This morning I am weary, my entire body is sick; I am weary, I am weary, boys (ya awlād)
Stiffened, like a stick, or as dry leather; I am weary, I am weary, boys
You unceasingly exhaust me, I fear you, oh, stalk of the shādūf; I am weary, I am weary, boys
I tremble like a leaf, looking at the stalk of the shādūf; I am weary, I am weary, boys
My hands are bruised, on the wood of the stalk of the shādūf, I am weary, I am weary, boys
My hands are injured, I call out for a doctor; I am weary, I am weary, boys
He heals my hands, and then says, pull the stalk of the shādūf; I am weary, I am weary, boys
Give me a good doctor, a bit of respite; I am weary, I am weary, boys
The world is quite bad; because I did not rest; I am weary, I am weary, boys. . .
– Excerpt from an Egyptian folk song describing the irrigation of summer crops
In the early 20th century, Georges Legrain, an Egyptologist working in southern Egypt, recorded and published a collection of folk songs sung by the inhabitants of the region.Footnote 1 Many of these songs chronicled the practice of agriculture, and some were dedicated to particular irrigation implements. One such tool was the shādūf, which consists of a basket or bucket attached to the end of a wooden crossbar that is fitted with a weight and balanced on two vertical supports planted in the soil a meter apart. The shādūf was a tool of summer (al-ṣayf), when Egyptian cultivators used it to lift water from an anemic Nile to irrigate summer crops that included cotton, sugarcane, fruits, and vegetables. The work of this irrigation left their hands bloodied and their backs stooped and sore.
Summer crops were exceptional. Because many remained in the ground following the arrival of the flood, these crops were planted on the Nile's banks and the berms that formed the basins that lined the Nile River, and in enclosed basins and irrigation canals. Until the 19th century, Egypt's Nile Valley and Nile Delta were cultivated according to the rhythms of flood-based agriculture, whose primary growing season was winter. The cultivation of winter (shitawī) crops began with the arrival of the flood in late July or early August when cultivators cut the banks of the Nile River to let floodwaters into large basins formed of earthen dikes that lined the river in the Nile Delta and Nile Valley.Footnote 2
Floodwaters remained in basins, where they soaked the soil and deposited nutrients. When the appropriate period elapsed, cultivators channeled what water remained to another basin or back into the Nile River, planting crops in the basins that had been drained. They harvested these winter crops in spring. When Egypt was a province of the Ottoman Empire, wheat, which helped to pay Egypt's taxes and feed other regions of the empire, was primary among these winter crops.Footnote 3
By the early 20th century, the region in which Legrain performed his fieldwork, Egypt's deep south, was unique for its practice of flood-based agriculture. In the second decade of the 19th century, the Ottoman-Egyptian state began to replace basin irrigation in portions of the Nile Delta with a new irrigation practice, perennial irrigation, to support the production of summer crops, among them long-staple, export-oriented cotton. Perennial irrigation also allowed for the planting more than one primary crop during each annual cycle, facilitating year-round agriculture. The practice continued to spread so that by the first decade of the 20th century, the Nile Delta and the northern half of Egypt's Nile Valley were perennially irrigated. Once confined to the limited stretches of land on which summer crops could be cultivated, cotton came to dominate Egypt's agricultural economy.
The social history of the Egyptian countryside in the 19th and early 20th centuries, specifically the changes in land tenure, labor, and agricultural production that accompanied the introduction and extension of perennial irrigation and the spread of cotton cultivation, is well-worn historiographical ground.Footnote 4 Within this robust body of literature, scholars have noted the contours of ecological change, especially as it might have influenced cotton yields, in perennially irrigated regions of the Egyptian countryside.Footnote 5 However, the historiography of rural Egypt in this period treats questions of ecology and agricultural labor as separate. In this piece, I explore the role that labor played in producing new relationships among laborer bodies and the multispecies ecologies of perennial irrigation, specifically the parasites that proliferated in new irrigation canals and moist fields. I also chart the significance of these relationships for experiences of agricultural temporality. Labor was the primary means of making and maintaining Egypt's perennially irrigated landscape, and laborer bodies were both agents and sites of ecological change.
