In the opening salvos of the First World War, a British Commission bemoaned the skyrocketing incidence of bilharzia (schistosomiasis) infection in Egypt. War sparked the fear that British soldiers stationed in Egypt might contract the infection and laid bare the weakened bodies of Egyptian agricultural laborers. While bilharzia was endemic in Egypt, the construction of the 1902 Aswan dam and its production of a new agricultural geography transformed the disease. Intensified agricultural labor regimes literally submerged vast numbers of Egyptian agricultural laborers in infected irrigation water. Experiences of the relationship between human and parasite became ever more painful, frequent, and fatal. Following the war, the British administration initiated a treatment campaign to fight bilharzia. In the 1920s, the new Egyptian government expanded the numerical and geographical reach of the bilharzia treatment program. During this period, officials at the Egyptian Ministry of Public Health estimated that nine to ten million of Egypt’s 13 million inhabitants were infected with bilharzia. Between 1920 and 1923, treatment annexes administered treatment to approximately 500,000 Egyptians. In 1927, the Rockefeller Foundation joined forces with the Egyptian government in their efforts to combat bilharzia. Drawing from a wide array of archival sources from the Egyptian Ministry of Public Health and the archives of the Rockefeller Foundation, this paper explores endeavors to imagine, thwart, and treat bilharzia infection during the interwar period in Egypt. The first portion of the paper chronicles the troubled imaginations of bilharzia among scientists, medical practitioners, and those infected. A diverse realm of material encounters with the environment at large fed these imaginations. During this period, treatment regimens were brutal and often ineffective, agricultural labor regimes assured the continual reinfection of laborers, and measures to combat the disease were centered on largely irrelevant “sanitation” campaigns in Egyptian villages. The second portion of the paper traces bilharzia’s nature as a fundamentally situated phenomenon. Efforts to transport the schistosome abroad for research met with failure. Live samples perished so frequently that a Rockefeller scientist, Claude Barlow, infected himself with the disease before travel in order to carry the parasite overseas. Both as a matter of treatment and as an object of research, bilharzia was intimately tied with a web of material relationships rooted in the specificity of the Egyptian environment.

During the late nineteenth and early twentieth century, Egyptian medicine was one of Britain’s “tools of empire.” Like steamers, quinine prophylaxis, quick-firing rifles, cables and railroads, historians of imperial science have added medicine to Britain’s arsenal of nineteenth-century technologies as it too allowed the English to penetrate and maintain imperial rule in Africa and Asia. This study on colonial Egypt similarly understands medicine as a technology of power, not over the natural world, but more significantly over people. It addresses how medicine allowed Britain to sustain Egypt as a colonial satellite by controlling its medical institutions and public health policies. Indeed, medicine was at the heart of Britain’s empire building in turn-of-the-century Egypt and the roles of Qasr al-Aini – Egypt’s only school of medicine at the time – and the School of Midwifery were determinative in transforming native practices of medical care and caregiving in unprecedented ways. However, Britain’s mandate of consolidating colonial rule is only half of the story of imperial medicine in Egypt. The other half is told by the often unrecognized role of natives who stood between Victorian science in London and native medical practices in Cairo. Rather than characterize this medical encounter in necessarily binary terms (i.e., antagonistic to British imperialism), this paper argues that intermediary Egyptian practitioners – like doctors and midwives – helped negotiate this spatial divide in ways both expected and unexpected, and thus complicates notions of native agency in the making of colonial medicine.

The establishment of Qasr al-Ayni medical school in Egypt under the rule of Mehmet Ali, and the supervision of Antoine Barthelemy Clot (d. 1868) ca. 1827 has been always seen as the first moment of introducing new Western medical paradigms, which were subsequently consolidated in Egypt, then Lebanon and the entire region. In dominant historiography, this ‘encounter’ was conditioned by narratives of efficacy (whereby the new medical system and technologies proved their effectiveness against a backdrop of older medical practices), and by debates of authenticity (seen to govern the relation between novel Western and traditional ‘Islamic’ practices, in the eyes of local elites). However, this dominant analysis takes for granted the claims of therapeutic efficacy as transhistorical and cross-paradigmatic, and neglects the understudied medical scene in eighteenth century Middle East including its intellectual landscape. This paper proposes that this 'encounter' should be understood within the context of medical history in the Middle East, and through analyzing the intellectual and practical priorities and positions surrounding and shaping old and emerging medical professional subjectivities. In this view, the medical paradigm that Qasr al-Ayni represented was part of a complex medical landscape that existed in the Middle East from the eighteenth through the nineteenth century, that was connected to important debates in European medicine, where Clot’s professional and intellectual positions were hardly uncontested. Through analyzing newly uncovered materials relating to medical education and practice in the Middle East from the eighteenth century on, the paper will investigate how the local medical practice, traditions of prophetic medicine, and the traditional pharmacopia interacted with European medical paradigms. It argues that Qasr al-Ayni represented a moment of colonial medical encounter in so far as it provided a tool for new medical governmentalities that relied on the school to penetrate an existing and evolving medico-scape, and to regulate the professional and paradigmatic spheres. Here, narratives of modernization, efficacy or authenticity need to be located within local sources, and local health/disease systems, which predated, surrounded and merged with the new medical systems and practitioners. To navigate this landscape, the paper will focus on two main areas, where the new medical institution interacted with existing paradigms; the pharmacopia and therapeutic technologies including disease-ecologies, and medical institutions including hospitals and their evolving roles during this period, professionalization and the development of new professional subjectivities.

In 1954, The Scientific Monthly —an American science magazine incorporated a couple of years later into the prestigious Science—published an article proposing a measurement instrument – a scale of fitness – designed to test the readiness of colonized people for self-government. Properly applied, this sociometric instrument would make sure that a democratic concern for the welfare of the governed rather than international power politics or imperial interests determined the schedule for independence. “If fitness can be defined and measured and degrees of it set as goals,” the article stated, “the trusteeship system is likely to work with less friction and probability of bloodshed in the future.” The man behind the proposal was Stuart C. Dodd, an American social scientist and pioneer of scientific polling techniques who had spent the 1930s and 1940s in the colonial Near East, conducting the first opinion and attitude field studies in the region as professor of sociology in the American University of Beirut. In the aftermath of the war, Dodd returned to the U.S. and became a vigorous exponent of the expansion of social scientific mechanisms and tools for international governance: from the use of public opinion polling as “barometer for international security” to the organization of an international association of pollsters that would launch “indigenous and self-supporting institutes of public opinion research in new territories” and tighten the affiliation of different national agencies toward a common project of “world surveying.” Joining other historians of science who have recently become interested in the specificity of late imperial epistemologies; this paper will examine Dodd’s initiatives (and opinion and attitude research more generally) in the context of colonial techno-politics. By inquiring into the role of social research in the governing and regulation of the mandate state, this paper also speaks to a broader historiography on social science as the new basis and standard of intelligibility for administrative practice in the second half of the twentieth century.