Data related to this article
“Documents from the private archives of Jean-Louis Renauld, psychiatrist/psychoanalyst.”
https://nakala.fr/collection/10.34847/nkl.8fba0059.
A collection including the documents taken from Jean-Louis Renauld’s private archives that were used in this research (facsimiles of typescripts and manuscripts and transcripts, photographs). These documents are also presented at the end of this article, in the section entitled “Documents from Jean-Louis Renauld’s Private Archives.”
- 1 The coopération system was set up after France’s colonies in Africa gained independence. It allowed (...)
1In the winter of 2017, as I was in the middle of developing a new research project on the history of madness in West Africa, I read an article about psychiatry in the Upper Volta, which was published in 1973 in the journal Psychopathologie africaine (Renauld 1973a). It was written by the then head of the Bobo-Dioulasso psychiatric unit, a Frenchman, Jean-Louis Renauld. As I had done in the past when researching former coopérants1 in Africa (Tiquet 2013; 2016), I looked for his name in the phone book. After a few unsuccessful calls to people sharing the same name, I did eventually find the right Jean-Louis Renauld, who was by this point almost 80 years old, and a psychiatrist and psychoanalyst in Cuers, in the South of France. We started communicating via email, until we met in person for the first time five years later, in January 2022.
- 2 Institutional psychotherapy was a psychiatric movement that aimed to radically transform the asylum (...)
2Born on 2 July 1940 in Riom (Puy-de-Dôme), in the middle of the Second World War, Jean-Louis Renauld had a nomadic childhood. He moved all over France with his parents before they ultimately settled in Germany in 1945, just after the end of the War. He remained there until 1959, when he returned to France to study medicine. He qualified as a doctor specialising in neuropsychiatry in 1965, and worked at the Clinique du Chesnaie in Chailles in the département of Loir-et-Cher—one of the bastions of institutional psychotherapy2—from 1968 through to the end of 1972, when he flew off to Bobo-Dioulasso to head up its hospital’s psychiatric unit within the framework of a two-year coopération contract (1972-1974).
- 3 Archives nationales du Sénégal (ANS), Fond AOF, 2G56/51, Rapport santé Haute-Volta, 1956. The FIDES (...)
- 4 Georges de Trémontels and Michel Raoux were the military doctors, and then Bernard Buis was the fir (...)
3The Bobo-Dioulasso psychiatric unit opened just before the independence of Upper Volta (now Burkina Faso) (Tiquet and Hien 2023). Its construction was completed in 1956, thanks to a loan from the FIDES (Fonds d’investissement pour le développement économique et social), but the unit did not open until the spring of 1957, due to a lack of equipment and personnel3. The FIDES played a decisive role in the funding of healthcare infrastructure, in particular in the construction of psychiatric hospitals, be it in Senegal, Ivory Coast, Niger or Upper Volta. Before 1972, the unit had been managed since its opening by two military doctors without any expertise in psychiatry, and then by a French coopérant neuropsychiatrist between 1970 and 19724. In 1972, Renauld found himself running a unit that was rather reminiscent of a penitentiary institution, with hundreds of patients piled on top of each other and locked up in abominably insalubrious conditions, some of them for years, and entirely cut off from their families.
- 5 The journal Psychopathologie africaine was edited, from 1965, by the Société de psychopathologie et (...)
- 6 To avoid excessive bibliographical references, see two detailed bibliographies published in Psychop (...)
4Despite having acquired some new momentum in recent years, the scientific literature on madness in Africa remains relatively sparse. Many studies initially attempted to identify the historical and institutional milestones of colonial psychiatry on the continent, mainly in English-speaking territories (Bell 1991; Deacon 1996; Sadowsky 1997; Keller 2001; Boroffka 2006; Mahone and Vaughan 2007; Heaton 2013). In francophone West Africa, the numerous, ground-breaking works of René Collignon have left an enduring mark on this field (1978; 1999; 2002; 2006). We should also note the rich variety of the numerous articles in the journal Psychopathologie africaine,5 written by players from the period—former coopérants but also the first African psychiatrists—which focussed on the topic of mental disorder and on the work carried out in new psychiatric units just after independence. As far as more contemporary periods are concerned, the subject has been seized upon by medical anthropologists, be it in terms of psychiatric institutions or of the analysis of family and/or community forms of care (Akyeampong, Hill and Kleinman 2015).6
5This text relies on a corpus of sources in a variety of formats, all of them (co-)produced by Jean-Louis Renauld. Around fifteen photographs taken during his stay allow us to visualise the unit as it was at the time. A small file of private archives put together by the psychiatrist and made up of handwritten or typewritten notes indiscriminately brings together a jumbled set of free reflections written during his stay, correspondence with various authorities, as well as a set of technical notes regarding the projects he initiated, and the copy of an article that was published in a medical journal (Renauld 1973b). Finally, the corpus includes our telephone conversations since 2017 (which were not recorded), as well as two recorded interviews carried out on 20 January 2022 at his home. We spent the morning discussing the photographs; in the afternoon, our second interview focussed on his childhood, his training and his experience in Bobo-Dioulasso. On 23 June 2023, we met again in the South of France to discuss the first version of the present article, and to clarify some of its details.
- 7 There are limitations to this exercise. I would like to thank in particular Camille Evrard, Raphaël (...)
6I am aware of the many pitfalls that a corpus such as this one can involve. An interview can turn out to be a highly codified exercise in “self-dramatization,” especially for a psychiatrist and psychoanalyst who, due to his profession, pays close attention—and carefully controls—the words he uses. Furthermore, I acknowledge that I have felt an increasing liking for this man who I have been communicating with for almost six years. The very structure of this article, which starts from Renauld’s life story and then progressively zooms out to reveal the daily life of the psychiatric unit, is aimed precisely at avoiding falling into the trap of its turning into a hagiographic narrative and lacking any critical distance from its discourse and the corpus it examines.7
- 8 A whole series of more personal and intimate photographs was filed in his archives together with th (...)
7Jean-Louis Renauld’s private archives are mainly focussed on his personal activity and reflections. The photographs mainly document his activities in the field, what he wanted to remember and show.8 As such, the corpus thus collected appears fragmentary and fragmented. Fragmentary in that it mainly focuses on the psychiatrist’s experience; in fact, a whole range of other players, be it the local nursing team or the patients and their families, are rarely referred to or barely visible. And fragmented in that this archive is made up of notes that are sometimes difficult to identify or contextualise. The photographs are useful, but there are only a limited number of them. Finally, during the interviews we carried out, Jean-Louis Renauld’s memory sometimes failed to reliably recall biographical details that go back over fifty years.
- 9 A trip in October 2021 to the Bobo-Dioulasso psychiatric unit allowed me to find traces of various (...)
- 10 Incidentally, it is interesting to note his inability to recontextualise some of the statements mad (...)
