Deadly Ideas

Ideas can kill, and last night one did.  Asaba, a 6 month old, was slain by a deadly belief.  

He was admitted to the hospital in mid-May with a diagnosis of malnutrition.  When I came back this week I found that in spite of being provided with milk and medicine, he had steadily dwindled, until he was barely over 4 kg (9 pounds), a skin-covered skeleton, all eyes and ribs.  His mother reported that he had continuous diarrhea, so we kept trying treatments, rehydration solution, feedings, checking labs.  By Wednesday, my third day to see him, I was alarmed enough to begin empiric TB therapy, thinking we did not have much time left.  Thursday, he had dwindled even further.   Then I counted his pills and milk packets and made a startling realization:  every medicine and most of the milk he had been dispensed was still there, unused.  We pleaded with her to take the situation seriously and give the treatments.  Finally she confessed to one of the nurses that the baby suffered from bhibabuli, internal wounds caused by a spiritual curse.  She believed that in this case the pills would possibly kill him, so she had not given any.  In fact she was using the local remedy for this syndrome:  herbal enemas, administered by gourds or hollow stems, concoctions blown into the baby’s intestines by his mother.  She came to stay in the hospital so that the baby’s spirit would not be angry with her, since if he died at home he might come back to disturb the family who had not pursued every option for care, but though she was occupying a bed she wanted nothing to do with our treatments.

I sympathized with her, knowing that she was merely doing what she thought would save her child’s life, knowing that she feared a malicious relative or neighbor had caused this problem by poisoning her breast milk using secret charms buried in a path that she had inadvertently walked over.  But I pleaded with her to believe that her remedies (withholding feeds and administering enemas) were actually killing him.  I called a meeting of all the patients and caretakers and argued with some passion.  They can make poultices and apply herbs and charms all they want, I said, but when I see babies’ gums being sliced open to remove “false teeth” or babies’ being dehydrated and starved to death by enemas, I can not keep silent.  On these two issues, I drew the line.

What is interesting about these two beliefs, the bhino (false teeth) and bhibabuli (intestinal wounds), is that they are recent additions to the culture.  They are not ancient traditions.  The bhino idea came into Bundibugyo in the 70’s with Idi Amin’s soldiers who hailed from northern tribes.  And the bhibabuli theory has just surfaced in the last two years, seeping over the border from the depths of the Ituri rain forest in Congo, gaining adherents month by month.  In a place where children die regularly, people are looking for answers.  And if herbalists/witch doctors/traditional healers can make serious money off of procedures and treatments, then the belief will be perpetuated.  

This is the real battlefront, and we need prayer to appropriately engage and fight against deadly ideas without blaming the victims or hardening into self-righteousness smugness.  Pray that we could be graceful warriors, the kind who find a child’s life an issue worth fighting over, but in a way that does not mow down the people we are called to help.

The other death in the hospital this week was a teenage girl who died of septic shock after a self-induced abortion.  More deadly ideas:  that a wire can solve her problems, that shame or fear prevents telling the truth and getting help, that the fetus’ life was inconsequential, that her life would be guaranteed.  

It is sad enough to mourn death from incurable diseases, but sadder still to consider these two lives lost needlessly to the power of false ideas.