A protester holds a Q sign as he waits to enter a campaign rally with then-President Donald Trump in Wilkes-Barre, Pa., in August 2018. AP Photo/Matt Rourke Conspiracy theories have been around for centuries, from witch trials and antisemitic campaigns to beliefs that Freemasons were trying to topple European monarchies. In the mid-20th century, historian… Continue reading Buying into conspiracy theories can be exciting – that’s what makes them dangerous
This summer, millions of marshmallows will be toasted over fires across America. Many will be used as an ingredient in the quintessential summer snack: the s’more. Eating gooey marshmallows and warm chocolate sandwiched between two graham crackers may feel like a primeval tradition. But every part of the process – including the coat hanger we… Continue reading A brief history of the s’more, America’s favorite campfire snack
This year, an estimated 1 million people will perform the hajj, which is considered one of the five pillars in Islam. Under the lottery, only 50,000 permits were allowed from these 50 countries, compared with 25,000 for U.K. Muslims alone in previous years.
In the past, too, the commercial, technological and secular aspects of the hajj have been a topic of much debate about whether they change the spiritual nature of the pilgrimage. As a scholar of pilgrimage, ritual and Islam, I know that the focus on commerce and profits has been part of the long history of the hajj.
Early roots of trade and commerce
Across religious traditions, pilgrimages have always had a commercial component. From pilgrimage caravans and markets that grow around religious sites to the gifting of relics and souvenirs, religion and commerce have been deeply linked.
The hajj is no different. As F.E. Peters, an eminent scholar of Islamic studies, noted in his 1994 significant study on the hajj, the Quran itself acknowledges that Muslims were permitted to indulge in commerce around the pilgrimage: Verse 2:198 in the Quran says, “There is no blame on you for seeking the bounty of your Lord during this journey.” Quranic commentaries have explained this verse to mean that Islam allows commercial activity before and after the days of hajj rituals.
As Islam spread, so did the commerce. While the narrow set of ritual acts of hajj remained, the total pilgrimage experience was shaped by business. For centuries, major overland caravan routes traveled through Damascus, Cairo and Baghdad, with merchants attaching themselves to these caravans.
Traders targeted the pilgrims as consumers, and many pilgrims themselves engaged in trade to pay their way. As traveling overland for the hajj journey could take up to two years, pilgrims traded fruits, wines, silk, carpets and other items. They purchased goods such as coffee and pearls for their return journey.
A changing world, a changing hajj
The evolution of technology and means of travel inevitably brought new economic considerations into the organization of the hajj. The invention of the steamship was central to the development of mass pilgrimage to Mecca in the 19th century – the total number of pilgrims per year rose from an estimated 112,000 participants in 1831 to some 300,000 in 1910.
European liner companies controlled major pilgrim sea routes, linking hajj to imperial business opportunities. In 1886, the British government called in the famed Thomas Cook & Son, the original package holiday entrepreneurs, to become official travel agents of the hajj.
The use of a for-profit tourism company to regulate the hajj may have seemed a new development, but agents and intermediaries had been central to the process for centuries. The “mutawwifin,” the hereditary guilds of pilgrimage guides, provided pilgrims with guidance in carrying out the rituals of the hajj and were central to Mecca’s government and its economy.
Over the centuries, these local guides would develop contacts in foreign lands, encouraging Muslims to perform the pilgrimage. In addition to linguistic and ritual guidance, the mutawwifin would also arrange meals, lodgings and tents – acting in ways that were similar to modern-day tour operators.
The modern era
The steamship was just one technological innovation that altered the hajj landscape into a more commercial venture. At the turn of the 20th century, Sultan Abdul Hamid II of the Ottoman Empire was an adamant promoter of the construction of the Hejaz Railway, meant to establish a connection between Istanbul, the capital of the Ottoman Empire, and the holy cities of Mecca and Medina.
The establishment of the Kingdom of Saudi Arabia in 1932 and the eventual replacement of shipping and rail with air transport transformed the nature of the hajj further. The new Saudi state adhered to the doctrine of Wahhabism, an Islamic reform movement originating in the 1700s that rejected all forms of innovations outside of the Quran and the traditions of the Prophet Muhammad in his time.
Yet despite this condemnation of innovation, the Saudi government has overseen decades of commercial development of the hajj, encouraging the tourism atmosphere and deriving significant profits from the obligatory pilgrimage.
Commerce or politics?
Muslim pilgrims pray on a rocky hill called the Mountain of Mercy near the holy city of Mecca, Saudi Arabia, in 2013.AP Photo/Amr Nabil
While the hajj has historically been linked to commerce, pilgrims of late have expressed dissatisfaction with the overt emphasis on the touristic experience and the sense that it is now diminishing the spiritual nature of the pilgrimage.
Indeed, commercial revenues from the hajj remain a contested and even a political topic. In 2018, Yusuf al Qaradawi, a prominent Muslim Brotherhood cleric based in Qatar, issued a fatwa calling for limiting spending on pilgrimage. “Seeing Muslims feeding the hungry, treating the sick and sheltering the homeless are better viewed by Allah than spending money on the hajj and umrah every year,” he declared. This statement was viewed as an attempt to undermine Saudi Arabia by discouraging Muslims from performing the pilgrimage, as the revenues go to the government.
Al Qaradawi’s fatwa drew ire from certain circles, as all Muslims who are financially and physically capable must attempt to complete the hajj, regardless of any geopolitical sentiment toward Saudi Arabia. Yet there is no doubt that the current hajj has refocused attention on whether the business of hajj remains in line with the original allowance to “seek bounty” during the pilgrimage to Islam’s holiest sites.
Noorzehra Zaidi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Heat waves are becoming supercharged as the climate changes – lasting longer, becoming more frequent and getting just plain hotter. One question a lot of people are asking is: “When will it get too hot for normal daily activity as we know it, even for young, healthy adults?”
The answer goes beyond the temperature you see on the thermometer. It’s also about humidity. Ourresearch shows the combination of the two can get dangerous faster than scientists previously believed.
Scientists and other observers have become alarmed about the increasing frequency of extreme heat paired with high humidity, measured as “wet-bulb temperature.” During the heat wave that overtook South Asia in May 2022, Jacobabad, Pakistan, recorded a maximum wet-bulb temperature of 33.6 C (92.5 F) – just below the theorized upper limit of human adaptability to humid heat.
People often point to a study published in 2010 that estimated that a wet-bulb temperature of 35 C – equal to 95 F at 100% humidity, or 115 F at 50% humidity – would be the upper limit of safety, beyond which the human body can no longer cool itself by evaporating sweat from the surface of the body to maintain a stable body core temperature.
