Friday, March 20, 2009

Sickness and Culture Clash

One of our students was away for the last few days. Turns out her daughter was unwell and had been in the local hospital.

“Malaria,” I asked? That’s by far the most common illness in Naivasha – even though there isn’t any malaria in this area (or very little). We don’t have the right species of mosquitoes living here which carries the malaria parasite. But that doesn’t stop the doctors from diagnosing everybody who comes to see them with malaria. All they need to have is a hint of a fever: malaria! Sometimes they don’t even have to have that and they leave the hospital with medicine for … malaria.

And if it isn’t malaria then it’s typhoid.

But in this case the little girl had neither. She had a white tongue and pneumonia according to the doctors. The mother was told the white tongue was because she has allergies.

Allergies. That’s another one like malaria. Parents bring their children to the school and half of them warn us about the child’s allergies. They’re allergic to beans, to meat (unusual, that one, in a country where “nyama choma,” roasted meat, is a luxury), to milk, to rice, to cabbage, to tea. I don’t quite understand it. What seems to happen is the child gets sick, goes to the local hospital, doctor looks at child then decides it is suffering from one of three things: malaria, typhoid, or allergies.


“Matumbo” (stomach) – when you can’t afford “Nyama Choma”

Sometimes being told you are allergic to a particular food can be quite useful! Don’t like beans? Can’t eat them; allergies, you know. Imagine what frustration this caused when we were preparing meals during youth camps. You never knew what to give or how to deal with people’s dislikes. Do you dare tell them what you think about the doctor’s advice?

But back to the little baby girl. It turns out that the child had not been feeling well so the grandmother had advised that the girl should go to the local “mganga” (the local herbalist) and have her uvula cut out. The uvula is the small piece of skin hanging down in the back of the throat. They go and after a snip with the scissors, it’s gone. That’ll cure whatever’s ailing you, at least according to the old Kikuyu customs.

The Hippo’s Uvula
(From “Little Polar Bear” by Hans de Beer)

No wonder the child is sick! But when you try and explain how pointless – and even dangerous – this surgery actually is, you just get this blank stare back. I knew this was a common practice in the Kenya of a bygone era. It surprised me to hear that it was still being done!

There is no point trying to tell people information that contradicts what the people in white coats have told them in the hospital. Or, as it turns out, what some herbalist claims will work.

The incident reminds me of the missionary in South America who wanted to prove to people in his local community that colds are the result of viruses and bacteria, not demons. He got out his microscope, prepared the slide, and showed them the bacteria in the sputum specimen. But he wasn’t expecting their response! They looked at his evidence, then recoiled and exclaimed in surprise, “Now we know what demons look like!”

We’ve heard some amazing things about what causes illness! Parents tell us at the school that their child should not drink juice. They should not drink cold water either. Why? Because these things cause colds. Children have become sick because they have climbed mango trees. That is where malaria comes from! I guess that’s not all that different from what the early settlers used to believe, that the yellow acacia trees around the lake caused malaria. After all, whenever people camped under them they suddenly came down with fevers, hence their common name, the “fever tree”.

Giraffe amongst the yellow “fever trees”

Sometimes these beliefs can be more dangerous, like when babies have their uvula cut out to stop illness. Another belief is that taking children outside causes pneumonia. Pneumonia is a big child killer in this country so parents fear it. If taking children outside will prevent it, then that’s just what they will do. The problem is that many people keep their homes very dark. If they have a window, they put curtains over it. Babies therefore spend much of their time in dark rooms and subsequently don’t get enough sunlight.

Surely that is one explanation for why we see so much rickets in this community! So their attempt to protect their children from one illness – pneumonia – leaves the child with another – rickets. How can such misconceptions be corrected, particularly when people in white coats encourage them?

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