Elise K. Burton, Genetic Crossroads: The Middle East and the Science of Human Heredity (Stanford University Press, 2021).

Jadaliyya (J): What made you write this book?

Elise K. Burton (EB): I started conceptualizing the book’s topic when I was an undergraduate at UC Berkeley. I was a double major in Middle Eastern studies and in biology, and everyone I knew constantly commented that this was an odd combination of subjects but could not articulate why. I worked in a genetics laboratory attached to the Museum of Vertebrate Zoology, and I remember constantly walking by a poster on their wall describing the work of one curator (James Patton) who had conducted research in Iran just a few years earlier. The connections were right in front of us! In a course on human genetics, we read about the then recent research on the Cohen modal haplotype, which was interpreted to mean that all Jewish communities were genetically related and descended from a Middle Eastern ancestor. I remember looking at the diagrams purporting to show the genetic relationships of different Jewish groups to Middle Eastern populations labeled “Lebanese” or “Saudi Arabian” and so on. At the same time, I was studying the formation of Middle Eastern nationalisms in the courses of Salim Tamari, Emily Gottreich, and others and understanding that the national and religious categories referenced in the genetic studies were barely more than a century old—not exactly an evolutionary timescale. By the time I decided to apply for a PhD, these experiences led me to say that I wanted to write a history about the relationship between ethnic nationalisms and the science of genetics in the Middle East.

J: What particular topics, issues, and literatures does the book address?

EB: The book brings together two scholarly literatures that are brilliant and well-developed on their own but have not overlapped much. First is the literature on Middle Eastern ethnic and national identities, which has engaged only in a very limited way with the history of science in general and racializing sciences (including human genetics) in particular. The scholars who have written about physical anthropology, race science, and eugenics in the Middle East have mainly focused on the period before 1950, and analyzed the relationships between these sciences and nationalist ideas mainly in a localized way, rather than portraying the Middle East as representative of a worldwide history of science.

Second, we have the literature on the history of genetics and race science which showcases the co-constitution of scientific and sociopolitical beliefs about national origins and ethnic ancestries. However, until now, the history of science has been Eurocentric in its focus; non-Europeans have been portrayed as having limited agency, serving as either victims of, or neutral conduits of information to, European and North American scientists. In this book, I tried to offer a history of genetics narrated from Middle Eastern sources and perspectives. For me, Middle Eastern scientific actors are full-fledged scientists and their work has shaped the international history of genetics. At the same time, Middle Eastern scientists should not be taken as heroic figures, but rather as three-dimensional humans who had sometimes contradictory motivations and discriminatory beliefs. There are troubling examples in the book of scientists who exploited and even actively harmed the religious and ethnic minority communities that they studied. In many cases, genetic scientists in the past—as quite a few still do today—claimed that their research exposed the ultimate truth regarding a community’s origins and ancestral relationships, while knowing that ancestry claims would de/legitimize that community’s civil rights or aspirations for self-determination. The book grapples with these ongoing ethical problems in genetic research as well. 

J: Who do you hope will read this book, and what sort of impact would you like it to have?

EB: Although it is a scholarly book, I worked hard to make my writing as clear as possible and I hope that general audiences, including within the Middle East, will be able to read it. I believe that the historical and ongoing issues I discuss in the book are relevant to anyone interested in nationalism, ethnicity, and race, and anyone who wants to understand what genetic research really means for these identities. Specifically, I hope this book can help prevent Middle Eastern people, in the region and in the diaspora, from falling for the seductive narratives of corporations selling “genetic ancestry” tests that purport to tell them whether they are “really” Armenians or Kurds or Jews or whatever. Ethnic identity is a social experience, the meaning of which changes over time, and your DNA cannot tell you your ethnicity; yet, governments around the world are increasingly making use of similar genetic ancestry data to try to deport people or exclude them from citizenship rights. There is a story in the book about a young Lebanese anthropologist in the 1950s whose friends and teachers ask him to measure their heads and tell them their “real” ethnicity, all in good fun—I hope readers realize that contemporary DNA tests for ethnic ancestry, despite using more advanced technology, are no different than this historical example.

