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Borderlands between Egypt and Nubia : a bioarcheaological analyis of the effect of conflict on health

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Title:
Borderlands between Egypt and Nubia : a bioarcheaological analyis of the effect of conflict on health
Creator:
Assefa, Sewasew Haileselassie
Place of Publication:
Denver, CO
Publisher:
University of Colorado Denver
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Language:
English

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Degree:
Master's ( Master of arts)
Degree Grantor:
University of Colorado Denver
Degree Divisions:
Department of Anthropology, CU Denver
Degree Disciplines:
Anthropology
Committee Chair:
Musiba, Charles M.
Committee Members:
Stone, Tammy
Warrener, Anna

Notes

Abstract:
Bioarchaeological studies of Egypt and Nubia have an extended history that focuses on health and activity patterns of populations. This study uses data from published research in combination with new skeletal data from the Nubian (Von Luschan) collection at the American Museum of Natural History (AMNH) to investigate the effects of conflict on health of borderland communities along the Nile River Valley. Both historically and prehistorically, Egypt and Nubia extensively interacted through trade, political negotiations as well as through cultural intermixing. The two empires often interacted in border conflicts, sometimes completely ruling over one another. Such interactions affected border areas with culturally and ethnically intermixed population. One of these populations available for bioarchaeological study is El-Hesa. El-Hesa, situated at the First Cataract of the Nile, has persisted in between the two empires for much of recent history. The El-Hesa cemeteries were excavated between 1907 and 1908 preserving skeletal remains from 395CE to 640CE. This skeletal collection, currently housed at the AMNH consist of 81 adult individuals with post cranial remains, thus providing a bioarchaeological case study in exploring the effect of political change on the health of individuals through observation of skeletal markers of dietary stress such as cribra orbitalia and activity stress markers such as degenerative joint disease and musculoskeletal stress markers. This study compares data from El-Hesa with data from populations in Egypt- and Nubia-proper for the Romano-Christian period as well as with populations temporally preceding and following it. The goal here is to explore the effect of conflict on populations living in border areas, particularly on health and quality of life using the El-Hesa collection. The form and content of this abstract are approved. I recommend its publication.

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University of Colorado Denver
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Auraria Library
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Copyright Sewasew Haileselassie Assefa. Permission granted to University of Colorado Denver to digitize and display this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.

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BOARDERLANDS BETWEEN EGYPT AND NUBIA: A BIOARCHAEOLOGICAL ANALYSIS OF THE EFFECT OF CONFLICT ON HEALTH by SEWASEW HAILESELASSIE ASSEFA B.A., Texas tech university , 2015 A thesis submitted to the Faculty of the Graduate School of the University o f Colorado in partial fulfillment Of the requirements for the degree of Masters of Art s Anthropology Program 2018

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ii © 2018 SEWASEW HAILESELASSIE ASSEFA ALL RIGHTS RESERVED

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iii This thesis for the Master of Art s degree by Sewasew Haileselassi e Assefa Has been approved for the Anthropology program By Charles M. Musiba, Chair Tammy Stone Anna Warrener Date: July 28, 2018

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iv Assefa, Sewasew Haileselassie (M.A., Anthropology Program) Borderlands Between Egypt and Nubia: A Bioarchaeolog ical Analysis of the Effect of Conflict on Health Thesis directed by Associate Professor Charles M. Musiba ABSTRACT Bioarchaeological studies of Egypt and Nubia have an extended history that focuses on health and activity patterns of populations. This stud y uses data from published research in combination with new skeletal data from the Nubian (Von Luschan) collection at the American Museum of Natural History (AMNH) to investigate the effects of conflict on health of borderland communities along the Nile Ri ver Valley. Both historically and prehistorically, Egypt and Nubia extensively interacted through trade, political negotiations as well as through cultural intermixing. The two empires often interacted in border conflicts, sometimes completely ruling over one another. Such interactions affected border areas with culturally and ethnically intermixed population. One of these populations available for bioarchaeological study is El Hesa. El Hesa, situated at the First Cataract of the Nile, has persisted in betw een the two empires for much of recent history. The El Hesa cemeteries were excavated between 1907 and 1908 preserving skeletal remains from 395CE to 640CE. This skeletal collection, currently housed at the AMNH consist of 81 adult individuals with post cr anial remains, thus providing a bioarchaeological case study in exploring the effect of political change on the health of individuals through observation of skeletal markers of dietary stress such as cribra orbitalia and activity stress markers such as deg enerative joint disease and musculoskeletal stress markers. This study compares data from El Hesa with data from populations in Egypt and Nubia proper for the Romano Christian period as well as with populations temporally preceding and

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v following it. The g oal here is to explore the effect of conflict on populations living in border areas, particularly on health and quality of life using the El Hesa collection. The form and content of this abstract are approved. I recommend its publication. Approved: Cha rles Musiba

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vi ACKNOWLEDGEMENTS I would like to say thank you to the American Museum of Natural History without their approval to access the El Hesa collection this project would not have been possible. I am eternally grateful to everyone at the AMNH, espec ially Gisselle Garcia and William Harcourt Smith for their support. Immeasurable gratitude is due to Ms. Connie Turner who has been a supportive and positive source throughout this degree. Thank you, Connie , for believing in all of us, encouraging us and k eeping our lives on track. Thank you to Dr. Tammy Stone for the fastest response time and care she has put into every question and draft she has received and for all her help in this project and my graduate study. Thank you to my family and friends who hav e listened to my complaints, sat through late nights and early mornings.

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vii TABLE OF CONTENTS CHAPTER I. INTRODUCTION ................................ ................................ ................................ . 1 II. THEORY ................................ ................................ ................................ ............... 5 Borderland ................................ ................................ ................................ ............. 5 Cost of conflict ................................ ................................ ................................ ...... 6 Economic ................................ ................................ ................................ .. 6 Sociocultural ................................ ................................ ............................. 8 Political ................................ ................................ ................................ ... 11 Health and Costs of Conflict ................................ ................................ ............... 12 Economy ................................ ................................ ................................ . 12 Sociocultural ................................ ................................ ........................... 13 Political ................................ ................................ ................................ ... 14 III. OBJECTIVES A ND HYPOTHESES ................................ ................................ .. 15 IV. HISTORICAL BACKGROUND ................................ ................................ ........ 16 4500 3100 BCE ................................ ................................ ................................ .. 16 3100BCE 2300 BCE ................................ ................................ ........................... 20 2300BCE 2100 BCE ................................ ................................ ........................... 24 2160 2055 BCE ................................ ................................ ................................ .. 27 2055 1650 BCE ................................ ................................ ................................ .. 29

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viii 1600 1500 BCE ................................ ................................ ................................ .. 33 1500 BCE 1189BCE ................................ ................................ ........................... 37 1189BCE 730BCE ................................ ................................ ............................. 44 730BCE 610BCE ................................ ................................ ............................... 48 610BCE 332BCE ................................ ................................ ................................ 53 332BCE 350CE ................................ ................................ ................................ .. 54 350CE 642CE ................................ ................................ ................................ ..... 61 V. METHODS ................................ ................................ ................................ .......... 64 Data Collection on Skeletal Material ................................ ................................ .. 65 Cribra orbitalia ................................ ................................ ................................ .... 66 Degenerative Joint Disease ................................ ................................ ................. 67 Musculoskeletal Stress Markers ................................ ................................ ......... 70 VI. RESULTS ................................ ................................ ................................ ...................... 73 El Hesa ................................ ................................ ................................ ......................... 73 Demography ................................ ................................ ................................ ................. 73 Cribra orbitalia ................................ ................................ ................................ ............. 74 Degenerative joint disease ................................ ................................ ......................... 79 Lipping ................................ ................................ ................................ ............. 79 Porosities ................................ ................................ ................................ ......... 85 Eburnation ................................ ................................ ................................ ....... 90

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ix Mean DJD ................................ ................................ ................................ ....... 92 Musculoskelet al Stress Markers ................................ ................................ ................ 93 Robusticity ................................ ................................ ................................ ...... 93 Stress lesions ................................ ................................ ................................ ... 97 Ossification ................................ ................................ ................................ ... 100 MSM average scores ................................ ................................ .................... 103 VII. Comparative Data ................................ ................................ ................................ ....... 107 Cribra Orbitalia ................................ ................................ ................................ .......... 107 Degenerative Joint Disease ................................ ................................ ...................... 109 Musculoskeletal Stress Marker ................................ ................................ ................ 115 Separated by site ................................ ................................ ........................... 116 Separated by region ................................ ................................ ...................... 117 Separated based on boarderland status ................................ ...................... 119 VIII. CONCLUSION AND DISCUSSION ................................ ................................ ..... 123 Results ................................ ................................ ................................ ......................... 123 Conclusion ................................ ................................ ................................ .................. 124 R EFERENCES ................................ ................................ ................................ ........... 128 APPENDIX ................................ ................................ ................................ ................ 135

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x LIST OF FIGURES FIGURES Figure 1: General map of Upper Egypt a nd Nubia indicating the location of El Hesa (Francigny et al. 2014) ................................ ................................ ................................ .................. 4 Figure 2: Distribution of the A group culture between the First and Second Nile cataracts ...... 17 Figure 3: Egyptian pre dynastic and contemporary Nubian sites 4500 3200 (Torok 2008) ...... 19 Figure 4: Extent of Egyptian control during Old Kingdom period (2691 218 1BC) .................. 21 Figure 5: Agriculturally fertile and Natural resource rich areas in Egypt and Lower Nubia ..... 23 Figure 6: C group and Kerma c ulture distribution in Nubia between 2300 2100BCE .............. 27 Figure 7: Political division of Egypt during the first intermediate period (2150 2080BCE) ..... 29 Figure 8: Extent of Egyptian kingdom during the Middle Kingdom period (2055 1650BC) .... 30 Figure 9: Distribution of regional control by different political powers during the Second intermediate period (1650 1580BCE) ................................ ................................ ......................... 34 Figure 10: Hyksos expulsion from Egypt at the end of the second intermediate period ............ 36 Figu re 11: Extent of Egyptian control during the New Kingdom period ................................ ... 39 Figure 12: Trade routes during the New Kingdom period ................................ .......................... 41 Figure 13: Trade routes and Natural resources distribution in Egypt and Nubia during 1400BC ................................ ................................ ................................ ................................ ....... 41 Figure 14: Political division of Egypt during the Third intermediate period and path of Kushite invasion (732BCE) ................................ ................................ ................................ ...................... 45 Figure 15: Extent of Egyptian Empire during the New Kingdom period and Kushite Empire during the 25th dynasty period ................................ ................................ ................................ ... 49 Figure 16: Extent of Roman control in the Nile Valley and Meroitic Empire during the

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xi Ptolemaic period ................................ ................................ ................................ ......................... 55 Figure 17: Kushite trade routes and natural resources distribution in 350CE ............................ 59 Figure 18: Direction of conflict between Roman and Kushite forces (300BCE 300CE) ........... 60 Figure 19: Placement of Kingdoms of Medieval Nubia: Nobatia, Makuria and Alodia ............ 62 Figure 20: Skeletal elements used in this study indicated in black ................................ ............. 65 Figure 21: Sex distribution in the El Hesa sample ................................ ................................ ..... 74 Figure 22: Age distribution in the El Hesa sample ................................ ................................ ..... 74 Figure 23: Prevalence of cribra orbitalia on the cranium in the El Hesa sample ....................... 75 Figure 24: Prevalence of cribra orbitalia on the orbits in the El Hesa sample .......................... 75 Figure 25: Distribution of Cribra Orbitalia of the Cranium ................................ ........................ 77 Figure 26: Distribution of Cribra orbitalia on the cranium by Sex ................................ ............. 77 square value of 2.852 with Df 2 and 2 sided asymptotic significance of 0.240 ................................ ................... 78 Fi gure 28: Distribution of Cribra orbitalia on the Orbits by Sex ................................ ................ 78 Figure 29: Frequency of Lipping in the El Hesa sample based on Joint complex and articular surface grouping ................................ ................................ ................................ .......................... 80 Figure 30: Distribution of Lipping in the El Hesa sample by age ................................ .............. 82 Figure 31: Distribution of mean scores of Lipping in the El Hesa sample by age ..................... 82 Figure 32: Mean Lipping scores of joint complexes in the El Hesa sample by age ................... 83 Figure 33: Mean lipping scores of the El Hesa sample by sex ................................ ................... 83 Figure 34: Distribution of mean lipping scores in the El Hesa sample by articular surface and sex showing minimum and maximum range ................................ ................................ .............. 84 Figure 35: Mean distribution of lipping in the El Hesa sample by articular surface and sex ..... 84

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xii Figure 36: Mean frequency of porosity scores in the El Hesa sample by joint complex and joint surface ................................ ................................ ................................ ................................ ......... 86 Figure 37: Mean score of porosity in the El Hesa sample by sex ................................ .............. 87 Figure 38: Distribution of mean por osity scores by articular surface and age ........................... 88 Figure 39: Distribution of mean porosity scores by articular surface and sex with minimum and maximum range ................................ ................................ ................................ .......................... 88 Figure 40: Mean score of porosity in the El Hesa sample by age ................................ .............. 89 Figure 41: Humerus from the El Hesa sample preserving evidence of eburnation .................... 91 Figure 42: Frequency of Robusticity scores in the upper body by attachment sites ................... 96 Figure 43: Frequency of Robusticity scores in the lower body by att achment sites ................... 96 Figure 44: Frequency of Stress lesion scores in the upper body by attachment sites ................. 99 Figure 45: Frequency of Str ess lesion scores in the lower body by attachment sites ............... 100 Figure 46: Frequency of ossification scores in the upper body by attachment sites ................. 101 Figure 47: Frequency of ossification scores in the lower body by attachment sites ................. 101 Figure 48: Mean musculoskeletal stress markers (MSM) scores for the lower body by attachmen t sites ................................ ................................ ................................ ......................... 103 Figure 49: Mean musculoskeletal stress markers (MSM) scores for the upper body by attachment sites ................................ ................................ ................................ ......................... 104 Figure 50: Mean musculoskeletal stress markers (MSM) scores for the upper body by attachment sites and sex ................................ ................................ ................................ ............ 104 Figure 51: Mean musculoskeletal stress markers (MSM) scores for the upper body by attachment site s and age ................................ ................................ ................................ ............ 105 Figure 52: Mean musculoskeletal stress markers (MSM) scores for the lower body by

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xiii attachment sites and age ................................ ................................ ................................ ............ 105 Figur e 53: Mean musculoskeletal stress markers (MSM) scores for the lower body by attachment sites and sex ................................ ................................ ................................ ............ 106 Figure 54: Percentage of cribra orbitalia on the orbit present by site ................................ ....... 108 Figure 55: Distribution of mean DJD scores by site ................................ ................................ . 110 Figure 56: Distribution of mean lipping scores by site ................................ ............................. 110 Figure 57: Distribution of mean porosity scores by site ................................ ........................... 1 11 Figure 58: Distribution of mean eburnation scores by site ................................ ....................... 111 Figure 59: Bivariate density ellipses graph showing 90% coverage of DJD scores by site and articular surfaces. The El Hesa sample is represented by checkerboard pattern. ..................... 112 Figure 60: Distribution of DJD scores by site and articular surfaces ................................ ....... 114 Figure 61: Distribution of mean DJD scores by site ................................ ................................ . 115 Figure 62: Distribution of mean MSM scores by sites ................................ ............................. 120 Figure 63: Distribution of mean MSM scores for the shoulder joint complex by sites ............ 120 Figure 64: Distribution of mean MSM scores for the elbow joint complex by sites ................ 121 Figure 65: Distribution of mean MSM scores of the upper body by sites ................................ 121 Figure 66: Distribution of mean MSM scores for the lower body by sites ............................... 122

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xiv LIST OF TABLES TABLES Table 1: Method of re cording lipping (Bukistra and Ubelaker 1994) ................................ ........ 69 Table 2: Method of recording Porosity (Bukistra and Ubelaker 1994) ................................ ...... 70 Table 3: Met hod of recording Eburnation (Bukistra and Ubelaker 1994) ................................ .. 70 Table 4: List of Muscle attachment sites and ligaments sites observed for Musculoskeletal stress Marker analysis and associated skele tal elements ................................ ............................ 71 Table 5: Methods of recording MSM (Hawkey and Merbs 1995) ................................ ............. 72 Table 6: Sex distribution of population ................................ ................................ ...................... 74 Table 7: Age distribution of El Hesa Sample ................................ ................................ ............. 74 Table 8: Frequency of cribra orbitalia on the cranium ................................ ............................... 75 Table 9: Frequency of cribra orbitalia on the orbits ................................ ................................ ... 75 square value of 2.998 with Df 2 an d 2 sided asymptotic significance of 0.223 ................................ ................... 76 square value of 0.847 with Df 2 and 2 sided asymptotic significance of 0.655 ................................ ................... 77 square value of 4.378 with Df of 2 and sig of 0.112 ................................ ................................ ............................ 78 square value of 3.394 Df of 2 and sig of 0.183. ................................ ................................ ................................ ... 78 Table 14: Presence and severity of Lipping in the El Hesa sample ................................ ........... 81 Table 15: Lipping vs Sex and age Kruskal Wallis test results ................................ ................... 85 Table 16: Frequency of porosity in the El He sa sample by articular surfaces ........................... 87

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xv Table 17: Eburnation vs Sex and age Kruskal Wallis test results ................................ .............. 91 Table 18: Robusticity vs Sex Kruskal Wallis and ANOVA test results ................................ ..... 94 Table 19: Robusticity vs Age Kruskal Wallis and ANOVA test results ................................ .... 95 Table 20: Stress L esions vs Sex Kruskal Wallis and ANOVA test results ................................ 97 Table 21: Stress Lesions vs age Kruskal Wallis and ANOVA test results ................................ . 98 Ta ble 22: Ossification vs sex Kruskal Wallis and ANOVA test results ................................ .. 102 Table 23: Ossification vs age Kruskal Wallis and ANOVA test results ................................ .. 102 Table 24: List of sites used in comparing % cribra orbitalia on the orbits by location and time period of sample used ................................ ................................ ................................ ............... 108 Table 25: List of sites used in comparing DJD by location a nd time period of sample used ... 109 Table 26: Lipping vs sites categorized by regional proximity: Lower Egypt, Upper Egypt, Lower Nubia and Upper Nubia ................................ ................................ ................................ . 112 Table 27: Porosity vs sites categorized by regional proximity: Lower Egypt, Upper Egypt, lower Nubia and upper Nubia ................................ ................................ ................................ ... 113 Table 28: Eburnation vs sites categorized by reg ional proximity: Lower Egypt, Upper Egypt, lower Nubia and upper Nubia ................................ ................................ ................................ ... 114 Table 29: List of sites used in comparing MSM by location and time period of sample used . 116 Table 30: K wallis comparative results of sites ................................ ................................ ........ 116 Table 31: K Wallis and ANOVA comparative result of sites grouped by regional proximity 118 Table 32: K wallis and ANOVA comparative results of sites grouped by boarderland .......... 119

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1 CHAPTER I INTRODUCTION Current studies in economics, political science, internal rel ations, and archeology focusing on boarder areas try to compute both qualitative and quantitatively the cost of conflict on human life and society. Egypt and Nubia present 5000 years of history, archaeology, cultural evolution and burials providing ideal c onditions to examine the interactions between social, political, and economic aspects with health. Furthermore, it provides test ground to observe an ancient life in boarder areas both during direct conflict times as well as post conflict periods. This stu dy contributes to this multidisciplinary question through an exploration of the northern, 1 st Cataract boarder between Egypt and Nubia during a relatively peaceful period that followed a period of conflict and contention. Egypt is located between the Medi terranean and the First Cataract of the Nile. Nubia occupies the region from the First Cataract south until the Sixth Cataract . Borders of Egypt and Nubia have been altered on several occasions throughout history including the recent separation of Sudan i nto The Republic of Sudan and South Sudan. Geographically, Egypt and Nubia are divided east and west by the Nile. In addition to the east and west divisions, Egypt has historically been divided into U pper and Lower Egypt . Upper Egypt , which is synonymous w ith southern Egypt, refers to the area between the delta and the First Cataract or the border of Nubia. Lower Egypt , n orthern Egypt, refers to the area from the delta northwards to the Mediterranean. The terms Upper and Lower Egypt are in reference to the Nile River that flows south to north referencing the frame of mind in organization of space . The Nile River has been essential for Egyptian resources procurement from inner Africa, for communication, travel and as the sole source of permanent water (Dumo nt 2009).

