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1. Ritual Work in Twenty-First-Century Uganda
From Folk Well-Being to Ex-Colonial Professionalization
The social nature of African healing, particularly ritual healing, is by now a well-rehearsed theme in a vast body of literature that cuts across Africanist ethnography, historiography, and public health scholarship.1 By comparison, allopathic physicians and clinical systems have expanded their emphasis on patient engagement and social determinants of health relatively more recently.2 In all these contexts, the social behaviors that shape health and well-being motivate keen interest, often because human behavior proves as challenging to understand and measure as it is formative for health outcomes. Within such an expansive domain, this chapter examines who traditional healing specialists are in southern Uganda by focusing on a common component of their work: they perform music with clients as an important feature of their broader repertories of health-related behaviors and interventions. In other words, people perform music as a form of ritual work within repertories of well-being that reveal sophisticated ways of thinking about illness and wellness.
Examining music as ritual work will mean considering three main questions:
- 1. What tools do the āthings of traditionā provide for Ugandan healers, and how do they understand them relative to their times?
- 2. What features of the present moment in Ugandaās development shape these tools and understandings?
- 3. How do these tools and the present moment render musical performance both influential and efficacious in Ugandan repertories of well-being?
The first question permeates this entire book. It emerges from the repetitive mention of two phrases by ritual healing specialists: the āwork of the ancestorsā or other spirits, and āthe things of tradition.ā3 The things of tradition include ancestral and other patron spirits, the songs that venerate them, other methods of invocation, hospitality for human and other-than-human familiars, bodily practices of possession, other physical practices of spiritual and environmental interaction, bodily and social practices of semiprofessional and professional mediumship, the gathering of spiritual information about specific interventions, the gathering of physical medicines, and methods and modalities of sacrifice and celebration. This inclusiveābut not comprehensiveālist only begins to introduce the concept, but it establishes some concrete notions of what it means to do ritual work.
Labor histories in the region emphasize the creative sociopolitical power of (largely precolonial) collectives that understood the social basis of health and healing.4 More recent colonial and postcolonial discourses have imagined that such social processes can be directed from places of administrative objectivity, a top-down model that the professionalization of traditional healing in Uganda since the 1960s reveals to be impossible.5 On the contrary, because the production of medical knowledge and the reproduction of well-being emerge from social processes, we must look to their most social componentsānamely the ritual performance of song and workāto learn about them.
What does it mean to be a professional in an ancient tradition of ritual work and folk wellness that is so frequently influenced by a current sociopolitical landscape of international aid and development? This chapter turns from the intersections of agriculture, pastoral life, and spiritual healing toward a more recent pair of discursively linked domains: ritual work and professional healing. The work of ritual healing has, in the twentieth and twenty-first centuries, transformed for some from a commitment to community into a professional endeavor that seeks respect from political authorities and legitimacy through networks of those who perform similar labor. Despite these habits of professionalization, connections to larger, older social structures of mutual aid produce knowledge about health and healing. These links socialize well-being in ways that place the relatively recent shift toward professionalization against the backdrop of Ugandaās most durable practices of mutual aid, community participation, and identity.
From (In)Visibility to Audibility: Traditional Healers in the Ugandan Ex-Colony
Recent historical scholarship on East Africa has drawn attention to the importance of āpublic healingā by analyzing oral narratives about the distant past and relating them to political and social phenomena. Work by Renee Tantala and Neil Kodesh has emphasized hearing oral narratives in order to understand history, a turn away from visual metaphors and toward aural perception, opening new avenues for scholars of indigenous and ritual healing.6 Kodesh and other scholars of the history of public healing in Uganda offer a partial response to Steven Feiermanās concern that at several points in their history public healers have ābecome invisible.ā7 Just as Kodesh and Tantala emphasize utilizing aural perceptions of public healers in order to understand their past, it has become more urgent now than ever for healers and their associations to make their voices heard while remaining somewhat out of view, to interact with public servants while continuing their practices away from other forms of public scrutiny. Their shifts encourage structures of support for organizations that value rather than degrade the possibilities that traditional healers offer.
As David Schoenbrun observes, the powerful spiritual forces on whom basamize and baswezi call in ritual have undergone a slow redefinition over the last six hundred years; once understood as entities capable of potentially beneficial impact, they are now perceived by many people to be forces with destructive proclivities, even demons.8 Visual narratives in tabloids like Red Pepper and sensationalist images in television news media have exacerbated this process by recycling footage and photographs to cover widely circulating allegations that traditional healing somehow involves bodily mutilation and human sacrifice. It is possible that the impulse to treat traditional healing with this level of suspicion offers a critical commentary on the transformation of a once public resource into a monetized profession. This trend is complicated by overlapping missionary efforts to demonize pre-Christian traditions and likewise by Muslim imams who speak out against practices they characterize as illicit. A shift in emphasis from visibility to audibility for Ugandaās indigenous healers seeks correctives for this ongoing deployment and consumption of neocolonial perception.
