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Blood and Biomedicine in the Modern Middle East

Panel IX-08, 2021 Annual Meeting

On Friday, December 3 at 2:00 pm

Panel Description
This interdisciplinary panel analyzes how twentieth-century biomedicine has transformed Middle Eastern beliefs and practices surrounding human blood. Previous scholarship has predominantly focused on 'blood' as a cultural signifier of lineage and on the religious meanings attributed to blood, including contexts of sacrifice and ideas about (im)purity. In contrast, this panel highlights new research in the history and anthropology of Middle Eastern medicine to investigate blood as a literal bodily fluid and site of scientific intervention. After the First World War, technologies of blood transfusion and genetic understandings of heredity built upon, rather than replaced wholesale, existing concepts of blood as a life-sustaining humour and a genealogical metaphor. Experimental treatments using transfusions of blood from deceased people and non-human animals prompted new ethical questions for medical practitioners and religious authorities. Biomedical research on the chemical properties of blood inspired new notions of blood as a potentially dangerous substance, capable of transmitting infectious and hereditary diseases. Middle Eastern scientists also began to study blood for genetic markers, which they used to classify the identities, origins, and kin relations of national, ethnic, and religious groups. The panel’s four papers examine how biomedical institutions and public health policies in Iran, Turkey, Cyprus, and Kuwait responded to these scientific developments, and in doing so, influenced existing social and cultural meanings attached to blood. The case studies show how Middle Eastern medical practitioners, being deeply integrated into transregional scientific networks, have implemented internationally legitimated practices of blood banking, human experimentation, population-level surveillance of HIV/AIDS, and genetic counseling for families affected by sickle cell disease. The panelists bring different disciplinary and methodological approaches to the analysis of Middle Eastern blood as historians of science and medicine, social and cultural historians, and medical-cultural anthropologists. Through its specific focus on blood, the panel demonstrates how biomedical practices intersect with both state-level politics and localized public concerns about modernization, migration, and national and communal loyalties. Accordingly, the panel models a path forward for further historical and social studies of Middle Eastern biomedicine to illuminate under-explored dimensions of some of the most prominent themes in Middle Eastern studies.
Disciplines
Anthropology
History
Medicine/Health
Participants
  • Mrs. Laila Prager -- Presenter
  • Dr. Laura Frances Goffman -- Presenter
  • Dr. Elise Burton -- Organizer, Presenter
  • Dr. Sara Farhan -- Discussant
  • Samin Rashidbeigi -- Organizer, Presenter
Presentations
  • Samin Rashidbeigi
    Transfusing blood from cadavers was a transfusion technique that originated during the 1930s in the Soviet Union and later experimented with in a few other places. The technique involved drawing blood from newly-deceased bodies and transfusing it to patients or storing it in blood banks. This paper discusses the case of Dr. Morteza Hakami, a professor of surgery at the University of Isfahan, who happened to learn about cadaveric blood transfusion in the 1960s, and decided to try out the method. Hakami first experimented with transfusing blood from dead dogs, and later found out about the technique the way it used to be practiced in the Soviet Union on human subjects. After finding a Russian textbook and receiving a religious permit from the ulama, Hakami ended up collecting blood from cadavers in Isfahan and using their blood for curing patients. Although Hakami and his assistant claimed that the technique was successful and promoted it in medical venues, cadaveric transfusions never became integrated into the blood supply system of Iran.  My aim in this paper is twofold. First, I wish to examine the implications of experimenting with (dead) human tissues, the controversies surrounding the practice, and its moral and religious ethics in Iranian society. As I consider cadaveric transfusion a Russian therapeutic method imported from the Eastern Bloc, I examine Hakami’s effort in the Cold War context in Iran. At this time in Iran, practices of blood were performed mainly based on “Western” medicine. I argue that Hakami’s introduction to cadaveric transfusion emerged as an isolated, and later a forgotten case, mainly because it did not fit into the Western “scientific” canon of medicine.  Second, I use the case of cadaveric transfusion in Iran to propose whether there is something meaningful to learn about failed and ineffective medical practices. I ask how we can deal with those practices that did not attach to the historical chain of progress and did not have a formative role in the development of contemporary medical knowledge. I argue that such forgotten practices offer incredible opportunities for social historians and historians of medicine, for they embody the tensions among various actors, institutions, and spaces, and explain the context of their unfulfillment.
  • Dr. Elise Burton
    The first purpose-built blood banks in the Turkish Republic and in the British colony of Cyprus were established in the 1950s. The life-saving medical services of these institutions were soon put to the test by outbreak of intercommunal violence in Cyprus and the ensuing hostilities against Greek Orthodox communities in Turkey. The scientific activities of the blood banks went well beyond the storage of blood for transfusions. The leading medical staff at these organizations examined the frequencies of ABO blood groups among their donor populations to evaluate their genetic relationships and racial classification. Based on scientific publications and archival documents from Turkey and the UK, this paper examines how the genetic research of the blood banks directly responded to the violence between Greek and Turkish Cypriots. At the end of the 1950s, the British prepared to end their colonial rule on the condition that Cyprus become independent rather than annexed to Greece (enosis). At this time, the British-employed leadership of the blood bank in Nicosia were sympathetic to the Turkish Cypriots and negatively inclined to the faction of Greek Cypriots determined to achieve enosis, whom they