Empire, Health, and Disease in the 19th and 20th century MENA
Panel X-20, 2022 Annual Meeting
On Saturday, December 3 at 5:30 pm
Panel Description
Health and medicine formed key parts of state-sponsored modernization programs in the countries and provinces of the Middle East/North Africa in the 19th and early 20th centuries. In many ways, efforts to introduce vaccination, hospitals, and new methods to control the spread of epidemic diseases represented the first contact most people had with a central, rather than regional or local, authority.
Despite this, most histories of the region have focused on the socio-political impacts of European economic domination and eventual political takeover during the era of high imperialism and its aftermath, with its focus on the nation state. These case studies demonstrate the importance of medicine and health in formulating policies at multiple levels--from the imperial to the local--and describe how citizens and subjects responded to these changes. While Gyan Prakash is correct in arguing that what made medicine colonial was the imperial assumption that local bodies were diseased and unhygienic, these papers will demonstrate that such assumptions did not go unchallenged by local practitioners and citizens alike in the MENA during the era of imperialism and statebuilding.
After a long and vicious fight between the French, British, Ottomans and Mameluke Beys, Egypt fell to Muhammad Ali an Albanian soldier from Kavala around 1805. While he did not set out to become the founder of an Egyptian dynasty, his career as the governor in Egypt ended with his family firmly entrenched as the dynasty that ruled Egypt until 1952. He established bureaucratic organizations that competed with existing social structures to gain both support and legitimacy as Egypt’s ruler. One of his most long-lasting accomplishments was the establishment of the medical school at Qasr al-Aini, a palace converted into a hospital by the French during the occupation of 1798-1801. Muhammad Ali placed European doctors in the position of educators and Egypt born doctors as support staff to entrench the notion that the center of the production of medical knowledge rested in the training of European doctors in European schools. To lead this effort, Muhammad Ali hired Antione Clot-Bey to teach medical sciences with the sole purpose of providing a medical corps for his military. Clot-Bey, the son of a soldier who partook in the Egyptian campaign transposed the work of the Orientalist scholars who came to Egypt with Napoleon by establishing Europeans in positions of authority and power well before the occupation of Egypt by the British in 1882. This paper will explore the ways that the medical school led by Clot-Bey established the notion of medical orientalism-to diminish both local notions of healing and healthcare while bolstering the superiority of European medical training coupled with the inferiority of Egyptian doctors because of their Oriental nature.
As the Pahlavi monarchy of Iran invested heavily in institutions like universities and hospitals, physicians contested traditional forms of knowledge, inserting European allopathy into the public discourse on curatives. The historiography, in emphasizing the development of institutions perpetuating western scientific knowledge, has not adequately illustrated the dynamic public reaction to medical practitioners. Parents and spouses, in particular, expressed their responsibility to their children and partners as their health, at times, deteriorated under the care of physicians and pharmacists.
“Families and Physicians: Rebutting the Experts” evaluates cases of medical malpractice and situates them in the context of evolving family dynamics in modern Iranian society. Parents, in particular, argued that they understood the needs of their children and could better assess the competence of the practitioners as well as the effectiveness of the medication prescribed. The doctor’s office and the pharmacy became vulnerable to public critique as parents challenged the care their children received. Just as the Pahlavi monarchy redefined the role of healthcare providers and parents, the latter argued that they were most capable of assessing the health needs of their children, especially when experts failed their children.
I argue that the historiography of the Middle East may further complicate the citizen-practitioner relationship as well as expose the experiences of children through medical malpractice suits. Like historians of Europe and Latin America, who have used the archives to examine children through court, police, and medical records, this presentation highlights individual stories to illustrate the role of children in families and the ways in which parents, as well as spouses, handled these tragedies. "Families and Physicians" ties together several historiographic strains, including medicine, nationalism, and children, to investigate tensions within Iranian society. Through Iranian archival sources, including transcripts and judgments on malpractice cases, as well as newspapers, the presentation assesses the transformation of both medicine and family dynamics, as well as their relationship with each other in public discourse.
An outbreak of cholera in Egypt in 1883 presented the newly installed Anglo-Egyptian government with its first major crisis. The government’s response marked a break from established public health policies and procedures away from those that developed by the Ottoman Egypt government with French assistance in the early and mid nineteenth century, and implemented anti-contagionist policies developed in British India two decades earlier that considered cost and economic impact key factors.
The British empire and its representatives in Egypt had strong opinions about what constituted "modern" medical practice, the appropriate relationship between medical provider and consumer, and the ways in which the consumer was expected to behave; personal hygiene practices and the acceptance of medical care were seen as markers of modernity and progress, even when restricting access to health services came at the expense of over fifty thousand Egyptian lives.
In this paper, I describe how the 1883 outbreak provided the nascent Anglo-Egyptian administration with the ability to remake the Egyptian health service along measures both more in fitting with imperial attitudes and desires for fiscal austerity. As a result, health, hygiene, and sanitation practices of ordinary Egyptians became used as litmus tests to justify indefinite extension of the British occupation.