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  • America's Arab Refugees: Vulnerability and Health on the Margins by Marcia C. Inhorn
  • Gabrielle Printz (bio)
America's Arab Refugees: Vulnerability and Health on the Margins
Marcia C. Inhorn
Stanford, CA: Stanford University Press, 2018
256 pages. ISBN 9780804786393

Inside a nondescript clinic in Dearborn, Michigan, refugees from Lebanon, Iraq, Yemen, and Palestine disclose personal histories shaped by both war and infertility. They are not unrelated experiences, as Marcia C. Inhorn demonstrates throughout this book. The ethnographic accounts she collects over her five years of study vividly collapse the health consequences of conflict, exile, and poverty into the frame of reproductive care in America. What possibilities remain for men and women in the double exile from reproductive futures and war-ravaged homelands? Moreover, what should be done to help Arab refugees establish lives and livelihoods? Inhorn contributes important language to these struggles in her conceptualization of "reproductive exile," and this work unfolds as a testament to the pain and prospects of making lives and families under the terms of US resettlement.

America's Arab Refugees is built on Inhorn's combined expertise as a medical anthropologist and scholar of Middle East studies. Its tight structure draws equally on both backgrounds, but it pushes beyond an academic exposition of the lives of infertile Arab refugees. The activist orientation of the text rings clearly, both in Inhorn's stated commitment to feminist scholarship and in the inspiration she takes from the Black Lives Matter movement. The text is pitched with emotion, directing the reader to empathize with refugee suffering in a political era marked by Trumpian xenophobia (released in 2018, the book's coda rests on the inauguration of President Trump). The instrumental nature of this text is aided by a detailed summary of the global political timeline that leads to the crescendo of the global "refugee crisis," providing necessary context for the claims on US moral responsibility for Arab refugee resettlement and care. Her own study begins at the outset of the Second Gulf War and ends with the nomination of then–presidential candidate Barack Obama, seemingly suspended between war and the specter of hope. However, her interlocutors are refugees of a slightly earlier wave: nearly one hundred men and women who [End Page 125] fled southern Lebanon during its long civil war, or Iraq during the First Gulf War, as well as US-attended conflicts elsewhere in the region. Dearborn, Michigan, is a significant site for this work, as the Detroit suburb that has received significant numbers of Muslim and Arab refugees since the 1980s and continues to serve as a destination of secondary migration for many others settled elsewhere in the States.

This book is organized in four sections that trace refugee stories: from sites of conflict, through processes of resettlement, in subsequent struggles as a marginalized group in one of America's poorest cities, and in travails through the American health-care system for IVF/ICSI procedures. The first chapter lays out these conflicts in more precise historical detail and, importantly, situates the experience of war as a broader set of health concerns. Readers are presented with war stories that involve direct violence on civilians and combatants, as in Mahmoud's devastating encounter with an Israeli tank in southern Lebanon, but a notion of "syndemics" expands the arena to register indirect damages to human health that co-occur in war. Destruction of infrastructure and the environment and the social and psychological tolls of armed conflict capture a much larger picture of suffering that often has long-term effects, far beyond the duration of war and escape from it. Inhorn identifies six health costs to structure her analysis of the syndemics of Lebanon's civil war and the wars in Iraq.

The mechanisms of resettlement are illuminated in the second chapter, which gives a fuller picture of institutional aid to refugees through the US Refugee Resettlement Aid Program (USRAP) as well as the depths of poverty in which Arab refugees have found themselves amid the precipitous reduction of USRAP resources. Thinning federal funds are aligned to the economic decline in the state of Michigan, one of the three states that have received the majority of refugees...

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