Laura Frances Goffman, Disorder and Diagnosis: Health and the Politics of Everyday Life in Modern Arabia (New Texts Out Now)

Laura Frances Goffman, Disorder and Diagnosis: Health and the Politics of Everyday Life in Modern Arabia (New Texts Out Now)

Laura Frances Goffman, Disorder and Diagnosis: Health and the Politics of Everyday Life in Modern Arabia (New Texts Out Now)

By : Laura Frances Goffman

Laura Frances Goffman, Disorder and Diagnosis: Health and the Politics of Everyday Life in Modern Arabia (Stanford University Press, 2024).

Jadaliyya (J): What made you write this book?

Laura Frances Goffman (LFG): In graduate school, as I was preparing to head to the archives, I felt like histories of Arabia and the Gulf were missing stories of everyday life, as well as the voices of people who could slip between official frameworks. Amid discussions of merchant capital and imperial policy, what did it feel like to be an ordinary person navigating the transformations brought by European empire, global integration, and state modernization in the nineteenth and twentieth centuries? I also wanted to write against the conventional, elite-centered ways of talking about the Gulf that elide the diversity, creativity, and historical dynamism of the region’s residents.

Once I began my research in the Gulf, the United Kingdom, the United States, and India, I found that disease, health, and medicine offered exciting avenues for approaching these concerns. As my book describes, the escalation of the British imperial presence and American missionary projects in the nineteenth-century Gulf corresponded with a growing microbiological understanding of contagion among the global scientific community. As non-elite people assumed new roles, from quarantined travelers to itinerant hospital patients, they became not only a target of governance but also a threat to more valued white, wealthy bodies. In other words, the diseases that they had the potential to carry led to their greater visibility in the historical record. Thanks to this confluence of biological, social, and political factors, I found that astonishingly resilient and resourceful historical protagonists emerge out of the crevices of accounts of disease and medicine.

I approach childbirth as a rich social process and a thick site of power struggle during periods of political and economic transformation...

J: What particular topics, issues, and literatures does the book address?

LFG: Disorder and Diagnosis is a social and political history of how medicine, disease, and public health transformed life in the Arabian Peninsula and Persian Gulf from the late nineteenth century until the 1970s oil boom. My goal was to center and contextualize surprising and striking archival fragments in ways that integrate the Gulf and Arabian Peninsula into global circulations of commodities and movements of people. I also sought to make women’s worlds more visible in the face of a historiography that has overwhelmingly characterized the rhythms of oceanic mobility and national development as masculine experiences.

Across the book’s six chapters, I focus on an array of health projects—quarantines, hospitals, childbirth, vaccinations, nursing, and folk medicine—to illustrate how the Gulf and its Arabian hinterland served as a buffer zone between “diseased” Asia, the Ottoman Empire, and white Europe; as an object of economic development; and as a space of scientific translation. My book is not just a top-down story: the chapters emphasize how mobile and multi-ethnic residents of regions that would become Kuwait, Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, and Oman accepted, modified, or rebelled against medical projects. 

For example, in chapter 3, “Childbirth,” I read American missionary accounts, scientific publications, and Arabic-language ethnographies of local folk medicine alongside each other to tell the story of how local women creatively pursued an assortment of health-seeking strategies even as various medical professionals clamored for control over childbirth. I approach childbirth as a rich social process and a thick site of power struggle during periods of political and economic transformation, which allowed me to center women as makers of their own history, even (or especially) when their menfolk were absent.

J: Who do you hope will read this book, and what sort of impact would you like it to have?

LFG: I write out of a political conviction that ordinary, non-elite people matter, and that their actions have far-reaching consequences. So, ideally, my work will challenge predominant expectations that some people are temporary or less important in the Gulf, and that their histories are not “of” this region. I hope that people who might fall into these categories will recognize their histories in this book, and I hope that readers coming from other areas of interest—science, medicine, women’s history—will use my book as an entry into understanding more about this part of the world.

In terms of academic audiences, this book will be of interest to scholars of health, medicine, sexuality, the body, state building, and everyday life. My book as a whole presents a coherent trajectory of health interventions over time, but it is also possible to pull out particular sections for special interests: each chapter tells a separate story of how a range of protagonists such as travelers, doctors, patients, mothers, nurses, oil workers, and scientists shaped the modern Gulf through their understandings of disease and their quests for health. 