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2 The Nile River and the Sahara d esert primarily influence the environment in Egypt and Nubia. The Nile at approximately 6800KM length is the only river crossing the Sahara year round . The Nile basin covers all of Egypt and Nubia. Although, the Nil e has been a permanent feature of the landscape and environment in Egypt and Nubia since 400,000 years ago, its width, height and volume have changed throughout history (Dumont 2009). The Nile is a meandering river; however, its route, rainfall and landmas s levels have been consistent for the past 6000 years. Between 8000 5000 BCE set tlements were formed along the N ile which contained flood basins during the rainy season supporting large trees including acacia, tamarisk and sycamore. During the dry season, g rass and brush dominate these areas. Until settlements closer to the river (Dumont 2009). Between 4000 and 3000 BCE the Nile flood zone is thought to have be en six to seven meters higher than today and the progressive aridity around 2350 BCE (Trigger 1968). In Egypt and Nubia, raised sand deposits allowed ideal conditions of se ttlement in and around the Nile delta (Dumont 2009). Trigger (1968) however argues most of the fertile sand along the Nile basin has accumulated since CE 1000. The Nile Valley civilizations individually long have been the focus of historical, archaeolog ical and bioarchaeological studies. Napoleonic campaign in 1826 lead to the rise of Egyptology that has continued uninterrupted through the centuries (Hassan 1988). On the other hand, Nubian archaeology is far more recent. Nubian archaeology began in 1907 through salvage archaeology sponsored by the Egyptian government (Trigger 1968). Archaeological exploration of Nubia continued to intermittently peak due to projects by other nations. In 1929 1934 a new peak of excavations in relation to the Aswan dam lead to

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3 exploration of Lower Nubia south to the Sudanese border (Trigger 1968). In 1959, UNESCO began archaeological expeditions to Nubia conducted by 25 nations (Trigger 1968). These excavations have led to a survey of all known Nubian cultures except the Isl amic period. In the 1990s and early 2000s the Sudanese government allowed further excavation of Nubian sites. However, since the escalation of political and ethnic conflict in Sudan ( now South and North Sudan ) excavations in Nubia have ceased. Archaeology in Egypt and Nubia have been highly influenced by the construction of the Aswan dam, Lake Nasser and the Merowe dam. Several issues continue to affect the archaeological research and evidence available for the study of the Nile V alley including: focus on e lite and religious sites, excavation focusing on endangered areas only, dominance of funerary sites over settlement sites and focus on Egypt while viewing Nubia as an extension of Egypt (Edwards 2007). Despite the issues present and gaps that continue to p ersist in our knowledge, we have substantial information regarding Egypt and Nubia individually. Recent research has begun to focus on the interactions of the two civilizations. Directions of research in these interactions include cultural intermingling, genetic variation , trade relations and political interactions. The current project follows in the trend of understanding political interactions of civilizations between Egypt and Nubia through the use of skeletal evidence . The goal here is to understand as pects of political interactions between Egypt and Nubia from a bioarchaeological perspective. The project focuses on the Roman (30BCE) and Christian period (641CE) of Egypt and the period following the collapse of the Meroitic Kush Empire in Nubia (300CE) . Through a review of historical and archaeological evidence , the project begins to develop the presence of both peaceful and conflicting interactions between the two civilizations. It s hypothesized that variation in quality of life and health can

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4 be obser ved in populations livin g in areas historically identified as border areas compared to areas of uncontested borders. To examine this, data on Degenerative Joint Disease (DJD), Cribra O rbitalia (CO) and Musculoskeletal S tress M arkers (MSM) were identified f rom previously published assemblages dated prior to, during and following the Christian period. The project uses the El Hesa collection as the primary data set and compares the results of the analysis to samples reported in the literature. Figure 1 : General map of Upper Egypt and Nubia indicating the location of El Hesa (Francigny et al. 2014) The El Hesa collection is from a site located on the First Cataract , a location disputed by both Egypt and Nubia as belonging to each throug hout history (see figure 1) . The current research project compares sites in Egypt proper, Nubia proper and El Hesa as well as sites prior to Christian era, during the Christian era and post Christian era periods from both empires. To place this study in co ntext, this report begins with chapters of historical accounts of Egypt and Nubia, a bioarchaeological methods chapter, and a theory chapter regarding border areas. Chapters presenting the data, the analytic results and a discussion section follow these.

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5 CHAPTER II THEORY In this paper the theoretical framework for understanding the effect of conflict on health is discussed by focusing on borderlands. To accomplish this, the paper begins with a discussion of borderland s and how borderlands are defined in t he literature. A discussion of the cost of war on the national economy, sociocultural structure, and political organization provides a background for the intensification of cost in borderlands. The third section provide s the relationship between discussed costs of war and decline of health. The last section presents a theoretical example of prehistoric effect of conflict on health from Egypt and Nubia to relate with contemporary studies presented in other sections of the paper with archeological aspects. Ov erall this paper argues health risks that arise due to conflict in contemporary conditions have occurred similarly in ancient Egypt and Nubia creating large areas of borderlands. Borderland Borderlands are geopolitical spaces defined differentially betwee n disciplines. Historians define borderlands as a land or district on or near the border between two countries (Parker 2006). Anthropologists, on the other hand, define borderlands as regions where new communities have developed or are developing near int ernational borders. Both of these definitions are problematic in understanding ancient political entities with unknown around or between political or cultural entitie s where geographic, political, demographic,

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6 cultural, and economic circumstances or processes may interact to create borders or frontiers that are fluid. A history of contention and fluid political association characterize borderlands . Borderlands are the f irst locations in which a political entity will enact a militaristic plan for strategic, economic or ideological gain prior to quest for administrative or political c , thus begins in borderlands and often continues until the end of conflict increasing the cost of conflict in borderlan d areas compared to all other regions. Cost of conflict In this section, I discuss the economic, sociocultural and political costs of conflict, especially in borderlands. Focusing on the costs and the origin of these costs allows me to develop the price of conflict. A discussion of how economic, sociocultural, and political costs relate to the cost of conflicts on health follows . Economic During times of conflict involved parties suffer damage to their economy, socio cultural structure as well as politic al organization. Three types of depletion characterize economic losses during political conflict: redirection of budget towards military means, destruction of productive aspects as mean of strategic damage, and loss of economically productive parts of the population. The first economic loss, redirection of funds, causes the most long term sustained damage to a group. Political groups spend increasing amounts of resources to maintain military defense and attack capabilities. For example, Knight et al.

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7 (1996) estimate modern military spending of additional 2.2 percent of Gross Domestic Product (GDP) during times of conflict compared to peacetime. The authors conclude the 2.2 percent of GDP spent during conflict time is often permanently lost (Knight et al. 199 6). Often additional spending is diverted from other productive aspects of the economy towards military means. This spending continues after the end of the conflict. Hoeffler and R eynal Q uerol (2003) estimate the average military spending during the first 10 years after a war is about 4.5 percent of GDP. This causes double loss because military spendings are not profitable investment and funds are removed from productive aspects leaving these aspects less productive. The second type of economic loss is de struction of productive aspects of the economy. Primary means of destroying productive sectors is damage to physical infrastructure. Hoeffler and Reynal Querol (2003) identify communication and support lines, airports, ports, roads and bridges as the main targets of physical destruction. In addition, looting of housing structures, schools and health facilities are enacted as part of strategic destruction. Infrastructure is one of the major determinants of economic growth and a determinant of economic declin e when it is destroyed. Several reasons play into economic decline due to loss of infrastructure: limited mobility , decreased safety of transportation, decreased trade , and increased repair spending. When local and national infrastructure are destroyed for militaristic means, damage is not immediately tended to. Instead, damage continues unattended until long after the end of conflict and relative stabilization. Due to the lack of attention, destruction of infrastructure continues to plague the economy of n ations for years after the end of conflict. T he t hird type of loss loss of productive population is discussed both as part of

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8 economic loss and sociocultural loss. During time of conflict, fear causes people to flee their homes often moving abroad (Hoef fler and Reynal Querol 2003). Individuals that are able to flee include people with financial, physical and social capabilities of moving. These individuals are also those with the ability to contribute to the economy the most. During wartime, individuals that continue to live in war plagued nations decrease their involvement in the economy. Individuals decrease their investment and retreat to less valuable subsistence strategies due to lack of return security and safety for investments. Modern national ec onomies depends on profit generated from both local and international businesses. However, during war time local individuals tend to invest abroad and international investors tend to cease their investment due to increased risk. Collier et al., (2002) calc ulate capital flight of wealth increases from 8.6 percent during peacetime to 19.7 percent during conflict and up to 26.1 percent for a decade after war. Many economic costs of war are also socioculturally costly. Due to increased economic risk , individual s alter their behavior and social interactions which led to the increased sociocultural cost of conflict. Sociocultural Sociocultural cost of war emerges from destruction of cultural property, criminal and opportunistic behavior, psychological trauma and increased expectation of corruption. Destruction of cultural property can occur from neglect, as collateral damage, through intentional destruction or looting. Often times, during conflict, cultural property is destroyed with the intention of destroying c ultural identity and as part of psychological warfare (Der Auwera 2012). Der Auwera (2012) argues military mobilization of people is dependent on common ideologies, identity and nationalism previously occurring within the culture. Cultural material support s cultural identities of groups by facilitating community awareness

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9 and cohesion, in group values and traditions that distinguish them from other communities, and borders that delimit territoriality and between group separations (Der Auwera , 2012). As such during conflict, cultural property is destroyed in order to erase memories, history and traditions attached with cultural material, architecture, and place, especially in conquered areas (Bevan 2006). Loss of cultural meaning of a place leads to inhabitab ility of the location and loss of the meaning. Der Auwera (2012) easier to believe the reconstructed version of history, which empowers the claim on the istory through the destruction of previously held ethnoscapes leads to ideological division of communities resulting in higher risk of cultural decline and local conflict. Homogeneity of myths, traditions and nationalism that contribute to the cultural sol idarity of nations are fragmented during conflict thus leading to spatial and ethnic division. Loss of cultural independence and ability to practice cultural beliefs requires individuals to adapt to new or imposed practices, which often leads to health ris ks. Acculturation is achieved through adoption of cultural elements of the dominant society including language, food, dress, music and many other activities (Lara et al. 2005). After the end of conflict individuals suppress their own culture to adapt to th e politically dominant culture in which case they are subjected to new activities, diet and social structure. Acculturation requires extended practice and willingness to dismiss previous cultural knowledge and uptake new ones. However, during conflict such changes must occur rapidly resulting in increased stress and health risks due to lack of cultural, historical , and traditional knowledge. A major cause of socio cultural decline is mortality, which influences both social

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10 interaction and psychological we llbeing. Additionally, exposure to brutality and subsequent displacement and civil disorder leaves individuals psychologically scarred , and leave the intricate network of social interaction torn (Hoeffler and Reynal Querol 2003). Guha Sapir and van Panhuis (2003) argue mortality rates after war are higher than mortality rates prior to the beginning of war. The authors argue that the majority of post war mortality is not attributed to exposure to combat. Instead, infectious disease and opportunistic behavior heightened during war continue throughout decades of the post war period therefore increasing mortality rates. Conflicts that have occurred during the past two decades, Hoeffler and Reynal Querol (2003) argue have sustained more civilian deaths compared t o combatants both during and after the conflict. Additional sociocultural cost of conflicts is the increase of opportunistic behavior. Opportunistic behavior including theft, murder and destruction of property, are heightened during conflict and continue as such after the end of conflict. Property is destroyed as part of financial profit regardless of its influence on loss of culturally associated meaning (Der Auwera 2012). Lack of assurance for survival and economic prosperity leads individuals to act on available opportunities regardless of moral and ethical deficiencies. Such behaviors are progressively elevated the longer conflict and social danger continues. However, it is not immediately reversed after the end of conflict , because most have lost thei r possessions, income opportunities , and property they previously owned. Furthermore, conflict destroys the education system, increases mortality and brings the fear of death to the forefront. As such birthrates frequently rise to replenish the population that has been lost. However, this strategy leads to the loss of cultural beliefs regarding childbirth and restructures basic organization of family.

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11 Political Political effects of war that last beyond the direct political unrest are differential resource a llocation, decline of policy integrity and equality. During time of conflict often, there is a power gap and groups compete for control of such a gap. In order to attain enough power leaders require support from the community. Leaders use coercive power to earn support from the community by promising favors and providing protection. As part of political legitimacy, leaders provide resources and protection for those in support of them even after the end of conflict. One aspect of long term political influenc e of conflict is resource allocation. Political affiliation and active participation of individuals and communities as a whole determines the amount of resources allocated to the community by political groups (Ghobarah et al.. 2003). Allocated resources in clude funding for education, public health facilities and local infrastructure. Ghobarah et al. (2004) explain political institutions and practices influence public health directly through access to health care. Indirectly, diminishing equality and policy integrity which lead s to increased fear and higher risk of health problems. Often time s after the end of a war , improvements of policies are expected in order to reintegrate, equalize and rejuvenate the community. However, Collier and Hoeffler (2002) ar gue once war occurs nations are at three times more risk of having another war compared to the risk for the average country. Hoeffler and Reynal (2003) calculated values based on Country Policy and Institutional Assessment (CPIA) five point scale for low i ncome countries during peacetime and in the first decade after war. Low income countries scored 2.75 during peacetime compared to 2.52 during the first decade after war. Based on the numbers, the authors argue war is not a catalyst for policy improvement. Collier and Hoeffler

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12 economy, less conducive structural policies for IV scale, low income countries that are at pea ce have a score of 2.11, and countries in the first postwar decade have a score of 1.49 (Hoeffler and Reynal 2003). This shows civil war leads to further depletion of policies and equality rather than improvements. Health and Costs of Conflict The goal of this section is to show the relationship between economic, sociocultural , and political effects of conflict seen above with their manifestation on increased health risks. This section allows me to develop the theory that health is influenced by conflict over a long term. Each aspects of society influenced by conflict is discussed through a display of its effect on human health. Economy In the section before , I discussed economic decline during conflict time through loss of productive population, local and international investments , and budget reorganization for militaristic means. In economic terms these conditions cause continuous economic instability and long term insecurity as well as change in the structure of national economy (Brenner 1979). Long term economic instability, insecurity and restructuring leaves individuals unable to cope and prosper with resources in their surroundings. Researchers in social sciences and economics identify Socio Economic Status (SES) as a reliable indicator of quality of health and length of life (Adams et al. 2003). Adda et al. (2003) explains wealth and income influence health conditions more than education and employment grade. As such, the economy plays major roles on overall health of a community. The local and na tional

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13 economy influences subsistence strategies, access to health care facilities and health care resources, and access to non dietary resources. The effect of economic loss on diet derives from loss of local products, loss of infrastructure and loss of productive population. Destruction of communication and transportation infrastructure limits individual ability to access resources through limitation of individual mobility and loss of transport of goods. Lack of access to non local resources leads to inc reased dietary scarcity and creation of food deserts. Added to this, loss of local resources due to violence and limited productivity further reduces resource availability. Diet has been linked as one of the primary causes of immune system decline. Health effects of economic stress are observable in the archaeological record. Methodologies to discern lack of important resources such as essential vitamins, iron, iodine etc have been formulated. These methodologies include assessment for cribra orbitalia, ena mel hypoplasia, Harris lines, tibial curvature, and additional developmental interruptions. Sociocultural Sociocultural loss during conflict affects health in several l ong term ways, including dietary and psychologically. Patrick and Nicklas (2005) sta te after the age of 3 or 4 diet is no longer determined by the necessity to eat; instead, it is determined by individual responsiveness to environmental cues of food intake. The authors explain eating behaviors are affected by several factors including the availability and preference of food, portion size, cultural values about food, preparation beliefs and practices, mealtime structure and feeding style (Patrick and Nicklas 2005). As seen above, sociocultural structure including traditional beliefs, and me altime structure are interrupted and often permanently changed during

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14 conflict. In addition to structura l l y disrupted communities, survivors of conflict have lost friends, family, familiarity and identity (Hoeffler and Reynal 2003). Researchers of nutriti on place increased importance on the influence family and social factors have on dietary behavior (Patrick and Nicklas 2005). Loss of social network and familiarity with surroundings during conflict reduces individual responsiveness to environmental cues o f consumption leading to increased risk of health problems arising from dietary behavior. Such risks are not due to the lack of food , similar to those seen in the economic causes of health risks. Instead, health problems arise from loss of social and cultu ral cues of dietary behavior. Health issues derived from sociocultural losses during conflict are difficult to discern in the archaeological record as they are confused with changes due to environmental influences, cultural evolution or various other reaso ns. Political The most significant long term political cost of conflict, other than domination by a new political group, is resource allocation and loss of systemic support for a community. When a community is no longer politically significant to leaders , the budget supporting the community is revoked to be spent on other matters. This leaves communities with underfunded health care facilities and less human resources. Lack of health care services leads to lack of prevention to preventable disease. Reduce d access to health care coupled with socio cultural changes discussed above results in increased occurrence of infectious diseases and the rise of new disease strains.

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15 CHAPTER III OBJECTIVES AND HYPOT HESES If the theory that experiencing conflict has lo ng term negative effect on health is correct and that these effects are manifested in border areas, then I can hypothesize that higher prevalence of disease will occur during and after periods of conflict in Lower Nubia compared to those from both Upper Nu bia and Egypt. Lower Nubia is a borderland area from the fall of the Meroitic Kush Empire to the Roman conquest , and through the Christian period. Specifically, there should be higher levels of disease and other indicators of stress in Lower Nubia . To exam ine this I compare skeletal populations from each of the regions. 1. El Hesa site will have higher level s of stress markers including Cribra Orbitalia, degenerative joint disease as well as musculoskeletal stress markers compared to other sites in the Nile R i ver V alley. 2. When sites are grouped based on their sociopolitical stance as boarder areas or main regions during the time period the population is from, sites identified as boarder areas will have higher prevalence of skeletal stress levels. 3. When site are compared based on regions , Lower Nubia n sites will have higher prevalence of stress level compared to Upper Nubia , Upper Egypt and Lower Egypt .

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16 CHAPTER IV HISTORICAL BACKGROUN D 4500 3100 BCE The periods known as the P re D ynastic in Egypt and the popul ation termed the A Group culture rise contemporaneously prior to 3000 BCE along the Nile R iver V alley (David 1999; Shinnie 1996). Above the First Cataract of the Nile, three cultures have b een identified as part of the pre dynastic period: Badarian, Amratian (Naqada I) and Gerzean (Naqada II) (David 1999 ). South of the First Cataract , the A Group population occup ies the region between the First and Third Cataract s . T hree phases are identifi ed : Early, M iddle and L ate A G roup (Shinnie 1996, Morkot 2001). The E arly A G roup and Pre Kerma cultures are contemporary with Naqada I and II of Egypt, both dating to 4000 3500 BCE (see figure 3) . The A G roup period concluded around 3200 BCE , around the s ame time as the end of P re dynastic Egypt and rise of the Egyptian Kingdom (David 1999). During 4500 3200 BCE the A Group population is estimated to over 8000, however, the A G roup population occupied a wide area obscuring population density and complicat ing comparisons with other populations in the region (Shinnie 1996, William 2006). Furthermore, estimating population levels are difficult due to the use of perishable goods that do not preserve in the archaeological record. Both populations are believed t o have lived in dwellings made of perishable material (David 1999; Trigger et al. 1983). The Badarian culture is thought to have lived in mud and plant covered houses while the Amratian utilized huts covered with animal skin (David 1999). The Gerzean perio d is characterized by

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17 increased construction of stone dwellings. However, construction of settlements varies north to south. Northern settlements in Egypt were permanent habitats made of mud bricks while southern settlements are often made of skin tents or mats on a pole (Shaw 2003). In A G roup settlements, structures were made of dry stone, mud and pebbles (Shinnie 1996). Sites without identifiable building structures with surface scatter of artifacts are thought to be huts of straw and reed (Shinnie 1996) . Most settlement areas that have been identified during this period follow along the Nile. Trigger et al. (1983) hypothesize that cultures and settlements of these periods might have been determined by environmental conditions rather than social and polit ical decisions. Figure 2 : Distribution of the A group culture between the First and Second Nile cataracts Both the A G roup and P re d ynastic period of Egypt were characterized by semi sedentary agricultural populations (David 19 99; Shinnie 1996). Evidence of wheat, barley, peas and lentils from both Egyptian and A G roup sites display presence of domesticated crops (David 1999; Shinnie 1996; Trigger et al. 1983). Shinnie (1996) argues that the A -

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18 G roup were the first to practice ag riculture along the Nile River Valley. Shaw (2003) negates this, explaining that the Badarian culture is the earliest evidence of agriculture in the Nile Valley. Evidence of animal domestication and husbandry is more prevalent in the Naqada II or Gerzean p eriod of Egypt than in the A G roup of Nubia. A G roup pottery is distinctive , differentiating the group from the P redynastic populations of Egypt. A G ware (Shinnie 1996). These ceramics are o ften burnished and decorated with patterned paintings. In contrast, northern Egyptian pottery during the P redynastic period was undecorated or simply incised red or black monochrome pottery (Trigger et al. 1983). In the Gerzean (Naqada II) period, Egyptia n pottery saw increased foreign influence from Palestine , bringing about the development of L ate Egyptian pottery. In Gerzean (Naqada II) period, copper artifacts become common and the use of gold becomes a symbol of luxury leading to increased separation of labor, social stratification, and complexity (Trigger et al. 1983). In A Group cultures there are two types of burials: oval pit and o val pit with a lateral niche for the body. In Egypt, burial customs developed from a simple pit burial during the Bad arian culture to the inclusion of grave goods in Naqada I and mastabas in Naqada II. During Naqada II, rulers and the ruled had different burial p atterns. Rulers were buried in m astabas (meaning bench), with complex chambers for the body and tomb goods (Da vid 1999). Increased separation of burial style is symbolic of the continued stratification of Egyptian society. Evidence from the tombs of Qustul cemeteries and the earliest tombs at Bahan Tombs have shown social differentiation in wealth and culture duri ng the M iddle and L ate phase of A G roup (Williams 2006). Williams reached the conclusion that during the A Gr oup Nubians claimed pharaonic status and victory in Upper Egypt (2006). In the Dongola

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19 Reach, a definite symbolic design suggests the presence of a dministrative arrangements (Williams 2006). Such findings entail the earliest aspects of the P re Kerma culture. The three cultures: A G roup, P re Kerma, and P re dynastic Egypt, began and developed as separate but interacting entities (See figure 3) (Shinni e 1996, Morkot 2001). Interactions between the two sets of cultures has been confirmed through the presence of artifacts in burials and symbolic images. Between 3500 and 3000 BCE the Egyptian K ingdom and the P re Kerma culture continued to develop and incre ase in complexity while the A G roup culture of Nubia disappears from the archaeological record. Figure 3 : Egyptian pre dynastic and contemporary Nubian sites 4500 3200 (Torok 2008) From 3400 BCE until 3100 BCE Egypt was separat ed into two kingdoms: Red Land

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20 and White Land. The R ed L and occupied the region between the Delta and Atfih. The W hite Land occupied the region from Atfih to Gebel es Silsila. In 3300 BCE , there is a decrease in Nile flood discharge that encouraged the un ion of the two lands. On the other hand, the decrease in Nile flood discharge exasperated the rate in which A G roup populations declined. Over the estimated 500 years of the P re dynastic period , Egypt underwent several restructurings leading to the rise of the D ynastic period. Egyptian restructur ing included economic centralization, complex religious beliefs, social hierarchy and political authority (Hassan 1988). Restructuring of Eg yptian government has been suggested as a factor on the disappearance of th e A Group populations. 3100 BCE 2300 BCE Between 3100 BCE and 2300 BCE the A G roup continued to decline to complete disappearance from the archaeological record, P re D ynastic Egypt unifies and the P re Kerma culture develops into the Kerma civilization. The disappearance of the A G roup has been attributed to environmental change as well as Egyptian aggression during the Old Kingdom (Torok 2009, Morkot 2001). Morkot (2001) argues that the A G roup population were driven out by Egyptian campaigns to live in the semi desert region adapting a nomadic lifestyle throughout this time. The earliest advance of Egypt into Lower Nubia has been observed in Elephantine in which the earliest urban architecture is identified from P re D ynastic Egypt between 3200 and 3000 BCE (Torok 2009). The first fortress, however, is attributed to the First Dynasty in which the southern frontier was established at Elephantine at the First Cataract .

