In my chapter about cultural differences in the expression of schizophrenia I traveled to Zanzibar to spend some time with anthropologist Juli McGruder who studied families on the island who lived with the disease. The chapter addresses the ways families in different cultures conceive of the disease and how those beliefs effect the experience of the ill person.

The auditory landscape of a place often becomes central to the experience of a schizophrenic. I've placed an audio clip of the sound of a public square in Zanzibar on the front page of this site because this is the soundscape in which a Hemed and his daughter Kimwana lived while they struggled with their disease. Sitting with anthropologist Juli McGruder and listening to the sounds of that square was a memorable moment for me in reporting this book.

 Kimwana's central delusion was that the bicycle repairman outside here house could see into her thoughts and feelings. That her delusions would come in the form of intrusive auditory hallucinations made sense given the location of the household. The roiling, pulsing sound that filled the square during theday was remarkable for its volume, texture, and complexity. Across the square from the house was the Bakathrir Muslim School for Girls, and directly to the right of the house was the Al Nour Islamic school for boys. At any given moment the undulating, overlapping choruses of hundreds of children chanting in Arabic could be heard. The noise that emanated from the schools created a kind of hypnotic background sound, like breaking surf. On top of that sound could be heard the single voices of individual children teasing and playing with each other or calling out to people in the courtyard. Then there were the voices and footsteps of adults heading across the square on their errands and the constant squawk of crows in the shade tree. in that cacophony of sounds reverberating and echoing off tin roofs and cement surfaces, the only discernable individual voices were those of the bicycle repairmen chatting among themselves or with their customers as they did their work.

Considering the additional commotion of the comings and goings of the members of the household, the noise must have been unrelenting. The many small children, though well behaved in the manner of most zanzibari children, created a racket. hemed, even though he could not walk or even bathe himself, could yell and often did for long stretches without ceasing. Several of the family
members shared with McGruder their belief that the noise itself was exacerbating kimwana’s illness. Bimkubwa, the most West-
ernized of the siblings, told McGruder that Europeans have much smaller families and that their houses were much quieter. “There are too many of us and this place is too noisy,” she said emphatically. Kimwana often asserted that she felt better when she was alone.
but given her auditory hallucinations and the general noisiness of her surroundings it was clear that she was talking not just about a desire for physical solitude but also for quiet. “i do like being on my own,” she once told McGruder. “being with people i feel like i am tangled with them. i feel like calming myself, just silently. Just quiet and silent.” Unfortunately time alone was a scarce commodity in the packed household. And silence was all but unavailable.


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  • 1/10/2010 1:49 PM Jim Anthony wrote:
    A very important topic which, by either design or inadvertance, has been externalized from the debate on globalization. This issue (the Americanization of Mental Illness) is embedded in the innards of the Pharma industry, University preoccupations with big money and the long reach of American imperial ambitions.
    I look forward with enthusiasm to reading Ethan Watters new book.
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