Among Egyptian cultivator-laborers, the consolidation of colonial economy in Egypt's countryside was embodied in part through encounters with disease. In 1910, Marc Ruffer, president of the Sanitary, Maritime, and Quarantine Council of Egypt and a professor of pathology at the medical school at Qasr al-ʿAyni in Cairo, identified the eggs of Schistosoma haematobium, which causes the disease bilharzia, in the kidneys of two mummies from the twentieth dynasty (1144–1010 BC), evidence that Egyptians had suffered from bilharzia for thousands of years.Footnote 6 Bilharzia was not the only parasitic disease with deep roots in Egypt; hookworm disease caused by Ancylostoma duodenale was so common in the 19th century that Europeans used the moniker “Egyptian chlorosis” to describe the anemia that resulted from severe infection with the organism as particular to the place itself. Although the presence of bilharzia and hookworm in Egypt long preceded the introduction and extension of perennial irrigation, the description of them as “endemic” elides the role played by political economy—specifically its labor—in fundamentally transforming the lived experiences of these diseases. Facilitated by new practices of environmental intimacy, the symptoms, geographies, and prevalence of infection with the Schistosoma haematobium and Schistosoma mansoni parasites that produce bilharzia and the Ancylostoma duodenale organisms that cause hookworm disease evolved, hitting populations of male cultivator-laborers hardest.
THE SOCIAL HISTORY OF PERENNIAL IRRIGATION
The familiar story of Egypt's modern agricultural history begins in the early 19th century with the spread of cotton cultivation, its relationship to the world economy, and the shifting patterns of land tenure and labor to which cotton was linked. In 1820, under the rule of Mehmed Ali, the Ottoman-Egyptian state introduced the cultivation of long-staple, export-oriented cotton in regions of the Nile Delta. Between 1821 and 1837, the state mandated cotton cultivation from peasants in regions of the Nile Delta, commandeered their harvest at below market prices, and reaped the profits of Egyptian cotton in European markets.Footnote 7 Production of the crop declined for a brief period in the middle of the century only to rebound with the outbreak of civil war in the United States and the resultant leap in the price of cotton. Between 1880 and 1884, cotton made up 75 percent of Egypt's total exports.Footnote 8 That number climbed as the occupation progressed, and between 1900 and 1913 cotton constituted 92 percent of Egyptian exports.Footnote 9 In the liberal era of Egyptian politics that began in 1922, Egypt's economy remained primarily agricultural, cotton's primacy undiminished.
The rise of cotton was only possible through the extension of perennial irrigation, itself enabled by the excavation of new networks of irrigation canals and the construction of irrigation works that raised the height of the river. In 1798, before large-scale cotton cultivation began, summer crops including cotton had covered a mere 250,000 feddans of agricultural land.Footnote 10 Beginning in 1821, Mehmed Ali directed the excavation of deep irrigation canals in the Nile Delta to carry water to cotton fields.Footnote 11 By 1833, Mehmed Ali's state had dug 240 miles of these canals to water 600,000 feddans of land in the Delta, more than doubling the surface area of land available for the cultivation of summer crops.Footnote 12 The extension of perennial irrigation continued in the second half of the century. In 1861, work on the Delta Barrages, constructed at the base of the Nile Delta where the river split into two branches, was first complete.Footnote 13 The barrages were intended to regulate the water supply to rich cotton-producing lands in the provinces of al-Bahira, al-Minufiyya, al-Gharbiyya, al-Qalyubiyya, al-Sharqiyya, and al-Daqhiliyya. During the reign of Khedive Ismaʿil, an additional 8,400 miles of canals were added to the irrigation landscape.Footnote 14 The khedive also presided over the construction of the Ibrahimiyya Canal, which supplied large portions of his private estates, the Daʾira Saniyya, with perennial irrigation to water sugarcane, another summer crop.Footnote 15
When the British occupied Egypt in 1882, their efforts were similarly focused on the promotion of cotton cultivation through perennial irrigation. The Egyptian Public Works Ministry was one of the first targets of British colonial oversight, and a set of British irrigation engineers, many of whom cut their teeth in northern India, were appointed to direct the administration of irrigation. During their early years in Egypt, British engineers focused on repairing and maintaining existent irrigation works, including the Delta Barrages. Their attention soon turned to creating new, perennially irrigated lands. In 1898, construction began on a dam on the Nile River, Khazan Aswan, near the town of Aswan in southern Egypt, which was completed in 1902. The dam worked in concert with a series of smaller barrages to raise the height of sections of the river to aid irrigation.Footnote 16 The waters stored by the dam were released in the late spring and early summer to water cotton and other summer crops. By 1904, one British irrigation engineer estimated that 4 million of Egypt's approximately 6.25 million cultivable acres had access to perennial irrigation.Footnote 17 An irrigation frontier emerged at the town of Deirut in the province of Asyut in central Egypt separating perennially irrigated regions of the Nile Delta and Nile Valley from areas to the south that continued to practice basin irrigation and follow the calendar of flood-based agriculture.Footnote 18 The dam was raised twice, once between 1907 and 1912 under the British, and a second time between 1929 and 1933 under the liberal-era Egyptian state.
