Before the holy month of Ramadan, Sandals For Goalposts sat down with Dr Yacine Zerguini, one of the world football’s leading orthopedic surgeons, in Algiers. Here’s what he had to say on the modern game in Africa…
SFG: Can you please introduce yourself?
Yacine Zerguini: Yes, I’m an orthopedic surgeon, did all of my courses here at Algiers University, but then I had a couple of fellowships in the United States and Spain. I helped create the first private sports surgery clinic in Algeria. Then I moved to a bigger place, the Chahrazade Clinic in Cheraga, where I now work. I also began working with the FIFA Medical Committee in 1994. I was invited by the then President, Mr [Joao] Havelange. Mr [Sepp] Blatter was General Secretary at the time.
I read that your father served on the Algerian Olympic Committee…
Yes, he was Chairman of the Algerian Olympic Committee for a few years and also worked with the International Olympic Committee.
Is that where you gained your love for football?
Yes. I was born into a sports family, and it was natural for me to include it in my job. He had a big influence on me, though I only knew him at the age of eight! He was a colonel in the War of Independence, so he left in 1956, when I was two years old. He came back in 1962, and they told me, ‘this is your father.’
What about with the Federation of Algerian Football? When did your relationship begin with them?
My first contact was during the  Africa Cup of Nations here in Algeria. At the time, I was in the National Sports Medical Centre and I was elected there as an assistant professor for sports surgery. I was on duty for the final match, and the centre is very close to the stadium. It was actually inside of the 5 Juillet campus. During the match, I received one of the players that was injured. Cherif El Ouazzani had a cut and, during the match,] we sat in front of the TV following the match, and I was stitching him up! That was my first entrance into Algerian football, and the Algerian Federation officially asked me to give a hand in 1994. I performed all kinds of roles, including the national team medic for a couple of years. Then I was the chairman of the medical committee and I believe this was my true calling.
Why did you stop working as Chairman of the Medical Committee a few years ago?
You’ll probably hear lots of stories about that. I had small problems with the President, the administration. But I did what I have to do, and then I felt I needed a change. But, still, I never left. I told many journalists that it’s not necessary to sit in an office to give your expertise. It’s better being free, and I like giving a helping hand.
For example, yesterday [Ed. Note: May 1st 2015] Mr. [Mohamed] Raouraoua called me. He said, “I know you have your projects and research, but we want you to help us with something bigger and I know you don’t have to be involved in an official capacity to help them out.” Today I had lunch with the FAF Executive Committee, and I gave my points at the meeting. The results will be made official today.
What do you think your biggest success and biggest failure was with the Algerian Federation?
My biggest success was to instil regulations. Before my arrival, players didn’t need a real medical assessment to get authorization to play. They used to just stamp the permit. Now you have to pass a medical under FIFA regulations. Cardiologists, EKG, everything. This is fundamental.
When I fail in something, I always consider it my fault. My failure is maybe that there are no doctors that work with the same motivation that I did. They absolutely don’t care.
So how would you assess your relationship with the Federation now?
Excellent. The President [Mohamed Raouraoua] knows me perfectly well, he knows what I did, and when I tell him something he always accepts it, even if he doesn’t like it. And at times, he doesn’t like it at all.
Can you tell us a little but about the Chahrazade Centre in Cheraga. It’s a FIFA Medical Centre of Excellence. How would you rate it in Africa and globally?
The facility is a fantastic place. We have everything to do a great job. They have a top-notch imaging department, with MRI’s, ultrasounds, etc. They also do open-heart surgery in the same place.
It’s not the best FIFA Medical Centre in the world. We can’t compare it to a U.S., a European, or Qatari one, because they invested millions into those. In Africa, South Africa has two fantastic centres in Cape Town and in Johannesburg. But that’s all in Africa: two in South Africa and one in Algeria.
In Nigeria, my friend Abdelkader Mouazou, who is the chairman of the Nigerian Football Federation Medical Committee, is doing good work in Nigeria. The people in Ghana are at quite a good level too. It’s more in English-speaking Africa, than French-speaking Africa. I don’t know why.
You have a role as a consultant at the Aspetar Clinic in Doha. What does that entail?
I began working with them because they asked me to be a part of what they call, ‘The Ramadan group.” We are currently working on injuries. Are there differences in injuries sustained before and after Ramadan? That’s our current project, but it’s only one of a litany of studies on sleep and performance.
So you believe it’s a good thing that the Algerian Federation renewed their contract with Aspetar a few months ago?