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21 Figure 4 : Extent of Egyptian control during Old Kingdom period (26 91 2181BC) Although the First three dynasties of Egypt conducted organized aggression towards Nubia, royal palaces of First through Third D ynastic period have not been identified thus far leading to the belief that palaces were constructed from Sun dried b ricks, wood and other perishable materials. In addition, Old K ingdom Egypt lacked class distinction within non royal individuals and focused on maintaining royal families. The rise of the Old K ingdom was marked by centrally organized state with large scale building projects along with a continuous societal evolution centered at Memphis (figure 4) . Between 2800 BCE and 2300 BCE Lower Nubia is archaeologically barren (Torok, 2009). During the period spanning from 2800 to 2600 BCE , Egyptian territory was expa nded further south to include the region between the First and Second Cataract . Egyptian settlements at Kuban near the Wadi Allaqi and at Buhen have been identified to indicate commercial route s between Egypt and Upper Nubia (Torok 2009). The last ruler of the

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22 Second Dynasty of Egypt led significant military expeditions into Nubia, most likely in Upper Nubia , before 2686 BCE . Several royal seals from Second to Fifth D ynasties of Egypt have been found at Buhen near the Second Cataract attesting to Egyptian c ontrol of Lower Nubia between 2890 and 2345 BCE . Further south of the Second Cataract very few Egyptian artifacts have been discovered pre dating the Early Kerma period (2500 2050 BCE ). At the end of the Second Dynasty of Egypt building with stone began. Du construction of large scale royal burials with multiple shrines and courts were similar to structures began embodying the belief that the king i s chosen by god and above all. In the Forth Dynasty rule of Sneferu, construction of royal tombs became the shape of a pyramid. Construction of burials in relation to astronomical bodies was altered to accommodate the rise of belief in the sun god Ra and O siris. The first sets of pyramids were constructed south of the Saqqara, two of which were dedicated to Sneferu. The b uilding of pyramid s was perfected during the reign of Khufu, named after the god of Elephantine near the First Cataract . The construction of such large monumental structures required resources to be diverted from other portions of the society including agriculture. Strong demand for resources required administrative advance, efficient taxation and search for additional sources of manpower an d economic support from abroad. Centers of large populations became administrative districts with organizational and strategic value. Furthermore, large scale constructions provided reasons for expeditions to acquire minerals and building supplies . Inscri ptions in the Sinai Peninsula depict names of Djoser, Sekhemkher, Sneferu and Kufu, the Palermo Stone, discusses forty ships containing wood from abroad, and Khufu

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23 west of Abu S imbel. Figure 5 : Agriculturally fertile and Natural resource rich areas in Egypt and Lower Nubia During the 3rd and 4th century military threat to Egypt was not present ; however, Egypt led numerous expeditions to Nubia and Libya to procure resources and subjugate enemies as part of the responsibility of kingshi p. Several evidences of sporadic Egyptian eradication campaigns in Lower Nubia and evidence of direct exploitation of diorite quarries at Toshka west of Buhen has been iden tified (Markot 2001). During the Fifth Dynasty of

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24 Egypt the Palermo stone inscribes an Egyptian campaign lead by Sneferu (2613 2589 BCE ) which resulted in 7000 captives and 200,000 cattle as booty which were settled in the Eastern Delta region. As well as trading missions of myrrh and electrum which were brought from the land of P unt to Fifth Dynasty ruler King Sahura (2487 2475 BCE , figure 5 ). In the fourth Dynasty religious revolution, private land ownership and the rise and spread of local nobility began to undermine the power of the pharaoh. Lower floods of the Nile and continued famines encouraged the decline of the state. At the end of the Sixth Dynasty , the power of the king had declined, and decentralization persisted leading to the final fall of the Old Kingdom. During the O ld K ingdom, control of Lower Nubia was of the highest importance to maintain trade routes, to gain access to goods from Upper Nubia and from the R ed S ea and to protect the southern frontier of Egypt (figure 5) . From the Second D ynasty until the Fifth Dynasty control over Nubia was mostly uncontested by the native population (Torok 2009 ). However, this was significantly altered and at the beginning of the Sixth Dynasty as Lower Nubia was resettled and reorganized into chiefdoms. 2300 BCE 2100 BCE Beginning in 2300 BCE Lower Nubia begins to be resettled and reorganized . Upper Nubia continues to prosper growing in local and regional control while the Egyptian K ingdom continues to decentralize and decline in power. The origin of pop ulations making up the C Group in Lower Nubia are unknown. However, several suggestions have been put forth including a resettlement of A G roup decedents , migration of populations from the Wadi Howar region of the eastern Sahara, as well as a P roto Meroiti c and P re Kerman populations. In addition, the growth of Lower Nubian chieftains have been attributed to decline of centralized government in Egypt during

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25 the Sixth Dynasty of the Old Kingdom. Archaeologically, the presence of several chiefdoms along the N ile River and their reorganization as a unified polity has been documented from stele. Four military expedition under Merenra and Pepy II were conducted throughout Nubia reaching Yam by Harkhuf. During his second expedition Satju and Irtet were united whil e during his t hird expedition Satju, Irtjet and Wawat were combined under the same rule. In Lower Nubia were described in reference to each of the 1st and 2nd Ca taract was known as Wawat (Torok 2009). At the beginning of the M iddle K ingdom of Egypt , the region between the 1st and 2nd Cataract was unified into Wawat, a Lower Nubia n culture known as the C G roup of 2400 1600 BCE (figure 6) . The broad timeline of the C Gr oup population of Lower Nubia has been further categorized in to three phases . The first phase, Early C G roup phase, has further been divided between phase IA and IB. These two early phases of the C G roup in Lower Nubia are contemporaneous with the Earl y Kerma or Kerma ancien and the O ld K ingdom to the M iddle K ingdom of Egypt. Trigger (1976) states that there was no archaeological data in Upper Nubia , however , by the 6 th Dynasty of Egypt the Northern Dongola Reach h as at least one chiefdom. The border b etween the Kerma culture and the C G roup is considered on the 2 nd Cataract as the furthest Northern Kerma site identified is Mirgissa. The K erma culture is characterized by thin highly polished black wheel, ani mal shaped vessels and other decorated animal motifs, specialized copper daggers, woodwork decorated with patterns of inlaid ivory and mica figures and ornaments sewn on leather caps ( H akem 1981 ) .

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26 The early C G roup population show similar burial practice s as those from Kerma with body facing to the east and the head to the North . C grave burials often contained a wealth of burial goods including: bead s , bracelet s , armlet s and hair rings. However, the two groups differed in their burial str u ctures. C G roup burials had solid stone masonry structures similar to the A G roup tomb structures while in Kerma burials were low sand and gravel mound superstructures with a ring of small stone slabs or large pebbles. Social hierarchy of the Early Kerma population is un known however variation in sizes of tomb superstructures and complexity of funerary equipment shows the rise of hierarchy and complex chiefdom. During the main part of the S ixth Dynasty the relation between Lower Nubia n polities were regulated to the advan tage of Egypt. During this time the most significant Nubian import were mercenaries. Similarly , the most important Egyptian import found in Nubian sites was f oodstuff which is identified in Egy ptian pottery at C G roup sites. Calcite vases found in Kerma wi th Pepy I and Pepy II sh ow a trade relation based on gift exchange between 6 th Dynasty Egypt and Yam. Gold and exotic wares from south near the Kerma basin were as important to Egypt as other imports from Byblos. , rulers of Upper Nu bia were able to control economy, war and ideology of power and cult. Their territorial power extended over the K erma basin and the region between the Second and Third Cataract s. The collapse of the O ld K ingdom leads to significant changes in Kerma and Egy pt relations.

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27 Figure 6 : C group and Kerma culture distribution in Nubia between 2300 2100BCE 2160 2055 BCE The First intermediate period lasting from 2160 to 2055 BCE represents the progressive decline of the O ld K ingdom in whic h centralization was lost in Egypt. Grandiose beginning of the First intermediate period. During the 5th and 6th dynasties, nomes, provinces were established to control reg ions further away from the direct management of the king. However, the development of nomes led to the increased power accumulation

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28 among provincial leaders. Nomes , began to acquire their own resources without the need for Egypt became richer and culturally complex due to lack of exploitation by the royal government and this led to a power struggle between the central government and provincial leaders. As local rulers grow in power the central government lost its influence. The last display of loss is observed in the change of the capital from Memphis to Herakleopolis. Egypt was divided between northern, Upper Egypt of the Herklepolitians and southern Upper Egypt of the Theban nomarchs , governors of nomes . War continued betwe en the Herakleopolian kings and Theban nomarchs between the regions of Abydos and Asyut until the rise of Thebans as the 11th Dynasty of Egypt. The lack of centralization and pharaonic control promoted productivity in the lower class of Egypt (figure 7) . Often the most productive aspect of Egypt during this period is identified in the provincial town s . The First I ntermediate period economic, social and political pattern of Egypt changed along with archaeological markers representing them. Funerary patterns during the O ld K ingdom changed as larger tombs of lower class individuals became widespread containing more grave goods. Similarly, artifacts of the First I ntermediate brought on previously unseen regional variation in construction and style. The Heraleop olitans controlled political offices for a period of ~185 years. At the end of their reign Herakleopolis was sacked by the T heban nomarchs and the 12th Dynasty of the M iddle K ingdom was formed.

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29 Figure 7 : Political division of Eg ypt during the first intermediate period (2150 2080BCE) 2055 1650 BCE The M iddle K ingdom marks the reunification of Egypt in the 12th Dynasty (figure 8) . The new capital of the M iddle K ingdom was set in the F aiyum region at the town of Itjtawy. The new cap ital allowed better access to Asiatic incursions and ensured a signal of a new political beginning. Mentuthotep II expanded this power to the Herakleopolital Kingdom and placed troops in fortresses at Elephantine to show power and to intimidate C G roup Chi eftains .

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30 During the M iddle K ingdom the K ing had Viziers who conducted campaigns in Nubia and surroundin g regions while the C hancellors controlled the eastern desert and the oases. Two governors of upper and Lower Egypt were formed in order to maintain uni ty and power within the hands of the king. Figure 8 : Extent of Egyptian kingdom during the Middle Kingdom period (2055 1650BC) Foreign relations during the Middle K ingdom stretched further to the northeast and the south under va rying policies. The northeastern border preserves large canals dating to the 12th Dynasty while the southern boarder presents fortresses constructed at Mendes, Semna and Quban in Nubia. Fortresses functioned to protect and service the gold mines in Wadi Al s progressed south as far as elephantine. At this time relationship with Nubia was transformed from loose

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31 trading networks to conquest and colonization (Markot 2001) . An inscriptio n at Lower Nubia n site of Korosko reads the people of Wawat were defeated in the 29th year of Amenemhat extending Egyptian territory beyond the First Cataract . In the reign of Senuseret numerous expeditions were sent to Nubia setting the new southern borde r of Egypt at Buhen. At this time Lower Nubia became a province of Egypt. Although Lower Nubia was not continuously garrisoned by Egyptian forces, campaigns in the Second Cataract were brutal: including crop destruction, felling trees, and razing of villag es ( M arkot 2001). As Lower Nubia was subsumed into Egypt , Upper Nubia was further exploited for overshadowing of variation from the First Intermediate P eriod to create a universal royal style within Egypt. The constructions of monuments at each of the main cults undermined the power of local temples and priests. Similar conquests of Kush continued throughout the reign of Amenemhat II. However , during Senusret II military campaigns ceased giving ways to increased trade and construction of irrigation systems in the Faiyum regions. During the reign of Senusret III (1870 1831 BCE ) military campaigns were sent to Nubia regularly for conquest. This period preserves a brutal cam paign against Nubians in which men were killed, women and children enslaved and fields burned. Following the conquest of Nubia mining and trade continued with the southern border of Egypt being marked by fortresses in Semna and Uronarti (Trigger 1976) . For eign relations between Nubians and Egyptians no longer held trade agreements . I nstead fortresses reinforced the frontier prohibiting Nubians from north bound travel beyond the Semna frontiers (Trigger 1976) . The 13th Dynasty continue d rigorous control ov er Nubian movements near the

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32 worked towards centralizing Egyptian government through a reorganization of political and social classes especially the middle class. Mi ddle K ingdom of Egypt reached its highest peak during Amenemhat III reign (1831 1786 BCE ). Amenemhat III further established the southern border at Semna and enlarged the fortresses. Social, economic and political peak of Egypt is marked by increased const ruction projects across all of Egypt and the Quarries of Nubia including Wadi Hammamat, Tura and Aswan. However, increased construction activities may have placed economic strain resulting on the progressive decline of the Middle K ingdom. The Thirteenth D ynasty displayed decline of the central government and Egyptian prominence as an increased number of rulers take up the throne, grandiose royal burials cease and border security declines. In addition to economic strain and political unrest climatic pressur es also played a role in the decline of the M iddle K ingdom as the height on the Nile Dynasty trade to the south with Nubia and to the northeast in the Sinai continued similar to the 13th Dynasty . However, an impoverished tomb of Awibra Hor displays the declining conditions of Egyptian economic and political power. The power of M iddle K ingdom Egypt continued with progressive decline during the reign of Sobekhotep IV where statues were found beyond the Third Cataract . However, during his reign the first revolts in Nubia began leading to the loss of Egyptian power over Nubia and beginning of Nubian rule over Egypt. Throughout the M iddle K ingdom Egyptian expenditure was supported by taxation and enforc ed labor through a corvee system. The corvee system began in M iddle K ingdom continued through the 17th Dynasty with Nubian the only people exempt from taxation and corvee. Government control was extended.

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33 1600 1500 BCE As taxation increased and power of t he central government declined giving way to local control and nomarcs, the northern part fell to the Hyksos. As Egypt struggled to maintain control of internal struggles Lower Nubia was abandoned and Kerma reached its peak (Trigger 1976). The extent o f th e C lassic Kerma has been established north at Mirgissa and Buhen along the Second Cataract and south 80 km below the Dongola to Argo Island (Trigger 1976) . At its peak the Kerma kingdom dominated over 1000km of the Nile valley (Edwards 2007). In Lower Nubi a , the Hyksos do not seem to have attempted to reoccupy the region. Although, Kushites have stationed token forces near the Second Cataract they do not seem to occupy the region either. Instead, the Kushites seem to have formed a mutually beneficial allian ce with the C G roup population to trade with Aswan (Trigger 1976). The site of Kerma during the classic period was highly fortified. The system of fortification included a system of massive walls, rectangular projecting towers, dry ditches that surrounded the towers and walls to prevent undermining as well as foundation stones from quarries at Tombos (Bonnet 1992). Additionally, some of the most puzzling structures of the Kerma culture are found during this period. One of such enigma is the western deffufa at the edge of the Kerma basin. An almost solid mud brick structure 52m long and standing at 19m high which resembles the Middle K ingdom forts of Egypt in the brick work and timber bonding (Trigger 1976). The construction of the deffufa preserves at least 12 phases of masonry (Bonnet, 1992). Rooms at the base contain vessels of Egyptian origin, raw material as well as unfinished products, raising numerous hypotheses that the deffufa might have functioned as: a trading post, w atch tower, manufacturing post, royal residence or religious building (Trigger 1976 , Bonnet 1992 ). Massive number, 565, of seals have been identified at

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34 the duffufa from 15 th Dynasty Hyksos rulers of Egypt indicating considerable trade between Lower Egypt and Kush (Trigger 1976). Findin gs of pottery, ivory and ebony at Kerma show trade with the N ear E ast and the eastern Mediterranean in addition to Egypt (Trigger 1976). Figure 9 : Distribution of regional control by different political powers during the Second intermediate period (1650 1580BCE) At Kerma a large cemetery , estimated to comprise over 20,000 graves during a span of a millennium, has been identified ( Sherif 1981 ). Sections of the cemetery dating to the Second intermediate period preserve a wide range of tomb sizes, burial goods and sacrificial people. The largest tumuli, K III, which contained up to 400 sacrificial humans who appear

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35 to have been buried alive. (Trigger 1976). The great tumuli of the Kerma cemetery suggests a centralized monarchy while the weapons, sacrificed retainers indicate significant importance of warfare (Trigger 1976). Trigger (1976) suggests, that the increase in human sacrifice and decrease in animal sacrifice could be related with the need to control a growing slave populatio n and increased emphasis on preserving family property. Unlike the practice in dynastic Egypt, tombs of all sizes are within the same cemetery. Although wealth and access to labor services can be seen in the Kerma burials no distinct delineation of social classes can be formulated due to variation present in tomb size, number and quality of burial goods (Trigger 1976). Profitable trade agreement between Hyksos and the Kushites continued until against the Hyksos. During the war against t he Hyksos, Kamose intercepted a letter from Aweserre to the King of Kush stating the king failed to notify him of his ascension as ruler and requesting to attack the Thebans as was agreed upon. The communication states, following the attack, if successful, the Theban region would be divided between Hyksos and Kushites (figure 9) . At this time the Theban domain included the Nile Valley as far north as the entrance to the Faiyum (Trigger 1976). After the rejection of the Hyksos, Egypt was reunited under Theb an rule by Kamose in 1575 BCE . Kamose focused on removing Hyksos from Egypt and reuniting New Kin gdom Egypt throughout his reign (figure 10) . The first ruler of the 18 th Dynasty , Ahmose followed similar policy until his 22 nd year of reign. The last stage of the war against Hyksos completed during the 11 th reginal year of Ahmose when Heliopolis was sieged and Avaris was occupied (Torok 2009). F Lower Nubia were reestablished and claims to have slaughtered many Nubians without a known southern reach

