CAIRO — Aisha's family has tried everything to cure her of the crushing headaches that ruin her days and the violent, swirling images that haunt her at night.

"At first, we went to the doctor, but he was unable to help," says her brother, Ahmed El-Said. "He prescribed her pills but, if anything, they made her worse. After some time, we came to the conclusion that her problem must be spiritual, so we took her to the mosque."

Aisha and her family sought the help of a sheikh. When they found him to be of no help, they visited another. But he was also of little use. "We have decided that all these sheikhs are fake. We have been to different ones and they all said the same thing. They all took our money and they did not help us," her brother explains.

With all options exhausted, the family took a more extreme step: they brought her to the Church of St. Samaan the Tanner in one of Cairo's Coptic neighborhoods, hoping to benefit from the spiritual treatment on offer.

The Church of last resort

Every Thursday, Father Samaan and his team provide exorcisms to the worshippers in attendance. Father Samaan, 74, built the church in the 1970s. It has continued to expand since then and is now the biggest cave church in the world. And for decades, Father Samaan has been performing exorcisms for anybody who requests it.

Outside this famous church in Moqattam, a growing crowd gathers in wait for Thursday's evening service. Most of them are local residents of Zabaleen, or "Garbage City," the unofficial recycling center for Cairo's trash. In the seated waiting area outside the church, children play while the adults cheerfully chat away with each other.

The Said family are clearly marked as outsiders by their Islamic dress, if not their palpable anxiety. But they are not the only ones. Sporadic groups of Muslim visitors sit detached from the familiar crowd.

Like Aisha and her family, the majority of them have never visited a church before, but have come today out of desperation. They suffer from a range of issues, from mental health problems to infertility, and all hope to find a cure from the service provided free of charge every Thursday.

Another visitor, Hany, waits with his wife. The couple has been married for seven years, but has so far failed to conceive a baby. They first visited a doctor, who ran tests to prove that he was fertile. But after the doctor was unable to help him further, Hany turned to a sheikh.

"The sheikh couldn't do anything," said Hany. "But he told me that somebody had put a curse on us. Her womb has been possessed, and in order to get pregnant she would need an exorcism."

"Good. Now, I feel good"

As the sun begins to set over the pigeon lofts and minarets to the west, the exorcist attendees are led into the 20,000-seat church, to sit in a special section at the front. The regular worshippers file in to the amphitheater above them and the service begins. The session lasts over an hour. All the while Aisha and her family wait.

As the service is concluded, and the regulars begin to leave the church, Father Samaan now turns his attention to the visitors seeking exorcism, who line up to get onto the stage and receive their treatment.

Ahmed Said stands alone in the pews above, watching on with wide eyes as his sister awaits her turn. One by one, the attendees are greeted by Father Samaan's team, who lead them to the bearded priest, armed with an ornate crucifix and a bottle of holy water. As the Father holds the cross up to them, and violently whips water across their faces, the recipients react unpredictably. Most let out screams of anguish. Many cry. Some even faint.

Following her ordeal, Aisha is led to a quiet pew and given some calm advice by the team, under the anxious gaze of her brother in the stands. When she finally finds the strength to stand she is still shaking but appears calm. When asked how she is feeling she replies, "Good. Now, I feel good."

As the exorcisms are concluded, Father Samaan is escorted out of the church and into a car, which waits for him in the tunnel that leads out from the cave. The tunnel is quickly filled with the echoes of screaming from one attendee who has not felt the benefits of the treatment she had hoped for. She begs the priest to do something for her, and the priest's staff are forced to intervene to protect the priest. Father Samaan offers her the spiritual guidance that he can from the passenger seat of his car, but after spending 15 minutes with the woman, he is eventually forced to leave her sobbing in the walkway. Aisha and her family leave quietly, confident that their long hardship is over.

Problems in the public health system

But Dr. Basma Abdel Aziz, of the General Secretariat of Mental Health, is worried this may not be the end of it. "Her symptoms sound like that of psychosis," she says. "We see this a lot. For different reasons, people prefer not to come to the hospital; there is still a stigma attached to it. For this reason, there is still not enough awareness about mental health issues in Egypt."

Dr. Abdel Aziz is concerned that spiritual exercises like this may be counter-productive. "Sometimes there is nothing physically wrong with the patient," she says, "and in these cases they might get some comfort or reassurance from visiting a sheikh or a priest. But often there is a serious underlying mental condition, and it can develop in the time it takes for them to come to us. Often people only come to us as the last resort, and too often it is too late."

She sees some of the roots of these problems in the public health system itself. "We do not have enough facilities," she says. "The private system has a lot more but there aren't nearly enough hospitals and clinics in the private system. We need more and we need to be more integrated in the community. There is plenty of room for improvement, but there will also be things that we cannot help with."

A week after the exorcism, the Said family are in still in good spirits. "I have slept properly for the first time in years," says Aisha. "I suffered such terrible headaches, stomach aches, and vivid dreams of rape and violence, but now I am so happy it is over. I hope I will never have to go through it again."

Aisha and her family remain hopeful that this is the end of her ordeal. But for her, like so many others, only time will tell.