projected mission of British colonialism, for example, that was perceived at the time as fundamentally benevolent and civilising, as well as undeniably profitable, have since been subject to powerful, iconoclastic accusations that have served to sharply refute many of the more benign associations imperialism once boasted of. Thus, the irredeemable evils of empire building have become a guilt-laden, culturally embedded, assumed fact in the contemporary consciousness. Yet such analyses are as captured within a specific socio-historical context, equally as much as that phenomena under study. It is timely to recall then to what extent the greatest admiration, as well as the opprobrium of historians and the informed public, is compelled by sheer fascination when contemplating the mightiest example of administrative, military and cultural hegemony of all: that of the Roman Empire. It is not inconceivable therefore, that emerging revisionist analyses in the ‘post’ postcolonial future may offer new shades of meaning and alternative interpretations for further consideration in our understanding of colonialism and its influences. Thus, as Keller (2001) advises, the more modest study of colonial psychiatry needs to move beyond over-simplistic accounts of racist oppression by colonials, towards a more nuanced and historically situated analysis in order to do this important topic justice.
A valuable corpus of literature on colonial psychiatry has begun to be consolidated over the past few decades, which provides important insights into formalised psychiatric services offered by the British, French and Dutch colonial authorities across Asia and Africa. Such a wide socio-historical-geographical span inevitably leads to rich, multilayered, diverse and textualised accounts that elicit our critical understanding of the processes, practices and principles underlying the establishment of services and their impact upon local communities. These historiographic studies in turn serve to illuminate ethnographic accounts of psychiatric service users, such as this study, where indigenisation has reshaped service provision to fit a postcolonial landscape, and where the historical thread is less distinct but still visible for tracing back to a beginning, if not the beginning.
Colonialism has been credited, albeit with much ambivalence, qualification and reservation, with the establishment of modern psychiatric services in its once occupied territories. Pan-Asia and Africa both saw numerous incidents of industry in the introduction of European psychiatry, albeit unevenly and with markedly different standards of care applied across communities. A necessarily brief tour through the literature reveals the extent of this enterprise to bring modern psychiatric care to the indigenous masses.
The imperial machinery, it is argued, was run through the careful coalition of its essential parts, in which psychiatry and medicine in general had a vital role to play in the consolidation of the Empire, along with bureaucratic administration and the militia (Bhugra, 2001).
Accordingly, Roland Littlewood questions how colonial administrations were served by the rising profession of psychiatry developing in parallel in colonised regions.
We might note, for instance, some affinities between the scientific objectification of illness experienced as disease and the objectification of people as chattel slaves or a colonial manpower, or the topological parallels between the nervous system and imperial order. Both argued for an absence of higher ‘function’ or sense of personal responsibility among patients and non-Europeans (Littlewood, 2001: 9).
In this analysis colonial authorities viewed subject people as being greatly in need of the new science of psychiatry due to their pathologically morbid tendencies, and generally benighted and ignorant condition. These practices were therefore viewed as an essential part of the armoury that an imperial state could utilise as useful propaganda in aiding the ambitions of notably, although by no means solely, the British Empire.
Dinesh Bhugra (2001) points out that the development of asylums in colonial India were predicated on European notions of medical hierarchy, management and care and governed by enlightened, paternalistic and preferably Anglo-Saxon expertise.
The ideal psychiatrist, like the ideal colonial officer or plantation owner, was a ‘father to his children’ (Littlewood and Lipsedge, 1989: 10).
In India we learn that the growth of asylums paralleled historical turmoil, and consequently were built in areas of social unrest with a high colonial presence (Bhugra, 2001). This conflated point is also noted in the more in-depth study by Waltraud Ernst (2010), and is also echoed in accounts of colonial psychiatry from Zimbabwe to Algeria and the Malayan archiepalego. Ernst (2010), however, observes that psychiatric institutions established in the British Raj were primarily there to care for the insane colonial, predominantly army personnel, who had become deranged through a combination of factors, including culture shock, climate differences, homesickness, alcoholism, and the rigours and privations of regular army life overseas, where soldiers were beset with very high disease and mortality rates from a battery of potentially fatal diseases.
While noting that asylum care in India was regarded as generally superior to that offered in the ‘home’ country, Ernst (2010) comments that strict distinctions were observed between colonial patients and their Indian counterparts in terms of comfort, where in case of Indians overcrowding and squalor were rife. However, equally she notes the prevalent asylum policy of this period, extended to Indian inmates, that maltreatment of patients by staff was strictly forbidden, in accordance with the principles of moral therapy. Ernst (2010), however, argues that the overwhelming scale of the local population caused the insane but innocuous ‘native’ to be relegated to a life of highly uncertain provision beyond the walls of the asylum. By contrast, those among the colonial insane who did not recover their wits within a certain timespan were regularly repatriated back to the custodial care of asylums in England.
McCulloch (2001) in turn notes the increase in asylums in the European context and the corresponding growth of patient populations in relation to an analysis of the social control of the working classes. He argues, however, that this has little relevance to the development of the asylum system in the colonies where other issues tended to predominate. Furthermore, McCulloch (2001), accused by Keller (2001: 319) of being an ‘apologist’ for colonialism, goes on to observe that in contrast, the building of asylums in the outback regions of colonial Africa symbolised a wish to emulate the ‘civic virtues’ of distant metropoles as well as expressing a need to control expatriate and indigenous deviancy (McCulloch, 2001: 79).
Lynette Jackson’s (2005) account of Ingutsheni Central Hospital, founded as an asylum in the first decade of the twentieth century in former Southern Rhodesia, offers a graphic analysis of racism in some of the harsh distinctions between the care of white and black patients, particularly in terms of certain forms of treatment, in the period leading up to Independence. Her thesis draws on Franz Fanon’s analysis in pointing towards the trauma of colonisation as providing the seeds of psychic disturbance in local populations, where contact with the colonial world could induce insanity in Africans (Jackson, 2005). This in turn chimes with McCulloch’s view, according to Keller (2001) that the social transition from traditional, indigenous rural economies to colonised, urban spaces generated psychological trauma in the African population. Curiously, Sadowsky (2003: 212) traces back the origins of such viewpoints to, for example, the ‘notorious’ J.C. Carruthers who wrote in the 1950s on the psychic impact of encounters with modernity by local Africans. It is indeed an intriguing peculiarity that such similar arguments have been employed diachronically to both castigate, as well as to justify certain colonial psychiatric perspectives of diagnosed mental health problems in indigenous populations.
Notably, Ernst (2010), Bhugra (2001), McCulloch (2001) and Jackson (2005) find that psychiatric admission of the local population was primarily focused on socially troublesome individuals, rather than the harmlessly insane in both colonial India an Africa. The inference is clearly suggestive of a Foucauldian analysis of the exercise of a power against indigenous grass-roots subversion by a threatened imperial State. However, as Keller (2001) in reference to Ernst (2010) points out, the few numbers of patients detained overall, hardly constitutes an effective custodial curb to social subversion. In this vein, Sadowsky in deconstructing this Foucault-inspired conspiratorial