It was not until recently that this limit was tested on humans in laboratory settings. The results of these tests show an even greater cause for concern.
The PSU H.E.A.T. Project
To answer the question of “how hot is too hot?” we brought young, healthy men and women into the Noll Laboratory at Penn State University to experience heat stress in a controlled environment.
These experiments provide insight into which combinations of temperature and humidity begin to become harmful for even the healthiest humans.
Each participant swallowed a small telemetry pill, which monitored their deep body or core temperature. They then sat in an environmental chamber, moving just enough to simulate the minimal activities of daily living, such as cooking and eating. Researchers slowly increased either the temperature in the chamber or the humidity and monitored when the subject’s core temperature started to rise.
That combination of temperature and humidity whereby the person’s core temperature starts to rise is called the “critical environmental limit.” Below those limits, the body is able to maintain a relatively stable core temperature over time. Above those limits, core temperature rises continuously and risk of heat-related illnesses with prolonged exposures is increased.
When the body overheats, the heart has to work harder to pump blood flow to the skin to dissipate the heat, and when you’re also sweating, that decreases body fluids. In the direst case, prolonged exposure can result in heat stroke, a life-threatening problem that requires immediate and rapid cooling and medical treatment.
Our studies on young healthy men and women show that this upper environmental limit is even lower than the theorized 35 C. It’s more like a wet-bulb temperature of 31 C (88 F). That would equal 31 C at 100% humidity or 38 C (100 F) at 60% humidity.
Similar to the National Weather Service’s heat index chart, this chart translates combinations of air temperature and relative humidity into critical environmental limits, above which core body temperature rises. The border between the yellow and red areas represents the average critical environmental limit for young men and women at minimal activity.W. Larry Kenney, CC BY-ND
Dry vs. humid environments
Current heat waves around the globe are approaching, if not exceeding, these limits.
In hot, dry environments the critical environmental limits aren’t defined by wet-bulb temperatures, because almost all the sweat the body produces evaporates, which cools the body. However, the amount humans can sweat is limited, and we also gain more heat from the higher air temperatures.
Keep in mind that these cutoffs are based solely on keeping your body temperature from rising excessively. Even lower temperatures and humidity can place stress on the heart and other body systems. And while eclipsing these limits does not necessarily present a worst-case scenario, prolonged exposure may become dire for vulnerable populations such as the elderly and those with chronic diseases.
Our experimental focus has now turned to testing older men and women, since even healthy aging makes people less heat tolerant. Adding on the increased prevalence of heart disease, respiratory problems and other health problems, as well as certain medications, can put them at even higher risk of harm. People over the age of 65 comprise some 80%-90% of heat wave casualties.
How to stay safe
Staying well hydrated and seeking areas in which to cool down – even for short periods – are important in high heat.
While more cities in the United States are expanding cooling centers to help people escape the heat, there will still be many people who will experience these dangerous conditions with no way to cool themselves.
The lead author of this article, W. Larry Kenney, discusses the impact of heat stress on human health with PBS NewsHour.
Even those with access to air conditioning might not turn it on because of the high cost of energy – a common occurrence in Phoenix, Arizona – or because of large-scale power outages during heat waves or wildfires, as is becoming more common in the western U.S.
A recent study focusing on heat stress in Africa found that future climates will not be conducive to the use of even low-cost cooling systems such as “swamp coolers” as the tropical and coastal parts of Africa become more humid. These devices, which require far less energy than air conditioners, use a fan to recirculate the air across a cool, wet pad to lower the air temperature, but they become ineffective at high wet-bulb temperatures above 21 C (70 F).
All told, the evidence continues to mount that climate change is not just a problem for the future. It is one that humanity is currently facing and must tackle head-on.
But for Alito, the 19th century looks like the true golden age: “In 1803, the British Parliament made abortion a crime at all stages of pregnancy and authorized the imposition of severe punishment.”
He goes on and on: “In this country during the 19th century, the vast majority of the States enacted statutes criminalizing abortion at all stages of pregnancy.”
“By 1868, the year when the Fourteenth Amendment was ratified,” Alito concludes, “three-quarters of the States, 28 out of 37, had enacted statutes making abortion a crime.”
But in his rather selective forays into history, Alito doesn’t ask what to me, as a historian, constitutes a set of fundamental questions: Why was abortion eventually criminalized during that time? What was the broad cultural and intellectual context of that period? And, more important, is there something peculiar about the 19th century?
As far as women’s bodies and abortion are concerned, the 19th century saw a decrease in the trust in, and power of, women themselves.
William Buchan’s book ‘Domestic Medicine,’ first published in 1769 and found in many American homes, contained instructions for an abortion.National Library of Medicine
As a medical procedure, abortion was widespread in Colonial and 18th-century America. By using more or less safe techniques, midwives and medical practitioners performed many types of operations on their patients. The woman could easily die, of course; but when she sought an abortion, no social, legal or religious force would have blocked her.
Also, a woman could choose from many available remedies rather than have an operation. Derived from juniper bushes, “savin,” or Juniperus sabina, was one of the most popular abortifacients. Other herbs and concoctions were similarly taken: pennyroyal, tansy, ergot, Seneca snakeroot or cotton root bark.
The truth is that America’s founders, together with their contemporaries, had a rather democratic understanding of the female body. They believed that women, physiologically speaking, weren’t qualitatively different from men; the two sexes were equal and complementary.
Men’s and women’s composition, medical doctors argued, was identical in essence – the only difference was anatomical, in that male sexual organs were more externally distended than female organs.
Just like the male, the female was thought of as fully in control of the workings of her physiology, including her sexuality. It was believed that both the man and the woman had to reach orgasm, better if simultaneously, for pregnancy to ensue.
This made 18th-century men attentive to the satisfaction of their female partners, though for utilitarian reasons.
Especially when sex was aimed at procreation, the woman had to be as active as the male partner. The 18th-century woman was active and in control. She trusted her bodily feelings, including her pleasures.
And crucially, only she could detect whether quickening had taken place in her womb. Consequently, she could immediately tell whether terminating a pregnancy at a given time was acceptable. Or if it was a crime.
19th-century American abortionist Ann Trow Lohman, who performed abortions in New York City and was referred to by one anti-abortion advocate as ‘the monster in human shape.’Wikipedia
19th-century woman: Weak and chaste
The 19th century changed all that. The understanding of physiology and the mechanisms of the female body underwent a deep transformation. European and American doctors, now, saw women as essentially different from men: From a “one body” model, the medical discourse shifted toward a “two body” model.