THE LABORS OF IRRIGATION
Both basin and perennial irrigation were rooted in the construction of specific forms of infrastructure, and the distinct labor regimes that built and maintained this infrastructure and moved water to crops. Under basin irrigation, intensive irrigation labor was concentrated in the early summer months, before the arrival of the flood. For cultivators with enough wealth to own draft animals, an animal-propelled waterwheel, the sāqiya, aided the work of summer irrigation. Songs dedicated to the instrument celebrated the cornucopia of fruits and vegetables that grew during the season: “Water of the sāqiya, go to the right, water of the sāqiya, go to the left; water the grapes, the peaches, the pomegranates; I think that the red heifer missed the lupines; she has grazed the grass that grows on the mounds.”Footnote 19
As draft animals were costly and periodically struck down by illness, laborers performed much of the work of ṣayfī irrigation manually with the shādūf, which took its toll.Footnote 20 Men spent the length of the day in the summer sun, whipped by wind and soaked by the water that fell as they raised and lowered the instrument. They lifted buckets of water in succession using the stalk that formed the instrument's lever (al-ʿūd or al-qibāḍ), which scarred the hands of cultivators: “My wound has gangrene, it has rejected ointment, my wound from the water hardens on me.”Footnote 21 A poor man's tool, the shādūf was dreaded for the bodily transformations that it wrought. As one folk song exclaimed, “The stalk of the shādūf made us wood and leather, the stalk is disgraceful, it makes the old cry.”Footnote 22
The shift from basin to perennial irrigation produced new modes of labor, performed according to a different calendar. Unlike the three distinct seasons of labor that marked flood-based agriculture, under perennial irrigation farm labor was distributed throughout the annual cycle.Footnote 23 In one typical schedule for cultivating cotton in the 19th century, the crop was planted in March or April and watered regularly after planting. When the heat arrived, it was irrigated every eight days. Pickings began in June or July and ended in December or January. Men irrigated the crop and women and children gathered cotton bolls.Footnote 24 By the early 20th century, cultivator-laborers who grew cotton typically planted in April, irrigated every two weeks during June, July, and August, and harvested their crops in September.Footnote 25 Other crops were then grown in rotation. Predominantly cultivated in central and southern Egypt, sugarcane was also a summer crop. Cultivator-laborers sowed sugarcane in February or March, and irrigated approximately every two weeks through the end of November. Unlike cotton, it remained in the ground for several seasons.Footnote 26
The system of perennial irrigation that irrigated summer crops was not made in one fell swoop, nor were its irrigation canals stable, fixed, or finished pieces of infrastructure. Laborers excavated and constructed dams and barrages and dug networks of new canals. Once complete, canals needed periodic repair and to be cleared of the large quantities of sediment deposited by the Nile waters that flowed through them. Laborers performed this work, often using only their bare hands as tools. Moreover, although the infrastructure of perennial irrigation raised the height of the river during the season in which it sunk lowest, the labor of lifting water into irrigation canals and watering fields remained. Mechanical tools such as irrigation pumps and canal dredgers aided in this work, but human laborers continued to perform much of it manually.
Until the last decade of the 19th century, the Egyptian state relied on corvée labor to construct and maintain the ever-expanding infrastructure of irrigation. The state had long demanded an annual labor tax from its male rural subjects in the form of physical labor, al-ʿawna or al-sukhra. By the early 1880s, nearly 60,000 corvée laborers spent five months of the year maintaining irrigation canals and clearing them of silt.Footnote 27 When the British occupation began, corvée was unpopular among laborers and wealthy landholders alike; colonial administrators added their voices to the cry calling for its end.Footnote 28 At the Egyptian Ministry of Public Works, British irrigation engineer William Willcocks worked to end the ministry's use of corvée. By the 1890s, the ministry had abandoned the use of corvée for canal clearance, instead contracting with labor brokers who recruited and managed gangs of male wage laborers.Footnote 29
The use of wage labor by the Public Works Ministry was mirrored on large estates in the Egyptian countryside. In the 19th century, taxation, conscription, debt, and the consolidation of property rights in the hands of a new elite produced an increasingly landless and land poor rural population. Throughout much of this period, some large landholders had access to corvée to help cultivate their estates. The end of corvée and the impoverishment of the Egyptian peasantry meant the expansion of agricultural wage labor and its use for a variety of tasks, including those associated with irrigation.Footnote 30 However, the work of perennial irrigation did not fall solely on the shoulders of agricultural wage laborers. Sharecroppers on large estates, small cultivators, and, until the late 19th century, slaves, were engaged in the maintenance of infrastructure, the work of moving water into canals, and the irrigation of fields.
