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Medicine, Politics, and Resistance

Session V-11, 2022 Annual Meeting

On Friday, December 2 at 1:30 pm

Panel Description
This panel explores the intersection of medicine, politics, and resistance in late nineteenth and twentieth century Egypt and Ottoman Anatolia. In the Middle East, institutionalized medicine developed in colonial contexts and/or during challenges to state sovereignty. Medicine was a means to intensify state and colonial hegemonies. It was an arena for contests over sovereignty and international legitimacy. Medicine defined and solidified gender and social hierarchies, often giving European or European-trained men medical authority over subaltern and women’s bodies. Yet, medicine was also a tool for resistance against these same hierarchies and state-logics. Women used their medical backgrounds to redefine their places in society or channel resistance into their medical practice. Patients and their families petitioned authorities for release from confinement in asylums or to demand treatment and admission into those same asylums. Doctors used etiologies of diseases to critique colonial and state governance. The papers on this panel address the complexity and contradictions of the relationship between medicine, politics, and resistance. In late nineteenth century Anatolia, Clara Barton, founder of the American Red Cross, “performed humanitarianism” to Ottoman and American audiences to demonstrate the efficacy of neutral, non-partisan aid. The Ottoman state reciprocated this performance, thereby increasing the international legitimacy of the concept of neutrality, which would become foundational to the American Red Cross and Ottoman Red Crescent humanitarian partnership. In late nineteenth century Egypt family members of mentally ill women filed ‘arḍaḥāl (citizen petitions), to contest the confinement of their relatives in the state mental asylum. These petitions offer alternative voices to ways in which women’s bodies and minds were defined and pathologized by colonial nosology. Throughout the colonial period, Egypt’s state mental asylums were overcrowded and rarely places for treatment. Patients who were discharged from the asylum prior to recovery or denied entry entirely often found themselves in hospitals and prisons. Physicians debated who was deserving of care, and the manner of that care, based on distinctions between “legitimate” afflictions, often argued to be the result of poverty and bad governance, and what doctors considered to be individual moral failings. Finally, over the course of the past century, Egyptian women doctors have used medicine as a means of resistance against state and societal logics. Nawal al-Saadawi, the founders of al-Nadeem Center for the Rehabilitation of Victims of Violence, and Mona Mina show the multiple ways in which medicine, gender, and politics have played out in different contexts.
  • This paper aim to shed light on the social and political roles played by women doctors in Egypt, with a focus on women doctors who played prominent roles in countering hegemonic state and societal logics. By highlighting three experiences of women doctors, I hope to illustrate the ways in which medicine, gender, and politics have played out in different contexts. First, I focus on the late Nawal Sadawi’s experience as a doctor-turned-feminist intellectual. By centering Sadawi’s medical education and career, I aim to shed light on how medicine shaped a significant part of her intellectual contribution. I will investigate how Sadawi’s understanding of medicine and its social roles enabled her to rise as the feminist voice she was. Second, I center the experience of al-Nadeem Center for the Rehabilitation of Victims of Violence. Founded in 1993 by three women doctors, Magda Adly, Suzan Fayad and Aida Seif Eldawla, al-Nadeem initially aimed to provide medical and psychological care to individuals traumatized by various forms of violence, domestic or otherwise. Soon thereafter, it transformed into a human rights organization that, in addition to medical and psychological care, provided legal assistance to individuals who experienced violence and torture and engaged in various forms of advocacy to end torture in Egypt. Over the span of three decades, al-Nadeem has played a significant role in documenting cases of torture, political violence, and police brutality. Conversely to Sadawi’s case, I argue that al-Nadeem founders’ feminism enabled them to deploy a particular discourse of resistance through medicine. Finally, I focus on the figure of Mona Mina, a Coptic Cairene pediatrician who rose to prominence in the aftermath of the 2011 uprising through her work in the Tahrir field hospitals and later as the first woman elected as Secretary-General of Egypt’s Doctors’ Union after years of leading a movement that mobilized on behalf of doctors’ demands for better wages and working conditions. By centering Mina’s experience, I attempt to understand the ways in which the woman doctor’s body is read in a patriarchal order and how the privileges bestowed by medicine can enable a certain rearrangement of the patriarchal bargain.
