Music therapy in South Africa is slowly negotiating a practice that takes into account our continent's musical vibrancy, as well as contextual understandings of "health" and "illness." Although music therapy in the (so-called) developed world is situated within the paradigms of medicine, education, psychology and research - in the formal and often scientific sense - in South Africa, this practice needs to be re-defined to make it relevant to the contexts in which we work. The Music Therapy Community Clinic (MTCC) is a non-profit organisation whose aim is to provide music therapy services to previously disadvantaged communities in Cape Town, South Africa. Socio-political problems such as poverty, unemployment, gang violence and HIV and Aids have lead to the fragmentation and disintegration of many of these communities. The MTCC's Music for Life project emerged out of a need to provide after-school music activities and to reach a wider group of children than those seen for clinical music therapy sessions. As the project has developed and expanded, the music therapists have drawn in community musicians to offer an increasing range of musical activities to children. The collaboration between music therapists and community musicians has led to many questions about the roles and identities of each. This article is based on a presentation given by the MTCC at a Symposium for South African Arts Therapists held in Cape Town in June 2007. The article discusses the merits and challenges of the Music for Life Project and offers reflections from both community musicians and music therapists pertaining to our negotiated and changing roles as we continue to develop the project together.

Music therapists engaged in musical-social development in territories with well-established legacies of suspicion towards state-sanctioned professional structures face uncomfortable dilemmas. South Africa’s Music Therapy Community Clinic (MTCC) has worked in the Cape Flats, in the Western Cape, for over a decade, and developed priorities and methods in attentive response to that particular market place. The ‘market place’ metaphor signals the possibilities for chaos and flourishing offered by spaces with distinctive – and not necessarily consistent – priorities and edges regarding music, safety, therapy, currency, work, economics and status. These reflections from the market place focus on the complex collisions of professional, musical and community loyalties that music therapists are offered by absent health and education resources and a rich social tradition of everyday music. While situated in a particular South African context, this article seeks to contribute to an adventurous broadening of community music therapy (CoMT) praxes everywhere.

Since forming the Music Therapy Community Clinic and beginning our work in Cape Town's townships, we have been overwhelmed by the needs of the communities, the open arms with which they welcome and invite us in, and the many challenges we meet on a daily basis. At times, we become disheartened, struggling to make sense of our work, and at others, the music just works: it sings, dances, permeates, draws in, explores and explains. As we are writing this article, in June 2005, we are in the process of reflecting back on a busy school term at our Heideveld Project. A new project focuses on a group of adolescents, facing the danger of becoming immersed in the gang culture of this community. This is the subject of this essay.

Without an African Voice, music therapy worldwide risks remaining a practice created by the vast written tracts that have become part of the international music therapy canon. The canon that music therapy students everywhere study, absorb, believe in-and what music therapy is NOT, then, is loudly stated by what the canon omits. Even if music therapy in Africa does not speak 'in the global tongue', it needs to be sounded, voiced, noted, and heard. Or remain invisible, non-existent, an illusion. (Pavlicevic, 2004)