Interrupting knowledge, decolonising care: understanding mental health with a refugee-run NGO in Sydney, Australia

© 2018 Dr. Mythily MeherAny expression of medical pluralism will reflect the organisation and hierarchisation of its traditions of knowledge. My thesis attends to moments in which diverse understandings of mental affliction are negotiated, and sometimes even silenced, in the networks and relationships surrounding a Sydney NGO. Here, alongside this NGO run for and by people from Central Africa, I explore approaches to questions of what mental affliction is, various notions of who (mis)understands it, and how afflictions and their percieved misunderstanding are dealt with. In the process, the category of ‘mental health’ emerges and disappears, is challenged and negotiated, within jostling epistemological frames of understanding. To examine this therapeutic landscape, I prioritise modes of analysis that are sensitive to the fluctuating complexities of caring for community through existing, yet not always equitable, structures for such care. I draw on affect theory’s slowness and attunement to the unseen, often unarticulated forces that unfold in encounters, conversations and in what is articulated (Stewart 2017: 192). Affective scenes provide an access point to each chapter's textured study of the refugee-migrant community health assemblage, which is examined in terms of: historical context (Chapter One), NGO sector development (Chapter Two), education (Chapter Three), belief (Chapter Four), faith (Chapter Five), and care (Chapter Six). Through such attention, this thesis asks after what medical pluralism looks like when a group of people with histories of a range of healing traditions—psychiatry, cosmopolitan medicine, religious faith healing, and spiritual cleansing of curses—move to Australia? How were these different knowledge traditions treated and talked about? And how could one meaningfully study these pluralities?—what would anthropological research and ethnographic writing, as modes of knowledge creation, come up against in trying to engage with plural traditions of knowledge? Through representational sensibilities, moments of ethnographic attention and narratives that circle back and interrupt themselves, this thesis builds an argument for ambivalence towards conclusive uses of knowledge. Ambivalence is presented as a counter to the kinds of simplified understandings of diversity that are often salient in the migrant health and community development sector, and that are shown, through this ethnography to beget subtle, structurally violent effects. I frame such ambivalence as an act of care. Part examination of the tensions “between fragmentation and connectedness-in-the-making” (Biehl and McKay 2012: 1210), part portrait of the tensions held in suspense when crafting an ethnography of knowledge(s), my work seeks to contribute to the decolonisation of knowledge and care