8This varied set of documents nevertheless seems useful and important, especially in a context where the sources produced by the unit itself since it was opened remain very limited, if not non-existent .9 Renauld’s personal notes, for example, allow us to access more “raw” thoughts, reflections from his experience that are situated (in time and space) and which neither the scientific articles he produced (which he wrote in his capacity as a psychiatrist) nor the interviews we conducted—which required him to activate his memory fifty years after the facts—have been able to reproduce.10 The diversity of this corpus thus allows us to gain a grasp of his professional career, but also to access fragments of his personal feelings as a young French coopérant.
9By reading between the lines, and encouraging a discussion-dialogue around the photographs (Bigando 2013), we were able to a certain extent to move beyond the trap of “self-representation” and to get a sense of the history of a medical service in which daily life and the relations between its different players—a lone white doctor, a nursing team, patients, families—still bore the imprint of colonial relations, a decade after independence.
10The idea for this article thus arose out of both a lack and a desire. A lack above all: the absence of alternative sources produced by the unit or by other players, which it might be possible to cross-reference with Renauld’s corpus, or which might possibly allow us to deconstruct it. And then a desire: to try and produce a record and an analysis on the basis of a limited and fragmentary documentary corpus, all of it produced by the same individual. As such, this article presents both a methodological challenge and an exploratory approach, by engaging in a deliberate back-and-forth between different scales of analysis. By taking as its starting point the figure of Jean-Louis Renauld, and his career and experiences in Bobo-Dioulasso during the two years of his assignment, this exploratory research project attempts to reconstitute the itinerary of an enquiry which, by relying in particular on one individual’s memory, more widely suggests that we reflect on the history of the coopération system and on what the day-to-day operation of the Bobo-Dioulasso psychiatric unit might have looked like a decade after the country gained independence.
11The first part of this article will examine Jean-Louis Renauld’s professional career until his departure for Upper Volta. The second part will focus more specifically on daily life in the unit, through the prism of the changes which he initiated, whether it be to the institution he was managing or to relations with the nursing team. Finally, in a last part, and in order to go beyond a self-centred narrative, we will examine the cases of certain patients, as well as the ways in which families and society viewed “madness” and this “imported” psychiatric unit.
12
- 11 “Mon grand-père [maternel] était un scientifique et je pensais que j’avais une sorte de destin de c (...)
13In 1959, having passed his baccalaureate, Jean-Louis Renauld started his first year of university in Paris, signing up for an MPC—“Mathematics, Physics, Chemistry”—course: “My [maternal] grandfather was a scientist and I thought I was sort of fated to continue what my grandfather had done”11 (interview with Jean-Louis Renauld, 20 January 2022, afternoon).
14A few months after he started his studies, he fell in love with a young woman who was preparing to sit the examination to study medicine. At the time, in order to gain access to this course, one had to follow a PCB—“Physics, Chemistry, Biology”—course. Renauld went to see the rector of the university and was granted the right to sit the PCB biology examinations, which he easily passed: “I was completely overwhelmed by how fascinating biology could be. You learnt the history of life in this PCB, it was splendid” (ibid.).
15Jean-Louis Renauld thus became a medical student in the early 1960s. At the same time, he took an interest in literature, philosophy and history. He eventually came to see psychiatry as a way of combining these two interests in the hard sciences and the humanities. In 1965, as he was working as an extern in Angers, he learnt that Roger Gentis, a psychiatrist at the hospital of Fleury-Les-Aubrais (near Orléans), and a major figure in the field of institutional psychotherapy (Gentis 1977), was looking for people who would be interested in doing a psychiatry internship. Renauld applied, and subsequently started his internship at the hospital of Fleury-Les-Aubrais:
- 12 “Et là j’ai appris beaucoup de choses parce que là, Gentis nous a fait véritablement une école de p (...)
“And I learnt a lot of things there because Gentis had really created a school of psychiatry there, open to the humanities. We studied ethnology, we studied psychology, we studied psychiatry, we studied linguistics, we also studied history, it was a moment when Foucault’s book about madness had just come out.” 12
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
- 13 Michel Foucault published his Histoire de la folie à l’Âge classique (History of Madness) in 1961, (...)
16Since the 1950s, in both Europe and the United States, there had been a profound calling into question of psychiatry and psychiatric institutions—especially as far as concerned the therapeutic value of internment and the conditions in which patients were treated (Henckes and Majerus 2022). Intense reflections were thus initiated by healthcare professionals, but also by a variety of political and scientific players, in order to uncover alternative therapeutic responses.13 This was the time of antipsychiatry (Robcis 2021), of reflections on “deinstitutionalisation” and the setting up of community or outpatient psychiatric services (Guillemain, Klein et Thifault 2018) or of other forms of therapeutic care provision, focussing on institutional psychotherapy and psychoanalysis. Furthermore, the 1950-1960s saw the emergence of the theoretical groundwork for and putting into practice of ethnopsychiatry or cross-cultural psychiatry (Delille and Crozier 2018), at the initiative of doctors such as Henri Collomb and his team in Senegal (Bullard 2022), or Thomas Lambo in Nigeria and the World Health Organization (WHO) (Pringle 2021). This context was to have a particularly big influence on Jean-Louis Renauld.
17At the end of his internship in 1968, he became a doctor and joined the Clinique de la Chesnaie, which had been founded by Claude Jeangirard in 1956 in Chailles, in the Loir-et-Cher, and was one of the bastions of institutional psychotherapy:
- 14 “En 1968 il y a eu une sorte de petite révolution à la clinique de Chailles où la place du médecin (...)
“In 1968 there was a kind of little revolution at the Chailles clinic, where the place of the doctor was called into question. Should it be the doctor who organises everything? […] And at that point I got to work in a slightly different way to what we had been doing in the psychiatric hospital, because the way life was organised in this clinic had nothing to do with the way it was organised in the hospital in Fleury-les-Aubrais, despite Gentis’ influence. You had a lot more freedom in these clinics than there was in the hospitals. Freedom for the patients and freedom for those who were caring for them, who were working. And the clinic in Chailles always tried to have a connection, or several connections with all sorts of institutions, which brought the life of the city or the life of the country into this place which was not supposed to be a place of confinement.”14
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
18This initial experience had a defining influence on the rest of his career. He worked in la Chesnaie until October 1972, when he left for Bobo-Dioulasso.
19In 1970, Jean-Louis Renauld took part in a psychiatry congress in Paris, where Henri Collomb, the director of the Fann psychiatric clinic in Dakar, in Senegal, was presenting his work methods (Collignon 1978; Arnaut 2009). Since arriving in Dakar at the end of the 1950s, Henri Collomb and his team had attempted to create a “psychiatry without borders” (Boussat and Boussat 2002) by opening up the institution to local definitions and representations of mental disorder. Surrounding themselves with ethnologists, sociologists and anthropologists, “the Fann School” relied on a practice that took into account the technical aspects of Western psychiatry and the experience of “traditional” therapists (Kilroy-Marac 2019; Bullard 2022):
- 15 “En l’écoutant, je me suis dit : ‘faut que j’aille voir ce type.‘ Je venais d’être officiellement m (...)