THE NATURE OF LABOR
The labor and infrastructure that built the environments of perennially irrigated agriculture forced an evolution in their ecologies and caused new worlds of animal life to flourish. In 1866, the bollworm was discovered in Egypt's cotton fields. The worm laid its eggs in cotton stalks and attacked the seed of the plant after it began to flower, preventing the development of the plant's capsule.Footnote 31 In the 1870s, cotton worms, nourished by the Egyptian clover (birsīm) which often grew before cotton in crop rotations, also began to attack plants. The worms multiplied in June, feasting on the leaves, shoots, and buds of young cotton plants.Footnote 32
The relationship between the Nile's water and the land that it nourished also evolved. Under basin irrigation, the Nile flood had washed soils, preventing the accumulation of salts and minerals that might stunt the growth of crops. Without the annual rinsing of the flood, salts and minerals accumulated, rendering soils increasingly saline. Year-round irrigation of crops and the absence of adequate drainage caused the subsoil water table to rise and soils to become waterlogged. The elimination of an agricultural dry season meant that soil no longer dried and cracked in the sun annually, a process that had aerated it and broken up colloids that functioned as repositories of nutrients and moisture. Finally, under perennial irrigation, floodwaters did not deposit rich silt, a natural fertilizer, on fields before cultivators sowed crops.Footnote 33 Demand for chemical fertilizers soared, and by the 1930s Egypt consumed the largest portion of artificial fertilizers per area of cultivated land of any region in the world.Footnote 34
Part and parcel of the ecologies in which they worked, the bodies of Egyptian cultivator-laborers were also transformed by perennial irrigation, in part through an explosion of bilharzia and hookworm disease.Footnote 35 During the late 19th and early 20th centuries, admissions at government hospitals climbed. In 1892, 16,848 patients were admitted to government hospitals.Footnote 36 By 1904, that number had risen to 27,921.Footnote 37 Although this increase cannot be attributed solely to parasitic disease, beginning in the 1890s the repair of the Delta Barrages and the completion of Khazan Aswan extended the practice of perennial irrigation, which directly correlated to an increase in the prevalence of disease. Physicians working at Qasr al-ʿAyni, Egypt's largest hospital and sole medical school, reported cases of patients with complicated and crippling symptoms of parasitic infection. Most of these patients were poor, male agricultural laborers from the Nile Delta region.
The spike in hospital patients was significant as many Egyptians had viewed the medical institutions built by the 19th-century Ottoman-Egyptian state and the doctors whom they employed with suspicion, associating them with the state's conscription efforts.Footnote 38 Throughout the 19th century, many Egyptians avoided state medical institutions, opting instead to seek treatment from local practitioners. In the early 20th century, patients continued to seek relief from local health barbers in the form of bloodletting, cautery, and cupping;Footnote 39 cautery, in particular, was used with some success as a counterirritant.Footnote 40 However, by this period, many Egyptians also sought treatment from the physicians who staffed Egypt's hospitals.Footnote 41 The Ottoman-Egyptian state that built a public health apparatus to track disease was the same state that introduced perennial irrigation, meaning that disease and the institutions that mapped it were contemporaneous. However, careful analysis of the changing environmental conditions of the period, including those that framed agricultural labor, and descriptions of the manifestations of parasitic disease, reveal that hospitals were crowded, in part because Egyptians engaged in agriculture were notably sicker than they had been in the past.
In Egypt, bilharzia, also known as schistosomiasis, resulted from infection with the Schistosoma haematobium and/or Schistosoma mansoni parasites, which penetrate human bodies through the contact of unbroken skin with freshwater containing infected urine or feces and the species of freshwater snail that serve as the organisms’ intermediate hosts. Schistosoma haematobium and Schistosoma mansoni differ in the morphology of their eggs, their pathways of infection inside the body, and their intermediate hosts. Schistosoma haematobium infects the urinary tract, its eggs passed through urine, while Schistosoma mansoni is concentrated in the digestive tract, its eggs exiting the human body in feces.
