fetish charms and totemic medicine

Many of the children present with advanced disease having been taken to the

local healer. Small sticks, coins and strips of cloth are afixed to the patient

with assumed magical powers to heal and protect against further illness.

In totemic worship physical objects are imbued with magical properties, and their

possession according the owner some divine protection.

On one sad occassion a small infant was brought with a padlock around his neck.

desperately ill his mother had lost 11 children to diarrhoeal illnesses and had padlocked

this , her last child,to remain here on earth. Thankfully the child did well from rehydration,

though it may be seen that the padlock charm did indeed work after all.

A similar case where a padlock is perceived to provide actual protection against ill-harm

Some local herb poultices do seem to keep some wounds clean, and it would be arrogant to disclaim the efficacy of traditional herbal practices. Some chronic infections seem to be stable

through the use of these poultices.

The belief in fetish medicine does however carry a high mortality.

Burning limbs to control seizures in malaria cause further infection and appalling contractures.

Delaying proven treatments through erroneous beliefs results in advanced presentations and

patients often beyond help.

Great sensitivity is required as contrary teaching only confuses and causes conflict.

You cannot change health beliefs by adding to an already full cistern.

The pantheon of river and natural deities pervade every aspect of individual and community life. With elements of these deities all around, from the white silty mud from the river that is used to create the ju-ju idols that are enshrined in the communities, to the zoomorphic gods that inhabit the fish and fauna of the river, the hold of totemic , fetish magic is very strong and has a pedigree of centuries, reinforced by the physical isolation of many of these communities.

Change comes from understanding why these beliefs are held and learning what keys can be used to slowly modify behaviour. There has to be a perceived benefit to the individual to change behaviour, and sometimes the key to change is unexpected . As some community council leaders become educated and have the evidence from outwith the community they can break the hold of the fetish leaders and use their position to change behaviour.

 One leader, a trained nurse has used his position to enforce change, another  the threat of fines to gain compliance for safe birthing methods.

The most effective witness is that personally experienced. A sad example is of a mother refusing all vaccinations for her children , suspicious of motives, only to lose her children whilst other families around her remain healthy.

Only through respect, cultural sensitivity, and mutual understanding can new practices have any hope of success, and can only ever be adopted, never imposed.

          Sick child with charms                   Strings charms for leg pain            Multiple cuts to 'heal'

  Gas Gangrene  treated with herbs       Diesel to treat burns      Chemical poultice for an eye injury

    (antibiotics refused)-child died                                                   causing bilateral blindness

Boy with weight loss and abdominal swelling exhibiting multiple cuts from the witch doctor.

Branded as possessed and ill-treated from adolescence, this 30 year old man suffers from epilepsy. His Father was happy to purchase medication and return for review.

   Malnourished child wears protective charm       Cleft-lip, surgically easily repaired, yet

                                                                       infants are being killed for what is seen

                                                                       as a curse.