“As I listened to him, I thought: ‘I have to go and see this guy.’ I had just officially become a doctor, and I hadn’t wanted to build up a clientele before doing a bit of exploration ever since we’d done a little ethnology with Gentis. I wanted to see what was happening in a country that functioned differently to ours, and especially in Africa.”15
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
20Once he had told me about this episode, I asked Jean-Louis Renauld about his relationship to Africa. Where did this attraction to the African continent come from? He mentioned two episodes from his childhood that had shaped his image of the continent and inspired a kind of “attraction” to Africa:
- 16 “Alors il y a une petite notion qui n’est pas inutile. À la Porte-Dorée [à Paris où il habitait enf (...)
“Well there is a little idea which has some utility. At Porte-Dorée [in Paris, where he lived with his parents as a child], there was the Musée des Colonies [Museum of the Colonies], and this Musée des Colonies had a sculpted concrete façade which presented images of the colonies in a way that could absolutely catch a child’s attention: what’s that, what’s that animal? And in fact, not far from the Musée des Colonies, there was the Vincennes zoo. And when I went to walk around there with people from my family, well we regularly went to the Vincennes zoo and I had a friendship with the elephant there […]. So that was my first contact with Africa.”16
(Ibid.)
21Jean-Louis Renauld mentions a second memory:
- 17 “[Ma grand-mère] avait un copain belge qui était un colonial et ce colonial il habitait en Côte d’I (...)
“[My grandmother] had a Belgian friend who was a colonial official, and this colonial official lived in Ivory Coast and at Christmas he would send us a bar of chocolate. And I think it was an imaginary world, I would imagine Africa, I would wait for Mr Polge’s chocolate. It was an opening up to world, this chocolate that would arrive. It had something to do with Africa.”17
(Ibid.)
22These two episodes reveal both the significance of the colonial context in mainland France (the presence of a colonist in one’s family or entourage) and a condescending tacit view that was quite widespread at the time: the continent was emptied of its population and reduced to the exotic animals and products that could be found there. In fact, we find this image again in the portrait of Jean-Louis Renauld (illustration no. 1) in the company of a little monkey he adopted during his stay.
- 18 “La Chesnaie nous a payé un voyage aller-retour où on a pris connaissance de ce qu’il y avait autou (...)
23Following the congress in 1970, Renauld then asked the head doctor at la Chesnaie, Claude Jeangirard, if he could spend a few weeks at Fann in order to observe how Collomb and his team worked. Jeangirard gave him his authorisation and he left, at the end of 1970, for two weeks, in the company of two nurses: “La Chesnaie paid for us to make a return trip where we became acquainted with what there was around Collomb. And so that made me want to leave, before settling down somewhere in France”18 (ibid.).
24Beyond his interest in the African continent, Renauld also connects his desire to leave to his experience as a child, when he moved a lot between France and Germany:
- 19 “Alors vous voyez, déjà, dans mon histoire, je ne suis pas né à Paris mais j’ai vécu à Paris. Je vo (...)
“So you see, already, in my story, I wasn’t born in Paris but I lived in Paris. I haven’t yet told you that when I was two, I was in the Morvan region, where my maternal grandmother lived. Then my father [a primary school teacher] […] was sent to the Massif central region and, even as a child, I didn’t have a fixed abode. […] When I arrived in Germany, I arrived in Neustadt, it’s in the Palatinate. Then my father went to Constance, then to Freiburg, then to Baden-Baden, then back to Freiburg again. […] After that I went to Grenoble, then I started studying medicine in Paris, then I went to Angers where I did my clinical training etc. etc. I moved around all the time. People tell me I’m unstable, but no, I’m curious.”19
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
25Once he was back from his stay in Fann, and further inspired by this experience, Renauld decided to pay a visit to the Coopération Ministry in 1972.
- 20 He left with his first wife and two children, before separating during their stay. His children ret (...)
26In October 1972, Jean-Louis Renauld became the fourth Frenchman to become the head of the Bobo-Dioulasso psychiatric unit,20 which had opened a few years before the independence of Upper Volta:
- 21 “Il y avait le ministère de la Coopération, j’ai demandé un rendez-vous. Quelqu’un m’a reçu et m’a (...)
“There was the Coopération Ministry, I asked for an appointment. Someone received me and explained to me which places it would be possible to go to. I saw that there was a psychiatric hospital in Bobo-Dioulasso that was asking for a doctor. It was a bit by chance, maybe, I didn’t have much choice, I would have preferred Dakar, but Dakar was already all taken, to work with Collomb. But on the other hand, in Dakar, I would still have been the student, a bit subservient. Whereas if I came to somewhere where I’d have to organise everything, that would put me in a more creative situation. So there, I arrived in Bobo, it must have been in October 1972.”21
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
27Within the small corpus of archives which Renauld allowed me to consult, we find two notes which he wrote at the time of his departure for Bobo-Dioulasso, which describe two things: the state of mind of this young coopérant of 32 years of age, and the negative image people had of the coopération system in French society at the time.
- 22 “Vous débarquez à l’aéroport, de cette caravelle d’Air Afrique dans laquelle l’atmosphère condition (...)
- 23 In Jean-Louis Renauld’s private archives, we have added in a numbered reference which indicates the (...)
“You disembark at the airport, from this Air Afrique Caravelle in which the conditioned air imported from Europe pushes back to the last moment the shock provoked by the contact with your skin and right into the inside of your lungs of this thick, greasy, humid, smelly air, the air of the savannah at the heart of the rainy season.
You are given a ceremonial welcome by the hospital doctors and their wives. All of them are white. You are supported, invited, transported, fed, integrated, digested, by the colony of white doctors for a week. No black person is involved in this welcome. Much later you will learn that there are black doctors at the hospital. None of them will ever invite you to their home.”22
(Private archives of Jean-Louis Renauld [AP Renauld] 153322, undated handwritten note.23 See Document 4 below)
28These are the first impressions recorded on paper by Renauld, soon after his arrival in Upper Volta. We see suggested in this narrative the paradox that was inherent to these stories of coopération (Guth 1984; Peralodi and Terrazzoni 2016). On the one hand a “dream of otherness,” which is expressed by the desire to leave, in the exoticism-laden description of his arrival, combined also with a “dream of assimilation,” underlined by his desire to distinguish himself from the other French people and his desire to throw himself into a new culture (Guth 1984, 16).
29And on the other hand, there is a weightier reality, illustrating the persistence of colonial relations. Jean-Louis Renauld was still an agent of the Coopération Ministry of the former colonial power, and his very function of head doctor at the psychiatric unit gave him a hierarchical position of authority in his relations to the local population, with the image of the “white doctor” as a backdrop (Peiretti-Courtis 2021). Furthermore, his “contractual exile” (Goerg and de Suremain 2014, 8), which was limited to a period of two years, did not allow him to realise this dream of assimilation. As is highlighted in fact by his note, we instead tend to observe a phenomenon of “communalisation” (Guth 1984; Beck 2016) between coopérants who would work together, invite each other, share the same activities and the same social lives.