Women’s level of self-determination decreased accordingly. Suddenly, they were not only weaker or softer than men, but inherently passive, too. Instead of being encouraged to take part in sex, actively and with vigor, 19th-century women were expected to be withdrawn.
They were thus recast as pure, chaste and modest. Commendable women were virgins, wives, mothers. Or else they were prostitutes, nearly criminals, which reflects the Victorian dualistic mindset. Instead of being urged to trust the quickening and other physiological events happening in her womb or her vagina, the honest woman had to trust her doctor.
Based on women’s own bodily sensations – not on medical diagnosis – quickening was denigrated. Quickening, of course, made doctors dependent on women’s self-diagnosis and judgment. Dr. Horatio R. Storer, the leader of the medical campaigns against abortion, described quickening as “in fact but a sensation.” In such a context, it could no longer be framed as the basis from where all moral, social and legal standards emerged.
In the Dobbs decision, Alito says: “The Court finds that the right to abortion is not deeply rooted in the Nation’s history and tradition.” This is a historical fact: Protection of the right to abortion wasn’t around in America before Roe.
But it is also an incomplete picture of the full story. The criminalization of abortion, plus the decentralization of the woman’s experience, plus the medicalization of her feelings that led to that decision, are facets that belong to the long-gone 19th century.
No American lives in that century any more - not even Justice Alito.
Maurizio Valsania does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
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string(13205) "The price physicians charge for every surgery, checkup or other procedure has a precise formula behind it. Morsa Images/DigitalVision via Getty Images
Modern medicine is remarkable.
Conditions like HIV/AIDS and hepatitis C were once virtual death sentences. Both can now be treated easily and effectively.
The biggest portion of that – hospital care, which makes up 31% of total spending – is now subject to transparency rules that are supposed to make it easier for patients to understand what their treatments cost. But so far hospitals’ compliance has been minimal.
Things are both more transparent and murkier when it comes to the second-biggest chunk of America’s annual medical bill: payments to physicians and for clinical services, which account for 20% of total health care spending, or $810 billion. How much a patient is charged for a hip replacement or a flu shot is the result of a highly technical process involving secretive committee meetings, doctor surveys and federal regulations.
A few decades ago, the federal government developed a seemingly scientific approach to solve these questions. As an expert on health care policy, I’ve learned that the formula is simple. But coming up with numbers for that formula is far more complex.
Physician free-for-all
For the longest time, the federal government tried its best to stay out of the examination room. By and large, medical care was a private endeavor, and physicians and other providers charged what they wanted – or what they thought patients could pay.
Then, in 1965, Congress established Medicare and Medicaid, which are federal programs that provide health insurance for the elderly and poor, respectively. Practically overnight, they turned the government into the largest spender on health care. That meant the Johnson administration had to figure out how to compensate physicians who had long been opposed to government involvement in health care and derided it as “socialized medicine.”
To minimize opposition, an agreement was forged that seemed innocuous enough: Physicians would be allowed to charge Medicare “customary, prevailing and reasonable fees,” and the federal government would not question them.
Yet the inflationary nature of this approach became quickly apparent as many physicians happily took the federal government up on this offer. Doctors often charged Medicare two to four times more than what they charged commercial insurers. The need for changes seemed inevitable.
A new payment system
It took another two decades to create a more evidence-based approach that relied less on a doctor’s discretion and aimed to rein in spending.
After a comprehensive study conducted by Harvard researchers and the American Medical Association, the federal government developed a framework that paid providers based on the resources and skills required for various treatments. The formula, which its creators dubbed the resource-based relative value scale, includes three steps to calculate how much money a physician could charge for a procedure.
First, you have the “relative value unit” for each procedure, which in turn is divided into three components. The main part is a physician’s actual labor. To determine that, the researchers used physician surveys as well as historical payment data to determine how much time, effort and skill each of thousands of medical procedures required. Higher values are assigned to more resource-intensive procedures, such as placing a catheter – 6.29 relative value units – and lower values to procedures requiring fewer, like administering a COVID-19 shot – a fifth of a unit.
The Centers for Medicare and Medicaid Services has an updated list of relative value units for every procedure imaginable, from an allergy skin test that requires puncturing the skin, which has one of the lowest values, at 0.01 unit, to the repair of a diaphragm hernia, which is the most expensive one listed, at 108.91 units.
The other two components are for general expenses, such as rent and medical equipment, and malpractice insurance. They are also determined by a similar process involving the cost of resources.
The next step involves adjusting these relative value units for local cost differences. The government developed three geographic cost indexes for each component. These figures are multiplied by their corresponding component to get a relative value unit total for that category. These are updated regularly by the Centers for Medicare and Medicaid Services. Some states have one set of indexes for all cities, while others such as California have several.
Finally, to obtain a dollar value for a medical procedure, the location-adjusted relative value units for each category are added together and multiplied by what is known as a conversion factor to get a dollar amount. The figure is the same across the country and is updated annually, with slight changes from year to year. For 2022, this was set at $34.61.
And voila: You have the prices you’ll pay for thousands of medical procedures.
To give you an example of how this all fits together, imagine you had a 20- to 29-minute appointment with your doctor, known as an outpatient visit. If you live in Alabama, your cost would be $86.90. The physician arrives at that figure by multiplying the relative value units for each component by their geographic index, then converting the sum of 2.51 units times the conversion factor of $34.61. That same visit would cost $118.36 in Alaska and $107.99 in San Francisco.
Problems with the process
While on the whole I believe the current system represents an important step toward developing a more evidence-based approach to physician payments, it’s not without its problems.
That means a handful of physicians are essentially deciding how the U.S. spends hundreds of billions of dollars annually. Besides potentially having their own personal and specialty interests to pursue, they may also lack the expertise and skills to judge the effectiveness or value of certain treatments over others. There is evidence that relative value units often do not adequately reflect the resources required for many procedures. And the overall process is highly opaque.
Last, the current approach mostly focuses on physician effort and not patient outcomes. This puts it in stark contrast to various efforts to implement pay-for-performance in health care.
Given the state of hyperpartisanship in Washington, D.C., and beyond, I believe it’s unlikely there’ll be any dramatic changes to the system any time soon. But incremental changes are possible and could make a meaningful difference – for example, by expanding the role of primary care physicians on the committee and by extending membership beyond physicians.
Simon F. Haeder does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
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string(14019) "Civil rights leader Martin Luther King Jr., left, and attorney Fred Gray, whom King called 'the brilliant young Negro who later became the chief counsel for the protest movement,' at a political rally in Tuskegee, Alabama, April 29, 1966.AP Photo/Jack Thornell
As a scholar of constitutional law and civil rights, I understand that Fred Gray hashad an enormous impact on American law and society. His cases are taught in every law school in the country, and his work has led to fundamental reforms in legal doctrine and helped to cement important changes in the lives of ordinary people all over the country.