Yes, it’s a fantastic thing. In my opinion it’s the best place in sports science.
What do you respond to people who say, ‘If you go elsewhere, you’re not helping sports science in Algeria, because you’re depriving them of the Algerian national team?’
That’s like if you have someone smart enough to be part of a NASA program and saying, ‘No’, we need to create something here to develop the aeronautical field. It’s stupid.
The Qataris created a hospital and are looking for the best people in any field to come there permanently or part-time. Any contribution helps. Football medicine at the level they practice is difficult to reach.
So would you agree that it would hold the national team back if they exclusively used Algerian facilities?
We are building a very nice medical department in Sidi Moussa as part of the Centre Technique Nationale. We are growing. Even Aspetar wants to join the project. But the facilities, the people, they have… it’s difficult to have that here. We need to grow with them and participate there.
Listen, maybe there are Algerians as patriotic as I am. But more patriotic than me? No. I love my country. When I say, ‘we need to send this player to Aspetar.’ It’s because I love my country.
With the FIFA Presidential Elections imminent, I wanted to ask about Sepp Blatter. Has he been a patron of sports science?
Oh yes, more than helpful. I can tell you that in helping science and football medicine, he’s been very good.
We briefly touched on the Ramadan study, but what other major projects have you worked on?
We worked on age determination. In the last meeting of the FIFA Medical Centres of Excellence, I sent a couple of proposals, which were accepted.
U17 age determination is possible because we learned that in taking an MRI bone scan of wrist cartilage, we could determine if a player was over the age of 17. Now we are working on U20 age determination. It will be determined with a clavicle MRI. It is the same method, our hypothesis is that growth cartilage should close at the age of 20.
When do you believe it could be implemented?
Maybe in 2-3 years.
We also helped worked on preventing sudden death on the pitch. The last study was an African assessment. It’s important for black players.
Could you expand on that?
We found a difference in EKG readings for different ethnicities.
So black players are more prone to cardiac arrest?
Absolutely. And now we have scientific proof after our study sponsored by FIFA. I worked with a famous cardiologist from Switzerland, and another from Italy. We also worked in Gabon with 200 players and it was published in the British journal of Sports Medicine.
What were the global results of the Ramadan study? Is it true that fasting does not adversely affect a player’s performance?
It’s a little more complicated than that. There is no global, unique result for the research. The conclusion, in my opinion, is that each case must be treated individually.
Faith, belief, plays a factor. If players believe fasting will have no impact on their performance, then it won’t. But if they have doubt, then they better eat.
In the Algerian domestic league, I assume the level of competence varies from club to club, but if you take a global assessment of the domestic league, would you say we are behind?
Oh, yeah. We are far behind. I didn’t say ‘they’ are. We are. Because it’s partly my duty as an Algerian specialist to be responsible. Even if I have no official position.
If you had a magic wand to effect one big change in your field in domestic football, what would it be?
Probably education. Educate everybody. To design a global education program for Algerian football from the beginning. My problem is that people are not motivated.
Clubs, players, everyone. Look, it’s very simple, we have sixteen professional clubs in the first division. I was in charge of the medical committee and I decided to have a seminar with sixteen team physicians. All clubs, by law, were obligated to have at least one doctor present. I organized the seminar, we paid for their hotel, their plane trip, and they didn’t show up. Tell me, what can I do? They just don’t care.
I told Mr Raouraoua, “let’s introduce more regulations. If we invite a doctor, and they are absent, we can fine the club.” And we did: 25,000 dinars.
I know of other clubs that pay their doctors 5,000 dinars to be present on matchday and that’s all. Not during training sessions or day-to-day activities.
We were also the first introduce blood doping controls in Africa. Not because it’s a big problem here, but in my opinion, it was a way to organize football.
Vahid Halilhodzic often openly criticized the physical condition of local players, as does Christian Gourcuff. Do they have a point?
There’s no doubt about it. Players in Algeria generally lack endurance and stamina. But they are not totally right. He was saying, ‘Oh they are bad.’ And that’s it. No.
Your job is to see how to use them. He can still use their contribution.
Mokhtar Benmoussa of USM of Algiers was taped with dipping tobacco in his upper lip a few months ago. It’s common to see that in the league. Your thoughts?
It’s a kind of habit in Algerian football. It’s the same in American baseball. They use chewing tobacco.
Does it have adverse effects on physical performance?
Tobacco will always have adverse effects, for sure. As for the impact on their performance, it shouldn’t be anything major.
This interview was conducted by Maher Mezahi.