Women and Health: Comparative Case Studies of the Middle East and U.S. Women of Color
by Elise Young

I want to say something about how I've worked as a scholar, because my scholarship and my activism have never really been separate. Obviously, as a Jew, I've felt that I had to take some sort of historical responsibility for what was going on in the world that was affecting my life as a Jew, and the lives of all Jews and many other people; also as a feminist, and particularly as a lesbian feminist. In 1982, when Israel invaded Lebanon, I turned my attention to that area, and began to do a lot on that issue. I had never been raised as a Zionist, not because my parents didn't support the state of Israel, but because their education didn't even include the concept of Zionism. I began to do a lot of reading of the literature, and became very frustrated by the construction of the conflict. It was being constructed as a struggle between two monolithic groups of people, Arabs and Jews, who have always been "eternal enemies." I began a long study of the historical relationships between Jews, Muslims, and Christians in the Arab world. It was quite a revelation to me, having gotten a very Eurocentric education in the Hebrew school I attended growing up. In other words, the predominant image of the Jew in my texts was of a European Jew. It was quite amazing to go through that process, to understand the racism in my own education, and I think that really helps me tremendously in my teaching of other students. I began to see how politicized the historical literature was, and that there was a tremendous amount of very interesting information about the historical relationships between Jewish, Muslim, and Christian women that was totally invisible.

A number of years ago I attended a wonderful conference here in the Valley, at Hampshire College. The Iranian scholar Eliz Sanasarian who has written on the women's movement in Iran(1) and done some fantastic work since then, spoke. This was ten or more years ago, when I was just beginning in the field. The first thing she said was, "I am not going to talk about the veil. Everyone in the West is obsessed with this, and I'm not going to talk about it." I was very, very struck by that. It was, in a way, the beginning of my process of maturation as a Middle East historian. Since then, of course, a tremendous amount has been written about the complexity of talking about the veil, but students always bring it up, and they always want to talk about it, and that very bringing up of it remains a problem.

Kumari Jayawardena(2) was also at that conference. I had talked to her about wanting to do a feminist analysis of the Israeli-Palestinian conflict, and she had strongly encouraged me. People were beginning to talk about it, but the enormous proliferation of literature on gender and nationalism that has come out since then did not exist at the time, so it seemed like a very risky thing to do. In my book Keepers of the History: Women and the Israeli-Palestinian Conflict (1992)(3) I talk about those historical relationships, about how nationalism is a gendered concept in itself, and about how women's associations have been disrupted by male-dominated nationalist movements. It set me on the path of wanting to continue to develop feminist historiography in order to have new ways of understanding what developments led to these conflicts, so that we could look at the gender, race, and class issues embedded in those historical developments and not see the conflict simply as a struggle between two groups viewed as having always been "eternal enemies." But I also have to say that, working as an activist in this area since 1982, and constantly bringing up the issue of women, it was very frustrating, because the topic of women is always seen as a subsidiary issue rather than one that is central to understanding the Palestinian-Israeli conflict. That was another motivation for writing the book. But I still feel that this approach is totally marginalized. It's extremely difficult, both in the activist world and in the academic world, for people to reconceptualize the conflict in a way that could lead to more attention to women, as well as to other issues. They continue to want to see it in a way that comes out of a male intellectual tradition, one that keeps Muslims and Jews poised as constant enemies, no matter how much historical validation you give to the other view. It's a very uphill struggle.

Through my activist work in Palestine, I became involved with the Union of Palestinian Medical Relief Committees, an activist group working in health care. I met Dr. Salwa Najjab- Khatib, one of the founders of the UPMRC, who also started the Women's Health Project, the first project in Palestine to specifically address Palestinian women's health issues. She was educated in the Soviet Union, and was going to be an engineering student. She had a Jewish professor who said to her, "You should become a doctor, because that's what your people will need." And that's what she did. She showed me something she had written when she first came here, which was quite interesting to me. Her analysis was a gender/race/class analysis. She talked about the differences among different groups of Palestinian women in Palestine, about women in the refugee camps and their health issues, and of course about the gender issues embedded in the society itself as well as those resulting from the Israeli occupation. We began to work together, and my research began to focus more on women and on health issues. I spent time in the refugee camps in Jordan, working with Palestinian women, and did a lot of oral histories.

