HARVARD GAZETTE ARCHIVES
A short history: Psychiatry in modern Africa
By Ken Gewertz
Harvard News Office
Psychiatrists working in Africa during the colonial period held to the belief that Africans did not suffer from depression. They based this idea on the assumption that Africans lacked the ability to be self-reflective or self-critical and therefore depression had no chance of gaining a foothold in their psyches.
Later research during the 1950s showed that this view was nonsense. Africans, along with people throughout the world, suffer from certain universal mental disorders. What differs is the nature of their symptoms, the way these disorders are expressed.
The plasticity of mental symptoms and their responsiveness to cultural factors is one of the themes that will be explored today (Dec. 14) in a one-day workshop on African psychiatry. Sponsored by the working group on Health, Healing and Ritual Practice in Africa (a part of the Africa Initiative), the workshop brings psychiatrists with an interest in Africa together with social scientists and humanists whose work looks at mental illness and healing from a variety of perspectives.
The workshop's coordinator, Emmanuel Akyeampong, professor of history and of African and African American studies, has had a long-standing interest in issues of health and disease in Africa. As a historian, he finds mental illness a particularly interesting topic because of its intrinsic connection with culture.
"What I've found fascinating about mental illness is that it is always defined by culture, and therefore culture comes to shape the profession of psychiatry and to define what we mean by madness," Akyeampong said.
The workshop's first session explores this theme with presentations such as "Music and Healing in the Ethiopian Orthodox Church" by Kay Shelemay, the G. Gordon Watts Professor of Music and professor of African and African American studies; "Language and the Discourse of Madness in Kenya" by John Mugane, professor of the practice of African languages and cultures; and "Cannabis and Madness in Ghana" by Akyeampong.
Another theme the workshop will focus on is the increase in mental health disturbances brought about by widespread violence in many African nations.
According to Akyeampong, several African countries, including Nigeria, Sudan, Senegal, and Ghana, have had strong psychiatric traditions beginning in the 1950s. This period saw the emergence of the African Psychiatric Association and its publication, the African Journal of Psychiatry, along with pioneering collaborations between psychiatrists and indigenous healers.
But progress in these areas was halted in the 1980s and '90s, a period of wars, political instability, and economic decline. Unfortunately, the dismantling of the institutions that supported psychiatric services and research occurred at a time when the need was greatest.
"The irony is that at the moment when we most need detailed studies of post-traumatic stress and other issues, these countries lack the means of providing that data," Akyeampong said.
The workshop's second session will look into this issue with presentations by researchers such as Richard Mollica, director of the Harvard Program in Refugee Trauma at Harvard Medical School, and William Murphy of Northwestern University, who has studied the impact of violence on child soldiers in Liberia and Sierra Leone.
Along with war and genocide, many African countries have suffered from widespread HIV/AIDS, a disease whose effects are both mental and physical.
"This is a chronic terminal illness that comes with a package of mental problems," said Akyeampong. "These include depression and anxiety, as well as a social stigma that affects not only the sufferers but also their families and caregivers."
The third session will look at the psychological impact of HIV/AIDS from a number of perspectives. Researchers and medical workers will present findings from Tanzania, South Africa, and other regions.
The final session will take up issues of mental illness as interpreted from an African perspective. Allan Hill, the Andelot Professor of Demography in the Faculty of Public Health, will discuss mental illness among women in Ghana; Ama de Graft Aikins of Cambridge University will speak on the mental health of the poor and homeless; and Victor Doku of University College London, will present his research on schizophrenia in West Africa. Arthur Kleinman, the Esther and Sidney Rabb Professor of Anthropology and professor of medical anthropology in the Faculty of Medicine, will provide the closing remarks.