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36 (Trigger 1976). to Kush during his 7 th and 8 th regal year and claim to have captured the chief of Nubia. The two rulers, Kamose and Ahmose , expelled the Hyksos and Kushites from Egypt to develop a buffer zone Lower Nubia to t he south and southern Palestine to the north east (Torok 2009). Figure 10 : Hyksos expulsion from Egypt at the end of the second intermediate pe riod During the New Kingdom period, in mid 18 th Dynasty , royal ideologies were altered to see kings as rulers of empires and conquers of foreign lands. Similarly, alteration of imagery and terminology are seen in paintings, murals and architectural decorat ions ( Morkot 2001). Conquering of foreign lands was similar regardless of race, people or countries however they applied different responses of control, integration and administration of African and Asian regions (Morkot 2001). Political strategies such as the creation of buffer

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37 zones, conquest and empires would further develop throughout New Kingdom Egypt to form an imperial rule in northeastern Africa. 1500 BCE 1189 BCE Although Egyptian conquest did not differentiate based on race or people motivation and execution of conquest were significantly different between Asiatic conquest and Nubian conquest. Egyptian presence in the Lavant was motivated by economic interests. However, in Nubia the motivation was economic, political as well as militaristic (Torok 2009). th Dynasty Egypt began the conquest of Lower Nubia . Wawat, Lower Nubia , was characterized by the C group culture during this time. Howev er, the C group: in tomb type, funerary artifacts, and b urial customs became Egyptian during the course of the 18 th Dynasty s of rubble made of vegetable material and leather in C group culture were replace by right angled mud bricks. Distinct C group population was present until mid 18 th Dynasty and the Nubian castle in Amada was still in use during the reign of Thutmose III (Adams 1977). In the early 18 th the C group burials consist of significant stratification. Rich burials were of rectangular shafts chiseled in hard stony silt wit h superstructur es sometimes with indication of an offering nich e on the east side (Adams 1977). By Late 18 th century Egyptian burial furniture was fully incorporated in Nubian burials and distinct Nubian burials can no longer be identified (Adams 1977). Th e conquest of Lower Nubia may have been expedited by the lack of Kerman garrisons, absence of Kerman religious administration and lack of loyal officials (Torok 2009). In the Second shown Lower Nubia until the Third Cataract has been subsumed as Egyptian territory (Torok

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38 2009). The o ffice of the viceroy was established in Lower Nubia during the reign of Lower Nubia was administered under the same lines as the nomes , sepat, with in Egypt. Prior to the end of the 18 th Dynasty , Egypt completed the conquest and integration of Lower Nubia and continued further south to Kerma. After the conquest of Lower Nubia , New Kingdom pharaohs continued south to conquer the Kingdom of Kush. Kerma went through several changes including the move of the royal cemetery from Kerma to south of the western deffufa and reached its peak in wealth and innovation, observable in some of the mortuary monuments. To this effect, Torok gives an example of a trunc ated conical pit burial, lined with blocks of Tombos granite, with a tall cylindrical stone superstructure and that has a mortuary cult chapel attached to the east (2009). At the start of the conques t of Kush, Amenhotep I claims he destroyed the bowmen of Kush in 1517 BCE but the Kingdom of Kerma survived this plundering (Torok 2009). Damage to the cemetery and surrounding area shows the brutality of these campaigns (Torok 2009). Thutmose I continued the plundering of Nubia south of the Third Cataract during campaigns in his 2 nd and 3 rd advanced to just above the 4 th Cataract where a boundary stela was left at Kurgus (Torok 2009). This advance however, did not complete ly eliminate Kerma as they h ave marched between the Third and fourth Cataract attack the K erma basin and the great bend of the Nile remained under Kerman control (Torok 2009). Regardless, in 1504 BCE Thutmose I left stele marking the s outhern boarders of Egypt at Kurgus and the northern at the banks of the Euphrates (figure 11) .

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39 Figure 11 : Extent of Egyptian control during the New Kingdom period While the conquest of Nubia below the 3rd Cataract continued , u prisings in Lower Nubia began to spark. An inscription from Thutmose II describes a conflict in Lower Nubia against Egyptian forces. Resistance from Nubians continued during the reign of Amenhotep I . Archaeologist agree uprisings such as these in Lower Nub ia are led by descendants of Kerma (Edwards 2007, connor 1982, Torok 2009). An inscription from Thutmose II describes the leader of a rebellion in Lower Nubia , probably a Nubian pri n ce , was taken to to Kush to hold office in the colonial government (Torok 2009). The same inscription also describes Upper Nubia organized in districts and governed by native princes left in their positions. Expatriates of the Kerman administration were progressively chang ed until they were completely replaced by a vicergal administration (Torok 2009). At this time, after 1492 BCE , a change in the goal of Egyptian policy is seen shifting from colonization to assimilation (Torok 2009, Adams 1977). Similar to previous 18 th Dy nasty

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40 several expeditions to Nubia both in regions already under the control of Egypt as well as new territory. Four expeditions, three in previously controlled areas to subdue rebellion during the chang (1473 1458 BCE ) expedition to Punt introduced a change in trade relations between Egypt and interior Africa. Although the relief describes tribute from the chief of Punt to the pharaoh the transaction tells of a trade between two polities in which worth was evaluated differently by each trade partner. This expedition set the stage for a change in ideologies and political significance of trade partners, beginning with the expedition to Punt goods arrivi ng from Nubia and those from south of Nubia were differentiated in their presentation to the public (Torok 2009) . Goods form Nubia were tributes due to submission following the loss of a war while goods from Punt were presented as tributes solely to the Egy ptian populace while they are a result of trade or gift exchange (figure13) . The reign of Thutmose III also established Egyptian domination as far south as the 4 th Cataract identified by a stela in Nubia from 1432 BCE placing Nubia under the framework of U niversal regency (Torok 2009) . Control of the Kingdom of Kerma secured access to products of internal Africa including Gold.

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41 Figure 12 : Trade routes during the New Kingdom period Figure 13 : Trade route s and Natural resources distribution in Egypt and Nubia during 1400BC

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42 In the period span ning 1500 1390 BCE , Nubian society was altered from politics to econom ic , and settlement patterns. Along with repetitive conflict, Egyptian overlords of Nubi a contribute d to Nubia through n ew trade relations and construction projects. Thutmose I controlled the Nile V alley up to the 3rd Cataract and conducted building campaigns in Lower Nubia . Some of construction sites include Kuban, Semna West, Semna east a nd Sai as well as a onnor , 1982). Economic aspects of Lower Nubia became entangle d with that of Egypt during the New Kingdom (Adams 1977 , figure 13 ). This can be see n in a market scene relief from Theban tomb TT57. The r elief shows ships of royal fleet bringing grain to Kush in exchange for Nubian and African products showing an integration of local and state controlled trade. Hunting and Pastoral lifestyle was still prominent in Lower Nubia . However, a portion of the cat ch or herd was now required as tribute to the government or temple (Adams 1977) . In this period, agricultural activities increased as settlement patterns and land ownership changed in Nubia. During the C G roup period of Lower Nubia , land was predominantly owned by the community while under Egyptian reign Land became property of the crown, local princes, administrators or temples (Adams 1977). Nubian towns at this time look like small scale Egyptian centers such as Thebes, presenting walled town center with smaller farming communities surrounding the wall. Ideolog ically, the goal and method of Egyptian control over Nubia changed throughout the New Kingdom period. It began with conquest to control Lower Nubia in order to reunify Egypt. This was later altered to economic and political gains . Minmose describes collecting tax each year from the land of Nubia in quotas of electron ore, gold, ivory, ebony and shipments of pal wood (Torok 2009). Tribute from Kush was also collected in the year

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43 31, 34, 35 and 47 of T hutmose III. This evolved to cultural assimilation of Lower Nubia then to threatening and conquest of a dangerous rival during III sent the body of one of the seven defeated chiefs captured in year 7 in the region of Takhsy in Syria to be hanged on the city walls in Nubia (Torok 2009). Amenhotep III also began an extensive plan to exploit the gold mining region which fell under the control of the viceroy of Kush. As part of the plan to exploit gold mines east of Lower Nubia several locations including 1982). These invasions increased the security on the frontier as well as improved access to the gold mines in the Wadi el Allaqi and mw 1 982). In the latter half of the 18 th Dynasty , Gold becomes the most significant product of Nubia pertaining to Egyptian interest in the Levant as well as to pharaonic propaganda . For for threatening the food supply of gold miners while Seti I and Ramesses II sunk wells in Wadi el Allaqi to several times as it held the key route to the Wadi el Allaq i to transport slaves and gold. Hatshepsut and Thutmose III developed trade relations with locations like Irem, Punt and others located in the 5 th and 6 th Cataract of the Nile. Seti continued developing the southern Egyptian gold mines and attacked Irem in order to gain access to the route leading to mw. Rameses followed the same trend in exploiting the gold mines and battling with populations that interfered with the gold supply. The name of the viceroy of Kush changed creased responsibilities to control the gold mines as well th year (1432BCE) the kingdom of Kerma at Napata was extinct and

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44 Napata was a permanent Egyp 1189 BCE 730 BCE After the glory of the 18 th and 19 th Dynasty , the 20 th Dynasty of Egypt presents an economic and demographic decline in Egypt and Nubia. Tr aditionally decline in economy and demography of Nubia are reconstructed based on the lack of 20 th Dynasty burials. However, this has been explained as caused by construction of family vaults and the burial of undatable small amulates with the dead instead of rich household items (Torok 2009). A shift from sedentary to pastora l economy also played a role in the population decline observed at this time (Torok 2009) Further, important administrative and trade centers such as Aniba, Buhen and Amara were abandoned in the course of the 20 th Dynasty (Adams 1977). Before 1100 BCE both Egyptian and Nubians were gone from Lower Nubia and the Baten E l Hajar region under unknown circumstances (Adams 1977). Abandonment of Lower Nubia had political and cultural repercussions on both Egypt and Upper Nubia . In Egypt , the southern limits were r educed first to Kawa then moved further north under Rameses III (1184 1153 BCE ) and Ramsese IX (1125 1107 BCE ). However, presence of viceregal activities in Napata provide contradicting evidence that Egypt was still politically influential in Nubia throughou t the 20 th Dynasty (Torok 2009). T Kush title continued until the end of the 20 th Dynasty stationed at Thebes amassing significant power that was not affected by the collapse of the agrarian economy (Adams 1977). This office also controlled the most effective military force in Upper Egypt upon would lead to the rise of the Kushite rulers as the 25 th Dynasty of Egypt . In Upper Nubia , abandonment of Lower Nu bia by Egyptians led to a progressive severance of political

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45 relations between Upper Nubia and Egypt (Adams 1977). Rise of the Libyan rulers in Egypt was encouraged by a weakening central government. Uncontrollable migration of the Eastern Mediterranean s ea people, continued conflict with Libya and change in the traditional outlook of political unity intensified the rate of Egyptian decentralization (Torok 2009 , figure 14 ). Following Egyptian decentralization, Libyans who controlled high offices in the Egy ptian government since 11th century BCE rose to power as the twenty Second Dynasty of Egypt (945 715 BCE ) (Torok 2009). Figure 14 : Political division of Egypt during the Third intermediate period and path of Kushite invasion (732B CE)

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46 A new outlook of aristocratic, descent and clan became a central aspect of the government for the next two centuries as Egypt fragmented into eleven major and independent regions with different rulers. Ramsese IX (1226 1108 BCE ) and Ramsese X (1108 1099 BCE ) faced constant violence from Libyans and economic crisis (Torok 2009). As internal Egyptian conflicts intensified, Nubia was left unattended by the Libyan rulers similar to the North West and Western Delta regions. These regions were agriculturally po or and commercially insignificant to the 21st and 22nd dynasties of Egypt. The Kushite kingdom capitalized on the lack of interest in upper and Lower Nubia as well as the decline of Aswan to invade Upper Egypt , figure 14 ). One of the signif icant individuals in the conflict between Kushites and Egypt for control of Lower Nubia is Panehasy (Penehasy). In year 17, 1093 BCE Amenhotep protected Ramsese XI for a victory against Panehesy (Torok 2009). However, the year s that followed, year 18 and 19 brought on further suffering in the Theban region. Torok characterizes this as full of war, famine, plundering and shocking atrocities (2009). In year 19 of Ramsese XI, Panehesy sustained losses that retreated his army to Lower Nubia . Despite his retreat to Lower Nubia Thebes (Torok 2009). At the end of the New Kingdom period the Kushite Viceroy, Panehesy, retained control of Lower Nubia and possibly Upper Nubia as well. P olitic al division continued Smendes in the north and Herihor in the south dividing the kingdom into two entities (Torok 2009). Panehesy is thought to have developed a cohesive and united Lower Nubia n governance as they were a ble to withstand Egyptian However, Lower Nubia Nubia was evacuated

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47 voluntarily and as a wholesale at about the time of Herihor and Pinankh primarily caused by n 1982). Lower Nubia n depopulation was further exacerbated by fluctuating Nile R egardless of these events Egypt maintained viceregal domain in Lower Nubia by choosing a ne w viceroy to replace Panehesy . In Egypt, Piankh succeeded Herihor in the high priesthood of Amun in Thebes and consolidated Upper Egypt as the regent of the Theban High priest along with his son Pinodjem I (1070 1055) (Torok 2009). Ramses XI continued colonial cont rol over the region north of the 3rd Cataract and unknown level of influence farther south. During this period Egyptian settlement pattern was altered focusing more on defensible and profitable town centers such as Tanis instead of Pi Ramses, Memphis and T hebes (Edwards 2007). Several regions, the delta Apex and the Hardai Gebelein Zone, in Egypt and Nubia were thought as more important than others during the 20th Dynasty . Such importance is marked by restrictions and fortification of the region (Edwards 20 07). In the 23 rd D ynast y Lenontopolis and Athribis Heliopolis also became royal towns as they provide access to the delta apex and link it to Tanis. Tanis as a defensible and economically stable center saw continuous temple construction. Furthermore, Third I ntermediate P eriod Egypt faced changes in symbolic and topographic outlook which reflect the shifting political powers and insecurity prevalent in the region. Royals of the 21 st and 22 nd dynasties moved their tombs to Tanis within the administration city walls (Edwards 2007). Dynasties that followed these also selected locations apart from the traditional royal burial sites for their tombs: 23 rd and 24 th in Leontopolist, 26 th Sais and 25 th Napata (Edwards 2007). In Lower Nubia , resettlement was

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48 not attemp ted under the 25th Dynasty , instead, maintaining a buffer zone between the Kushite powers in Upper Nubia and those of Egypt in the north held mutual importance (Edwards 2007). Aside this the only documentation regarding the predecessors of 25 th Dynasty Kus hite rulers is their burial at Kurru. Burials at Kurru indicate continuous use starting around 860 BCE that is unaffected by changes in Egypt. In addition, Egyptianization of Upper Nubia achieved during the N ew K ingdom period had been lost in the wake of th e 25 th Dynasty . This is indicated by the circular earthen tumuli covering simple pit and chamber tombs and non Egyptian orientation found at Kurru. However, several Egyptian artifacts have been identified showing significant trade with variety of contact ( Edwards 2007). 730 BCE 610 BCE In Upper Nubia the conditions immediately after Egyptian departure at the end of the New Kingdom period is unknown. However, soon local chieftains rose to power in Napata forming the Napatan period of the Kushite Kingdom. Wit h the accession of Kashta to the throne of Kush , the Kushite Empire reappeared as a powerful polity in the Nile river valley (figure 15) . In the 8th century, as the 6th or 7th ruler of Kush, Kashta was invested with some of the titles of pharaoh in Thebes ( Adams, 1995 ). Successor of Kashta, Pianky (Piye) was vested in with similar titles in Thebes as well. During the reign of Pianky, Theban political stance was threatened by rulers from the western delta. Priests of Amun requested Pianky to defend their sta nce as they did not possess the resources to defend themselves ( Adams, 1995 ). Pianky was crowned as Pharaoh prior to his battles against several attackers of Lower Egypt upon his victory he claimed dominion over all of Egypt ( Adams, 1995).

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49 Figure 15 : Extent of Egyptian Empire during the New Kingdom period and Kushite Empire during the 25th dynasty period The start of the Kushite rule was marked by numerous conflicts both with other Egyptian rulers as well as external occupiers su ch as the Assyrians. Pianky stopped continued to rule. In his victory stela, Pianky mentions 19 fortified towns along 266Km stretch of middle Egypt . The massive number of fortified towns entails insecurity, civil wars and invasions conquered the Delta to be come the overlord of Egypt and ruler of the 25th Dynasty of Egypt .

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50 Although Shabako succeeded in ruling over Egypt fragmentary political structure of the administration in Egypt o r (1982) states Kushites ruled based on military strength leaving civil government to local Egypt ian dynasties while ( Sherif , 1981 ) states the King stood as the center of the administration as an absolute aristocrat whose word was law. Sherif (1981) also states the Kings power was not delegates and there was no administrative office in which a power concentration can be observed. further evidence in that the Theban office of God's wife and high pries thood were maintained without their military or civil authority (O'Connor 1982). Kushite rule was based on military strength and not political propaganda which limited their ability to create internal orders to besieged towns for peasants not to go to field or plowmen 1982). The Kushite Empire is a highly stratified social system in which delineations can be made between royals, upper class, and lo wer class individuals. Two non royal cemeteries at Meroe and Sanam are prime examples of Kushite stratification and social conditions. Various types of graves are present including vaulted chamber graves with stairway entrances where bodies were mummified and placed in coffins, rectangular pit graves containing extended burials accompanied by exclusively Egyptian type goods and pottery, and oval graves containing contracted burials accompanied by both Egyptian made and locally made pottery. ( Adams, 1995 ). T hese burials are thought to correspond with nobility or upper class,

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51 west cemetery infant burials with funerary objects detailing of their Noble status ( Sherif 1981 ). T h e early Kushite Empire was mainly dependent on animal husbandry and agriculture ( Sherif 1981 ). Cattle breeding was part of Kushite identity observed in iconography, burial rites, metaphors and more. Later in the Napata and Meroe period, agriculture of Lowe r Nubia was influenced by climate and lack of fertile land ( Sherif 1981 ). Although the use of Shaduf was known since the 15th century before our era, the use of Saqiya known in Nubia as Kole is only found at Dakka and Gammai beginning in the Third century BCE ( Sherif 1981 ). During peaceful periods of Kushite rule local markets became major outlets of surplus while local deities became important mediators. In the later Kushite rule, Amani nete yerike (431 405 BCE ), Harsiotef (404 369 BCE) and N astasen (335 310 BCE ) ancient traditional practices were observed with zealous which were elemental in creating a distinctive Kushite culture ( Sherif 1981 , Adams, 1995 ). During the process of ascending the throne, rulers were elected from Royal brethren in Meroe. Then jour neyed to Napata to receive permission from the gods for their ascension to the throne ( Sherif 1981 ). Despite the emphasis on the journey to Napata and approval from the gods, inscriptions confirm the king was selected and accepted prior to his journey. Ob servation of traditions expanded beyond the royal ascension to include burial practices, residences, and mythology. A pseudo old kingdom creation myth was created, Memphis was restored as the royal residence and the royal tombs in Napata were designed acco Kurru in a stone pyramid. Emphasis on nontraditional religious ideas assisted Kushites in cordance

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52 Syria. Their expansion into Palestine and Syria placed their base of operation in Lower Nubia and brought them in direct conflict with the growing power of Assyria ( Adams, 1995 ). 664 BCE ) of the 25th Dynasty and continued until the Kushite retreat from Egypt. Several conflicts between Kushite and Assyrian rulers occurred in the 7th century B CE . In 701 BCE Kushites campaigned against Assyrians , in 674 BCE Assyrians invaded Egypt , 671 Assyrians conquered the delta, 668/7 Assyrians lost to King Taharqa who regained control of all Egypt , 664/3 Assyrians regained control of Lower Egypt after tempora ry loss to Tan tamani Adams, 1995 ). In 663 Assyrians won over Tantamani to take control of Upper Egypt and incur the end of the 25th Dynasty ( Adams, 1995 ). Kushite opposition against Assyrians developed a coordinated military and political system with in the Egyptian dynasts. Assyrians applied a policy of vassal states strong enough to resist a Kushite attack with help of Assyrians but weak enough not to threaten Assyrian position. Assyrians also ruled from a distance with their high ranking officials stationed with in Assyria instead of Egypt. Such organization placed Egypt as a vassal state of Assyria with buffer zone functionalities. Egypt provided offerings to Assyrian gods, tribute to administrators, and protection to the center of Assyr ian power in the levant (Edwards 2007). Lack of Assyrian reciprocity to Egyptian loyalty combined with Kushite emphasis on ideological and ritual unity formed the contextual base for Egypt ian unity under the 26th Dynasty of Sais (Edwards 2007). Psammetichu s I exploited both Kushite military exhaustion and the enormity of Assyrian to access mercenary forces from Anatolia to reunite Egypt by the time of his death in 610BCE.

