Beginning in the second decade of the 19th century, Egyptian agriculture began a process of transformation from basin to perennial irrigation. This shift facilitated the practice of year-round agriculture and the cultivation of summer crops including cotton whose temporalities did not match that of the annual Nile flood. One facet of the perennially irrigated landscape was an increase in the prevalence of the parasitic diseases bilharzia (schistosomiasis) and hookworm, the symptoms of which came to constitute normative experiences of the body among those engaged in perennially irrigated agriculture. Male agricultural laborers, who most often performed the work of irrigation, were at the greatest risk of infection. This article considers the significance of agricultural labor in the continuous making and maintenance of perennially irrigated agriculture and the role of parasitic disease in producing temporal experiences of this labor.
Author's note: I would like to thank the anonymous reviewers selected by IJMES, the organizers and participants of the “Medicine and Knowledge in the Middle East” workshop at the Graduate Center, City University of New York, Beth Baron, and Yoav Di-Capua for their thoughtful comments on drafts of this article. The feedback that I received produced a stronger piece of scholarship. Whatever faults remain are my own.
1 Legrain, Georges, Louqsor sans les pharaons: Légendes et chansons populaires de la Haute Égypte (Paris, Bruxelles: Vromant et C°, 1914), 172–73.
2 Basins ranged in size from between 5,000 to 15,000 acres. Peel, Sidney, “British Administration and Irrigation in Egypt,” Political Science Quarterly 20 (1905): 517.
3 For a robust treatment of agriculture in Egypt in the Ottoman period, see Mikhail, Alan, Nature and Empire in Ottoman Egypt: An Environmental History (Cambridge: Cambridge University Press, 2011).
4 See, for example, Berque, Jacques, L'Égypte: Impérialisme et révolution (Paris: Impr. Firmin-Didot, Edition Gillimard, 1967); Owen, Roger, Cotton and the Egyptian Economy, 1820–1914: A Study in Trade and Development (Oxford: Clarendon Press, 1969); Hamid, Raʿuf ʿAbbas, al-Nizam al-Ijtimaʿi fi Misr fi Zill al-Milkiyat al-Ziraʿiyya al-Kabira, 1837–1914 (Cairo: Dar al-Fikr al-Hadith li-l-Tibaʿa wa-l-Nashr, 1973); Richards, Alan, Egypt's Agricultural Development, 1800–1980: Technical and Social Change (Boulder, Colo.: Westview Press, 1982); Shalabi, ʿAli, al-Rif al-Misri fi al-Nisf al-Thani min al- Qarn al-Tasiʿ ʿAshar, 1847–1891 (Cairo: Dar al-Maʿarif, 1983); Cuno, Kenneth, The Pasha's Peasants: Land, Society, and Economy in Lower Egypt, 1740–1858 (Cambridge: Cambridge University Press, 1992); Abbas, Raouf and El-Dessouky, Assem, The Large Landowning Class and the Peasantry in Egypt, 1837–1952, trans. Amer Mohsen with Moni Zikri (Cairo: American University in Cairo Press, 2012); and Mikhail, Alan, The Animal in Ottoman Egypt (New York: Oxford University Press, 2014).
5 These ecological changes, specifically their effect on cotton yields during the first three decades of the 20th century, are the subject of an historiographical debate. Bent Hanson has argued that they were the cause of a 20 percent decline in overall agricultural yields between 1900 and 1920 that did not recover until a decade later; Hansen, , The Political Economy of Poverty Equity and Growth: Egypt and Turkey (Oxford: Oxford University Press, 1991), 39, 104–5. Ellis Goldberg has refuted the idea of an ecological crisis by arguing that “deliberate investment choices to ensure the production of a high-quality good had effects that, when measured in a particular way, mimicked those of an ecological crisis”; Goldberg, , Trade, Reputation, and Child Labor in 20th-Century Egypt (New York: Palgrave Macmillan, 2004), 35.
6 Ruffer, Marc Armand, “Note on the Presence of ‘Bilharzia Haematobia’ in Egyptian Mummies of the 20th Dynasty [1250–1000 B.C.],” British Medical Journal 1:2557 (1910): 16.
