And what could be more intimate than destruction? (Taussig Reference Taussig2005)
…every delirium has a strong historical, geographical, political, racial content (Deleuze and Guattari Reference Deleuze and Guattari1972)
How are we to reckon with the psychic, the psychopathological and the intimate in a Congolese border city? Bukavu is located in the Ruzizi Plain,Footnote 1 lying between a chain of mountains and the Ruzizi River, a natural border between Congo, Burundi and Rwanda, and known for biodiversity, protected reserves, fertile lands and sometimes drought. For centuries, the plain comprised meeting points for fluid ethnic identifications among the Bashi, Balega, Bahavu, Hutu, Tutsi and Batwa. Plagued by conflict since the mid-1990s, the Ruzizi Plain became a zone of insecurity, violence and secrecy. Madness may align with or call forth forms of intimacy. Such acts of violence – hitting, raping, bullying, mugging – may forge a dispersal among familiars or a novel nexus.
This article considers four concrete cases of madness with figurations in this chaotic Congolese city, lying on an international border with a hyper-orderly nation state, Rwanda, known for genocide, securitization, and discipline. Kagame’s state is a ‘puppet master’ in ‘war-infested’ hills, with ‘genocide in its rear-view mirror’ (Harding Reference Harding2011). As violence resounds, defiant, disorderly reactions erupt. Working from the microscopic and everyday life, the research for this articleFootnote 2 shows how the intimate makes madness differently tangible. Rarely a matter of necessary causal arrows, a lattice of contingencies with scales of doubt and mistrust appears.
A milieu, with a border and conflict
Bukavu, provincial capital of South Kivu, is a turbulent, disordered city of 62 square kilometres, key to troubled zones in Congo’s East. Decades of armed conflict and destructive rape have generated population growth, severe housing shortages, and violent land disputes. The dangerous erosion of the steep, muddy hills goes with stripped trees and foliage, all due to the intensity of in-migration.Footnote 3 Once a dynamic, prosperous colonial town, Bukavu is located beside a spectacular lake at the western edge of Africa’s Rift Valley. In postwar Belgian Congo, European settlers took pride in the beautiful mountains, important tourist economy, scientific conferences and Art Deco buildings (McCarthy Reference McCarthy2013; van Overbeek and Tamás Reference van Overbeek and Tamás2020).
In 1994, militias and refugees, fleeing machetes and death, flooded this border city from Rwanda’s horrific genocide. Bukavu’s history since that year has known insecurities, criminalities, land conflicts and warlike scenes of death (Thill Reference Thill2019a; Hoffman et al. Reference Hoffmann, Muzalia and Pouliot2019; Thill et al. Reference Thill, Muzalia, Mugoli, Batumike and Nshokano2023). The wars that followed from 1996 killed up to three million, contributing to chaos and shambles. When the rebel group Rassemblement Congolais pour la Démocratie (RCD) occupied the region, Bukavu became prime for rape, pillage and terror (Prunier Reference Prunier2009; Harding Reference Harding2011; Smith Reference Smith2022). An important base for a long United Nations peacekeeping mission,Footnote 4 the city witnessed the arrival of many humanitarian organizations and research operations.
The city is still mired in the entangled afterlives of genocide and eruptions of ongoing wars. The relationship between South Kivu and post-genocidal Rwanda seemed wrapped in suspicion, nervousness (Hunt Reference Hunt2016) and terror during our research in 2019. Analysts speak of ‘no-war-no-peace’ dynamics (Hoffman Reference Hoffman2005), witnessed in rhythms of violence in and near Bukavu, where the intrusive, aggressive Kagame regime has remained brutal. Holding onto a psychopolitical register enables tracing out scales of paranoia, fear and deliria on both sides of the border. Godefroid Muzalia and others puzzle deeply about such issues (Thill et al. Reference Thill, Muzalia, Mugoli, Batumike and Nshokano2023), and many scholars ask about the dynamics of conflict, opportunism, policing, gangs (Thill Reference Thill, De Herdt and Titeca2019b; Hendriks Reference Hendriks2021) and mining (Smith Reference Smith2022; Geenen Reference Geenen2016) in relation to armed conflict in this Rwanda–Kivu zone.
Theft and new ways of generating wealth, through mining, land and property speculation, peacekeeping and humanitarianism, have been critical. Economies of resentment suggest that class tensions deserve serious research. So does the proliferation of stylish weddingsFootnote 5 as forms of distraction and ostentation. It would be good to know more about how weddings consolidate wealth and alliances, and relate to fame, fertility, social reproduction, class, and the ongoing psychic toll of so much rape.
A rape capital, a Nobel prize, hospitals
Due to widespread, disturbing sexual violence in the Kivus, gender-based cruelty became pivotal to humanitarianism. Bukavu has been scripted by journalists and humanitarians as a ‘rape capital’ (Mertens Reference Mertens2019; Mertens and Pardy Reference Mertens and Pardy2017; Lewis et al. Reference Lewis2019).Footnote 6 Mental precarity and vulnerability have grown in perceptions since 1996 in this city construed as exceptional, and a set of urban spaces also known for catastrophe, disorder, maiming and bereavement (Thill Reference Thill2019a; Hunt Reference Hunt and Gobodo-Madikizela2019). Congolese, European and American experts showed up, with German and American psychologists pursuing experimental therapies for raped women and demobilized soldiers (and former rapists).Footnote 7
There is madness in venalities, in terrible intimate violations, and in the perennial inability – or refusal – to repair and develop the city’s roads. Bukavu seems poised between furtive, extractive economies and the shared clamour around fashion, decent homes, lavish celebrations, social mobility, dreaming and the search for joy. Kagame’s state remains a land of suspicion. It bans plastic bags, encourages an eco-tourism fixated on gorillas and genocidal memorials, and insists on security checks, backed by spy dogs and ubiquitous vehicle-reading detection machines. Bukaviens, who use the word madness to speak of regimented Rwanda and its leader, know that their city of over a million is noisier, poorer, more festive, and less securitized.