Before the introduction of perennial irrigation, when the calendar of the annual flood structured the practice of Egyptian agriculture, bilharzia infection was likely a hazard of al-ṣayf. The organism flourishes in warm weather. In the early 20th century, Egyptian cultivator-laborers referred to the infection as the “June itch,” which they reported feeling most acutely during summer daylight hours and sometimes labored at night to avoid.Footnote 42 The labor necessary for irrigation during this season, when cultivator-laborers utilized irrigation canals and enclosed basins to water summer crops, complemented the role that seasonal temperature played in encouraging infection. The parasites that cause bilharzia thrive in enclosed and slow-moving bodies of water, and the necessity of laboring in these sources of water spelled the near certainty of their use as sites of urination and defecation.Footnote 43 It is unlikely that cultivators contracted the infection from the river itself, as its intermediate mollusk hosts do not fare well in large bodies of rapidly moving water.Footnote 44
The introduction and extension of perennial irrigation increased the prevalence of bilharzia infection. In 1850–51, when Theodor Bilharz, a German professor at Qasr al-ʿAyni and the figure who would lend the disease one of its names, first identified the organisms as the cause of the symptoms that would come to be associated with bilharzia, he located these organisms in 32 percent of the autopsies that he performed. Bilharz's measurements likely captured the first jump in the prevalence of the disease that followed the introduction of perennial irrigation three decades earlier. In the decades that followed his discovery, rates of bilharzia infection in areas with access to perennial irrigation continued to climb.Footnote 45 In the first decades of the 20th century, the completion of Khazan Aswan and the consolidation of a landscape of state-sponsored perennial irrigation in northern and central Egypt caused the prevalence of the disease to skyrocket.
In a study published in 1937, after two projects to heighten the dam and extend the geography of perennial irrigation, Rockefeller Foundation researcher J. Allen Scott found that infection rates with Schistosoma haematobium averaged 60 percent in regions with access to perennial irrigation, more than 30 percent higher than what Bilharz observed in the middle of the 19th century.Footnote 46 In some towns of the Delta, the prevalence of infection exceeded 90 percent.Footnote 47 The persistence of basin irrigation in Egypt during the 20th century allowed for a comparison of the relative prevalence of disease in geographically proximate regions. Scott's study confirmed that in the select areas of southern Egypt that had access to perennial irrigation, the prevalence of infection with Schistosoma haematobium mirrored that of regions with access to perennial irrigation in the Nile Delta and northern Nile Valley, while infection rates hovered at just 5 percent in areas of the south that continued to practice basin irrigation.Footnote 48 Infection statistics in areas that remained under basin irrigation likely reflected levels of infection in other regions before the introduction of perennial irrigation.
Schistosoma mansoni’s relationship to perennial irrigation was initially less clear than that of Schistosoma haematobium. Unlike Schistosoma haematobium and its intermediate snail host, Bulinus truncatus, which were present in both the Nile Delta and the Nile Valley, in the 19th and early 20th centuries, Schistosoma mansoni and its snail host, Biomphalaria alexandrina, were confined to specific regions of the Delta, namely its north. In perennially irrigated regions in which the parasite and its host were present, infection rates were high, averaging 58 percent. In areas of the Delta in which the disease was not endemic, the prevalence of infection was much lower, hovering at approximately 5 percent.Footnote 49 The organism and the disease that it causes were almost nonexistent in the Nile Valley.Footnote 50
One cause of the increased prevalence of Schistosoma infection was the proliferation of irrigation canals throughout Egypt's countryside. These canals rarely dried, aquatic vegetation blossomed within them, and populations of freshwater snails—the same snails that serve as the intermediate hosts for bilharzia infection—flourished.Footnote 51 Battling booming snail populations in the canals used for perennial irrigation was a challenge. When Claude Barlow, a hookworm and bilharzia researcher employed by the Rockefeller Foundation in Egypt, tested the efficacy of killing snail populations by closing canals for a period to allow them to dry, he happened upon somewhat-miraculous results:
In order to test snails, I removed them from a canal, put them in the laboratory to dry and they promptly died. I then dried the canal and collected dried snails (after a month's drying naturally) took them to the laboratory and tried reviving them. They recovered in a few minutes when given water. Keeping the remainder completely dry I tried reviving a few each month. I found they would survive for TWELVE WHOLE MONTHS!Footnote 52
Even had the snails not demonstrated such hardiness, many canals never fully dried despite a rotation system during which they were periodically closed, the remaining moisture aiding the revival of snail populations when they again filled with water.Footnote 53
The risk posed by canals teeming with Schistosoma organisms and their intermediate hosts was compounded by the new forms of environmental intimacy bound up with the labor regimes of perennial irrigation. In areas under perennial irrigation, infection and frequent reinfection were a near certainty among cultivator-laborers.Footnote 54 Whereas once they only came into contact with canal water in the short growing season before the arrival of the flood, cultivator-laborers in perennially irrigated regions relied on canal water for irrigation year-round, spending longer periods of the annual cycle immersed in this water. The extension of perennial irrigation was also associated with a change in the relative popularity of the implements used to move water to crops. In areas under perennial irrigation, the Archimedean screw (ṭanbūr) became more common than the shādūf.Footnote 55 While less scarring than the shādūf, use of the ṭanbūr meant that cultivator-laborers came into more contact with irrigation canal water than with the shādūf, rendering them increasingly vulnerable to infection with Schistosoma parasites.Footnote 56
The labor of perennial irrigation was not only framed by new agricultural seasons; the temporal demarcations of this labor were in part constituted by the lifecycles of organisms that infected the bodies of cultivator-laborers. Schistosoma haematobium and Schistosoma mansoni develop in the space of the irrigation canal according to particular temporal cycles. The organisms begin their lives as eggs suspended in human feces or urine. When expelled into water, the eggs hatch, releasing free-swimming larvae that are capable of penetrating tiny freshwater snails for a period of eight to twelve hours. After penetrating a snail, the organism further develops. Stimulated by light, snails release waves of cercariae that penetrate human skin according to a circadian rhythm.
