr Morsy is a leading medical anthropologist who has published numerous valuable studies on her native Egypt, based primarily on field work in a Nile delta village for which she uses the pseudonym of "Fatiha". In this book, her work in this area culminates in a broad-ranging study of conceptions of sickness and healing in rural Egypt. In Fatiha, the author argues, medical diagnosis is retrospective and focuses on social causation rather than underlying pathology. Peasant views spring from their conviction that all misfortune is connected in some way to the supernatural; and as the management of social relations is the central concern of their lives, this is where ultimate causes are usually sought. Spirit possession, the evil eye, sorcery, and the machinations of supernatural creatures dwelling underground or in rivers or ponds are almost always evoked when a villager falls ill, and in the quest for the ultimate social causes for such afflictions, gender relations play a pivotal role. "Sayeda", for example, suffered from umbilical hernia and chronic infectious bronchitis, but to Sayeda and the other villagers, the real problem was a family quarrel and mistreatment by her husband: a malicious "'gaze" had brought her under the control of a spirit which not only caused her emotional and physical malaise, but also threatened to kill her husband if he beat her again. Significantly (if not surprisingly), Morsy finds that while women are deemed more susceptible to such afflictions than men, spiritual maladies are most frequent among villagers, whether men or women, who are identified as less powerful than their fellows. Health care in Fatiha thus involves considerable recourse to charms, potions, and various other means to defend against supernatural forces, plus a variety of home remedies and locally available materia medica. Practitioners include both specialists in natural medicine (humoralists, bonesetters, and herbalists) and spiritual healers and sorcerers. The popularity of the latter reflects not the efficacy of their cures, but rather the fact that these remedies make sense in terms of the way the peasants construct their medical world. Ultimately, it is this harmony which legitimates supernatural medicine to the villagers of Fatiha. Despite this, modern cosmopolitan medicine is highly esteemed. Beyond the family context, formally trained physicians are the peasant's first choice in about 70 per cent of the cases Morsy recorded, and are sought for acute illnesses involving bodily disfunctions. A villager will sometimes visit the doctor, wear amulets, and seek the intercession of a deceased saint, all in an effort to reverse a state of ill health, and even traditional healers will resort to cosmopolitan practitioners. The peasants see no contradiction in this behaviour, which Morsy regards as typical of the medical pluralism of rural Egypt. The gender issues discussed by Morsy are of particular value, and she makes a major contribution to our understanding of the role of women both in health care and as patients, though some of the feminist agenda she formulates is highly doubtful. Her own book offers many examples proving that government health policy under Nasser, however laudable for the improvements it brought about in rural conditions, can hardly be characterized as "state feminism". The arguments of this book are in the main clearly presented, and only occasionally lapse into jargon (e.g., p. 51: "a husband is likely to overindulge in the exercise of the culturally sanctioned authority with which the local organisational power structure endows him", meaning "husbands often batter their wives"). This reviewer found the translation of Arabic terms overly literal at times, and in potentially misleading ways. The hamil al-Qur'an (p. 51), for example, is not a "learned carrier of the Qur'an", but someone who has memorized the whole text; a suifa mabraka (p. 186) is not a "blessed wool", but a vaginal suppository, of whatever drug composition (certainly not usually wool) to which some charm has been associated.