I’m not the only person to recognize Gray’s enormous contributions: Martin Luther King Jr. called him “the brilliant young Negro who later became the chief counsel for the protest movement.” And on July 7, Gray will receive the Presidential Medal of Freedom, the highest civilian honor in the nation, from President Joe Biden.
At an October 2021 ceremony, the city of Montgomery, Alabama, changed the name of W. Jeff Davis Avenue – named after the Confederate leader – to Fred D. Gray Avenue; it was where Gray, right, listening to his wife, Carol, grew up.Julie Bennett/Getty Images
‘Destroy everything segregated’
Remarkably, Fred Gray did not plan on becoming a lawyer.
The youngest of five children, whose father died just after his second birthday in December 1932, he aimed for the ministry as one of the few professions open to Black men at the time. He attended a church-sponsored high school in Nashville and traveled around the country with the school’s president as a boy preacher.
But that ambition changed during his junior year at what was then called Alabama State College for Negroes – now Alabama State University. Fed up with degrading treatment on Montgomery’s segregated buses, Gray wrote in a memoir: “I concluded that in addition to being a minister and trying to save souls for eternity, that in the here and now African Americans were entitled to all the rights provided by the Constitution of the United States of America. Therefore, I decided I would become a lawyer.”
Rosa Parks, left, who was fined for violating the bus segregation law in Montgomery, Alabama, with E.D. Nixon, center, former Alabama state president of the NAACP, and attorney Fred Gray.AP Photos
He would go to law school, he wrote, “determined to destroy everything segregated that I could find.” And there were plenty of segregated things to destroy: rigid segregation of housing, education and jobs, and almost no Black people were allowed to vote anywhere in Alabama.
But fulfilling this ambition would be a real challenge. No law school in Alabama admitted Black students. Although he almost certainly could have won a lawsuit to force his admission to the University of Alabama, he realized that the authorities would find some excuse to prevent him from graduating or getting admitted to the bar.
So Gray enrolled at Case Western Reserve University in Cleveland, mainly because he could work part time while going to school. “In September of 1951, with barely enough money to cover expenses, I took a segregated train to Cleveland to begin law studies,” he wrote in his memoir.
After getting his law degree in 1954, he moved back home to Montgomery. Then he faced the daunting task of obtaining character references from five experienced local lawyers before he could sit for the Alabama bar exam. The problem was that there were fewer than five experienced Black lawyers in the state at the time. But several white lawyers – notably Clifford Durr, a leading New Deal attorney and brother-in-law of Supreme Court Justice Hugo Black – supported his application.
But no white lawyer would employ him, and there was only one other Black lawyer in Montgomery. So he rented a small office from a Black minister who served as an adviser and helped refer clients to him.
More important, he became active in the NAACP, where he got to know Rosa Parks and other leading civil rights activists. This made him the go-to lawyer for the movement and set him on the path of fulfilling his ambition to destroy segregation.
Protesting segregation from lunch counters to schools
From his base in Montgomery, Gray represented sit-in demonstrators arrested for protesting segregated lunch counters, and freedom riders, the demonstrators – white and Black – who rode buses throughout the South to protest segregation on buses and in terminals.
Fred Gray shows a diagram of a bus to help illustrate the ultimately successful case he brought on behalf of Black people in Montgomery, Alabama, to desegregate the city’s bus system, in February 1956.Photo by Don Cravens/Getty Images
Gray’s legal work desegregated state universities and public schools throughout Alabama. He filed the lawsuit that allowed the Selma-to-Montgomery march to proceed after the police violence against marchers on what became known as Bloody Sunday. That march led to the passage of the Voting Rights Act. Then, Gray won some of the most important early cases testing the law’s promise that Black people could no longer be disenfranchised.
Gray knew that his efforts would incur the wrath of the white power structure. And that wrath was not long in coming.
For example, state authorities in 1956, at the height of the bus protest, indicted him for stirring up civil rights lawsuits, which could have resulted in his law license’s being lifted. The charges were dismissed almost immediately because it was clear that the state had no case on the merits and lacked jurisdiction to prosecute him. Later that year, the local draft board tried to induct him into the Army. The national director of selective service, Gen. Lewis Hershey, squashed that gambit.
At age 91, Gray is still practicing law full time – while the U.S. still faces enormous challenges tackling systemic racism. That’s a point not lost on Gray even after a lifetime of success in fighting segregation.
In an interview he gave to USA Today in 2005 to mark the opening of a Smithsonian exhibit on the Montgomery bus boycott, Gray said, “My interest and my concern is not so much to … commemorate what happened 50 years ago but to look at where we are now. We have to realize racism is not going to go away by itself.”
I have known Fred Gray for nearly 40 years and have written extensively about his work and career.
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string(12786) "Research shows that short spacing between childbirth and another pregnancy comes with heightened health risks.Aleksandr Kirillov/EyeEm via Getty Images
Now that the U.S. Supreme Court has eliminated the constitutional right to an abortion, access to birth control has taken on new urgency. By moving the decision about abortion access to states, the fall of Roe v. Wade means that it will be even more important for people to be able to prevent an unwanted or mistimed pregnancy.
Given the health risks of having a rapid repeat pregnancy, avoiding pregnancy is especially critical for those who have recently given birth. But not all health care providers offer birth control to their patients.
Over the past two decades, the number of Catholic hospitals in the U.S. has risen dramatically. But it might come as a surprise to many people to learn that Catholic hospitals are not allowed to provide health care that is considered by their religious leaders to be “intrinsically immoral.”
The Catholic religion holds that sex should only occur within marriage and that while it should be performed for the good of the spouses, each act must be open to procreation. Because of this, the U.S. Conference of Catholic Bishops has published ethical and religious directives, last updated in 2018, that prohibit Catholic hospitals from providing birth control, abortion and infertility treatments. There are no exceptions, even if the care is needed to protect a person’s life or health.
As a result, many people who want birth control before they leave the hospital after childbirth may not receive it.
However, many people are not even aware that they are choosing a Catholic hospital when they decide where they will deliver. Others do not have an option or may not realize that where they give birth might affect the reproductive treatment options available to them.
As a result of hospital mergers and acquisitions, between 2001 and 2016 the number of Catholic acute care hospitals grew by 22%. Overall, about 17% of acute care hospital beds in the U.S. belong to Catholic hospitals.
