Dr. Awad is a Professor Emeritus in the Department of Psychiatry and is on the Faculty of the School of Graduate Studies at the Institute of Medical Science, University of Toronto, Canada In 1949, I enrolled in medical studies at the Faculty of Medicine, Cairo University, Egypt. Throughout my six years of medical undergraduate studies, Cairo and other major cities were besieged by major political upheaval, including frequent massive demonstrations that at that time had led to violence and the assassination of politicians. The economy was failing, moving from one crisis to another and was further crippled by rising religious extremism. Among the major events that led to the temporary disruption of regular life and suspension of schools and university studies, was the humiliating defeat of the ill-prepared Egyptian army in 1948, in the Israeli War of Independence in Palestine. In January 1952, Cairo was besieged by massive demonstrations that lead to the torching of the centre of Cairo, including all foreign and, specifically, British-owned fashion and entertainment businesses, in what is known as Black Saturday. This major incidence was triggered by the massacre of over fifty Egyptian police officers in the city of Ismailia, beside the Suez Canal, by British army forces camped around the canal, under the false pretense that the police officers were preparing to attack the British garrison nearby. In six months, amidst the political unravelling in Cairo and other big cities, the Egyptian army seized power, abandoned the corrupt monarchy, toppled the government and assumed full political and governmental power in what became known as the "July 23rd Revolution". About four years later, in 1956, the year that was assigned to be the graduation of our medical class, all of a sudden the country was besieged by an abrupt and rather complex disquieting event known as the Suez Crisis, that quickly impacted several aspects of regular life, including the postponement of my graduation until the following year. The Suez Crisis began with what started as an ambitious plan to deal with major economic disparities between the failing agricultural sector and big-city economies, through the construction on the Nile of one of the world's largest embankment dams, the Aswan High Dam. It was to provide year-round water for expanded agricultural purposes and for further generations of electricity, to enhance the electrification plans of the countryside outside big cities. It was good and encouraging news for Egypt, but President Nasser and his government had to secure massive economic support for such a major project from the United States, the United Kingdom and other wealthy countries. However, in early 1956, the United States and other countries started to express displeasure with President Nasser's evolving close relationship with the Soviet Union and its allies for the procurement of modern military weaponry. With President Nasser ignoring such threats and becoming more critical of western countries meddling in Egyptian internal policies, in no time the conflict turned into a major crisis, with the United Kingdom and the United States threatening the suspension of the funding plans of the Aswan High Dam. The crisis became further deepened by the rise of the western powers' concerns about Nasser's overambitious political influence in the Middle East. By mid-1956, with the failure of the negotiations, the western countries announced the suspension of the funding agreement. In an angry and retaliative response, President Nasser announced the seizure of the Suez Canal management, in a major speech given on the fourth anniversary of the 1952 army revolution. Management of the canal had been imposed by western countries shortly after its opening in 1863, as the result of concerns about massive foreign debts incurred during the construction of the canal and the extra lavish expenditure incurred by the Ottoman/Egyptian ruler, Khedive Ismail, in the opening celebrations of the canal. The highly secretive arrangement by the United Kingdom, France and Israel to seize back the management of the Suez Canal by force seemed to quickly fade away and eventually failed, as a result of the massive protests critical of the return of the colonial era, as well as the United States' negative response for not being consulted about the Tripartite Invasion and the fear of precipitating a much bigger conflict and war with the Soviet Union. In the end, President Nasser was clearly the winner, reclaiming the ownership of the canal. As a result, he was emboldened to continue his expansive and aggressive international plans, threatening neighbouring countries. On the other hand, the Suez Crisis, in personal terms, turned out to be a major negative turning point for my future plans and my life in general. My early arrangements for further post-graduate studies in London, as was frequently done by Egyptian medical graduates, was abruptly cancelled as a result of the suspension of all relationships between the UK and Egypt, in the aftermath of the failed Suez Canal invasion. The only alternative was to accept my first independent job, an assignment as a rural physician serving a rather poor and remote region of Egypt, close to the Suez Canal and the extensive British camps that held the British garrison that continued their occupation of Egypt. My three-year medical service in the impoverished region of Bani Ayoub, turned out to be the best experience for a young physician early in his/her medical career. Successfully fighting pellagra, a major endemic nutritional deficiency condition, brought quick fame to me and conferred on me almost magical and mystical powers. The noted lack of energy and the tiredness and lethargy of pellagra's victims, including common serious dermatological skin changes, as well as the more serious central nervous-system complications that led to cognitive deficits such as dementia, began improving in a matter of less than six months of treatment with vitamin and nutritional supplements, such as inexpensive Baker's yeast and its rich vitamin B complex, which seemed to clearly make a major gradual recovery that looked like a general "awakening". As often noted, success and fame brings more success and further fame. Word of my local popularity eventually reached and impressed my superiors in Cairo, who declared my medical program in Bani Ayoub a resource for the field testing of new medications. An added responsibility was quickly established to test the very new and soon to be approved contraceptive pill, donated by an American international foundation interested in social engineering in over-populated, but underdeveloped countries. Our quickly established contraception clinic, without any fanfare nor much publicity in order to avoid antagonizing religious local authorities, proved to be an immediate success, most likely as a result of a small monetary added reward for the patients of ten piastres. A new focus was on the emerging and significant socioeconomic problem of the rapidly increasing population in Egypt, although, with its sparse population, it was not a significant challenge in the region I was serving. Nevertheless, the new focus brought me closer to my continuing interest in academic medicine, by seconding me on a part-time capacity basis to join Professor Fouad Al-Hifnawi, to assist him in developing a new academic program concerning reproductive biology and population growth, at the recently developed National Research Centre in Cairo. Back in the region of Bani Ayoub the program proved to be a success by the number of women enrolled, though in my opinion the program was a mixed success, as a significant number of women were observed dropping the pills in the river on their way home from the clinic, despite my continuous urging of my superiors in Cairo to introduce a medication education and support program.