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53 610 BCE 332 BCE The period between 610 BCE and 332 BCE brought on several changes to cult ure, political structure and ideologies with in the Nile valley. This period coinciding with the Late period of Egypt , brings on a unique combination of New kingdom and Third intermediate characteristics. From the Third intermediate: archaic ideologies gea red to the reunification of Egypt, decreased control of power by the Kings as well as tendency for power to concentrate along familial lines were carried over to the late period (Edwards 2007). Royal income from the Levant and Nubia were also limited. Simi larly, the late period emphasized defensive tactics such as alliances with foreign states dominated Egyptian foreign policy while conflict continued to dominate within and surrounding Egypt. The office of the overseer of the river harbors was created to re gulate these two issues, decrease in peripheral revenue and increase in conflict . The office resulted in 50% increase in revenue in four years and 100% increase in 15 years and secured some of the provincial harbors to provide additional support for cities lacking in defense (Edwards 2007). Furthermore, a royal governor was placed between the second and Third Egyptian providences and a royal garrison placed at Aswan in Upper Egypt eliminating contact between Thebans and Kushites. The Kushite kingdom contin ued to rule from Napata while Lower Nubia became an uninhabited and uncontested region between the two powers. Later in this period several Egyptian rulers invaded Upper Nubia : Psammetichus II, Cambyses and Khabash (Edwards 2007).

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54 332 BCE 350 CE This perio d saw the revival of the Kushite Kingdom in Nubia and Greco Roman dominance in Egypt. In 300 BCE the Kushite royal cemeteries were moved from Napata to M eroe (Edwards 2007 , figure 16 ). However, Meroe was founded around the same time as Napata. nam e was the earliest (593 568 BCE ) found in the Meroitic ruins while a stela from Amani Nete Yerkie (431 405) preserves the first mention of M eroe by name ( Adams, 1995 315 BCE ), Kushites are thought to have ruled from Meroe at least part time beginning in 431 405 BCE ( Adams, 1995 ). The final transfer of the capital of Kush from Napata to Meroe is debated at sixth century or end of fourth century BCE yet scholars view this period as a time when both capitals were used at different time like , less centralized and less theocratic ( Adams, 1995 ). Several populations in the eastern desert, Kordofan and between the red sea and the Nile were independent and semi independent ( S herif 1981 ). A significant factor for lack of centralization in the Meroitic period was the lack of proper communication due to the vast size of the Kingdom. For the administration to function, leaving some authority to provincial governors was required ( S herif 1981 ). The move further south to Meroe is associated with political and dynastic changes in roman Egypt as well as contact and relations with internal Africa (Edwards 2007).

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55 Figure 16 : Extent of Roman control in the Nile V alley and Meroitic Empire during the Ptolemaic period The royal residence at Meroe preserves the numerous cultural, political and economic influences present during this period. The residence was a walled compound with 2 large palaces, audience chambers, magazines, domestic quarters for the palace staff, a little prostyle temple decorated with brightly colored paintings of the king and queen and various officials and a later addition of roman style bath with channel system to bring water from nearby well ( Adams, 1995 ). This compound is connected to a huge temple of Amun comparable in size to the great temples at Napata and Thebes. The combination of structures both in the royal residence and the adjoining temple of Amun reflect persisting importance of the god Amun, an Egyptian god important in the religion and politics of Nubia , walled compounds reminiscent of Kerma, and roman style baths showing contemporary influence of

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56 roman Egypt. The Meroitic period presented significant construction in Upper Nubia di stinguishing the Meroitic period form the Napatan period in which few construction projects were under taken in Nubia. Three sites, Wad Ban Naqa, Musawwarat al Sufra and Naqa , south of the Fifth Cataract , testify to the construction campaigns in the meroet ic period. Wad Ban Naqa preserves large brick palaces and small temples while Naqa has remains of at least 7 stone temples and a large town and Musawwarat al Sufra displays at least 3 temples, cast labyrthine complex of enclosures with dressed stone ( Adams , 1995 ). In addition to the economic and labor investments these sites would have required , they are also built along the dry desert wadis which further required artificial catchment basins for water supply ( Adams, 1995 ). Farther nor th from Meroe no distin ctively Meroitic sites are identified until Napata which is hypothesized to suggest communication was through the Bayuda road instead of along the Nile ( Adams, 1995 ). The m ajority of the construction campaigns in Lower Nubia were undertaken by Natakamani and Amanitore (12 BCE 12 CE ). The brother and sister are associated with at least a dozen monuments they have built or rebuilt . The temples are much smaller than those from the Napata period consisting of a single large room entered through massive pylon gat es. However, they preserve much more detailed carvings of processions and smiting of foreign enemies in an immemorial Egyptian tradition ( Adams, 1995 ). Wall carvings in Meroitic buildings present a unique iconography of more robust figures and rulers of Af rican features ( Adams, 1995 ). Apart from royal residences and palaces, each town site preserved a few two story houses made of mud brick though to be the home of the non elite population ( Adams, 1995 ).

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57 Economically, the Meroitic period was multifaceted in cluding metallurgy, agriculture, cotton trade, gold and precious stones, pastoralism . Adams ( 1995 ) states the economic prosperity of the northern Kushite province depended on trade with roman Egypt while bases for the southern province are unknown. Near th e fertile valley of the Nile agriculture was significant, however in cities that are further in land nomadic and pastoral subsistence is thought to continue during the Meroitic period. Adams ( 1995 ) has suggested state controlled agricultural and pastoralis m might have provided the economic foundation needed for the later Kushite kingdom. In the first century CE there was a resettlement of Lower Nubia following the introduction of the Saqiya. As Lower Nubia become reoccupied large and profitable farming vi llages and local cemeteries rise along the Nile banks adding up to over 60 archaeological sites between the roman frontier at al Maharraqa and the Second Cataract ( Adams, 1995 ). This region cultivated barley, wheat, sorghum and durra, and lentils, lens esc ulenta, cucumbers, melons, and gourds. While on non edible crops cotton was the most significant produce. Around 4 th century BCE cultivation, spinning and weaving of cotton reached i t s highest level becoming one of the sources of wealth in Meroe ( Sherif 19 81 ). While cultivation of cereals and cotton were open to the population, fruits in orchards and grapes in vineyards were limited to temples. At the peak of the Meroitic Kingdom the Meroe was intensively cultivated shown in networks of canals and hafirs, a nd irrigation basins . A scepter in the form of a plough or hoe is preserved as emblems of Meroitic Kings and priests at this ( Sherif 1981 ). Despite the increased use of agriculture and cultural importance in this period, agricultural products were not expo rted material as they were barely sufficient for local consumption ( Sherif 1981 ). However, cotton was heavily exported to roman Egypt as cotton

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58 was not yet cultivated in Egypt. In addition to Cotton, iron, gold, and precious stones were important sources of income for the Meroitic kingdom. Numerous heaps of iron slag and remains of furnaces have been identified to show iron smelting was a significant industry in Meroe. However, the level of production and exportation are unknown ( Adams, 1995 ). On the othe r hand, Kush was one of the major gold producing areas in the ancient world . Gold and its exports were not only one of the main sources of the wealth and greatness of the kingdom but greatly influenced foreign relations with Egypt and Rome ( Sherif 1981 ). I t has been calculated during antiquities Kush produced about 1,600,000KG of pure gold. ( Sherif 1981 , figure 17 ). P recious and semi precious stones such as amethyst, carbuncle, hyacinth, chrysolith, beryl and others originated from the eastern desert. Altho ugh these mines were not all controlled by the Meroitic kingdom, their products went through Meroitic trade channels as a last resort of transportation which increased the fame of Meroe as one of the richest countries in the ancient world ( Sherif 1981 ).

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59 Figure 17 : Kushite trade routes and natural resources distribution in 350CE Relations between R oman Egypt and Nubia surpassed their common interest in trade and economic growth. In the Second century of Ptolemaic rule, previously depopulated regions of Lower Nubia once again became a point of contention between the two regional powers. This region was resettled and developed quickly following Roman conquest of Egypt. At this point, Egypt began claiming sovereignty over the norther n part of Kush between the 1 st and 2 nd Cataract s during this period. In order to resolve repetitive conflict an agreement was reached for the area to be designated as an estate of the goddess Isis ( Adams, 1995 ). However, R omans who have ruled over all of E gypt since 30 BCE were not content with the arrangement and induced Kushite rulers to sign a treaty making Kush a tributary to Rome. Soon the Kushites repelled and began attacks on outposts of Aswan in opposition to the new treaty (figure 18) . The back lash for attacks on Aswan reached as far into Kushite kingdom as Napata ( Adams, 1995 ). Yet another treaty was signed after the attack placing

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60 roman Egypt frontier at Hierasykaminos (al Maharraqa) 70miles south of the First Cataract . Following the treaty an adm inistrative office of Lower Nubia was posted at the frontier with the head called Paqar , the first holder was Akinidad, the son of Teritiqas and Amanirenas who fought against roman invasion of Nubia ( Sherif 1981 ). This treaty maintained peaceful commercial relations between the two powers until the end of the Kushite kingdom. Figure 18 : Direction of conflict between Roman and Kushite forces (300BCE 300CE) In the Third century CE (300 350CE) the Meroitic kingdom collapsed lacking all observable evidence of literate civilization and monarchical power ( Adams, 1995 ). Several causes for the collapse of Meroe have been suggested but satisfactory evidence has not arisen in support of one factor over another. Some of the causes that have been presented include: conflict with the Axumite kingdom, attack by barbarian people from west of the Nile,

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61 political collapse, and cultural changes are among the most debated. Although, some continuity is seen between Meroe and post Meroitic populations most urban settlements of the Meroitic period declined and disappeared as centers of population seeming none survived into the medieval period. Meroe was never again a center of political or religious activities after early 4 th century CE ( Adams, 1995 ). 3 50 CE 642 CE With the loss of central authority in Meroe several regional powers rose. In the northern part of Nubia, the new Kingdom of Nobatia that maintained Kushite regalia and worship of Kushite gods began (Adams 1993). The history of Nobatia is divided into two phases, the Ballana phase occurring prior to Christianity and the Christian period. Ballana phase rulers were buried with a wealth of jewelry, furniture, weaponry and sacrificial animals and slaves representing both Kushite and Egyptian tradition s (Adam 1993). The large quantities of imported objects in burials found in Ballana and Qustul testify to the presence of trade. However, no stone monuments of Nobatian rulers from the Ballana phase have been found. Instead, earthen tumuli and few royal in scriptions in ungrammatical Greek have been discovered. The use of Greek rather than the native Meroitic script further shows the disappearance of the Meroitic culture including Meroitic writing prior to the Fifth Dynasty CE ( Adams, 1995 ). However, burials of rulers are buried with representations of Horus and Uraeus that were part of the Kushite royal insignia ( Adams, 1995 ). In 453 CE a conflict arose between Kushite locals and roman governors of Upper Egypt because roman governors tried to suppress Isis wo rship at Philae ( Adams, 1995 ). By 580 CE all of Nubia was converted to Christianity beginning the Christian period that is isolated from the Kushite tradition of the Nile valley (Adams 1993).

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62 In the 6th century CE three well established Kingdoms: Nobadia in North, Makuria in middle Nile and Alwa in the south, were discovered in what used to be the territories of Kush ( Adams 1995 , figure 20 ).After the beginning of Christianity burial practices in the Nile valley changed showing new forms of graves, no grave g oods and destruction of temples with the rise of churches. During the 8 th century CE Makuria and Nobatia united into one Kingdom with a capital at Dongola. Nobatia continued as a free trade region connecting Egypt with the middle Nile region and internal A frica. Main export from Nobatia were slaves and dates , and importing wine, textiles. Glass, glazed pottery and bronze. On the other hand, Makuria was closed to foreigners and no money was in circulation. Alloidia never united with Makuria and Nobatia of Me dieval Nubia. After this, t he Christian period sees nearly 600 years of uninterrupted peace. Figure 19 : Placement of Kingdoms of Medieval Nubia: Nobatia, Makuria and Alodia

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63 Nubians at this time lived in small communities densely concentrated on fertile land along the Nile River. The main crops cultivated were sorghum millet, wheat, barley, varity of fruits and some vegetables. While luxury pottery and textile were distributed from Qasr Ibrim, Faras and Dongola, many local potters , weavers and carpenters were spread out in smaller villages. Ownership in Medieval Nubia was focused on nuclear family and private ownership instead of kinship and community ownership. Inscriptions from burials and legal documents from Qasr Ibrim lack any mention of parentage and ancestral obligations. During this period, settlement was centered around churches in which 120 examples from Nobatia have been discovered (Adams, 1993). Religious life influenced iconography, decoration, and literature. Some of the cultural achievements can be seen in church architecture, mural decoration, pottery and religious literature. Cathedrals built from cut stone and at a much larger scale than standard Nubian churches have been identified. Cathedrals in Nubia were unique in that they had two aisles on either side of a central nave, narthex or portico at the west end and the roofs were on monolithic columns topped by ornate capitals (Adams, 1993). After the 8 th Century Nubian churches and cathedrals were all decorated with mural paintings. Religious iconography were also used in pottery items that were highly prized and traded.

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64 CHAPTER V METHODS The project collected data for the El Hesa population and compared the results to previously published datasets. Comparative da ta sets aim to provide a regional and temporally varied sample to observe variation in activity and stress pattern between border regions and central areas. To accomplish this, comparative data were included from sites in historically Egypt proper, Nubian proper and from regions historically contested, specifically Lower Nubia . As well as from Pre Christian period, Christian period, and Post Christian period. Sites used as comparative samples in th is study were selected based on their similarity to the El H esa collection such that they are composed of a dults with post c ranial material and researchers utilized similar methodologies to assess cribra orbitalia ( CO ), degenerative joint disease ( DJD ) , and musculoskeletal stress markers ( MSM ). Statistical Methods In this study SPSS 25 was used to assess data through quantitative methods. Frequency feature of SPSS was used to display the demographic distribution of the El Hesa data. The first lesions to be analyzed were Cribra orbitalia which were observed using c hi square test. The chi square test was selected for its ability to tabulate nominal data such as presence or absence for Cribra orbitalia vs. categorical data for age and sex groupings. The resulting P Value was used to interpret the data as randomly occu rring or with association to different characteristics. The next set of analysis were conducted on DJD and MSM using ANOVA and K Wallis . The two tests which compare the means and dispersion around the mean for multiple independent samples were selected to allow analysis of different skeletal

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65 elements independent ly while also observing variation occurring due to age or sex. Both tests were utilized to address questions r egarding similarity and comparability of results achieved using different statistical tec hniques ( Cheverko and Hubbe 2017). In the comparative section of the analysis similar statistical techniques were used to test association s and correlations between CO, DJD and MSM to regional and boarder land groupings. Dat a C ollection on S keletal M ateri al Figure 20 : Skeletal elements used in this study indicated in black The first step towards a skeletal analysis is inventory. Inventory of skeletal material is recorded according to the Standards for Data Collection from Human S keletal Remains (Buikstra and Ubelaker 1994 see figure 21 ). For each cemetery assemblage in which

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66 demographic data has been previously recorded, the recorded data is used. For the El Hesa assemblage, demographic data, is collected using numerical evaluatio ns outlined in Buikstra and Ubelaker (1994). Sex assessment methods based on pelvic analysis by Phenice (1969) using subpubic, greater sciatic notch and pre auricular sulcus is used. The Phenice method was chosen because it has been tested for accuracy and ha s yielded over 88% accuracy (Ubelaker and Volk 2002). Sex assessment is conducted using visual methods from S t andards for Data Collection from Human Skeletal R emains (Buikstra and Ubelaker 1994). Additional methods of sex assessment have been reviewed b y Bass (2005) using long bone measurement . H owever , l ong bone measurements are highly dependent on diet and population. Thus, they will not be used to assess Nubian skeletal material. The Second set of demographic information needed is age. First step in estimating age at death is dental development. Charts from Ubelaker (1989) and Buikstra and Ubelaker (1994) are used to document and later analyze dental development. Second, epiphyseal union assessment based on Scheuer and Black (2000) is undertaken. For adults, pubic symphysis wear pattern detailed by Brooks and Suchey (1990) and auricular surface as sessment methods by Lovejoy et. al (1985) are used. These two methods were selected for their high accuracy across all populations. However, they are limited i n estimating ages over 50 years old. Cribra orbitalia Cribra orbitalia is one of the most broadly used nondestructive methodology to observe nutritional stress in populations (Mittler and Van Gerven, 1994). Cribra orbitalia, although debated on the nutrie nts causing the lesions be that iron deficiency (Mittler and Van

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67 Gerven 1994). F or deficiency of Vitamins A, B12, B6 and B9 (Rivera 2017, Walker 2009) is considered a reliable sign of dietary stress in individuals. Skeletal changes are due to bone marrow h yperplasia. Bone marrow hyperplasia occurs during the production of erythrocytes and iron deficient red blood cells. As bone marrow hyperplasia continues, diploic space for the bone marrow continues to expand leading to the thinning and destruction of the cranial outer table (El Najjar et al 1976). This thinning and destruction of the outer table of the crania is the physical feature observed in bio archaeological studies such as the present. Researchers have argued parasitism, non dietary anemia, and other diseases that prohibit the body from proper retention of iron and vitamins from dietary sources can cause similar effects (Hengen 1971; Carlson 1973). Walker et al. (2009) further explains sociopolitical unrest that contribute to the lack of access to ani mal sources, vegetarianism without supplementing vitamins such as B12, individuals who are socially disadvantaged during times of depleted animal sources have higher chance of developing lesions observed as cribra orbitalia. Cribra orbitalia preserves as p ittings from 1mm to large openings on the compact bone of the skull often observed on the orbital roof, parietal and occipital bones (Stuart Macadam 1985). Thus, Cribra Orbitalia is observed based on the presence absence of visual signs of pitting on the o rbits and crania of individuals. Degenerative J oint D isease Degenerative joint disease is a pathological condition of the joints. DJD is an outcome of imbalance between joint capacity to withstand stress and stress placed upon the joint. However, genetics , age, hormones and natural variation play a role in the presence and extent of DJD as three physiological stages of biochemical alterations lead to joint deterioration (Klaus et al 2009 ). The three stages of biochemical alterations are over

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68 production of enzymes, imbalance between proteolytic process and enzyme inhibitors causing cartilaginous erosion and fibrils breakdown, and release of protoeoglycans and collagen fragments into joint space. The first skeletally observable stage of DJD, lipping, occurs w hen attempt to repair joint from inflammatory responses due to cartilage breakdown in the synovial membrane caused by increased proteolytic enzymes result ing in bone overgrowth. The second stage in DJD occurs when vascular barrier between cartilage and bo ne are broken down by fibrillation and osteocytes migration . When the cart ilage has disappeared and subc hondral bone is destroyed subchondral resorption and joint surface porosity occurs (Klaus et al 2009 ). The final observable stage, eburnation occurs whe n the joint is continuously used in lea of cartilage and synovial membrane between articulating bones. Bone to bone contact leads to the polishing effect that characterizes eburnation. For decades DJD has been used as an indicator of activity patterns and stress level in populations. However, many researchers have advised against using DJD to infer specific lifestyle as the etiology of DJD is not fully understood and many factors play a role. Some of the factors influencing the presence and extent of DJD a re genetics, anatomy, body mass index, age, sex and environmental factors (W e iss and Jurmain 2007). Weiss and Jurmain (2007) refer to twin and familial genetic studies in which osteoarthritis had an overall heritability of 50% and higher heritability for s pine and hip joints compared to others . C linical studies referred by Weiss and Jurmain (2007) show higher osteoarthritic prevalence in individuals with higher body mass index (Dumond et al 2003, Manek et al 2003). However, Weiss (2005, 2006) reached contra dicting results in osteological in which individuals with lesser estimated body size had higher osteoarthritic scores. Weiss and Jurmain (2006) provide an explanatory hypothesis in which skeletal loading and bone size or

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69 variation in body mass index from a ncient to modern populations could explain contradictory results between clinical and osteological researches. H owever, through out Weiss and Jurmain (2007) review of factors influencing DJD a clear message is put forth , we have yet to understand the eti olo gy of osteoarthritis as well as the interplay between the factors influencing the presence and severity of the condition. Furthermore, DJD has been used to reference lifestyle and activity patterns of populations . H owever due to the interaction between a ge, sex, anatomy and the presence of DJD accurately identifying lifestyle has been contradictory. Here DJD is used to infer activity stress level in comparison with other populations in the region. Rather than inferring complex acti ons such as farming , tex tile workers and sailors, in this study the focus has become in understanding the level of use in each joint and how it compares to other data sets in the region. Degenerative joint disease is recorded according to the extent of joint surface involvement in the three biochemical physiological alterations. Evidence of DJD is recorded following methods in Standards for Data Collection from Human Remains (Buikstra and Ubelaker 1994). Lipping is score 1 4, Porosities 1 3, eburnation 1 3 (Table 1 3) . In order to account for some of the uncertainties researchers have pointed out regarding using DJD as an indicator of activity pattern and stress, musculoskeletal stress markers were used. Table 1 : Method of recording lipping (Bukistra and Ubelaker 1994) Lipping Characteristics Score Barely discernible/ less than 1/3 of surface involvement 1 Sharp ridge / between 1/3 and 2/3 surface involvement 2 Extensive spicule/ above 2/3 of surface involvement 3 Ankylosis 4