30In a second handwritten note found in Renauld’ private archives, and which is difficult to contextualise, the departure of a psychiatrist for Africa is negatively highlighted:
- 24 “Y’a pas à dire, ces psychiatres ils ont vraiment un grain. Je vous assure, j’en connais un, il ava (...)
“Well these psychiatrists really have a screw loose and that’s a fact. Honestly, I know one, all he had to do was sit down in his chair and watch his clients go by on his couch. Nice and easy, you know, he’d regularly pick up his little bag of loot. Instead of that, you’d think he was even more eaten away by these complexes than his clients, there he goes, off to the Zulus or something similar, at the head of a kind of stables, what am I saying a pigsty, and there he is strutting around this freak show, I’m the big white witch doctor and I’m going to heal you of your crazinesses! He wasn’t right in the head, he’d go into a transe too, that’s why he went over there! I tell you, he was good to stay with his crazies.”24
(AP Renauld 153133, typewritten document on paper bearing the letterhead “Docteur Jean-Louis Renauld,” undated. See Document 1 below)
31At first sight, this thought, which Jean-Louis Renauld himself was not able to put back in its original context during our interviews, is more of the order of an anecdote, a short, partial—in both senses of the word—tale. However, rather than delegitimising this type of “trace,” I view such notes as starting points that allow us to elaborate hypotheses, both regarding what this kind of discourse tells us about the man and his career, and the social, historical and professional context it is part of.
32In relation to this handwritten note, we can put forward the hypothesis that a twofold negative representation is at play here. There is a first one connected to the very profession of the psychiatrist, portrayed as a job that is not very hard but nevertheless lucrative, and a second one connected to leaving for a coopération assignment. This desire to discover foreign lands is mocked, misunderstood. The person wanting to leave is suspected of being mad himself. In the view of his detractors, what a strange idea it is to go into exile so far away on a continent whose description is suffused with racist imagery, making brutes of local populations that are reduced to the status of savages.
Illustration no. 1: Portrait of Jean-Louis Renauld in Bobo-Dioulasso, 1974
Credit: Jean-Louis Renauld.
33Aside from letting persons suffering from mental disorders be cared for by their communities or families, the city of Bobo-Dioulasso, during the colonial period, only had a “lazaret” consisting of a few pavilions where “lunatics” who were agitated or had been picked up by the police were locked up. No treatment was delivered, and the institution mainly aimed to isolate individuals who posed a risk to public order (Zoungrana 1992; Tiquet and Hien 2023).
- 25 “La ségrégation a produit l’abandon, qui lui-même a engendré un univers désespéré du côté des infir (...)
34A psychiatric unit was opened in 1957, two years before independence. Despite being part of the Bobo-Dioulasso regional hospital—which is now the Centre hospitalier universitaire Sourô Sanou (CHUSS)—it was located 4 kilometres away from there, on the edge of town, stuck between the “trypano” centre (the former regional centre for treating patients suffering from human trypanosomiasis in West Africa), the slaughterhouses and the railways lines. The geographical position of the unit and its asylum-style architecture (a prison-like building—bars on the windows and a closed space—patients piled on top of each other and locked up) set the tone: this was more of a place of relegation and exclusion than of care. Initially designed to cater to seventy patients, it housed over two hundred when Renauld arrived in 1972: “Segregation had produced abandonment, which itself created a desperate environment for the nurses, and a cesspit for the patients”25 (Renauld 1973b).
Illustration no. 2: Hand-drawn sketch showing the location of the psychiatric unit
Credit: Jean-Louis Renauld. See also Document 8 below, Typewritten page with a map showing the location of the psychiatric unit, undated.
Persistent identifier: https://doi.org/10.34847/nkl.ff1238p7.
- 26 “[Le service] est devenu l’obstacle principal au traitement des malades mentaux.”
- 27 “un cadeau empoisonné de l’ancienne métropole au nouvel État indépendant.”
35Whether it was in our interviews, his notes or the scientific articles that Renauld wrote about his experience in Bobo-Dioulasso, the psychiatrist could not find words harsh enough to describe the state of the institution as he found it when he arrived: “[The unit] has become the main obstacle to treating the mental patients”26 and constituted “a poisoned chalice offered by the former mainland to the new independent country”27 (ibid.).
- 28 “L’Asile est en fait directement lié à l’idéologie coloniale, et […] de ce fait, sa liquidation res (...)
36His initial observation was as follows: “The asylum is in fact directly connected to colonial ideology, and […] as such, its elimination remains subject to a purely Western logic. […]. This has […] never worked in favour of a liberalisation or even a medicalisation of psychiatric practice”28 (AP Renauld 153125, notes on paper bearing the letterhead “Docteur Jean-Louis Renauld,” undated [see Document 1 below]).
- 29 Centre des Archives diplomatiques de Nantes (CADN), MAC Ouagadougou, 499PO/1/672, Projet de dévelop (...)
- 30 This decree was inspired by the Law of 1838 in Metropolitan France. Psychiatric care underwent a ma (...)
37This severe judgment can be explained in two ways. Firstly, by a desire to stand out and “go down in history.” Trained in a school of psychiatry that was very critical of the institution, the unit Jean-Louis Renauld was discovering was a fertile terrain for experimentation for him. Secondly, the department, which was still quite new, had not had a duly appointed psychiatrist until 1971. Before this date, it had been administered remotely by military doctors assigned to the hospital of Bobo-Dioulasso and not specialised in psychiatry. In addition, no legislation specific to psychiatry had been implemented in Upper Volta. It would take until the end of the 1980s for Burkina Faso to launch, in collaboration with the WHO, a mental health development programme across the whole of its territory.29 The treatment of patients at this point was based on legal texts of a generalist nature, and on the Colonial Decree of 1938 that created a psychiatric assistance service for “colonial lunatics” in the federation of French West Africa (AOF – Afrique-Occidentale française).30 Jean-Louis Renauld, in an undated letter which he probably wrote to Henri Collomb, shared his dismay at this situation:
- 31 “J’ai pris contact avec le procureur. Lui-même est tout à fait ignorant des lois concernant les mal (...)
“I have contacted the prosecutor. He himself is entirely ignorant of the laws concerning mental patients, and I find myself faced with this dilemma, whether I should draft for Upper Volta and the health code a law on internment, including all arrangements for free and voluntary institutionalisation, or whether I should leave the legislator in its current grey area. I have not yet examined the problem from all angles, everything currently happens as though the patients were sectioned, except that the Law of 1838 is applied with all the fantasy, randomness and sloppiness of Africa.”31
(AP Renauld 153647-713, Letter from Jean-Louis Renauld to Henri Collomb, undated, probably a few weeks after Renauld’s arrival in Bobo-Dioulasso)
- 32 “Introduire la psychothérapie dans un service de psychiatrie qui fonctionne sur le même mode qu’une (...)
