Kamran Asdar Ali. Planning the Family in Egypt: New Bodies, New Selves. Austin: University of Texas Press, 2002. xii + 233 pp. $22.95 (paper), ISBN 978-0-292-70514-2; $55.00 (cloth), ISBN 978-0-292-70513-5.
Reviewed by Omnia E. Shakry (Department of History, University of California, Davis)
Published on H-Gender-MidEast (March, 2003)
Reconfiguring the Family: Planning, Pedagogy and Modern Power
Slippage Between Policy and Lived Experience
In Planning the Family in Egypt Kamran Ali argues that the family planning program in Egypt not only regulates reproduction, but also introduces new notions of individual choice and, more fundamentally, helps "construct a new kind of individuality, guided by legal constructs of citizenship rather than by communitarian and familial control" (p. 1). It is through the pedagogical project of the modernizing state, as articulated in family planning programs, that the management of population, and the construction of new bodies, selves, and subjectivities are effected. Yet, as Ali skillfully shows, the desire to recreate the autonomous, self-regulating subject of liberal individualism is not so easily achieved in the Egyptian setting. As the Egyptian state and international development agencies face a population that "conceives and constitutes its selves, bodies and communities in different and diverse forms" (p. 15), there is a slippage between the imposition of policy agendas and the reality of people's everyday lived experiences. As a medical doctor and an anthropologist who conducted his fieldwork in various sites, ranging from Cairo family planning clinics and governmental agencies to a Delta village, Ali was uniquely placed to explore "vernacular voices and practices" and "their popular refusal to integrate into the available forms of middle-class identifications and moral truths" (p. 15).
Beginning with a brief overview of the history of the population debate in Egypt and its relation to Western demographic theories, Ali notes the crucial shift in the late 1940s from demographic theories which emphasized socio-economic change as the impetus for demographic transition to the focus on high fertility rates as impediments to modernization (p. 29). Such a shift led to a focus on individual choice and birth control, rather than societal change. The Egyptian state, Ali argues, resisted this orthodox demographic agenda until the mid-1980s at which point, constrained by the demands of donor agencies such as USAID, it began to emphasize service delivery of contraception and women's "free choice." Prior to that time, family planning had been embedded within a larger model of socio-economic development. Thus, he argues, international donors modified Egypt's family planning program away from a focus on structural development toward a focus on behavior modification and contraceptive choice. A further shift initiated by the aggressive USAID involvement has been from the widespread use of the contraceptive pill to the encouragement of longer-term methods such as the IUD and injectables.
Yet, perhaps, Ali attributes too much historical agency to exogenous forces (international donor agencies) in transforming Egypt's family planning programs. A more historically grounded approach might emphasize the economic liberalization or infitah policies under Sadat, and their concomitant liberal-capitalist regime, as having been the underlying structural basis for a shift from a notion of family planning as embedded within a social welfare model of the state (under Nasser) to a more economistic model in the post-infitah era.
Most interestingly, Ali devotes attention to the concrete manner in which family planning programs gather information on family life and gender roles. Indeed, his emphasis on the ways in which the family planning program in Egypt "seeks to create knowledge and consensus regarding its policies" and "uses this knowledge to influence behavior patterns at the community and individual levels" is an object lesson in the state's attempt to fabricate its hegemony (p. 41). As Ali shows, the production of consent for family planning relies on the notion of a liberal subject who is a free agent. Yet, paradoxically, such consent also relies on the individual's submission to the state as benevolent caretaker of the social good (the need for family planning for the national good), as well as upon the medical establishment which determines patient choice (the form of contraception). The relationship between the individual and the state is thus mediated by the constitution of new families (recast as nuclear).
Yet, the social implementation of the pedagogical project of family planning confronts its own limitations. Ali discusses how in Egypt, women's bodies and selves "coexist and cohabit in this world with spirits, animals, plants, stones, and God" (p. 98). Biomedical conceptions of fertility thus coexist with women's own cultural constructions of their bodies and their fertility, which are not neatly aligned with liberal notions of an a priori unitary self, as in the case of spirit possession (pp. 99-101). Women's choices, moreover, do not always align with the goals of family planning programs. The social significance of fertility and being fertile in the Egyptian setting mean that decisions regarding fertility control are related to a complex of relations within the household and beyond (p. 119).
Also interesting is Ali's emphasis on male roles and the use of family planning, as well as recent attempts to integrate men into family planning research and findings, such as in the 1991 Egypt Male Survey. His exploration of men and family planning complicates stereotypical representations of Middle Eastern men and links the construction of masculinity to social and economic aspects of life, drawing on Deniz Kandiyoti's discussion of hegemonic and subaltern masculinities (chapter 6).
Further, in discussing how the modern Egyptian state has been linked to transformations in the domestic sphere, Ali addresses the class- and gender-inflected nature of the reconstitution of the private sphere. In particular, upper-class women have continued their dominance in the reorganization of the domestic sphere as they help propagate a reproductive rights and population control agenda.
In his final chapter Ali addresses the issue of Islamist groups in Egypt, such as the Muslim Brotherhood, and their opposition to hegemonic secularist constructions of population control and family planning. He also examines popular religious practices, such as mulids (or saint's festivals) and their relationship to the Islamic tradition and the modern state, illustrating how "people's strivings against oppression and marginalization are embedded in the imagination and practice of religion" (p. 162). While the discussion of groups like the Muslim brotherhood, who explicitly counter the arguments of the state family planning program is clear, the relation between marginalized religious practices, such as the mulids, and family planning is somewhat less apparent.
In brief, Ali's text highlights how the family planning program in Egypt is based, simultaneously, on an emancipatory politics grounded in individualism, yet also embedded within modern regimes of social control and disciplinary coercion. However, as he also shows, the implementation of such programs in Egypt inherently interrogates the politics of emancipation and individual rights, as they confront other conceptions of self, society, and community. In this sense, Ali's text is part of a larger literature (Asad, Chatterjee, Trouillot, Appadurai) which questions the emancipatory narratives of a universalized liberal capitalism and civil society. More critically, Ali implicitly critiques simple anthropological arguments which put forth a model of a resilient and resistant "indigenous culture" in the face of global capitalism. Rather, his text tells the more complex story of the uneven integration of cultural and social meanings within the process of globalization, as well as the ultimate irreducibility and heterogeneity of culture and society. As Talal Asad astutely observes, "when a project is translated from one site to another, from one agent to another, versions of power are produced. As with translations of a text, one does not simply get a reproduction of identity."
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Omnia E. Shakry. Review of Ali, Kamran Asdar, Planning the Family in Egypt: New Bodies, New Selves.
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