When I came back to this country and began to think about that material and write it up, the place that I found was most useful in terms of feminist theory was black feminist theory specifically, the work of Patricia Hill Collins. Of all the feminist theory I had been looking at for understanding the knowledge-making processes of Palestinian women in the refugee camps, her work struck me as the most relevant, particularly her book Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment.(4) Of course, any Middle East scholar who addresses these issues will bring up this question: What is the applicability of Western feminism to that situation? And it became very frustrating for me, after many years of going to conferences, that what was meant by Western feminism was always white Western feminism. But Hill Collins' critique of traditional epistemology, and her presentation of a combined Afrocentric and feminist approach, provide a meaningful framework for exploring ways that Palestinian women working in health movements in refugee camps in Jordan construct knowledge as a community, rather than as isolated individuals. What Hill Collins defines as Afrocentric epistemology, for example, illuminates how subordinate groups create knowledge that fosters resistance, and this is precisely what I've observed happening among Palestinian women. Health is one of the major areas that women organize around in the camps. It's an organizational tool, and it's highly politicized, because these women's definition of health is very intertwined with the issue of right of return. Besides dealing with all of the specific health- related issues in the camps -- environmental issues, poverty, unemployment, rape -- they base their understanding of health on their ability to return home. That's what health is. It's a metaphor for their ability to go back to Palestine. This is true especially in times of war, for example, Black September in Jordan.(5) Also, it's very clear that among these women, shared conditions of oppression foster values that permeate the family, religion, and community life, which is also how Hill Collins defines Afrocentric values. Both Afrocentric and feminist epistemologies reject Eurocentric, masculinist privileging as impersonal procedures for establishing truth. This is very much true among these women. Hill Collins shows that concrete experience is the basis for credibility, a basis for developing an ethical system, and a basis for developing core beliefs among the community. Knowledge claims are worked out through dialogue with other members of the community, and this is true among Palestinian women also. Also, neither emotion nor ethics is subordinated to reason, but all are seen as very interconnected.

At Westfield State College, where I teach, most of the students come from working-class backgrounds. The students of color, the African-American and Latina women I have in my classes, have not had the kind of education that gives them analytical skills, because we have such a segregated class system in our educational system. But they connect very directly with the experiences, for example, of women living under military occupation. It's not very hard to make connections between the so-called domestic Third World and what's going on out there for these students. When Salwa Najjab-Khatib was visiting here, we went to Nueva Esperanza in Holyoke, which does grassroots organizing around women's medical needs, among other things. Talking to these women, who are doing preventative health care, she found so many connections between strategies being used to develop health care programs for Palestinian women and for women in Holyoke. She was also astonished to see what they were struggling with; she said she felt the conditions of their lives were even worse than the conditions of Palestinian women living under military occupation.

We have always made an effort to try to bring our work into communities where we can make those kinds of connections. So, when I formed my institute with Magda Ahmed who is from Sudan, we wanted to work with some grass-roots organizations. I had been talking with Maria Morales at the Spanish-American Union in Springfield. They had a program there called Women's Health Connections -- Latina, African-American, Vietnamese, and Cambodian refugee women developing health care programs by educating themselves on particular health care issues, then going out to other women in their communities and sharing this information with them. We've started to develop a program with them to bring Palestinian women here, from the territories within Israel, and also Israeli-Jewish, Palestinian-Muslim, and Christian women we've been working with to create a forum in which we could learn each other's histories, understand how historical developments have created certain kinds of health issues, where there are similarities and differences, and what kinds of common strategies can be developed. We're hoping to get that program off the ground. That work became the basis for the course I'm teaching in the Women's Studies department now, "Comparative Approaches to Women and Health: Historical and Activist Case Studies." This is the course description:

Concepts of health and disease are historically-specific, gendered, and, in the 20th-century Middle East, connected to the formation of the modern nation-state. The primary goal of this course is to study the international context of women and health, drawing our case studies from Egypt, Palestine, Israel, Jordan, and Western Massachusetts. The course explores historical developments relevant to women and health, such as the interaction between Middle Eastern and Western systems of medicine, and, in both geographic contexts the politics of medicalization, the social production of ill-health as a result of racism, poverty, sexual politics and refugee status; the gender politics and definitions of health and disease, women's activism and community-based preventative health care, militarism and violence against women, the politics of reproduction and infertility. Students will engage in cross-cultural research through association with community-based health care organizations in Palestine and in Jordan, and a community-based organization of African-American, Latina, Vietnamese, and Russian women in Springfield, Massachusetts.

The most difficult challenge in teaching a course like this is that so much of the material is primary material that I gathered doing research in the field. It's very difficult even to make enough copies for the students, and I haven't quite figured out how to do all of that yet.