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70 Table 2 : Method of recording Porosity (Bukistra and Ubelaker 1994) Porosities Characteristics Score No porosities present 0 Pinpoint or less than 1/3 rd of surface 1 Coalesced or between 1/3 rd and 2/3 rd of surface 2 Both pinpoint and coalesced or mor e than 2/3 rd of surface 3 Table 3 : Method of recording Eburnation (Bukistra and Ubelaker 1994) Eburnation Characteristics Score Barely discernible 1 Polish only 2 Polish with grooves 3 Musculoskeletal Stress Markers MSM is used to refer to the effect of regular and minor stress on the surface where muscle, ligament, or tendons originate and insert on to the periosteum of bone. The attachment site is subjected to regular stress the number of capillaries supplying the periosteum i ncrease encouraging osteon remodeling and resulting in the lesions observed as MSM. Although this method is broadly used to refer to activity patterns, researchers have brought to question the link between a specific activity and lesions observed as MSM (J urmain et al 1999). For each available skeletal element of an individual, data is taken on Musculoskeletal Stress Markers (MSM) using the Hawkey and Merbs method (Hawkey and Merbs 1995). A total of 44 muscle/l igament sites were observed on eight skeletal e lements (Table 4) . These muscle/ligament attachment sites were selected in the Hawkwey and Merbs (1995) methodology and utilized here as they allow the observation of attachment sites that are most often used in daily activities such as muscles of the sho ulder, elbow, knee, and hip

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71 joint complexes. Observation of musculoskeletal stress markers was scored on three different characteristics: Robusticity, Stress Lesion, and Ossification Exostoses. Each of the three characters were evaluated based on a 0 3 sco ring system (Table 5) described by Hawkey and M erbs (1995). Table 4 : List of Muscle attachment sites and ligaments sites observed for Musculoskeletal stress Marker analysis and associated skeletal elements Muscle Attachment Site B one Type of Attachment Conoid Clavicle Ligament Costoclavicular Clavicle Ligament Subclavius Clavicle Tendon Insertion Trapezius Clavicle Tendon Insertion Trapezoid Clavicle Ligament Pectoralis minor Scapula Tendon Insertion Trapezius Scapula Tendon Insertion Deltoideus Humerus Tendon Insertion Common Extensors Humerus Tendon Origin Common Flexors Humerus Tendon Origin Infraspinatous Humerus Tendon Insertion Latissimus dorsi Humerus Tendon Insertion Pectoralis Major Humerus Tendon Insertion Su bscapularis Humerus Tendon Insertion Supraspinatus Humerus Tendon Insertion Teres Major Humerus Tendon Insertion Teres Minor Humerus Tendon Insertion Anconeus Ulna Tendon Insertion Brachialis Ulna Tendon Insertion Pronator quadratus Ulna Tendon Origi n Tricpes brachii Ulna Tendon Insertion Biceps brachii Radius Tendon Insertion Pronator Teres Radius Tendon Insertion Supinator Radius Tendon Insertion Adductor magnus Os Coxae Tendon Origin Gluteus medius Os Coxae Tendon Origin Gluteus minimus Os C oxae Tendon Origin Illiacus Os Coxae Tendon Origin Pectineus Os Coxae Tendon Origin Rectus femoris Os Coxae Tendon Origin Semimembranosus Os Coxae Tendon Origin

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72 Adductor magnus Os Coxae Tendon Origin Gastrocnemius Femur Tendon Insertion Gluteus maxi mus Femur Tendon Origin Gluteus medius Femur Tendon Insertion Gluteus minimus Femur Tendon Insertion Illiacus Femur Tendon Insertion Pectineus Femur Tendon Insertion Piriformis Femur Tendon Insertion Quadratus femoris Femur Tendon Origin Vastus inte rmedius Femur Tendon Insertion Vastus lateralis Femur Tendon Origin Vastus medialis Femur Tendon Origin Flexor digitorum Femur Tendon Origin Popliteus Tibia Tendon Origin Soleus Tibia Tendon Insertion Semimembranosus Tibia Tendon Origin Tibialis ant erior Tibia Tendon Insertion Tibialis posterior Tibia Tendon Origin Table 5 : Methods of recording MSM (Hawkey and Merbs 1995) Musculoskeletal Stress Markers recording method according to Hawkey and Merbs (1995) 1: Faint 2: Mode rate 3: Strong Robusticity Barely discernable rounding of the cortex without distinct crests or ridges The surface has easily visible mound shaped elevation without sharp crests or ridges Distinct sharp crests and ridges Stress Lesion Shallow less tha n 1mm pitting into the cortex with lytic like appearance Deeper pitting larger than 1mm and smaller than 3mm covering larger surface area Marked pitting larger than 3mm or longer than 5mm Ossification Exostoses Small exostosis that is round and less than 2mm in height from the cortical surface Distinct exostosis with various shapes measuring 2mm 5mm from the cortex. Exostosis is larger than 5mm from the surface and covers a large surface area.

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73 CHAPTER VI RESULTS El Hesa Demography The El H esa sample is composed of over 200 individuals of which 89 include postcranial remains. For this project, 35 of the 89 individuals were observed. Of the 35 individuals observed 29 were included in the final assessment. The seven individuals removed during data collecti on include two sub adults, and four individuals without postcranial material. The El Hesa sample included adults of both sexes, t welve females (41.37%), f ifteen m ales (51.72%), and two intermediate (6.89%). The collection also included two individuals between the ages of 20 and 35, fifteen (51.72%) individuals between 35 and 50, eleven (37.93%) individuals over 50 years of age and one (3.45%) individual with indet erminable age (See figure 23) . Sex Sex Frequency Percent Female 12 41.4 Intermediate 2 6.9 Male 15 51.7 Total 29 100.0

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74 Table 6 : Sex distribution of population Table 7 : Age distribution of El Hesa Sample Figu re 22 : Age distribution in the El Hesa sample Cribra orbitalia Observation of Cribra orbitalia was divided between cranial and orbital cribra orbitalia. Cribra orbitalia was observed on the parietals and occipitals of 17 (58.62%) i ndividuals and signs of cranial cribra orbitalia were present in 10 (34.48%) individuals and two (6.9%) individuals lacked cranial material to observe Cribra orbitalia. Age Frequency Percent 20 35 2 6.9 35 50 15 51.7 50+ 11 37.9 Total 28 96.6 Figure 21 : Sex distribution in the El Hesa sample

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75 Table 8 : Frequency of cribra orbitalia on the cranium A h igher number of individuals displayed cribra orbitalia of the orbits than cranial cribra orbitalia. Fourteen (48.28%) individuals did not show signs of crib ra orbitalia, 11 (37.93%) individuals displayed orbital cribra orbitalia (Figure 25/ Table 9) . Two (6.89%) individuals were missing cranial material and two (6.89%) individuals displayed fractures preventing observation of cribra orbitalia of the orbits. Table 9 : Frequency of cribra orbitalia on the orbits In both cranial orbitalia and orbital cribra orbitalia males had higher rate of presence than females. In the case of Orbital cribra orbitalia two (6.89%) more males preserved the Cribra orbitalia on the cranium Frequency Percent Absent 17 58.6 Present 10 34.5 Total 27 93.1 Cribra orbitalia on the orbits Frequency Percent Absent 14 48.3 Present 11 37.9 Total 25 86.2 Figure 24 : Prevalence of cribra orbitalia on the orbits in the El Hesa sample Figure 23 : Prevalence of cribra orbitalia on the cranium in the El Hesa sample

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76 lesions than females. One (3.45%) more male individual preserved cranial cribra orbitalia than females. Individual s with intermediate sex (3.45%) also s howed both cranial and orbital cribra orbitalia. Although a higher number of males showed presence of cranial and orbital cribra orbitalia, presence of cribra orbitalia and sex had a no association p value= 0. 655 on the cranium and p value= 0. 183 on the or bits scores in this sample. When the sample is categorized by age groupings, more individuals in each group lacked cranial Cribra Orbitalia than those with the lesion. In individuals between 20 and 35 (6.89%) 2 individuals, between 35 and 50 (31.03%) 9, ov er 50 (17.24%) 5 and (3.45%) 1 on indeterminate individuals lacked the lesion. Occurrence of cribra orbitalia was investigated for association with age and sex using Chi square tests. During the chi square investigation sex category of intermediate was rem oved from the analysis because it had expected value less than 5 (N=1). Similarly, age group of 20 35 was removed from chi square analysis because the group had 2 individuals and expected value below 5. In the El Hesa sample weak association between crania l orbitalia with age and sex as well as orbital cribra orbitalia with age and sex were identified . Table 10 : Frequency of Cribra Orbitalia on the cranium by Age square value Cribra orbitalia on the Cranium by Age Absent Present 20 35 2 0 35 50 9 6 50+ 5 4 Total 16 10

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77 of 2.998 with Df 2 and 2 sided asymptotic significance of 0.223 Figure 25 : Distribution of Cribra Orbitalia of the Cranium Table 11 : Distribution square value of 0.847 with Df 2 and 2 sided asymptotic significance of 0. 655 Figure 26 : Distribution of Cribra orbitalia on the cranium by Sex Cranial orbitalia was observed at a higher prevalence on individuals over 50 years of age on the orbits. No individuals (6.89%) between 20 and 35, 4(13.79%) between 35 and 50, and 6 (20.7%) over 50 years of age individuals showed orbital cribra orbitalia with no s tatistically significant difference between the age groups . Cribra orbitalia on the Cranium by Sex Absent Present Female 8 4 Intermediate 0 1 Male 9 5 Total 17 10

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78 Table 12 square value of 4.378 with Df o f 2 and sig of 0.112 Figure 27 : Distribution of Cribra orbitalia on the Orbits by Age square value of 2.852 with Df 2 and 2 sided asymptotic significance of 0.240 Table 13 : Distribution of Cribra orbitalia square value of 3.394 Df of 2 and sig of 0. 183 . Figure 28 : Distribution of Cribra orbitalia on the Orbits by Sex Cribra orbitalia on the Orbital by Sex Absent Present Female 8 4 Intermediate 0 1 Male 6 6 Total 14 11 Cribra orbitalia on the Orbital by Age Absent Present 20 35 2 0 35 50 9 4 50+ 3 6 Total 14 10

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79 Degenerative joint disease Lipping The highest level of l ipping observed in t he El Hesa sample is two (moderate lipping of the joint surface with 1/3 rd to 2/3 rd of the surface affected). For lipping, a score of 2 was observed in the hip, wrist and knee joints (Table 14) . Level two lipping is observed in one left distal radius, one left acetabulum, one right patella and two left patellae. Frequency of l ipping in the El Hesa sample listed by joint surfaces and organized by joint complexes is displayed in figure 30. When the sample is grouped by age individuals over 50 years of age had the highest overall mean score of lipping, 0.243 (fig ure 30 ). When mean scores are separated by joint surfaces, prevalence of l ipping by age shows highest mean for Acetabulum and Distal Tibia in the 20 35 age group. Age group 35 50 showed the highest lipp ing mean score for d istal ulna, d istal radius, and g lenoid fossa. See fig ure 31 for mean lipping scores and age distribution. There were no significant variation in age for lipping , see table 15 . However, left proximal radius (p=0.002), left distal radius (p=0.047), and left acetabulum (p=0.008) had different distribution at least across one category of sex .

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80 Figure 29 : Frequency of Lipping in the El Hesa sample based on Joint complex and articular surface grouping

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81 Table 14 : Presence and severity of Lipping in the El Hesa sample Joint Surface Right Left 1: slight 2: moderate 1: slight 2: moderate Glenoid fossa 40% 8/20 0% 0/20 38.10% 8 0% 0 Proximal Humerus 25% 6/24 0% 0/24 20.83% 5/24 0% 0/24 Distal H umerus 11.11% 3/27 0% 0/27 7.69% 2/26 0% 0/26 Proximal Ulna 14.81% 4/27 0% 0/27 23.08% 6/26 0% 0/26 Distal ulna 23.08% 6/26 0% 0/26 9.52% 2/21 0% 0/21 Proximal Radius 0% 0/26 0% 0/26 0% 0/24 0% 0/24 Distal Radius 11.11% 3/27 0% 0/27 26.09% 6/23 4.35% 1 /23 Acetabulum 61.54% 16/26 0% 0/26 56.00% 14/25 4% 1/25 Proximal Femur 28.00% 7/25 0% 0/25 30.43% 7/23 0% 0/23 Distal Femur 25% 7/28 0% 0/28 21.43% 6/28 0% 0/28 Proximal Tibia 0% 0/26 0% 0/26 0 0%/26 0% 0/26 Distal Tibia 14.81% 4/27 0% 0/27 20% 5/25 0% 0/25 Patella 8.33% 2/24 4.17% 1/24 8.33% 2/24 8.33% 2/24

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82 Figure 30 : Distribution of Lipping in the El Hesa sample by age Figure 31 : Distribution of mean scores of Lipping in the El Hesa sample by a ge

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83 Figure 32 : Mean Lipping scores of joint complexes in the El Hesa sample by age Figure 33 : Mean lipping scores of the El Hesa sample by sex

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84 Figure 34 : Distribution of mean lipping scores in the El Hesa sample by articular surface and sex showing minimum and maximum range Figure 35 : Mean distribution of lipping in the El Hesa sample by articular surface and sex

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85 Table 15 : Lipp ing vs Sex and age Kruskal Wallis test results Lipping Side Sex Sig. Age Sig. Glenoid Fossa Right 0.667 0.741 Glenoid Fossa Left 0.735 0.723 Proximal Humerus Right 0.248 0.534 Proximal Humerus Left 0.100 0.518 Distal Humerus Right 0.810 0.933 Distal Humerus Left 0.353 0.269 Proximal Ulna Right 0.601 0.871 Distal Ulna Right 0.382 0.721 Proximal Ulna Left 0.143 0.877 Distal Ulna Left 0.608 0.590 Proximal Radius Right 1.000 1.000 Distal Radius Right 0.165 0.621 Proximal Radius Left 0.002 0.612 Di stal Radius Left 0.047 0.691 Acetabulum Right 0.389 0.536 Acetabulum Left 0.008 0.636 Proximal Femur Right 0.120 0.467 Proximal Femur Left 0.240 0.147 Distal Femur Right 0.788 0.649 Distal Femur Left 0.418 0.554 Proximal Tibia Right 0.627 0.306 Dis tal Tibia Right 0.729 0.788 Proximal Tibia Left 0.221 0.152 Distal Tibia Left 0.256 0.765 Patella Right 0.586 0.262 Patella Left 0.618 0.260 Porosities The highest level of Porosities observed in the El Hesa sample is two (moderate porosity of the art icular surface with 1/3 rd to 2/3 rd of the surface being affected). For porosity, a score of 2 was observed in the shoulder, k nee, h ip and e lbow joints (see table 16) . Frequency of Porosity in the El Hesa sample listed by joint surfaces and organized by joi nt complexes is displayed in fig 36 . Overall, males had a higher average porosity than females. When the sample is grouped by age individuals over 50 years of age had the highest overall mean score of

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86 porosities, 0.36 (fig 38 ). When mean scores are separa ted by articular surfaces, prevalence of l ipping by age shows highest mean for a cetabulum, proximal femur, and proximal ulna in the 20 35 age group. Age group 35 50 showed the highest porosity mean score for p roximal humerus. See fig. 39 for mean porosity scores and age distribution. For porosities Vs. Age right proximal ulna (p=0.015) was not distributed the same across all age factors. Left Distal Ulna (0.020), left proximal radius (p=0.011), left distal radius (p=0.021), and right distal femur (p=0.035) were not distributed the same for at least one category of sex , table 1 7 . Figure 36 : Mean frequency of porosity scores in the El Hesa sample by joint complex and joint surface

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87 Table 16 : Frequency of por osity in the El Hesa sample by articular surfaces Figure 37 : Mean score of porosity in the El Hesa sample by sex Porosity Articular surface Right Left Glenoid fossa 5.26% 1/19 0.00% 0/19 20.00% 4/20 0.00% 0/20 Proximal Humerus 34.78% 8/23 0.00% 0/23 37.50% 9/23 4.17% 1/23 Distal Humerus 14.81% 4/27 3.70% 1/27 23.0 8% 6/26 0.00% 0/26 Proximal Ulna 18.52% 5/27 0.00% 0/27 22.22% 6/27 0.00% 0/27 Distal ulna 8.33% 2/24 8.33% 2/24 8.70% 2/23 0.00% 0/23 Proximal Radius 7.41% 2/27 7.41% 2/27 12.00% 3/25 0.00% 0/25 Distal Radius 7.41% 2/27 0.00% 0/27 4.35% 1/23 0.00% 0/2 3 Acetabulum 46.15% 12/26 7.69% 2/26 52.00% 13/25 4.00% 1/25 Proximal Femur 33.33% 8/24 8.33% 2/24 39.13% 9/23 4.35% 1/23 Distal Femur 27.59% 8/29 0.00% 0/29 20.69% 6/29 0.00% 0/29 Proximal Tibia 19.23% 5/26 3.85% 1/26 7.69% 2/26 3.85% 1/26 Distal Tib ia 7.41% 2/27 0.00% 0/27 4.00% 1/25 0.00% 0/25 Patella 8.33% 2/24 12.50% 3/24 8.70% 2/23 17.39% 4/23

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88 Figure 38 : Distribution of mean por osity scores by articular surface and age Figure 39 : Distribution of mean porosity scores by articular surface and sex with minimum and maximum range

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89 Figure 40 : Mean score of porosity in the El Hesa sa mple by age

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90 Table 17: Porosity vs Sex and age Kruskal Wallis test results Porosity Side Sex Sig. Age Sig. Glenoid Fossa Right 0.383 0.912 Glenoid Fossa Left 0.464 0.179 Proximal Humerus Right 0.392 0.386 Proximal Humerus Left 0.319 0.863 Distal Humerus Right 0.718 0.154 Distal Humerus Left 0.458 0.437 Proximal Ulna Right 0.470 0.015 Distal Ulna Right 0.459 0.683 Proximal Ulna Left 0.360 0.224 Distal Ulna Left 0.020 0.685 Proximal Radius Right 0.442 0.367 Distal Radius Right 0.190 0.857 Pr oximal Radius Left 0.011 0.660 Distal Radius Left 0.021 0.750 Acetabulum Right 0.883 0.377 Acetabulum Left 0.329 0.429 Proximal Femur Right 0.462 0.134 Proximal Femur Left 0.280 0.481 Distal Femur Right 0.035 0.835 Distal Femur Left 0.348 0.791 Pro ximal Tibia Right 0.855 0.424 Distal Tibia Right 0.823 0.481 Proximal Tibia Left 0.274 0.310 Distal Tibia Left 0.088 0.636 Patella Right 0.473 0.256 Patella Left 0.508 0.258 Eburnation The highest level of e burnation observed in the El Hesa sample is one (slight eburnation of the articular surface with 1/3rd or less of the surface being affected). For eburnation, score of 1 was observed in the shoulder and h ip joints . Overall, females (0.00385) had a higher average eburnation than males. When the samp le is grouped by age individuals over 50 years of age had the highest overall mea n score of eburnation, 0.00769 . When mean scores are separated by articular surfaces, prevalence of eburnation by age shows highest mean for proximal humerus in the above 50 a ge group . There was no difference

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91 across age categories for eburnation. Right proximal ulna (p=0.001), left proximal ulna (p=0.040), left Distal ulna (0.10), right distal radius (p=0.35) and left proximal radius (p=0.002) had different distribution of ebur nation in at least one categories of sex (table 17) . Figure 41 : Humerus from the El Hesa sample preserving evidence of eburnation Table 17 : Eburnation vs Sex and age Kruskal Wallis test results Eburnation Side Sex Sig. Age Sig. Glenoid Fossa Right 0.248 0.864 Glenoid Fossa Left 0.370 0.177 Proximal Humerus Right 0.704 0.240 Proximal Humerus Left 0.786 0.681 Distal Humerus Right 0.913 0.335 Distal Humerus Left 0.913 0.335 Proximal Ulna Right 0.001 0.6 51 Distal Ulna Right 0.171 0.741 Proximal Ulna Left 0.040 0.335 Distal Ulna Left 0.010 0.791 Proximal Radius Right 0.066 0.124 Distal Radius Right 0.035 0.335 Proximal Radius Left 0.002 0.612 Distal Radius Left 1.000 1.000 Acetabulum Right 0.584 0. 637 Acetabulum Left 1.000 1.000 Proximal Femur Right 1.000 1.000 Proximal Femur Left 1.000 1.000 Distal Femur Right 1.000 1.000 Distal Femur Left 1.000 1.000 Proximal Tibia Right 1.000 1.000 Distal Tibia Right 1.000 1.000 Proximal Tibia Left 1.000 1.000 Distal Tibia Left 1.000 1.000 Patella Right 1.000 1.000

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92 Mean DJD Two statistical analysis were conducted to observe the variation in DJD between age and sex. A Kruskal Wallis independent test was conducted between each of the DJD characteristics v ersus age and sex . A Kruskal Wallis test was also run on mean DJD score for the El Hesa sample and there were no cases in which the distribution was different for all age categories. There was one case, left acetabulum (p=0. 0 35) which had at least one cate gories of sex without the same distribution of DJD. The second statistical analysis performed was an ANOVA between DJD vs sex and age followed by a LSD post Hoc. Between DJD and sex: left acetabulum (p value=0.010), right distal femur (p value) 0.05 and l eft proximal tibia (p value= 0.024) were significant. There is a significant difference between male and intermediate individuals (p value= 0.009), males scoring 0.305 higher on average on left proximal tibia DJD than indeterminate individuals. There is a significant difference between female and intermediate individuals (p value= 0.010), intermediate scoring 0.303 higher on average on left proximal tibia DJD than female individuals. Males had a significantly smaller DJD score (p value=0.016) than indetermi nate individuals with males 0.38 average DJD score lower than indeterminate. There were no statistically different DJD scores for categories of age.

