Security and the Traumatized Street Child: How Gender Shapes International Psychiatric Aid in Cairo


The history of psychiatry from the 16th century until recent times became recentered in Germany, Switzerland, Great Britain, France, and the Low Countries. In the early years of 18th‐century Germany, the most influential contributor to the history of psychiatry was Georg Stahl. Progress in psychiatry has been so enormous in the past 25 years that it would be no exaggeration to say that more has been written, and more knowledge has been accumulated, during this period than in the preceding 2,500 years. This chapter is devoted to the history of psychiatry, yet history inevitably blends into current events seamlessly and without a clear boundary. An emerging field whose research has contributed both to the understanding of personality and to the treatment of its disorders is evolutionary psychiatry.

Trauma has become a major signifier of our age. […] However, it is rarely called into question—either as a category of intelligibility or as an object of compassion.

Fassin and Rechtman (2009, xi)


It is ten o’clock on a sunny and unusually chilly January morning in Cairo, Egypt. Young Amir and Hassan slouch lazily in uncomfortable plastic chairs positioned next to me. We are waiting in the entryway of Dr. Mona’s enormous and high‐ceilinged psychiatric clinic. The office is funded by a French‐based international organization I will refer to hereafter as Children’s Charity International (CCI).1 This transnational organization services those deemed most vulnerable in society, especially women and children. In Egypt, their projects primarily center on the health and welfare of adfāl al shawāri’ (street children)—a category the organization and the Egyptian state define as the country’s most vulnerable and at‐risk population.

From time to time, Amir and Hassan shiver and rub their hands together for warmth, just as I do, a firm reminder that the room lacks proper heating. We traveled together for nearly an hour in city traffic from CCI’s homeless children’s shelter, located on the city’s fringes, to this quaint clinic of psychiatry nestled deep in the heart of downtown Cairo. The room is completely bare except for a clunky old TV set positioned on a wooden table at the front of the room. A popular daytime Syrian musalsala (daytime soap opera) is on. Loud dialog and melodramatic music echo throughout the room, and we all suddenly fixate on the show before us.

I accompanied Amir and Hassan on this monthly medical trip to interview their child psychiatrist about her experiences servicing street children in Cairo. In Egypt, the practice of seeking emotional support or therapeutic intervention from a medical professional rather than a family member or religious authority is rare, even among the middle and upper middle classes. Therefore, I was especially interested to learn how the children at CCI and Dr. Mona understand and experience what Fassin and Rechtman (2009) refer to as “humanitarian psychiatry”—the global deployment of mental health care by international aid organizations on behalf of vulnerable groups worldwide.