Inside the human body, Schistosoma haematobium and Schistosoma mansoni organisms begin a process of migration. The organisms mature into worms that migrate in sexed and matched pairs to the veins surrounding the intestine in the case of Schistosoma mansoni, or those surrounding the bladder in the case of Schistosoma haematobium. As they carve their pathways through the body in the weeks following infection, Schistosoma haematobium and Schistosoma mansoni produce a range of symptoms that include fatigue, fever, aching, cough, and diarrhea. Estimated to survive on average between three and five years, worms lay eggs, about half of which are shed through feces or urine back into freshwater. The other half remain in the body where they produce an inflammatory response that damages and scars local tissues and can inhibit organ function. Severe infections with Schistosoma haematobium are marked by blood in the urine and can contribute to cancer of the bladder. The long-term symptoms of Schistosoma mansoni infection include high blood pressure through the liver, an enlarged spleen, excess fluid in the abdomen, and swollen areas in the esophagus and digestive tract that can rupture and bleed.
The repeated exposure of irrigating cultivators to Schistosoma parasites produced layered and complex temporalities that framed experiences of perennially irrigated agriculture. Multiple infections increased the number of worms—the worm load—in a patient's system and intensified the symptoms and duration of the disease.Footnote 57 Writing in 1910, Frank Cole Madden described the scarring of agricultural laborer bodies by perennial irrigation:
The cause of the severity of the symptoms and the mortality is the repeated reinfection to which the fellaheen (peasants) are particularly liable. A single infection may be, and often is, entirely recovered from, especially in females (Elgood), but it is difficult to see how such a happy result can be expected in the agricultural labourer, whose very work and habits render him all too liable to a long series of infections. It is not uncommon to find very old bilharzial lesions in the bladder and rectum, and at the same time quite young worms in the portal vein, with intermediate stages in the chronological sequence of bilharzial pathological changes scattered throughout various parts of the body.Footnote 58
Madden's description of the effect of serial bilharzial infections illustrates one scale of the ecologies of perennial irrigation, that of internal body landscapes marked by scars and lesions, and occupied by worms. As infections progressed, laborers experienced the chronological progression of symptoms, complicated by the presence of multiple infections, each with their own trajectory.
There is also evidence that repeat and multiple infections increased the mortality of the disease. In 1922, more than one hundred men died from severe infections with Schistosoma mansoni in the village of Saft al-ʿInab near Damanhur in the Nile Delta. The Schistosoma mansoni outbreak in Saft al-ʿInab was concentrated among poor, male agricultural laborers, who “Being reinfected, they suffer severely.”Footnote 59 In Saft al-ʿInab and beyond, growing numbers of cultivator-laborers were infected with both Schistosoma haematobium and Schistosoma mansoni.Footnote 60 The frequent exposure of agricultural populations to infection also produced new symptoms of disease. In 1907, Frank Cole Madden, an Australian physician at Qasr al-ʿAyni, published Bilharziosis. The text offers photographic evidence of patients disfigured and disabled by large growths on their genitalia and recta, the result of the repeat and complicated infections that were one product of the labors of perennial irrigation.Footnote 61 By the 1940s, after more than two decades of state-sponsored treatment programs, these symptoms had become much less common.Footnote 62 Egyptian doctors argued that the lower likelihood of encountering these severe symptoms meant that while most patients continued to be reinfected following treatment, the regimen reduced the severity of infection.
The prevalence of bilharzia was highest among men engaged in irrigation labor, one facet of the embodied experience of gender among rural Egyptians during the late 19th and early 20th centuries. As irrigation canals became a central feature of village life, significant numbers of women and men in rural areas were infected, but the percentage of women with the disease was, on average, approximately ten percentage points lower than that of men.Footnote 63 Even when mixed populations of male and female field laborers were measured, rates of infection among men were higher because—in addition to field labor—men irrigated and cleared canals.