I teach another course called "Introduction to the Non-Western World." That is what the title was when I came in, and it will be changed now that I'm in control of it. The interesting thing about this course is that it's the multicultural requirement for the History Department. In the first year I've been teaching it the focus has been on the Middle East and Africa. Among the issues that are raised in the literature, and that certainly come up among the students, is the privileging of Islam in the lives of women. The students have absolutely no idea, first of all, what Islam is, but they think it's something that totally controls everything that happens in the Middle East. So you have to begin the class by talking about all the complexities of different economies, races, languages, class structures, and religious traditions -- in short, the diversity of the Middle East. I also use newspapers to do comparative studies, so the students can understand women's struggles around nationalism and other issues in terms of U.S.-based nationalist mythologies. They have to understand what their own nationalist mythologies are in order to understand what anybody else is struggling with. So we analyze such questions as: How do the media present the Middle East? How does our system of education here teach about the Middle East? and there's a lot of material there that the students pick up quite readily, the racism involved in that, and they're quite open to seeing it, so that's heartening. I give them pretty sophisticated material and have them do research projects. I had one student, who is in the Criminal Justice department, do a study of the five different schools of Islamic law. This is a guy who is being trained to become a policeman. He said, "Oh, I could never do this. It's much too complicated." But he really, really got into it. He produced a lengthy paper and did a class presentation. I'm giving them material that I feel will both open up another world for them and also open up their own world to them.

Rosemary Sayigh was one of the first women to write about women's movements in the Middle East; she totally inspired me on my path, and I always use her work in my courses. She wrote an article in the early 1980s called "Roles and Functions of Arab Women: A Reappraisal."(6) In it, she does a wonderful critique of Orientalist thought. Orientalism is a concept that we definitely have to deal with right away in the course, and the students understand it, they grasp it, they're able to translate it into concepts they can apply to their own lives, so that's very useful. Reading Edward Said in the original is too difficult for them though. He has too many literary allusions, and he assumes so much education that these students can't deal with him. Social biography is definitely the approach to take with these students, because they can relate to actual individual people's lives. I'm using a lot of short novels in the course, and there's also a wonderful collection of short biographies I always use, Edmund Burke's Struggle and Survival in the Modern Middle East.(7) For example, it has a piece on a woman named Shemsigul who was a Circassian slave in Egypt in the early 19th century.(8) After she is raped, she brings a case to court, and we see how the court system deals with it. The students are amazed that she could bring it to court, and you get to teach the whole social structure that way. Another good piece in the collection is about Zinab, an Algerian Sufi Saint. (9) It's very useful for teaching French colonialism in Algeria and the role of women in Sufism, and all kinds of complex understandings of social relations come out in it.

I always break everything down in terms of class, particularly, because this is something they can really understand that different people in the society benefit differently from historical developments and that there are different consequences for them. I always begin the course with a critique of the geographic terms that we're using that these are colonialist terms, and the question of why we call it the Middle East, and I give them some of that historical background. I talk about East-West dichotomizing as itself a gendered construct: that the East is feminized and the West is looked on as masculine. That's how I begin to teach concepts of gender, because this is the first time they have been exposed to any kind of feminist theory.

I don't separate my work as a scholar and as an activist in the classroom. I talk to my students about it: Why am I doing this scholarship? How did I get there? What does it mean to me? They love that, they really appreciate it. And it makes the difficulty of the pieces that I'm giving them to read less overwhelming, because they see me as somebody engaged with that scholarship in a very real way. I feel that's a part of wanting to educate them as activists as well as scholars.

1. Eliz Sanasarian, The Women's Rights Movement in Iran: Mutiny, Appeasement, and Repression from 1900 to Khomeini (New York: Praeger, 1982).

2. See Kumari Jayawardena, Feminism and Nationalism in the Third World (London: Zed Books, 1986).

3. Elise G. Young, Keepers of the History: Women and the Israeli-Palestinian Conflict (New York: Teachers College Press, 1992).

4. Patricia Hill Collins, Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment (Boston: Unwin Hyman, 1990).

5. On Black September, 1970, the Jordanian military attempted to rid the refugee camps in Jordan of PLO cadres who were organizing resistance in the camps.

6. Rosemary Sayigh,: "Roles and Functions of Arab Women: A Reappraisal," Arab Studies Quarterly 3 (1981): 258-274.

7. Edmund Burke III, ed., Struggle and Survival in the Modern Middle East (Berkeley: University of California Press, 1993).

8. Ehud R. Toledano, "Shemsigul: A Circassian Slave in Mid-Nineteenth-Century Cairo" in Burke, Struggle and Survival, 59-74.

9. Julia Clancey-Smith, "The Shaykh and His Daughter: Coping in Colonial Algeria" in Burke, Struggle and Survival, 145-163.

10. Elise G. Young, "From Daya to Doctor: Health, Gender and the Race for Control of Knowledge-Making in Mandatory Palestine," Thamyris 4 (1997):347-358.

© Elise G. Young

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