Deadly Beliefs

One of the great gifts of having a team nurse is that Heidi has allowed (?insisted) that I not do inpatient rounds EVERY day . . which has freed up Tuesday mornings this month for one of my first loves, community health and medical anthropology, the exploration of beliefs and their impact on health.  There are many strong and healthy and God-reflecting aspects to local culture.  There are many other neutral practices.  But there are a few deadly ideas, beliefs which result in much suffering and needless mortality.  I applaud the former, ignore the middle, and vehemently protest the latter.   I frequently see children in the terminal stages of dehydration and infection who have come to the hospital in a last desperate attempt to save their lives, after their well-meaning parents have subjected them to some barbaric practices.  Though I plead and lecture on the ward, it is a losing battle.  So this month I invited five recent CSB grads (3 of my male students and 2 girls whom I came to know well as their cell group leader) to conduct qualitative research on the topic of "bhiino", or "false teeth".  

These kids conducted 50 interviews with a cross-section of community members, and today we gathered to discuss their results.  The basic idea is that severe diarrhea in infants is caused by the presence of  evil abnormal teeth hidden in the gums, and these offending teeth must be cut out by specialists in the community, extracted by knife-point from the toothless gums of the babies.  This cultural practice filtered into Bundibugyo in the 1970s on the heels of Idi Amin's soldiers, who carried the idea from their home regions to the North.  By now it is so pervasive and popular that EVERY woman and most of the men interviewed reported having taken at least one child for this procedure, and EVERY informant believed beyond the shadow of a doubt that such teeth exist and must be manually extracted to save the life of the child.  

Sadly, the reality is that the mutilated babies refuse to drink, becoming more dehydrated, and the wounds from the non-sterile crude knives often become infected.  We say on our team (in memory of Michael Masso and Kevin Bartkovich) that we are life-long learners.  And though I've been speaking out against this practice for 15 years, I learned new things today.  First, that mothers blame themselves when their baby gets this problem, for not wearing herbal protective charms around their waists consistently throughout their pregnancies.  This struck my heart, because I know that parents allow and in fact pay high prices for this procedure because they truly want what is life-saving for  their child . . and now I realize the underpinning of guilt that makes the whole scenario even more desperate.  Secondly, I learned that the what I consider to be the second most deadly belief, the forcible administration of enemas to babies, is not a completely separate entity but is often combined with the tooth extraction.  So the baby who was already sick, whose mouth has just been sliced up, is further compromised by the dehydrating and painful procedure of having herbal solutions blown into  his or her bottom through a pumpkin stem.

This week's task:  for the young people to design an intervention to combat these deadly beliefs.  The encouraging thing is that our communities WANT their children to survive and are going to great lengths to ensure that they do . . it is just the tragic misunderstanding of reality that turns their heroic efforts of love into the fatal incisions of destruction.  I read to the group from Matthew 2, Revelation 12, Jeremiah 31, all referring back to Genesis 35:  the battle is real, and the battlefield is all too often the vulnerable bodies of babies.  Rachel weeps when her children are assaulted. Let us comfort her with truth.