For over a thousand years, the Hippocratic system of medicine prevailed in Europe. It went into oblivion during the Dark Ages, when there was a reversion to the demoniacal theories of mental illness. Hippocrates’ works survived, however, in the library at Alexandria, where they were translated into Arabic. These and other classical works were retranslated into Latin and Greek from the 12th century on, ushering in the Renaissance.

Around 1284 CE, the Sultan of Egypt, Al Mansour Kalawoon, bequeathed one of his palaces in Cairo for the construction of a general hospital with a department of psychiatry. It soon became one of the most famous hospitals throughout the Islamic world. It was, and still is, known as Dar Al Shefa, literally the House of Healing (Okasha et al, 1993). Two features were remarkable for that era: the care of mental patients in a general hospital, and the involvement of the community in the welfare of the patients, which foreshadowed modern trends by six centuries (Baasher, 1975).

The mentally disturbed usually received baths, fomentation, compresses, bandaging and massage with various oils. Blood letting, cupping and cautery were also widely used. A familiar term for an antidepressant in the medieval period was mufarrih an nafs, ‘gladdening of the spirit’. Those suffering from insomnia would be placed in a separate hall to listen to harmonious music and to hear skilled story tellers recite their tales (Buergel, 1975; Dols, 1992).

Mental health resources

Today, the population of Egypt is around 61 000 000 (National Information Centre, 1997). There is one psychiatric bed for every 6000 citizens; psychiatric hospital beds represent less than 10% of the total. These are largely concentrated in Cairo, bringing the ratio there to 1 bed per 2200 – the four public psychiatric hospitals in Cairo provide 5800 beds, and the remaining 1200 beds are distributed over the rest of Egypt (Ministry of Health, 1998). Psychiatric hospitals are currently experiencing difficulties in the provision of care, treatment and rehabilitation, as they have limited resources.

Egypt has one psychiatrist for every 130 000 citizens, compared with one physician for every 500. Clinical psychologists total around 250 in the whole country, most of them also concentrated in the capital.