Notable is Bukavu’s brave, committed entrepreneur Dr Denis Mukwege, whose heroic success in repairing women from destructive rapes made this skilled gynaecologist-turned-humanitarian famous. Mukwege, no small figure, received the Nobel Peace Prize in 2018 (Rubin Reference Rubin2019). His work is important, his impact fascinating (Braeckman Reference Braeckman2012), as is the ambivalence surrounding him in Bukavien eyes and words. A feminist mental health space with a gendered psychosocial experimentality is called City of Joy,Footnote 8 founded by the gifted, outspoken American feminist playwright Eve Ensler. Her Bukavu work often aligns with Mukwege’s aims (Cannon Reference Cannon2012; Baaz and Stern Reference Baaz and Stern2021).
Our research detoured away from the rape-focused enterprises of Dr Mukwege, Eve Ensler, their patients and followers. Mukwege, from his major hospital, still provides surgical care for rape and fistula patients, and increasingly mental health care for injured women. Distinctive in Bukavu’s streets are billboards proclaiming Mukwege’s success and part of his humanitarian infrastructure, not unlike a performance for his city. Bukavu’s populace moves through a density of vehicles before these mounted, promotional signs, announcing fame and benevolence. The placards summon pride, yet popular envy and hostility towards this same doctor figure suggest rejection. Biting stories, hinting at theft and sorcery, circulate with irony or odium.Footnote 9 Many Bukaviens, struggling to eat, seeking income, rents or a next meal, seem to have little patience with the famous doctor’s image booming out from hectic intersections.
In 2018, I headed up to the city’s psychiatric hospital, Sosame, welcomed by the director, a brother of the Frères de la Charité, a Catholic order founded in Ghent and long focusing on mental health. Since the 1940s, these Frères have opened clinics in Belgian Africa. From decolonization in 1960, they added hospitals in Rwanda, Burundi and two Congolese border cities, Goma and Bukavu. Confidence in Sosame is weak across Bukavu, due to high fees and a spurning of the vernacular diagnostic word ndoki (sorcery).Footnote 10 Still, it remains the place to obtain neuroleptics for psychotics.
This article veers away from Sosame, although we did ethnographic work in these clinical spaces (whose import and intricacies will be detailed elsewhere). In neighbourhoods and at crossroads, Sosame is a rich sign within popular imaginaries, sometimes seen as caring and curative, especially for those able to afford its drugs and services. But Sosame can also seem an unfathomable space of aggression, one with well-defined practices of medicating hallucinating, psychotic and agitated patients. Fearful, angry perceptions are overheard in popular conversations, as in Bukavu’s tightly packed commercial vehicles transporting passengers. Sosame is a deeply ambivalent space with ascending walls and often a carceral tone, and outdated in relation to those contemporary community health imperatives that have reshaped and eradicated asylums across the world, since the critical field of anti-psychiatry brought together the likes of Frantz Fanon, R. D. Laing and Franco Basaglia, from the 1950s and 1968.
Still, neither hospital can be entirely avoided here. The entangled wanderings of chronic psychotics reveal the build-up of Mukwege’s enterprise, its impact on traffic congestion, and patterns of seeking and avoiding care at Sosame. This article also sidesteps a focus on PTSD (Hunt Reference Hunt and Gobodo-Madikizela2019) as too easy and inclined to miss much – like deliria. The word trauma goes with psychological humanitarianism, not the subject here. Still, a ‘trauma zone’ surely emerged in Bukavu from 1994 alongside genocide, war, ‘PTSD infrastructures’ and a humanitarian industry (Fassin and Rechtman Reference Fassin and Rechtman2009; Binet Reference Binet2014; Beneduce Reference Beneduce2019; Hunt Reference Hunt and Gobodo-Madikizela2019).
Concepts
As early as 1961, Michel Foucault argued that a history of madness should aim less at psychiatry (as a science) than at ‘madness … in all its vivacity’ (Foucault Reference Foucault1961: 16; Hunt Reference Hunt, Hunt and Büschel2024). He evoked madness, in early modern Europe, as ‘present in the social horizon’ and ‘as an aesthetic and daily fact’. With the arrival of modernity, Foucault suggested, madness ‘lost’ its inclination towards ‘revelation’ and ‘manifestation’.
Still, plenty of manifestations of madness, including vivacity, are present in Bukavu. Drawing on Karl Jaspers’ performative approach, we saw many instances of each. Jaspers (Reference Jaspers1963: 784) criticized the ‘concept of psychic illness’ as a ‘kind of deficiency’. This article follows him in broaching psychopathologies as performance, as ways of telling and doing in everyday psychopolitical worlds. Madness may take shape through moods, atmospheres and ironies. Like most cities, Bukavu knows madness and the mad in its postcolonial spaces. Useful when studying colonial madness is the work of the Martinican psychiatrist Frantz Fanon (Reference Fanon1963), who critiqued racialized violence, saw psychic dissolution in decolonizing Algeria at war, and studied intimacy and harm.
Loved ones, shunned intimates, figures of care, and war and death suggest forms of intimacy. Ann Stoler (Reference Stoler2006) conceptualized intimacy in relation to domestic imperial spaces, alongside tenderness, breaches and hierarchies. Michael Taussig (Reference Taussig2005; Reference Taussig2008) found unexpected kinds of intimacy in relation to war zones, with disintegrating states and paramilitary violence. He observed vicious upheavals of people on the move, their bodies in motion, with strangely intimate political assassinations. How relations between a state and aggression become intimate, he showed, involves a culture of violence – exuberant, excessive, elusive – beside corpses, disfigurements and luxurious or barren forms with sensuous, transgressive or agitated mixtures.
Phenomenological approaches to the psychiatric and catastrophe unpack individualized, collective and vernacular senses beside politicized registers (Jaspers Reference Jaspers1963).Footnote 11 A disaster calls for attending to the milieu, and to those enduring the harsh impact of history with anguish, bodily violations and affective boundary states. The phenomenological opens up Bukavu terrains, its persons, events, figurations, ruptures and moments of distress. A person reeling and entering the psychopathological may achieve a sense of triumph through developing a performance offering a sense of accomplishment (ibid.: 784), as we will see in two portraits below.