portrayed as irrational fanatics. After studying the blood of Cypriots from all backgrounds and across the island, they argued that not only was there no genetic difference between Greek and Turkish Cypriots, but that all Cypriots shared their ancestry with peoples from Anatolia, and had no biological connection to mainland Greece. Turkish hematologists working at the Istanbul blood banks translated these results as evidence that Cypriots were racially “Turks” and were inspired to carry out comparative studies in the 1960s that sampled blood from the Greek Orthodox community of Istanbul. On the basis of the blood group data, Turkish scientists argued that this community, like the Cypriots, shared its racial ancestry with Turks rather than mainland Greeks. Genetic markers in blood thus became the basis for instrumentalist political arguments about the illegitimacy of Greek territorial claims to Cyprus and parts of the Turkish Republic. The blood-based discourse of genetic kinship between Turks and Greek Orthodox communities did not reduce the intense political and social discrimination faced by Greek Orthodox people in Turkey. Instead, this paper argues, the Greek-Turkish case is only one early example of how the ongoing geneticization of identity and ancestry serves to deflect responsibility from the political forces that foment ethnic violence connected to nationalist territorial disputes.
  • Mrs. Laila Prager
    From the 1980s onwards, the Republic of Turkey has launched a public campaign against the practice of consanguineous marriages, the alleged genetic risks of which are continuously propagated by the media, medical scientists, and state institutions including schools and hospitals. In the context of these campaigns, ideas of modernity and backwardness were clearly set along the lines that persons that are still engaging in consanguineous marriages are usually uneducated and anti-modern. Moreover, since the 1990s, particularly in the Mediterranean parts of Turkey, there have been warnings that children born to consanguineous marriages may have higher risks of inheriting the genetic disease of Akdeniz Anemisi (Mediterranean Anaemia or ß-thalassemia, and Sickle Cell Anaemia). It was at this time that the Turkish Ministry of Health implemented a premarital screening programme and built prenatal diagnostic centres in Mediterranean cities, such as Adana and Antakya, to manage the risks of these potential blood diseases. Among the diverse ethnic groups that live in these cities, the Arabic-speaking Alawites are depicted as being particularly at risk due to their ongoing practices of cousin marriage. After years of state financed education, genetic counselling and screening programs, biomedical publications stress that the rates of sickle cell disease and ß-thalassemia are still increasing in Adana and Hatay, explicitly blaming Alawites for their “unwillingness” to stop engaging in consanguineous marriage. This paper analyzes how health programs supported by scientific research in Turkey use ideas of “healthy and unhealthy blood” not only to create a healthier population, but also as a means of state governmentality and control of ethnic and religious minorities within the nation, stigmatizing those that do not perfom well. Secondly, the paper examines how Alawite communities in Southeastern Turkey are working towards dynamic ways of understanding “blood” and “genes” in order to adapt to the Turkish state’s vision of “modernity” while remaining committed to the preservation of their ethno-religious identity. In the aftermath of the public health campaigns, Alawite kinship ideas and conceptualizations about blood and genes are shifting, and Alawite families are embracing new marriage patterns between individuals they consider to be more distant “blood relations”. The concept of sharing “blood” among the Alawites remains intertwined with ideas of marriageability, kinship solidarity, and religious and ethnic identity, making it a complex field of thought that does not easily compare to bio-medical explanations.
  • The HIV/AIDS pandemic evoked anxieties that were tied to Kuwait’s particular histories of gendered citizenship and dislocations of globalized labor. In 1986, the Kuwaiti Ministry of Health began conducting blood tests to identify people living with HIV among specific categories of noncitizen residents. The Ministry of Health reported the first noncitizen to test positive for HIV in Kuwait in November of 1986. He was immediately deported. Starting in 1988, all incoming noncitizen residents had to be tested for HIV after arriving in Kuwait and before they could receive their iqāma, or residency permit. The local press reported a string of deportations in the wake of these policies. By 1994, blood tests were identifying a much larger number of people who were HIV-positive, and the Minister of Health announced that 135 noncitizens had been deported. Kuwaiti citizens, in contrast, were not automatically tested for HIV on returning home from abroad, although they did have to undergo HIV testing before starting employment or obtaining a marriage license. Such policies of biomedical surveillance in response to HIV/AIDs were not unique to Kuwait, the Gulf, or the Middle East; the United States, for example, barred the entry of people living with HIV from 1987-2010. Moreover, in Kuwait, to the best of our knowledge, HIV/AIDS has not reached epidemic levels. But in the midst of global discussions of HIV/AIDS in the late 1980s and early 1990s, anxiety surrounding Kuwait’s integration into transnational networks of travel and tourism brought tensions over gender roles, citizenship, sexuality, and infidelity to the forefront of public discourse. These anxieties converged on the blood tests for HIV that authorities used to police access to the nation and on national pride in the fact that Kuwait, unlike some of its neighbors, did not depend on imported blood. Drawing on local newspapers, public health campaign material, and state-sponsored publications on Islamic interpretations of HIV/AIDS, this presentation explores how citizens and noncitizen residents of Kuwait articulated these anxieties in the context of waiting—waiting to be infected, waiting for a national outbreak, waiting in quarantine, and, for noncitizens who tested positive for HIV, waiting to be deported. By the mid-1990s, this process of anticipating and taking concrete legal measures to prevent a future epidemic resulted in the medicalization of social and political patterns of gender inequality, nativism, and differential citizenship.