Ungovernable Life
Mandatory Medicine and Statecraft in Iraq
Omar Dewachi


Contents and Abstracts
Ungovernable Life: An Introduction
chapter abstract

The introduction gives an overview of key concepts and provides background on the rise and eventual unraveling of Iraq's health care infrastructure. It develops the notion of "ungovernability" as a concept to probe both the logics and limits of biopower, and introduces the notion of mandatory medicine as a framework for understanding the history of state making in colonial and postcolonial Iraq. Problematizing the dearth of empirically grounded knowledge about Iraq in media and academic discourses, the chapter proposes an alternate genealogy of Iraq's state breakdown—one read through the material history of the country's health care infrastructures and doctors from the colonial period to the present. In response to recent literature on the recession of the welfare state as driven by neoliberal logics, the chapter suggests that scholars must develop different methodological and conceptual tools when considering the case of Iraq and other states unraveling under war and sanctions.

1 Intervention Pathologies
chapter abstract

This chapter analyzes the British takeover of Iraq from the Ottomans during the World War I and how the logics of this intervention drew heavily upon discourses of tropical medicine and ecology. The chapter shows how British efforts to subdue and rule Iraq were couched within pathologizing discourses that portrayed Iraqi territories and populations as a medical problem with which imperial powers had to reckon, and which they had to understand and correct. Detailing the unruly strategies and corporeal vulnerabilities of those conducting this initial imperial campaign, the chapter argues that discourses about the medical and ecological ungovernability of Iraq shed light upon the imaginations and anxieties of its imperial occupiers and, more broadly, reflect defining features and fragilities of the colonial enterprise.

2 Vitality of the State
chapter abstract

The chapter analyzes how, during the interwar period, Iraq became a laboratory for statecraft to determine the limits of both colonial and European health care regimes, as competing visions of the future of Britain's health care system based in London found a proxy site for experimentation in Baghdad. The chapter highlights how the newly established public health directorate departed from the discursive determinism of tropical medicine and embraced the ethos of a "bio-politician," such that the biological conduct of the population now articulated the contours of state power. The chapter focuses on the management of the cholera epidemic of 1923 during the annual Shia pilgrimage, which coincided with anxieties about the rapid spread of pathogens facilitated by modern transportation. The nationwide coordination required to manage the epidemic was taken as proof of the importance of centralizing health care administration in the capital city as opposed to decentralized provincial control.

3 Doctors without Empires
chapter abstract

This chapter explores how the dismantlement of Ottoman medical networks generated debates about science and nation-building under the British mandate. Previously shaped by regional medical training under Ottoman rule, Iraq's newly established medical training program would be defined by a long-term relationship with the British medical enterprise both in Iraq and at the metropole. Doctors descended upon Iraq from the former Ottoman territories to participate not only in medicine, but also in a new nation-building project. A diverse array of medical-political actors debated the formation of health institutions as part of a larger conversation over the shape of Iraqi citizenship. The chapter analyzes the dynamic political and scientific stakes that led to the inception of Iraq's first national medical school, the Royal College of Medicine. Contentious debates about the College's language of study reflected broader anxieties and disagreements around the imagination of the new nation.

4 The Royal College
chapter abstract

This chapter explores the autobiographies of Iraq's doctors and their documentation of the early years at Baghdad's Royal College of Medicine. It highlights the tensions around the sustainability of the school and its attempt to fashion Iraq's modern citizens, crystalized in the figure of the medical doctor. The Royal College sought to cultivate doctors to become cosmopolitan and Western-oriented, through training both inside and outside Iraq. The rootedness of this professionalization within Western tastes, expertise, and pedagogy revealed a core tension within Iraq's biopolitical project: doctors were expected to formulate professional expertise based upon relations with the metropole while also serving the interests of the state to expand biomedicine to the rural areas of the country—areas doctors regarded as antithetical to their optimal course of professionalization. Doctors' simultaneous obedience to and evasion of state policy reveal the contradictions involved in state building through science.

5 Development and Its Discontents
chapter abstract

Tracing contestations around state development programs in the 1950s, this chapter illustrates how these interventions drew upon therapeutic discourses of "ungovernability" in ascribing a distinct political and biological backwardness to rural populations. Popularized in the writings of Iraqi sociologist Ali al-Wardi, the notion of an urban/rural duality of Iraqi society became central to development discourses. Specifically, this chapter focuses on the consequences of state development interventions on the massive migration of farmers to the capital and the subsequent construction of Thawra City (Sadr City)—initially Iraq's most extensive social housing project and eventually its largest urban ghetto. As a historically-rooted reflection on the promise and unruliness of biopolitical interventionism, the chapter shows how large-scale development projects in Iraq produced geographical, biological, and political transformations that conditioned the 1958 socialist revolution.

6 Infants and Infantry
chapter abstract

This chapter addresses the paradoxes of statecraft arising during the eight-year Iran-Iraq war, among the longest inter-state military conflicts in the twentieth century. In response to battlefield losses, the state focused on the expansion of its health care services and cultivated the broader social significance of wartime survival and productivity. The regime's mantra—"we fight with one hand, and we build with the other"—captured the interconnections between the war and social mobilization to respond to the "assault" on the physical and social body. The chapter focuses on complex population politics that are often obscured or ignored in academic discourse on the conflict, and shows how Cold War-era state medicine and international health politics became implicated in the conflict. The chapter interrogates the Iran-Iraq war as a terrain for the mobilization of different regimes of population politics that shaped everyday life during the conflict.

7 Empire of Patronage
chapter abstract

This chapter shifts the ethnographic focus from Iraq to Britain in order to trace the trajectories of Iraq's doctors in Britain's NHS. The loss of Iraq's doctors to the West since the 1990s is one of the main tragedies of recent wars and interventions. Beginning during the devastating 1990-2003 United Nations sanctions and accelerating during the violence and turmoil of the post-2003 US-led occupation, the ongoing exodus en masse of Iraqi doctors to the imperial metropole and other destinations speaks not only to the lack of security but also to the longstanding transnational genealogy of the Iraqi state. Based on fieldwork in London with Iraqi doctors practicing or seeking careers within the NHS, the chapter comes full circle to show how Britain's historical involvement in medicine and state building in Iraq refracts through the quest of doctors to seek careers and refuge in the metropole of the Empire.

chapter abstract

This chapter reflects on the legacy of US biopolitical warfare, addresses key concepts, and raises questions for future inquiry. The chapter explores the implications of the fragmented health care geography arising from the targeting and dismemberment of Iraq's health infrastructure. Broadening the conversation beyond discourses and productions of ungovernability in Iraq, the chapter reflects upon how the notion of the "ungovernable" might be a useful conceptual tool in understanding the workings and limits of power. The chapter closes by gesturing toward the cruel symmetry between the colonial depictions of Iraq's biological unruliness and the increasingly undeniable research indicating the spread of both disease and antibiotic-resistant pathogens in the country. This symmetry between colonial imagination and present-day reality intends to spur reflection and encourage further research on the varied legacies and wounds of recent wars targeting health infrastructure and the biopolitical apparatus.