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Of Fistulas, Sutures, and Silences

Published online by Cambridge University Press:  25 March 2021

Beth Baron*
Affiliation:
The Graduate Center, City University of New York, New York, NY, USA

Extract

Upon arrival at the Qasr al-ʿAyni Hospital in Cairo in 1908, a woman from a village in Qena province in Upper Egypt related her harrowing medical saga. It began when she developed a urinary fistula (nāsur bawlī) due to prolonged labor (a urinary fistula causes urine to leak from the bladder into the vagina, resulting in deep discomfort and social ostracism of those afflicted). She had gone to a hospital in the city of Qena, capital of the province with the same name, but medical officers there sent her to Asyut. There, in the government hospital, she underwent three operations without success, whereupon doctors instructed her to go to Qasr al-ʿAyni Hospital in Cairo to see Dr. Nagib Mahfuz (1882–1974), who had developed a reputation for his surgical prowess in treating fistulas. The woman from Qena traveled by foot, begging along the way, until, exhausted, she reached the city of Minya, halfway between Asyut and Bani Suwayf. There she was sent once again to the government hospital, examined, and once again told to go to Qasr al-ʿAyni.

Type
Roundtable
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

1 This is the “other” Nagib Mahfuz, the obstetrician gynecologist, who delivered the author and Nobel Prize winner; the parents of the future author were so appreciative of Dr. Mahfuz's obstetrical intervention in a difficult labor that they named their son after him.

2 Mahfouz, Naguib, The Life of an Egyptian Doctor (Edinburgh: Livingstone, 1966), 7677Google Scholar; Mahfuz, Najib, Hayat Tabib (1966; Cairo: al-Hay'a al-Misriyya al-‘Amma li-l-Kitab, 2013), 124–25Google Scholar. There are slight differences between the Arabic and English versions of the memoir. According to Department of Public Health records, Asyut's government hospital opened in 1899; Qena did not have one until 1914. See Ministry of the Interior, Egypt, Annual Report on the Work of the Department of Public Health for 1926 (Cairo: Government Press, 1929).

3 Mahfouz, Life, 76–77; Mahfuz, Hayat Tabib, 124–25.

4 Khaled Fahmy, “Giulio, the Islands and National Security,” Mada Masr, 23 April 2016, https://www.madamasr.com/en/2016/04/23/opinion/u/giulio-the-islands-and-national-security.

5 Yoav Di-Capua, Gatekeepers of the Arab Past: Historians and History Writing in Twentieth-Century Egypt (Berkeley CA: University of California Press, 2009); Omnia El Shakry, “‘History without Documents’: The Vexed Archives of Decolonization in the Middle East,” American Historical Review 120, no. 3 (2015): 920–34; Lucia Carminati, “Dead Ends In and Out of the Archive: An Ethnography of Dar al-Watha'iq al-Qawmiyya, the Egyptian National Archive,” Rethinking History 23, no. 1 (2019): 34–51.

6 Lucie Ryzova, “The Good, the Bad and the Ugly: Collector, Dealer and Academic in the Informal Old-Paper Markets of Cairo,” in Archives, Museums and Collecting Practices in the Modern Arab World, ed. Sonja Mejcher-Atassi and John Pedro Schwartz (Burlington, VT: Ashgate, 2012), 93–120.

7 Omnia El Shakry, The Great Social Laboratory: Subjects of Knowledge in Colonial and Postcolonial Egypt (Stanford, CA: Stanford University Press, 2007) and The Arabic Freud: Psychoanalysis and Islam in Modern Egypt (Princeton, NJ: Princeton University Press, 2017); Jennifer L. Derr, The Lived Nile: Environment, Disease, and Material Colonial Economy in Egypt (Stanford, CA: Stanford University Press, 2019).