Contexts
Most African cities know derangement and deliria, and, since 1989, mental health care has seemed urgent. As the continent became many structurally adjusted, neoliberal spaces in the 1990s, war, trauma and humanitarianism became salient (Hunt Reference Hunt and Gobodo-Madikizela2019). Global Mental Health emerged in the 2000s as an evidence-based, academic pursuit and humanitarian industry, with psychiatric care stretching across slums, gated communities and clinical trials. Africa’s mental health zones embrace precarity, NGOs, war-related trauma work, technologies of securitization and community health – each is partially present in Bukavu. Patterns of psychiatric resort in this ‘boomtown’ (Büscher Reference Büscher2018; Dranginis Reference Dranginis2016) stretch beyond PTSD to vernacular and modernizing healing practices (Hunt Reference Hunt, Hunt and Büschel2024), with tradipracticiens – modern-leaning vernacular healers – tending to those suffering from agitation, mania and sleeplessness. Similar practices go back to the seventeenth century in the region’s Bushi kingdoms (Newbury Reference Newbury1978; Greenen Reference Geenen2016; Stroeken Reference Stroeken2018). ‘Spiritual brokers’ with charismatic prayer rooms and Pentecostal churches date to at least the 1950s (Cazarin and Cossa Reference Cazarin and Cossa2017). Bukavu’s psychiatric hospital dates precisely from the year of Rwanda’s genocide: 1994.
All veins of healing know shared and secretive sides before security, venality, rape and death. ‘Knowing about not knowing’, before therapeutic ‘non-systems’ (Last Reference Last1981), remains important in these mountains with ancient monarchies, pastoralists and farmers who, for centuries, cultivated fame, deference, secrecy and suspicion (Newbury Reference Newbury2009). These emphases remain alive in Bukavu (Thill Reference Thill2019a; Reference Thill, De Herdt and Titeca2019b; Vlassenroot et al. Reference Vlassenroot, Mudinga and Musamba2020b; Hendriks Reference Hendriks2021; Smith Reference Smith2022), with its violent layers of history.
Madness is on many lips in Bukavu, and the ironists often point to the way that psychopolitics (Hunt Reference Hunt, Hunt and Büschel2024) intertwines madness, regimes and everyday lives. The city’s fous (mad persons, often chronic psychotics) are visible, discussed and nicknamed, though rarely policed. A semiotics of tattered clothes, unkempt hair and nakedness on the streets (Achebe Reference Achebe2003; Biaya Reference Biaya1998; Comaroff and Comaroff Reference Comaroff and Comaroff1987) has endured since at least the 1960s across much of Africa. Rebels and dictators suggest forms of madness (Hunt Reference Hunt, Hunt and Büschel2024). The word goes with the figurations of poets and novelists (Foucault Reference Foucault1961; Bahizire Malinda Reference Bahizire Malinda2005; Veit-Wild Reference Veit-Wild2006).
My approach moves beyond the diagnostic categories of psychiatry and reckons with the off-kilter, eccentric, delusional and perilous. Tensions and fluidities are worth tracking, as is how the psychiatric meets – or does not meet – vernacular, religious and literary modes.
Bukavu, a milieu of madness, let’s remember, is located along a fraught border where militarized and psychopolitical dimensions hide out and blaze. Like most Congolese cities, it seems a crazy place (Yoka Reference Yoka1999). Yet it is unique as a transit and operational hub for criminalities, industrial and artisanal mining in gold, coltan and other minerals, and death.
Method
This article grew out of ethnographic research undertaken by four Congolese research assistants and me over the last six months of 2019. We veered away from rape and trauma, and generated copious observations and fieldnotes, debated in weekly seminars. We sketched out lines among experiences, and their management or redirection by kin, neighbours and passers-by.
A central analytic thread focuses on social and material interconnections, with violence often as causative context. Manifestations of that word madness enabled our granular approach, with diverse proximities and intimacies. Analysis emerges through stories. Mania is often an interruptive force with shades of hostility or affection, dramatized within a diminutive public sphere: a small market or gnarled traffic scene. These cases, big or small, suggest dynamics of abandonment or care, as well as the social and political uses of the mad by politicians or ordinary persons. Overlapping elements surface as madness mingles with fierceness – intimacy, too. The empirical flux deepens understandings of psychosis, psychopolitics and volatility. The interpretation zeroes in on street knowledge, vernacular interpretations, and many fous roaming the streets as a commonplace.
Broaching madness with capacious and microscopic lenses opens up the metaphorical, the nervous and the psychopolitical. The psychiatric helps determine illness and patterns of resort. The boundary between fact and figuration is complex in this decolonizing situation of ethnographic writing (Nyenyezi et al. Reference Nyenyezi, Ansoms, Vlassenroot, Mudinga, Muzalia and Kash2020). The fictive, the monetary and strong imaginations seeped into our work.
The figurative entered as an artefact of our refractory subject: how madness is performed and construed. ‘Crises of presence’ (Martino Reference Martino2012) surface in this impressionistic narrative, evoking the hubbub of a mid-size Congolese city, alongside economies arising from conflict, minerals and humanitarianism, ever saturated by eager researchers. The word zone urges thinking about niches (Hacking Reference Hacking1998) and contours (Hunt and Büschel Reference Hunt and Büschel2024) of psychosis.
Bukavu is a milieu of violence with textures. The method traces the impressionistic as well as the microscopic, knitting strands and cases into an incomplete portrait of a city. One aim is to show how scholars of other cities might read the inchoate in relation to violence, intimacy, power and madness. Uneven, these storied and useful cases open wide a terrain for further exploration.Footnote 12 The portraits emerged from many conversations and the ethnographic fieldnotes of my 2019 research team: four youthful, politicized members of Bukavu’s intelligentsia. They worked beside me cleverly, creatively, and in relation to my – increasingly our – fixations.
These four cases from Bukavu’s streets are not representative, but they afford opportunities to think of the intimate in relation to madness, style and venality. Each is about ‘madness’ in a city where ubiquitous violence, spilling into social memories, immersive realities and fantasies, is linked to contexts, atmospheres and event-based urgencies.
