Psychiatry and Decolonisation in Uganda
Total Page：16
File Type：pdf, Size：1020Kb
Mental Health in Historical Perspective Psychiatry and Decolonisation in Uganda Yolana Pringle Mental Health in Historical Perspective Series Editors Catharine Coleborne School of Humanities and Social Science University of Newcastle Callaghan, NSW, Australia Matthew Smith Centre for the Social History of Health and Healthcare University of Strathclyde Glasgow, UK Covering all historical periods and geographical contexts, the series explores how mental illness has been understood, experienced, diag- nosed, treated and contested. It will publish works that engage actively with contemporary debates related to mental health and, as such, will be of interest not only to historians, but also mental health professionals, patients and policy makers. With its focus on mental health, rather than just psychiatry, the series will endeavour to provide more patient-centred histories. Although this has long been an aim of health historians, it has not been realised, and this series aims to change that. The scope of the series is kept as broad as possible to attract good quality proposals about all aspects of the history of mental health from all periods. The series emphasises interdisciplinary approaches to the feld of study, and encour- ages short titles, longer works, collections, and titles which stretch the boundaries of academic publishing in new ways. More information about this series at http://www.palgrave.com/gp/series/14806 Yolana Pringle Psychiatry and Decolonisation in Uganda Yolana Pringle Department of Humanities University of Roehampton London, UK Mental Health in Historical Perspective ISBN 978-1-137-60094-3 ISBN 978-1-137-60095-0 (eBook) https://doi.org/10.1057/978-1-137-60095-0 Library of Congress Control Number: 2018957447 © The Editor(s) (if applicable) and The Author(s) 2019. This book is an open access publication. The author(s) has/have asserted their right(s) to be identifed as the author(s) of this work in accordance with the Copyright, Designs and Patents Act 1988. Open Access This book is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. The images or other third party material in this book are included in the book’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the book’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifc statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affliations. Cover illustration: © Dennis Wegewijs/Alamy Stock Photo; all rights reserved, used with permission This Palgrave Macmillan imprint is published by the registered company Springer Nature Limited The registered company address is: The Campus, 4 Crinan Street, London, N1 9XW, United Kingdom ACKNOWLEDGEMENTS This book, which originated in doctoral research at the University of Oxford, was made possible through the generous support of the Wellcome Trust. It is due to them that it has been published open access, and so freely available to the many scholars, medical practitioners and other interested individuals in Uganda who may not otherwise have been able to read it. Given the persistence of high barriers to research and pub- lication in Africa, open access publishing has never been more important. While this project was in its early stages, Sloan Mahone, my supervisor at Oxford, supported me with encouragement and critical insights, while allowing me room to pursue unexpected avenues in my own way. David Anderson, Jan-Georg Deutsch, and Pietro Corsi also provided much appreciated guidance and support. My examiners, Mark Harrison and Mike Jennings, offered helpful critiques which encouraged me to transform my research into a monograph, and suggested ways to take the project in new directions. In Uganda, my research would not have been possible without the expert assistance of research assistants Ronald Byamukama, Robinson Kisaka, Ronald Muruya, and translators Eugene Malimba and Andrew Muhimbise. I am grateful for the guidance provided by staff at Mengo Hospital, Toro Hospital, the Church of Uganda (Rukungiri), Uganda’s various district archives, the Uganda National Archives, the Albert Cook Memorial Library, Butabika Hospital, PROMETRA, the Joint Clinical Research Centre (Mbale), Makerere University, the Ministry of Health, Mental Health Uganda and the Uganda Human Rights Commission. v vi ACKNOWLEDGEMENTS Seggane Musisi, Joseph Bossa, Robinah Alambuya, Kabale Benon, Eddie Nkurunungi and Stella Ndyanabangi deserve special thanks for gener- ously sharing their warmth and time, and for encouraging me to think about my project in new and exciting ways. I am indebted to all of the people who agreed to be interviewed and patiently answered all of my questions. Most respondents have been anonymised in order to protect their privacy, but this by no means diminishes their importance. Moreover, I thank Allen German, Jim Wood, John Orley, Wilson Acuda and Diane Zeller for responding enthusiastically to my requests for information and clarifcation, and sup- plying me with some invaluable unpublished materials. An earlier version of Chapter 4 was published as Y. Pringle, ‘Investigating “Mass Hysteria” in Early Postcolonial Uganda: Benjamin H. Kagwa, East African Psychiatry, and the Gisu’, Journal of the History of Medicine and Allied Sciences 70(1) (2015), pp. 105–136. I thank Oxford University Press for permission to reproduce some of this material here. In addition to support from the Wellcome Trust, I have benefted from funding from Jesus College, Oxford, and the British Institute in Eastern Africa. The bulk of the work to transform my research into this monograph was done as a result of the freedom afforded by a Mellon- Newton Interdisciplinary Postdoctoral Research Fellowship at the Centre for Research in the Arts, Social Sciences and Humanities (CRASSH) at the University of Cambridge. The University of Cambridge’s Returning Carers Scheme, which allowed me to follow up on new research leads in Uganda, deserves special mention not only for its role in shaping the later chapters of the monograph, but for its importance (particularly for early career women) in aiding the transition back to academia after a career break. During the research and writing of this monograph, more people than I am able to acknowledge here have provided support and much-needed perspective. Special thanks must nevertheless go to Charlotte Cross, Nicki Kindersley, Dan Branch, Roberta Bivins, Harriet Palfreyman, Michelle Sikes, Pat Stys, Kathleen Vongsathorn, Andrea Grant, Lynsey Shaw and Belinda Clark. The series editors Matt Smith and Cathy Coleborne, as well as Oliver Dyer and Molly Beck at Palgrave Macmillan, have expertly guided me through the publication process, while the anonymous reviewers have provided critical insights and encouraged me to do more with my sources. New colleagues at the University of Roehampton have encouraged the fnal push to get this monograph out. Acknowledgements vii My mother, Mariette, who is more inspirational than she knows, has always encouraged me to pursue education. Her love and support cannot be thanked enough. Finally, apart from being my intellectual sounding board and best friend, my husband, Tim, has been a constantly supporting voice. I look forward to spending more time with him, with Zoe, and with Nicholas, who has become far too used to me hiding away to ‘work on the computer’. CONTENTS 1 Introduction 1 2 A Place on Mulago Hill 27 3 The ‘Africanisation’ of Psychiatry 59 4 ‘Mass Hysteria’ in the Wake of Decolonisation 93 5 The Psychiatry of Poverty 117 6 Mobility, Power and International Mental Health 153 7 The ‘Trauma’ of War and Violence 177 8 Conclusion 209 Bibliography 221 Index 247 ix ABBREVIATIONS ACMM Albert Cook Memorial Library, Makerere University AMO African Medical Offcer BOD Bodleian Library, University of Oxford CEHURD Centre for Health, Human Rights and Development CMS Church Missionary Society DC District Commissioner DMS Director of Medical Services DMSS Director of Medical and Sanitary Services DPM Diploma in Psychological Medicine DSM Diagnostic and Statistical Manual of Mental Disorders ECT Electroconvulsive Therapy JDA Jinja District Archives KDA Kabale District Archives MDA Mbale District Archives MHAC Mental Health Advisory Committee MMU Mountains of the Moon University, Fort Portal MO Medical Offcer NAMH National Association for Mental Health PCO Psychiatric Clinical Offcer