NancyLynn once (maybe twice) mentioned she had an uncle, a physician, who spent some time working in Africa. At a family gathering last summer, I met Dr. Swift. A quiet, unprepossessing man, he quickly fascinated me with information bits about how mental illness was perceived in Tanzania. He said that he was publishing a book about his experiences there. When the book was published, I immediately ordered it. I read it this fall. My major criticism is that the book ended.

His writing covered the time from his and his family’s arrival in 1967 until their departure in 1974. He worked as an employee of the new Tanzanian government, setting up a mental health system and, along with his Tanzanian colleagues, training future doctors, nurses and aides. He was based in Dar es Salaam but often traveled the country, setting up a regionally based system, in spite of the obstacles sometimes placed in his way by a few contract physicians who were leftovers from the colonial system or by the lack of immediate funding and personnel. He was able to persuade those in charge to place mentally ill in hospitals, not prisons. His own wry comments on his struggle with his own reactions to the foot dragging by government bureaucracy resonated with some of the experiences my colleagues and I have working in the state system.

Although the chapters are organized by the years he was there, these chapters were filled with short stories about the people and systems he met – government-in-exile liberation movement leaders, Jane Goodall, Zanzibar’s tyrannical government, Tanzanian medical students and colleagues, and interesting friends and neighbors. His criticism of how US aid is not in the best interests of the people of the receiving country touched me in a way more cynical thinking could not, although it should not have surprised me.

Although I initially thought the book rather expensive ($38 or so for a relatively thin paperback), by the time I was halfway through, I thought it worth every penny. There is a gentleness and lack of self-aggrandizement in his writing that I found engaging.