Case 1: Two mad brothers, a caring mother
Let us begin with an account of two brothers, adults, living with their sad parents. One is near death in the neighbourhood where he received some schooling before spending a small amount of time at the psychiatric hospital, until the family deemed Sosame inappropriate for their sons. Their poverty is overwhelming. His parents arranged a little place next to their home for one son to sleep ‘with his cardboards’. The mother greeted us while washing clothes. Neighbours seemed always present, just as war memories and their son’s trembling are part of the other brother’s story. They appear an unbroken family, with two disturbed sons and a mother bereft, tending to her family and restlessly labouring with a piece of soap so little it would soon disappear. The quiet brother is dying. The other, boisterous, is still producing life.
It may be an idealized, incomplete account, but it is useful as a partial baseline about intimacy and care in families. This family retreated from Sosame, for reasons of cost or forms of aggression encountered there, common complaints for those experiencing it as a negative space. The account suggests the structural violence of Bukavu, with a small family accepting derangement while shoring up its forces of care: an exemplary mother, soap, and discarded cardboard boxes.
Case 2: A mad ex-governor’s mad traffic cop
Most Bukaviens understand that, when someone goes mad, the turbulence is complicated to manage. This portrait is about chaos, traffic jams, those who undo them, and a partially mad governor solving problems through madness.
One fou, TC, long perceived as mentally ill, has been serving the community by regulating traffic on the busy, congested Panzi roadway in Ibanda, near Dr Mukwege’s build-up of clinical and humanitarian infrastructure (Achiza Reference Achiza2019). People say he smoked too much hemp and indulged in distilled alcohol, Kanyanga, brewed from fermented corn. Kanyanga, known to kill in Tanzania, Kenya, Rwanda and Eastern Congo, suggests the hip and cool, the tough and stylish, and tends to move beside automobile sales and rap music. It is unevenly criminalized in the Swahili-speaking zone from Congo’s Kivu provinces to Dar es Salaam. Rwanda tries to capture Kanyanga and its users, enforcing rehabilitation. In Congo, Kanyanga knows criminals and has figured in the ransom demands of armed men. In 2010, after seizing some women hostages near Mwenga, a demand of US$800 included a long list with salt, cigarettes, flashlight batteries, plastic sheeting, corn flour, Kanyanga bottles, and 5,000-minute phone cards.Footnote 13 Most say that Kanyanga-associated madness can never be healed, so it would be useless to take an addict in for modern psychiatric care. TC’s case, the logic continues, should not be linked to bad luck, sorcery or punitive harm. In popular eyes, his self-imposed ‘voluntary madness’ would benefit little from family support. No one, it seems, ever took TC to a clinic, since his malady became entangled with his regular, furtive consumption of hemp and Kanyanga.
In about 2014, South Kivu governor Marcellin Cishambo tried to restore Bukavu to its once shiny colonial image, insisting on demolishing shabby residential and commercial structures along certain routes. He was often present at these demolition sites, supervising and directing while joking with citizens. A project to build a new stretch of national highway began, heading towards Uvira with the Sino Congolese Company undertaking the works. The colourful, controversial Cishambo is known for rejecting ‘tribalist’ ideas, aiming for modernity,Footnote 14 and ordering the demolition of houses along the route. In the process, he apparently sought out some fous, ‘active’ on this stretch of road, active in the sense of wandering through, begging, redirecting vehicles, and achieving an audience.
‘Hot’ crossroads, like the intersections at Place Essence Major-Vangu and the Kamagema and Panzi neighbourhoods, attract the deranged amid volatility and a density of vehicles. When the Kamagema bridge first collapsed from erosion, the potholes left many ‘ashamed’.Footnote 15 When a fou improvised with the traffic at this dicey spot, fluidity increased thanks to a constancy of now de-blocked vehicles. Urgency intensified as activities increased in the Panzi neighbourhood (Hoffmann et al. Reference Hoffmann, Muzalia and Pouliot2019), where Dr Mukwege’s General Hospital was flourishing and growing in size. TC, skinny, in his forties, often agitated and unstable, could be found at the entrance to Kamagema market, declaring what should be. Dressed in a blue military cap, black military boots and a petrol-green vest, and with a whistle suspended from his neck by a thin rope – all suggested the national police uniform.
In the midst of heavy jams of taxi-buses, motards (motorcycle taxis), cars and trucks, women would display their goods on the ground, hurrying before others to sell the most. In this greedy competition, sellers encroached on the road as if taking it hostage, while cars moved across the bridge spanning the Kamagema River. Motards and taxi drivers were competing too, rushing to pick up passengers going to Essence. The motards sometimes resemble a parked gang, chatting while waiting. Other vehicles hurried to Mukwege’s hospital or the Catholic parish. Given the swirling chaos, TC would stand, sounding the whistle on his lips, while steering vehicles entering the parking lot.
People began to say that Cishambo was a crazy governor, like other madmen in Bukavu. When insulted, this big man reacted discourteously. Some claimed that TC was regulating traffic in Kamagema because ‘the other madman’ – Cishambo – placed him there. Such a pairing in public imaginaries does not suggest intimacy, but it is an important commentary about psychopolitics: how the psychiatric and the political coalesce or mingle.
The region knows the effects of a ‘madman’ in places needing fluidity. A bistro waitress told of fewer Kamagema traffic jams due to this fou’s acumen. He would run off to find some hemp or a half-bottle, returning with ‘more madness’ to regulate the – also mad – traffic. He would return logical, fierce, rigorous, beating vehicles sternly with kicks and fists. Most prefer taps aimed at the driver, not his vehicle. TC’s kicks restore order, and hitting cars knows a touch of madness. A businesswoman said: ‘TC is a real madman, who hits vehicles with his hands! He can never be healed, as his madness goes beyond other kinds. TC plays a fundamental role in this area.’ A young man buying and selling said that, if all madness were similar, the world would be a better place. He knew another serious fou regulating traffic in Kadutu, ensuring that schoolchildren cross the road safely. Many believe madness results from bad luck related to unrest, stealing or succession disputes. Panzi residents – women selling bread, ‘Gaddafi’ selling fuel (Lamarque Reference Lamarque2013) – know that Cishambo placed TC at Kamagema, since a madman at a junction bursting with skirmishes calms down the turmoil. A Burundian barmaid from Nourrisson Nightclub said: ‘Between the plain of the Ruzizi and Tanzania, popular opinion knows that when a madman frequents a crossroads, there is greater flow in traffic’ and fewer accidents ‘in this crazy place’. Bukavu, she reminded us, lies in the Ruzizi Plain, a zone of danger, insecurities with armed groups, cattle thefts, kidnappings, murder and robberies.