J: What other projects are you working on now?

LFG: In the late twentieth century, concerns of a shrinking proportion of citizens in the Gulf flooded local discourse. I am currently thinking about how such demographic anxieties intersected with discussions of sexuality and reproductive health. My 2021 article in Radical History Review, “Waiting for AIDS in Kuwait,” represents my initial foray into these issues. Through a close reading of Kuwaiti media, the article traced how, 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 marital infidelity to the forefront of public health. My new research will further explore such assemblages of health and political economy by examining the convergence of politicized demographics, gendered citizenship and migration, and biological reproduction. 

 

Excerpt from the book (from Chapter 5, “Nurses,” pages 131 to 134)

In 1965, the menace of cholera gave Kuwait an opportunity to deploy its expanding medical infrastructure. Cholera had appeared on Iran’s Afghan frontier in July, and Iran responded by shutting down communications with its eastern regions, dispatching 1,428 medical workers, closing schools, banning public gatherings, and imposing quarantines on its borders. In stark contrast to the Sultan of Oman’s lackluster response in 1899 to warnings that cholera would likely make landfall in Muscat if he did not take precautionary measures, by 1965, the Kuwaiti reaction to news of cholera in Iran exemplified how drastically government attitudes toward preventing disease had transformed. When Kuwaiti authorities learned of the outbreak, they halted travel between Kuwait and Iran and prohibited the import of food. The government requested additional vaccine from abroad and ordered vaccination for “the entire population of Kuwait.” Moreover, Kuwait’s residents were willing participants in these public health measures, perhaps thanks in part to the long history of vaccinations in Kuwait. According to the director of the Ministry of Health’s preventive services, “Vaccination is currently being done without resorting to force and compulsion because health awareness in Kuwait has reached an impressive level . . . the people are coming for vaccination in a manner that is reassuring.” 

Nurses, the largest population of medical professionals, were on the front lines of these sweeping vaccination efforts. Jamila Fadil Khoury, the Syrian woman who directed Kuwait’s nurses throughout the 1960s, seized on the cholera epidemic to argue forcefully that Arab women nurses were state builders, comparable to—and in no way less than—skilled male professionals and even patriotic soldiers. Using military metaphors to explain disease, Khoury declared, “In my opinion, as far as Kuwait feels the need to build a strong modern army to protect its borders and defend them from the enemy, there is also a need for another army of Kuwaiti Angels of Mercy to keep the country safe from the invisible enemy of disease.” Emphasizing the central role of the nurses in Kuwait’s response to cholera, she continued, “This [need] became clear in recent days when this army— I mean the female nurses and the male first aid responders—played their honorable role in immunizing citizens to stave off the danger of cholera.” The role of the nursing staff, she elaborated, “was exactly as the role of the army in a state of antagonism and war . . . side by side, day and night, with full attention and desire to vaccinate the citizens.” 

Khoury’s comparison of nurses and soldiers suggests that she understood how a sizable population of working women, many of whom were unmarried, sat uneasily with patriarchal norms and anxieties surrounding citizenship, family, and sexuality in Kuwait’s rapidly changing social world. Throughout her interviews in Kuwait’s vibrant press, Khoury combated such tensions over the professional status of women nurses by presenting her own migration to Kuwait—and the migration of other women Arab nurses—as a political act. Nurses, in her view, helped to stitch the newly minted sovereign state (Kuwait gained independence in 1961) into the Arab world and to integrate it into a particular transregional vision of decolonizing modernity. More than a medical administrator, in her interviews she used her personal narrative to advocate for the professional virtue of women workers. Khoury was born and completed primary school in the town of Mashta Al Hilu in northwestern Syria. She moved with her family to Tripoli, where she finished secondary school, and then enrolled in the nursing program at the American University of Beirut. After graduating at age nineteen with a nursing certificate, she worked in Tripoli and Homs. With the outbreak of the 1948 war, Khoury rushed to Lebanon’s border with Palestine so that she could “provide first aid to the mujāhidīn and fighters.” The war proved a formative experience, solidifying her sense that nursing was a patriotic duty. The fact that Khoury had worked as a nurse in the 1948 Palestine war also would have endeared her to Kuwait’s expanding professional class who were deeply involved in Pan-Arabism and the Palestinian issue. In a 1963 interview, she explicitly linked her work as a nurse to her political awakening in 1948, stating, “In this war, painful calamities occurred that affected my soul and pushed me to devote myself more and more to the profession.”

