Short Abstract:
Biomedicine, biomedical technologies and health are poorly covered research areas in the anthropology of the MENA region. We invite papers focusing on biomedical technologies and the multiple social arrangements and practices they generate, both among patients and health care professionals.
Long Abstract:
Biomedicine, biomedical technologies and health in general are poorly covered research areas in the anthropology of the Middle-East and North Africa (MENA) region. While a corpus of literature broaches reproductive and contraceptive technologies, important topics developed in other regions are still to be more widely explored, such as drugs, medical imaging, clinical trials, genetic testing, blood tests / banks / donation, or organ transplantations. In this panel, we invite researchers working in one or several MENA countries to discuss uses of and interactions around biomedical technologies, considering both patients' and health professionals' practices. As the local shapes, meanings, and impacts of biomedical technologies depend on the social, political and economic contexts as well as on the community of practice, variations in their interpretations and uses may reveal their inherent plasticity. This malleability shall be considered in relation with actors' specific identities such as social class, ethnicity, religion, gender and sexual identities, age, marital status, handicap. Therefore, practices related to biomedical technologies can foster agency or conversely reinforce domination, inequalities or oppression. Moreover, biomedical technologies are caught up in local and global logics that transcend their specific medical application, turning them into instruments that can be used to domesticate bodies, shape specific forms of subjectivity, build political agendas, etc.
What are the similarities, convergences or discrepancies in the uses of biomedical technologies throughout the MENA region? What kind of specific social arrangements do they imply / legitimate / enable? How do these arrangements impact existing power structures and cultural meanings?
Accepted papers:
Session 1
Beautifying Istanbul: on neoliberal selves and aesthetic body modification as surveillance medicine
Claudia Liebelt
(FU Berlin)
Paper short abstract:
Drawing on research on aesthetic body modification and femininity in Istanbul, this paper looks at aesthetic body modification and surgery as a form of "surveillance medicine" in a specific urban place.
Paper long abstract:
With an estimated total of over 1,000 plastic and aesthetic surgeons, Turkey recently ranked among the top ten of countries worldwide with the highest number of plastic surgeons per capita, and its cultural capital Istanbul has become a regional center for cosmetic surgery tourism, as well as for the fashion and beauty industry. Drawing on anthropological research on aesthetic body modification and femininity in Istanbul, my paper looks at aesthetic body modification and surgery as a form of 'surveillance medicine' (Armstrong 1995), which, alongside so-called corrective measures, seeks health and wellness through 'preventive' measures that are tied to wider consumption practices. While in contrast to Beirut or Teheran, post-surgery pride is still rare in Istanbul, against the background of neoliberal urban restructuring, the feminization of the urban service sector and the expansion of the urban middle classes, aesthetic surgery has become ever more normalized and is seen as a form of investment in bodily capital by an increasing number of (working) men and women. Finally, with beauty therapists and aesthetic surgeons musing on the specificities of the Turkish body and 'race' in private TV make-over shows and other media, aesthetic medical practices are becoming intricately linked to specific imaginations of modernity, glamour and the beautifying nation on the margins of the Middle East.
The medicalised repairs of the hymen: purification and absolution techniques ?
Ibtissem Ben Dridi
(EHESS)
Paper short abstract:
I will deal with surgical repairs of the hymen in Tunisia considering them in relation with the virginity norm and its adjustments. I will show how genital surgeries put medical techniques at the intersection between cultural norms and individual, social and religious arrangements.
Paper long abstract:
The reestablishment of female virtue is currently subject to medicalization, a phenomenon that is acquiring growing visibility. Drawing on ethnographic research in Tunisia, I will focus on two genital surgical techniques: hymenorraphy and hymenoplasty. I will examine the social uses of these practices and the gendered body norms legitimating them. I will analyse the discourses of several categories of actors: women, religious authority, and medical doctors. Young unmarried women conceive of genital surgeries as a means to purify their physical and moral person cancelling the defilement caused by premarital sex. The Islamic Organization for Medical Sciences, the main authority dealing with bioethics issues in the Muslim world, mentioned the idea that genital surgeries can be a technique of purification in 1987 during a debate on the legality of virtue repairs. Based on the principles of the common good, discretion, protection and repentance, some Sunni religious authorities have thus authorized hymenorraphy, defending its moral nature. Some legal opinions issued in 2007 and 2009 have confirmed this position, triggering the public reactions of more conservative groups. If genital surgeries are located at the intersection between cultural norms and multiple socio-religious arrangements, physicians are caught up in an ambiguous position. While some practitioners criticize the constraining norm of female virginity, others do not easily accept to endorse a social lie, although they are well aware of the importance of genital surgeries in that they allow the social reintegration of young women who have "sinned".
Longing for health or beauty? A study of cosmetic surgery in Iran
Marzieh Kaivanara
(University of Bristol)
Paper short abstract:
This article focuses on the intersection of health and beauty in highly sought-after cosmetic surgical procedures in Tehran.
Paper long abstract:
This article focuses on the intersection of health and beauty in highly sought-after cosmetic surgical procedures in Tehran. With the recent modes of self-presentation through the media emphasising on the "perfected" selves, bodies are seen in "need" of repair and correction. Cosmetic surgery, in this sense, is not only pursued to create beauty, but also to "cure" the defected body. Arrays of body shapes and facial features are strictly marked by names, seen as correctible and demarcated through objective indicators. Health in this respect is understood beyond its standard meaning (e.g. WHO definition), rather it encapsulates conformity to the global idealised beauty.
