Up until a few years ago, I was a practitioner of child health care, holding special sessions for people who can not make use of the Dutch health services because of their language and culture. I worked specifically in the children's and youth health sector, but because the majority of the patients are not used to such professional care and there was an interpreter present, all kinds of other medical and social problems were discussed and I often had to act as intermediary. My patients were mainly of Turkish and Moroccan origin who had come to the Netherlands as migrant workers. More recently, I am seeing people from Ethiopia, Eritrea and Somalia, who have come to Europe as political refugees. The first group indicated that the jinn was the cause of their problems or illness. In the second group, the desert spirits or the jinn have a different name - zar or buda.

Attributing an accident or illness to God (Allah), spirits or other people's magic practices is a personalistic attribution that also occurs in the Western world, but that has been suppressed by the naturalistic (no- nonsense) attribution of today's demythologised society. Although the personalistic attribution relates to more than just the jinn, time restraints force me to limit myself to the jinn, or zar. A jinn can hit people (matrush, madrub), which is accompanied by a bodily function suddenly being impaired, but it can also live in the person itself (maskun, mecnun), in which case, the jinn has established itself in the person and causes attacks of epilepsy. I will give examples of both forms. Although demon possession is a universal phenomenon that also occurs in the Western world (think of films such as Rosemary's Baby, The Exorcist), it seems to be most common in agricultural communities in the Muslim world.

Jinns appear in the Koran as entities created by Allah from 'fire without smoke'. Just as in the Bible, there is good as well as evil: Satan (seytan) and his helpers. A Moroccan man told me a popular legend, not from the Koran, but from folklore:

Jinns are just like people; there are good ones and bad. However, in my opinion, it is the bad jinns that play the role of "Mother's Little Helpers". I will relate a couple of cases, which make this role clear. At the same time, I will say how I deal with this attribution.

Aicha has been in the Netherlands for just a few weeks. She is 17 and can neither read nor write. She comes from the Rif mountain area, in a remote part of Morocco. Her husband, with whom she was forced into an arranged marriage, is middle-aged (in his 40s). She is referred to the ophthalmic surgeon by her general practitioner because she has lost her sight for the past few days. The surgeon stated that there is nothing medically wrong with her eyesight. As a diagnosis, he suggests 'conversion' and advised the couple to seek psychiatric help. The diagnosis of conversion is often given to my patients. Conversion is a psychiatric diagnosis that applies to physical complaints, for which no physical cause can be proven. In addition, the complaints must be symbolic for the underlying psychological conflict; in this case, Aicha probably preferred not to see her husband! I have to add that in popular theory (psychobabble), this theory is often applied incorrectly. In the past, we talked of 'hysteria' (sometimes of grand hysteria) but since the DSM classification came into being, we talk of conversion, linked to a theatrical personality defect. The attention that the patient gets, guarantees that the complaints continue.

With the jinn, as with conversion, it is very often a case of phenomena such as sudden paralysis, blindness, attacks that are similar to epileptic attacks, and so on. Other Western diagnoses in connection with the jinn include hyperventilation, self-hypnosis, or atypical epilepsy, common anxiety reaction or a psychotic episode.

Aicha travelled to Morocco and received adequate help from a fqih - a traditional healer. He asked: "My daughter, what were you doing when you became blind?" She said that she had had visitors that evening. She had done the dishes and because she just could not get used to the kitchen sink in the Netherlands, she wanted to throw the water down the drain out on the street. Driven by fear for jinns, she remained standing on the threshold and threw the water outside. The fqih said: "The hot water had scalded a jinn. You will stay blind as long as the jinn is in pain.

The husband asked the fqih what he could do to satisfy the jinn. The fqih then contacted the jinn and asked him what he wanted. The jinn answered via Aicha that he wanted to sleep alone and receive presents (such as jewellery, perfume, and so on) regularly. The husband agreed to this. In this way, Aicha gets a quieter life, she can put some distance between herself and the husband she does not love, she gets a bigger house and some extra attention. The jinn has helped her. Speaking with my medical background, I call this 'conversion', Aicha calls it the jinn. What's in a name? By assigning the jinn as the cause, she gives me a working hypothesis, which makes it possible for me to communicate with her. The socio-economic position of European women makes it possible for women to divorce. Aicha can not get by in the Netherlands on her own; the jinn improves her position.

Zauwdita is an 21-year old Muslim woman. She came to the Netherlands as a 5-year old from Harer in Ethiopia with her mother. Her father stayed. For years, neither the mother nor the daughter heard anything from him. Zauwdita was disobedient and often went out with older men. Her mother has no control over her and finally, Zauwdita is placed in care via a crisis centre. In the beginning she is very popular, but later her fellow- residents start criticising her. She acts like a princess, they say, and is given the nickname of the Queen of Sheba. She runs away again and lives with the family of her Somali boyfriend Mohammed. In the beginning things go well, but after a while, Zauwdita gets the feeling that the family is exploiting her. No one is on her side. She gets support from successive employers. The family objects to the fact that she is on friendly terms with her - male - employers. Then Zauwdita is suddenly possessed by a zar-spirit she calls 'buda'. This has nothing to do with Buddhism, but is the name that her culture gives to that zar spirit. The name means 'strange' and 'dangerous'. It is therefore a dangerous spirit, which, if things do not go the way it wants, will rearrange your intestines in a way that could prove fatal. She has already been admitted to hospital urgently because the symptoms were that of appendicitis. She strongly resisted an operation because: "If blood flows while you have a buda, you can die".  As soon as a buda gets his way, he becomes peaceful.

