This book is about the cumulative causes and consequences of persistent poverty and gross inequalities. It is concerned with the essential features of the distribution of wealth, income and opportunities, including access to basic social services and job opportunities. The focus is not on formal theorizing, modelling or a technical style of analysis. Rather, it is on understanding – in ordinary parlance – the form, origins and impact of co-existing affluence and deprivation, and what governments and non-governmental organizations (NGOs) are doing about them. The book has, therefore, a broad scope. Based on empirical investigation, it helps the reader to understand some lessons of the past and the prospects and challenges facing the region at the turn of the century. Towards this comprehensive understanding, it provides an analytical framework, making each chapter a building block. Moreover, the book’s aim of filling a gap in knowledge about the Middle East has a positive motivation; the study may lead, not necessarily immediately, to some practical results enhancing human well-being. This task of building knowledge is by way of identifying the common cultural and economic factors which – in their interaction over time – have brought about such extremes in wealth and deprivation.