“It Looks Like a Jail”: On Global Mental Health Infrastructures in a Tanzanian Psychiatric Ward

• In Event: The Material-Semiotics of Global Health Infrastructures II: Valuations and Expansions

Abstract

This paper examines idealized global mental health infrastructures in the context of a psychiatric ward in Dar es Salaam, Tanzania. Psychiatric wards, and hospitals more broadly, are microcosms of global health infrastructures and reflect broader ideological shifts in culture and medicine. Proponents of “post-asylum” and deinstitutionalized approaches to psychiatric care argued against aesthetics of confinement and overcrowding in the redesign of psychiatric wards. I examine both the jail-like appearance of the Tanzanian ward and Tanzanian psychiatrists’ past and present efforts to renovate the ward to reveal how the built ward itself contains colonial and carceral infrastructures despite efforts to move away from these kinds of treatment facilities. Drawing on ethnographic encounters and the design of the ward itself, I argue the Tanzanian ward illuminates how the infrastructures embedded in the built architecture of the ward operate in opposition to contemporary Global Mental Health ideals. Focusing on the Tanzanian ward thus reveals broader inequalities about how some mental health infrastructures get repurposed in global mental health and some do not.

Author

• Bryan Dougan, UNC-Chapel Hill