M'Naghten and the Witch-Doctor: Psychiatry and Crime in Africa

Abstract

It is easy to understand why psychiatry was a relative latecomer to the medical scene in sub-Saharan Africa. The emphasis of colonial medical services was naturally and properly on providing the qualified personnel and facilities to fight tropical disease, reduce needless mortality and increase life expectancy. For many decades now, resources have been expended on basic remedial work, so much so, in fact, that even adequate preventative programs have had to await the prior provision of doctors, hospitals, nurses and medical supplies; public health specialists are still in short supply. And if the sheer size of the problems-in terms of the numbers of patients, the difficulties of travel and the diversity of language-were not enough, they have been multiplied by the resistance to change produced by superstition and ignorance.' It must be remembered that throughout the colonial period even in Europe psychiatry was only slowly feeling its way forward toward acceptance. Basic ideas of the discipline were still evolving; facilities and personnel were only gradually becoming available as the barriers of European superstition and ignorance began to break down. With psychiatrists in short supply in Europe, few could be made available for service in the colonies. In addition, there was a tendencym--sometimes articulated but often not-toward assuming that mental disorder was more the problem of the economically advanced, urbanized and overtly stressful nations. By contrast, the life situation of the less inhibited African was seen as not so fraught with possibilities of disturbance. Only the manifestly deranged needed isolation when they created a public nuisance; for the rest, the extended family was frequently seen to act as a general social welfare agency.