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The carpenter who makes the cajons talks to my friend in Kinyarwanda, telling her he simply doesn’t know how these two boxes he’s crafted can be used as music. As I try them both out, testing the bass notes in the centre of the instruments, and the higher snare sounds at the top, he remains unmoved, his face and his mind unchanged. I beat out rhythms, but he still doesn’t see how a box can be music.

In a group the next week, the bass of the new cajon is imagined as a kick drum and the treble snare sound as a cymbal. I sit on the other new cajon and offer a grounding bass beat to accompany. To all of us it’s music.

A lesson that working here teaches me regularly is that music is defined by each person. Last October I gave a presentation on music therapy to the staff of a psychiatric hospital, made up of about 60 people including a group of student nurses. The student nurses sat together wearing pink scrubs; qualified nurses wore blue scrubs and sat at the back; doctors wore suits; and senior doctors and administrators sat up front wearing nicer suits. I took along drums and sticks and shakers and we were able to play as a drum circle together, managing to improvise ideas and come together with shifting dynamics and textures. I was pretty proud of the cohesive sound we’d made and I spoke about how playing together had connected us from the fragmented way we had begun, bridging the divides of rank and profession. Afterwards I travelled back to Kigali in a car with a couple of the nursing students and they began by saying how it was interesting and useful, which made me feel good. Then they asked “Why didn’t we play any music?”

In music and in therapy, definition and meaning come from the participants. The same song or the same experience can hold very different meanings for different people.

Playing the cajon with groups I can feel the bass rhythm anchoring together the individual strands of the participants’ music. Isolation, marginalisation and fragmentation can be factors that develop from the stigma and identity of HIV. They are also effects common in conflict, poverty, ethnic or social division, and illness. In musical terms, different musical elements can offer a resource to cohesion and stability. In therapeutic terms, consistency, acceptance, and a safe space can provide that resource. Sitting on the firm, structured, grounded cajon, playing a consistent, appropriate bass beat I feel the group is provided with those elements. And in response comes music. How the group defines this, and what it means to them, I’m learning.

When the carpenter sees how much I smile at the sounds his boxes are making he talks to my friend again in Kinyarwanda, telling her he wishes he had quoted a higher price.