7 Owen, Roger “The Introduction of Long-Staple Cotton, 1820–1837,” in Cotton and the Egyptian Economy, 1820–1914: A Study in Trade and Development (Oxford: Clarendon Press, 1969), 58–88.
8 Toledano, Ehud R., “Social and Economic Change in the ‘Long Nineteenth Century,’” in The Cambridge History of Egypt, vol. 2, Modern Egypt, from 1517 to the End of the Twentieth Century, ed. Daly, M.W. (Cambridge: Cambridge University Press, 2008), 272, citing Owen, Roger, The Middle East in the World Economy, 1800–1914 (New York: I.B.Tauris, 1981), 68, 219.
9 Toledano, “Social and Economic Change,” 272.
10 Richards, Egypt's Agricultural Development, 21.
11 Cuno, The Pasha's Peasants, 115.
12 Ibid. Alan Mikhail notes that the canals of Mehmed Ali's era were dug and maintained by human, and not animal, labor. Mikhail, The Animal in Ottoman Egypt, 55.
13 The barrage gave way soon after its completion and was repaired during the British occupation.
14 Toledano, “Social and Economic Change,” 261.
15 In the 1860s, after the crash in the price of cotton that followed the American Civil War, Khedive Ismaʿil expanded the cultivation of sugarcane on his personal estates, the Daʾira Saniyya, and built a series of mills to process the crop.
16 At the turn of the 19th century, smaller weirs existed at Zifta, Asyut, where the Nile River split into its two branches in the Nile Delta. Barrages were completed at Esna and Nag Hammadi in the decades that followed.
17 Willcocks, Sir William, The Assuan Reservoir and Lake Moeris: A Lecture Delivered at a Meeting of the Khedivial Geographical Society, Cairo, 16 January 1904 (London: Messrs E. & F.N. Spon, Ltd., 1904), 6. In his 1906 annual report, Lord Cromer, consul-general of Egypt, stated that the total number of cultivable acres in Egypt was 6,387,100; Gorst, Sir. E., Reports by His Majesty's Agent and Consul-General on the Finances, Administration, and Condition of Egypt and the Soudan in 1906, Presented to both Houses of Parliament by Command of His Majesty April 1907 (London: Printed for His Majesty's Stationary Office by Harrison and Sons, 1907), 46–47. Joel Beinin, following Bent Hansen, states that the total cultivated area of land in Egypt stabilized at 5.5–5.8 million feddans between 1900 and 1940; Beinin “Society and Economy, 1923–1952,” The Cambridge History of Egypt, 2:321, citing Bent Hansen, Political Economy, 91.
18 This irrigation frontier marked a demarcation in areas with access to state-sponsored perennial irrigation. South of the irrigation frontier, in select regions, the Egyptian Sugar Company and large landowners sponsored the construction of private infrastructure to provide perennial irrigation.
19 Legrain, Louqsor sans les pharaons, 176.
20 During an outbreak of Schistosoma mansoni in the village of Saft al-ʿInab in the Nile Delta, one public health official daftly suggested that cultivators should opt for the use of the sāqiya over that of the ṭanbūr, paying no mind to the expense of draft animals; Khalil, M., “Parasitic Disease at Saft el Enab Village,” in Department of Public Health, Reports and Notes and the Public Health Laboratories, Ankylostomiasis and Bilharziasis in Egypt (Cairo: Government Press, 1924), 181.
21 Maspero, Chansons Populaires, 189. Hamid Ammar describes the significance of the ʿūd in the experience of working the shādūf, as do Gaston Maspero and Georges Legrain; Ammar, , Growing Up in An Egyptian Village, Silwa, Province of Aswan (London: Routledge and Kegan Paul Ltd, 1954), 29; Legrain, Louqsor san les Pharaons, 171; Maspero, Gaston, Chansons populaires recueillie dans la Haute-Égypte de 1900 à 1914 pendant les inspections du service des antiquités (Le Caire: L'Imprimerie de l'Institut Français, 1914), 186.