Her ideas recalled our research conversations about fous with evil spirits within, roaming and taking away souls. These spirits with vivid weapons go crazy, and their calmed crossroads prevent accidents. Evil spirits know no rest before a fou, and a madman will never be cured of spirits growing inside him. Crossroads go with madness in many parts of Africa, novels suggest (Bozouzoua Reference Bozouzoua, Brochard and Pinon2016; Veit-Wild Reference Veit-Wild2006). A Yoruba prayer – ‘May we never walk when the road waits, famished’ – marked Wole Soyinka’s The Road (Reference Soyinka1965), with lorries and road accidents. Ben Okri’s The Famished Road (Reference Okri1991; Guignery Reference Guignery2021) is a parable about the road as a swallowing King of the Road, with insatiable hunger and limitless greed. A ravenous road that devours also kills, and conciliatory rituals may quell the treacherous hunger.
Where is the violence and intimacy? There is intimacy present in these stories with a doubled madman: the opaque governor and a famous traffic cop. We do not learn about TC’s childhood, nor do massacres appear here. War is linked more to Dr Mukwege’s fame. Public investment in this heroic cop figure, who fears nothing and subdues the unruly, tells of popular imaginaries invested in craziness, evil spirits and crossroads. The violence and punishment are shadowy, but further research regarding the ‘mad’ governor may well yield stories of atrocity. The intimacy remains faint and social, with the collective adoption of a madman’s steering calm, a commonplace in popular narratives exhibiting affection and relief.
Case 3: An addict with dreadlocks, a mother washing clothes
This portrait features a man of the streets, an addict sporting Rasta dreads and nicknamed a buzzing pest. His long-lost mother emerged from her Goma home to find him at Bukavu’s psychiatric hospital, which likely arranged for her to be with their patient. Her husband – his father – long ago wielded a machete, threatening his wife amid a violent tantrum. This ‘wife’, though not of bridewealth, left. Their kids melted into the streets, including the son who became a hospital patient. This addict kept slipping beyond Sosame’s porous borders for more cannabis and drink. He was not the first to feel that the space was like a prison, scapegoating him.
Moments of affection emerged with his mother busy taking care of him as well as a couple of other women patients. He displayed some gratitude, appreciating his mother’s presence, washing his clothes. This street youth had been picked up by the police over the years. His violent, crazy, pathological father had sent them all running, just about the time that destructive rape became a massive problem in the region. A hospital nurse suggested he was schizophrenic, despite a lucidity to his anger. This man from a broken family, and now broken from addiction, found himself in this hospital seeking taller walls and stricter rules.
This story is spare. It entangles familial and institutional violence with addictive habit and a remembered time of intensities in rape. It provides glimpses of intimacy in tender maternal love and her domestic chores. The violent father hovers over horizons and cruel memories. Sosame appears in a grim light, a carceral place, contrary to the many caring moments glimpsed there amid the everyday practices of its nurses, doctors and staff. Yet the patient – a street addict with transgressive hair and a schizophrenic allure – conjured the clinic’s capacities to lock in, even capture. Sosame’s policies and practices, encouraging kin to arrive at all costs and share in the labours of care, suggest the contradictory impulses of one psychiatric hospital in Africa, where intimacy, care and violence become entangled, even confused (Hunt Reference Hunt, Hunt and Büschel2024; Hunt and Büschel Reference Hunt and Büschel2024).
Case 4: Cimpunda’s ex-musician star
Monsieur XC showed us ‘his market’ and claimed to be a leader of taxation: ‘This market belongs to me.’ When asked if he wanted a doughnut, he said he would like 50 francs worth of rice. Gladly, he showed us through his market, while a woman seller offered him a piece of meat and another gave him bits of fufu.
This last portrait is about XC, whom we met under a harsh sun in Bukavu’s streets, suffocating dust in the air. We were equipped with notebooks, phones and pens, and we arrived at the Cimpunda market, where he was not the only fou in this poor marketplace with stagnant water and sellers spreading their food for sale on the ground. Several pointed to XC as a case of madness. He, perhaps fifty or more years old, was lying on the ground in the middle of the stalls. We asked some sellers how long he had visited this market scene. Some said more than twenty-five years, which would place his arrival here to 1994, the year of Rwanda’s genocide, with consequences stretching far.
Later, we found XC’s adoptive family in the rainy season. All paths were narrow and muddy, sliding like slippery suds. We found a living room with sewing machine, four chairs, table, television and calico fabric. Some printed matter on display said: ‘Sixteen days of activism against violence toward women and girls. Together, let’s encourage the equitable distribution of chores between girls and boys, and also fight against violence toward women and girls.’ A key Bukavu context, female vulnerability before destructive rape, rang out through these sentences. The immediate context was more serene: two women sewing. One owned the house and had known XC since her childhood. He once lived with neighbours, a friendly family. When this first adoptive family moved to Kisangani, XC went to live with another, who could not bear his ‘whims’. They chased him off, annoyed that he came home late at night. Soon he was spending nights in a gutter and suffered much from neglect. When some motards fought in the area, they threw stones and XC got hurt in the fray.
