Honolulu: University of Hawaiʻi Press, 2020. x, 283 pp. (Tables, maps, B&W photos.) US$28.00, paper. ISBN 978-0-8248-8846-6.
Jacqueline Leckie introduces her study on mental illness in colonial Fiji with two vignettes of indigenous Fijians who, in the late nineteenth and early twenty-first century, were charged with murder but found not guilty by reason of insanity. Expanding on these individual cases, the author takes her readers to St. Giles Psychiatric Hospital in Fiji’s capital Suva. Founded in 1884 (i.e., one decade after Fiji became part of the British Empire) as the Public Lunatic Asylum, St. Giles has been the only institution of its kind in Fiji. Chapter 1 outlines its establishment, early history, and the legal framework it was built on. Although St. Giles and the community of patients and staff it produced feature prominently throughout the book, Colonizing Madness is far more than an account of one mental health facility in the Pacific Islands. Rather, the author uses the hospital (and previous asylum) as a window into the history and social construction of madness in Fiji’s multiethnic society which is made up of indigenous Fijians, Indo-Fijians (of South Asian ancestry), and various smaller population groups.
Colonizing Madness mainly builds on Leckie’s consultation of several thousand records on former patients at the Public Lunatic Asylum (and St. Giles). “(R)eading the lunacy archives” (4) allows her to draw a historically rich picture of madness in Fiji which is simultaneously shaped by “the localized historical context” and “the global and colonial history of madness and psychiatry” (20). The author’s aim is not to offer any diagnosis on whether (or not) patients were mentally ill but to “address how madness was constructed and managed and how it affected individuals and communities” (4). While Leckie does not question the “brutal imposition of [colonial] power” (2), she also explores in detail local community perceptions of mental (dis)orders and the role of kin in caretaking responsibilities. She argues that, apart from imported biomedicine, concepts of madness in colonial Fiji were also built on an assemblage of “cultural, religious, gendered, economic, and political nuances within Fiji’s communities” (2). Building on such a framework allows the author to unwrap the entanglements of state legislation and control, asylum building, and community perceptions of mental health, carefully weighting up the control exercised by the colonizers against the very limited resources (financial constraints, lack of medical specialists, etc.) available to Fiji’s Public Lunatic Asylum (and St. Giles) throughout its history. The fact that the colonial government put little priority on mental health exposes the limits of “hegemonic colonial power” and the “ambiguities in power relationships between the colonial masters and the ruled, and the agency of the colonized” (17).
Chapter 2 engages with Indo-Fijian perceptions of mental disorders and heavily draws on the topic of displacement, i.e., “physical dislocation from migration” and “profound shifts in (…) cultural worlds” (25). The chapter focuses mainly (but not exclusively) on the indenture system that brought a great number of labourers (girmitiyas) from British India and other areas of South Asia to Fiji, and laid the foundation of its multi-ethnic (post)colonial society. Throughout the colonial period, girmitiyas (and their descendants) formed the asylum’s largest group of patients, followed by indigenous Fijians to whom Leckie turns in chapter 3. While she discusses Fijian concepts of madness, support of the mentally ill in the communal system, and changing care patterns, she also explores the political dimension of madness and describes how the colonial regime exerted control over agitators and dissidents “through the construction and discipling of mad subjects” (54). One interesting finding is that in some cases, “medical specialists were at odds with colonial authorities” (78), potentially pointing to political strategies behind presumptive medical concerns. While chapters 2 and 3 focus on population groups circumscribed by ethnicity, Leckie never loses sight of the multiethnic dynamics intrinsic to Fiji islander sociality. Episodes which testify how colonial Fiji islanders tried various forms of medical intervention into mental illness, ranging from spiritual remedies to biomedicine (e.g., 49–50), are thought-provoking and help to correct simplistic images of Fiji’s supposed plural society. Chapter 4 expands on the previous discussion with a focus on gender. It unwraps that the process of diagnosing so-called mad women would often rest on an amalgamation of racial and “cultural perceptions of appropriate gender identity and behaviour” (97) whereas “mad women’s testimonies offer insight into the stresses women faced and the contradictions of gender roles in the community” (88).
The two consecutive chapters zoom into Fiji’s only mental health institution and draw a vivid picture of the diagnosis (chapter 5) and treatment of madness as well as patient resistance (chapter 6), which commonly unfolded “in nonverbal or nonliterate ways” (152). Throughout, Leckie never loses sight of the entanglements of the governmental health care system with class, ethnicity, and gender. This allows her to unearth the challenges and ambiguities related to assessing madness and insanity in colonial Fiji. The same applies to her discussion of the treatment of mental illness against the backdrop of limited biomedical knowledge and lack of medical supplies and qualified staff, as well as the nexus of state and community healthcare which characterized the asylum and its “inadequate structural environment” (160) well into the twentieth century. In the final, seventh chapter, Leckie shifts her focus to developments at St. Giles after Fiji’s independence in 1970. These developments have been especially hampered by Fiji’s severe economic limitations, the low priority given by Fijian governments to mental health, and periods of political turbulence which accumulated in a series of coups d’état that riddled postcolonial Fiji. Despite visible improvements—for example in the areas of drug regimes, staff training, patient turnover, and outpatient care—“the process of change was uneven and painfully slow” (189).
Colonizing Madness is a commendable piece of scholarship and is the first book-length exploration of mental illness in Fiji. The book benefits from Leckie’s longstanding work on the history and anthropology of Fiji. It will be of great value to scholars concerned with Oceania and to a broader audience interested in colonial psychiatry and the social and historical construction of mental illness, and health more generally.
Dominik Schieder
University of Siegen, Siegen