As the authors state, Higher Powers: alcohol and after in Uganda’s capital city ‘explore[s] the lived experiences of people navigating a therapeutic ecology’ in Uganda. The book particularly focuses on how Ugandans deal with alcohol addictions, a problem that has continued to bedevil the country. As the book highlights, 6 per cent of adults in Uganda have an alcohol use disorder, and the country has one of the highest per capita consumption rates of drinkers in the world (p. 5). Yet, in the face of this growing problem, there is a ‘general decline in scholarly energy dedicated to non-biomedical healing traditions in medical anthropology’ (p. 18). This book is therefore timely in how it addresses a topical problem in Uganda and suggests that the ways in which Ugandans deal with alcoholism depend on methods rooted in their understanding of the world and existing support systems. The book also provides methodological insights into how to write about particular themes using ‘evidence’ that might be considered unacceptable in the Western world.

Broadly, the book focuses on four pathways or models that people facing alcohol-related problems in Uganda follow. While a growing number of people facing alcohol-related problems are admitted into rehabilitation centres, others resort to care outside these institutions. Alternatives include the use of herbal medicine and seeking help from Pentecostal churches and empewo (literally, ‘winds’). The chapters are organized according to these pathways.

Chapter 1 examines the social history of alcohol in Uganda. In this chapter, the authors emphasize the central role of beer in Ugandans’ lives, even for those who do not drink. They depict bars ‘not only as spaces of recreation but as sites for opportunity and for building connections and deep friendships’ (p. 45). They use this chapter to support the argument they make in Chapter 2 – that the Western model of dealing with alcohol addiction is unsuited to the environment of Uganda.

Chapter 2 focuses on the chronic relapsing brain disease model, which originated in the West and is being imposed on African societies. This model views drinking problems as manageable but incurable. To ‘manage’ alcoholism, patients are encouraged to avoid certain spaces and people who might lead them to relapse. This includes avoiding bars as well as friends who have the potential to draw people back into addictive drinking habits. This model, the authors contend, is unworkable in Uganda because it uproots patients from their support systems. Additionally, because it describes the problem as ‘incurable’, it takes hope away from many patients.

Chapter 3 ‘is centred on an urban herbalist who treats alcohol-related problems with a form of emetic therapy’. The authors talked to several of the herbalist’s patients who were ‘cured’ and stopped drinking after some herbs had been added to their alcohol. Chapter 4 focuses on the healing or deliverance that happens in Pentecostal churches. In these churches, people are taught that addictions are ‘the result of the actions of demonic spiritual forces in their lives’ (p. 26). The problem is solved by exorcizing the demonic spirits through deliverance. As in Chapter 2, the authors also interviewed people who attested that they overcame their addiction when they visited the church. Chapter 5 focuses on the ‘community of basamize who participate in the form of mediumship and worship known as kusamira’. The community members view alcoholism as resulting from the influences of spiritual forces. As in churches, the problem is viewed as resulting from an external force.

The authors make at least two major contributions. First, they have managed to write about a subject that draws on a body of evidence most Western academics would reject. They were able to do this by letting their interlocutors tell their stories without questioning the authenticity of their experiences. This allowed them to write from the perspectives of the people whose postcolonial experiences and views on alcoholism they aimed to capture. What is also laudable is that the authors did not just interview people and observe them in churches and at their shrines; instead, after writing the book, they went back to the same people, who ‘corrected our interpretation and challenged us to write with words and intentions that corresponded to their own understandings of the world’ (p. 24). This contrasts with academic works that purport to respect the communities they research and to give agency to Africans, yet do not do enough.

The second major contribution of this book is how the three authors collaborated. The nature of collaboration between Scherz, Mpanga and Namirembe in the research and writing of the book also helped them critique Western approaches to curing alcohol addiction while emphasizing Ugandan perspectives. Lastly, the authors make fascinating observations about how Ugandans deal with the problem of alcohol addiction, but one wonders if the case of Maurice, which the authors use to support their argument in Chapter 2, adequately represents those who are admitted into rehabilitation centres in Uganda. Readers do not get an appreciation of the experiences of patients who were successfully treated in these rehabilitation centres, if indeed they exist.