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L’hôpital en Asie du Sud

 | 
Clémence Jullien
, 
Bertrand Lefebvre
, 
Fabien Provost

Le bien-être en question : expériences de soins / Well-Being in Question: Care Experiences

“This Hospital is not Good!” A Mad Narrative from a Psychiatric Ward in Mumbai

“Cet hôpital n’est pas bien !” Récit d'un fou dans un service psychiatrique de Mumbai

Annika Strauss

Abstract

Mad stories, particularly in the context of biomedical institutions beyond the West, have rarely been explored and analysed systematically. In mental hospitals, mad narratives tend to be ripped apart in the processes of bureaucratic admission and diagnosis. They are considered as corrupt and void of social meaning. However, from a social anthropological perspective “mad narratives” emerge from certain ways to experience and frame the world. Moral claims of mad persons concerning psychiatric treatment and well-being though, are mostly ignored in mental health institutions and therefore not taken up by professionals in the context of ethical contemplations or debates. I analyse and contextualise a psychiatric patient’s talk from a public mental hospital in Mumbai whom I encountered during my ethnographic research. Ramesh’s talk gives insights into a life world determined by the experience of suffering, structural violence and failure. As Ramesh’s case illustrates, mad narratives can serve as an effective tool in managing a life of unsoundness that has to be lived in an often threatening institutional environment.

Récit dʼun fou dans un service psychiatrique de Mumbai Les histoires de fous, particulièrement dans le contexte des institutions biomédicales en dehors de l’Occident, ont rarement été explorées et analysées systématiquement. Dans les hôpitaux psychiatriques, les récits de fous ont tendance à être éradiqués des processus d’admission et de diagnostic bureaucratiques. Ils sont considérés comme corrompus et dénués de sens social. Cependant, du point de vue de l’anthropologie sociale, ces « récits insensés » proviennent de certaines manières d’expérimenter et de structurer le monde. Les affirmations morales de personnes folles concernant le traitement psychiatrique et le bien-être sont pour la plupart ignorées dans les établissements de santé mentale et ne sont donc pas reprises par les professionnels dans le cadre d’études ou de débats éthiques. J’analyse et contextualise le discours d’un patient dans un hôpital psychiatrique public de Mumbai que j’ai rencontré lors de mes recherches ethnographiques. Le discours de Ramesh donne un aperçu d’un univers déterminé par l’expérience de la souffrance, de la violence structurelle et de l’échec. Comme l’illustre le cas de Ramesh, les récits insensés peuvent constituer un outil efficace pour gérer une vie de mal-être qui doit être vécue dans un environnement institutionnel souvent menaçant.

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Excerpt

— Ramesh (R): This hospital is not good. I know about it. I have spent six and a half years here so I know about it. Patients expire* here in ward number 11. In ward number 11, the sick ward. Patients die there.
— Akshay (A): How do patients die?
— R: Because of heart attack*.
— A: Heart attack*?
— Ramesh: Yes it’s true. I have seen the dead body* when they took it outside in the van. When they work, observe them. Patients die here. I don’t know how they die, but patients die here. I think it’s because of heart attack*.

My research partner, Akshay, and I met Ramesh in a huge mental hospital in Mumbai that treated around 1,300 inpatients. We met Ramesh in front of the “criminal ward” were patients are admitted who either committed a crime during an acute phase of their mental illness or who fell mentally ill during their stay in prison. The structure of the governmental hospital still resembles a huge asylum typical of treatment facilities in the beginning of the 20th century in Europe. I...

Author

She is lecturer in Social Anthropology at the Institut für Ethnologie/Westfaelische-Wilhelms-Universitaet Muenster. Her PhD project tackles “Narrative Constructions of Reality” in a public mental hospital in Mumbai, India. Her areas of interests include the social anthropology of psychiatry, biomedicine and organizations, (applied) medical anthropology, sexualities and gender and methodological self-reflection as a research and teaching method. Since November 2018 she additionally works as a medical anthropologist and project coordinator in a collaborative, interdisciplinary and -institutional enterprise that is concerned with the improvement of community health of an underprivileged neighbourhood in the Ruhr region.

© Éditions de l’École des hautes études en sciences sociales, 2019

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