After the war, Khoury was head nurse at a hospital in Jeddah. Her next stop was Syria, where she also taught nursing. Khoury then traveled on a Rockefeller Foundation fellowship to the United States, where she earned a bachelor of science in educational and administrative nursing before returning to Syria. Kuwait’s Department of Public Health, at that time headed by Shaykh Fahad al-Salem Al-Sabah, offered her a position in 1959. She worked as the director of nurses in Al-Amiri and Al-Sabah hospitals before being promoted to lead the country’s nursing staff, a position she held until the 1970s. Although in her public narrative she emphasized her credentials as an Arab woman dedicated to serving the pan-Arab community, her American education—both at the American University of Beirut and in the United States—facilitated Khoury’s professional mobility in the Arab world and authorized her to promote an Arab version of this universally feminized profession. 

Gulf migration is regularly presented as an explanatory mechanism for twentieth-century transformations in the Arab world. But histories of state building and multidirectional migration within, to, and from the Gulf have yet to fully explore the ground-level interactions that populated large-scale economic, social, and political changes, let alone how people understood the meaning of their own migrations. Largely because of the focus on the oil industry, there also has been scant attention to how Arab women’s labor shaped these demographic and social processes or to the gendered experiences of Arab women migrants. As state agents, nurses were tasked with translating, standardizing, and implementing biomedicine into local health practices. As migrant and professional women whose jobs entailed intimate interactions of physical touch and personal care with Kuwaiti residents from all walks of life, nurses also contributed to shifting dynamics between women and men. Their specialized training made them essential to the state’s modernizing project, but their status as women resulted in systemic economic devaluation of their labor, frequent workplace harassment, and paternalist laws that regulated their movements and leisure. 

The focus on elite and male foreign experts and on economic causality rather than social processes has elided an important reality: migrant women mediated the majority of residents’ interactions with the state’s medical infrastructure. These women’s labor was crucial to building the modern welfare state. Moreover, Khoury’s argument for the moral and professional role of Arab women reminds us that, as Andrea Wright states, “migration is not a simple economic calculus,” and “much is lost in using supply and demand, surplus and scarcity” to explain the migration of workers to the Gulf. Khoury did not conceptualize the presence of noncitizen Arab women nurses as the result of a surplus of people in Egypt, Lebanon, and Syria and a shortage of medical workers in Kuwait. In 1963, when a reporter asked Khoury, “What is your view of the Arab girl and what is your advice to her?” Khoury replied: “The Arab girl is distinguished by her strong morals and her ambitions. She is now working in all fields. She has proven her great merit and her ability to master every job that is entrusted to her. My advice is to avoid vanity and to learn a lot from science.” Khoury adeptly used her position of medical leadership to promote the idea that women had a duty to participate in the Arab national project as nurses, that their efforts demanded specialized training and expertise, and that they deserved society’s respect. She offered up Arab nurses as agents of social change in a newly independent Kuwait.

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New Texts Out Now: Mandy Turner and Cherine Hussein, guest eds. "Israel-Palestine after Oslo: Mapping Transformations in a Time of Deepening Crisis." Special Issue of Conflict, Security & Development

Conflict, Security and Development, Volume 15, No. 5 (December 2015) Special issue: "Israel-Palestine after Oslo: Mapping Transformations in a Time of Deepening Crisis," Guest Editors: Mandy Turner and Cherine Hussein.

Jadaliyya (J): What made you compile this volume?

Mandy Turner (MT): Both the peace process and the two-state solution are dead. Despite more than twenty years of negotiations, Israel’s occupation, colonization and repression continue–and the political and geographical fragmentation of the Palestinian people is proceeding apace.