The rich medical anthropological literature for Congo reminds us that kin are key to healing. They are an obligatory part of many phases in long therapeutic rituals, including those aimed at healing madness (Devisch Reference Devisch1993; Hunt Reference Hunt, Parker and Reid2013), with kin actively participating, providing afflicted relatives with food, clothes and attention. By singing and dancing for and with them, washing them too, relatives contribute to the healing process. The appearance of intimacy in mad people’s lives suggests continuity with such healing practices. Treatments may be tried with ‘traditional’ practitioners or in prayer rooms. When XC gets sick, his adoptive family helps. They wash his clothes, take him to the Red Cross for medicines, and help him get home again. XC frequently suffers from headaches and has been unwell for some two decades. Still, Sosame has not been his preferred location for care. His aversion bursts forth: ‘Sosame? No, no. They are children! Sosame’s agents are children. They cannot take me … I want to go back to my village for work.’ In a sense, this man who lost his parents and a sister, becoming like an adopted child, found care through this new family with a degree of tenderness. He expressed his loathing for the psychiatric hospital, experienced by him or through his delirious imagination as a space of fear and violence.
The adopting female figure had him treated in a Red Cross clinic in 2014. Concerned, she welcomed him into her family, where he has hovered ever since. Long abandoned, passing nights in the rain, Monsieur XC came to accept his new family, who welcomed him and gave him a pan to prepare his food. He eats directly from this pan, refusing a plate. He is integrated in part because he loves children, and he does not defecate outside like many other mad persons, using a toilet instead. Kind to everyone, this lover of rice does not drink the water offered to him, fearing dirt. He masters Congolese franc bills, knows how to count, begs for vegetables, seeks cigarettes and rice, and collects cartons for firewood.
XC’s father was a judge. His mother’s name was Joy. Both are deceased, although he has three brothers. When asked for details, delirium entered: ‘Me, I am known here for what I am in Cimpunda.’ What is your age? ‘I am twelve, twelve and eighteen years old.’ Are you married? ‘No, I am still a baby. I am five years old. I’m still looking for a girl to marry. I am two years old. I am five years old. I do not flirt because I am still too young. Girls often refuse me. I am only five years old!’ His village, Mushekere, was his late father’s. XC married, although his two daughters of Goma, born before he became ill, neglect him. When his father died, XC went home to inherit his fields at Mushekere and fell mad when people there bewitched him. Recently, a sister visited, confirming that XC began to suffer when in Mushekere for their father’s inheritance ceremony. She tried to get him treatment when their parents died, but had limited means. Now she lives at a distance in a family of two. Other relatives have died, suggesting less violence in the family than intimacies frayed.
A woman near the market declared: ‘Monsieur XC is a star. He is known all over the world in this district.’ An old man said XC long ago had an accident affecting his brain, when he was a boxer in Kinshasa, long before that inheritance ceremony. After being driven away by some neighbours and living in Kinshasa, he worked as a musician. The Mwachi vendors knew him as once a great musician in Congo’s capital city. Dirty with tattered clothes, damp from palm oil, he wears multicoloured shoes like those of Bukavien comedians. He usually wears a hat and more than two jackets. His muddy, torn clothes resemble a bird’s nest, lined with bits of vegetation, pebbles, feathers and found fragments. Drilled with oil stains, his outfit sometimes leaves him exposed before the women sellers. With fabrics and pointed hat, his shoes announce the elegance of a Congolese musician headed somewhere special.
These charming stories worked to protect him from harm. This delirious man built his safety and sense of intimacy from banal gestures suggesting he has few problems. He spends most of his time in the market, returning to his adoptive home in the evening. When he wakes each morning around 7.30, he goes off to the markets. Always a ‘gentleman’, he walks with his bag, visiting the markets of Mwachi, central Kadutu, and the small Basho. He walks around morning markets begging for fried beans, sweet potatoes and bananas. He behaves like a taxman, visiting Mwachi, table by table, vendor by vendor. When he notices that he does not have money, he widens his begging field, circulating in the big Kadutu or small Bacho markets. As he begs, he sells bits of food to purchase his favourite meal – rice – cooking it in Mwachi market while using cardboard boxes thrown away by vendors as firewood. In these delirious journeys of begging and imagined tax collection, XC carries a bag holding a water bottle, saucepan and frayed bags. If tired, he sleeps on the market ground using his bag as a pillow. Some sellers say he often is the victim of theft, since he sleeps with his pockets open, and street children zoom in and fly away with his money.
Compared with other fous living off Bukavu’s markets, XC has experience. He began living by the market more than twenty-five years ago, and mastered a certain trust among all the traders, mostly women. When a new seller arrives, he may try to drive her out as an outsider. Most sellers find he behaves well, since he does not steal. He does not disturb the peaceful, poor saleswomen. Most neighbours accept his presence, although one said that living near a fou may interrupt a family’s blessings. The fact that XC forbids strangers from entering his adoptive family’s yard from 7 p.m. tells much about the way in which utility and intimacy may combine to prevent violence.
The motivations of his host family deserve attention in this case about a ‘madman’ adopted almost as kin. The family belongs to a civics association, New Dynamics of Civil Society Association or NDSI/Kadutu, and it was they who kept the NDSI paper about ending gender violence. They let the mayor of Kadutu know that ‘their madman’ was spending the night to regularize his situation, so if he ever turned up dead, the town hall would recognize him as adoptive kin. The adoptive mother and her husband decided to build a hangar to protect him in the rainy season. Eventually, he began spending the night outside. At first he refused, but then he began to pass nights in this enclosure. He did not want to stay in the living room, though welcome there. Present was the idea of XC as a brother more than a madman: ‘We find it not normal to neglect the mentally ill since they are people like so many others.’ The intimacies of adoption are suggested, amid humanitarian inclinations.
The intimacy in this case derives from a chronic psychotic, whose presence bordering as a night watchman protected the family from harm. According to one woman neighbour of the host family, Monsieur XC is a ‘serious madman’, a fou sérieux, who has a quiet, clean, non-violent air and can undertake helpful tasks. This popular designation may mean many things about derangement, habits or deliria, but, in this case, it embraces efficacy in fending off trouble and protecting others. However delirious and unkempt, the fact that XC knows when to enter his nocturnal enclosure and act as security guard for this family makes him sérieux. His presence in the family’s yard works to protect them from thieves and intruders in this dangerous city. His performances as taxman, comedian and onetime musician protected him and brought some strangers close.