Finally, this book is for everyone who wants to read a history of modern science that places the Middle East at the center. I hope this book becomes part of a bigger trend of scholarship and popular media that breaks old stereotypes suggesting that the region has not contributed to major discoveries in science and medicine since a medieval “golden age.” In the future, I want to read the research of young Middle East scholars who pick up where I have left off. I also want to see new documentaries, museum exhibits, and other media that showcase the role of the Middle East in nineteenth- and twentieth-century science—these can help change public discourses on the topics I write about.

J: How does this book connect to and/or depart from your previous work?

EB: This is my first book, and most of my previously published articles are related to this project in one aspect or another. Another project I completed long ago was a comparative study of how state education systems in Turkey, Iran, Israel, and Saudi Arabia address the teaching of evolutionary biology. That project engaged with several broad themes related to this book, such as the interaction of scientific knowledge production with political and social ideologies. However, that project was very much about contemporary events and policies, whereas Genetic Crossroads is truly a historical book in its sources and analysis.

J: What other projects are you working on now?

EB: I am starting a new project about the history of trans-Asian scientific collaborations—specifically, a set of collaborative relationships between scientists in Turkey, Iran, India, and Japan. I am continuing to analyze the research of medical geneticists, but also expanding to examine the fields of archaeology and dermatoglyphics (the scientific study of fingerprint patterns). I am particularly interested in examining what kinds of ideas about shared Asian racial ancestry and nationalized differences are used or produced by these collaborations. Furthermore, I am looking to understand whether the kinds of power dynamics I observed in European-Middle Eastern scientific collaborations were similar or different to those in trans-Asian collaborations. Although the idea for this project specifically emerged out of unexpected connections I discovered while researching Genetic Crossroads, I am excited to be part of an emerging trend of scholarship that aims to look beyond the Middle East’s fraught relationship with “the West” and instead investigate the region’s historical connections to other parts of Asia, Africa, and Latin America.

 

Excerpt from the book (from Chapter 6, “Genes Against Beans,” pp. 154-157)

Shortly after the annexation of Austria to Nazi Germany in 1938, the Jewish pediatrician Richard Lederer left the University of Vienna to take up a post at the Royal College of Medicine in Baghdad. Lederer, with his reputation as a dedicated physician and clinical investigator, was also appointed the personal pediatrician of young Faisal II, then the Crown Prince of Iraq. Despite this privileged position, Lederer had trouble adjusting to the Mesopotamian climate and diagnosing unfamiliar “tropical” diseases in his new patients. His Iraqi colleagues drew his attention to one particular condition, a seasonal phenomenon of acute anemia, jaundice, and dark urine in young children. After differentiating these symptoms from likely suspects, such as the “blackwater fever” caused by malaria and quinine treatment, Lederer began a concerted investigation to characterize what he believed to be a previously unknown disease, which he named “Baghdad spring anemia.” In the course of his research, he discovered the Italian medical literature on favismo (favism), a condition brought on by the consumption of fava beans that allegedly occurred only among the inhabitants of Sicily and Sardinia. Lederer noted that favism had markedly similar symptoms to those of his own patients, and he found that many of them had eaten fava beans immediately before the onset of illness. However, he was unable to conclusively show that fava beans were the causative agent. Lederer therefore published a description of Baghdad spring anemia as a separate disorder with curious demographic features: all his patients were “light-complexioned” boys under age five, and thirteen out of fourteen were Iraqi Jews.

After Lederer’s untimely death by skin disease in early 1941, the task of confirming that Baghdad spring anemia and favism were the same disorder fell to a new group of researchers: European-trained Ashkenazi Jews, like Lederer, studying Iraqi Jewish immigrants to Israel in the late 1950s. By that time, this obscure and exotic disease of the Mediterranean and Fertile Crescent formed the basis for a transnational network of medical researchers extending from Seattle and Chicago to Naples, Tel Aviv, and Shiraz. Favism rapidly attracted this international attention due to the discovery of its cause: a hereditary deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD). G6PD plays an important role in energy metabolism in the cells of all kinds of organisms, from bacteria to plants and animals. In humans, G6PD is crucial for the protection of red blood cells from oxidative stress. Mutations in the gene responsible for producing G6PD can result in abnormally low levels of the enzyme, i.e., G6PD deficiency (G6PDd). Certain medications, infections, and foods like fava beans may cause the rupture of red blood cells in individuals with this deficiency, producing anemia and jaundice. In mild cases, this may be experienced only as fatigue and shortness of breath, but severe cases may lead to organ failure and death. G6PDd is currently recognized as the most common inherited enzyme deficiency in the world, with recent estimates of 400 million people affected.

