THE ALTERNATIVE MEDICINE METHOD

We live in a time of contrasts - the very latest scientific developments and the total illiteracy of the backward countries; space flights and hunger. And we, too, have our own contrasts. Even though there is no shortage of clinics and diagnostic equipment many people still prefer not to approach the medical establishments but turn to the exponents of alternative medicine.

Let us qualify what we are saying: the concept of "alternative medicine" is a very broad one and it includes a whole range of "services", from herbal treatment, which is widely used by quacks and, incidentally, not disclaimed by traditional medicine, to the occasionally fairly risky measures conducted by faith healers ("sunnatci"), chiropractors ("sinigci"), Azerbaijani quacks ("copcu"), neuro-pathologists ("cildagci") and waist-dressers ("belci").

Using the methods of a barbar

On 3 April a tragedy occurred in the Qadirov family. An "expert", called to the home, carried out an operation to remove the foreskin of two-year old Huseyin. Some time later the child died from loss of blood. Criminal proceedings relating to article 124.1 (manslaughter) were instituted on the child's death at the prosecutor's office in Abseron District. One theory that the child was ill with haemophilia (an inherited disease linked with an abnormality of the process of blood clotting) is being considered. If the child had been in a medical establishment under the care of qualified doctors the tragedy might have been avoided…

Removing the foreskin of a child (sunnat) in Azerbaijan is an important event in every family. It is believed that if a child is circumcised he is already nearly a man and his parents are playing out a "small wedding ceremony" for him. The use of circumcision is not only mentioned in the sacred book of the Koran - this surgical procedure is prescribed out of medical considerations. But it so happens that barbars, passing off as "surgeons", who carry out the process of removing the foreskin by fairly crude methods, are often invited to carry out this obligatory custom in Azerbaijan. It is interesting that some families still resort to help from these home-spun "doctors from the people". Often such "experiments" end in tears despite the fact that the operation is not considered difficult. For example, a couple of years ago in Ganca an "experienced barbar", as well as the foreskin, removed the end of a boy's penis. This happened even though doctors are constantly warning people that if you turn to people without any medical or surgical qualifications it can lead to serious complications. Failure to observe the rules of asepsis risks carrying infection, which in turn leads to suppuration. Necrosis of tissues, bleeding and many other things are also possible. Accordingly, cases where after an unsuccessful circumcision at home parents turn to medical establishments for help are widespread.   

According to Rauf Mirzayev, a top-qualified surgeon of Hospital No 1, whereas in the old days barbars revered the methods handed down from generation to generation, thanks to which in the years when medicine was undeveloped such operations were quite successful, today's barbars do not abide by any rules. "Today anyone can call himself a barbar because decent money can be earned doing this. And, unfortunately, by force of habit parents prefer to turn to people who have no medical education. But it is better not to take a chance on this," the doctor says.

…the copcus

32-year old Parviz (his name has been changed) always thought of himself as a pragmatist. He laughed at stories about magic carpets and was very sceptical about anything "unworldly". But his little daughter suddenly fell ill. Her temperature remained high for a fortnight and her health was in the balance. "All the doctors claimed it was an infection and fed the child antibiotics," Parviz says. "But nothing helped." Then, two weeks later, at his own peril, after listening to the advice of his relatives and losing all hope of getting qualified help from the doctors, he risked taking the child to see a copcu. This is what he has to say about the results of this move: "The copcu extracted from my daughter about 100 grammes of some bits of rotten food. The child was back on her feet literally within 24 hours. Then I asked the doctors to explain why this had happened and they admitted to me that they themselves take their children to a copcu from time to time." Parviz's scepticism - before that he had angrily reviled his wife for any such comments and piety towards quacks - was considerably diminished.

Narmina had been taking her three-year old son to a copcu for some time. These visits were a kind of panacea for her. Any rise in temperature she was inclined to see exclusively as a sign that "something had caught in the child's throat".

Generally speaking the copcu's theory was that the formation of a child's epipharynx and larynx, unlike an adult's, is such that there are a number of minor folds there in which small foreign bodies become lodged. These foreign bodies cause torpidity, weakness and an increase in temperature, and sometimes nausea and vomiting. Copcus work in the following manner: pressing on the throat in the region of the larynx, they flush out the epipharynx in a special way and the aforementioned foreign body leaps out into the palm of his hand placed there ready. Of course, there is a downside to this very exotic and radical means: during the "flushing out" a caveola (a so-called "cop yeri" - "place of the cop") forms in the larynx, which subsequently means that foreign bodies and bits of food lodge in it, thereby ensuring that the copcu always has work to do. Incidentally, technology does not stand still: there are individual "specialists" for such cases who for a decent fee are willing to close this cursed "caveola" once and for all without leaving a trace The copcus themselves and, strangely, some doctors, generally give such a plausible explanation for the uninitiated. 