This is not news, nor is it surprising to any keen observer of the situation. But what is surprising–and thus requires explanation – is the resilience of the Oslo framework and paradigm: both objectively and subjectively. It operates objectively as a straitjacket by trapping Palestinians in economic and security arrangements that are designed to ensure stabilization and will not to lead to sovereignty or a just and sustainable solution. And it operates subjectively as a straitjacket by shutting out discussion of alternative ways of understanding the situation and ways out of the impasse. The persistence of this framework that is focused on conflict management and stabilization, is good for Israel but bad for Palestinians.

The Oslo peace paradigm–of a track-one, elite-level, negotiated two-state solution–is therefore in crisis. And yet it is entirely possible that the current situation could continue for a while longer–particularly given the endorsement and support it enjoys from the major Western donors and the “international community,” as well as the fact that there has been no attempt to develop an alternative. The immediate short-term future is therefore bleak.

Guided by these observations, this special issue sought to undertake two tasks. The first task was to analyze the perceptions underpinning the Oslo framework and paradigm as well as some of the transformations instituted by its implementation: why is it so resilient, what has it created? The second task, which follows on from the first, was then to ask: how can we reframe our understanding of what is happening, what are some potential alternatives, and who is arguing and mobilizing for them?

These questions and themes grew out of a number of conversations with early-career scholars – some based at the Kenyon Institute in East Jerusalem, and some based in the occupied Palestinian territory and elsewhere. These conversations led to two interlinked panels at the International Studies Association annual convention in Toronto, Canada, in March 2014. To have two panels accepted on “conflict transformation and resistance in Palestine” at such a conventional international relations conference with (at the time unknown) early-career scholars is no mean feat. The large and engaged audience we received at these panels – with some very established names coming along (one of whom contributed to this special issue) – convinced us that this new stream of scholars and scholarship should have an outlet.  

J: What particular topics, issues, and literatures do the articles address?

MT: The first half of the special issue analyzes how certain problematic assumptions shaped the Oslo framework, and how the Oslo framework in turn shaped the political, economic and territorial landscape.

Virginia Tilley’s article focuses on the paradigm of conflict resolution upon which the Oslo Accords were based, and calls for a re-evaluation of what she argues are the two interlinked central principles underpinning its worldview: internationally accepted notions of Israeli sovereignty; and the internationally accepted idea that the “conflict” is essentially one between two peoples–the “Palestinian people” and the “Jewish people”. Through her critical interrogation of these two “common sense” principles, Tilley proposes that the “conflict” be reinterpreted as an example of settler colonialism, and, as a result of this, recommends an alternative conflict resolution model based on a paradigm shift away from an ethno-nationalist division of the polity towards a civic model of the nation.

Tariq Dana unpacks another central plank of the Oslo paradigm–that of promoting economic relations between Israel and the OPT. He analyses this through the prism of “economic peace” (particularly the recent revival of theories of “capitalist peace”), whose underlying assumptions are predicated on the perceived superiority of economic approaches over political approaches to resolving conflict. Dana argues that there is a symbiosis between Israeli strategies of “economic peace” and recent Palestinian “statebuilding strategies” (referred to as Fayyadism), and that both operate as a form of pacification and control because economic cooperation leaves the colonial relationship unchallenged.

The political landscape in the OPT has been transformed by the Oslo paradigm, particularly by the creation of the Palestinian Authority (PA). Alaa Tartir therefore analyses the basis, agenda and trajectory of the PA, particularly its post-2007 state building strategy. By focusing on the issue of local legitimacy and accountability, and based on fieldwork in two sites in the occupied West Bank (Balata and Jenin refugee camps), Tartir concludes that the main impact of the creation of the PA on ordinary people’s lives has been the strengthening of authoritarian control and the hijacking of any meaningful visions of Palestinian liberation.

The origin of the administrative division between the West Bank and Gaza Strip is the focus of Tareq Baconi’s article. He charts how Hamas’s initial opposition to the Oslo Accords and the PA was transformed over time, leading to its participation (and success) in the 2006 legislative elections. Baconi argues that it was the perceived demise of the peace process following the collapse of the Camp David discussions that facilitated this change. But this set Hamas on a collision course with Israel and the international community, which ultimately led to the conflict between Hamas and Fateh, and the administrative division, which continues to exist.

The special issue thereafter focuses, in the second section, on alternatives and resistance to Oslo’s transformations.

