Politics & Policy

Doc Jihad, Part II

An old connection.

Terrorist doctors? There’s nothing unusual here, I’m sorry to say. On the contrary, in the universe of Islamist radicalism, professional terrorists — who are also professionals — are the oldest story in the book. Consider this: A study of 172 al Qaeda members and associates found that two-thirds had gone to college. Most of them were professionals. Another study of five major anti-Western attacks by Islamists found that 54 percent of the terrorists had attended college (compared to 52 percent of Americans who have done so). A study of 300 militants prosecuted for the assassination of Egyptian President Anwar Sadat found that, of those who were students, around a third were studying in Egypt’s elite faculties of medicine and engineering.

These facts and more are laid out in “A Matter of Pride,” a thoughtful article by Peter Bergen and Michael Lind. Bergen and Lind do an excellent job of puncturing “the myth of deprivation” — the notion that poverty causes terrorism. Certainly Bergen and Lind allow us to conclude that the British terror doctors are not anomalies. Unfortunately, Bergen and Lind go on to make some less-than-convincing suggestions about what actually does cause Islamist terror — and how to go about stopping it. Tracing down the sources of Islamist terror is the key to solving some of America’s most urgent policy dilemmas. So here, in Part II of “Doc Jihad,” I’ll continue to explore the strikingly significant role played by medical doctors in the spread of political Islam, in light of which we can return to the important issues of theory and policy raised by Bergen and Lind.

Under-Employed

In Part I, we learned that Egypt’s massive expansion of higher education under Presidents Nasser and Sadat produced unexpected results. Instead of taking a nation of pious traditional villagers and turning them into secular modern technocrats, college students fresh from Egypt’s villages were turning the nation’s secular professions into Islamist bastions. Far from eliminating the traditional system of honor and shame, the mass education of women had actually brought back the veil as a traditionalist strategy for coping with coeducation. And instead of churning out a new democratic elite, Egyptian higher education’s authoritarian methods were simply reproducing traditional cultural modes.

Yet something else intervened to tip the balance against liberal modernity and in favor of Islamism. There was more at work than village traditionalism and authoritarian education. Egypt’s economic troubles played a critical role as well. This is the kernel of truth in economic explanations of Islamist radicalism. Egypt’s huge new generation of doctors, lawyers, and engineers may not have been poor, but after years of study and sacrifice they were seriously underemployed. The emergence of Islamism is less a tale of abject poverty than a classic case of social revolution fomented by rising expectations.

Nasser’s rash promise of a government job for every graduate was never fulfilled. By the mid-1980s the waiting list for public-sector jobs was up to eight years long. And without a job, Egypt’s socially traditional graduates were forced to remain unmarried celibates, living alone, or under the authority of their parents for years. Many of those professionals who did have jobs made barely more than manual laborers. In fact, some had to give up their profession and become manual laborers just to make ends meet. These young doctors, lawyers, and engineers couldn’t help but wonder why they and their families had sacrificed for so long.

A massive make-work bureaucracy couldn’t generate the sort of economic growth that would employ Egypt’s huge new cohort of professionals. Paralyzed by a bloated and corrupt government, the Egyptian economy was stuck in recession — at the very moment the new professional class was pouring into the job market.

For a time, in the 1980s, migration to the oil-rich Gulf states provided a solution. A newly minted Egyptian physician could find work in Saudi Arabia, just as Middle Eastern doctors find work today in Britain, Canada, Australia, and the United States. Remittances sent back from the Gulf by migrants in the 1980s effectively propped up the Egyptian economy. In the meantime, Egyptians were exposed to the austere form of Islam which seemed to many to account for Saudi Arabia’s prosperity. God appeared to have blessed the pious Wahabbis, but to have turned his back on an impoverished, secular Egypt. The need to toil in a foreign land for years, just to save up enough money to finance a respectable wedding and start a household, was galling. What was wrong with Egypt, the public asked, that its sons could succeed only by leaving? When the Gulf job-boom ended in the 1990′s and the migrants headed back to a still-stagnant economy, the failure of the Egyptian system seemed obvious. Was Islam the solution?

