My friend and colleague Dr Bundi Karau opines that one day he will hopefully discover the gene that makes Africans so religious, denomination not withstanding. 

I hope that  his massive genomic project will also attack the issue of beliefs in Witch craft and curses. 

In the sub tribe of Meru where Bundi and I  hail from, curses and witch craft are held as strongly as gods and the devil. So much so that when I graduated as a doctor  nearly a decade back I had to address myself to that notion. 

Having read  the physiology of the nervous system and then dissected the anatomy of the brain and spinal cord, I could not wrap my head around witch craft. Studying psychiatry and psychology did not completely explain it. 

Happening during the uruûra season when everyone has depleted their food stores and is looking forward to the new season’s crop, it was a financial torment to get any of my folks or siblings travel the hundreds of kilometres to Eldoret for my graduation. I chose to graduate solo and carry my gown, hood and cap to the village.

We opted for a small mass during the second week of December to celebrate my graduation.

The priest may not have been fully briefed because he kept mentioning how I had cleared bachelors and masters degrees, and now I had brought home the PhD! 

Protocol did not grant me a chance to shout some corrections. May be it was a dream being verbalized. Or may be the short stopover at my friend’s in Nairobi which had me exposed to a mannerless Nairobi fly had given my face an old man’s look. Six years of non stop university education can make one age too. Trust me, I saw it! 


A summary of Medical School

Now, when the chance for the guest of honor to speak came, I decided to summarize what is entailed in medical school.

I narrated how the 6 years were  divided into 3 segments: 2 basic science years, 1 preclinical year and 3 clinical years.

I told them that during the first two years we had studied the normal structure and function of the healthy human body. That is where we had dissected every muscle and nerve. We had peeped into the bottom of the heart and sliced the brain open. Just to know how a human being is structured. 

For the preclinical year we had learnt how a diseased body looks like. And how the disease affects the body. For the practicals we would be found in the mortuary. Here we would spend afternoons splaying open the hearts of heart attack victims to study the wall thickness and contrast them with normal. We would sequentially move up or down the body depending on the unit we were covering.

Having known the healthy and the dead, we had then been ushered into the realm of the ailing. Here you may not have the luxury of cutting them open to demonstrate the disease. But with a scan and a lab test you can add documentary evidence to your mental picture. Those three clinical years culminated in the tall dark and lanky graduate who stood before them, I added. 

After nearly fifteen minutes of this ad lib recap of medical school punctuated with memorable personal experiences here and there, I surveyed my audience wondering whether they had understood everything or nothing at all. 

“In a nutshell, in those 6 years I have learnt that the only real witchcraft comes in the form of poisoned food,” I concluded. I think some of them clapped. 

I would have spoken about îchiaro

If wishes were horses, I would have spoken about curses. And another  belief called îchiaro. This is a firm belief that bad things will befall you if you wrong someone from a particular clan. I grew up knowing that there are certain clans with which our clan has such a relationship. Wronging someone from these clans means inviting calamity which can come in whichever form. 

I must confess that there are diseases that behave in such suspicious ways that even if there is scientific explanation, it is difficult to describe them to the laity. Such become fodder for these believes. 

One such condition is called foramen magnum syndrome. It arises from compression of the spinal cord as it exits the skull. The progression of loss of sensation follows a circular distribution that at first glance looks so suspicious.

I remember quipping to a fellow classmates back in the days, ‘there is no way you are convincing a relative that their patient has not been bewitched to develop this weird problem’. 

Now having resigned to surgery, I have not  been keen on foramen magnum.This is the forte of Dr Bundi and others. That does not mean weird-looking diseases are not in surgery.

Flesh eating disease

They come for example in the form a flesh eating disease called Fournier’s gangrene. It attacks the private parts, starting around the genitals and quickly creeping up the crotch to the Lower belly skin. Often times it can go as up as the collar bones. It may arise from an infection in the anus or the urethra. There is a detailed anatomy pattern that describes the spread of the disease.

Fournier’s gangrene is so weird and scary that supernatural powers could easily be invoked to explain its origin and progression. 

When patients turn to supernatural explanations, the curse and îchiaro come to play.

It was not any different when Mr BK,  a man in his sixties was brought to our unit with Fournier’s gangrene. 

At first look, my medical officer and I shouted ‘debridement’ in unison. He needed urgent surgical source-control before he could collapse into overwhelming infection. The damage is best assessed after surgery. And it scares the patients.

Usually the patient will get several trips to theatre, every time the surgeon removing the dirty tissue as an addendum to the tons of medication given to fight the bacteria responsible. 

Waiting for mwîchiaro

The return to theatre for BK was tricky because his blood level was low. We needed to put our heads together with the anaesthetist and make a hard decision. Being fully alert, I did not expect any challenges with obtaining informed consent for the second surgery.

Yet it did not come.

The patient sent for the relatives. Even after arrival of the relatives, there was another key stakeholder that was required before the patient could give the go ahead. Another day!

As we waited for the consent, we kept searching for the ever scarce blood.

Hata mwîchiaro alikuja na wakamaliziana sasa tunaweza kuendelee na surgery.”

I was taken a back with this update. 

I was later to learn that Mr BK was convinced he had  suffered this tormenting disease because he had wronged someone from an îchiaro clan. His family had brought the aggrieved to lift the curse that had befallen our patient in the form of a flesh eating bacterial infection.

I can only imagine what wrongs he may have committed and why it should manifest through a danger to his private parts.

Having gotten this clearance, now the anaesthetist was allowed to review and ‘clear’ him for surgery.

Since that day, Mr BK demonstrated such strong spirit and hope that he agreed to surgery and actually started recovering very well.