Cherine Hussein’s article charts the re-emergence of the single-state idea in opposition to the processes of separation unleashed ideologically and practically that were codified in the Oslo Accords. Analysing it as both a movement of resistance and as a political alternative to Oslo, while recognizing that it is currently largely a movement of intellectuals (particularly of diaspora Palestinians and Israelis), Hussein takes seriously its claim to be a more just and liberating alternative to the two-state solution.

My article highlights the work of a small but dedicated group of anti-Zionist Jewish-Israeli activists involved in two groups: Zochrot and Boycott from Within. Both groups emerged in the post-Second Intifada period, which was marked by deep disillusionment with the Oslo paradigm. This article unpacks the alternative – albeit marginalized – analysis, solution and route to peace proposed by these groups through the application of three concepts: hegemony, counter-hegemony and praxis. The solution, argue the activists, lies in Israel-Palestine going through a process of de-Zionization and decolonization, and the process of achieving this lies in actions in solidarity with Palestinians.

This type of solidarity action is the focus of the final article by Suzanne Morrison, who analyses the “We Divest” campaign, which is the largest divestment campaign in the US and forms part of the wider Palestinian Boycott, Divestment and Sanctions movement. Through attention to their activities and language, Morrison shows how “We Divest”, with its networked, decentralized, grassroots and horizontal structure, represents a new way of challenging Israel’s occupation and the suppression of Palestinian rights.

The two parts of the special issue are symbiotic: the critique and alternative perspectives analyzed in part two are responses to the issues and problems identified in part one.

J: How does this volume connect to and/or depart from your previous work?

MT: My work focuses on the political economy of donor intervention (which falls under the rubric of “peacebuilding”) in the OPT, particularly a critique of the Oslo peace paradigm and framework. This is a product of my broader conceptual and historical interest in the sociology of intervention as a method of capitalist expansion and imperial control (as explored in “The Politics of International Intervention: the Tyranny of Peace”, co-edited with Florian Kuhn, Routledge, 2016), and how post-conflict peacebuilding and development agendas are part of this (as explored in “Whose Peace: Critical Perspectives on the Political Economy of Peacebuilding”, co-edited with Michael Pugh and Neil Cooper (PalgraveMacmillan, 2008).  

My first book on Palestine (co-edited with Omar Shweiki), Decolonizing Palestinian Political Economy: De-development and Beyond (PalgraveMacmillan, 2014), was a collection of essays by experts in their field, of the political-economic experience of different sections of the Palestinian community. The book, however, aimed to reunite these individual experiences into one historical political-economy narrative of a people experiencing a common theme of dispossession, disenfranchisement and disarticulation. It was guided by the desire to critically assess the utility of the concept of de-development to different sectors and issues–and had a foreword by Sara Roy, the scholar who coined the term, and who was involved in the workshop from which the book emerged.

This co-edited special issue (with Cherine Hussein, who, at the time of the issue construction, was the deputy director of the Kenyon Institute) was therefore the next logical step in my research on Palestine, although my article on Jewish-Israeli anti-Zionists did constitute a slight departure from my usual focus.

J: Who do you hope will read this volume, and what sort of impact would you like it to have?

MT: I would imagine the main audience will be those whose research and political interests lie in Palestine Studies. It is difficult, given the structure of academic publishing – which has become ever more corporate and money grabbing – for research outputs such as this to be accessed by the general public. Only those with access to academic libraries are sure to be able to read it – and this is a travesty, in my opinion. To counteract this commodification of knowledge, we should all provide free access to our outputs through online open source websites such as academia.edu, etc. If academic research is going to have an impact beyond merely providing more material for teaching and background reading for yet more research (which is inaccessible to the general public) then this is essential. Websites such as Jadaliyya are therefore incredibly important.

Having said all that, I am under no illusions about the potential for ANY research on Israel-Palestine to contribute to changing the dynamics of the situation. However, as a collection of excellent analyses conducted by mostly early-career scholars in the field of Palestine studies, I am hopeful that their interesting and new perspectives will be read and digested. 

J: What other projects are you working on now?

MT: I am currently working on an edited volume provisionally entitled From the River to the Sea: Disintegration, Reintegration and Domination in Israel and Palestine. This book is the culmination of a two-year research project funded by the British Academy, which analyzed the impacts of the past twenty years of the Oslo peace framework and paradigm as processes of disintegration, reintegration and domination – and how they have created a new socio-economic and political landscape, which requires new agendas and frameworks. I am also working on a new research project with Tariq Dana at Birzeit University on capital and class in the occupied West Bank.