Some people attend a Catholic hospital because they have limited choices. There are 46 Catholic hospitals in the U.S. that are the sole providers of short-term acute hospital care in their geographic area, including in Santa Fe, New Mexico; Grand Junction, Colorado; and Bellingham, Washington. Others might be limited in where their health insurance will cover their care.
Some people are not even aware that they are attending a Catholic hospital. A 2018 national survey asked adult women of reproductive age where they go for their reproductive care; 16% named a Catholic hospital. However, over one-third of the women who named a Catholic hospital did not know that their hospital was Catholic. Furthermore, those who were wrong about their hospital’s Catholic status described themselves as being “sure” or “very sure” about their incorrect response.
‘As U.S. hospitals are struggling, more and more are merging with Catholic institutions.’
In some cases, people might be unaware of their hospital’s status because its name does not sound religious. Also, people might not know that a Catholic network purchased their secular hospital and that their hospital is now required to follow its ethical and religious directives. A 2017-2018 review of hospital websites found that 21% of Catholic hospitals did not explicitly disclose their Catholic status on their website.
Even if people know that their hospital is Catholic, they might not know that attending a Catholic hospital could restrict the scope of care that they are able to receive. A large survey of women found that most did not expect restrictions on care at Catholic hospitals, especially for services viewed as less taboo than abortion. Respondents did not realize that Catholic hospitals are restricted in providing birth control, including female sterilization methods such as tubal ligation.
The need for birth control after childbirth
Using birth control after childbirth is critical, because people’s fertility returns quickly. Having at least 18 months of spacing between childbirth and a new pregnancy is important to protect the pregnant person and the infant’s health.
Short birth spacing increases the risks of adverse outcomes such as preeclampsia, preterm birth and health problems for the newborn infant. Because of the health risks, the U.S. Department of Health and Human Services recognized birth spacing as a high priority in the 2030 Healthy People Objectives.
For people who do not want to have more pregnancies, immediately after delivery can be the most convenient time to have a tubal ligation. For this reason, about half of all tubal ligations are performed after delivery. About 6.2% of deliveries in the U.S. are followed by a tubal ligation. Failing to receive a desired postpartum tubal ligation increases the risk of having a rapid repeat pregnancy.
A tubal ligation seals off the fallopian tubes, which carry eggs to a person’s womb, in order to prevent pregnancy.
Birth control use following delivery at Catholic hospitals
Our team decided to investigate whether women who recently delivered at a Catholic hospital were less likely to be using birth control during the postpartum period compared to women who delivered at a non-Catholic hospital.
Even if ethical and religious directives state that Catholic hospitals are not allowed to provide birth control, it is plausible that some hospitals might fail to enforce the rules or providers might find ways to work around them. For example, providers at Catholic hospitals might place an intrauterine device, or IUD, in a patient who desires one by justifying its use for noncontraceptive purposes. Or providers might perform an elective cesarean delivery in order to surreptitiously perform a tubal ligation.
My colleagues and I used survey data from the Pregnancy Risk Assessment Monitoring System from five states – Alaska, Illinois, Maine, Oregon and Wisconsin – over the period of 2015 to 2018. The Centers for Disease Control and Prevention and state health departments annually conduct this survey of women who gave birth in the last two to six months. We linked this survey data to birth certificates to know whether women had delivered at a Catholic or non-Catholic hospital.
Our study found that at two to six months postpartum, women who had delivered at a Catholic hospital were about half as likely to have had female sterilization as women who delivered at another type of hospital. This difference remained statistically significant after we adjusted for women’s age, race or ethnicity, education, insurance status and parity.
These studies illustrate the need for people to have access to the birth control method of their choice – a choice that is all the more important now that people have lost their constitutional right to an abortion.
_Editor’s note: This story has been updated to clarify the Catholic religion’s stance on the purpose of sex; it holds that sex should only occur within marriage and be performed for the good of the spouses, but that each act must be open to procreation.
_
This article is republished from The Conversation, a nonprofit news site dedicated to sharing ideas from academic experts.
Read more:
Maria Gallo receives funding from Relias Media for consultant work and grant funding from the National Institutes of Health and non-profit foundations for research.
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string(14937) "Supporters of Democratic presidential candidate Pete Buttigieg prepare to caucus for him in a high school gym, Feb. 3, 2020, in Des Moines, Iowa. Chip Somodevilla/Getty Images
The party needs to balance the legitimacy that comes with a process making it easy for average Democrats to insert their voices with the safety valve that lets savvy party insiders weigh in on the selection. All those pieces must produce a process long enough to ensure real competition, but not so long that internal party fences can’t be mended well in advance of the general election.
This time around, the Democratic National Committee is targeting that mix of states that will start the nomination process, hoping for something better than what’s been in place. It’s taken the unusual step of setting up a competition among state parties to help it set the 2024 calendar. Sixteen states and Puerto Rico just made their pitches to the national party to be among the first to hold contests, with a decision expected later this summer.
Going early matters because it gives Democrats in those states a larger voice in the nomination. Candidates flock to the early states, interacting with voters and sometimes tailoring their policy appeals to the needs unique to a state. The first contests don’t determine who will win, but they typically knock some candidates out of the running.
The two major U.S. parties are federal in nature, their organizational structures reflecting the array of elective offices for which they compete, from county sheriff to the president. Even so, the national party is well positioned to call the shots at the state level, shored up by a now decadesold Supreme Court decision establishing the national party’s superiority over state parties.
The national committee has kept control over the calendar for a long time, starting down that path when it overhauled nomination rules after the contentious 1968 Democratic national convention. The package of reforms, implemented first in 1972, sought to take presidential nominations out of the proverbial back room and make them more open, more democratic.
Before the 1972 reforms, delegate selection wasn’t always tied to outcomes in primaries and caucuses. According to nomination expert Elaine Kamarck, 25% of 1968’s presidential delegates were selected in 1967, well before what’s now considered the formal start of the nomination race.
From caucuses to primaries
Under the initial terms of the 1972 reforms, the national party didn’t limit how early in the election year a state could hold its nomination contest. That Iowa went first in 1972, though, was not so much a deliberate move for positioning as an unintentional byproduct of another national party rule.
The reformed system, in the interest of allowing time to publicize contests, required 30 days’ notice of delegate selection contests. That meant Iowa had to start early, since the state’s process involved a series of contests, not just the prominent precinct caucuses. But Iowa started even earlier than dictated by the new rules, essentially because of a fluke involving high demand on hotel rooms.
