Visiting Nagboo Patient

Recently, I was able to visit one of my patients in his home, to greet his wife and new baby boy and to pray with them. Over a year ago, I had to amputate his lower leg. He had been shot by armed robbers. The tibia and fibula were shattered and the blood supply to the foot was compromised. The patient first chose to go to the local “bone setter,” and returned only when the foot was already dead. He finally agreed to amputation and healed well afterwards. He was highly motivated to get a prosthesis and did very well with the training. Once he returned from the training center with his new leg, he rode his bike from his village to the hospital (about 3 miles) just to greet me.

When we went to the Baptist church in his village, he saw me and invited me to greet his wife and new baby. The pastor of the church accompanied me and we encouraged him and prayed with them. The best part was when my son asked me which leg was the fake leg!

Situs Inversus Totalis

There are certain conditions that you read about in medical school, think how interesting that it must be, and never expect to see it in real life.

** WARNING: GRAPHIC IMAGES **

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The Christian Ministry of Healing Where Medicine Is Magic

Heidi contributed an article to IMB.org about the challenges of navigating traditional African religion and superstitions when providing Christ-centered medical care.

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Gaba, the “Adulterous Widow” Charm

Before I get into the story behind gaba charms, I probably have to explain what I mean by an “adulterous widow.” In Tony Naden’s Mampruli dictionary, he defines the unique Mampruli word gaba as “a widow who has sexual relations with another man before her late husband’s funeral.”

Heidi visits with women at a final funeral performance.

In Western cultures we usually hold funerals soon after the deceased passes so the idea of “cheating” on your unburied husband seems a bit absurd. However, the Mamprusi hold two funerals (or three, depending on how you count) for their deceased. The final funeral can occur months or even years after the deceased has been buried. That extended length of time makes a widow’s impatience a bit more understandable but it is, nonetheless, considered an immoral act by the Mamprusi. She must show her late husband honor by abstaining from sex until his final funeral has been performed.

If a woman commits this taboo (and is caught) she is labeled a gaba and considered to be so wicked that her mere gaze can cause harm. The most commonly held superstitious belief about a gaba is that if she looks at a sick person then he or she will die. That is terrifying considering that you never know who might actually be an adulterous widow.

But wait! There’s a cure!

It is believed that if one takes a scrap of cloth belonging to a gaba and ties it to his wrist or ankle when he is sick, then he will be protected from the evil gaze of an adulterous widow. This magical charm is also called a gaba.

This belief is seen in practice every day at the Baptist Medical Centre of Nalerigu, Ghana.

Trey’s friend Latif was sick with typhoid and wore a gaba in the hospital.

Look closely at patients’ wrists and ankles and you’re likely to see a scrap of cloth tied as a bracelet or anklet. Usually a relative brings the patient the gaba when they visit him or her in the wards.

I’ve asked around to find out how people get these in the first place. No one sells the scraps of cloth (seems like an untapped business opportunity if one were a gaba) but instead people have a habit of stealing cloth from known adulterous widows when they are washing their clothes or bathing. Those cloths are torn into scraps and shared among friends and family who hold onto them until the day comes when they are needed by a loved one who has fallen ill.

PJS (and not that’s not pajamas)

A 13 year old boy, who years before had a bowel resection for an intestinal obstruction, was admitted to our hospital several times with abdominal pain. The pain was intermittent but severe.  After conservative treatment, he got better, but only for about a week. He then returned with pain, vomiting and inability to pass stool or gas. I decided to operate.

I found an intussusception causing a bowel obstruction. A tumor attached to the inside wall of the small intestines caused the bowel to fold and twist upon itself. I was able to reduce the intussusception and remove the tumor. As I examined the remaining bowel, I realized that he had multiple other small tumors throughout the small intestines. I removed several of the larger tumors, but could not remove all of them.

As I examined the bowel and resected the tumors, I remembered something peculiar that I had noticed on the patient even as he was lying on the operating table waiting for surgery. I had not yet made the connection. He has black spots on his lips, palms and soles of his feet. Together, these findings constitute a syndrome, Peutz Jehger Syndrome.

The good news is that this means the tumors are benign, but have potential to become cancer. I explained to the family that he would have to be examined on a regular basis, including colonoscopy to rule out the presence of any cancers.

He is a sweet kid who lives close by, and always has a smile for me whenever we meet.

** WARNING: GRAPHIC IMAGES **
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Appendicitis

It’s been a busy week! In five consecutive days, I did five procedures for five patients with appendicitis. For each patient, I used the ultrasound to guide my approach. This week really helped me to fine tune my skills of finding the appendix with ultrasound!


** WARNING: GRAPHIC IMAGES **

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