1. The Problem of Knowledge
1.1. It is fairly typical for LARGE segments of "lower-income social class" members (particularly the men) of the rural oasis communities and Urban Egyptian underclass to have "deeply opposed views" to the morally questionable NRT being used in big cities Cairo.
1.2. Despite the massive globalization of NRT themselves, the accompanying science of assisted conception has "not so easily spread around the world", including to the middle east.
1.2.1. "Conflicting knowledge systems" between Egypt and Western society
1.2.1.1. Local peoples have often resisted the global expansion and supposed omnipotence of Western science.
1.2.2. Profound disjuncture between Western knowledge scientific system aka (Western scientific orthodoxy) in which NRT are WHOLLY based vs "LOCAL SCIENTIFIC KNOWLEDGE SYSTEMS" deeply embedded in Egyptian history
1.2.2.1. Local understandings contradict the notion of“universal science"
1.2.2.2. Western society idea of science is solely based on "contemporary/categorization"
1.2.2.3. OFTEN EXCLUDING categorizing science itself to other knowledge systems. A LACK OF WILLING TO ENGAGE IN "DIFFERENT WAYS TO LOOK AT THE WORLD"
1.2.2.3.1. Western notions of human reproductive biology, are notions assumed by Westerners and (Western anthropologists) to be universal
1.2.3. Such challenges serve to demonstrate how science is BOTH "SOCIALLY AND CULTURALLY SITUATED" deeply influenced by its "SURROUNDINGS"
1.2.3.1. Western ideas of scientific literacy are profoundly Eurocentric male dominated (fail to include moral, religious, metaphysical, existential and social knowledge Acquisition of scientific literacy)
1.2.3.1.1. ARGUE THAT: By listening to "nonscient at all edcational levels and from a variety of ehtnic and socioeconomic stettings
1.2.3.2. Western "romance of egg & sperm"
1.2.3.2.1. While, Middle eastern societies popular script of human procreation do not involve "this romance". Maybe be thought of as "EGG FREE"
1.3. Egyptians acquire knowledge about these technologies is a "mass-mediated society"
1.3.1. Both media promotes yet warns Egyptian society about NRT (MORAL DISCOURSE-CAUTIONARY TALES) LEAVING POTENTIAL EGYPTIAN CONSUMERS UNEASY/ MAY INHIBIT THEIR UTILIZATION
1.3.2. Consumers of NRT search for knowledge in many places. Notion of “informed consent” is problematic
2. Problems of Procreative Knowledge
2.1. Knowledge acceptance of NRT is heavily constrained by social class (class-based knowledge) and internal knowledge about human body and procreative processes
2.1.1. "Deeply held belies about human reproduction technologies"
2.1.1.1. Among illiterate Egyptian population, rural/urban views of procreation are decidedly "MONOGENETIC" (Men create life: one sided)
2.1.1.1.1. BLOOD- LINE AND LINEAGE- OBSESSED -SOCIETY VIEWS FATHERS/ FATHER'S RELATIVES AS THE "TRUE BLOOD" OF CHILD. A BELIEF THAT MEN have "BIOLOGICAL OWNERSHIP" AND patrilineal kinship system.
2.2. Today among lower class Egyptians models of procreation changing: ENVISIONS WOMEN AS "EGG PRODUCERS" VS TRADITIONAL (ABSENCE OF "EGGS")
2.2.1. DUO GENETIC SPERM-OVUM VIEWS: both eggs and sperm are equally needed for conception
2.2.1.1. DEPENDS ON EDUCATIONAL- CLASS BACKGROUND: ILLITERATE GROUPS LESS LIKELY TO RECEIVE DUO-GENETIC VIEWS= WILL ALWAYS VIEW WOMAN EGGS AS LESSER OR BLAME FOR INFERTILITY
2.2.1.1.1. Accept male infertility in theory, but not in practice
2.3. IVF involves stimulating egg production, removing eggs from women's bodies, fertilizing these eggs in lab with isolated sperm, returning embryo to womb