By 1980, Iowa had secured its role as the first caucus and New Hampshire was designated as the first primary. For that election cycle, the Democratic National Committee imposed a rule condensing nomination contests into a 13-week window, beginning in early March. But then-President Jimmy Carter, seeking reelection and with sway over his party, pushed for an exception for Iowa and New Hampshire, states that had jump-started his 1976 campaign and might serve as a firewall. The national committee ultimately granted the exception.
Back in the 1970s, the Democratic National Committee had no beef with caucuses, and more states held caucuses than primaries. They were seen as settings for deliberation and activist engagement.
But in 2022, caucuses are under fire for being exclusionary, and most states hold primaries. The switch from caucuses to primaries in the 1970s and 1980s was largely an unanticipated consequence of the initial reform, because complying with those new rules from 1972 was easier with primaries than caucuses. In 2020, the Democratic National Committee pushed states to expand the use of primaries, asserting that they are more inclusive, transparent and accessible than caucuses.
Caucuses and primaries aim to winnow down large fields of candidates. These 10 Democrats were only half of the field when this debate was held on June 26, 2019, in Miami.Joe Raedle/Getty Images
Losing sway
The irony is that in moving to a primary, a party relinquishes power.
This summer’s actions by the Democratic National Committee could shake up the 2024 calendar. Iowa’s at risk of losing its privileged position, but so far the committee hasn’t guaranteed any state an exception to the 13-week window. The committee says that up to five states will be able to hold contests before the window begins. The other three traditional early-goers, I believe, are positioned a little better than Iowa to nab one of the early slots.
There’s no reason to think that White House pressure would prevail as it has in the past, but if so, the “gut punch” Iowa delivered to then-candidate Biden in 2020 and his “resurrection” in South Carolina would likely carry weight in the deliberations.
Iowa Democrats submitted their proposal to the Democratic National Committee in early June 2022, describing a process that retains the caucus label yet complies with stated committee criteria of fairness, transparency and inclusivity. Notably, Iowa’s new plan provides for a period for participants to express presidential preferences before the actual caucuses, meaning there would be a way for voters to participate without attending the caucuses. This would make the process a little more inclusive.
A final decision on which states will be able to hold early contests is expected from the Democratic National Committee in early September.
Whatever the shape of the new calendar, it’s a safe bet that things won’t play out precisely as planned, given that unanticipated consequences have marked the party’s reform efforts in the past.
Barbara A. Trish does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
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string(14839) "A protester holds a Q sign as he waits to enter a campaign rally with then-President Donald Trump in Wilkes-Barre, Pa., in August 2018.AP Photo/Matt Rourke
But the “golden age” of conspiracy theories, it seems, is now. On June 24, 2022, the unknown leader of the QAnon conspiracy theory posted online for the first time in over a year. QAnon’s enthusiasts tend to be ardent supporters of Donald Trump, who made conspiracy theories a signature feature of his political brand, from Pizzagate and QAnon to “Stop the Steal” and the racist “birther” movement. Key themes in conspiracy theories – like a sinister network of “pedophiles” and “groomers,” shadowy “bankers” and “globalists” – have moved into the mainstream of right-wing talking points.
Much of the commentary on conspiracy theories presumes that followers simply have bad information, or not enough, and that they can be helped along with a better diet of facts.
But anyone who talks to conspiracy theorists knows that they’re never short on details, or at least “alternative facts.” They have plenty of information, but they insist that it be interpreted in a particular way – the way that feels most exciting.
My research focuses on how emotion drives human experience, including strong beliefs. In my latest book, I argue that confronting conspiracy theories requires understanding the feelings that make them so appealing – and the way those feelings shape what seems reasonable to devotees. If we want to understand why people believe what they believe, we need to look not just at the content of their thoughts, but how that information feels to them. Just as the “X-Files” predicted, conspiracy theories’ acolytes “want to believe.”
Over 100 years ago, the American psychologist William Jamesnoted: “The transition from a state of perplexity to one of resolve is full of lively pleasure and relief.” In other words, confusion doesn’t feel good, but certainty certainly does.
James called this the “sentiment of rationality”: the feelings that go along with thinking. People often talk about thinking and feeling as though they’re separate, but James realized that they’re inextricably related.
For instance, he believed that the best science was driven forward by the excitement of discovery – which he said was “caviar” for scientists – but also anxiety about getting things wrong.
So how does conspiracy theory feel? First of all, it lets you feel like you’re smarter than everyone. Political scientist Michael Barkun points out that conspiracy theory devotees love what he calls “stigmatized knowledge,” sources that are obscure or even looked down upon.
In fact, the more obscure the source is, the more true believers want to trust it. This is the stock in trade of popular podcast “The Joe Rogan Experience” – “scientists” who present themselves as the lone voice in the wilderness and are somehow seen as more credible because they’ve been repudiated by their colleagues. Ninety-eight percent of scientists may agree on something, but the conspiracy mindset imagines the other 2% are really on to something. This allows conspiracists to see themselves as “critical thinkers” who have separated themselves from the pack, rather than outliers who have fallen for a snake oil pitch.
One of the most exciting parts of a conspiracy theory is that it makes everything make sense. We all know the pleasure of solving a puzzle: the “click” of satisfaction when you complete a Wordle, crossword or sudoku. But of course, the whole point of games is that they simplify things. Detective shows are the same: All the clues are right there on the screen.
Powerful appeal
But what if the whole world were like that? In essence, that’s the illusion of conspiracy theory. All the answers are there, and everything fits with everything else. The big players are sinister and devious – but not as smart as you.
QAnon works like a massive live-action video game in which a showrunner teases viewers with tantalizing clues. Followers make every detail into something profoundly significant.
When Donald Trump announced his COVID-19 diagnosis, for instance, he tweeted, “We will get through this TOGETHER.” QAnon followers saw this as a signal that their long-sought endgame – Hillary Clinton arrested and convicted of unspeakable crimes – was finally in play. They thought the capitalized word “TOGETHER” was code for “TO GET HER,” and that Trump was saying that his diagnosis was a feint in order to beat the “deep state.” For devotees, it was a perfectly crafted puzzle with a neatly thrilling solution.
It’s also key to avoid saying that conspiracy theories are “simply” irrational or emotional. What James realized is that all thinking is related to feeling – whether we’re learning about the world in useful ways or whether we’re being led astray by our own biases. As cultural theorist Lauren Berlantwrote in 2016, “All the messages are emotional,” no matter which political party they come from.
Conspiracy theories encourage their followers to see themselves as the only ones with their eyes open, and everyone else as “sheeple.” But paradoxically, this fantasy leads to self-delusion – and helping followers recognize that can be a first step. Unraveling their beliefs requires the patient work of persuading devotees that the world is just a more boring, more random, less interesting place than one might have hoped.