- 33 “détricoter la camisole…”
38It is difficult in this context to import the methods of institutional psychiatry or practices inspired by his experience of Fann: “Introducing psychotherapy into a psychiatric unit that works in the same way as a prison would be tantamount to idiocy or fraud”32 (AP Renauld 153118, typewritten document on paper bearing the letterhead “Docteur Jean-Louis Renauld,” undated [see Document 1 below]). His first task would then be to “unknit the straightjacket”33 that had been elaborated by the colonial administration. In order to achieve this, he initiated two projects: modifying the asylum-like structure of the department’s buildings and changing the professional ethics of the nursing team.
- 34 “Un travail important a été entrepris pour transformer ce qui était une prison, en un lieu pourvu d (...)
“Considerable work was carried out to change what was a prison into a place equipped with a minimum level of hospitality.”34
(AP Renauld 153125, typewritten document on paper bearing the letterhead “Docteur Jean-Louis Renauld,” undated [see Document 1 below])
39Renauld initially set out to transform the very structure of the hospital premises. Doors were opened up into the walls in order to allow patients and their families to circulate freely between the different hospital pavilions, the idea being to make the patients go outside the buildings as often as possible.
Illustration no. 3: Men’s Building and Men’s Courtyard, undated
- 35 Most of the photographs presented here are of relatively poor quality. This is due to the way the (...)
Credit: Jean-Louis Renauld.35 See also Document 16 below, Bobo-Dioulasso, July-October 1974: photographs of the unit, of the psychiatric village and of the team.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
40During our interviews, Jean-Louis Renauld lingers over this “shack” we see in the photograph (see illustration no. 4). Called the “coopération hut” because it was financed by the Ministry on the occasion of a visit from one of the Pompidou government’s Africa advisers, this hut was the space that was favoured—in the style of the “palaver hut”—by Renauld and his team to organise interviews with the patients.
Illustration no. 4: Photograph of the “Coopération Hut,” 12 July 1974
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
41But the greatest project launched during these two years was the construction of a small “village” adjoining the unit and made up of two types of “traditional” huts, one using Mossi architecture (“paillotes,” or shacks) and the other Bobo architecture (“square terraced” huts).
Illustration no. 5: Sketch of the walls and roofs of the psychiatric village huts
AP Renauld 153307. See Document 3 below, handwritten notes by Jean-Louis Renauld on the village’s banco huts, undated (between 1972 and 1974).
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.b7914f4x.
- 36 “Ce village c’était une révolution. J’avais appris ça chez Collomb. C’était véritablement une révol (...)
42Inspired by similar experiments carried out by Collomb in Senegal (Collomb 1978; Collignon 1983), the aim of this “psychiatric village” was twofold: to get the patients involved in the construction of these huts, and to organise a living space similar to a village in order to receive the families of patients and bring a little outside life into the unit. “This village was a revolution. I’d learnt that with Collomb. It really was a revolution. It has to be said too that the patients were also involved in the construction of the huts all around”36 (interview with Jean-Louis Renauld, 20 January 2022, afternoon). The village was completed before the winter of 1973 and the first patients and their carers took up residence there:
- 37 “Dans un premier temps, le malade est soigné intensivement dans les bâtiments anciens. Dès que son (...)
“Initially, the patient receives an intensive treatment in the old buildings. As soon as his behaviour becomes tolerable for the family (usually by the end of a week), the patient is entrusted to the family in the hut that has been reserved for him. Parents are taught how to provide the care the patient requires, with this now taking place in a relaxed atmosphere, and where the nursing staff finds radically transformed working conditions.”37
(AP Renauld, 153738-819, “Considérations préliminaires concernant la construction d’établissement pour malades mentaux en Haute-Volta, 1973” [see Document 15 below].)
Illustration no. 6: Photograph of the “psychiatric village” with part of the unit’s team, 15 July 1974
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
43Several photographs taken by Renauld at the time show scenes of life around the village and psychiatric unit.
Illustration no. 7: Photograph of a carer and a kitchen, 17 July 1974
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
- 38 “Jean-Louis Renauld : Alors voilà, ça, imaginez c’était la cuisine d’une accompagnante voilà, en to (...)
“Jean-Louis Renauld: So here we are, this, imagine it was the kitchen of a carer, there, at any rate it’s funny the people with their bikes so there was also a fountain that was there that was at people’s disposal and the people from the town would come to fetch their water from the fountain.
– Romain Tiquet: So it was a meeting place too?
– J-L R: Yes yes yes and there were hawkers who would come and the carers would buy either food or little knick-knacks from the merchants who would come to this place.”38
(Conversation about the photographs with Jean-Louis Renauld, 20 January 2022, morning.)
Illustration no. 8: Photograph of the fountain close to the “psychiatric village,” 19 April 1974
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
44On this photograph, we see the watering hole that was installed at the back of the village, near to the railway line. In the background is a little garden tended to by the nurses and the unit caretakers. The construction of this village and its workings then made up Jean-Louis Renauld’s main activity during this stay, as is shown by most of the photographs presenting the village, even if the experiment remained limited. Only seven huts were available for all the patients.
45When Jean-Louis Renauld arrived in Bobo-Dioulasso, he found a team in place at the unit made up of nurses, unskilled workers and caretakers. He remembered each person’s role with joy and nostalgia upon seeing a group photograph which he took at the time.
Illustration no. 9: Photograph of the nursing team in front of the “psychiatric village,” 30 October 1974
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
- 39 “Alors ça c’est (rires), ça c’est le major [le plus grand sur la photo]. Il y avait deux infirmiers (...)
“Well, this is (laughs), this is the medical officer [the tallest one in the photograph]. There were two nurses, one who was Mossi, the other Senufo. This one, I can’t remember what job she did, she did very good work. She was a nurse or something like that. And this one was the medical officer’s auxiliary and all the others were carers who took care of the premises, they were the caretakers. Only the ones who were in white were carers with an official qualification.”39
(Conversation about the photographs with Jean-Louis Renauld, 20 January 2022, morning)
46Renauld’s second challenge was to try to change the nursing team’s practices. He believed it was necessary to “demythologise” mental illness and make the nurses understand that the “shack” (meaning confinement) was not the only treatment. But the psychiatrist had his work cut out for him:
- 40 “Qui donc va accepter d’aller travailler en enfer ? Du plus gradé au moins gradé, c’est la fuite. L (...)
“Who on Earth will agree to go and work in Hell? From the highest rank to the lowest, everyone is running away. Since its foundation in 1958, the unit has had three psychiatrists during the periods 1958-1960 and 1970-1973. Between these two periods, one of the doctors from the general hospital, which is located 5 km away from the psychiatric unit, was responsible for it. The unit is left in the hands of the nurses, and their assignment to the psychiatric unit is seen as a punishment…”40
(Renauld 1973b)
47And he goes on:
- 41 “Toute la morale professionnelle, guidée par le principe général d’évitement du malade mental, pouv (...)
