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Arousing Debate in Egypt

A move to lift the ban on Viagra is stimulating discussion of difficult subjects, including sex education, population growth and corruption.


CAIRO — With the possible exception of the Palestinian conflict, few events have been as widely discussed here, as deeply debated. Newspapers, magazines and office gossip in contemporary Egypt have all focused on the same pressing issue:

When will Viagra be on store shelves?

The little blue pill that fights male impotence has been illegal here since it first hit the global market, although it is routinely smuggled and widely available at a premium. A former health minister banned the drug, saying it "would destroy family relations."

The current minister has moved to lift the ban, a decision that will make Viagra, while still expensive for most Egyptians, a lot cheaper. Prices are expected to drop by half, from about $10 per tablet on the black market.

"Egyptian Men Soon to Be Virile in Bed," announced a recent front-page headline in the English- language Egyptian Mail, in a story hailing the minister's decision. "My fellow men, it's time to rejoice," the article concluded.

But it is not just Viagra's medical effectiveness that has made it such a hot topic. To talk about Viagra is to confront many of Egypt's most pressing issues, from an unmanageable population explosion, to government corruption, to the anxieties of a conservative religious society where neither men nor women are taught much about their own bodies.

This is still a country where most women undergo genital excision and where discussing sex between a husband and a wife remains taboo--facts that have also fueled the Viagra dialogues.

"There is lack of early marriage, economic troubles, lack of apartments for the ordinary middle class, a lack of economic means, and the population is suffering," said Dr. Aziz Khattab, 77, a pioneer in sex education in Egypt. "If you propagate love in Egypt, it will be the solution to lots of Arab problems."

Egyptians are good at making jokes and poking fun at themselves, and Viagra has spawned its share of quips, like the one told by a religious scholar involving the man who took five Viagra tablets and died. "There was only one thing standing up when guests came to pay their condolences," joked Abdel Sabur Shaheen, a linguistics professor and widely respected religious thinker in Egypt.

But these are serious issues, issues that Shaheen and his community are struggling to come to terms with, issues that cut to the core of this tradition-bound developing country. Take the case of young men: They are terrified of their wedding nights. Not all of them, of course, but enough that Khattab said he put a whole chapter titled "Wedding Night Syndrome" in his textbook on human sexuality.

It's true, said Tarek Shabrawy, a 25-year-old pharmacist in Cairo. He said young men often buy Viagra and a sensation-killing "delay spray" to help consummate their marriage.

"Here in Egypt, we have no experience before marriage," Shabrawy said. "We have something inside us that frightens us. So some guys take drugs to help."

Shabrawy explained, however, that this is a more complex issue than the common psychological stress of performance anxiety. It has its roots in social conventions that demand that men buy a home and pay a bride price before they can get married. But the economy is so bad, unemployment is so rife and housing is so limited that few young men can meet the requirements--especially in the big cities--and so they must wait.

"In the states, they condone sex before marriage, but here that is a problem," he said.

Then there are matters of religion. Under Islamic law, a woman may initiate a divorce if her husband doesn't gratify her sexually. (Of course, it's difficult for a woman to prove that to the satisfaction of the male-dominated system.) "If a man can't satisfy his wife, she may commit adultery and that may open the door to prostitution," said Shaheen, the religious scholar. "To protect against sin if he can't satisfy her, she has the right to divorce."

Talk about pressure.

Finally, there are complications that stem from values linked to a traditional way of life outside the teachings of Islam. Among them is the much-criticized practice of genital excision, widely known here as female circumcision.

According to the most recent comprehensive health survey, conducted in 2000, 97% of women of child-bearing age in Egypt reported having undergone the procedure, and Khattab said half of those women cannot reach a climax during sex. One physician in his 20s said that excision, while catastrophic for women, puts added pressure on already performance-conscious men. Many, he said, turn to Viagra, or at least want to.

"Everybody is using it," said Ahmed Tantawy, 25, another pharmacist. "They think they will be stronger if they take it."

An Ancient Quest

This interest in performance enhancers is hardly new. For centuries, Egyptians have turned to herbal remedies, like the mixture of more than 16 herbs called "Happy Life" sold in a renowned herb shop here.

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