Part of review forum on “Higher Powers: Alcohol and After in Uganda’s Capital City”
Higher Powers deploys ethnography to complicate biomedical understandings of alcoholism based on the CRBD (Chronic Relapsing Brain Disease) model, contrasting theories of addiction—that have only recently started gaining traction in Uganda—to vernacular therapies. The book makes a compelling and impassioned case for the importance of attending to vernacular healing and redressing its “erasure” in medical anthropology, exploring a diverse therapeutic “marketplace” that includes rehabilitation centers, herbal remedies, Pentecostal healing, and spirit possession. It is no surprise that the authors avoid getting stuck in the clinic (Scherz Reference Scherz2018)! In their reflexive account, the authors discuss how they grappled with the representation of competing ontologies, highlighting the challenges of taking people from different persuasions “seriously” simultaneously. They achieve this remarkably well.
The introduction examines the problematization of alcohol consumption in Uganda as a health and social concern; one that could then be quantified and tackled. Beyond the statistics, there are figures that stick, like that of the university student who drank all their school fees. Chapter One introduces the drinking scene in Kampala, where the pleasure of drinking often comes with the pleasure of spending. Being able to buy for others is more than a question of status: it feels good. We also learn about the “bar math” that women engage in to turn drinks gifted by men back into money. Bars are essential sites of opportunities in a context where “being part of one another … constitutes the necessary condition for experiencing a sense of well-being and for securing basic necessities.” Chapter Two nicely contrasts this “ethics of interdependence” with the AA’s strong emphasis on self-reliance. The three vernacular therapies examined in the book offer different orientations toward the future, away from chronicity; ones where transformation is possible. And whereas rehabilitation breeds suspicion and hopelessness, the church (Chapter Four) and the shrine (Chapter Five) provide hope.
The book follows several Ugandans on journeys to recovery, release and, for some, relapse. We meet Kajumba: “Over time, alcohol built a house on me,” he told George, unable to hold back the tears. Kajumba suffered, but eventually, he “got saved.” We meet Maurice who has been in and out of rehab several times, and Mayanja who, after taking emetics and vomiting for days, never touched alcohol again. He still hangs out in bars where he drinks soda and plays Ludo with his friends. Victorious battles with alcohol are coupled with livelihood and kinship achievements. Indeed, Higher Powers is a hopeful book. And not the kind of hopeful that is essentially speculative, but rather a hopeful grounded in ethnography.
Higher Powers opens the possibility to imagine life after alcohol otherwise, offering a (re)thinking of alcohol misuse from Uganda, all the while highlighting the limits and potential harms of biomedical therapies developed elsewhere. And this is arguably one of the book’s most valuable contributions: it shows how ethnography can help complicate ideas we take for granted. As a result, however, the biomedical remains the standard against which other therapies come to be defined as “alternative” (14) and as filling the “treatment gap” (18). And I wonder if thinking about alcohol misuse from Africa, necessarily requires, or leads to, a contrast with biomedical models, especially since in Uganda, CRBD is still an “emergent assemblage” (48).
At one level, this is a question of intended audience. And I’m glad the book was written with readers like me and my students in mind. At another level, it is a question about the very purpose of anthropology, and of Africanist Anthropology, in particular; a question that requires continued critical attention, as the authors themselves acknowledge. Thinking about things like alcohol misuse from Africa is certainly generative, but could we not also, or instead, think about things in Africa? And if so, what would that entail?
Despite its thorough investigation of the “therapeutic ecology” around alcohol misuse, there is one therapeutic avenue that the book may have overlooked. What happens in other sites in Kampala such as the spin studios where middle-class Ugandans craft hopeful temporalities (Lindquist Reference Lindquist2024)? As globally circulating ideas about wellness gain currency across Africa, it will be interesting to track changes to alcohol consumption. In some places, the gym has started competing with the bar, as a site of opportunities and sociality. Will the water bottle replace the beer bottle as a status symbol?
The book culminates in a feast at the Jjajja Kasuba’s shrine—a moment of effervescence reminiscent of a Jean Rouch film. As the celebrations wind down, Kawumpuli, the spirit, reveals to China that the insights gained in Uganda will help her rescue her own country; a country that is suffering. And so perhaps thinking in Africa also already involves thinking from Africa.
Higher Powers is a superb example of the power of ethnography to unsettle assumptions. It also sets the bar high for collaborative research and authorship. Thank you, China, George, and Sarah, for this wonderful book!