“The whole professional ethics, which was guided by the principle of avoiding the mentally ill person, could be summed up as follows: the higher up the caregiver was in the hierarchy, the more the institution had a duty to keep them far away from the patient. Thus, for example, when I was interviewing a patient, the nurses would take care to keep him well away from me under the pretext that I had to beware of the patient’s lice.”41
(AP Renauld, 153126, typewritten document on paper bearing the letterhead “Docteur Jean-Louis Renauld,” undated [see Document 1])
- 42 “corps à corps avec le malade…”
- 43 “à celle du manœuvre qu’à celle de l’infirmier…”
- 44 “la connaissance intime qu’ils avaient du malade…”
- 45 “dans un premier temps complètement dérouté l’équipe soignante…”
48Jean-Louis Renauld thus now found himself, after having spent several years practising institutional psychotherapy, in which the watchword was to be prepared to engage “hand-to-hand with the patient,”42 engaged in a way of relating to patients that was much closer “to that of the unskilled worker than of the nurse”43 (these are his own words). Nevertheless, he quickly attempted to impose his work style, which involved engaging in a close relationship with the patients and not paying heed to the hierarchical positions within the unit’s team, but only “to the intimate knowledge they have of the patient.”44 According to his own account, these methods “initially completely flummoxed the nursing team”45 (ibid.). According to him, the idea of a “relational” psychiatry appeared to the nurses as one of these slightly wacky “toubab” ideas. If the unit did try to move away from the simple concern of watching over the patients, the nursing team would turn to the biomedical model—meaning the use of a drug-based solution—which restored distance, authority and dignity to the nurse.
- 46 We did not ask Renauld about what impact this experience had on the development of his own medical (...)
49Despite the nursing team’s initial reticence, it seems that the bet did pay off to a certain extent. The facility was made to look less like an asylum, a “psychiatric village” sprouted out of the earth, and a reflection on the relationship to illness was initiated, both together with the nursing team and with the patients’ families, who were invited to stay at the unit and take part in its daily life. Renauld’s assignment more widely illustrates how therapeutic models would circulate in West Africa in the 1970s, in a context that was heavily influenced by a methodical criticism of asylum-based psychiatry and the influence of the “Fann School” as a breeding ground for the foundation of a psychiatry in the community and embedded in the local social and cultural fabric.46
- 47 I found, in the unit’s archives, two psychiatric expert assessments signed by Renauld, for the atte (...)
50Because the corpus at our disposal mainly focuses on Renauld’s practice, it is impossible for us to examine in detail the lives of the patients in the unit. We would need other sources—such as the patient files47—to retrace this history. Nevertheless, it is possible, based on certain sentences, on a few scattered notes, to formulate certain thoughts about the patients treated at the unit.
51Bobo-Dioulasso, which is located in the South-West of the Burkinabé territory, was an area that thousands of Voltaic migrants passed through on their way to work on plantations in the Ivory Coast (Zanou 1994; Mandé 1997).
- 48 Renauld is referring here to Saint Paul, using his Jewish name Saul, who, on the road to Damascus, (...)
- 49 “Bobo-Dioulasso, Novembre 1972
Un gamin est amené par la police au service de neuropsychiatrie. Comp (...)
“Bobo-Dioulasso, November 1972
A kid is brought into the neuropsychiatric unit by the police. Abnormal behaviour in public. What were you doing on the road?
– I was walking to the Ivory Coast. My father told me go over there and come back to the village when you’ve made some money.
– Where have you come from?
– From Koudougou (200 km).
– What were you doing on the road, we’ve been told you were attacking people?
– No I wasn’t! I was talking to God!
– Eh?
– When I was on the road, a bolt of lightning tore through the sky and I started communicating with God.
– How long ago did you leave, what day is it today?
– Today is the day of my death, and the day of my birth.
– How old are you?
– In the eyes of human beings I’m 18, but in the eyes of God I have no age because he makes me be born at every moment!
The medical officer to the doctor: In my opinion this guy is completely mad!
Was that really the issue? I thought about Saul on the road to Damascus.48 He too was completely mad.”49
(AP Renauld 153330, typewritten document on paper bearing the letterhead “Docteur Jean-Louis Renauld,” Bobo-Dioulasso, November 1972 [see Document 5])
- 50 The shift reports from the 1960s, which I consulted in the unit’s unclassified archives, often ment (...)
- 51 “Une frayeur persécutive avec hallucinations…”
52Jean-Louis Renauld, during these two years at the unit, was struck by the constant presence of young Voltaic migrants on the way back from the Ivory Coast, who had fallen ill on the train and been sent to the Bobo-Dioulasso psychiatric unit, the first of its kind on their route home50. On the train, these young people were most often stricken with anxiety, which the psychiatrist explained alternately by the fear of the failure of their migration (fear of debt if they did not bring back enough money to their extended family) or by a decompensation due to a lack of sleep after having taken stimulants in order to stay awake and not be robbed of their money during their return trip. “A persecutory terror with hallucinations”51 (Renauld 1973b) would follow, which was treated by the psychiatrist and his team following the same protocol: electroshocks and stabilisation using neuroleptic drugs.
- 52 “Ceux qui faisaient une bouffée délirante dans le train, pour ces gens-là je commençais par leur fa (...)
“Those that had an episode of delirium on the train, for those people I would start by giving them an electroshock because it would screw their head back on straight, I was used to it […]. So someone comes in and they were completely agitated, and instead of knocking them out with an injection of neuroleptics, well, we’d go to an electroshock. Electroshocks do after all have this ability to purge the brain of all its chemical mediators. And those people, who had come from the train and were sometimes having a manic attack or an acute attack, all you had to do was give them an electroshock and then slowly a tiny bit of a neuroleptic drug so they wouldn't fall back into their thing from before, and after ten days they would be cured and they would leave again.”52
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
- 53 “conflit entre un moi qui revendique un destin individuel et compétitif et un moi soumis à la loi d (...)
- 54 “entre-deux-culturel…”
53Renauld explains these crises in psychoanalytic terms, as being evidence of a “conflict between a self who is claiming an individual and competitive destiny and a self who is subject to the law of the group and of the ancestors, forged by traditional society, central place of money as a signifier”53 (ibid). This sentence is somewhat reminiscent of the observation of a former head doctor at the Fann psychiatric unit, Momar Guèye, who spoke of a “cultural in-between”54 to describe the tension inherent to these young people torn between the claim of a certain individualism, the sign of a new “modernity,” and the reminder of their social and family environment, in which any individuality was subsumed in the collective unit constituted by the family (Guèye 2009, 35).
- 55 This claim was not confirmed, however, during an informal conversation with Jean-Louis Renauld’s su (...)