23 Ammar, Growing Up in an Egyptian Village, 25.
24 This description of cotton labor is applicable to the period of its cultivation under Mehmed Ali; Owen, Cotton and the Egyptian Economy, 30–33.
25 Ibid., 206.
26 Willcocks, William and Craig, J.I., Egyptian Irrigation, 3rd ed. (London: E.& F. N. Spon, Ltd., 1913), 776.
27 Moncrieff, Colin Scott, Note on the Irrigation Works of Egypt and the Improvements to Be Made to Them (Cairo: Britannia Press, 1884), 9.
28 The hundreds of thousands of corvée laborers mobilized by the state during the early 19th century to dig irrigation canals made possible the perennial irrigation of large swaths of the Nile Delta and the cultivation of cash crops, namely cotton. Cotton cultivation and perennial irrigation continued to spread on large agricultural estates in the Nile Delta, formed in part by land grants from Mehmed Ali and his successors to elites. As Nathan Brown and more recently Anne Clement have argued, large landholders whose estates depended on a ready supply of cheap labor did not desire to see that labor tied up by the government under the corvée system. See Brown, Nathan, “Who Abolished Corvée Labor in Egypt and Why?,” Past and Present 144 (1994): 116–37; and Clement, Anne, “Rethinking ‘Peasant Consciousness’ in Colonial Egypt: An Exploration of the Performance of Folksongs by Upper Egyptian Agricultural Workers on the Archeological Excavation Sites of Karnak and Dendara at the Turn of the 20th Century (1885–1914),” History and Anthropology 21 (2010): 73–100.
29 By December 1889, “the canal clearance Corvée was abolished, and the Public Works Department undertook to do all earth-work maintenance for £400,000 per annum”; Willcocks, William, Sixty Years in the East (London: Blackwood, 1935), 98. The ministry continued to rely on corvée to survey the river during flood.
30 For a discussion of the tension between agricultural wage labor and the fraught endeavor to impose capitalist time on the Egyptian countryside, see On Barak, , On Time: Technology and Temporality in Modern Egypt (Berkeley, Calif.: University of California Press, 2013), 193–97.
31 Owen, Cotton and the Egyptian Economy, 135.
32 See Jakes, Aaron, “Boom, Bugs, Bust: Egypt's Ecology of Interest, 1882–1914,” Antipode 49 (2017): 1035–59.
33 See Richards, Alan, “Technical and Social Change in Egyptian Agriculture, 1890–1914,” Economic Development and Cultural Change 26 (1978): 726–29.
34 These products were not produced domestically and thus the world nitrogen cartel, comprised of the German chemical manufacturer, I.G. Farben, the British Imperial Chemical Industries, and the Chileans met Egypt's demand. When these markets failed them, as they would when fertilizer supplies were cut off during World War II, their crop yields plummeted; Mitchell, Timothy, Rule of Experts: Egypt, Techno-politics, Modernity (Berkeley, Calif.: University of California Press, 2002), 20.
35 In Rule of Experts, Timothy Mitchell chronicles the relationship between the outbreak of malaria in Egypt's south and the consolidation of a perennially irrigated landscape.
36 Cromer, Lord, Report on the Finances, Administration, and Condition of Egypt and the Progress of Reforms, Presented to both Houses of Parliament by Command of Her Majesty, March 1893 (London: Printed for Her Majesty's Stationary Office by Harrison and Sons, 1893), 23.
37 Cromer, Lord, Report on the Finances, Administration, and Condition of Egypt and the Soudan in 1904, Presented to both Houses of Parliament by Command of His Majesty, April 1904 (London: Printed for His Majesty's Stationary Office by Harrison and Sons, 1905), 68.
38 Kuhnke, Laverne, Lives at Risk: Public Health in 19th-Century Egypt (Berkeley, Calif.: University of California Press, 1990), 150–51. Despite a suspicion of hospitals as sites of treatment, in their encounters with the law Egyptians increasingly turned to the forms of evidence provided by medical procedures. See Kozma, Liat, “Negotiating Virginity: Narratives of Defloration in Late Nineteenth-Century Egypt,” Comparative Studies of South Asia, Africa, and the Middle East 24 (2004): 57–69; and Fahmy, Khaled “The Anatomy of Justice: Forensic Medicine and Criminal Law in Nineteenth-Century Egypt,” Islamic Law and Society 6 (1999): 224–71.
