An Ethnography of mental health care practices in Abẹokuta, Southwestern Nigeria

Abstract

In the context of the rising global burden of mental illness, this PhD thesis explores the complex assemblages of mental healthcare practices in Abeokuta, Southwest Nigeria, a city renowned for innovative and eclectic practice in mental healthcare over the last century. The thesis draws on recent work in Medical Anthropology and related disciplines that has in various ways interrogated questions of multiplicity in biomedicine. Building on this literature, the thesis presents an in-depth ethnographic account of the production of medical multiplicity within Aro hospital, a large and well-known psychiatric hospital in Nigeria. The first part of the thesis follows the patient journey through this hospital. It develops arguments about the multiple nature of personhood that is part of shared understandings between staff, patients and caregivers in the hospital, before showing how this understanding of personhood shapes what it means to be a patient, with a particular focus on how understandings of dependency play out within the forms of patienthood that are produced in the hospital. From here, we see how treatment in the hospital responds to these multiplicities of personhood and patienthood, and is itself a set of multiple, distributed practices. The second part of the thesis zooms out to consider multiplicities of different scales and how this shape what happens at Aro hospital. The first focus is the therapeutic landscape in the area around the hospital, and how the practices of biomedicine of the hospital interrelate with those of the religious and ‘traditional’ healers who are often frequented by patients and caregivers who attend Aro hospital. The final ethnographic chapter situates the practices of staff at Aro within a global context, underlining how connections to an international order produce another form of multiplicity within the hospital.