54Thus, as has been pointed out by Sanou Zezouma, the first Burkinabè to be head doctor from 1979 (Zezouma 1981 2017), the disorder created on the journey home can be explained as the sign of a desire to escape from the weight and expectations of the family unit. As such, without having access to more detailed sources, we can imagine that hospitalisation in the unit, for many of these people, was a necessary refuge, a transition between the period of migration and their return to the village. In some cases, in fact, Renauld mentions that the issuing of a prescription was used by these patients as a kind of “laissez-passer” to return to the village in case the migration had turned out not to be the desired and expected path to success.55
55The following can be read in a note found in Jean-Louis Renauld’s archives:
- 56 “Autrefois les fous étaient enfermés dans le béton toute la journée, ne sortant que quelques heures (...)
“In the past, madmen were locked up inside concrete all day, and only went out for a few hours during the morning into a fenced-off courtyard. They presented a spectacle that was very popular with the schoolchildren who would come to be vaccinated in their hundreds at the great endemic diseases dispensary, which was right next to the leper colony. This was what you might call the reward after the injection: there was always somebody who would say: An bé ta fatow flé, let’s go and see the madmen. The caretakers often had to chase away the children before they started throwing stones at the madmen to wind them up.”56
(AP Renauld 153528, typewritten document on paper bearing the letterhead “Docteur Jean-Louis Renauld,” undated [see Document 8])
56Throughout his coopération assignment, Renauld, working together with the nursing team, tried to change the views local populations had of the patients and the unit. In this regard, the psychiatrist, during our interviews, mentioned two anecdotes that illustrate the necessity of “reassuring” the populations about the danger or supposed “derangement” of the patients. During a conversation that was sparked by the sight of a photograph showing one of the unit’s buildings, taken on the psychiatric village side, Jean-Louis Renauld lingered over the curtain of trees that we see appear in the background, and where we can make out posts holding up a metal wire fence.
Illustration no. 10: View of the unit on the psychiatric village side, 27 May 1974
Credit: Jean-Louis Renauld.
Persistent identifier: https://doi.org/10.34847/nkl.90aexl3b.
- 57 “J-L R : Quand je suis arrivé il y avait ce grillage et si j’avais enlevé ça, ça aurait pas été bon (...)
“J-L R: When I arrived there was this fence and if I had removed that, that would not have been good, you couldn’t let the madmen go out all the time after all, there were always two nurses or nursing auxiliaries who were there, at the point where there was an opening in the fence, and who would let people go in and out or not.
– R T: Right, so there was still a need to reassure people.
– J-L R: Yes, because in general the patients would arrive from their village far away because they were unbearable in the village, people couldn’t put up with them anymore and the people in the village were always afraid they would be let loose without warning so they would come and get up to mischief.”57
(Conversation about the photographs with Jean-Louis Renauld, 20 January 2022, morning)
57The idea of having a visible separation (the trees and the fence) had been suggested by the unit’s medical officer in order to contribute to maintaining a physical and “moral” distance between the populations and the “patients,” while also reassuring the population about the fact that the “madmen” were not entirely free to come and go.
58While talking about the young people who were returning from the Ivory Coast and had been treated using electroshocks and neuroleptic drugs, Renauld came back to the effect of the treatment:
- 58 “J-L R : Heureusement qu’il y avait ces gens-là, heureusement, car ça pouvait faire la preuve que q (...)
“J-L R: Luckily we had those people, luckily, because it could prove that someone who was mad, after a certain amount of time, after a few days, he wasn’t mad anymore.
– R. T.: Luckily, for the other patients? Or for everybody?
– J-L R: For everybody, to show that it wasn’t an asylum where people were being locked up forever. When I arrived there were people who’d been there for five-six years, isolated and who didn’t move.”58
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
59For many patients, a stay at the psychiatric hospital meant certain social death, a sign of their abandonment by their family group and of their having broken with it. But Jean-Louis Renauld, as a practitioner of institutional psychotherapy, saw keeping the patient within their family and social circle as the keystone of the therapeutic process. At the same time as the construction of the village, Renauld introduced, from 1973, the model of housing carers within the unit, inspired by the experiment that had been conducted a few years earlier at Fann (Kilroy-Marac 2014; Koundoul 2015).
- 59 “Son système symbolique c’était de représenter l’hôpital pour les gens du village et de représenter (...)
60The carer was usually a relative or member of a patient’s family who would come to stay at the unit in one of the huts of the “psychiatric village”: “His symbolic system was to represent the hospital for people in the village and to represent the village for people at the hospital. If things aren’t working out, you have to know how things happen in the village and it’s up to you to take him back or to tell the family to take him back if things aren’t working out”59 (interview with Jean-Louis Renauld, 20 January 2022, afternoon.)
- 60 See AP Renauld 153738-819, “Considérations préliminaires concernant la construction d’établissement (...)
61For patients of which over 40% were not originally from the Bobo-Dioulasso area, but rather from several hundreds of kilometres to the North or East of the country,60 keeping up their family and social connections through a carer remained a vital aspect of their therapeutic care.
- 61 “On soigne avec les médicaments, l’électricité et la parole.”
62The sentence used in this title was not said in Bobo-Dioulasso but in Fann, in the 1960s, by a nurse at the clinic (Storper-Perez 1974, 19). Nevertheless, it perfectly applies to the therapeutic pluralism that was introduced to the Bobo-Dioulasso psychiatric unit.
63Regarding the treatments he had at his disposal, it seems, when we listen to Renauld, that when he arrived only chlorpromazine was prescribed within the unit. This molecule had a very considerable sedative effect, prompting the clinician to state that the psychiatric unit “did indeed deserve to still be called the hypnosarium” (Renauld 1973b).
64Less strong neuroleptics, administered in tablets or through injections, were then slowly introduced at the start of 1973, and allowed patients to be treated without being kept in a state of somnolence. In addition, these drugs allowed for patients to participate in the daily life of the unit, in particular during the making of bricks for the construction of the village (interview with Jean-Louis Renauld, 20 January 2022, afternoon).
65Aside from neuroleptics and electroshocks, Jean-Louis Renauld also very much relied on individual psychotherapies (conducted in French), which placed conversation and speech at the heart of the doctor-patient relationship. The central role of speech in therapeutic treatment, however, raises the question of access. For example, an agitated patient will not always be able to communicate. In addition, the very framework of the conversation, organised between the doctor and the patient, could appear as a therapeutic ploy and an act of symbolic violence, since verbalisation sometimes imposed a fundamental cultural transgression (Ortigues and Ortigues 2000; Tiquet 2023).
66The issue of language and its translation also posed a challenge here, especially in a context of strong linguistic diversity. This reflection on languages and their meanings is in fact a point that Renauld has been interested in since childhood:
- 62 “Le fait d’avoir été en Allemagne à l’âge de 5 ans, j’ai eu ce privilège que beaucoup ont quand ils (...)
