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When Cultural Practices Affect The Treatment Of Patients

In quite a few of the cultures in south africa people tie ribbons, strings and tassels around their own and their children’s wrists and waists. These tassels are imbibed with power to keep evil spirits at bay, I am told. If these tassels come off then the patient is completely unprotected from any and all marauding evil spirits that may be lurking around. Of course, not wanting to be responsible for the unopposed assault by multiple evil spirits, most people are fairly reticent to remove these things. I saw it slightly differently.

As a student I took my lead from my senior. If he removed the tassels then I would be ok with it. If he felt that we should respect the culture of the patient and sort of try to move the tassels out of the way of the operating area or even operate around them, despite the increased infection risk, I sort of reasoned it was his patient and even if I medically didn’t agree with him, the reasoning of respecting the patient’s culture surely held some water at least and I didn’t argue. The fact of the matter was that a number of the sisters would become quite aggressive with the doctor if they thought he was going to remove the tassels and strip the patient of his evil spirit protection, and I think some of the doctors were scared. Then one day something happened that cemented my views and actions for the future. Read more »

*This blog post was originally published at other things amanzi*

Breast Cancer: How One Surgeon Protected A Patient From Another Surgeon

After having spoken about when you seem to know more than your consultant, I was reminded of another incident from my internship year where a colleague of mine taught me that sometimes it is best to do certain things under cover of darkness.

The patient (a sangoma) turned up at the surgery clinic one day. My colleague asked her what the problem was. Without uttering a word she lifted up her shirt to expose her breasts. The left one had a massive tumour that had fungated through the skin probably some time ago. There was a large stinking cauliflower-like mass with central ulceration that caused a fist sized cavity right up to the chest wall. The smell was also remarkable. Read more »

*This blog post was originally published at other things amanzi*

Stolen Body Parts In South Africa

I spoke about foreigners and relative attitudes between them and myself. But, truth be told, one of the reasons they think they are in deepest darkest Africa when they are here is because they are!!!

We pick up the story roughly where I left it off. The initial accident claimed two lives. Then the young son has to survive a brain bleed and a neck fracture. Somehow the neourosurgeon sorts all that out. Then in ICU he gets acalculous cholecystitis and I meet him, almost in exitus. We fetch him from the pearly gates and tie him up in ICU for a while. He survives. He can walk. His maths and science still works. Miraculous!

But for a moment imagine the father, the only one not really injured in the accident. He is in a foreign country. He has just lost 50% of his family and there is a real chance his son might die or be paralysed or retarded for life. The daily ICU vigil alone must have taken a toll on him. And then things slowly start improving.

After too long away from home they are ready to leave. The son is amazingly well. He is neither paralysed nor retarded. Also he is alive which everyone sees as a positive thing. Then they have the unpleasant task of getting the bodies of the other two members of the family. What do they find? Certain body parts are missing, including one hand!!! Stolen from the dead in the morgue. You just can’t make this sort of thing up. I dare you to try.

I have spoken before about body parts stolen to be used by sangomas for so called traditional medicine, so I suppose I shouldn’t be shocked, but I was. I couldn’t help feeling for him. Over and above all the terrible things that happened to this man and his family he has to endure the bodies of his departed family being desecrated.

This story so affected me I followed it in the local papers for a while and pretty much put it together. At least some of the people were actually arrested so quite a lot of the story became public. It seems there were people working in the morgue who regularly stole body parts to sell to sangomas. They would target the bodies which were to be cremated and cut out the desired organs just before cremation. No one would be the wiser. The foreigners were targeted, it seems, because the body lay in the morgue so long while the boy recovered in hospital.

So, in conclusion, this is deepest darkest Africa and here you will truly be amongst us savages.

*This blog post was originally published at other things amanzi*

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