Once in a while, Zauwdita gets a serious attack in which she becomes hysterical and buda relates his wishes: special pieces of cloth (in the rasta colours red, yellow and green, also the colours of the Ethiopian flag), perfume and golden earrings. At the same time, Mohammed goes to Rotterdam to get everything buda has demanded.

A Surinamese witch doctor ('bonoeman') relieves her of the buda in a spectacular session. Ever since then, Zauwdita is depressed.  Then another spirit comes along which she describes as 'the man from Harer'.  This one is less aggressive, but he also has his own desires. He advises her: she must go back to school!

According to her, he has made her a clairvoyant. When I ask who the man is, she says: "Just someone who wants something from me". The witch doctor is of the opinion that, if she really wants to be cured, she will have to become his apprentice, but Zauwdita does not want to do this.

A Somalian friend told me that also in his country, zar is a well-known attribution. His own mother went to meetings with a zar master regularly. His father, who did not believe any of this, tolerates this and gives her money so that the zar master can buy the things the zar spirit demands. "That is typically a woman's affair" is his comment. "In this way, she gets to go out".

Are Aicha and Zauwdita taking us for a ride? I don't think so. Like the French cultural anthropologist Michel Leiris, I distinguish between 'theatre vécu' and 'théatre joué'. Anyone who has ever been confronted with possession will agree with him that this is a theatrical event. 'Theatre vécu' (lived theatre) is applicable to demonstrations of possession in which the person involved is  really convinced of being possessed. With 'théatre joué' the opposite it true: the person is manipulating the situation. Leiris proposes a sliding scale between these two extremes. I am of the opinion that the majority of cases are 'théatre vécu'. People are after all often too scared of jinn to dare to simulate being possessed. Possession is then often a socially accepted form of problem solving in communities. Miraculous healings can be an alibi here (conscious or unconscious) to shake off the illness so to speak.

The attrubution of problems to jinn or zar, can occur in two ways: participational, in which it is supposed from the beginning that there is a jinn at work, but also explicative. In the latter case, the cause is unknown and therefore it must be the work of a jinn.

In both cases, the spirit is the ally of the woman since in her culture it is less common for a woman to stand up for herself.

For Aicha, the jinn makes her marriage more bearable. Zauwdita needs someone to support her with her in- laws. She misses her father especially, in this respect.

Because people are in awe of the jinn, she gets the attention she needs.

The exorcism made it impossible for her to express her problems to the outside world in an implicit way and to solve them. This is why a new spirit comes to her aid. This latter form of possession is less aggressive. The man from Harer is her conscience, which advises her in difficult situations and also gives her the gift of clairvoyance, which earns her a higher status in the community. The advice to become a witch doctor is also a universal thing, called 'sangoma sickness'  in parts of Africa. The deviant person, often a woman, has little chance of living a so-called 'normal' existence. The role of 'sangoma' (traditional healer) is reserved for her and gives her a carreer.

In my work, I have met several Muslim women who had been treated for 'atypical epilepsy' by a neurologist, while in my opinion a jinn was a more obvious explanation. The anti-epileptic medication calmed her down but took away the possibility of expressing conflicts to the outside world in an implicit way.

Migrants often have a double cultural identity. In such a case, it is possible that culture- based elements such as possession, are no longer used in a standardised way (in other words, in a way that is common to the culture) but rather in an eccentric fashion (in other words, in an unusual way). This does not make it any easier to deal with these culture-based elements.

The best way to deal with jinn, in my experience, is to use the attribution of the client as a working hypothesis, even though you may not believe it yourself. In this way, you remain in contact with the client and you are in a better position to help them.

What do you do if someone gets an attack of possession? Remain calm; don't try to stop the other person from dancing. If necessary, take off her shoes and loosen her clothing. It is said that jinns appreciate something to drink. Go and fetch some water. This gives you the opportunity to establish some distance between yourself and the client and gives you some time to reflect on what to do next

I hope that I have adequately explained my proposition: 'Jinns are mother's little helpers', and that I have given you some insight into these fascinating culture-based elements. If you consider culture as a solution to problems (as does the Dutch philosopher Jaap van Heerden), it is easier to deal with attributions that are not your own.

Martha van Endt-Meijling (1999) Met nieuwe ogen, werkboek voor de ontwikkeling van een transculturele attitude. Dick Coutinho

Martha van Endt-Meijling (1994) Etnogeneeskunde bij Turken. Zin in Welzijn (October)

Martha van Endt-Meijling (1995) Visies op het ontstaan van ziekte. Patient Care (August)

Michel Leiris (1954, 1996) Miroir de l'Afrique. Quarto, Gallimard