Parallel Government

Egypt may not have been a democracy, but at least the government had been able to dole out goodies to the public — the massive university expansion had once stood as proof of that. Yet an Egypt in recession, weighed down by a bloated and corrupt bureaucracy, could provide neither jobs nor services. So the new Islamist groups stepped in to fill the gap. To call the Muslim Brotherhood’s student and professional associations “unions” doesn’t quite do justice to what they became. In truth, the Muslim Brotherhood (quite possibly backed by Saudi money), began to construct a kind of state within a state.

Once again, doctors led the way. The Muslim Brotherhood gained power in the physicians association in the 1980′s, just as the cost of medical care was skyrocketing. With young doctors underemployed and financially strapped, the association offered a health-care plan to union members and their families. Soon other professional associations followed suit, always under the direction of Islamists. Eventually, Brotherhood-led professional associations expanded these services to cover marriage funds, maternity benefits, consumer purchases, housing, business training, insurance, pensions, even vacation packages.

When a massive earthquake hit Cairo in 1992, the Medical Association arrived on scene long before the government, providing food, blankets, and medical care — compliments of the Muslim Brotherhood. Fearing that the professional associations had succeeded in forming a state within a state, President Mubarak cracked down on the Brotherhood, which had nonetheless firmly established itself by then as what it remains today — the only organization capable of posing a genuine challenge to the government.

So it was the provision of services — the virtual creation of a parallel government — that expanded the appeal of the Muslim Brotherhood to the broader membership of the professional associations, thereby facilitating the Islamist takeover. Given Egypt’s strapped economy, even pooling the financial resources of the most well-off professionals (perhaps with some Saudi help) couldn’t fundamentally reverse the economic condition of the downwardly mobile professional middle class. Nevertheless, the Muslim Brotherhood was visibly doing more than the government. Egypt’s corrupt bureaucrats could barely manage the state’s social services without looting them. The Islamists, on the other hand, were honest. In recent years, this pattern has been repeated throughout the Middle East. From the religious parties in Turkey, to Hezbollah in Lebanon, and Hamas in Gaza, Islamist parties win hearts and minds by providing honestly managed social services, where corrupt governments cannot.

Of course, the Muslim Brotherhood and other Islamist organizations are anything but liberal. Having taken over the Medical Association, the Brotherhood forced union members to sign a pledge to be pious Muslims (by the Brotherhood’s Islamist standards, of course). Farag Foda, a prominent Egyptian secular liberal, objected, arguing that the association must belong to all Egyptian doctors, not just Muslims. For this and other such offenses, Foda was killed by Islamic militants (although not by the Muslim Brotherhood as such, which had formally renounced violence).

A Different Modernity

Despite its stunning success with doctors, engineers, scientists, and to a lesser extent, lawyers, Egypt’s Muslim Brotherhood has had trouble breaking through to the less prestigious unions of veterinarians, teachers, and agricultural workers. These groups are all state employees, and can ill-afford to antagonize the government by throwing in their lot with the Brotherhood. Lawyers, as we’ve seen, are more likely to be liberal, given their education in, and professional devotion to, the rule of law. Egypt’s doctors, on the other hand, are relatively independent of the state, yet also largely bereft of liberal leaning and accustomed to traditional Muslim mores.

In a sense, when it comes to Egypt’s physicians, private enterprise and the modernization paradigm have had some real success. There is unquestionably something modern about the new Islamist ethos. A traditional Egyptian peasant doesn’t much concern himself with either social reform or political participation. True to the classic modernization paradigm, educated Islamist professionals have attained a sense of civic obligation, and a conviction that they are capable of bringing about morally informed social change. Yet the ongoing power of tradition, the failure of liberal mores to penetrate the educational system, and the corruption and weakness endemic to Middle Eastern economies and bureaucracies, have combined to produce a hybrid. Here is the self-confidence and transformative social power of a conventional modernizing middle-class — yet all under the direction of an ideology descended from Sayyid Qutb.