39 “One boy, age 13, was cured though he had a history of being obliged to walk with his head bowed down because of the pain in his back. On admission he had great tenderness on the right side at the 10th dorsal, and on the left side from the 7th to the 11th dorsal vertebrae, he had cautery marks as large as a penny over the 2nd dorsal and to the left of the 9th and 10th dorsal spines. The actual cautery is a very favorite treatment among peasants for internal pain of any kind”; Sandwith, Fleming Ment, The Medical Diseases of Egypt (London: Henry Kimptom, 1905), 297.
40 Writing in 1922, Frank Cole Madden, then Professor of Surgery and Senior Surgeon at Qasr al-ʿAyni, described the treatments administered by barbers for inflammation: “It is rare indeed to find any untoward effects from these not altogether unscientific but entirely nonantiseptic methods”; Madden, , The Surgery of Egypt (Cairo: Nile Mission Press, 1919), 5–6.
41 Sandwith, The Medical Diseases of Egypt, 271.
42 C.H. Barlow, Egypt Hookworm Studies, Annual Report 1931, pp. 26–27, Folder 82, Box 5, Claude H. Barlow Papers, Rockefeller Archive Center (RAC). Khalil also reported that cultivators felt the itch in summer after exiting the water; Khalil, , “Parasitic Diseases in Saft El Enab,” in Department of Public Health, Reports and Notes and the Public Health Laboratories, Ankylostomiasis and Bilharziasis in Egypt (Cairo: Government Press, 1924), 163.
43 Urination and defecation were also situated near canals because of the availability of water with which to wash; Khalil, “The History and Progress of Anti-Ankylostomiasis and Anti-Bilharziosis Work in Egypt,” 63.
44 Bulinus truncatus, the intermediate host for Schistosoma haematobium, fares relatively better in moving water than does Biomphalaria alexandrina, the host of Schistosoma mansoni in Egypt; Dazo, B.C., Hairston, Nelson G., and Dawood, I.K., “The Ecology of Bulinus truncatus and Biomphalaria alexandrina and Its Implications for the Control of Bilharziasis in the Egypt-49 Project Area,” Bull, Wld Hlth Org. 35 (1966): 339–56.
45 Sandwith, The Medical Diseases of Egypt, 214.
46 J. Allen Scott's measurements relied on urine and stool samples, which he acknowledged do not catch all cases of bilharzia, and thus the actual prevalence of infection was likely higher than measured; Scott, , “The Incidence and Distribution of the Human Schistosomes in Egypt,” American Journal of Epidemiology 25 (1937): 595.
47 Ibid., 578.
48 Ibid., 603; M. Khalil, “Incidence of Bilharziasis and Ankylostomiasis amongst the Inhabitants of Nag‘Hammadi District,” in Ankylostomiasis and Bilharziasis in Egypt, 183–86.
49 Scott, “The Incidence and Distribution of the Human Schistosomes in Egypt,” 598.
50 Following the completion of the Aswan High Dam, infection with Schistosoma mansoni would come to replace Schistosoma haematobium as the most common form of bilharzia in the Nile Delta and its snail host, Biomphalaria alexandrina, spread south throughout the Delta and into the Nile Valley. When this migration began to take place is an open question, but in the 1930s, Scott had already begun to wonder whether the distribution of the Biomphalaria genus of snails—Planorbis in the classification system of the early 20th century—might be shifting: “Explanations for the restrictions of Planorbis snails to the north of Cairo have all been based on the assumption that some environmental factor makes the district to the south of this point unsuitable to them. The alternative is that they can live and may be slowly spreading southward.” Scott, “The Incidence and Distribution of the Human Schistosomes in Egypt,” 611.