However, the prevalence of the condition is not evenly distributed. Because the G6PD gene is located on the X chromosome, clinical symptoms of the deficiency manifest more often in males than in females. Furthermore, mutations causing the deficiency occur most frequently in African, Asian, and Mediterranean populations. The form of G6PDd most common in Africa is relatively mild, whereas the genetic variant common across the Mediterranean and Middle East—the one responsible for favism—is more severe. Favism had long been recognized as a potentially serious condition by local peoples, whose historical lore and folk medicine included warnings against the consumption of fava beans. However, its incorporation into a major international research agenda began only in the 1950s, in concert with postwar malaria treatment and eradication programs. Because certain antimalarial drugs trigger acute hemolytic anemia in G6PD-deficient patients, the discovery of G6PDd and the determination of its biochemical and genetic characteristics was a direct outgrowth of malaria research. Its relevance to malaria drove national health agencies to allocate funding specifically to G6PDd surveys in many countries throughout the 1960s, while the World Health Organization (WHO) convened expert committees to standardize terminology and methodology for the growing number of researchers working across the Americas, Southern Europe, Africa, and Asia.

Despite its close connection to antimalaria campaigns, from the moment of its discovery, G6PDd took on not only clinical but also anthropological significance. In the United States, University of Chicago researchers first characterized the condition during the Stateville Penitentiary malaria projects, which used prisoners to test a range of new antimalarial drugs. They found that about 10 percent of African American prisoners, but not white ones, developed hemolytic anemia in response to primaquine; a further study published in 1956 demonstrated that a deficiency of G6PD caused this response. Like the simultaneous research conducted on sickle cell disease, the U.S.-based studies of G6PDd initially framed the condition as a “Negro” disease indicative of African ancestry. But after studies in Italy and Israel independently confirmed that G6PD deficiency was also the cause of favism, geneticists influenced by the Chicago school, like Arno G. Motulsky, sought to explain the deficiency’s prevalence among both Africans and the “Caucasians” of the Mediterranean and Middle East. After reviewing a compilation of available data from Central Africa, Asia, and the Mediterranean, Motulsky proposed that G6PDd, like sickle cell trait and thalassemia, could confer resistance to falciparum malaria parasites. Therefore, he argued, natural selection acted to maintain the defective gene within populations inhabiting regions of endemic malaria.

Yet the data that Motulsky compiled from South and West Asia introduced a potentially confounding factor into his malaria selection hypothesis. Like sickle cell disease, the frequency of favism in these regions varied significantly between groups inhabiting the same environment but divided by social factors like religion, language, and tribal affiliation. These genetic variations therefore mapped onto major social contestations in the young nation-states of the Middle East. Focusing on the years between 1955 and 1970, this chapter traces how medical researchers in the Middle East used favism to create a medical-anthropological discourse that projected contemporary nationalist ideologies deep into the past. Scientists in Israel and Iran configured a metabolic response to both modern pharmaceuticals and traditional cuisine as living testimony to thousands of years of migration, war, slavery, religious conversion, and social transformation. Reduced quantities of the G6PD enzyme in a handful of individuals became the basis for dramatic assertions about the ancestry of ethnoreligious communities and, by extrapolation, about national origins.

I argue that by favoring locally specific narratives over universal explanations like the malaria hypothesis, favism research in the Middle East expressed ambivalence about the international public health regimes and biomedical research agendas directed by Europe and the United States during this period. As in the case of sickle cell disease, this ambivalence did not necessarily represent ideological rifts between Western and Middle Eastern researchers but rather produced factions of scientists who favored different kinds of evolutionary hypotheses. The distinguishing feature of favism lies in its entanglement with malaria not only as an abstract force of gradual natural selection but also as an immediate public health issue. Furthermore, the disorder’s unique interaction with fava beans, a significant protein source in the Middle East, made it a concern for national and international management of agriculture and public nutrition. Medical researchers from these different fields all confronted the urgent need to address the ethnic and religious variability of favism rates. As a result, the faction that converged around Israeli and Iranian ethnonational explanations for genetic difference included a number of American and European scientists who collaborated with physicians in those countries.