The disease became so common in areas of the Nile Delta that rural populations understood the blood in the urine that marked infection with Schistosoma haematobium as a kind of normalized male menstruation. In 1934, Rameses Girges, an Egyptian physician who treated bilharzia in the town of Tanta in the Nile Delta, reported:
The fellaheen do not pay the disease its due care, and even consider it an ordinary event common to all men. It some parts of the country it is even considered as a sign of fertility corresponding to menses in women. They do not treat it until the condition becomes advanced and prevents them from their ordinary work.Footnote 64
Rural life produced a shared set of environmental intimacies, but some modes of environmental interaction differed according to age and gender, the effects of these interactions contributing to differentiated experiences of gender.
In addition to the Schistosoma parasites that produce bilharzia, the Ancylostoma duodenale organisms that produce hookworm disease likewise infected the bodies of Egyptian cultivator-laborers. Fleming Ment Sandwith, a prominent professor and physician at Qasr al-ʿAyni, described hookworm as “an insidious wasting disease characterized by progressive anemia without apparent cause, and by digestive and nervous deterioration occurring chiefly in earth and brick laborers of warm climates.”Footnote 65 Hookworm was common in the American South, South America, and among populations of mine workers in Europe. Although statistics charting the prevalence of hookworm outside of hospitals are not available before the early 20th century, evidence from the first decades of the century strongly suggests that hookworm infection became more widespread in the Nile Delta and central Egypt as a result of the transformed ecologies and labor regimes of perennial irrigation.
In 1914–15, the Egyptian Public Health Department organized the first campaign to measure the prevalence of hookworm outside of hospitals. The department's team chose as their study sites regions of northern and southern Egypt that they deemed “typical,” Sharqiyya in the Nile Delta and Asyut in Upper Egypt.Footnote 66 The results of the survey revealed that 55 percent of the population in perennially irrigated Sharqiyya and 46 percent of the population of Asyut, much of which was still under basin irrigation, were infected with Ancylostoma duodenale.Footnote 67 The high rates of infection in Sharqiyya and Asyut—regions with different climates and irrigation systems—were the product of multiple factors that included the extension of perennial irrigation.Footnote 68
Whereas the prevalence of infection with Schistosoma haematobium was directly linked to the extension of perennial irrigation, the array of factors promoting Ancylostoma duodenale infection was more complex, perennial irrigation only one among many. In a 1931 article, Muhammad Khalil, the director of the Bilharzia Research Section and Professor of Parasitology at the University of Cairo (King Fuʾad University), argued that both climate and soil moisture levels encouraged hookworm infection.Footnote 69 Khalil argued that in the Nile Delta, where the climate was relatively cooler, the infection's prevalence likely stemmed from the increased moisture of the soil that resulted from perennial irrigation. The relatively warmer climate in Upper Egypt allowed the infection to thrive, despite the drier summer soil in this region.Footnote 70 Khalil believed the disease was worst in perennially irrigated regions of central Egypt in which the combination of a warmer climate and moist soil produced the highest prevalence of infection. As perennial irrigation spread south, hookworm disease among rural populations likely became more common. Later work by Rockefeller Foundation researcher J. Allen Scott demonstrated that temperature and soil moisture were only two of the multiple factors influencing levels of infection.Footnote 71 Soil composition might have also played a role. The organism's New World cousin, Necator americanus, thrives in sandier soil. Footnote 72 Reclaimed lands that lay to the north of the irrigation frontier which had been produced by Khazan Aswan had a higher content of sand because they had not been coated annually with sediment from the flood.