51 Robert Leiper reported that snails were most prevalent during the month of April; Leiper, , “Observations on the Mode of Spread and Prevention of Vesical and Intestinal Bilharziosis in Egypt, with Additions to August, 1916,” Proceedings of the Royal Society of Medicine 9 (1916): 166. Subsequent work revealed that snail reproduction rates in Egypt were actually highest in March but that snail counts tended to undercount young snails; Dazo, Nelson Hairston, and Dawood, “The Ecology of Bulinus truncatus and Biomphalaria alexandrina and Its Implications for the Control of Bilharziasis in the Egypt-49 Project Area,” 339.
52 “Bilharzia Work in Egypt,” pp. 3–4, Folder 19, Box 2, Series 2, Claude H. Barlow Papers, RAC.
53 M. Khalil, “The Control of Bilharziasis in Egypt,” in Ankylostomiasis and Bilharziasis in Egypt, 100.
54 In the early 1920s, Khalil argued persuasively that there was nothing that agricultural laborers could feasibly do to protect themselves from infection. Ibid., 98–99.
55 Ammar, Growing Up in an Egyptian Village, 25.
56 M. Farooq, “Bilharziasis in Egypt,” schisto1-emro-egypt 1966, Archives of the Parasitology Collection, World Health Organization.
57 Bustinduy, Amaya L. & King, Charles H., “Schistosomiasis,” in Manson's Tropical Diseases, by Farrar, Jeremy and Manson, Sir Patrick, 23rd ed. (Philadelphia, Pa.: Saunders, Ltd, 2014), 706.
58 Madden, Frank Cole, “The Incidence of Bilharziosis in Egypt and Its Clinical Manifestations,” The British Medical Journal 2 (1910): 966. The possibility that a single infection might be recovered from, especially one acquired in childhood, remains an open question among bilharzia researchers; Dr. Shona Wilson, Department of Pathology, University of Cambridge, correspondence with the author.
59 Khalil, “Parasitic Diseases at Saft el Enab Village,” 177.
60 Scott estimated that in regions with Schistosoma mansoni, approximately 35 percent of the population was infected with both species of the organism; Scott, “The Incidence and Distribution of the Human Schistosomes in Egypt,” 608. In his autopsy examinations, Bilharz found worms in the bladders and recta of his patients, indicating the presence of Schistosoma haematobium and Schistosoma mansoni, as the first is usually confined to the bladder, and the second to the intestinal tract. When the Public Health Department sent a team to Saft al-ʿInab in 1922 to investigate the spate of deaths, 73 percent tested positive for infection with Schistosoma haematobium and 34 percent with Schistosoma mansoni; Khalil, “Parasitic Diseases at Saft el Enab Village,” 160–63.
61 Frank Cole Madden, Bilharziosis (New York: William Wood and Company, 1907).
62 “Noticeable among the serious complication of bilharziasis haematobia were genito-urinary lesions due to infiltrations of eggs, papillomas, ulcerations, fistulae, malignant growth, stones, and secondary infections destroying the whole tract. The intestinal type of the disease produced similar symptoms due to the infiltration of eggs and cicatrization in the large bowel, liver and spleen. Intensive and extensive treatment carried out by the units was successful in diminishing the number and severity of the complications and it is well acknowledged now  that they are much rarer incidences.” Claude Barlow, “Bilharzia: A World Scourge,” p. 9, Box 2, Series 2, Claude H. Barlow Collection, RAC.
63 Scott, “The Incidence and Distribution of the Human Schistosomes in Egypt,” 602–5. The 1922 study of the Schistosoma mansoni outbreak in the village of Saft al-ʿInab showed similar results as the percentage of men infected with Schistosoma mansoni, 37 percent, was 9 percent higher than the 28 percent of women infected. Most of those assessed, both men and women, were field laborers and thus likely to be exposed to infection; Khalil, “Parasitic Diseases at Saft el Enab Village,” 165.
64 Girges, Rameses, Schistosomiasis (Bilharziasis) (London: John Bale, Sons & Danielsson, Ltd, 1934), 498; Madden, Frank Cole, “The Incidence of Bilharziosis in Egypt and Its Clinical Manifestations,” The British Medical Journal 2 (1910): 966; Khalil, “Parasitic Diseases at Saft El Enab Village,” 164.