“The fact that I was in Germany at the age of 5, I had this privilege that many people have when they have parents who, for example, come from a different background, this ability to understand that from one language to the other, there is not, between words, an “equal” like you find in mathematics. The meanings of one word and another can be the same, but one word does not speak the same.”62
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
67In this context, Renauld stands by his choice to have carried out intensive individual courses of psychotherapy, involving one consultation a week over several months, only with patients who spoke French perfectly, patients who were “acculturated,”63 to use the psychiatrist’s own terms (ibid.). For the others, he was supported by the nursing team, which would translate or conduct the consultations.
- 64 “Je pense qu’on ne dit pas au Blanc des choses et que c’était important aussi qu’il y ait un autre (...)
“I think there were some things you didn’t say to the White Man and that it was important for there to be another space for speech that did not use French. The medical officer was there to get me to understand a certain number of things. I spoke a little Dyula, but I didn’t understand a word of [the] Bobo [language] and the Bobos sometimes spoke French, you had to be able to chat a bit like that.
For example, I would say to someone: ‘Ask him a few questions about this,’ and so the conversation would happen between him and the patient. I often got the nurses to help me, you can’t play the guy who understands everything. In fact, I didn’t understand a thing in a way.”64
(Interview with Jean-Louis Renauld, 20 January 2022, afternoon)
68In this last extract, Jean-Louis Renauld underlines the importance of going beyond the framework of the sole relationship between the white doctor and the patient, in order to achieve a verbalisation that might contribute to the patient’s recovery. In his last sentence, he furthermore underlines two other elements. The first is that a distinction must be made between verbalisation—as therapeutic process—and comprehension by the doctor or the nursing team. Secondly, by insisting on the fact that he “didn’t understand anything in a way,” he is just as much underlining the language barrier as his ignorance of the cultural, social and family dynamics between the local populations and himself.
69Starting from Jean-Louis Renauld’s career, this article has brought to light three lines of analysis. Firstly, accepting a certain closeness to my interlocutor, I have mainly examined Renauld’s life and professional career in order to explore the motivations that led him to become a coopérant. Trained in institutional psychotherapy in a context in which the psychiatric institution had been being called into question since the 1950s, and greatly influenced by the “Fann School,” Jean-Louis Renauld arrived in Upper Volta in the early 1970s. Then, by relying on a corpus of sources that is admittedly limited but diverse, I have attempted to explore the daily life of the Bobo-Dioulasso psychiatric unit through the “projects” that Renauld initiated there: a break with the asylum model and an introduction to the nursing team of a new professional code of ethics, by demythologising mental illness and introducing a more “relational” form of psychiatry.
70Finally, starting from the observation that the corpus of sources I used remains very focussed on the figure of Renauld, I have tried to get a sense of the experience of other players by analysing certain patient profiles and the relationships that existed between families and society, both in terms of mental disorders and of the psychiatric unit.
71I mentioned in the introduction to this article that the initial idea for this text came from a lack and a desire. It ends with a kind of dissatisfaction and relative frustration. A dissatisfaction at only having been able to use the “psychiatrist’s sources” and not “the sources of madness,” to use the title of this special issue. A frustration at not having entirely been able to extract myself from Renauld’s professional career stricto sensu in order to analyse in detail the daily working life of a new West African psychiatric unit in the 1970s.
72Beyond its exploratory approach, this article, by exclusively using private archives and resorting to interviews, poses a methodological challenge that brings to light some of the issues connected to the use of these sources that are ambivalent, but essential to writing the history of psychiatric units in West Africa, and more largely the history of Africa itself. We must stress the risk of falling into a hagiographic narrative, adopting the discourse of a man who wants to show that he has “left a trace” and who enjoys presenting himself as a pioneer who upturned the way the psychiatric unit functioned. Another risk is that one might tend to come up a little too fast with hypotheses that are not verifiable due to a limited corpus, and which constrain us to proceed from “trace to trace.” These scattered notes, these sketches, these anecdotes recorded in writing or mentioned during our interviews, the small corpus of photographs, are all elements that illustrate a fragmented, partial and discontinuous personal and professional memory. But their use and their analysis also allow us to make other memories emerge in the background, be it that of the coopération system or that of a psychiatric unit in West Africa, one decade after independence.
01. Typewritten Notes on the Daily Life of Jean-Louis Renauld at the Bobo-Dioulasso Psychiatric Unit
73
- 65 “Assistance Psychiatrique Régionale en Afrique – les villages thérapeutiques”
02. Annexe (Regional Psychiatric Care in Africa—Therapeutic Villages65)
74
03. Handwritten Notes by Jean-Louis Renauld on the Village’s Banco Huts
75
04. Handwritten note by Jean-Louis Renauld on his arrival in Upper Volta
Untitled, undated (between 1972 and 1974).
AP Renauld 153322.
Persistent identifier: https://doi.org/10.34847/nkl.cceat536.
05. Typewritten note by Jean-Louis Renauld about a young man on his way to the Ivory Coast who was brought to the unit by the police
Untitled, November 1972.
AP Renauld 153330.
Persistent identifier: https://doi.org/10.34847/nkl.22a9h9x6.
06. Typewritten page by Jean-Louis Renauld on daily life at the psychiatric unit
07. Renauld, Jean-Louis. 1973b. “La psychiatrie à Bobo-Dioulasso – 1973”
08. Typewritten page with a map showing the location of the psychiatric unit
Jean-Louis Renauld, undated.
AP Renauld 153528.
Persistent identifier: https://doi.org/10.34847/nkl.ff1238p7.
09. Handwritten notes about patients treated by Jean-Louis Renauld (1972-1974)
AP Renauld 153537, 153542, 153555, 153604, 153610.
Persistent identifier: https://doi.org/10.34847/nkl.feab29d0.
10. Quotes in Dyula and in French, handwritten
Jean-Louis Renauld, undated.
AP Renauld 153618.
Persistent identifier: https://doi.org/10.34847/nkl.6bf5s39t.
11. Typewritten note by Jean-Louis Renauld on the relationship between staff and patients in the Bobo-Dioulasso psychiatric unit
Untitled, undated. Page bearing the Renauld letterhead.
AP Renauld 153626.
Persistent identifier: https://doi.org/10.34847/nkl.e28c67u0.
12. Handwritten note by Jean-Louis Renauld on a patient describing his rural background
Undated.
AP Renauld 153633.
Persistent identifier: https://doi.org/10.34847/nkl.2bccg656.
13. Handwritten letter from Jean-Louis Renauld on letterhead paper, probably sent to Henri Collomb at Fann
76
14. Typewritten letter from Jean-Louis Renauld to an American at the Catholic relief service to request support for the psychiatric unit
77
- 66 “Considérations préliminaires concernant la construction d’établissements pour malades mentaux en (...)
15. Typewritten page by Jean-Louis Renauld: “Preliminary Considerations Regarding the Construction of Establishments for Mental Patients in Upper Volta”66
78
16. Photographs of the Bobo-Dioulasso psychiatric unit, of the psychiatric village and of the staff, July-October 1974
79
17. Photographs of the Kenia-Émile Badiane psychiatric village, Ziguinchor, Senegal, February 1974
80
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