Class-Based Chronicities of Suffering and Seeking Help: Comparing Addiction Treatment Programs in Uganda
Class-Based Chronicities of Suffering and Seeking Help: Comparing Addiction Treatment Programs in Uganda
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基于阶级的慢性痛苦和寻求帮助：比较乌干达的成瘾治疗方案
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发表时间：
2017
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通讯作者：
Julia Vorhölter
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作者：
Julia Vorhölter
基于民族志田野调查，这篇文章着眼于改变话语和实践在乌干达的精神卫生保健领域。特别地，它分析了两家旨在治疗药物和酒精成瘾的心理治疗机构，以及它们对来自不同阶级背景的人的可及性和可负担性。第一个中心是坎帕拉附近的一个高级住宅设施，提供最先进的成瘾治疗，但只有富人才能负担得起。第二个中心是位于乌干达北部的一个由教会资助的组织，主要照顾那些来自贫困农村家庭的人，他们负担不起医疗费用。比较这两个中心不仅提供了对精神疾病、药物滥用和精神保健的暂时性的重要见解，而且还提供了对当代乌干达更广泛的社会经济动态和对痛苦的理解。“基于阶级的慢性病”一词指的是人们寻求治疗的紧迫性（什么时候某人遭受了足够的痛苦？）和他们接受治疗的时间（什么时候某人被认为“康复”？）是高度依赖于阶级的。在理论层面上，本文展示了心理治疗模式作为哲学系统如何运作，不仅影响治疗实践，而且产生不同的成瘾实体和与成瘾相关的主体性。因此，它促成了一种新兴的成瘾人类学。
Based on ethnographic fieldwork, this article looks at changing discourses and practices in the field of mental health care in Uganda. In particular, it analyzes two psychotherapeutic institutions designed to treat drug- and alcohol-addiction, and their accessibility and affordability for people from different class backgrounds. The first center is a high-class residential facility near Kampala which offers state-of-the-art addiction therapy, but is affordable only for the rich. The second center, a church-funded organization in Northern Uganda, cares mainly for people from poor, rural families who cannot afford exp/tensive treatment. Comparing the two centers provides important insights not only into the temporalities of mental illness, substance abuse and mental health care, but also into broader socio-economic dynamics and understandings of suffering in contemporary Uganda. The term ‘class-based chronicities’ refers to the way both the urgency with which people seek treatment (when has someone suffered enough?) and the length of treatment they receive (when is someone considered ‘recovered’?) are highly class-dependent. On a theoretical level, the article shows how psychotherapeutic models operate as philosophical systems which not only impact on treatment practices, but also produce different addiction entities and addiction-related subjectivities. As such, it contributes to an emerging anthropology of addiction.