All posts by L.L. Wynn

Viagra soup: a photo essay

In an earlier post, I wondered: Why are there a dozen local brands of sildenafil (the generic name for what’s in Viagra) available in Egyptian pharmacies, and only one brand of emergency contraceptive pill (ECP)? I’m not sure that I have a wholly convincing answer to this question, but I’ll lay out some parts of the puzzle. Jump in with a comment if you have other ideas.

Some Egyptian brands of sildenafil: Viagra, Virecta, Erec, Kemagra, Vigorama, Phragra, and Vigorex

Local brands of sildenafil available in Egypt, including: Viagra, Virecta, Erec, Kemagra, Vigorama, Vigoran, Phragra, and Vigorex. Photo by Lisa Wynn

First, Americans might think of erectile dysfunction drugs (EDDs) as somewhat shameful (think about mocking attitudes towards Bob Dole’s decision to do Viagra ads), but they have a more positive connotation in Egypt. Two reasons:

  1. As I’ve written elsewhere, in Egypt these drugs seem to be associated as much with the promise of exuberant, excessive sexuality rather than a shameful lack of erection. Maybe it would be more accurate to call them erection enhancement drugs rather than erectile dysfunction drugs. Continue reading →

Why is there no official EC fatwa in Egypt?

Now in the last post on the topic, I mentioned that EC website that Princeton runs, http://ec.princeton.edu. There’s an NGO in Cambridge, MA called Ibis Reproductive Health that got a grant to make EC information and educational materials available in Arabic. A significant chunk of that grant was dedicated to creating an Arabic language version of the EC website. At Ibis, Angel Foster led this project and I took on the job of putting up the Arabic text that she created (with translator Aida Rouhana) online.

These days it’s not that hard to do websites in Arabic, but six years ago, it was a real puzzle. I couldn’t find any Arabic language plug-ins for DreamWeaver or FrontPage, so as I cut and pasted the Arabic text into the HTML programs, it wouldn’t display the Arabic properly, so it was really hard to do the links on specific words. The Arabic phrase for emergency contraception, which looks like this in Arabic:

منع الحمل الطارئ

looks like this in HTML code:

منع الحمل الطارئ

So I just had to muck around, highlighting different phrases, counting off letters or doing searches for strings of HTML code like that above, putting in links and then seeing where the links showed up in the Arabic texts, and then shifting the links around accordingly. It was a stupidly slow process. There was probably a better way to do it, but I wasn’t able to figure it out, so I slogged through the slow way.

Translation vs adaptation
I’m getting off the topic. Angel had decided that we couldn’t simply translate the existing website into Arabic. It had to be adapted to fit the social and cultural context of the Arabic speaking world and meet users’ needs. So, for example, she decided to include specific questions in the FAQs section on the interpretation and acceptability of EC in Orthodox Christianity and in Islamic jurisprudence. We hunted around for any fatwas on EC, both in published compendia of fatawa as well as in online databases, but we couldn’t find any. In fact, in the past 5 years, I have only found 1 fatwa on EC in an one of the many online fatwa databases.

That’s where interest in this Egypt research project came from. What did it mean that there were no fatwas on EC? Either it meant that EC wasn’t on anyone’s radar screen and was so totally unknown that nobody was asking about its status in Islam – hard to believe since there were dedicated products available in several Middle Eastern countries (including Yemen, Egypt, Tunisia, and Lebanon) – OR it meant that EC was just wholly uncontroversial and subsumed under jurisprudential discussions about pre-coital hormonal contraceptives. Continue reading →

Why is emergency contraception interesting to think with?

[UPDATE: Formatting issues preventing this article from displaying properly have been fixed! – Ed.]

I promised that the next post would be about emergency contraception in Egypt, but I couldn’t resist first writing about EC more generally and describing debates about EC in the U.S.

From rape treatment to mainstream contraception

For more than four decades, medical researchers have known that there are methods you can use after sex to prevent – not terminate – pregnancy. Emergency contraception (EC) was first researched in the 1960s by physician-researchers trying to find a way to prevent pregnancies in survivors of sexual assault. They experimented in giving rape survivors high doses of regular oral contraceptive pills (OCPs). Later it was established that inserting a copper-bearing IUD after sex was even more effective at reducing pregnancy risk.

Remember that this was during the pre-Roe v. Wade era so there were political reasons for looking for a way of preventing pregnancy, rather than expecting to be able to resort to abortion, for women who got pregnant after sexual assault. But of course there are also enduring religious and public health reasons for wanting to find ways to prevent pregnancy, rather than end it with abortion.

Increasingly, knowledge about this contraceptive technique filtered out to a wider public and in the 1970s through the 1990s, there was an underground movement of women and doctors spreading the word about do-it-yourself emergency contraception. You just take several pills from a regular pack of birth control pills within 5 days after sex.

(There’s a website run by Princeton University’s Office of Population Research that tells you exactly how many pills to take depending on what brand of Pill you’ve got, and as far as I can tell, this website was actually the first health information website on the Internet.)

Even though this form of contraception has been known for decades, it’s only in the past ten years or so that emergency contraceptive pills (ECPs) have become more widely known and marketed as a contraceptive option for all women, not just rape survivors. There’s been a global movement to introduce “dedicated products” worldwide and to lobby for them to be made available without prescription. (A “dedicated product” is when emergency contraceptive pills are packaged and marketed specifically for that purpose. Activists have long argued that this is an important improvement on the DIY culture of cutting up packets of pills because it increases awareness of EC and lends the method popular legitimacy.)

Continue reading →

New Reproductive Health Technologies in Egypt

Thanks to Kerim and Savage Minds for inviting me to contribute. I thought I’d write something about a new research project I’ve recently started on new and emerging reproductive health technologies in Egypt. This project looks at Egyptian interpretations of four technologies: emergency contraception, medication abortion, hymenoplasty, and erectile dysfunction drugs.

Some interesting paradoxes to contemplate:

  • Why are there at least a dozen local brands of sildenafil available from Egyptian pharmacies, and “Viagra sandwiches” or “Viagra soup” is on the menu at almost every restaurant that specializes in seafood, but there is only one brand of emergency contraceptive pill in Egypt, which is sold by an NGO because it’s not considered commercially viable enough for the mainstream pharmaceutical companies to bother with it?

The tap in the bathroom of the apartment where I stay when I’m doing research in Egypt. My roommate and I have often wondered where these came from. Was it a marketing campaign by Pfizer during the era when they weren’t allowed to engage in direct-to-consumer advertising for their product? Or did some sink manufacturer just think it would be cool to put Viagra on the handles?

Continue reading →