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93 Musculoskeletal Stress Markers Robusticity Similar to the analysis conducted on characteristics of DJD, ANOVA and Kruskal Wallis tests were ran on characteristics of MSM. The first characteristics of MSM, r obusticity, had four muscle/ligament sites that were statistically significant in the ANOVA test , see tables 18 and 19 . These muscle/ligament attachment s ites were: Costoclavicular (p value=0.040), subscapularis (p value=0.030), Triceps brachii (p value=0.012) and pectineus (p value=0.018). A Kruskal Wallis test was also ran which resulted: Costoclavicular (p value=0.045), Subscapularis (p value=0.038), Tri ceps brachii (p value=0.017), and pectineus (p value=0.025). A post hoc (LSD) analysis was conducted. Subscapularis attachment site was found to be significantly different (p value= 0.015) between male and females with mean difference of 0.483 with higher male score . Pronator quadratus had females and males with significant difference (p value=0.039) of 0.550 with females scoring higher . Triceps brachii had p value=0.021 difference between male and females with a mean difference of 0.550 and p value= 0.015 between males and indeterminate with a mean difference of 1.133 with males having a higher score in both cases . Lastly, gluteus minimus males had a significant ly higher (p value=0.034) between score than females with a mean difference of 0.571. Robusticit y had the same distribution among age categories for all attachment sites except tibialis posterior (p value=0.033 ANOVA and p value=0.044 Kruskal Wallis).

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94 Table 18 : Robusticity vs Sex Kruskal Wallis and ANOVA test results Attac hment site: Robusticity K Wallis Vs Sex ANOVA vs Sex Conoid 0.843 0.853 Costoclavicular 0.045 0.040 Subclavius 0.543 0.514 Trapezius 0.163 0.219 Trapezoid 0.769 0.775 Pectoralis minor 0.420 0.367 Trapezius (S) 0.460 0.585 Deltoideus 0.759 0.791 Co mmon Extensors 0.419 0.435 Common Flexors 0.196 0.200 Infraspinatous 0.807 0.791 Latissimus dorsi 0.259 0.268 Pectoralis Major 0.843 0.896 Subscapularis 0.038 0.030 Supraspinatus 0.167 0.169 Teres Major 0.486 0.504 Teres Minor 0.927 0.933 Anconeus 0.148 0.141 Brachialis 0.127 0.132 Pronator quadratus 0.144 0.100 Tricpes brachii 0.017 0.012 Biceps brachii 0.486 0.504 Pronator Teres 0.250 0.260 Supinator 0.850 0.860 Adductor magnus 0.538 0.575 Gluteus medius 0.569 0.589 Gluteus minimus 0.78 1 0.795 Pectineus 0.025 0.018 Quadratus femoris 0.401 0.419 Semimembranosus 0.859 0.870 Gluteus medius 0.737 0.771 Gluteus minimus 0.105 0.084 Pectineus 0.675 0.843 Piriformis 0.392 0.467 Quadratus femoris 0.651 0.670 Vastus intermedius 0.560 0.68 2 Vastus lateralis 0.348 0.428 Flexor digitorum 0.641 0.659 Popliteus 0.810 0.822 Soleus 0.650 0.704 Tibialis anterior 0.833 0.844 Tibialis posterior 0.573 0.591

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95 Table 19 : Robusticity vs Age Kruskal Wallis and ANOVA test resu lts Attachment site: Robusticity K Wallis vs age ANOVA vs age Conoid 0.948 0.955 Costoclavicular 0.455 0.529 Subclavius 0.960 0.980 Trapezius 0.487 0.548 Trapezoid 0.559 0.615 Pectoralis minor 0.247 0.217 Trapezius (S) 0.411 0.428 Deltoideus 0.796 0.810 Common Extensors 0.615 0.639 Common Flexors 0.648 0.672 Infraspinatous 0.833 0.929 Latissimus dorsi 0.746 0.768 Pectoralis Major 0.498 0.547 Subscapularis 0.488 0.514 Supraspinatus 0.793 0.816 Teres Major 0.774 0.793 Teres Minor 0.232 0.238 Anconeus 0.984 0.990 Brachialis 0.622 0.681 Pronator quadratus 0.108 0.086 Tricpes brachii 0.253 0.253 Biceps brachii 0.510 0.535 Pronator Teres 0.546 0.592 Supinator 0.955 0.961 Adductor magnus 0.330 0.378 Gluteus medius 0.729 0.753 Gluteus mini mus 0.901 0.913 Pectineus 0.635 0.679 Quadratus femoris 0.590 0.619 Semimembranosus 0.821 0.842 Gluteus medius 0.362 0.395 Gluteus minimus 0.178 0.196 Pectineus 0.190 0.359 Piriformis 0.264 0.507 Quadratus femoris 0.607 0.625 Vastus intermedius 0. 780 0.854 Vastus lateralis 0.855 0.845 Flexor digitorum 0.226 0.231 Popliteus 0.353 0.369 Soleus 0.494 0.545 Tibialis anterior 0.766 0.786 Tibialis posterior 0.044 0.033

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96 Figure 42 : Frequency of Robusticity scores in the u pper body by attachment sites Figure 43 : Frequency of Robusticity scores in the lower body by attachment sites

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97 Stress lesions There were two attachment sites with significant stress lesions scores (Table 20 and 21) . These muscle/ ligament attachment sites for ANOVA were: brachialis (p value=0.023) and gluteus medimus (p value=0.033). A Kruskal Wallis test was also ran which resulted: brachialis (p value=0.030) and gluteus medimus (p value=0.050). A post hoc (LSD) analysis was condu cted. Latissimus dorsi attachment site was found to be significantly higher for males (p value= 0.0.03) than females with mean difference of 0.642. Brachiallis was higher in male s than female s with significant difference (p value=0.011) of 0.450. Gluteus m edimus had p value=0.013 with intermediates scoring higher than males with a mean difference of 0.50 0 and p value= 0.020 . Three attachment sites were identified without the same distribution across all age groups: deltoideus (p value=0.000 ANOVA, 0.009 K W allis), s emimembranosus (p value=0.011 ANOVA, p value= 0.019 K Wallis ) and quadratis femoris (not significant in ANOVA, p value=0.000 K Wallis). Table 20 : Stress Lesions vs Sex Kruskal Wallis and ANOVA test results Attachment site: Stress Lesion K wallis Vs Sex ANOVA vs Sex Conoid 0.450 0.401 Costoclavicular 0.412 0.588 Subclavius 0.265 0.275 Trapezius 0.646 0.670 Trapezoid 0.809 0.822 Pectoralis minor 0.114 0.192 Trapezius (S) 0.265 0.277 Deltoideus 0.830 0.787 Common Exten sors 0.462 0.479 Common Flexors 0.462 0.479 Infraspinatous 0.411 0.429 Latissimus dorsi 0.119 0.090 Pectoralis Major 0.595 0.664 Subscapularis 0.440 0.459 Teres Major 0.462 0.479 Teres Minor 0.303 0.315

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98 Anconeus 0.822 0.833 Brachialis 0.030 0.023 Pronator quadratus 0.627 0.644 Tricpes brachii 0.492 0.509 Biceps brachii 0.565 0.536 Pronator Teres 0.380 0.394 Supinator 0.381 0.396 Adductor magnus 0.638 0.721 Gluteus medius 0.144 0.145 Pectineus 0.144 0.144 Quadratus femoris 0.740 0.757 Semi membranosus 0.840 0.852 Gluteus medius 0.050 0.033 Gluteus minimus 0.750 0.774 Pectineus 0.196 0.200 Piriformis 0.741 0.767 Quadratus femoris 0.693 0.710 Vastus intermedius 0.540 0.546 Vastus lateralis 0.324 0.336 Popliteus 0.284 0.295 Soleus 0.20 5 0.246 Semimembranosus 0.803 0.853 Tibialis anterior 0.684 0.700 Tibialis posterior 0.462 0.479 Table 21 : Stress Lesions vs age Kruskal Wallis and ANOVA test results Attachment site: Stress lesion K wallis vs age ANOVA vs age Conoid 0.695 0.118 Costoclavicular 0.160 0.140 Subclavius 0.295 0.307 Trapezius 0.411 0.439 Trapezoid 0.924 0.933 Pectoralis minor 0.423 0.418 Trapezius (S) 0.802 0.818 Deltoideus 0.009 0.000 Common Extensors 0.833 0.850 Common Flexors 0.833 0.85 0 Infraspinatous 0.675 0.693 Latissimus dorsi 0.646 0.246 Pectoralis Major 0.498 0.622 Subscapularis 0.440 0.459 Teres Major 0.204 0.206 Teres Minor 0.554 0.573

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99 Anconeus 0.088 0.079 Brachialis 0.547 0.570 Pronator quadratus 0.817 0.834 Tricpes br achii 0.817 0.834 Biceps brachii 0.885 0.928 Pronator Teres 0.586 0.609 Supinator 0.114 0.107 Adductor magnus 0.294 0.205 Gluteus medius 0.244 0.251 Pectineus 0.147 0.147 Quadratus femoris 0.936 0.945 Semimembranosus 0.019 0.011 Gluteus medius 0.5 13 0.551 Gluteus minimus 0.913 0.921 Pectineus 0.123 0.117 Piriformis 0.607 0.639 Vastus intermedius 0.573 0.670 Vastus lateralis 0.080 0.070 Popliteus 0.288 0.299 Soleus 0.820 0.898 Semimembranosus 0.653 0.776 Tibialis anterior 0.155 0.153 Tibia lis posterior 0.833 0.850 Figure 44 : Frequency of Stress lesion scores in the upper body by attachment sites

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100 Figure 45 : Frequency of Stress lesion scores in the lower body by attachment sites Ossifica tion No significant difference of ossification was identified between sex categories by ANOVA and Kruskal Wallis tests. However a post hoc (LSD) test identified gluteus medius to be significantly (p value=0.03) higher by mean difference of 0.429 in interme diate individuals than males while significant (p value=0.09) between intermediates and females with a mean difference of 0.91. LSD post hoc test also identified semimembranosus to be (p value= 0.00) significantly higher by 0.846 in intermediate indiv iduals than males and between intermediate and female (p value=0.012) individuals with mean difference of 1.000. All attachment sites had the same distribution across age categ ories both for ANOVA and K Wallis (table 22 and 23) .

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10 1 Figure 46 : Frequency of ossification scores in the upper body by attachment sites Figure 47 : Frequency of ossification scores in the lower body by attachment sites

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102 Table 22 : Ossification vs sex Kruskal Wa llis and ANOVA test results Attachment site ANOVA vs sex K Wallis vs Sex Conoid 0.308 0.297 Costoclavicular 0.650 0.630 Trapezius 0.632 0.607 Trapezoid 0.625 0.607 Pectoralis minor 0.449 0.424 Trapezius (S) 0.497 0.472 Deltoideus 0.422 0.407 Pector alis Major 0.665 0.648 Subscapularis 0.693 0.675 Teres Minor 0.710 0.693 Tricpes brachii 0.644 0.27 Biceps brachii 0.646 0.629 Adductor magnus 0.646 0.629 Gluteus medius 0.062 0.068 Quadratus femoris 0.088 1.000 Semimembranosus 0.083 1.000 Gluteus minimus 0.665 0.462 Pectineus 0.479 1.000 Semimembranosus 0.734 0.717 Table 23 : Ossification vs age Kruskal Wallis and ANOVA test results Attachment site K wallis Vs Age ANOVA vs age Conoid 0.130 0.124 Costoclavicular 0.820 0 .839 Trapezius 0.392 0.418 Trapezoid 0.836 0.853 Pectoralis minor 0.574 0.601 Trapezius (S) 0.543 0.568 Deltoideus 0.951 0.957 Pectoralis Major 0.833 0.850 Subscapularis 0.675 0.693 Teres Minor 0.651 0.670 Tricpes brachii 0.651 0.674 Biceps brach ii 0.819 0.836 Adductor magnus 0.693 0.717 Gluteus medius 0.448 0.472 Semimembranosus 0.256 0.267 Gluteus minimus 0.672 0.695 Pectineus 0.833 0.850 Piriformis 1.000 Semimembranosus 0.781 0.803

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103 MSM average scores The highest mean MSM scores of the lower body were observed on the sites for gluteus minimus on the pelvis (0.556), adductor magnus (0.517) and piriformis (0.494). While on the upper body the highest mean was for trapezoid (0.613). In the upper body groupings in sex and age did not present different results of means. In the lower body, a dductor magnus had a higher mean score in 20 35 age group and gluteus minimus (P) had highest score in individuals over 50 years of age. When mean scores are grouped by sex gluteus minimus (P) 0.69 and adduct or magnus 0.606 had the highest values for males and piriformis had the highest score 0.533 for females. Figure 48 : Mean musculoskeletal stress markers (MSM) scores for the lower body by attachment sites

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104 Figure 49 : Mean musculoskeletal stress markers (MSM) scores for the upper body by attachment sites Figure 50 : Mean musculoskeletal stress markers (MSM) scores for the upper body by attachment sites and sex

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105 Figure 51 : Mean musculoskeletal stress markers (MSM) scores for the upper body by attachment sites and age Figure 52 : Mean musculoskeletal stress markers (MSM) scores for the lower body by attachment sites and age

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106 Figure 53 : Mean musculoskeletal stress markers (MSM) scores for the lower body by attachment sites and sex

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107 CHAPTER VII COMPARATIVE DATA In this study a wide array of previously published data were pulled in order to acquire temporally and spatially varied comparative sample. Reporting of the comparative analysis has been separated according to observed conditions: Cribra Orbitalia (CO) , Degenerative J oint D isease (DJD) and Musculoskeletal S tress markers (MSM) . The comparative sites use d differ depending on the condition that is being analyzed. Thus, a table has been provided in each section to show the sites used, time period and location of the site in the Nile valley (Table 2 4 , 25, 26, and 27) . Cribra Orbitalia In order to compare CO , scores for CO of the orbits were used as most studies of CO in the Nile valley utilize solely the orbits to identify the condition. The El Hesa population had the third highest percentage of orbital CO compared to other sites in the Nile V alley but there were no significant association between sites and orbital CO (Chi square= 0.235) . However, w hen sites are grouped by regions with in the Nile V alley, there were no statistical difference s (p value= 0.190 ANOVA, Chi square= 0.371) in the distribution of C O of the orbits. When sites are divided based on their status as boarderlands there are no statistical significance (P value=0.079 ANOVA, Chi square= 0.386).

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108 Figure 54 : Percentage of cribra orbitalia on the orbit present by site Table 24 : List of sites used in comparing % cribra orbitalia on the orbits by location and time period of sample used Site Time period Location Cribra orbitalia on the orbits Kerma M iddle Kingdom/2 nd interm ediate Upper Nubia 13.31 C Group Middle Kingdom Lower Nubia 11.23 Tombos N ew Kingdom Upper Nubia 4.35 Tombos Napata Upper Nubia 19.050 SJE C group M iddle Kingdom Lower Nubia 11.240 pharaonic N ew Kingdom Lower Nubia 20.970 Kulub21s46 Christian Lower Nubia 30.795 Kulub21r2 C hristian Lower Nubia 23.868 kellis2 Christian Lower Nubia 16.24 Ein Tirghi Christian Lower Nubia 38.47 M is is la nd 3j10 Christian Lower Nubia 44.8 M is is la nd 3j11 Christian Lower Nubia 47.5 Q uareh N ew Kingdom Upper Egypt 14.470 Dakhleh Oasis Roman Upp er Egypt 21.69 Memphis New Kingdom Lower Egypt 9.71 Shellal New Kingdom Upper Egypt 13.94

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109 Degenerative J oint D isease When the El He sa data was compared with six sites from l ower and Upper Nubia , El Hesa had the lowest DJD score, 0.16 and C G roup populat ion had the highest score at 0.449. When the average scores were observed based on DJD characteristics, El Hesa had the lowest scores for l ipping, 0.218. However, in porosities El Hesa had the 4 th highest score 0.258) out of seven sites. Similarly, El Hesa had the 4 th highest score (0.00308) for eburnation. However, statistically there were no significant difference between the four regions of the Nile river valley for lipping and eburnation (Table 26 and 27) . Left proximal humerus (p value=0.039), right d istal humerus (p value=0.017), right proximal radius (p value=0.09), right acetabulum (p value=0.027), left acetabulum (p value=0.012), right proximal femur (p value=0.07), left proximal femur (p value=0.004) and right proximal tibia (p value=0.035) had at least one category of loc ation differently distributed. Table 25 : List of sites used in comparing DJD by location and time period of sample used Sites for DJD with Lipping, Porosity and Eburnation values provided Site Time Period Location Boarderland Reference El Hesa Christian Lower Nubia Yes Current Tombos New Kingdom Upper Nubia No Schrader 2010 Tombos Napata Upper Nubia No Schrader 2010 Kerma Middle Kingdom 2 nd intermediate Upper Nubia No D.C. Martin 2015 C group Middle K ingdom Lower Nubia yes Schrader 2010 Pharaonic New Kingdom Lower Nubia yes Schrader 2010 O16/P37 Kerma Ancient Upper Nubia no Schrader 2010

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110 Figure 55 : Distribution of mean DJD scores by site Figure 56 : Distribution of mean lipping scores by site

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111 Figure 57 : Distribution of mean porosity scores by site Figure 58 : Distribution of mean eburnation scores by site

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112 Figure 59 : Bi variate density ellipses graph showing 90% coverage of DJD scores by site and articular surfaces. The El Hesa sample is represented by checkerboard pattern. Table 26 : Lipping vs sites categorized by regional proximity: Lower Egypt, Upper Egypt, Lower Nubia and Upper Nubia Lipping Side ANOVA K Wallis Glenoid Fossa Right 0.280 0.157 Glenoid Fossa Left 0.091 0.157 Proximal Humerus Right 0.360 0.480 Proximal Humerus Left 0.628 0.858 Distal Humerus Right 0.721 0.476 Distal Humerus L eft 0.391 0.480 Proximal Ulna Right 0.879 0.721 Distal Ulna Right 0.478 0.724 Proximal Ulna Left 0.750 1.000 Distal Ulna Left 0.318 0.289 Proximal Radius Right 0.827 0.724 Distal Radius Right 0.505 0.857 Proximal Radius Left 0.850 0.724

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113 Distal Radi us Left 0.943 0.714 Acetabulum Right 0.588 0.724 Acetabulum Left 0.551 0.858 Proximal Femur Right 0.648 0.480 Proximal Femur Left 0.549 0.476 Distal Femur Right 0.613 0.480 Distal Femur Left 0.781 0.480 Proximal Tibia Right 0.985 1.000 Distal Tibia Right 0.123 0.154 Proximal Tibia Left 0.523 1.000 Distal Tibia Left 0.602 0.721 Table 27 : Porosity vs sites categorized by regional proximity: Lower Egypt, Upper Egypt, lower Nubia and upper Nubia Porosity Side ANOVA K Wallis Glenoid Fossa Right 0.381 0.157 Glenoid Fossa Left 0.481 0.277 Proximal Humerus Right 0.123 0.157 Proximal Humerus Left 0.122 0.077 Distal Humerus Right 0.029 0.034 Distal Humerus Left 0.007 0.034 Proximal Ulna Right 0.498 0.721 Distal Ulna Right 0. 355 0.372 Proximal Ulna Left 0.312 0.212 Distal Ulna Left 0.785 1.000 Proximal Radius Right 0.303 0.480 Distal Radius Right 0.617 0.480 Proximal Radius Left 0.120 0.157 Distal Radius Left 0.516 0.589 Acetabulum Right 0.380 0.480 Acetabulum Left 0.1 98 0.154 Proximal Femur Right 0.102 0.074 Proximal Femur Left 0.065 0.108 Distal Femur Right 0.097 0.157 Distal Femur Left 0.093 0.154 Proximal Tibia Right 0.192 0.289 Distal Tibia Right 0.009 0.034 Proximal Tibia Left 0.160 0.476 Distal Tibia Left 0.366 0.329

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114 Table 28 : Eburnation vs sites categorized by regional proximity: Lower Egypt, Upper Egypt, lower Nubia and upper Nubia Eburnation Side ANOVA K Wallis Glenoid Fossa Right 1.000 Glenoid Fossa Left 1.000 Proximal Humerus Right 0.122 0.078 Proximal Humerus Left 0.286 0.248 Distal Humerus Right 0.245 0.237 Distal Humerus Left 0.242 0.237 Proximal Ulna Left 0.289 0.248 Distal Radius Right 0.286 0.248 Proximal Radius Left 0.080 0.078 Acetabulum Right 0.286 0.248 Acetabulum Left 0.437 0.386 Proximal Femur Right 0.357 0.659 Proximal Femur Left 0.772 0.696 Distal Femur Right 0.137 0.372 Distal Femur Left 0.189 0.172 Proximal Tibia Right 0.148 0.271 Distal Tibia Right 0.286 0.248 Proximal Tibia Left 0.117 0.0 78 Figure 60 : Distribution of DJD scores by site and articular surfaces

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115 Figure 61 : Distribution of mean DJD scores by site Musculoskeletal Stress Marker For Musculoskeletal Stress Marker analysis twel ve previously published sites were used as a comparison. The comparative sites used originate from Lower Nubia , Upper Nubia and Lower Egypt . Compared to the 12 sites, El Hesa had the lowest mean MSM score. However, when MSM scores were separated bas ed on u pper and lower body, El H esa mean MSM score was higher than all sites in Egypt and the tombos new kingdom population for upper body. For lower body, the El Hesa collection had comparable results to the New Kingdom Tombos population and lower than all popul ations with lower body MSM data available.