Part of why conspiracy theories have such a strong hold is that they have flashes of truth: There really are elites who hold themselves above the law; there really is exploitation, violence and inequality. But the best way to unmask abuses of power isn’t to take shortcuts – a critical point in “Conspiracy Theory Handbook,” a guide to combating them that was written by experts on climate change denial.
To make progress, we have to patiently prove what’s happening – to research, learn and find the most plausible interpretation of the evidence, not the one that’s most fun.
Donovan Schaefer does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
This summer, millions of marshmallows will be toasted over fires across America. Many will be used as an ingredient in the quintessential summer snack: the s’more.
Eating gooey marshmallows and warm chocolate sandwiched between two graham crackers may feel like a primeval tradition.
But every part of the process – including the coat hanger we unbend to use as a roasting spit – is a product of the Industrial Revolution.
The oldest ingredient in the s'more’s holy trinity is the marshmallow, a sweet that gets its name from a plant called, appropriately enough, the marsh mallow. Marsh mallow, or Althea officinalis, is a plant indigenous to Eurasia and Northern Africa. For thousands of years, the root sap was boiled, strained and sweetened to cure sore throats or simply be eaten as a treat.
The white and puffy modern marshmallow looks much like its ancient ancestor. But for hundreds of years, creation of marshmallows was very time-consuming. Each marshmallow had to be manually poured and molded, and they were a treat that only the wealthy could afford. By the mid-19th century, the process had become mechanized and machines could make them so cheaply that they were included in most penny candy selections. Today the marshmallow on your s’more contains no marsh mallow sap at all. It’s mostly corn syrup, cornstarch and gelatin.
A 16-century image shows an Aztec women frothing chocolate. Lacking sugar and milk, ancient chocolate was much more bitter.Chocolate Class
Chocolate is another ancient food. Mesoamericans have been eating or drinking it for 3,000 years. The Europeans who encountered indigenous people in Mexico in the 1500s noted that chocolate was used to treat numerous ailments ranging from dysentery and indigestion, to fatigue and dyspepsia.
But again, it was the Industrial Revolution that made chocolate cheap enough and palatable enough for the average person. The chocolate that the Mesoamericans ate was dark, grainy and tended to be somewhat bitter.
In 1875, a candlemaker-turned-chocolatier named Daniel Peter invented a process to mix milk with chocolate. He then added some more sugar, and the modern milk chocolate bar was born. Peter’s company eventually merged with Henri Nestle’s two companies, and Peter’s invention was dubbed the Nestle chocolate bar. It proved to be so much more popular than the darker bars on the market that other candy companies, from Cadbury to Hershey, released their own versions.
Finally, the graham cracker was invented by the Presbyterian minister Sylvester Graham, who felt that a vegetarian diet would help suppress carnal urges, especially the scourge of “self-pollution” (read: masturbation).
The original graham cracker used unsifted whole-wheat flour. Graham felt that separating out the bran was against the wishes of God, who, according to Graham, must have had a reason for including bran.
In his “Treatise on Bread, and Bread-Making,” he gives many examples of prominent writers throughout history who urged the consumption of whole wheat flour.
Graham was highly influential in the development of the health food movement of the 19th century, and his acolytes included John Harvey Kellogg of the Battle Creek Sanitarium, who used the graham cracker as a basis for his famous flaked cereal line.
As for how the graham cracker became a part of the s'more, the snack’s true origin remains unclear.
The first mention of this treat is in a 1927 edition of the Girl Scout manual “Tramping and Trailing with the Girl Scouts.” In a nod to the treat’s addictive qualities, it was dubbed “Some More.”
Some think the moon pie may have inspired the s'more.Evan-Amos
Today, the s'more has become so popular that it’s inspired a range of spin-offs. You can eat a s'mores-flavored Pop Tart for breakfast, munch on a s'mores candy bar for dessert and even unwind after a long day at work with a s'mores martini.
As I often tell my students, the health-conscious Sylvester Graham is probably rolling over in his grave after what became of his beloved cracker.
Jeffrey Miller does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
For many people around the world, the very first moments of the new year will be filled with the sounds and colorful light shows of fireworks. From loud bangs to long whistles, bright reds to pale blues, there are thousands of variations of fireworks and an entire branch of chemistry that explores these fun explosions.
I’m a chemist and president of the Pyrotechnics Guild International, an organization that promotes the safe use of fireworks and their use to celebrate holidays like the New Year.
There are hundreds of chemical formulas – or as I like to think of them, pyrotechnic recipes – for fireworks. These recipes are still based off an ancient mixture of chemicals that produces the quintessential bang, but modern fireworks use all sorts of chemical magic to put on the incredible shows of today.
The first ingredient of any firework is the ancient explosive black powder. It was discovered by Chinese alchemists more than a thousand years ago, and the recipe has been virtually unchanged in the centuries since. To make black powder, all you need to do is mix 75% potassium nitrate, 15% charcoal and 10% sulfur. To make a basic firework or fire cracker, you just put this powder in a container, usually made of thick cardboard or paper.
Black powder is used to launch the firework in the air as well as ignite and propel the effects – like color – into a pattern in the sky. So how does it work?
Once lit with a fuse or spark, the sulfur melts first at 235 F (112.8 C). The sulfur flows over the potassium nitrate and charcoal, which then burn. This combustion reaction quickly produces a large amount of energy and gas – in other words, an explosion. If there is a small hole for the gas to escape, the reaction launches the firework into the air. In a very confined space, it blasts the components of the firework apart and ignites everything nearby.
In addition to changing how confined the black powder is, changing the size of the granules of powder can change how fast it burns, too. Think about a campfire. When you add a large tree limb the flames burn longer and slower. If you toss a handful of sawdust into the flame it burns hot and fast. Black powder works similarly, and this makes it easy to control how much and how fast energy is released.
If you put very fine black powder powder in a confined space it explodes in a cloud of heat, gas and noise. So where do the colors and bright light come from?
When you heat up any material, what you’re really doing is putting energy into the electrons of that material’s atoms. If you excite the electrons enough, when they fall back to their normal energy levels they release that excess energy as light.
There are a number of different elements that, when added to a firework and heated, release different wavelengths of light that appear as different colors. Strontium makes red. Barium produces green. Copper burns blue, and so on.
[The Conversation’s science, health and technology editors pick their favorite stories.Weekly on Wednesdays.]
Making fireworks that produce blues has long been a challenge for fireworks chemists. Deep blues are too dark and can’t be seen against the night sky. But if the blue is too light, it appears white. So the wavelength of the “perfect blue” has to be very precise. This is hard to achieve because blue light has a shorter wavelength – meaning the distance between the peaks and valleys of the wave of light are very close together.