  • The Ottoman Red Crescent Society began its evolution when a delegate from the “Society for Aiding Wounded and Ailing Ottoman Soldiers” based in Istanbul signed the first Geneva Convention on behalf of the Ottoman Empire in 1865. The American Red Cross Association joined the Geneva Convention in 1882. Both had origins in the civic voluntarism that arose from conflicts of the mid-19th century. By the 1890s, both began to develop humanitarian assistance missions in addition to their original battlefield roles. This humanitarian dimension was emphasized by Clara Barton. Barton, founder of the American Red Cross, built on her experiences caring for wounded soldiers in the American Civil War. As one of her first humanitarian missions, she reached out to Ottoman subjects, particular Armenians, suffering at the hands of Sultan Abdülhamit II. In this project, Barton relied on the core Red Cross principle of neutrality: non-partisan aid to all in need. The Ottoman government at first was very wary of her. With its growing awareness of the impact of Western press reports on such interventions though, it finally permitted her to proceed. Barton thus in 1896 staged a humanitarian intervention in certain areas of Anatolia, the point of which was not actually to get aid to all who needed it (an unachievable goal anyway). It was more to show how this could be done without alienating local authorities—an alternative model from previous Western aid projects with overtly sectarian agendas. While the long-term effects of her mission were not so substantive in material terms, it was “performative” by showing Ottoman and American audiences how non-partisan aid systems might be made effective. After initially rebuffing her, the Ottomans carried out their own “performative” dimension of this encounter: awarding her the most prestigious official medal ever given to a woman in the Ottoman Empire up to that time. Parallel processes of change on both sides spurred by this episode reflected the increasing acceptance of Red Cross/Red Crescent neutrality. Although severely tested in the next few decades, this concept led finally to the establishment of the American Red Cross and the Ottoman Red Crescent as international partners, despite both organizations’ complex and problematical relationships with their respective governments, societies, and each other. Sources for this study will include contemporary press reports, as well as official records of Barton’s mission.
  • This paper addresses situations in which Egyptians suffering from mental and physical afflictions found themselves locked out of state mental asylums rather than locked in. It treats the discourses of doctors and patients as coeval, exploring the ways in which both groups coproduced mental maladies, debated etiologies and appropriate treatments (or denial of treatment). The sources for this project are Egyptian government records such as the “Annual Lunacy Division Reports,” “Central Narcotics Intelligence Bureau Annual Reports,” contemporary scientific and medical journals, and other publications produced by both Egyptian and British doctors. During the British occupation of Egypt, the ‘Abbasiyya and Khanka state mental asylums were overcrowded, underfunded, and provided minimal treatment for inmates. Except for individuals considered to be too dangerous and unmanageable, most patients were discharged from the asylums well before they were recovered. Moribund or physically ailing patients, whom doctors assessed as too weak to harm others, were turned over to willing or unwilling relatives in order to create space. Egyptians seeking voluntary admission were frequently turned away. This paper investigates how Egyptians afflicted with mental maladies were managed outside of the asylums, particularly in prisons and hospitals. It shows that doctors made distinctions between diseases that they described as “legitimate” madness and afflictions that they diagnosed as resulting from individual moral failings. These distinctions were deeply influenced by class and gender, and they played significant roles in determining patient treatment or lack thereof. For instance, British and Egyptian doctors described “pellagra insanity” as a disease of poverty from which the fellaheen, described as stoic and uneducated, had minimal defense. But these doctors disagreed amongst themselves and with colonial officials about whether addiction to opioids and cocaine, more prevalent in Cairo and Alexandria, resulted from an individual or societal deficiency. British doctors tended to view this type of addiction as a moral degeneracy, subjecting patients to harsh, painful, and experimental treatments in prisons and hospitals, including immediate withdrawal, injection with their own blood, and blistering. Yet in the case of fellaheen drug addiction, many doctors and colonial officials argued that the painful and impoverished life of the fellaheen was to blame.
