Culture, Medicine, and Psychiatry

, Volume 41, Issue 4, pp 564–589 | Cite as

Class-Based Chronicities of Suffering and Seeking Help: Comparing Addiction Treatment Programs in Uganda

  • Julia VorhölterEmail author
Original Paper


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.


Addiction treatment Alcoholism Class-based access to mental health care Chronicity Uganda 



I thank Rebecca Lester for her very thoughtful comments on an earlier version of this paper. I am also grateful to the participants of the ‘Ethnographic Theory Workshop’ at Washington University in St. Louis, the participants of the ‘African Diversities Colloquium’ at the Max Planck Institute for the Study of Religious and Ethnic Diversity in Göttingen, Jovan Maud, and two anonymous reviewers for their comments and suggestions on earlier versions.


Parts of the research for this article were funded by the Fritz-Thyssen-Foundation and the Volkswagen Foundation.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Institute of Social and Cultural AnthropologyGöttingen UniversityGöttingenGermany

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