Drawing on the interviews I conducted with cosmetic surgeons and "patients" in Tehran, in this study, I have demonstrated how the distinctions between health (and reconstructive surgeries) and aesthetics (and cosmetic surgeries) have blurred. In this regard, natural trajectory of bodies is seen in need of continuous monitoring and perpetual care and cure.
Drawing on Butler's work on performativity, in this article I will argue how health and its praxis are constructed through repeated citational acts; in other words, health is not a state of well-being, but a never-reaching process which is practiced through cosmetic surgery based on the postmodern idealisation of health.
Practices around paediatric intellectual disability diagnosis: what the social uses of biomedical technologies tell us about care, agency and domination in Moroccan healthcare system.
Julie Pluies
(Social Sciences Institute)
Paper short abstract:
This paper examines the uses of biomedical technologies for the diagnosis of paediatric intellectual disability in Morocco. As we demonstrate children’, parents’ and health professionals’ social arrangements around technologies, we also highlight how public health policies influence actors’ agency.
Paper long abstract:
This paper aims at improving the understandings of the uses of biomedical technologies for children with intellectual disability. Based on a fieldwork conducted in a Moroccan psychiatric hospital, we focus on I.Q tests and medical imaging, both technologies being used for intellectual disability diagnosis. Referring to WHO biomedical technology definition, which includes "devices and procedures developed to solve a health problem and improve quality of life", we pay attention to the social uses of these technologies and their impact on the daily life of children, parents and professionals. From a critical medical anthropologic perspective, we think that actors have agency capacities, varying with social characteristics. We describe therapeutic itineraries and interactions during medical and patients' home visits to illustrate some individual arrangements made to gain time, plead for mercy, share or evade responsibilities or reduce discrimination. Whatever the situation, we advance that arrangements tie social bonds and reveal care for each other. Furthermore, we suggest considering the broader political context, shedding light on the tension between local environment and the global trend of standardization in shaping care for children with psychiatric disorders. At this local/global intersection, actors' agency may be caught up in a series of logics that relativize it and potentially perpetrate inequalities and domination. We demonstrate that these logics, embodied in public health policies, concern financial issues and the rise of cognitive and neuroscience approaches in a postcolonial context. Conclusively, we propose that sociocultural dimensions of the uses of technologies should be emphasized to improve paediatric psychiatric care.
Limiting political participation: the role of psychiatry and stigma in repressing activism.
Monica Ronchi
(University of Exeter)
Paper short abstract:
Mental health and the stigma associated with it has always influenced both social and political dynamics in the MENA region. My research looks how psychiatry has been abused by political elites to limit and repress political and social participation in the area.
Paper long abstract:
The interconnection between social, political and medical systems have been documented in all areas of the world: in particular, the political abuse of psychiatry is a phenomenon that has taken many forms throughout the world. Moreover in some regions, such as in the MENA (Middle East and North Africa), discourse on mental illness is still surrounded by stigma and outdated beliefs, especially in rural areas particularly disconnected from large urban centres.
My research deals with current manifestations of the political abuse of psychiatry in North Africa, where, a variety of factors ranging from the effects of the colonial mental health infrastructure and the instability of the political system has lead to the abuse of psychiatry as a medical science and a set of institutions.
In my presentation I will focus on a specific aspect of my research project, the use of mental health as a tool in the hands of the political elite to discourage, segregate and repress members of the opposition. This is the direct consequence of coercive political elite and an underdeveloped mental health system, which allows for the manipulation of personnel and institutions deeply impacting the political identity of activists and those surrounding them. Of course my research does not imply that the mental health systems analysed are corrupt as a whole. Rather, I will show that in a region where mental illness can lead to isolation from society, psychiatry - its institutions and diagnoses - is used as an instrument for the delegitimization of political activism.
HIV/AIDS and biomedical subjectivities in Lebanon
Elizabeth Berk
(Southern Methodist University)
Paper short abstract:
This paper, based on ethnographic fieldwork, examines HIV/AIDS and its treatment in Lebanon. It asks after the types of biomedical subjectivities generated by the provision of free anti-retroviral medications at the intersection of conflict, political-economic constraint, and social stigma.
Paper long abstract:
Despite recent work by global health professionals and natural scientists, there have been no long-term social scientific inquiries into HIV/AIDS in MENA. UNAIDS labels this region "low prevalence/high risk," indicating a relatively small amount of individuals currently living with this illness, but a dramatic increase in cases in the last decade.1 Lebanon has had a particularly robust response to this epidemic since its appearance in the region in the 1980s, with civil society activists, medical professionals, and a government program working in concert to educate the public about prevention and provide anti-retrovirals free of cost to anyone diagnosed.
This paper, based on four months of ethnographic fieldwork with local civil society organizations, Lebanon's National AIDS Program, infectious disease physicians, and individuals living with HIV/AIDS, takes the provision and use of these anti-retroviral biomedicines as a starting point for an inquiry into the constitution of biomedical subjectivities and agency at the intersection of conflict, political-economic constraint, and social stigma.
How does the free provision of these life-saving biotechnologies shape individual subjectivities for patients, providers, and advocates? How does Lebanon's unique citizenship landscape, based on ethno-religious group membership, interact with internationally produced biomedical regimes to redefine these subjectivities? Are there ways in which actors understand Lebanon's HIV/AIDS response as other than biomedical, as a way to buttress Lebanon's place in the global imaginary? Further, as HIV/AIDS in Lebanon is spreading most rapidly among men who have sex with men, what does the availability of these medications only through increased government and medical surveillance mean for those practicing non-normative sexualities?