The outpatient center in Cairo is next to the Church of SS. Mary and Matthew. (photo: Dale McGeehon)
Patients, family members and program workers gather together at the farm. (photo: Dale McGeehon)
Kameel, a patient at Best Life, prepares koshary, a popular Egyptian dish. (photo: Dale McGeehon)
Amba Serapion, bishop of public, ecumenical and social services. (photo: Dale McGeehon)
Suleiman a patient at the farm, is responsible for washing the dishes. (photo: Dale McGeehon)
An addict dozes on a sofa at the outpatient center. (photo: Dale McGeehon)
Gamal shuffles into a Cairo office in jerks. His face is expressionless. He slurs his words and constantly wrings his hands.
Gamals behavior is typical of people whose bodies are reacting to withdrawal from drugs. Many addicts like him are seeking help from the Best Life Program, which is run by Egypts Coptic Orthodox Church.
Like Gamal, most drug users are young men who, until recently, could receive treatment only in mental hospitals. There they would stay for several days until they were detoxified and released. But most, perhaps more than 85 percent, relapsed quickly.
In Egypt, drug use is spreading. The Egyptian government reports that in 1990 the courts tried 13,507 people on drug related charges. In the first eight months of 1992 alone, the courts tried 12,951.
Traditionally, hashish has been Egypts drug of choice, but opium and heroin are growing in popularity. The government estimates that it seizes only one-ninth the amount that flows into the country.
While engaged in their diverse pastoral activities, Coptic church leaders heard repeated whispers of drug abuse. They became alarmed and moved to combat this growing threat. The church formed a plan for the Best Life Program in 1988 and sought funding from outside sources. In 1990, Catholic Near East Welfare Association was the first to commit financial aid. The next year, the European Community agreed to fund 75 percent of the programs budget. With solid financial backing, the church launched the program in 1991.
Offering more than what Egypts mental hospitals can provide, Best Life takes a comprehensive approach to solving drug addiction.
Best Life is modeled on the methods of New Yorks Daytop Village, a Catholic organization that trains people to take a community-based approach in fighting drug abuse. Best Lifes workers give lectures on drug awareness throughout Cairo, run an outpatient and educational center at its headquarters in the city and operate a 10-bed residential drug treatment center on a farm 70 miles northwest of the capital. The program is the only one of its kind in Egypt.
In three years, Best Life has conducted more than 300 awareness sessions within Cairo, informing youth, teachers and others about the dangers of drug abuse. Through November 1993, 62 addicts visited the outpatient center. Before they could receive further treatment from the program, first they had to be detoxified at a hospital.
Light drug users participate in group therapy and social activities at the outpatient center. The more serious cases go to the farm.
Located on 40 acres, the farm is a quiet oasis far from the bustle of Cairo. Irrigation trenches transform the desert into fertile soil suitable for cultivation. Eucalyptus and evergreen trees shade older buildings that serve as a kitchen, a dining room, workshops and bedrooms. Because officials know the program will grow, they are constructing new buildings: a 24-bed dormitory, a kitchen and dining hall, a rabbit house and chicken and duck coops, complete with a small pond and fountain.
At the headquarters in Cairo, Gamal and his family plead with Dr. Victor Samy, a psychiatrist who is general manager of the program, to admit Gamal to the farm. They say Gamal, who used synthetic codeine, alcohol, hashish and stimulants, attempted suicide many times. He visited the hospitals but relapsed two days after he checked out. Now he has not taken any drugs because he wants to cure his addiction. Gamals father tells Samy he has not slept in eight clays so he could keep a careful eye on his son to ensure that he did not relapse.
According to Samy, Gamal is a good candidate for the farm. A commitment demonstrated by the addict and his family is an important criterion for admittance to the farm. Samy tells the family to go home; if Gamal can remain drug-free for another few days, he will be admitted.
In addition to receiving addicts and serving as a place for group therapy, the outpatient center is the site for a family support group. Once a week, the mothers, fathers and wives of the addicts gather at the farm to learn how to build a stronger, healthy family.