As Karl Jaspers (Reference Jaspers1963: 784) illuminates, distancing from a mad person ‘takes a surprising turn when it covers phenomena that can be and have been evaluated positively’. In the process, madness ‘interrupts and destroys’, with something ‘achieved in spite of or as the actual condition for certain performances’ (ibid.: 784). We saw this vein of madness with the traffic cop even if at a different scale, while XC’s daily performances had him alternating between beggar and taxman.
Concluding reflections
This article has shown how violence, madness and intimacy cross in structural, familial and street contexts. Mobility, performance and politics are among the veins of madness in this warlike zone, sometimes grim, absurd or deranged. These performances tell of the everyday in post-1994 Bukavu. Each ethnographic case permits a glimpse of manifestations of madness in this complicated, binational, warlike milieu since 1994 (Prunier Reference Prunier2009), with repetitions in crisis, refugees, massacres and humanitarianism.
Casework
The two men in the longer portraits were achieving stability and orderliness while stirring admiring glances and acceptance. These adaptive figures embraced an enduring ‘star’ of Cimpunda and an intrepid traffic cop of Panzi known for hitting vehicles into obedience. The Cimpunda star’s deliria seem to have entailed a shifting self, sometimes acting as an imaginary tax collector. Within scales of proximity, the Cimpunda star and Panzi cop provide useful services in order to secure a home or defuse turbulent traffic near Dr Mukwege’s all-engulfing enterprises. The public presence of the cop, so the story goes, came from a frenzied governor pursuing supremacy through vernacular idioms about the spiritual powers of a madman. Such useful madness entails a ‘serious’ reordering of disorder by a fou sérieux. The unbroken family was peaceful and poor amid maternal tenderness, a bar of soap, and two ill sons. Addiction emerged with different tonalities – one about social acceptance of a fou sérieux cop, and a Rasta-like Sosame patient. A portrait about disorderly, brazen power – a pathological husband, machete in hand – destroyed a family, emptying into streets of separation and addiction.
This article follows Karl Jaspers in challenging madness as mere deficiency, reducible to mental categories of disorder. Madness appears alternately as disruptive force, performance and repetitive deliria, as these appeared within stories and in our observations. I did not interrogate layers of provincial and municipal governmentalities, but future research could well do so, along with Congo’s explicit and latent policies towards its many urban mad wanderers (Yoka Reference Yoka1999; Hunt Reference Hunt, Hunt and Büschel2024). Homeless or semi-homeless chronic psychotics know a wide spectrum, with neglect and kindness but rarely control or incarceration.
Psychopolitics
Knotted evidence suggests that violence may cause or intensify forms of madness. War intruded terribly from 1996, making many grim marks with strands of conflict since. Still, not all psychic struggles manifest as social catastrophe. Structural violence appeared as debilitating poverty. Beside war and genocide, harm combined with rape and much seeking of shelter. Injurious ‘big’ events entail individualized, political and vernacular specificities. In the postcolonial, post-genocidal contexts of Congo’s Kivu provinces, with armed groups, terrible deaths, rape and many remembered massacres, madness bursts forth with idioms flaring.
A heuristic emerges from Foucault’s suggestion about social horizons with aesthetic and everyday dimensions. In Bukavu, a signal horizon embraces fear of Rwanda’s Kagame, in ways related to what James Smith (Reference Smith2022) has called the slow, regular ways in which people in the Kivu provinces have been striving for steadiness by composing an ‘incremental temporality’. These stories can be situated as aftermaths or afterlives (Hunt Reference Hunt2016; Reference Hunt2020), yet necropolitical dynamics of amplifying wealth and power remain urgent, and only partially pacified through international peacebuilding. In this city of turmoil, violence is recollected socially and also held back, as if in wait.
Madness also pries open the psychopolitics of regimes and everyday speech in Bukavu’s streets, markets and bars. Psychopolitics (Hunt Reference Hunt, Hunt and Büschel2024) enable gesturing towards the ways in which politics and micropolitics merge, with psychological, psychiatric and psychoanalytic dimensions, as in nervous states (Taussig Reference Taussig1992; Hunt Reference Hunt2016). The psychopolitical surfaced with the ambitious governor, perceived as mad, who used a fou to stir up fearful and farcical energies. It is also present in social memories regarding an intensification of domestic cruelty during a time of social frenzy involving much rape. The psychopolitical everywhere leads to shadow energies and unconscious dimensions. It adds moods, atmospheres and enmities to an analysis of a city, police force, province and war zone, or even to a querulous, subaltern, postcolonial research team being guided towards decolonial registers (Vlassenroot et al. Reference Vlassenroot, Mudinga and Muzalia2020a).
Intimacy
Intimacy is not necessarily accessed through the microscopic. Still, it is important to track its planes woven with textured evidence. Forms of belonging – of, by and for the mad – surfaced again and again in this rough, dodgy milieu. In shared spaces, a sense of collective intimacy or belonging may form from common knowledge, exchanges, remembered pasts or ambivalent figures. If fraught or belligerent, intimacy betrays complex secrecies.
Violence is often more structural than event-based. Conflict may yield intimate dimensions, deliria, or connections with harm, kinship, mobilities or theatricality. Madness embraces intimacy and relations of power. Familiars and strangers are involved. Even when kin, loved ones, shunned intimates and figures of care are not prominent, proximities or layers of madness, intimacy and violence may stream forth. When madness surfaces in a concrete milieu or in everyday collective imaginaries, clues about the intimate – kindness, tenderness, belonging, aggression – may tell much. Notably, these portraits suggest that, when a person enters into a ‘crisis of presence’ (Martino Reference Martino2012), intimate matters of self-care – bathing, toilet arrangements, dress – crop up as clues about affection, aversion and disgust.