Sovereign at Last

And now, for the first time, the Muslim Brotherhood has gained sovereignty over a piece of territory. Hamas, an armed annex of the Muslim Brotherhood, now controls Gaza. Hamas was founded in 1987 — by a doctor, and a pharmacist who first encountered the Brotherhood while studying in Cairo. Along with al Qaeda’s Ayman al Zawahari — the most famous member of the Muslim Brotherhood to turn terrorist — the founders of Hamas are some of the original doctors of terror. With the Muslim Brotherhood now governing territory next to Egypt, Mubarak is deeply worried. So as happened following the ‘92 earthquake, Mubarak has recently cracked down on the Brotherhood, jailing hundreds of its doctors, businessmen, and engineers.

Today, the high quality Islamist-run medical clinics long popular in Cairo have spread throughout the Middle East. There’s even an Islamist-run medical clinic in the Sunni-dominated Western part of Baghdad. It would be interesting to know if the Baghdadi doctor at the center of the British terror plot might have had contacts there before he migrated. According to the German magazine Spiegel, the average member of the Muslim Brotherhood is a middle class doctor, pharmacist, teacher, or lawyer “filled with rage…over what he sees as the close cooperation between his government and the hopelessly corrupted West.” Sounds like the rage-filled terror doctors of Britain have plenty of company.

To what degree Briton’s terror doctors were radicalized in their home countries, and to what degree they radicalized after migration is unclear. Some of the British terrorists may have imbibed middle class Islamism early on, and some may have been driven to radicalism by Qutb-like disaffection with their “hopelessly corrupted” Western environment. The point is that the Islamist doctor is a well-established phenomenon — one that has everything to do with rising radicalism in the Islamic world.

Islamist Democracy?

So what are we to make of all this? What does the story of Islamism’s medical radicals tell us about terrorism’s causes and cures? After disposing of the “deprivation myth,” Bergen and Lind point to two key causes of Islamist terror. First, they argue that terrorist movements emerge from a feeling of collective humiliation — especially the humiliation of military occupation, as in Iraq and the Palestinian territories. Bergen and Lind go on to suggest that terrorism is an outlet for grievances in politically closed societies, like Egypt and Saudi Arabia. On Bergen and Lind’s analysis, the obvious solution to the problem of Islamist terror would be an American withdrawal from Iraq, Israeli withdrawal from the Palestinian territories, and American support of democratic participation by the Muslim Brotherhood in Egypt.

If this program strikes you as unlikely to be put into practice, it shouldn’t. An early American exist from Iraq grows more likely every day. Israel has already withdrawn from Gaza, thereby opening the way for the triumph of Hamas (a military arm of the Muslim Brotherhood). And in addition to Bergen and Lind (who wrote for a Democratic policy journal), the centrist Democrat, Progressive Policy Institute, recently released a paper urging engagement with Egypt’s Muslim Brotherhood as a solution to the problem of Islamist terror. A recent article in Foreign Affairs calls for engagement with the “moderate” Muslim Brotherhood, in an effort to moderate them further, thereby isolating al Qaeda from more “mainstream” forms of Islamism. Call this new policy wave Dinesh D’Souza’s revenge.

By these indications, should the Democrats gain the presidency, an attempt to open Egyptian democracy to a supposedly “moderate” Muslim Brotherhood could become an even more serious policy option than it’s been under President Bush. The Bush administration has apparently had second thoughts about democracy promotion — certainly when it comes to the likes of the Muslim Brotherhood — and hasn’t bothered to protest Mubarak’s recent crackdown. Surprisingly, however, there is now a stream of policy thought among Democrats (and certainly some Republicans as well) that may take the Bush democratization strategy to a whole new level — intentionally cultivating and empowering Egypt’s powerful Muslim Brotherhood, in hopes of somehow isolating radical terrorists.

