Experimental Infrastructure, Global Medical Networks, and the Politics of Collaboration in Tanzanian Psychiatry

In the last 20 years, psychiatrists and mental health professionals around the world have been creating and engaging in collaborations in the name of “Global Mental Health” (GMH) to address the lack of mental healthcare, frequently in countries in the “Global South.” These research teams conduct research studies to understand whether mental healthcare treatments developed in the “Global North” can be adapted and implemented in countries where they did not originate. This work, however, sits within longer histories of interventions and programs that have focused on creating more possibilities for people to access mental healthcare.To contextualize these current collaborations, this dissertation examines how psychiatrists in Tanzania have worked alongside different groups to create biomedically grounded mental healthcare in the postcolonial era (1961-present). It contextualizes the social, political, and economic conditions that have shaped the work Tanzanian psychiatrists have done with a range of people, including other psychiatrists in Africa, program officers at the World Health Organization, exiled anti-Apartheid activists, and university-based researchers from the US. To do this, I describe how psychiatrists in Tanzania have engaged in a variety of collaborations across different scales to implement programs and seek opportunities to increase mental healthcare. In doing so, I demonstrate how the different aspects of their work, including research and providing clinical care, are linked together. This dissertation draws on ethnographic and archival research. I conducted ethnographic research in summer 2019. I engaged in participant-observation in the psychiatric ward at Muhimbili National Hospital in Dar es Salaam, where I observed clinical care in the wards and attended major rounds. I also conducted interviews with psychiatrists at Muhimbili, a retired WHO official, and GMH researchers. Archival research was conducted in summer 2017 and winter 2020 at the World Health Organization archives in Geneva. I also analyzed published scientific papers and documents published by psychiatrists in Tanzania and their collaborators.