AFRICAN TRADITIONAL MEDICINE

It's the 1st of January 2015 at around 8.00a.m and I'm lazing on my bed in Machakos. My mum walks in to wake me up and immediately after wishing her a happy new year I ask her if there are any PPI's (antacids) in the house. I was bloated, having serious GERD, hyperacidity and was convinced that I must have caught H-pylori. I happened to be sharing my room with my grandmother Mwaitu who had come to visit us. Immediately grandma heard me ask about antacids she told me that I was definitely having KAVASO and she would 'lift' it for me. KAVASO is  a Kamba word for epigastric pain and hyperacidity  believed to be caused by retraction of the sternum and subcostal region mostly associated with stress. It can be lifted with oily warm hands or using a cup heated up to create a vacuum. I don't really connect the pathophysiology behind KAVASO and hyperacidity so I naturally refused to have it 'lifted.' After coaxing and explanation, I agreed to have the 'procedure' done just to please grandma.  One has to be Nill Per Oral (N.P.O) ; i was all set because I had just woken up. She rubbed glycerine on her palms and the painful exercise started. She dug her fingers deep behind my subcostal region and sternum and literally lifted my rib cage. It was very painful (there was no anaethesia used) and I was screaming. She told me that I was a terrible patient and had to learn to endure pain. She went ahead and made 'intra-op finding' of my KAVASO being 'swollen' and that I would need 'post-op' care in form of bitter herbs to be taken once daily for 3 days. I decided to faithfully take the concotion out of curiosity.  I still couldn't make any connection between the rib-cage and hyperacidity. The procedure ended well and we went to have breakfast with the family. There was alot of feasting during the day and the days that followed,   spicy food, nyama choma, fizzy drinks and generally unhealthy eating. I did not get any hyperacidity or epigastric pain despite the sinful feeding. Did grandma's treatment work? What's the medical connection and pathophysiology of KAVASO as an illness ? I don't know!! I probably need to do a research on this, formulate a hypothesis and see if there's any explanation; who knows, it could be a new medical discovery.   

 The previous day, a heavily  pregnant neighbour came in and told us that she had breech presentation(legs first) at 30weeks discovered on examination and on ultrasound. I did Leopold's Monouver on her and confirmed the diagnosis. I reassured her that it would be well  but  advised her  that if the baby remained in such a position at 38 weeks then she should opt for an elective caesarean section.  My grandma jumped in and told us that the baby could be turned traditionally to cephalic presentation( head down). I needed to know more about it and she told me that she had done the procedure to several women successfully over the last 40 years . My own sister was a breech and was turned to cephalic presentation at 40weeks just 4 days before she was delivered normally and without any complications . This correlates perfectly with an obstetrics manouver called EXTERNAL CEPHALIC VERSION. After explaining the traditional procedure to me, I realized that it was exactly as explained in Obstetric text books.  It is known and accepted in modern medicine but not widely practised now due to the complications that may occur; some parts of Europe and America still practise it but under strict ultrasound monitoring. We got talking more and I realized that my own style of doing obstetrics examination was almost similar as my grandma's. She told me that she had even done INTERNAL CEPHALIC VERSIONS (through the vagina) successfully for transverse  and oblique presentations that had come in labour mostly during the colonial era . There were stories of successful 'incubations' for pre-term and low birth weight babies using banana leaves and warm ash under strict controlled temperatures those many years back. It was a very interesting talk and i agree that probably the only thing our wise old women didn't know was how to perform caesarean sections ( I should probably invite grandma to theatre one day). We concluded that indeed the external cephalic version is a manoouver that could be done but we expounded on the possible complications, how they present and what to do in the event that they occur.    


  When I had mumps in childhood at 9 years, I was successfully managed by my grandma. We had an adventurous way of managing it that was well known by the kids in the neighbourhood.   She took me to a river very early in the morning at around 6.00a.m . Calabash derived ornaments were hang on my ears and we sang and danced a known 'mumps song' in  Kikamba while facing a tree called KIVUTI. 'Kivuti mbunye ngumbu, na tata ndae ngumbu, na mwaitu ndae ngumbu' (Kivuti remove my mumps, father did not have mumps, mother did not have mumps). We then hang the calabash ornaments on the tree branches and I was told to run home straight without looking back or talking to anyone on the way . The mumps would apparently be 'transferred' to the tree. In just one day I was totally mumps-free and back to school. As a medical doctor now, I try to give a medical meaning to this traditional treatment and I realize that it's probably all in the mind. Mumps being a viral illness is self-limiting so it was going to heal without treatment anyway. I only give paracetamol and recommend oral rehydration to kids who present in my office with mumps and reassure them that it would heal on it's own. I however give special consideration to male children just incase they get orchitis (testicles inflammation). My own children will undergo both traditional and modern treatment of mumps to get a feel of their culture and customs.

 I can go on and on about experiences in my childhood. For instance Mwaitu was my 'dentist' as I grew up and my teeth are perfectly aligned (a beauty model would be jealous). She would fill my cavities with raw pawpaw pulp and the 'fillings' have remained intact for over two decades. A septic leg wound resistant to antiobiotics was successfully treated using fresh Aloe-Vera juice and it completely healed with no scar.    There you have it, should Traditional African Medicine be mixed with modern medical practices? You tell me and feel free to share your thoughts and experiences. My drive to study medicine was highly influenced by my two maternal grandmothers;  probably it's a gift that has been passed down but in form of modern medicine.