Excerpt from the Editor’s Note 

[Note: This issue was published in Dec. 2015]

Initially perceived to have inaugurated a new era of hope in the search for peace and justice in Palestine-Israel, the Oslo peace paradigm of a track one, elite-level, negotiated two-state solution is in crisis today, if not completely at an end.

While the major Western donors and the ‘international community’ continue to publicly endorse the Oslo peace paradigm, Israeli and Palestinian political elites have both stepped away from it. The Israeli government has adopted what appears to be an outright rejection of the internationally-accepted end-goal of negotiations, i.e. the emergence of a Palestinian state based on the 1967 borders with East Jerusalem as its capital. In March 2015, in the final days of his re-election campaign, Israeli Prime Minister, Benjamin Netanyahu, visited the Jewish settlement of Har Homa in Palestinian East Jerusalem, which is regarded as illegal under international law. Reminding its inhabitants that it was him and his Likud government that had established the settlement in 1997 as part of the Israeli state’s vision of a unified indivisible Jerusalem, he promised to expand the construction of settlements in East Jerusalem if re-elected. And in an interview with Israeli news site, NRG, Netanyahu vowed that the prospects of a Palestinian state were non-existent as long as he remained in office. Holding on to the occupied Palestinian territory (oPt), he argued, was necessary to ensure Israel’s security in the context of regional instability and Islamic extremism. It is widely acknowledged that Netanyahu’s emphasis on Israel’s security—against both external and internal enemies—gave him a surprise win in an election he was widely expected to lose.

Despite attempts to backtrack under recognition that the US and European states are critical of this turn in official Israeli state policy, Netanyahu’s promise to bury the two-state solution in favour of a policy of further annexation has become the Israeli government’s official intent, and has been enthusiastically endorsed by leading ministers and key advisers.

[…]

The Palestinian Authority (PA) based in the West Bank also appears to have rejected a key principle of the Oslo peace paradigm—that of bilateral negotiations under the supervision of the US. Despite a herculean effort by US Secretary of State, John Kerry, to bring the two parties to the negotiating table, in response to the lack of movement towards final status issues and continued settlement expansion (amongst other issues), the Palestinian political elite have withdrawn from negotiations and resumed attempts to ‘internationalise the struggle’ by seeking membership of international organisations such as the United Nations (UN), and signing international treaties such as the Rome Statute, the founding treaty of the International Criminal Court. This change of direction is part of a rethink in the PA and PLO’s strategy rooted in wider discussions and debates. The publication of a document by the Palestine Strategy Study Group (PSSG) in August 2008, the production of which involved many members of the Palestinian political elite (and whose recommendations were studiously discussed at the highest levels of the PA and PLO), showed widespread discontent with the bilateral negotiations framework and suggested ways in which Palestinians could ‘regain the initiative’.

[…]

And yet despite these changes in official Palestinian and Israeli political strategies that signal a deepening of the crisis, donors and the ‘international community’ are reluctant to accept the failure of the Oslo peace paradigm. This political myopia has meant the persistence of a framework that is increasingly divorced from the possibility of a just and sustainable peace. It is also acting as an ideological straitjacket by shutting out alternative interpretations. This special issue seeks a way out of this political and intellectual dead end. In pursuit of this, our various contributions undertake what we regard to be two key tasks: first, to critically analyse the perceptions underpinning the Oslo paradigm and the transformations instituted by its implementation; and second, to assess some alternative ways of understanding the situation rooted in new strategies of resistance that have emerged in the context of these transformations in the post-Oslo landscape.

[…]

Taken as a whole, the articles in this special issue aim to ignite conversations on the conflict that are not based within abstracted debates that centre upon the peace process itself—but that begin from within the realities and geographies of both the continually transforming land of Palestine-Israel and the voices, struggles, worldviews and imaginings of the future of the people who presently inhabit it. For it is by highlighting these transformations, and from within these points of beginning, that we believe more hopeful pathways for alternative ways forward can be collectively imagined, articulated, debated and built.