January 2006

January 2006

Dear family and Friends,
Since we have been working here in Uganda we have been wrestling with a problem; how to relate to the omufumu (witchdoctor) or as they prefer to be called omushaho emibazi yenzarwa (the doctor of traditional medicine). At least 90% of our patients are regular visitors of the omushaho but it has eluded us how to engage in a relationship when our approaches are so different. The prescribing of herbs is of course not an issue as many western medicines are derivates of plants but scarification and incantations are more problematic for us.
Kristin Jensen a Tulane medical student recently arrived accompanied by her father Ken (also a Tulane graduate and practicing Urologist). When the subject of the difficulties relating to the omushaho was raised Ken astutely mentioned that there exists communality of interest; we are all involved in the business of attempting to improve the health of those afflicted by disease. With this in mind we arranged a meeting with the abashaho (many omushaho) to explore this communality.
They arrived as a group and we distributed warm sodas, peanuts, bread and fruit. They introduced themselves and then related their particular area of interest which included specialties in backache, malaria, pneumonia, poisonings, lightening strikes and removal of spells, particularly in pregnancy. When asked how we could assist them surprisingly they requested that we provide them with gloves and that we host a future discussion of standards of care and ethics of the practice of traditional medicine. An area that we hoped to address during the meeting was the timely referral of difficult obstetrical cases. Last week had witnessed the death of two infants who had been sent too late to prevent their demise. Before we could speak, a traditional birth attendant/omushaho stood up and said that their group had to be aware of when to refer pregnant patients to us. Would we be willing to teach them about care of the pregnant patient? There also ensued a discussion of how they could improve their referral of difficult cases to the hospital in particular TB, malaria and the seriously ill child. We agreed to work with them and to meet on a monthly basis.
Finally one omushaho stood up and expressed his gratitude in having the opportunity to engage in this discussion. Apparently he had been reticent to approach us for fear of being judged; now the abashaho and western doctors were sitting together, sharing food and discussing how to improve the health of the community. He stated emphatically that “this could only be accomplished by the power of God!”
The meeting was concluded with a prayer of thanksgiving. We then adjourned outside where we joined in joyous singing and dancing accompanied by resounding drumming.
I wonder how many difficult situations can be resolved by warm soda, bread, fruit, drums, singing, dancing, prayer and a willingness to listen? Next meeting mid May, be there.
Scott and Carol

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