65 Sandwith, The Medical Diseases of Egypt, 241.
66 Khalil, “The History of Progress of Anti-Ankylostomiasis and Anti-Bilharziasis Work in Egypt,” 9.
67 The prevalence of infection was not always measured as higher in the Nile Delta: the next significant study, conducted in the summer of 1927, pegged infection rates as slightly higher in Upper Egypt; Augustine, D.L., Helmi, M., and Nazmi, M., “Ancylostomiasis and Ascariasis in Egypt,” American Journal of Hygiene 11 (1930): 136–48.
68 A. Abdallah, “Ancylostomiasis in Egypt,” in “Expert Committee on Helminthiasis (Soil-Transmitted Helminths)” (report by the World Health Organization, Rio de Janeiro, 26–31 August 1963), 2.
69 Khalil, “The History and Progress of Anti-Ankylostomiasis and Anti-Bilharziasis Work in Egypt,” 68.
70 “These two factors are practically antagonistic in Egypt, the northern Provinces enjoy perennial irrigation but are colder than the Southern Provinces which are under basin irrigation. The result is that the middle provinces around Cairo are the most intensely affected if they are under perennial irrigation.” Khalil, M., “The Pail Closet as an Efficient Means of Controlling Human Helminth Infection Among Prisoners as Observed in Tura Prison, Egypt and a Discussion on the Source of Ascaris Infection,” Annals of Tropical Medicine and Parasitology 25 (1931): 44.
71 Scott, J. Allen, “Observations on the Transmission of Hookworm Infection in Egypt,” American Journal of Hygiene 26 (1937): 506–26.
72 Necator americanus is relatively more prevalent in sandy soils and the prevalence of infection higher in populations living in areas with sandier soils; Mabaso, ML, Appleton, CC, Hughes, JC, and Gouws, E, “Hookworm (Necator americanus) Transmission in Inland Areas of Sandy Soils in KwaZulu-Natal, South Africa,” Tropical Medicine and International Health 9 (2004): 471–76.
73 Scientists have most recently posited that geophagia, which is common throughout many regions of the world including the American South, might function as a means of combatting intestinal illness, especially among vulnerable populations. Sandwith reported that 26 percent of the patients that he questioned reported consuming mud; Sandwith, The Medical Diseases of Egypt, 244, 254.
74 See, for example, Moncrieff, Colonel Sir Colin Scott, Public Works Ministry: Irrigation Report for the Year 1887 (Cairo: National Printing Office, 1888), 7–9.
75 Sandwith states that because the disease caused pain in the epigastrium, the disease was sometimes referred to as “mal de cœur”; Sandwith, The Medical Diseases of Egypt, 241.
76 Simon J. Brooker and Donald A.P. Bundy “Soil-transmitted Helminths (Geohelminths),” in Manson's Tropical Diseases, 779–80.
77 The larva of Ancylostoma duodenale develops between twenty and thirty degrees. Ibid., 779.
78 Khalil, “The History of Progress of Anti-Ankylostomiasis and Anti-Bilharziasis Work in Egypt,” 10.
79 Augustine, Helmi, and Nazmi, “Ancylostomiasis and Ascariasis in Egypt,” 144–45.
80 When Augustine, Helmi, and Nazmi tested women for infection with Ancylostoma duodenale, the prevalence of the disease among women was consistently lower than it was among men, mapping to patterns of environmental behavior. Ibid., 138–43.
81 “The Egyptian peasant works all day with his naked feet, legs, and hands exposed to a coating of mud, mixed with water containing ankylostoma embryos which have sprung from the eggs contained in the fæcies of infected natives”; Sandwith, F.M., “Note on the Entrance of Ankylostoma Embryos into the Human Body by Means of the Skin,” The British Medical Journal 2:2124 (1901): 691.
82 Merleau-Ponty, Maurice, Phenomenology of Perception, trans. Colin Smith (London: Routledge Classics, 2002), 353.
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