Protestant Medical Missions in Iran: Negotiating Religion and Modernity in Mission Hospitals

Round 1

Reviewer 1 Report

The article aims to show how missionary hospitals in Iran were "places in between" during the Reza Shah Pahlavi region. This is an important argument, but needs development. I recommend acceptance subject to major revisions. 

I recommend reorganization and expansion of the first and second sections of the article (1. Introduction and 2. The Protestant Hospitals in Iran). The introduction should include a detailed literature review (at least two paragraphs) to explain how the article contributes to existing studies; has anyone else argued that medical missions were places in between, for example in the context of Egypt or British India? Were medical missions as places in between unique to Iran? (See Heather J Sharkey's American Evangelicals in Egypt and Samir Boulos's European Evangelicals in Egypt).

I also recommend discussing sources in the introduction rather than in the second section. The author can explain what sources they are using and what are their benefits/limitations. The author explains about benefits/limitations of sources, but in the analysis considers missionaries' view as self-evident. To what extent do missionaries' reports and records reflect the view of Iranian patients? Missionaries' reports and records are racially charged, which the author does not consider at all. One way to resolve this is to state clearly in the introduction that missionaries presented the hospitals as places in between, rather than claiming patients perceived the hospitals as such.

The second section then can focus on a brief history of medical mission work in Iran and a details discussion about "medical modernity". What does medical modernity entail? What is the relationship between medical modernity and imperialism? The author does not consider at all that medical missions were part of the process of "imperial formations". This is reflected in the article discussion sections. So how do medical missions as places in between relate to missionaries as imperial actors? (The author might find Ann Laura Stoler's work useful as well as literature that discusses the relationship between mission and imperialism). 

The second and third parts of the article (3. Protestant modernity and Iran; 4. Hospitals: producing convents and patients) need to be developed to present the article's argument - medical missions as places in between - better. The author might need to engage with a larger number of primary sources in these sections. Missionaries produced a large number of materials, which the author mentions. Of course, it is impossible to engage with them all in an article but the author needs to engage with more primary sources to strengthen their argument. They can explain this in the introduction: for example, they can say, they are engaging with published books and reports widely available and not private correspondence and why. At the moment, the argument about places in between is somehow lost. 

For example, on page 7, the specific location of the hospital is presented as evidence, but how did the missionaries acquire the land? Did they choose it intentionally in the city center, near a Muslim shrine? Many mission hospitals in British India were built outside the city centers. So if the missionaries in Mashhad chose to build the hospital intentionally in the city center, the author needs to explain this. 

Also, the author states that the hospital was built in the "American style". What does the American style entail? Many hospitals in the US were high-rise structures in the 1920s and 1930s. They were not two-stories structures looking like an "American House". So, the author needs to engage with the literature on hospital architecture in the US (For example, see Jeanne Kisacky's Rise of the Modern Hospital and Annmarie Adams' Medicine by Design). 

The last section presents missionaries' views as evidence of how patients perceived the hospitals, which is problematic. For example, referring to drug addiction as a "social problem" might not be reflective of Iranian views. Or missionaries talking about women suffering abuse is highly racially charged. So I would recommend rethinking this section to explain that these were the views of missionaries. They wanted to present the hospitals as places in between and how this relates to imperialism and imperial modernity (Sujit Sivasundaram's "Sciences and the Global" might help the author consider how they can use missionaries' views to access patients' views if that is why they aim to do in their larger project).

Instead of "a hospital", the author might consider saying "mission hospitals" in the title of the article as they do not discuss only one hospital.

I hope the author finds my comments useful. I understand it might seem significant but the article only requires some expansion and rethinking. They will make the article clearer and stronger.

I wish the author the best of luck in revising the article.

The article reads fine - the language is clear. But some minor editing of some sentences would be useful. There are some long sentences throughout the article and there are a few typos. 

Author Response

Dear Reviewer,

I appreciate your suggestions and opinions regarding both the structure and the content of the article, I found your recommendations valuable and necessary to modify or clarify some of the statements and to improve the whole article.

I decided to reorganize the structure of the text, mainly parts 1 and 2, and to expand them.

