As noted by anthropologist Mazyar Lotfalian in his unique volume, Islam, Technoscientific Identities, and the Culture of Curiosity (2004), there is a glaring lacuna in the study of science and technology in the Middle East and broader Islamic world. Yet, Islam encourages the use of science, technology, and medicine to solve practical problems, including those pertaining to human health. It is not surprising, then, that the Middle East is home to a burgeoning high-tech medical industry, and that many Middle Easterners make use of the latest medical developments. This panel brings together for the first time medical anthropologists who are exploring the horizons of this high-tech medical realm in the Middle East. Part I of this two-part session maps the "technoscientific revolution" in Iran, recounting the ways in which scientists, physicians, and ordinary citizens have paved the way for award-winning programs in primary health and end-of-life mortuary care. However, Iranian "discontent" is also traced in the brain drain and circulations of knowledge outside the nation-state. Issues of discontent, exile, and health disparity are also taken up in papers on the travel of Arab patients outside their home countries in search of both life-saving and "elective" medical care, as well as in the ordeal of Gaza children needing emergent treatment for cancer. Part II focuses entirely on reproductive medicine across the region, from social media programs to distribute emergency contraception to young people, to community-based efforts to prevent maternal mortality through midwifery in Afghanistan. In addition, the local moral worlds surrounding assisted reproductive technologies, prenatal genetic testing, and technologies to maintain weight and future fertility are explored through ethnographically rich empirical studies from Turkey, Israel, and the United Arab Emirates. As such reprogenetic technologies become further entrenched in the Middle East, and as human stem cells and cloning eventually become available, it will be crucial to interrogate new local moralities that are likely to arise in response to these report-technological innovations. As this panel shows, and as anthropologist of science and technology, David Hess (1994), rightly observes, "Anthropology brings to these discussions a reminder that the cultural construction of science is a global phenomenon, and that the ongoing dialogue of technoculture often takes its most interesting turns in areas of the world outside the developed West."
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Dr. Mazyar Lotfalian
In this paper, I argue that oral history can be instrumental in mapping the world of science, technology, and medicine in the Middle East. By drawing on research on oral history of Iranian scientists, I show that this method can help generate a nuanced knowledge of actors, practices, and the formation of institutions. For the past hundred years, the careers of scientists, educational systems and the institutions of science have changed in Iran. There are very few historical accounts of these changes and their effect on the community. The impact of the revolution on Iranian scientific community is still being debated among historians, anthropologists, and philosophers of science and technology. One major obstacle in debates is a lack of social scientific data and personal accounts on this changing community from before and after the revolution. In Iran the question of the national and cultural character of science was raised after the revolution. Islam as the main trope of social change brought back century old questions concerning the role of religion in scientific development. However, the actual experience of this resurgence turned ideological, resulting in purging faculties from the universities. This negative impact notwithstanding, the debate about the national and cultural character of science in Iran is still ongoing. Yet another consequence of the revolution was the formation of technical and medical diaspora. The transnational community of scientists and medical professional grew in size and its horizon of experience. This change poses the question of brain drain from Iran. Although recent studies show that in contemporary context, movement of capital and expertise can change brain drain to brain circulation (e.g., India), very few studies exist that can help us evaluate the case of Iran (and I think the Middle East at large). This paper argues that scientists’ narratives provide a rich map of their immediate experiences for the past thirty years, their education, scientific projects, and the career traces. More importantly, the analysis of these narratives helps us move away from gross generalization and focus on details and culture-specific aspects of these communities.
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Dr. Soraya Tremayne
Zahra’s Paradise, Muslim burial, and Digital Technology in Tehran
Beliefs surrounding death and its associated rituals remain elaborate and form an important part of everyday life both in Iran, and among Iranians elsewhere. The treatment of the dead and burial are based on Islamic concepts of life after death, with the ultimate aim of facilitating the passage from this world to the next. Reverence for the dead is a deeply ingrained feature of Iranian culture and it is essential that the body of the deceased undergo the correct procedures to be able to make its journey to the afterlife.
While the core beliefs about death and after life remain conformist in essence, and follow the Islamic instructions meticulously, the procedures to achieve them have had to alter due to the unforeseen challenges. The emerging situations stem from, among other factors, a rapid population growth and an increased rate of urbanisation, both of which require larger spaces and more efficient burial services. The need for effective burial facilities in Iran was also greatly aggravated by the unusual number of death due to the Islamic Revolution and an eight year war between Iran and Iraq, which resulted in over half a million death and increase pressure on cemeteries. But, nowhere was this pressure felt more than in Tehran, with a population of over 8 millions and where a great number of the war martyrs are buried.
This paper discusses how the main cemetery in Tehran, Zahra’s Paradise (Beheshte Zahra) where most of the city’s dead are buried, has been transformed into a modern centre making use of digital technology to ensure that all stages of the journey from death to the final burial are performed to uphold the Islamic values. Zahra’s Paradise, possibly one of the largest cemeteries in the world, with its nearly 600 hectares of land, accommodating nearly 1.5 million buried bodies, has evolved from a mere burial place to embody every aspect of social, cultural and political life, accommodating the worldly needs of the living as well as safeguarding the spiritual well-being of the dead, through the treatment of the body.
