In a recent post on the trends of Arab Internet users, we didn’t talk about Google queries related to traditional medicine. Nevertheless, if we look in detail, keywords like ‘herbal’, ‘herbs’, ‘alternative’, and so on, are recurring in the first 20 querries.

According to an american study published in 2010, “77% percent of Medicine students agreed to some extent that patients whose doctors know about complementary and alternative medicine (CAM), in addition to conventional medicine, benefit more than those whose doctors are only familiar with conventional medicine. Seventy-four percent of participants agreed to some extent that a system of medicine that integrates therapies of both conventional medicine and CAM would be more effective than either conventional medicine or CAM provided independently. Eighty-four percent agreed to some extent that CAM contains beliefs, ideas and therapies from which conventional medicine could benefit.” Already 25% of our conventional medicines include plants used for a long time in traditional medicine. And the trend is likely to increase for two reasons:

• the rise of drug resistance,
• the very long duration of drug development.

However, if researchers are focusing more and more towards traditional medicine to find new treatments and whether modern medicine examines an alternative model that meets the needs of the population, in Maghreb-Mashreq the place of medicine remains very important -and less and less discreet.

The Khella is growing across the whole Maghreb-Mashreq. Particularly known in Morocco and Egypt in traditional medicine to treat diabetes, bladder pain, palpitations of the aorta and kidney stones, it is currently used¹ by the pharmaceutical industry for the treatment of asthma.

Modern medical knowledge and traditional Islamic background

Modern medicine has an important place in the Arab world and health tourism is a real proof of the vitality of the sector. However, for most people primary care are rooted on a popular culture of traditional medicine.

Arabic traditional medicine is derived from two major currents; one, influenced by Indian and Mesopotamian medicine, made the synthesis of the Western medical knowledge of Hippocrates and Galen², the other one, called Medicine of the Prophete, was based on simple remedies and pre-Islamic practices of Bedouins. Islam did not play a negative role, unlike Christianity in the West with a poles apart system of sacred and profane. Islam is an all-encompassing religious system which rules the society and its customs. Compared to the Latin West, “religion was not advancing a definition of penitential disease; it was not perceived as a divine punishment, which allowed the medical institution to intervene in the way of therapy”³. For Muslims, God created the remedy at the same time as the disease. And the doctor must find it.

This background has disappeared from the aspects of modern urban life to stay confined to the private sphere, to emotional life. It appears sometimes concretely in a magic ritual during care practices, hygiene, prevention and fight against disorders (headache, fever, nausea, skin diseases, etc.) most of time by plants (infusion, fumigation, etc.). For a long time, modern medicine has been suspected to be a West foreign contribution. For example, despite the expansion of hospital systems and advances in perinatal medicine, many women still give birth at home, in the hands of traditional birth attendants (TBA). In Morocco, 2 out of 3 births are made by these qablas. Sometimes, some women after being hospitalized  recreate at home a place “as if” they had given birth at home for visits from family, relatives and friends.

What is the future of traditional medicine?

The crux of the matter is that traditional medicine knowledge is free, transmitted from generation to generation and shared among practitioners. On the contrary, the pharmaceutical industry is trying to patent the use of certain plants. Without addressing the environmental problems that the intensive exploitation of traditional medicinal plants local could cause, we may wonder about the protection of local traditional knowledge vs the rising use of plants and traditional remedies in the modern pharmaceutical industry. According to the World Health Organization, the worldwide market for traditional medicines represents an estimated 16 billion U.S. dollars.

In the Maghreb-Mashreq, traditional medicine and modern medicine have suffered from antagonistic and conflicting relationships. Although this modern medicine, as a colonial legacy, was sometimes painful⁴, it has played a key role in both individual behavior and social standards. In the Maghreb, Western medicine has forced the individual body and the social body, under the administrative rules of colonization, to forget its traditional physical practices to establish a standardized and normalized society.

However, an alternative model could emerge today. Traditional medicine is widely popular because its effectiveness is proven in many areas. But modern medicine is confronted with challenges that only traditional medicine could overcome: the high concentration of physicians in urban areas makes traditional medicine essential for the maintenance of primary care in remote rural areas. To conclude, traditional treatments are very inexpensive and can benefit to the people who have no medico-social coverage -it will not last very long anyway if the pharmaceutical companies continue to develop intensively remedies based on traditional pharmacopoeia .. .

Sources :

• Abbott, R. B. et al., “Medical student attitudes toward complementary, alternative and integrative medicine“, Evidence-based Complementary and Alternative Medicine, janvier 2010.
• Longuenesse Élisabeth (sous la direction de),« Santé, médecine et société dans le monde arabe », Éditions L’Harmattan, Maison de l’Orient Méditerranéen, Paris, 1995, 322 p.
• Oueida F., “Médecine arabe et ethnopharmacologie, les plantes du Coran“, Université de Pharmacie de Beyrouth, pp.327-330
• Organisation Mondiale de la Santé, Quelques chiffres sur la Médecine traditionnelle.

1. Including cromolyn, derivative of khellin. [↩]
2. A famous example of this synthesis is The Canon of Medicine of Ibn Sina, called Avicenna, 980-1037, which was the teaching basis of Western medicine until the seventeenth century [↩]
3. Floréal Sanagustin, “Nosographie avicennienne et tradition populaire“, Santé, médecine et société dans le monde arabe, sous la direction de Élisabeth Longuenesse, Éditions L’Harmattan, Maison de l’Orient Méditerranéen, Paris, 1995, p.40 [↩]
4. i.e. the very technical and humiliating (quite ‘panoptic’) way to stem and treat the plagues and epidemics among indigenous people. [↩]