Certain elements produce different colors, but what about sparkles and flashes? To make these effects, various metals can be added to the pyrotechnic formulas. Aluminum, magnesium and titanium all produce white sparks. By adding iron you get gold sparks. Mixing in various types of charcoal can produce red and orange sparks. Each of these elements burns at a different speed and in a different way and so produces varying colors and intensities of light.
Special formulas and rocket shapes can produce sound effects like whistles.
Making a whistle or a boom
The final piece of a good firework is an exciting sound effect.
To add sound effects to fireworks you need a formula that produces a large amount of gas very quickly. If a firework has a small opening for the gas to exit through it will produce a whistling sound. The velocity of the gas and size of the opening will vary the pitch and sound of a whistle.
Making a boom is much easier. Simply put an energetic formula in a confined space with nowhere for the gas to go. When ignited, the pressure will build and the firework will explode, producing a sudden boom or bang.
As you watch the fireworks this New Year’s Eve or launch some of your own in the backyard, you’ll now know how they work. Fireworks are a lot of fun, but the explosions and burning chemicals are dangerous – even if they do come in colorful packaging. If you can legally launch consumer fireworks in your town, please handle them properly.
Paul E. Smith is president of the Pyrotechnics Guild International, Inc. He is a member of the American Pyrotechnics Association, the National Fireworks Association, and the International Pyrotechnics Society. He has a license from the BATFE to manufacture fireworks.
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string(15537) "A view of the Kaaba at the Grand Mosque during the hajj pilgrimage in the Muslim holy city of Mecca in Saudi Arabia on July 6, 2022.AP Photo/Amr Nabil
This year, an estimated 1 million people will perform the hajj, which is considered one of the five pillars in Islam. Under the lottery, only 50,000 permits were allowed from these 50 countries, compared with 25,000 for U.K. Muslims alone in previous years.
In the past, too, the commercial, technological and secular aspects of the hajj have been a topic of much debate about whether they change the spiritual nature of the pilgrimage. As a scholar of pilgrimage, ritual and Islam, I know that the focus on commerce and profits has been part of the long history of the hajj.
Early roots of trade and commerce
Across religious traditions, pilgrimages have always had a commercial component. From pilgrimage caravans and markets that grow around religious sites to the gifting of relics and souvenirs, religion and commerce have been deeply linked.
The hajj is no different. As F.E. Peters, an eminent scholar of Islamic studies, noted in his 1994 significant study on the hajj, the Quran itself acknowledges that Muslims were permitted to indulge in commerce around the pilgrimage: Verse 2:198 in the Quran says, “There is no blame on you for seeking the bounty of your Lord during this journey.” Quranic commentaries have explained this verse to mean that Islam allows commercial activity before and after the days of hajj rituals.
As Islam spread, so did the commerce. While the narrow set of ritual acts of hajj remained, the total pilgrimage experience was shaped by business. For centuries, major overland caravan routes traveled through Damascus, Cairo and Baghdad, with merchants attaching themselves to these caravans.
Traders targeted the pilgrims as consumers, and many pilgrims themselves engaged in trade to pay their way. As traveling overland for the hajj journey could take up to two years, pilgrims traded fruits, wines, silk, carpets and other items. They purchased goods such as coffee and pearls for their return journey.
A changing world, a changing hajj
The evolution of technology and means of travel inevitably brought new economic considerations into the organization of the hajj. The invention of the steamship was central to the development of mass pilgrimage to Mecca in the 19th century – the total number of pilgrims per year rose from an estimated 112,000 participants in 1831 to some 300,000 in 1910.
European liner companies controlled major pilgrim sea routes, linking hajj to imperial business opportunities. In 1886, the British government called in the famed Thomas Cook & Son, the original package holiday entrepreneurs, to become official travel agents of the hajj.
The use of a for-profit tourism company to regulate the hajj may have seemed a new development, but agents and intermediaries had been central to the process for centuries. The “mutawwifin,” the hereditary guilds of pilgrimage guides, provided pilgrims with guidance in carrying out the rituals of the hajj and were central to Mecca’s government and its economy.
Over the centuries, these local guides would develop contacts in foreign lands, encouraging Muslims to perform the pilgrimage. In addition to linguistic and ritual guidance, the mutawwifin would also arrange meals, lodgings and tents – acting in ways that were similar to modern-day tour operators.
The modern era
The steamship was just one technological innovation that altered the hajj landscape into a more commercial venture. At the turn of the 20th century, Sultan Abdul Hamid II of the Ottoman Empire was an adamant promoter of the construction of the Hejaz Railway, meant to establish a connection between Istanbul, the capital of the Ottoman Empire, and the holy cities of Mecca and Medina.
The establishment of the Kingdom of Saudi Arabia in 1932 and the eventual replacement of shipping and rail with air transport transformed the nature of the hajj further. The new Saudi state adhered to the doctrine of Wahhabism, an Islamic reform movement originating in the 1700s that rejected all forms of innovations outside of the Quran and the traditions of the Prophet Muhammad in his time.
Yet despite this condemnation of innovation, the Saudi government has overseen decades of commercial development of the hajj, encouraging the tourism atmosphere and deriving significant profits from the obligatory pilgrimage.
Commerce or politics?
Muslim pilgrims pray on a rocky hill called the Mountain of Mercy near the holy city of Mecca, Saudi Arabia, in 2013.AP Photo/Amr Nabil
While the hajj has historically been linked to commerce, pilgrims of late have expressed dissatisfaction with the overt emphasis on the touristic experience and the sense that it is now diminishing the spiritual nature of the pilgrimage.
Indeed, commercial revenues from the hajj remain a contested and even a political topic. In 2018, Yusuf al Qaradawi, a prominent Muslim Brotherhood cleric based in Qatar, issued a fatwa calling for limiting spending on pilgrimage. “Seeing Muslims feeding the hungry, treating the sick and sheltering the homeless are better viewed by Allah than spending money on the hajj and umrah every year,” he declared. This statement was viewed as an attempt to undermine Saudi Arabia by discouraging Muslims from performing the pilgrimage, as the revenues go to the government.
Al Qaradawi’s fatwa drew ire from certain circles, as all Muslims who are financially and physically capable must attempt to complete the hajj, regardless of any geopolitical sentiment toward Saudi Arabia. Yet there is no doubt that the current hajj has refocused attention on whether the business of hajj remains in line with the original allowance to “seek bounty” during the pilgrimage to Islam’s holiest sites.
Noorzehra Zaidi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
