After stopping by Makerere University, we decided to make a stop to see Nankya Elizabeth. Nankya is an herbalist who runs her business out of a kiosk located in the small streets that lie behind some of Kampala’s largest nightclubs. We found her at her shop, seated behind the counter on the floor, television tuned to the soccer game. She was eating her lunch: meat soup, matooke (a Ugandan staple made of steamed green bananas), and pumpkin. She was happy, even astonished, to see us and she told us that just the day before, she had suddenly thought of me, after nearly a year away. She thought of giving me a call, but didn’t have my number.
Nankya quickly welcomed us into the small space behind her counter, though George said we might not stay long. We took off our shoes and arranged our limbs to fit with her on her mat. She got out a small pillow for me to sit on and insisted on going to buy sodas for us. On the counter of the shop, there was large blue polythene bag filled with long dried tobacco leaves. As customers came, Nankya would rise from the mat to twist off sections of tobacco, wrapping them in newspaper and collecting small bills from her regular customers.
We have been coming to this shop for two years to talk with Nankya about her practice as an herbalist and especially about the patients she has helped as they have tried to stop drinking. Like many herbalists in Kampala, Nankya is often asked to provide the medicine involved in a form of aversion therapy common here in Uganda. When asked, Nankya prepares a medicine that can be added to alcohol to induce an episode of violent and uncontrollable vomiting. The ingestion of this emetic is also thought to create a permanent aversion to alcohol by causing the patient to find the smell of alcohol repulsive. Some drinkers seek out this therapy for themselves, but, more often, family members or friends administer this treatment without the patient’s knowledge or consent. As she speaks, she pulls out a small basket of dried seedy berries that she uses to make the medicine. She gathered these berries in a village about four hours away from Kampala few months back.
This technique for eliciting a life-long aversion to alcohol is one among many in the array of medical and spiritual practices being taken up to respond to cases of problem drinking in contemporary Kampala. Concepts like addiction, alcoholism, and recovery are becoming increasingly familiar to Kampala’s English speaking population. Inpatient rehabilitation centers and Alcoholics Anonymous meetings have also grown in number and size over the course of the past decade. Yet, these spaces still constitute only a small part of a much broader therapeutic ecology (Langwick 2008). Most importantly, in addition to herbalists like Nankya, there are pastors, spirit mediums, priests, and lay people using prayers and offerings to resolve problems in this world through their engagement with higher powers in another.
That alcoholism is such a common problem may come as a surprise. Substance abuse does not often figure on the standard list of “African Problems.” People have learned to think about food security, deforestation, education, AIDS, war, water, and malaria, not alcohol abuse. And yet, drinkers in Uganda consume more alcohol per capita than drinkers in Russia, a country quickly associated with exceptionally high rates of alcohol related problems (World Health Organization 2014). While government efforts to pass new legislation to better regulate the production and sale of alcohol are presently stalled and aid agencies have been slow to fund initiatives focused on substance abuse in Uganda, a diverse and growing group of people is seeking to respond to alcohol related problems.
The multi-sited approach we have taken in our efforts to understand these diverse approaches to addressing problems related to alcohol makes for odd agendas. One day might include a morning visit to the shrine of the lubaale spirit Kawumpuli and an evening spent at a hotel ballroom fundraiser for an NGO seeking to raise awareness about substance abuse. The next morning may find us dancing at a Pentecostal church service and spending the afternoon hanging out with a regular group of drinkers at a roadside pork joint. While such days can be dizzying, they also make clear the diversity of medical and religious practice in contemporary Kampala and the points of conflict and commonality between these varying modes of responding to our troubles.