System Failure

It would be a mistake to attempt to draw the Muslim Brotherhood into supposed moderation by licencing what would effectively be illiberal democracies in the Middle East. A faulty account of the sources of Islamist terror lies at the root of this policy error. Bergen and Lind’s notion that collective humiliation is the chief source of terror has already been ably critiqued.

If humiliation stimulates terrorism, we still need to know why some societies feel humiliation more acutely than others. Bergen and Lind don’t come close to uncovering the underlying sources of Islamism’s famously acute sense of humiliation.

The well springs of terror run deeper than military occupation — or the democratic exclusion of Islamist organizations (groups that were never truly democratic to begin with). That is what our survey of middle-class Islamist professionals reveals. For example, although poverty per se does not cause terror, powerful economic forces have facilitated the rise of Islamist radicalism, and these economic forces flow from still more fundamental social and cultural roots.

A critical generator of Islamist humiliation is the economic and social stagnation of Middle Eastern societies. Islamist complaints about Western imperialism are a relatively safe way to point to the real source of humiliation — the weakness of Middle Eastern societies themselves. Countries characterized by corrupt, factionalized, and bureaucratically top-heavy governments do not inspire pride.

These governments are incapable of operating according to modern principles of individual rights, equal justice, bureaucratic neutrality, or rule of law, because their broader publics have never truly encountered, much less embraced, any of these ideas. Middle Eastern society itself is structured according to principles alien to modern liberalism, one of which happens to be an honor-shame dynamic that acutely accentuates feelings of humiliation. A society constructed around tightly woven, mutually suspicious, in-marrying kin groups feeds corruption and leaves Islam as the only non-kin based justification for altruistic cooperation. The result is “hopelessly corrupted” governments, and an emerging Islamist welfare state that transcends local rivalries by accentuating a sense of collective Muslim dishonor (i.e. “humiliation”) vis-a-vis the West. (For more on the way this pattern plays out in Egypt, see my 2002 piece, “With Eyes Wide Open.” And for more on the tensions between modernity and traditional Muslim kinship practices, see “Marriage and the Terror War” Part I and Part II.)

There are no quick or simple solutions to these problems. The actual social causes of Islamist terror are interlocking and systemic. No mere Western political response will, by itself, solve the problem, because no Western policy has truly caused it. As brittle Middle Eastern governments rattle, while nervously glancing at possible Islamist takeovers (see Pakistan), the West is headed for a long-term struggle — much like Israel’s long-term battle, but this time played out on a world-wide scale.

There are things we can do. In the short term, military action will sometimes (by no means always) be necessary. In the long term, I think Europe provides the most opportune theater in which to begin a slow social transformation of the Islamic world — breaking up the old social networks and injecting a liberal spirit. Right now, globalization works against us in Europe. But change Muslim society there, and the positive shift could bounce back to the Middle East.

One thing we can say right now is that appeasing Islamists by precipitous retreat, or handing groups like the Muslim Brotherhood the keys to a bogus “democratic” takeover is a bad idea. Over the very long term, genuinely liberal democracy may see the light of day in the Middle East. Yet that will be a late-stage outcome of a longer and deeper process of social transformation. Premature (and therefore illiberal) Islamist democracy is not the solution.

And the doctors of terror? Let them stand as a reminder of the profundity of our challenge. It turns out that mere wealth and scientific knowledge are not the most important things about modernity. In the end, it’s liberal democracy that makes us who we are. Yet it will take years of slow and deep social and cultural transformation before the Middle East is ready for that. In the meantime, recognition of the deep-lying nature of the problem should stiffen our spines and warn us away from fantasies of retreat. Who knew that such strong and bitter medicine would best be delivered by doctors?

Stanley Kurtz is a senior fellow at the Ethics and Public Policy Center.

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