Cross-Cultural Psychiatry – Relations between tradition & globalisation Within the understanding of mental illness In a Hausa context (Northern Nigeria)

 

“Nigerian man detained in mental institute in Kano ‘because he renounced Islam’” (Saul, Independent, 2014); “On Mental Health: An African Myth” (Shaheedah, Ezibota, 2015). These are publications relating to mental illness and more especially among Hausa people, which will be the main topic of this independent study project.

DEFINING MENTAL ILLNESS

Mental illness is mainly defined, according to Mayo Clinic Staff (2015) as referring to ”a wide range of mental health conditions – disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.”

However it is true that only a general and vague definition can be applied to mental illness as no definition can be truly universal (White, 2013). Indeed, as stated in the article (ibid), “If mental illnesses were to have universal biological causes, then standard treatments could be readily applied across the world irrespective of local differences and associated cultural differences.” In his article, White (2013) presents the position of the biological psychiatry that does not take into account cultural differences as it is understood based on biological evidences without acknowledging the various settings of the numerous cultures in the world. However, in his suggestion, White (ibid) implies that the question on the definition of mental illness cannot be treated as universal. Indeed it needs to account with regards to the variety of cultures, how mental illnesses are caused within these differing groups of people. Also there is a need to understand how to treat mental illnesses among the various cultures of the world.

Culture is understood as “a set of institutional settings, formal and informal practices, explicit and tacit rules, ways of making sense and presenting one’s experience in forms that will influence others” (Kirmayer, 2006, p133). In other words each culture has its own system of understanding, as the experience is unique to the cultural group in question. In addition to that, every culture has a myth of its own that relates to its the social norms (Ogunjimi & Na’Allah, 2005, p56). Myths can thus be used with regards to the understanding of the categorization of mental illnesses. If the myth relates to the norms of a cultural group, then it also relates to mental illnesses in the way that mental illnesses are not defined by the norms therefore they are perceived as abnormalities, and thus called “illnesses”.

EMERGENCE OF CROSS CULTURAL PSYCHIATRY

As a consequence of this different approach to mental illnesses taking into account the cultural embedment of the patients, a new field within psychiatry has taken an increased importance over the last two decades, which is the “Cross-Cultural Psychiatry” (Wintrob, 2010). More characteristics of the patients are being acknowledged as relevant within the research “This includes identifying features of race, ethnicity, religion, and socioeconomic class, relevant immigration history, experiences of acculturative stress, and personal and family aspirations.” (ibid). The origins of cross-cultural psychiatry is believed to be through the work of Kraepelin (1904a, 1904b) in Java (Oda, Banzato & Dalgalarrondo, 2005). However it could be dated from much earlier on as theories were already addressed – but no date has been provided (ibid). Cross cultural psychiatry is thus a field that has gained more and more importance due to the broader understanding of the cultural significance – as well as a more detailed background in order to comprehend and treat the patients accordingly to their relative experience.

WHO ARE HAUSA PEOPLE? 

Hausa as a language is one of the most widely spoken languages in Sub-Saharan African (Greenberg, 1963, p45), however there is no exact estimation of the total number of speakers as its numbers may also speak Hausa language as a second or third language. “Hausa speakers are found in Nigeria, Benin, Togo, Ghana, Cameroon, Chad and scattered through Sudanic Africa from Senegal to the Red Sea, from Maghrib in North Africa down to the Zaire Basin, where their commercial interests as traders have taken them in quests of profits” (Wall, 1988, p6). A native Hausa speaker is referred as Bahaushe (m.) or Bahaushiya (f.) in Hausa language and is someone that “has internalized the cultural structure lying behind the language itself” (Wall, 1988, p7). Wall (ibid) also adds the reference to Hausaland, not as a defined territory but as a “culture area”. A main feature of Hausa people is their ties with Muslim religion due to the Islamization of Hausa kingdoms in the 14th century (Wall, 1988, p9). Even the language itself uses Arabic script with vocabulary borrowed from Arabic language such as Sharia (law), Jarida (newspaper) or even the greetings. Thus Hausa people are embedded within a Muslim culture. However as it is something that happened as a result of the Islamization, they still have kept their traditional beliefs such as in the Bori spirit.

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This independent study project will tackle the topic of mental illness among Hausa people in Northern Nigeria. Through the case study of Hausa people, this paper will address the question on how tradition – Hausa tradition – & globalization – spread of psychiatry – can be entagled when relating to mental illnesses and the notions of norms within the society.

In a first point, this paper will settle information regarding Hausa culture and its relation to the concept of medicine as well as its practitioners & ways of practices. Then it will understand mental illnesses within an Hausa context as far as the perceptions, beliefs are concerned, but also its definition in Hausa language as well as its categorization and the role of religion in relation to mental illness.

As a third point, this paper will study the various causes & the diagnosis of mental illness among Hausa people.
It will then try to analyze the various reactions of Hausa people within the society toward mentally ill people or patients.

Consecutively, the paper will also examine the numerous ways of treating mental illnesses among Hausa people, with emphasis on spirit possession & treatments available in mental institutions such as Kano in Northern Nigeria.
Finally, this paper will draw reflections on cross-cultural psychiatry answering questions regarding the education of the doctors, the methods they use but also where their judgment stands as well as how they are perceived using “Black skin, white coats: Nigerian psychiatrists, decolonization, and the globalization of psychiatry” (Heaton, 2013) as main reference.

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