Medicine shortages drive Gazans to alternative healing

Zero stock levels of essential medications in the Gaza Strip have been increasingly problematic.
Hatem Omar Maan Images

GAZA CITY, occupied Gaza Strip (IPS) - “When I came back to Gaza in 2006, before the siege started, people came to me for acupuncture,” says Dr. Hisham Mwtoweh, a medical doctor and acupuncture practitioner trained in China and Korea.

“After the siege began, life here got very difficult and money became a serious problem. Now if someone has money, they use it for food, not for something like acupuncture.”

Since 2007, zero stock levels of essential medications in the Gaza Strip have been increasingly problematic (37 percent of the 480 essential drugs were at zero stock in June 2011). With one of the highest rates of unemployment in the world and 80 percent of Palestinians food aid dependent, few in Gaza can afford treatments like acupuncture.

“Acupuncture is not cheap,” says Dr. Mwtoweh. “The needles are single-use, and are more expensive than before. A box of needles which cost me 10 shekels [three dollars] years ago costs me 60 shekels now.”

The cost is complicated by the longevity of the sessions. “I can treat migraines, lower back pain, sinusitis and strokes, among other things,” Mwtoweh says. “But people here are used to medicine which normally has a rapid result.

“Acupuncture needs time, more than five or six sessions before you start to feel the effects of the therapy, and many people don’t want to wait or to spend precious money on that many visits.”

Consequently, Mwtoweh’s acupuncture practice has taken a dramatic fall. “In 2006, I had an average of over fifty patients per month. Now a good month is six patients.”

Turning toward traditional healing

However, some traditional healing practitioners have had a different experience. Business is steady for Mahmoud Shamali, a pharmacist and practitioner of hijama, a cupping practice which treat certain ailments and invigorates the blood.

“With Gaza’s poor economy, more people started to seek out alternative healers, because many are cheaper than using pain medications or repeated visits to the doctor,” says Shamali.

”Hijama is not a foreign concept in Palestine, since Islam speaks of the importance of cupping as a therapy and for overall health. So people trust it.”

Traditionally, cupping was done by heating sterilized glasses and applying them at various points of the body, often the back and neck.

Dr. Khamis Elessi, certified in physical medicine and rehabilitation, also practices complementary medicine, including tuina (Chinese massage), acupuncture, herbal remedies and cupping.

“The idea of wet cupping — when incisions are made in the skin and a small amount of blood is let out — is that it stimulates the bone marrow to produce fresh red blood cells, which have a life span of 120 days.” An increase of young red blood cells increases the body’s energy, he says.

“Cupping will boost your immune system and normalize your blood pressure.”

As cupping does not routinely require new equipment and usually needs just one session, the costs per visit are low. For some with ailments not treated for want of expensive or non-existent medicine, hijama is an option.

“Many people who go for cupping can’t find the medicine they need, so they look for alternative remedies,” says Khamis.

“Backaches, headaches, toothaches, and depression — these are some of the things cupping treats,” says Mahmoud Shamali.

Treating post-traumatic stress disorder

A World Health Organization (WHO) survey in July 2009 found that 23 percent of children aged 5-14 developed bed-wetting problems after the last Israeli war on Gaza.

”Hijama can treat this, as can acupuncture,” says Shamali.

Following the 2008-09 Israeli invasion of Gaza, the Gaza Community Mental Health Center (GCMHC) reported more than 90 percent of Palestinian children in Gaza and 65 percent of the general population suffered symptoms of post-traumatic stress disorder (PTSD).

GCMHC also notes a continual rise in depression among children and adults. For adults, with the crushing responsibility of caring for a family in an impossible situation — under siege and still reeling from the last Israeli war on Gaza — the depression can be severe.

Dr. Mwtoweh says acupuncture can treat depression and PTSD, but that many in Gaza are reluctant to admit they have a problem.

Instead, many have turned to Tramadol, a synthetic opioid painkiller sold in pharmacies. “After the war many people started using Tramadol to numb their psychological pain. They temporarily forget their problems with it,” says Mwtoweh.

“People here think it is a medicine, not a drug, so they use Tramadol too much and become addicted.”

Dr. Mwtoweh says his acupuncture therapy can stop the addiction, if people were aware they are addicted and are aware of the treatment.

No replacement for essential medicines

Abu Ali, 43, a holistic practitioner, treats patients free of charge from his one-room house in Gaza’s Beach Camp.

His herbal remedies treat physical ailments, depression and even extend to those with diabetes. The WHO reports some diabetes drugs are at zero-stock levels in Gaza.

“I give diabetes patients amoora, a herb similar to zaatar [wild thyme]. I also give zaatar and strawberry leaves, depending on the severity of their diabetes or other health problems.”

He lists other herbs common to Palestine, like ekleel jabal, a mountain plant whose green leaves help treat 52 different kinds of ailments.

“Add the leaves to water and drink it for ten days,” Abu Ali advises. Aside from invigorating the body, the herb helps regulate high blood pressure, he says. Drugs for hypertension and cardiac conditions are on the zero-stock list.

Abu Ali believes that any illness can be treated holistically. “People must have the will to cure themselves,” he says. “They have to believe that they can be their own doctor and are stronger than their disease.”

While other complementary medicine practitioners like doctors Khamis, Mwtoweh and Shamali see a niche for their work, they say it is imperative that the essential medicines and supplies at zero stock levels be brought into Gaza.

“Not all problems can be treated by complementary or alternative means,” caution Mwtoweh and Shamali. “Like anti-cancer drugs — there are no alternatives,” says Shamali, whose own grandmother suffers for want of an anti-cancer drug unavailable in Gaza.