Mount Lebanon Mutasarrifate
Afifa Karam was born in Amsheet, then in the Mount Lebanon Mutasarrifate, into the wealthy Maronite family of a doctor in the Ottoman army. Karam was educated in local missionary schools until the age of thirteen, when she was married to a relative, John Karam. In 1897 she and her husband moved to the United States and settled in Shreveport, Louisiana.