Minding Time: Healthy Living Amid the Clinic, the Church, and the Home(land) in the Republic of Cameroon

Abstract

This dissertation examines how hospital staff, patients, and families at Jamot, the flagship public psychiatric hospital in the secular Republic of Cameroon, negotiated the idea and experience of mental health and the kinds of life outside the clinic engendered by mental health. I ground this examination in two years of fieldwork at Jamot and in patients’ urban communities within the Republic’s capital, Yaoundé, and against the backdrops of public mental health reform, initiated in 2016; the increasing domestic popularity of Pentecostalism; and an ongoing Republic-secessionist conflict, widely known as the Anglophone Crisis, that was militarized in 2016. My ethnography moves with patients over time and in time among the clinic and their churches and homes, in the dual sense of home as house and as homeland. Through this ethnographic movement, I argue that time and its variations are central to health and its possibilities. This dissertation has five chapters. Chapter One situates Jamot within history and futurity. I trace how institutional and clinical practice at this hospital has been influenced by the mid-20th century school of transcultural psychiatry at the Fann Psychiatric Clinic in Dakar, Senegal; and by more recent, ongoing Global Mental Health initiatives. Chapter Two examines present-day practice at Jamot. I detail how hospital staff sought to teach patients and families that a mentally healthy everyday life was one from which patients would not seek or want to escape. Chapter Three delves into the vital role of psychopharmaceuticals in patients’ navigations of everyday life upon discharge from the hospital; and of the means, ends, and vitalities of life itself, in encounters with their families and clinicians. Chapter Four examines how many patients’ confidence in psychopharmaceuticals and public psychiatry was imperfectly reinforced by their religious faith, in a process I conceptualize as a Pentecostalization of psychiatry. Here I detail convergences and divergences of time amid the secular public clinic and Pentecostal churches. Chapter Five focuses on how the progression of the Anglophone Crisis during my fieldwork influenced certain patients’ confidence in psychiatry, faith in Pentecostalism, and imaginaries and timing of political possibility and of health itself.