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116 Table 29 : List of sites used in comparing MSM by location and time period of sample used Separated by site Table 30 : K wallis comparative results of sites Attachment site K Wall is Conoid 0.423 Costoclavicular 0.333 Subclavius 0.333 Trapezius 0.261 Trapezoid 0.406 Deltoideus 0.333 Common Extensors 0.364 Common Flexors 0.364 Infraspinatous 0.416 Latissimus dorsi 0.321 Pectoralis Major 0.333 Subscapularis 0.416 Site Time period Location Boarder Reference Tombos New Kingdom 3 rd Cataract/ Upper Nubia No Schra der 2010 Tombos Napata 3 rd Cataract/ Upper Nubia No Schrader 2013 Kerma Middle Kingdom/2 nd intermediate Upper Nubia No DC martin 2015 C Group Middle Kingdom 2 nd Cataract/ Lower Nubia Yes Schrader 2010 Pharaonic New Kingdom 1580 1000bce Lower Nubia Yes B uzon 2006 O16/p37 Kerma ancient 2500 1650 Upper Nubia No Schrader 2013 Abydos Middle Kingdom Upper Egypt No Zabecki 2009 Giza Old Kingdom Lower Egypt No Zabecki 2009 Naga ed der Pre Dynasty Lower Egypt No Zabecki 2009 Hierakonpolis Pre Dynasty/ Earl y Dynastic Lower Egypt No Zabecki 2009 NDRS Kerma Upper Nubia No D.C. Martin 2015 SJE C group Middle kingdom Lower Nubia No D.C. Martin 2015

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117 Suprasp inatus 0.416 Teres Major 0.333 Teres Minor 0.416 Brachialis 0.364 Tricpes brachii 0.364 Biceps brachii 0.437 Supinator 0.406 Gluteus medius 0.416 Gluteus minimus 0.416 Quadratus femoris 0.416 Flexor digitorum 0.317 Popliteus 0.416 Separated by region Using ANOVA, Costoclavicular (p value=0.017), subclavius (p value=0.034), Trapezius (p value=0.044), Latissimus dorsi (p value=0.000), teres Minor (p value=0.015), triceps brachii (p value=0.017), Gluteus medimus (p value=0.025) had significant diff erence in the distribution of at least one category of location. Post hoc (LSD) analysis was conducted on sites with statistically significant difference between locations. C ostoclavicular showed significant (p value=0.024) difference between Upper Egypt s ites and Lower Egypt sites with a mean difference of 1.36, Upper Egypt and Upper Nubia (p value=0.024) with difference 1.24, Upper Egypt and Lower Nubia (p value=0.003) difference of 2.24, and Upper Nubia and Lower Nubia p value=0.049) with 1.003 mean diff erence. Subclavius showed significant difference between Upper Nubia and Upper Egypt (p value=0.09) with a difference of 0.718 and between Upper Nubia and Lower Egypt (p value=0.028) with a difference of 0.533. Deltoideus showed a difference of 0.447 betwe en Upper Nubia and Lower Egypt at significance level of 0.032 and between Upper Nubia and Upper Egypt (p value=0.033) with mean difference if 0.442. Common extensors showed significant (p value=0.0.030) difference between Lower Nubia and Upper Egypt with a mean difference of 1.485. Common flexors showed significant

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118 difference between Upper Nubia and Lower Egypt (p value=0.047) with a difference of 0.857. Between Lower Nubia and Upper Egypt , b rachialis showed a significant difference (p value=0.041) with a m ean change of 1.28. Tricep b rachii showed significant (p value=0.014) difference between Lower Nubia and Lower Egypt sites, (p value=0.007) between Lower Nubia and Upper Egypt , (p value= Upper Nubia and Upper Egypt (p value=0.037 ) with mean difference of 0. 768, 0.878, and 0.693 respectively. Table 31 : K Wallis and ANOVA comparative result of sites grouped by regional proximity Attachment site K Wallis ANOVA Conoid 0.265 0.351 Costoclavicular 0.086 0.017 Subclavius 0.110 0.034 T rapezius 0.076 0.044 Trapezoid 0.741 0.599 Deltoideus 0.094 0.081 Common Extensors 0.159 0.115 Common Flexors 0.162 0.124 Infraspinatous 0.143 0.081 Latissimus dorsi 0.111 0.000 Pectoralis Major 0.180 0.251 Subscapularis 0.137 0.079 Supraspinatus 0.143 0.064 Teres Major 0.339 0.549 Teres Minor 0.143 0.015 Brachialis 0.040 0.113 Tricpes brachii 0.045 0.017 Biceps brachii 0.397 0.2 61 Supinator 0.819 0.722 Gluteus medius 0. 143 0.025 Gluteus minimus 0.143 0.060 Quadratus femoris 0.143 0.078 Flexor digitorum 0.317 Popliteus 0.143 0.197

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119 Separated based on boarderland status Table 32 : K wallis and ANOVA comparative results of sites grouped by boarderland Attachment site K Wallis ANOVA Conoid 0.245 0.355 Costocl avicular 0.040 0.047 Subclavius 0.557 0.677 Trapezius 0.076 0.044 Trapezoid 0.480 0.374 Deltoideus 1.000 0.864 Common Extensors 0.537 0.348 Common Flexors 0.315 0.288 Infraspinatous 0.127 0.256 Latissimus dorsi 0.825 0.928 Pectoralis Major 0.769 0.967 Subscapularis 0.268 0.371 Supraspinatus 0.127 0.276 Teres Major 0.240 0.330 Teres Minor 0.127 0.193 Brachialis 0.164 0.072 Tricpes brachii 0.216 0.148 Biceps brachii 0.909 0.738 Supinator 1.000 0.780 Gluteus medius 0.275 0.318 Gluteus mini mus 0. 275 0. 408 Quadratus femoris 0.827 0.580 Flexor digitorum 0.317 Popliteus 0.827 0.992

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120 Figure 62 : Distribution of mean MSM scores by sites Figure 63 : Distribution of mean MSM scores for the s houlder joint complex by sites

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121 Figure 64 : Distribution of mean MSM scores for the elbow joint complex by sites Figure 65 : Distribution of mean MSM scores of the upper body by sites

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122 Figure 66 : Distribution of mean MSM scores for the lower body by sites

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123 CHAPTER VIII CONCLUSION AND DISCU SSION Results Three hypotheses were put forth for this study and have been reproduced below. 1. El Hesa site will have higher level of stress mark ers including c ribra o rbitalia, degenerative joint disease as well as musculoskeletal stress markers compared to other sites in the Nile R iver valley. 2. When sites are grouped based on their sociopolitical stance as boarder areas or main regions during the time period the population is from, sites identified as boarder areas will have higher prevalence of skeletal stress levels. 3. When site are compared based on regions Lower Nubia n sites will have higher prevalence of stress level compared to Upper Nubia , Up per Egypt and Lower Egypt . Hyp 1) Following the results from this project it has been observed the El H esa sample is one of the healthiest samples in the Nile V alley with the lowest DJD scores compared to other sites. El Hesa sample also had a lower MSM s core compared to all sites in Upper Nubia and Egypt. Hyp 2) When sites were grouped based on their historical borderland/main land status, the E l H esa sample showed lower MSM mean scores than main land sites as well as other borderland sites.

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124 Hyp 3) Whe n sites were compared according to region, Upper Nubia n sites had the highest MSM scores, followed by those from Lower Nubia and with Lower Egypt ian sites having the lowest MSM scores. Conclusion Bioarchaeological researchers have emphasized the complexit y of understanding stress level in population s level. Although sociopolitical conditions, environmental factors, economic conditions all affect the amount of stress placed upon a population ver y few of these are observable in ancient populations. Aspects that can be observed archaeologically include: stress on the skeletal remains , architectural and monumental constructions, and those of site abandonment . These remains give us a view of stressor s that might have influenced populations. Of these, stress on skeletal material alone provides us with observable data into the effect these factors have on health. This project has taken a multidisciplinary approach in which studies of economics, intern ational relations and anthropology have influenced its theory. Through the integration of these fields we are able to observe how sociopolitical changes in a population can influence stress levels observed in anthropological skeletal remains. As such the hypotheses in this project were formed based on a perspective of boarder lands theory and sociopolitical and economical studies that emphasize populations living in boarder areas will face higher stress levels due to limitations in trade access, militarist ic confrontations from both polities with in the region as well as limitation to resources. In these studies the effect of conflict on health is estimated to last decades after the end of the confrontation and to influence several generations post conflict . The El Hesa collection

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125 comes from an excavation in 1907 and housed at the AMNH since 1942. The skeletal material was excavated from the First Cataract region, historically the border between Egypt and Lower Nubia . The s ite dates to approximately 395 CE 6 40 CE from the end of the Roman Hellenic period to the end of the Byzantine period in Egypt (Francigny et al 2014). In the Nile River valley, the end of the Roman Hellenic period presents the end of centuries long conflict and attempts of imperial expansio n of R oman and Egyptian forces into Lower Nubia . The El H esa collection is an interesting site in which it is located in a border area between the two polities as well as from a time when imperial progression was at a decline. As such the El H esa sample al ong with comparative samples, allows us not only to observe variation in stress level based on region and time but from the perspective of boarder studies , the influence conflict has on health after conflict has ceased . The results in this study, however, present a contradicting result compared to that of the hypothesis. In general, the population from El Hesa are healthier than other sites in the Nile valley including those from Upper Nubia , Lower Nubia and Lower Egypt . The El H esa site lacks statisticall y significance difference from other comparative sites in both DJD and MSM scores. T hese results bring us back to the multidisciplinary and complex aspect of this project. Although theories in economics, and conflict studies attest to the long term effect of conflict on health, anthropological studies emphasize the need to have accurate temporal context , environmental context , dietary information and genetic data in order to understand factors influencing skeletal stress markers (Weiss and Jurmain 2007). In a recent genetic study of Egyptian and Nubian populations, Kindschuh (2015) E l Hesa [demonstrating] the significant genetic heterozygosity present while the close distances between E l Hesa and the other

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126 implication one is increased genetic variability could skew comparability of conditions such as D JD between populations because genetic homogeneity is one of the factors influencing compatibility of OA (Weiss and Jurmain 2007). Secondly, her results open the door to research such as the present in which the Nile R iver valley can be observed as a broad land mass with numerous interacting polities and populations throughout time rather than placing limitations due to political boundaries such as Egypt and Nubia. The results from this project ht to be in the border between Egypt and Nubia experience an intertwining of culture, economic and political environment as well as stress levels with both of their conflicting neighbors. The short historical account in chapter 3 was included in order to show the long historical entanglement of Egypt and Nubia. Interactions between the two populations was not a unique phenomenon limited to specific time periods. Instead the two civilizations arose as independent yet interacting populations around 4500 BCE and continue to interact through trade, politics, and culture to the present time. The two civilizations share similar trade routes including the Nile River, and the eastern desert. They also import trade goods from similar locations such as middle Africa, eastern Africa, the Middle East and the Mediterranean. Their intertwined economic interests have led them through periods of mutually beneficial periods as well as conflicts. Throughout history it is seen the two civilizations copy, borrow and reproduce c ultural material and policies that was successful in the other. As such the Nile valley has become a spectrum of cultural, economic and po litical variation rather than two detached civilizations: Egypt and Nubia. In this perspective regions in Lower Nubia and

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127 Upper Egypt show a cultural entanglement of both Egyptian and Nubian elements. The results from this study further tell a story of an intertwined land mass rather than a boar der land and main land division . The change in perspective of looking at the Nile valley requires further investigation in order to understand the interaction in regions with high level of cultural mixing, to fully grasp the history of the Nile valley as a region influenced by numerous cultures as well as the intermixing of them. The current research can be improved upon by including additional sites and controlling for time period.

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128 REFERENCES Adams, Peter, Michael D. Hurd, Daniel Mcfadden, Angela Merrill, and Tiago Ribeiro (2003) Healthy, wealthy, and wise? Tests for direct caus al paths between health and socioeconomic status. Journal of Econometrics 112(1): 3 56. Adams, W.Y., 1995. The Kingdom and Civilization of Kush in Northeast Africa. Civilizations of the Ancient Near East , 2 , pp.775 89. Adams, William Y. "Medieval Nubia." E xpedition 35, no. 2 (1993): 28. Adams, William Y. "The Kingdom and Civilization of Kush in Northeast Africa." Civilizations of the Ancient Near East 2 (1995): 775 89. Adams, William Y. 1977 Nubia: corridor to Africa . Princeton University Press, Princeton, NJ. Adda, Jérôme, Tarani Chandola, and Michael Marmot 2003 Socio economic status and health: causality and pathways. Journal of Econometrics 112(1): 57 63. Armelagos, G.J., 1968. Paleopathology of three populations from ancient Nubia (Doctoral dissertation , Ph. D. dissertation, University of Colorado, Boulder). Auwera, S.V.D., 2012. Contemporary conflict, nationalism, and the destruction of cultural property during armed conflict: A theoretical framework. Journal of Conflict Archaeology , 7 (1), pp.49 65. Auw era, Sigrid Van Der 2012 Contemporary Conflict, Nationalism, and the Destruction of Cultural Property During Armed Conflict: A Theoretical Framework. Journal of Conflict Archaeology 7(1): 49 65. Bevan, Nigel 2006 Practical issues in usability measurement. interactions 13(6): 42. Bonnet, C., 1992. Excavations at the Nubian royal town of Kerma: 1975 91. Antiquity , 66 (252), pp.611 625.

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134 Trigger BG, Kemp BJ, O'Connor D, and Lloyd AB. 1983. Ancient Egypt: a social history: Cambridge University Press. Trigger BG. 1968. New Light on the History of Lower Nubia. Anthropologica: 81 106. Trigger, Br uce G. 1976 Nubia under the pharaohs . Westview Press, Boulder, CO. Ubelaker, D.H. and Volk, C.G., 2002. A test of the Phenice method for the estimation of sex. Journal of Forensic Science , 47 (1), pp.19 24. Ubelaker, D.H., 1989. Human skeletal remains. Exca vation, analysis, interpretation . Weiss, E. and Jurmain, R., 2007. Osteoarthritis revisited: a contemporary review of aetiology. International Journal of Osteoarchaeology , 17 (5), pp.437 450. White, Tim D., Michael T. Black, and Pieter A. Folkens. Human ost eology . Academic press, 2011. Zabecki, M. (2009). Late Predynastic Egyptian workloads: musculoskeletal stress markers at Hierakonpolis . University of Arkansas.

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135 APPENDIX A

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1 Mean MSM scores for the upper body Sje C group El hesa C group pharao nic NDRS kerma Tombo s New Kingd om Tombo s napata O16/p 37 abaydo s giza Nag ed_Der hierak opolis Anconeus 1.03 0.21 BicepsBra chii 2.77 1.19 1.69 2.67 0.25 2.12 2.24 1.13 1.29 1.8 1.44 Brachialis 3.45 1.03 1.44 2.07 1.67 1.65 0.25 1.55 0.64 0.9 0.4 0.69 Common Extens 2.88 0.21 1.53 2.35 1.33 1.63 0.91 2.39 3.08 0.4 1 0.33 0.78 Common Flexor 1.81 0.32 1.3 1.44 1.18 1.37 0.42 1.3 2.41 0.47 0.67 0.43 0.62 Conoid 1.32 1.83 1.52 1.46 0.56 1.73 0.84 1.2 1.06 Costoclavi cular 1.15 0.83 2.4 1.79 0.89 3.21 1.32 3.25 2.42 Deltoideu s 1.21 1.43 1.51 1.55 0.58 1.33 1.06 0.86 1.12 Infraspina tous 1.85 0.29 0.58 3.09 0.11 2.02 3.13 Latis Dorsi 0.75 1.27 1.29 0.4 0.38 0.17 0.17 0.29 Pect Major 1.32 1.64 1.68 1.87 0.64 1.73 1.29 0.86 1.15 Pecto Minor 1 0.09 Pronator Teres 0.72 0.27 PronQuad rat 0.79 0.16

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2 Subclaviu s 0.88 0.5 1.15 0.81 0.18 0.21 0.52 0.2 0.26 Subscapul aris 1.5 0.42 1.5 2.48 0.45 1.6 2 Supinator 0.22 0.47 0.67 0.3 0.17 0.0 9 Supraspin atusHum 1.85 0.5 0.58 3.09 0.1 1.94 3.13 TeresMaj or 0.61 1.09 1.31 1.45 0.48 2.25 1.06 0.67 0.75 TeresMin or 1.07 0.5 0.43 2.3 0.3 1.19 1.62 Trapezius 0.96 1.17 1.31 1.34 0.32 Trapezius Scap 0.88 0.1 Trapez oid 1.68 0.21 1.92 0.56 0.2 0.4 TricepBra chii 1.91 0.86 0.96 1.57 1.02 1.22 0.32 1.49 1.43 0.29 0.6 0.63 0.54 Anconeus 1.03 0.21 BicepsBra chii 2.77 1.19 1.69 2.67 0.25 2.12 2.24 1.13 1.29 1.8 1.44 Brachialis 3.45 1.03 1.44 2.07 1.67 1.65 0.25 1.55 0.64 0.9 0.4 0.69 Common Extens 2.88 0.21 1.53 2.35 1.33 1.63 0.91 2.39 3.08 0.4 1 0.33 0.78 CommonF lexor 1.81 0.32 1.3 1.44 1.18 1.37 0.42 1.3 2.41 0.47 0.67 0.43 0.62 Conoid 1.32 1.83 1.52 1.46 0.56 1.73 0.84 1.2 1.06

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3 Lower Bod y SJE c group El hesa SJE Pharaonic Kerma Tombos New Kingdom T ombos N apata O16/p37 Adductor Magnus 1.39 0.54 Flexor Digitorum 1.59 1.37 0.21 Gluteus Medimus Pelvis 0.7 0.03 Gluteus Medius 1.54 0.4 1.75 3.51 0.7 1.77 2.35 Gluteus Minimus 1.81 0.12 1.77 3.44 0.86 1.82 2.56 Gluteus Minimus Pelvis 0.36 0.1 Illiacus 0.9 0.18 Pectineus 0 0.22 Pectineus Pelvis 0.12 0.09 Piriformis Femur 0.41 0.48 Popliteus 1.5 0.71 0.62 1.57 0.18 0.954 0.38 Quad Fe moris 1.76 0.48 1.62 2.67 0.03 1.52 1.85 Quadra Femoris Pelvis 1.46 0.03 Semimembranos 2.5 0.31 3.17 3.21 3.35 Semimembranus Pelvis 0.08 0.11 3.135 2.36 Soleu s 0.25 0.93 Tibialis Anterio 0.32 0.6 Tibialis Posterio 0.123 0.39 Vastus Intermedius 0.48 0.41 Vastus Lateralis 0.71 0.22 Adductor Magnus 1.39 0.54 Flexor Digitorum 1.59 1.37 0.21 Gluteus Medimus Pelvis 0.7 0.03 Gluteus Medius 1.54 0.4 1.75 3.51 0.7 1.77 2.35 Gluteus Minimus 1.81 0.12 1.77 3.44 0.86 1.82 2.56 Gluteus Minimus Pelvis 0.36 0.1 Illiacus 0.9 0.18 Pectineus 0 0.22 Pectineus Pelvis 0.12 0.09 Piriformis Femur 0.41 0.48

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4