This analysis neither minimizes the real threat of bodily violence present in some specious ritual practices nor detracts from at least some legitimate reporting on the issue. To be clear, charlatans exist in Uganda just as they do elsewhere. In extreme cases, they promise riches in exchange for severed body parts or human sacrifice. In a series of articles for the Pulitzer Center that drew wide criticism for ethical negligence, Italian journalist Marco Vernaschi documented both the problem of child sacrifice and efforts to eradicate it.9 Vernaschi made no attempt to highlight the related matter of sensationalist reporting practices, and the Pulitzer Center has since apologized for his contributions to that problem.10 Dozens of articles by journalists and citizen media alike from 1999 to 2016 detail these tragedies, but even rare retractions like the Pulitzer Centerās have done little to mitigate the devastating impact these stories have had on traditional healers. Many such stories simply amplify rumors, and others have later been discredited as fabrications trumped up by overzealous critics of traditional healing.11 The matter is not as simple as some publications make it appear. The question is not whether all traditional healing practices are either destructive or helpful, but rather how do traditional healers mitigate potentially harmful natural, human, and spiritual power in pursuit of healing and well-being for their communities?
Fraudulent healers raise entirely separate questions that lie beyond the purview of this book, and yet narratives about them definitely affect an ongoing redefinition of healersā powers to manipulate spiritual relationships and human well-being. This impact in turn affects the public perception of healers and a great many decisions that professional healers make regarding the visibility of their practices. For example, some allow photographs and video, others only audio recordings, and still others no electronic documentation of their practices at all. Some invite all into their presence; others carefully define and restrict who may pass beyond the initial threshold of their compounds or their shrines. For a category of people once characterized quite accurately as public healers and who still offer primary health care services to a huge swath of the Ugandan public, these considerations frame their shift toward less visible spaces. The same factors also enliven the focus here on how healers nevertheless remain persistently audible.
Public performances of spirit possession ritual in East Africa predate the colonial encounter by at least four hundred years.12 Over the past hundred years, the visibility of ritual practitioners in Uganda has undergone major shifts. However, their continuing activities testify to the value that people in this region place on spiritual healing as a form of local knowledge and indigenous scientific practice. Healersā associations and NGOs in contemporary Buganda and Busoga have begun to reshape the public impact of these practices. These groups move local dialectics of wellness into broader discourses on indigenous knowledge and public health.
This recent history emerges from several historical trajectories for kusamira practitioners. European explorers and colonial administrators commented on the boisterous public presence of visually distinctive popular healers during the late nineteenth century.13 After Uganda became a British colony in 1900, administrative policies and Christian missionary work pushed kusamira into less public settings. Ritualists appear in colonial-era literature as āsecret societiesā and āAfrican gypsies,ā clandestine groups whose activities Europeans conflated with witchcraft.14 Ugandaās 1957 Witchcraft Ordinance made a distinction between the two types of practitioners by excluding ābona fide spirit worship or the bona fide manufacture, supply, or sale of native medicinesā from the definition of witchcraft.15 This ordinance made little difference in the popular imagination, however: even today, articles in sensationalist print media and websites in Uganda and abroad continue to conflate the two. This coverage is overtly exoticizing and neocolonial in its gaze. One story (in the far-right US outlet Breitbart) even used an unrelated image of bare-breasted women covered in white body paint and dancing. The conflation of traditional healing and witchcraft is aimed at linking alleged child sacrifice to politics.16
Independence in 1962 eased relatively short-lived colonial legal constraints enough to facilitate the founding of the first healersā associations, but when President Milton Obote abolished traditional kingdoms in Uganda in 1966, many other cultural institutions also suffered. During the 1970s, Idi Aminās regime undermined the budding government support that Oboteās administration had encouraged for the fledgling independent nationās health-care system.17 It was not until the early 1990s that foreign investment and emerging political leadership renewed efforts to foster meaningful health-care sector collaborations with indigenous healers. NGOs that promote traditional medicine have since expanded their activities. Uganda has seen immense growth in the number of publicly recognized local healers, especially those who register with these organizations.
What are healersā motivations for aligning with healersā associations and NGOs during the past two decades? How do the groups affect healersā public influence? How do they link local practices with a broader discourse on the value of indigenous knowledge? As these groups move between government collaborators and critical nongovernmental enterprises, they consciously push for a respectful approach to indigenous knowledge in the health-care system. They encourage shifts from the unwieldy media coverage toward environments in which they can exercise more control over the discourse. Eschewing the negative visibility of media coverage, these associations promote audibility for indigenous healers. They make their voices heard through focused attempts to professionalize indigenous healing according to local definitions of healing practices and through a ubiquitous and recognizable musical repertory for spiritual healing. Their current efforts to be heard are consistent with a tendency in ritual practice to manipulate paths toward healing through song.
Development-era public infrastructures for integrating indigenous knowledge into the national health-care system had antecedents in two broad categories: the NGOsā efforts to raise awareness of indigenous methods, and government-funded initiatives related to plant research. Examples of the latter include efforts to test local plant species for medicinal use as early as 1962 at the Natural Chemotherapeutic Research Laboratory (NCRL), and instruction on indigenous medicine in the Makerere University School of Medicine beginning in 1988.18 These early pushes to assimilate both plant medicine and local techniques into clinical and hospital systems have yet to give way to robust competing efforts to professionalize indigenous healing in its original context, the healersā shrines (amassabo). In the present era of development politics, the dialectical tension between the grassroots-level (and NGO) professionalization of indigenous healing and the government-supported institutional reform continues to shape the...