2.3.1. Poor Egyptians continue to question manipulation of sperm and embryos--privilege of women's eggs
3. Morality and Scientific Literacy
3.1. Separation of procreation from sex is morally problematic, artificial and therefore illegitimate.
3.1.1. ALL Egyptians have the same common question is: "what happens to procreative substances during the period in which they are in vitro or (outside body)
3.1.1.1. Verity of male paternity elicits oppositional moral stance toward IVF/ICSI
3.2. Egyptian men fear " mixing of sperm"
3.2.1. Egyptian women fear "artificial fetus created and gestated outside womb = biological connection
3.2.1.1. Based on adoption beliefs as it prohibited, fetus viewed gestated outside body, demmed "natural", like orphans view as " strangers"
3.2.1.1.1. extracorporeal reality of IVF made sinful in Islam, RESULT OF LACK OF TECHNICAL UNDERSTANDING
3.3. Scientific literacy in the realm of NRT can only be understood within a moral framework
4. Acquiring Scientific Literacy
4.1. Most desperate would be willing to learn
4.1.1. Item 1
4.1.2. Item 2
4.1.3. Item 3
4.2. By 1996, overall IVF knowledge and centers evidently have flourished in Eygpt
4.2.1. Knowledge has become a form of power in Egyptian test-tube baby making, varies heavily by social class thus knowledge
4.2.1.1. By achieving "moral acceptance" vs the poor " niggling moral anxieties"
4.2.1.2. Highly accepted treatment by middle-to-upper class, highly rejected less-educated lower-class
4.2.2. Many infertile couples genuinely interested in understanding differences between AIH, IVF, and ICSI
4.2.2.1. IVF = BETTER FOR FEMALE INFERTILITY/TUBAL OBSTRUCTION AND IF SPERM IS GOOD N ACTIVE. ICSI= 100 % BETTER FOR MALE INFERTILITY, WEAK SPERM
5. Scientific Literacy in a Mass-Mediated Society
5.1. MEDIA HAVE SERVED A MAJOR ROLE IN PROMOTING PUBLIC UNDERSTANDINGS
5.1.1. Username:
5.1.2. Password:
5.2. EGYPT IS BOTH THE " HOLLYWOOD" AND "CNN" OF THE MIDDLE EAST. CREATING HIGH-QUALITY MEDIA PRODUCTIONS AMONG ARAB SPEAKING SOCIETIES
5.2.1. Noteworthy for science and health reportage e.g.. TV big source (80% all Egyptian households own TV, 75% married women watch TV)
5.2.2. Media has 1) promoted awareness of NRTs, 2) provides publicity for Egyptian IVF centers (paid, non paid), 3) covered ongoing development globally (international news), 4) and has created lively public moral debate of the uses of NRTs abroad and locally.
5.2.2.1. Overall served to "normalize" these technologies
5.2.2.1.1. Biggest media news "birth of triplets via ICSI" under Dr. Yehia Mohamed care, FIRST TO INTRODUCE ICSI IN EGYPT.
5.3. Overall Egyptians infertile couples prefer to hide or keep their treatment silent for moral Islamic reasons
5.3.1. Username:
5.3.2. Password:
6. Paths to Knowledge
6.1. 3 main paths among IVF seeking patients for acquiring these knowledge: 1)written books/printed material for Arabic audience. 2) Belief in doctor’s authority and other forms at IVF centers. 3) Exposure to media publicity/media-saturated society.
6.1.1. Low class infertile women =less educated. Cannot read Arabic nor English, rely on popular broadcast forms e.g.soap operas
6.1.2. Middle-upper class= rely on doctors + media, readers, self educated, books
6.1.3. Doctors are employing the services of a full-time health educator, plus"patient information consent" to yield greater success
7. Conclusion: The Desire for Knowledge
7.1. Islam enjoins believers to seekers of knowdlege from "cradle to grave"
7.2. Muslims belief" God gives humans knowledge to overcome their problems, just as he provided treatments to overcome "diseases" such as infertility
7.3. Access to knowledge itself is embedded in Egyptian class structures. In all those who end up in IVF centers, generally are literate middle-to-upper class who consume knowledge from many sources
8. The Oasis Dwellers
8.1. Uses the case study of Mabruka and Ragab (poorly educated-low-income) from rural oasis community to illustrate different knowledge systems about infertility and conception, iatrogenic medical procedures, impact of infertility on a couple’s relationship, and sources of mistrust of NRT
8.1.1. She recounts how, in the early part of her marriage, she had "some infections," for which she underwent cervical electrocautery
8.1.1.1. An outdated and even dangerous procedure that is widely performed by Egyptian gynecologists
8.1.1.1.1. KNOWLEDGE GAP ABOUT THE TECHNOLOGIES