Hookworm is transmitted to human beings through the direct contact of skin with the organism. Passed through infected excrement, the organism migrates to mud after it matures and moves beyond the feces in which it exits the human body. In 19th- and early 20th-century Egypt, mud was everywhere. It was used to build huts, poultice wounds, and grow crops, and was the material upon which rural Egyptian populations strode barefoot. Hookworm can also be acquired through ingestion of the organism. Colonial doctors reported that significant numbers of their patients consumed mud during the annual Nile flood. Reportedly served with a lemon, this soil was called ṭīn iblīs (devil's mud), and was associated with nourishment.Footnote 73 Finally, and most significantly, mud both molded and clogged irrigation canals. Egyptian cultivator-laborers maintained these canals and cleared them of sediment. Mud was central enough to the work of irrigation that when British officials at the Egyptian Ministry of Public Works accounted for the labor of clearing canals, they did so in units of earth.Footnote 74
Agricultural laborers faced a heightened risk of hookworm infection as they worked in moist fields and were engaged in the making and remaking of irrigation canals. As with bilharzia, the lifecycles of Ancylostoma duodenale parasites were one temporal frame that structured experiences of labor. The disease's prevalence meant that normative embodiments of labor included symptoms of weight loss, diarrhea, fatigue, abdominal pain, and the severe anemia that resulted from worms sucking blood from the wall of the intestines.Footnote 75 Once inside the body, an Ancylostoma duodenale larva begins a journey to the lungs that lasts three days. After arriving in the lungs, the organism breaks through the alveoli to travel to the trachea, where it is swallowed, passes through the esophagus, and enters the digestive system. The migration of the organism from the skin's surface to the small intestine lasts approximately one week. In the intestines, the organism matures sexually over a period of three to five weeks before mating and producing eggs. Humans then release these eggs in excrement, after which larvae hatch, feed on bacteria and organic matter, migrate to the soil, and transform twice, eventually into filariform larvae, which can live in the soil for up to two years.Footnote 76
In the bodies of Egyptian cultivator-laborers, the temporality of a hookworm infection was more complex than the sum of the days of a single infection's progression. Experiences of hookworm often stretch much longer than the one- to three-year lifespan of Ancylostoma duodenale. Dormant larvae stored in muscle tissue can replace dead worms, allowing the infection to perpetuate itself. Hookworm infection was seasonal, its prevalence increasing as the weather warmed in the approach to summer and throughout the season of the flood.Footnote 77 As the heat climbed, laborers were easily reinfected, each infection adding a new layer of temporal complexity to the physical experience of labor.
Like bilharzia, in populations of adults hookworm was more common among men than women. In a study conducted during the summer of 1927, D.L. Augustine, M. Helmi, and M. Nazmi measured rates of infection with Ancylostoma duodenale in twelve Egyptian villages. Whereas only men and boys had been tested in the 1914–15 survey of Sharqiyya and Asyut, the 1927 survey measured the prevalence of infection among men, women, and children.Footnote 78 The researchers found that while large numbers of both men and women were infected, the proportion of men infected at all ages was consistently higher. Measures of the relative rates of infection with Ancylostoma duodenale stood in marked contrast to those with the Ascaris lumbridcoides organism, which was known as a “household” infection and was more common among women.Footnote 79 Among men, infection with Ancylostoma duodenale peaked between the ages of twenty-five and thirty, before gradually declining.Footnote 80 Women sometimes worked in agriculture, but labor, especially that involving irrigation, was primary among the gendered forms of environmental behavior that placed men at the highest risk.Footnote 81 As with bilharzia, hookworm was most prevalent among those who performed the work of agriculture, in particular, irrigation.
CONCLUSION: THE SICK SUBJECTS OF COLONIAL ECONOMY
In regions with access to perennial irrigation, encounters with environmental disease were more complex than a spike in infection, and more significant than an effect of new irrigation regimes. During the 19th and early 20th centuries, infection with Schistosoma haematobium, Schistosoma mansoni, and Ancylostoma duodenale came to constitute normalized, if not normative, experiences of the body among cultivator-laborers in perennially irrigated regions of Egypt. The vast majority were infected with one environmental disease; many suffered from more than one. The symptoms of infection with Schistosoma haematobium, Schistosoma mansoni, and Ancylostoma duodenale—and their intersections—were fundamental to embodied experiences of agricultural labor.
Bodies were, in part, the product of the ecologies in which they were situated and the specific practices that helped constitute their relations with a broader material environment. Under basin irrigation, the bloodied hands and sore backs caused by use of the shādūf marked the arrival of summer. The advent of perennial irrigation produced new agricultural seasons and experiences of temporality. One scale at which cultivator-laborers lived the temporality of perennially irrigated agriculture was that of the migration and lifecycle of hookworms and schistosomes in the body.
Egypt's incorporation into the British-dominated imperial world economy during the 19th century was an ecologically situated phenomenon, and not simply because it drew on the nonhuman world for material resources. When the British occupation of Egypt began in 1882, the environmental transformations of this incorporation, including those wrought on the body, had been underway in certain regions of the Nile Delta for more than half a century. The labor that made and maintained this agriculture was one process through which colonial economy was etched onto the material world. Among populations engaged in this agriculture, the normative subject was a subject sickened by disease. To borrow a phrase from the phenomenologist philosopher Maurice Merleau-Ponty, “but to the extent that I have a body, and that through that body I am at grips with the world” (emphasis added),Footnote 82 the enmeshment of laboring bodies within the ecologies of perennial irrigation were central to the production of historical experience and agricultural temporality among Egyptian cultivator-laborers. There is no disentangling the production of agricultural space from the act of labor that made it, or the material body of the laborer from the space in which it was constituted.
