Bounding 'Alien Lunatics' in Modern Ghana

Abstract

Bounding ‘Alien Lunatics’ in Modern Ghana is the first examination of patient files in the Accra Psychiatric Hospital, the second oldest mental hospital in West Africa. Combining oral history and participant observation methods with research in this overlooked archive, I show how mental healthcare became a conduit for immigrant scapegoating and social control in urban West Africa. Colonial Ghana was the site of intense regional labor migration, due to cocoa farming and gold mining, from Muslim dominated regions known as the “Northern Territories” as well as states that became incorporated into the federation of French West Africa. Historians of psychiatry have argued that the over-confinement of regional labor migrants in insane asylums across colonial Africa was due to the state’s concerns about law and order. My work, in contrast, underscores the layered scientific, medical, and political production of labor migrants as psychologically unsound. Processes of psychiatric confinement and emergent psychotherapeutic practices in colonial and post-colonial Ghana were transformed by debates between the state and local ethnic elites in urban spaces, including among the Ga of Accra and the Asante of Kumasi.

Medical historians argue that psychiatry in Africa was mainly a European imposition but also a weak tool of social control. By embracing a geography that extends across British and French imperial boundaries in West Africa, and attends to deep histories of regional migration, I demonstrate that African politicians and merchants used psychiatry as a tool of territorial control. They sought to regulate the political membership of transregional migrants in their rapidly growing urban centers. Departing from a long-standing scholarly premise that psychiatry in Africa was a European import, I argue that colonial psychiatry did not displace pre-existing African psycho-therapeutic norms; rather, it was built upon and adapted to them.

Bounding Alien Lunatics moves across multiple scales of analysis: from the asylum in Accra to the streets of Kumasi, from debates in the legislative assembly in Ghana to the large sphere of ethnic admixture created by centuries of north-south migration from Burkina Faso and Cote d’Ivoire toward southern Ghana. By tracking the movement of migrants, therapeutic regimes, and colonial diagnostic categories across these spaces, I tell a history of psychiatry shaped by intense mobility at a time of rapid social change and urbanization. In so doing, this project also contributes to scholarship on ethnic formation and labor migration in West Africa.

This work is grounded in a life-long personal and now academic engagement in southern Ghana; a unique fund of archival materials collected in Ghana, Senegal, France, the United Kingdom, and Switzerland; and dozens of interviews with local historians, psychiatrists, nurses, and the families of psychiatric patients. Most importantly, my inquiry was rooted in ten months observing doctor-patient interactions during outpatient clinic days and by joining medical students during their training at the Accra Psychiatric hospital.