In the first reorganized part, I included the general review of the literature emphasizing the recent publications on medical missionary initiatives in Iran. In so doing, I pointed out how my studies may contribute to the previous ones. It was necessary to define the situation of the missionaries during the reign of Reza Pahlavi. I argue that the situation was determined by 1) the governmental unification policy based on the linguistic patterns, 2) the governmental legal initiatives that regulated the medical market and medical professions, 3) the growing Westernized Iranian middle class and the increase of the national medical practitioners (lines 139-145). What seems to be highlighted is a quite different position of Iran in world politics, it means: 1) the country was never colonized, 2) the process of westernization was instrumentalized (in a sense also the missionary work) by various Iranian governments. Under the political and social changes initiated by the Iranian authorities, the missionaries’ attitudes toward Iranians changed, but it should not be neglected that also some Iranians expressed rather critical thoughts on tradition and Islam. Thus, the racial and imperial issues are complex in the Iranian context especially when they are referred to the patients of missionary hospitals. They came from various social strata and represented both the representatives of Westernized and traditional parts of the society.

I placed in the first section the general review of sources and listed the main archives where the materials concerning the missionary hospitals are stored.

I realized that a short introduction to the missionary work in Iran was necessary. So, I placed in the second section a short description of the missionary activity with special reference to the medical work (from line no 188).

I also introduced some changes in sections 4 and 5 tracing more examples to make the argument stronger. I agree the point on the “American style” hospitals while just some accounts referred to Mashhad hospital were given in the text, was not enough. I modified that part. I also expanded a paragraph where the location of the hospitals was mentioned.

Thank you once more for your comments, and remarks. Your advice proved very helpful in improving the article.

Reviewer 2 Report

I would change the title. Instead of 'Protestant medical missions in Iran: negotiating religion and modernity in a hospital,' I would change it to 'Protestant medical missions in Iran: negotiating religion and modernity in hospitals;' since more than one hospital is addressed. Or 'Protestant medical missions in Iran: negotiating religion and modernity in the hospital system.' Either one adds clarity.

Use “it” only when “it” is clearly defined. Do not write something like, “It is said that denim jeans were popular in the 1980s.” The word “it” is not defined; therefore, do not use. “It” should take the place of a word. For example, “The car I just bought is from 2002. It is not running well. Using the word “it” in this case is fine because the word “it” is substituted for the word “car.”

Only use a quote to further a point, not to prove a point. Example: Do not write that Peterson states, “The majority of the unreached peoples are located in the area known as World A, in hard to reach areas.” Instead write, “There are several places where unreached peoples are located. Most of them are in difficult places. Peterson states, ‘The majority of the unreached peoples are located in the area known as World A, in hard to reach areas.’” Quote one states a point; quote two furthers a point.

Use the complete name with a brief introduction for the first citation and then the last name only for each additional citation. For example: Oxford professor Charles P Melville writes ….

Hassan Dahqani-Tafti is not his full name. It is Hassan Barnaba Dahqani-Tafti

Conclusion not Conclusions

For non-English works, write the non-English title first with the translation in parentheses followed by the rest of the citation. For example: H. B. Dehqani-Tafti, Garanbahri va Arami [Anxiety and Peace] ...

Capitalization in the bibliography is inconsistent 

Author Response

Dear Reviewer,

Thank you very much for your comments and suggestions. Following your recommendation, I modified the title of the article. I also rearrange some parts of the text, mainly sections 1 and 2. I read through the whole article to remove some inconsistencies.

I would like to thank you for your appreciative and helpful feedback.

Round 2

Reviewer 1 Report

The article has been improved significantly and I recommend publication. However, some rewriting and reorganizing are still required. I have highlighted some of these in the article and made some recommendations. Please find attached. Please ask the journal for some time to copy-edit the article and make these changes. The article has been revised in haste. 

Comments for author File: Comments.pdf

The articles must be copy-edited. 

Author Response

Thank you very much for your comments and suggestions. They helped me to reorganize the text and rewrite some paragraphs. I introduced some changes in the section referring to sources (page 5). The fragment that referred to what makes the study different was removed and added to the part presenting the article’s core idea. 

I agree that the paragraph comprising some information about architecture, American solutions, etc. (pages 8-9) needed significant changes. Rephrasing that part, I avoided too general claims. Regarding Edward Frederic Hoernle, yes, he worked in Iran, but Augustus Frederic Rudolf - in India.
Thank you for your review and advice to simplify and correct some parts of the text.

The article was carefully reread and corrected.

Round 3

Reviewer 1 Report

Many thanks for the careful revisions. I do not have any further comments. I would only suggest to consider rereading page 4 to make sure it is clear and reads well. I think instead of 'I believe', it is better to say 'I draw on ... to examine the process of ...' 

On p. 2, why only "Muslims or Bahais"

In the bibliography, it is Honarmand Ebrahimi, Sara and not Ebrahimi, Sara Honarmand

Thanks

No further comments, just please make sure it reads well throughout.