How does the medical profession explain this phenomenon and what are the experts doing about it? ENT specialist Lala Seyfullayeva says, yes, there is a difference in the formation of the epipharynx and larynx between adults and children, but it is not that great. In the epipharynx and larynx there are no folds in which foreign bodies can lodge. These foreign bodies and bits of food can remain in the food pipe, and the symptoms are quite different: not those which usually cause people to turn to a copcu. In actual fact, by pressing on the larynx, the copcu induces a vomiting reflex and the bits and pieces caught in the food pipe or even sunk into the stomach could easily leap out. Furthermore, an ENT specialist can easily rid a person, and especially a child, of all foreign bodies in the larynx. This is carried out with the aid of special tweezers and is completely painless. The radiologist Nailya Quliyeva confirms this: "You can't be completely sure precisely where a foreign body is and what it has done in the organism, nor can anyone else, such as a copcu, who does not have the methods of medical diagnosis at his disposal. Moreover, if there is an increase in temperature, this points to an inflammatory process which may diminish or become chronic, and a chronic pocket of infection in the organism is like a time-bomb. If an ENT specialist's examination does not produce results pharyngoscopy and/or esophagoscopy is required to diagnose and extract the foreign bodies. Extracting foreign bodies independently is fraught with disastrous consequences. Imagine that a child has stuck something up his nose. Because of swelling the foreign body cannot be discovered, the other nostril ensures he can breathe, but the copcu by blowing may push the foreign body further into the respiratory passages. Going to the copcu puts off the moment when a child could receive qualified help."

That is undoubtedly the qualitative judgment of the medical profession. But having said that, thousands of people, and especially mothers, maintain that the copcu is much more "effective" than conservative doctors who ply children with antibiotics. However, it is strange that the phenomenon of the copcu as a panacea against lodged bits of food exists only in our country. But many mothers take exception to this: "How do you know? They also take foreign bodies out of children's larynxes in other countries." That's true, but it is not being done by home-spun quacks but professional doctors with special equipment. Besides, copcus, like other colleagues in the trade, are in fact good psychologists, and frequently a worried mother, seeing something "leap out" of their child's larynx, is immediately calmed.

…cildagcis and sinigcis 

The main problem is that people do not always trust the institution of official medicine, preferring to resolve their problems in the old way. Purely mental peculiarities are important here. When the majority of the population lived in villages, medicine was undeveloped, there was just one herbal quack and one midwife to a whole district, people ran to local folk craftsmen to decide such "insignificant" problems, and this was normal. People  now - and what is worse not only in the regions but in large towns - have still not changed their opinion.

The same applies to such "folk craftsmen" as childagchis, sinigcis and so on. A cildagci is the equivalent of a neuropathologist who by cauterising certain points "chases away" fear and stress from people. The neuropathologist Dilara Seidbayli gives her assessment of this phenomenon: "There is a method of acupuncture such as cauterization but only of certain points. As we know, acupuncture is a type of oriental medicine which requires years of practice and training. Childagchis make the same cauterizations but I don't think that they know the biologically active points. This acts more as a psychological factor, and in general all these folk craftsmen are good psychologists and they tell people what they want to hear. But they don't turn to neuropathologists through illiteracy and mentality because the majority of the rural - and not just the rural - population equate neuropathologists with psychiatrists, although a neuropathologist may provide top qualified help with stress and depression with the help of both drugs and autosuggestion. But people who don't want to be bogged down in detail believe it is shameful to turn to doctors. It is much easier for them to explain their ailments as 'supernatural' or religious causes - this induces more respect than to admit that this ailment may be treated by the interference of a doctor."

Sinigcis deal with the re-setting of dislocated bones and fractures. However, traumatologists do the same work more efficiently and professionally.

Compared with these exponents of traditional medicine, traditional herbal treatment or, to put it another way, herbal medicine, seems somehow inoffensive. Although any professional doctor, while not disclaiming the methods of herbal medicine, will say that the use of herbs should be strictly measured and most importantly, on no account should one treat oneself. The main condition for arranging any treatment is correct and prompt diagnosis.

According to Azerbaijani law, medical activity without obtaining a licence from the Ministry of Health is considered illegal and offenders may be penalised.