Beginning with interconnections among madness, violence and intimacy, no certain causality emerged. I avoided asserting easy causal errors in the analytical logic or assuming that everyone is traumatized. In sidestepping PTSD as overplayed, I emphasized the psychotic, the delirious and performances. Rather than focusing on already researched institutions, such as Bukavu’s police (Thill Reference Thill, De Herdt and Titeca2019b), this article considered unkempt, wandering figures from a Congolese city’s streets (with only glances towards clinical spaces). These vignettes suggest the need in histories of madness to move beyond psychiatric categories to vernacular readings and forms of care (Hunt Reference Hunt, Hunt and Büschel2024). Analytically, it is important to focus on manifestations, interruptions, theatrics and forms of belonging in shared spaces. When we documented cases in 2019, the milieu knew differentiation, fear and intense precarity, beside shadowy big men and turbulent gangster figures.
Vivacity, performance, domestication
Psychosis is always puzzling, unsolved and concerning, regardless of the environment, history or milieu. Dissociation is a telling thread, slenderly broached here, but rich in Africa’s new historiography of madness (Hunt and Büschel Reference Hunt and Büschel2024). Still, kindness may transpire beside teasing or conviviality.
Madness, manifest within a public or domestic atmosphere, may burst forth with ironic laughter. Striking proximities arise in Bukavu from teeming markets, traffic jams and sonic intensities amid ranking, nicknaming and teasing everywhere. These portraits embrace violence and ‘vivacity’, following Foucault (Reference Foucault1961; Hunt Reference Hunt, Hunt and Büschel2024). At a remove from economies of speculation and extraction, the sane and the insane suffer from precarity. Some turn to begging, with plenty of fous ‘active on the road’, as the vernacular idiom goes, eking out lives, stirring attention and doing crucial chores.
Everyday forms of irony spill into perceptions of madness and the mad. The theatrics of a madman may amuse passers-by. Many Bukaviens are fascinated by how a fou – a chronic psychotic – settles into predictable and unpredictable situations. They are also keen to itemize, ironically and competitively, all the fou figures they have spotted, along with their nicknames and intersections of habit. This kind of listing performance made by the sane is suggested by the poem of Bukavu’s Muzalia Zamusongi, ‘Au carrefour des heures’ (Bahizire Malinda Reference Bahizire Malinda2005). This kind of playful, poetic capture is significant to sardonic distancing and social acceptance.
This article has been about madness in relation to intense proximities and violated intimacies. It has portrayed a spectrum of manifestations, related to harm and injury in a key city in Africa’s Great Lakes region. It has quarried forms of vivacity among those performing their madness as well as those philosophizing while counting and naming the mad and watching their performances. Methodologically, biography and performance reveal much, as do disruptions, disconnections and intrusions. This exploratory slice of portraits, taken from investigative interpretations still in process, are worth developing further, in and beyond Bukavu.
An aspect that surfaced relates to the burden of taking care of a chronically psychotic person in an African city. Bits of solidarity and empathy suggest how the mad survive in this setting. How any figuration of madness unfolded, around one construed as mad, speaks to the complex textures of turbulence in this border city. These portraits speak to the ways in which Bukaviens make use – socially, hygienically, politically and philosophically – of those perceived as mad. Madness often contains creative, positive elements and shifts scales from a single sufferer to a public audience amid political critique and shared laughter. In the end, this material suggests that stigmatizing the mentally ill is much less common in Bukavu than the latitude and the agility of the mad, and their exceptional domestication by familiars and strangers.
Acknowledgements
A generous 2018 John Simon Guggenheim fellowship made this research possible. I am also deeply grateful to everyone who welcomed me to Bukavu, especially the four intellectuals who co-produced ethnographic research with me and enabled many details and interpretations here. I am thankful to the brilliant historian Godefroid Muzalia, director of Bukavu’s Groupe d’Études sur les Conflits et la Sécurité Humaine (GEC), GEC’s Irène Bahati and Cubaka Vianney, and historian Gillian Mathys. Josaphat Musamba was a superb mediator, more than once. Much gratitude goes to GEC’s generous Koen Vlassenroot and the ever smart, unstinting Michel Thill. Many thanks go to the director, doctors, nurses, staff and patients of Bukavu’s Sosame hospital, especially the Bukavu psychiatrist Eric Kwakya. I am ever grateful to Jean and John Comaroff: John invited me to share a draft at Harvard in 2020, and brilliantly invited Byron Good as discussant. Jean generously took time to synthesize and extend all the precious comments. Julia Tischler assembled a pandemic-time Zoom circle, where I benefited from smart minds, and ultimately those of two Africa reviewers. I am thankful for University of Florida’s biomedical IRB for an instructive process about the ethical stakes in psychiatric research. The luminous Danny Shub, psychiatrist from Perth, offered critical guidance near Bonnieux on ethics and vocabulary. I thank them all.
Nancy Rose Hunt, an anthropological historian of DR Congo, teaches African history at the University of Florida. University of Michigan professor emerita of history since 2016, she is co-editor of Psychiatric Contours: new African histories of madness (Duke University Press, 2024), and author of its Introduction and a chapter about speed and mental illness. She received the Herskovits Prize for A Colonial Lexicon (Duke University Press, 1999).
Eric Banyanga Batumike is an Assistant de Deuxième mandat and teaches in the Department of History and Social Sciences at the Institut Supérieur Pédagogique in Bukavu, as well as being a researcher at the Groupe d’Études sur les Conflits et la Sécurité Humaine GEC-SH (Email: [email protected]).
Elisée Balolage Cirhuza has been an affiliated researcher at GEC-SH since 2018. He has also worked as a MEAL Specialist for CARE International in the Democratic Republic of the Congo since 2020 and is a member of the Outcome Mapping Learning Community (Email: [email protected]).
Alice Nalunva Mugoli has been an affiliated researcher at GEC-SH since 2017. She has also worked as a monitoring and evaluation manager for IITA Sud-Kivu in the Democratic Republic of the Congo since 2022 (Email: [email protected]).
Bienvenu W. Mukungilwa, a doctoral student in Anthropology at the University of Florida, continues as a research assistant at ISP-Bukavu and has long worked as part of GEC-SH in eastern Democratic Republic of the Congo (Email: [email protected]).