  • The history of mental illness and psychiatry in the Middle East reflects the multiple ways in which colonial governments defined their national projects and relationships with their subjects. With the British occupation of Egypt in 1882, and the British professionalization of mental health, the responsibility for treating mental illnesses was placed within the hands of British, and British-trained, male doctors who acquired increasing legitimacy. Ultimately, the British administration of Egypt’s asylums transformed mental health care in general, whilst having a disproportionate impact on women. Women, as both patients and nurses, were therefore a central part of the new medical and social order that was being defined and constructed by British experts and administrators in turn-of-the-century Egypt. This study examines the impact of the professionalization of psychiatry on definitions of mental health and modes of treatment in relation to men and women in Egypt. In what ways was the ascribing of mental illness to women different from that of men? How was this affected by the development of the psychiatric profession and the creation of the modern European-trained psychiatrist in Egypt? The study will explore how the professionalization of mental health, as practiced in the asylum by male doctors who possessed medical authority over women’s minds and bodies, actively sought to assert the primacy of British psychiatric practices whilst excluding traditional healing methods such as the zār, in which women were the primary providers and patients. It will also reveal how members of the psychiatric profession developed a colonial nosology largely influenced by Victorian gender norms that incorporated perceived cultural constructs of Egyptian women. Traditional marital and reproductive roles were thus essential factors in the diagnosis and treatment of women’s madness. The study has attempted to present alternative voices to the state’s hegemonic discourse by relying on citizen petitions, ‘arḍaḥāl, to amplify the voices and experiences of mentally ill women and their families. These petitions reveal the manner in which Egyptian men and women contested the confinement of family members during the first decade of the asylum’s establishment. The research also makes use of primary archival material including administrative reports at Dār al-Wathāʼiq al-Qawmīyah in Egypt and the National Archives at Kew Gardens as well as reports of the Lunacy Division and the Department of Public Health at the Wellcome Library.
  • Cholera has been dealt with in the Mediterranean extensively as a disease that changed how port cities traded with each other for two thousand years (Barbieri, 2018). More recently, newer studies have scrutinized the role of quarantine across Europe, the Mediterranean and the Indian Ocean in the nineteenth century as a colonial technology of imperial surveillance and biopower that slowed down trade and subsequently receded in the face of sanitary reform (Opera, 2020; Mukharji 2012; Tagliaczzo, 2014; Maglen 2002; Low, 2020). In contrast, recent nineteenth-century legal histories have emphasized the use of quarantine as a site of local modernity; one that was not yet mended to British colonialism (Fahmy, 2018). This paper returns to earlier claims surrounding quarantine as a biopolitical technology. It does so by undertaking a history of quarantine measures in Mehmet Ali’s early years of rule (1831-3) in the Mediterranean. Looking at Mehmet Ali’s quarantine measures in Candia (Crete) and the Levant, it seeks to connect these far-flung territories back into histories of the Mediterranean and maritime aspects of quarantine, (Greene, 2010; Khuri-Makdisi, 2014). In so doing it adopts a material history of quarantine and explores microcosmic aspects of quarantine such as conditions of nourishment, sanitation and the cost of board inside these quarantine houses. Thus this paper contributes to strands of biomedical and legal historiography that deal with quarantine to offer a different intervention. Namely, this intervention demonstrates how individuals inside these quarantine facilities faced new jurisprudential and bodily challenges: from avoiding infection from those quarantined with them, finding affordable food, keeping their cargo safe, to burying their loved ones according to Sharia jurisprudence. By picking the early years of Mehmet Ali’s rule — an understudied epoch in Egyptian and Mediterranean history — and focusing on the bodily challenges that quarantine produced, this paper contributes to the ‘material’ and ‘biomedical’ turn in the study of Egyptian history, (Jakes, 2015). In particular, it offers a material history of quarantine measures from the point of view of Mediterranean merchants who used Candia as a transiting station and port of disembarkation.