8 Mahfuz, Hayat Tabib.

9 Najib Mahfuz, Amrad al-Nisaʾ (Cairo: Matba‘at al-Tawfiq, n.d.); Najib Mahfuz, Fann al-Wilada, 4th ed. (Cairo: Dar al-Ma‘arif, 1957); Naguib Bey Mahfouz, The History of Medical Education in Egypt (Cairo: Government Press, 1935); Naguib Pacha Mahfouz, Atlas of Mahfouz's Obstetrics and Gynaecological Museum (Altrincham, UK: John Sherratt, 1949). For the museum, see Dr. Naguib Mahfouz Ob/Gyn Teratology and Pathology Museum (website), accessed 30 January 2021, https://obgynmuseum.com. For an article by Shehab Fakhri Ismail on the museum before it was renovated, see https://www.medinaportal.com/naj (accessed 30 January 2021). I thank Dr. Youssef Simaiki, Najib Mahfuz's great grandson, for answering numerous questions and providing me with difficult to access materials and critical feedback.

10 N. Mahfouz Bey, “Urinary and Recto-Vaginal Fistulae in Women,” Journal of Obstetrics and Gynaecology of the British Empire 36, no. 3 (1929): 581–89.

11 “It is surprising indeed, that while bilharziasis accounts for almost all the urinary fistulae in men, it is responsible only for under 1 percent in women” (ibid., 583).

12 Naguib Mahfouz, “Urinary Fistulae in Women,” Journal of Obstetrics and Gynaecology of the British Empire 64, no. 1 (1957): 26.

13 Mahfouz Bey, “Urinary and Recto-Vaginal Fistulae in Women,” 585.

14 Mahfouz, “Urinary Fistulae in Women,” 1957, 26.

15 Mahfouz Bey, “Urinary and Recto-Vaginal Fistulae in Women,” 583.

16 Ibid., 584.

17 Ibid., 582–83; Mahfouz, “Urinary Fistulae in Women,” 1957, 28; Mahfouz, Life, 74; Mahfuz, Hayat Tabib, 120.

18 Mahfuz made several films of his surgeries, which he showed during his lectures. One example is, “Operations on Urinary Fistulae in Women: Performed by N. Mahfouz,” in the author's private collection.

19 For example, he learned about planes of compression during contraction and the impact on the urethra. Mahfouz, Atlas, vol. 2, 617; Mahfouz, “Urinary Fistulae in Women,” 1957, 27, Fig. 5.

20 The museum was renovated in 2018: see Naguib Mahfouz Bey, Catalogue of the Private Pathological Gynaecological and Obstetrical Collection (Cairo: Government Press, 1928); Mahfouz, Atlas; Dr. Naguib Mahfouz Ob/Gyn Teratology and Pathology Museum, https://obgynmuseum.com.

21 N. Mahfouz Bey, “Urinary Fistulae in Women,” Journal of Obstetrics and Gynaecology of the British Empire, 37, no. 3 (1930): 566–76; Naguib Mahfouz Bey, “A New Technique in Dealing with Superior Recto-Vaginal Fistulae, Journal of Obstetrics and Gynaecology of the British Empire 41, no. 4 (1934): 579–87; Naguib Pacha Mahfouz, “Urinary and Faecal Fistulae,” Journal of Obstetrics and Gynaecology of the British Empire 45, no. 3 (1935): 405–75.

22 Naguib Mahfouz, “Urinary Fistulae in Women,” 1957, 23–34.

23 Ibid., 27.

24 Catherine Hamlin with Little, John, The Hospital by the River: A Story of Hope (2001; Chicago: Lion Hudson, 2016), 77Google Scholar.

25 Mahfouz Bey, “Urinary and Recto-Vaginal Fistulae in Women,” 583.

26 Sims, J. Marion, “On the Treatment of Vesico-Vaginal Fistula,” American Journal of the Medical Sciences 23 (1852): 5982CrossRefGoogle Scholar; Sims, J. Marion, The Story of My Life, ed. Sims, H. Marion (NY: Appleton, 1888), 226–46Google Scholar; Owens, Deidre Cooper, Medical Bondage: Race, Gender, and the Origins of American Gynecology (Athens, GA: University of Georgia Press, 2018)Google Scholar.

27 Mahfouz, Life, 77; Mahfuz, Hayat Tabib, 126.

28 In my current book project on medicine, disease, and reproduction in Egypt, I seek to restore the voices of patients, both those who survived childbirth and surgeries and those who died, to the history of medicine.