- © 2008 Canadian Medical Association
It began with frantic cries from several of the staff. A pickup truck entered the gates of Kindamba Hospital and dropped off a patient. Staff presumed it was the first victim of a rumoured internecine war among the district's Ninja rebels.
I saw panic on the faces around me as we received a pregnant woman soaked with feces and urine. As her companion informed us, the patient was at term and in labour.
Touching her shoulders, I felt no muscle mass. Her head had a skeletal appearance and her hair was sparse and reddish blond, a sign of severe malnutrition.
We rushed to the operating room to stabilize her and do a cesarean section. The operation was successful. We delivered a boy but the mother's condition soon deteriorated, with fever and loss of appetite. We ordered a malaria test and the result was negative. She had no antenatal care records.
Her husband had brought her from Kimba, 45 km to the north. There she had been under the care of a sorcerer to chase out evil spirits that took away her first husband, who died 2 years ago from some mysterious disease. She met and married her current husband in Kimba.
The husband added that the family had little to eat back in the village, just river fish, vegetables and manioc [a root consumed like potatoes or ground into flour and baked into a bread]. He said they were better off in the hospital until his wife regained sufficient strength to farm.
We offered voluntary counselling and HIV testing, to rule out the possibility that an opportunistic infection could be the cause of the high fever. The patient accepted, and sadly the test result showed her to be HIV positive.
We proposed transferring the mother and child to an antiretroviral treatment centre. But she asked to go back to her village first, to wrap up the sorcery business. Otherwise, the sorcerer could summon up harmful spirits.
Unfortunately, we lost contact with her and still don't know her whereabouts.
The sorcerer has treated her clients using Jinn spirits, amulets and herbs.
The mind is a powerful thing. I would like to find an anthropologist who can explain how this sorcerer controls the minds of the people.
Footnotes
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CMAJ invites contributions to “Dispatches from the medical front,” in which physicians and other health care providers offer eyewitness glimpses of medical frontiers, whether defined by location or intervention. Submissions, which must run a maximum 400 words, should be forwarded to: wayne.kondro{at}cma.ca