The burden of recovery does not rest solely on the shoulders of the addict. If the family plays a role in drug abuse, it must also learn how to heal.
At one meeting, about 20 family members sat in a large circle and read from a pamphlet that listed negative parental practices. One such practice is to punish a child in front of others. Another is to make him feel his parents are perfect. Yet another is not saying, I love you. Some of the participants blushed.
The next day, some of those present at the family meeting traveled together to visit the farm. Relatives may not see their loved one until he has stayed at the farm for three months and then only if he is improving. A recovering addict needs to attain independence from his family in order to build a new life. Also the program stresses that the farms patients should stay for one year to piece their lives back together and to build confidence in themselves.
On the ride to the farm, some mothers sing hymns in Arabic that sound mournful. I make a mental note to ask Samy what they mean.
Two of the women are quite jovial and gregarious. Their sons are eight-month veterans at the farm. These women treat other families and patients as part of their own families, helping them not to give up hope. They have also spent hours with addicts at the mental hospitals, encouraging them to join the Best Life Program.
Dr. Emil Zaky, the manager of the farm, keeps the patients on a busy and strict schedule. Beginning at 7 A.M., the patients have a day packed with chores, Bible study and other activities. They learn how to support each other emotionally and influence one another to do their respective jobs well; if a person stumbles they are openly critical. If a patient lies or breaks a rule, his punishment being ostracized for two days for example is equal to the infraction. The patients note their activities and their habits in three notebooks: one for good work, another for mistakes on the job and a third for personal errors.
Chores include feeding rabbits, harvesting lemons, cooking meals, building furniture or cleaning buildings. Officials hope that by selling goods produced at the farm, it will eventually become self-sufficient.
The goal in performing these tasks is for the patients to learn that they can make a contribution, gain a sense of accomplishment and feel good about helping others and themselves.
Osama is in the midst of his recovery. Softly, he explains how he began to take drugs to escape the problems at home. His habit, which included hashish, LSD and heroin, grew worse after his father died more than four years ago. He, his mother and sister each reveal shy, wounded smiles, as if they have endured many hardships.
They all agree Osama has improved. I now feel a joy about him, said Claire, his mother. I am now nearer to God, Osama said. I have gained myself again.
Because Christianity plays a large role in the recovery of the patients, Zaky indicated he would not force any Muslims should any come to the farm to study the Bible. The church has not advertised the program outside the Coptic community, preferring that news spread by word of mouth. As a result, almost all the patients have been Copts, whom the government estimates comprise six percent of the population.
Most people have come in because of advertising in the church, not because all addicts are Copts, said Jehan Ameen, who manages the public awareness division.
Because some of Egypts Muslims are also addicts, a few have received help at the programs outpatient center. Bishop Serapion, who oversees the program and heads the churchs public, ecumenical and social services, hopes that Best Lifes methods can be shared.
I dont think we can alone solve the problem, the bishop said, but at least we can contribute on a national level to Egyptian society by proceeding with this as a model. Others can benefit.
Another objective of Best Life is to help the recovering addicts reenter society. After living a sheltered life on the farm for a year, the patients need a transitional period in which they can adapt to living in an urban environment without supervision.
To provide living quarters, officials want to construct another building at the Cairo headquarters. There, the first floor can be used for administrative and outpatient services. The second floor will be used as a temporary home for the patients.
Maged is one of the two patients who is almost ready for the reentry phase. Before coming to the program, Maged sold drugs and was detoxified four times. Program workers implored him to join Best Life. Eventually, he decided he needed help.
Now, as an eight-month veteran of the farms residential center, Maged moves with an air of confidence. Other patients look up to him and try to follow his example.
Before I left the farm, I saw Maged talking intimately with his mother, Faisa. She was one of the singers on the bus. It reminded me to ask Samy what the hymns meant. The psychiatrist explained that the lyrics ask God for his mercy for humanitys many faults and imperfections. But, as one hymn continues, God can work miracles.
Dale McGeehon is a freelance journalist living and working in Egypt.