In conclusion, in Zahra’s Paradise, death, as the marker of the end of one life and the birth of social reproduction and the regeneration of social order, is managed by digital technologies, to ensure the continuity of the most revered conservative Islamic values.
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Prof. Mohammad Shahbazi
Since the 1980s, rural Iranians have been able to seek treatment at health houses, established in the villages and staffed by the villagers, as the first stop for medical care, rather than an emergency room. The health
houses are staffed by health workers, not doctors, and the focus is on disease prevention and health promotion instead of treatment alone. Consequently, the infant mortality rate (just for an example) has dropped from 200 per 1,000 live births to 26. When a medical anthropologist,
familiar with both communities' health conditions and cultures, reported that the World Health Organization (WHO) commends Iran's Primary Health Care System - its health houses in particular, a physician, who has worked around Mississippi Delta for 40 years and is spearheading the effort to transform health care in a region (where nearly three out of 10 infants die, and residents suffer from various chronic illnesses), said "why not try Iran's common sense-based practice in Mississippi?" Coordinated by a medical anthropologist, since spring of 2009 a group Iranians and Americans have been working on this innovative approach, referred to as, the Community Health House Network Project in Mississippi. Modeled on the Iranians Primary Health Care System, this network has three levels of intervention facilities. Level 1 is the health house, staffed by trained and certified community members - they are called community health workers. Level 2 is a local primary care clinic or practice staffed by general physicians) and nurses, and level 3 is the existing hospitals, which serve the targeted Mississippi Delta region. The unique feature of this model is the formal relationship among the three levels which translates into a system in which no matter the entry point the patient becomes a responsibility of the entire network. With an anthropological approach, this paper will present a detailed feature of the Iranian PHC and its in-progress and culturally appropriate version in Mississippi.
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Prof. Daphna Birenbaum-Carmeli
Gaza healthcare system cannot provide treatment for children with cancer. Families must, therefore, seek therapy abroad. Many look for treatment in Israel's high-tech medicine. Obtaining the right for such treatment is, however, a harsh obstacle course. This paper describes the distressful paths of Gaza families of children with cancer who try to obtain approval for treatment in Israel. Against this background, the paper analyzes Israeli media presentations, which tend to center on the excellent treatment as symbol of benevolence across the political divide. My analysis will offer a critical reading of this favorable portrayal: health services in the Gaza Strip were the official responsibility of Israel, the conquering party, from the 1967 occupation until the Oslo Accord (1994). In 1994, the responsibility was transferred to the Palestinian Authority. However, severe limitations, including tight, ongoing Israeli restrictions on the movement of health professionals and medical supplies, resulted in a deficient healthcare system. The situation has further deteriorated since 2007, when the Hamas assumed power over the Gaza Strip and Israel enforced a general blockade. Seriously ill Gaza residents thus depend on foreign providers, for their survival. They also depend on the Israeli authorities for permits to cross the Gaza-Israel checkpoint. Being the only persons allowed to request such exit permits, and being in urgent need of life saving high-tech medicine that is not available locally, these sick individuals – now rendered "humanitarian cases" – as well as their relatives, are an invaluable source of information for Israel's security forces. As such, they are being subjected to interrogations by the General Security Service, and their fate largely depends on satisfying political-security demands. Notably, once approved, the treatment itself is of the highest standard. The costs are covered primarily by the Palestinian Authority and by Israeli NGOs that are funded by EU donations. Within this context, the media focus on the quality medicine and care seems to serve several ends. It enhances Israel's 'Western' 'scientifically advanced' as well as peace seeking image. At the same time, these very images allow to bracket off Israel's role in generating the need of Gaza citizens to seek treatment abroad, the fate of those Gaza patients who are refused treatment, and more generally, the construction of high-tech medicine as a reward for prescribed political behavior.
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Dr. Beth Kangas
Old and new stereotypes of Muslims and Middle Easterners interfere with our ability to understand the plights of patients who must seek medical care outside their countries. In popular and academic representations of medical travelers, Middle Eastern patients are often reduced to the moneyed sheiks of the 1970s oil embargo, the terrorists of the September 11 attacks, or those needing “halal” diets within healthcare’s concern for cultural competency. These portrayals fail to uncover the individual concerns and experiences of patients pursuing medical care abroad.
The proposed paper uncovers these stereotypes within various academic and popular sources. For example, the paper highlights the simplicity within discussions of transplantation where the issue of organ procurement is summarized as wealthy patients from the Gulf buying the organs of poor individuals forced to sell them. The paper illustrates the intrigue that fictitious leaders of Middle Eastern countries (and perhaps of terrorist networks) create when they visit as patients U.S. hospital dramas. It critiques the characterization in the medical tourism press and websites of Middle Eastern patients as high-spending customers who bring along their family members and dietary requirements, creating both opportunities and challenges in the capturing of this market.
The paper contrasts these cursory representations with the rich findings of in-depth anthropological research on medical travelers from Middle Eastern countries. I feature my own two-year ethnographic study of Yemeni medical travelers in Jordan and India as a case study of what can be learned beyond the stereotypes. Anthropological studies reveal the diverse motivations, hopes, and fears of patients and their family members unable to access the care they need in their home countries. By recording insider perspectives and experiences, these studies generate compassion and understanding rather than reinforce simplifications and generalizations.