Still, Tunisia’s support of science has clear limits: Projects whose aim is solely to advance knowledge get no support. “Everyone would like to do [basic] research,” says Taieb Hadhri, Minister of Scientific Research, Technology, and Competency Development, who has held the cabinet-level post since the department was created in 2004. “I’m a mathematician by training, and I would also like to do [basic] research. But that will have to come later. We have more pressing needs now.”
And the push toward advancement here is not entirely free from the pull of tradition, as I learn when I visit Habiba Bouhamed Chaabouni, a medical geneticist who splits her time between research and teaching at the Medical Faculty of the University of Tunis and seeing patients at the Charles Nicolle Hospital, also in the capital. In 2006, she won a L’Oréal-UNESCO Women in Science Award, a $100,000 prize given to five women, each representing one of the continents, for her work analyzing and preventing hereditary disorders. When she greets me in her office, she is wearing a white lab coat. Test tubes clink as they spin in a centrifuge to separate strands of a patient’s DNA that Chaabouni will examine later.
Chaabouni recalls the early days of her career, in the mid-1970s, when she saw children afflicted with disfiguring diseases. “It was very sad,” she says. “I met families with two, three, four affected siblings. I wanted to do something about it, to know how to prevent it.” There was no facility for genetic research at that time, and for two decades, she lobbied government officials hard for it. “We wanted better conditions and facilities. They also saw we were publishing in international [peer-reviewed] journals. I think the policymakers finally understood the value of developing research.”
The Tunisian medical-genetics community, which includes about 100 doctors and technicians, now publishes more than any other Arab country. “We looked on PubMed, and we’re ahead of Egypt,” Chaabouni says, beaming. “Not by a lot, but remember, we’re one-tenth the size.”
Over the last 30 years, Chaabouni has also seen how people who once resisted her message have begun listening. Once, genetic counseling or even coming in for certain treatments almost amounted to a social taboo; now, it is becoming more accepted, and things that were once simply ignored or not spoken of—such as autism in children, which is being identified more commonly—are more often out in the open.
For all that, Chaabouni still sees how her advice sometimes clashes with her patients’ beliefs. Like many Arab and Muslim countries, Tunisia has a high incidence of congenital diseases, including adrenal and blood disorders, that Chaabouni has traced to consanguinity.
“It’s a custom here, and in the rest of the Arab world, to marry cousins, even first cousins,” she tells me, though the practice is becoming less common. “Of course, that means they share a lot of genes from common sets of grandparents.”
In other fields, pure research does not get support; in medical genetics, even practically applicable knowledge can spark conflicts with Islamic culture. “Taking a blood sample to study abnormalities is not a problem,” Chaabouni says. “That’s just investigation. The problem is when you take the results of research into the clinic and try to give genetic counseling to patients. Then you have people who won’t accept the idea that they have to stop having children or that they shouldn’t marry their cousin.”
Today prenatal screening and genetic testing is more widely accepted, and when it’s necessary to save the mother’s life, doctors terminate pregnancies. Islamic law permits abortion in cases of medical necessity (where the mother’s life is in jeopardy) until 120 days in utero, at which point it regards the fetus as “ensouled” and abortion becomes homicide. For Chaabouni, the challenge is mainly one of communication. “They look for arguments why you may be wrong,” she says. “They go to other doctors. In the end, they usually follow our advice, but it’s hard because you’re giving them bad news that may also go against what they believe.”
Mohammed Haddad, an Islamology specialist at the Université de la Manouba in Tunis, points out the many little assaults that can turn people’s minds against scientific advances. For example, a sheikh recently declared that he’d found a cure for AIDS—spelled out in the Koran. “He was from Yemen, but they reach us by satellite, and it’s all a big business,” Haddad says. “People listen, and it’s a problem. In this situation, many will die.”
Amman, Jordan: “The Koran says, ‘Read,’ but it does not even say ‘Read the Koran.’ Just ‘Read,’” says Prince El Hassan bin Talal, who greets me at the Royal Scientific Society, Jordan’s largest research institution—one that he helped establish in 1970. Hassan was heir to the throne until his brother, King Hussein, bypassed him in favor of Abdullah, Hussein’s own son. The 60-year-old prince, who speaks classical Arabic and Oxford English and has studied biblical Hebrew, can tick off a whole list of things that are wrong with Jordan, from Western governments and nongovernmental organizations that come proposing solutions without having identified the causes of problems, to a culture that does not value reading. He is bookish himself; during our 40-minute-plus interview, he refers to Kierkegaard, Karen Armstrong’s A History of God, and What Price Tolerance, a 1939 book by his wife’s relative Syud Hossain.
