When I wrote “Mental Hygiene and Disability in the Zionist Project” in 2007, I could not have imagined that there would eventually be an IJMES special roundtable on disability and the Middle East. That article, featured in Disability Studies Quarterly, charts the place of disability as a historical category and the treatment of disabled people in the Zionist project in Mandate Palestine. In it, I suggest that “the concept of disability figures as a prominent cultural signifier that underscores many facets of the Zionist nationalist project.”Footnote ¹ To illustrate this contention, I specifically examine mental disability as a “marker of whether or not Jews could constitute a legitimate normalized nation” and people with mental illness as objects of selective immigration policy, ultimately translating into prioritized access of the able bodied to the Yishuv (Jewish community in Mandate Palestine). Indeed, barriers to immigration based upon disability debunked the movement's promise to welcome all Jews to create a resilient, ideal society.Footnote ² This article was much more in line with the historical interventions of disability history than my book about malaria eradication in Mandate Palestine. Although I had already started to engage with disability history by the time the book was published, I mainly positioned the book within the history of medicine, particularly the subfield of colonial medicine.

Since then, a seminal set of essays featured in the Bulletin of the History of Medicine in Winter 2013, and a more recent elaboration on the subject by prominent disability historian Catherine Kudlick in 2018, highlight the distinctions between disability history and the history of medicine but also the potential for these two fields to engage in “productive conversation.”Footnote ³ As I suggested as part of a 2014 conference panel on the subject, a main distinction between the fields is that a disability historian asks a research question that seeks, first and foremost, to understand the meanings of disability and the experiences of disabled people in any given society. According to theorist Aly Patsavas, this priority forms the key component of a disability analytic.Footnote ⁴ This analytic derives from the fact that, as Kudlick aptly notes, disability history as a field comes out of the work of the Western disability rights movement; it is fundamentally a project that considers the rich histories of disabled people but also how concepts surrounding disability (like normalcy, difference, marginality, able-bodiedness, deviance, or pathology) structure spatial, family, political, economic, ideological, and societal relations.Footnote ⁵

In contrast to the history of medicine, which tends to represent people with impairments as patients, disability history also considers the actions and thoughts of people with impairments outside of the clinic, treating them as actors with a full range of interests, ambitions, and politics. Whereas disability historians acknowledge that not all disabled people are actually ill or even interface regularly with the medical establishment, historians of medicine primarily emphasize the workings of medicine, its stakeholders, and its impact upon patients.Footnote ⁶

Since this academic dialogue began five years ago, scholars and students from both fields have asked: How can we write histories that maintain the respective concerns and emphases of each field but that also reflect a more serious engagement of one with the other? How can such mutuality generate new insights into a multitude of societal dynamics and hierarchies? By extension, I want to ask: what are some possibilities for ways MENA historians can advance this productive conversation, even finding ways to push boundaries and forge new understandings about disability and medicine/public health (or other domains) and how they intersect or diverge in particular localities? The thoughts that I will pose here reflect a partiality to engaging with disability history approaches—since that is where the lacuna in Middle East Studies mostly exists—but I also try to speculate what a history of medicine of the Middle East would look like that treats people with disabilities as historical actors in their own right, rather than as appendages to history.

One of the main questions shared by both disability history and history of medicine is how notions of capacity, fitness, perfection, and normality operate conceptually and practically in nationalist movements. To be sure, within the colonial context, Western medical notions of what constituted the modern body and its symbolic meanings seeped into the ways in which non-Western (but perhaps Western-educated) leaders framed their nationalist projects. Further, colonial medical discourses and those about disability often overlap, which makes sense given their shared foundations in late 19th- and early 20th-century, social Darwinist and eugenic thinking and practices. How do these themes manifest in the territories of British and French colonial rule in the Middle East?

The MENA region offers potentially numerous, intriguing cases to examine such ideas and their practical implications, not only during the period of colonialism but also in postcolonial contexts. First, the MENA scholar could ask: what constitutes these and related notions in Middle Eastern contexts and what cultural and political work do these concepts do at different moments in time? So, for instance, a scholar of Algeria might seek to understand how (or if) these ideas help structure the language and strategies of Algerian resistance to French rule. Other scholars might explore how Arab nationalist leaders refracted correlative concepts in various political texts and/or how (and why) different groups leveraged such ideas in, for example, the Egyptian, Libyan, or Iraqi movements. Using the insights of histories of medicine of Africa or South East Asia to inform a disability analysis of the MENA's case specificities, still others might look at how or if these discourses impacted family relations, debates about the nation's future, and the formulation and implementation of educational or social welfare programs. Scholars could consider more recent historical instantiations, asking how such threads operate(d) in specific antiautocratic Arab revolutionary movements.

Beyond discursive inquiries, explorations about the historical treatment of people with disabilities and how people with disabilities responded to and shaped their communities in MENA remains a relatively open field. Certainly such treatment by the medical and religious establishments, by governments, by political parties, by individual families, and by labor and educational systems, reflects broader societal orientations to vulnerability and fragility, empowerment and tenacity.

Charting the historical treatment of people with disabilities could certainly enhance medical histories that explore, for example, the politics of medical technology and medical care, health NGOs and development, and the impacts of migration, trauma, and war. MENA scholars working in any of those areas could begin to reconsider how the dynamics of medicine, development, and migration, respectively, affect and are affected by people with disabilities. A history that engages these concerns could trace the politics of medical care in contemporary Lebanon, for instance, while also giving weight and attention to the providers and recipients of medical care, their caregivers, and their interpretations of and engagement with those politics. Certainly thinking about the availability of medical interventions, pharmaceuticals, and networks of care can be part of this account, but a history that pushes the boundaries of disability and medical history would treat patients and healthcare professionals as not only inhabiting those roles but also others, like fathers, mothers, sisters, brothers, workers, activists, and public personas. Such a history would treat both types of actors as bringing equally valuable perspectives about Lebanese medical care and society.

For their part, instead of passive or ignored observers, people with disabilities in MENA societies—those interfacing with medical systems or not—have formed disability federations and close disability communities, worked toward greater access to clinical and public spaces, and created innovative tools and strategies to navigate their worlds. Outside of the clinic, they have forged relationships with teachers, siblings, caregivers, employers, and politicians, and have influenced social and cultural terrains. To be sure, people with disabilities embody other axes of identity—age, gender, race, religion, sexuality, and more—which together have produced varied, complicated historical experiences that scholars have yet to explore.

The stories of these people—and of marginalized populations more broadly—should not be written as an “add on” but rather as an integral part of the historical narrative. They can serve as a way to understand societal and political hierarchies, the mechanisms of and forms of resistance to structural violence, and a variety of other phenomena in this very complex region.Footnote ⁷

I have offered more questions than answers in this short essay but have tried to give IJMES readers ways to imagine how to more deeply engage with notions and practices concerning disability in their historical work. I agree with Kudlick that the fields of history of medicine and disability history have distinct orientations that should be honored and preserved. But I have also found in my own research and teaching that when each field's scholarship deeply informs the other, new questions and critical perspectives emerge, leading to well-grounded insights and unexpected conclusions.