The devil in health

As science sheds light on disease causation, attributing ill health to the devil is shifting to the periphery more and more. Take the example of Kilifi in the days when malaria was killing hundreds of children a year. A child that had cerebral malaria was thought to have been attacked by a spirit that hated bad smells and children suffering from convulsions were exposed to bad smells to drive the spirits away. Cerebral malaria has a high fatality rate and so it is understandable why it was not seen as an ‘ordinary’ disease to be treated in the hospital.

It was not until the 1990’s when, with successful treatments at the KEMRI-run pediatric ward at the Kilifi District Hospital, people started to see that cerebral malaria was as treatable as other childhood illnesses. As more and more children recover from cerebral malaria, the idea that the disease is caused by a child being struck by ‘mnyama wa ndzulu’ has faded.

I could not help searching science journals for mention of demon possession. I found a little article in The Lancet of 1896:

The writer says ‘In this modern day, the person to be resorted to for the exorcism of spirits and demons is the ophthalmic surgeon’. The writer was convinced that if eye surgery did not sort things out, the possession was ‘due to imposture’.
How great it would be if all who were demon possessed or thought they were – would be cured through ophthalmic surgery! However, the issue of demon possession has not evaporated.

This is especially so for most mental diseases which science has not cracked. Since mental illnesses result in behaviour change with no physical ailments and rarely have treatments that can completely cure them, patients are dragged from one healing crusade after another, in the hope that the bad spirits will be driven out of them.

Autism is another of those diseases, where a perfectly normal child suddenly changes before a parent’s eyes. A while ago, I spoke to a mother whose child suffered from autism and she narrated a sad tale.

‘My son was about 3 years old and he was able to say ‘ma-ma, ba-ba and was always singing along the Tanzanian song ‘agape’ when he suddenly just stopped talking. We took him to the doctor and it only seemed to make it worse. I could not leave him alone even for a moment as he would just get out of the house and run away without knowing where he was going. We took him to Pandya and Mvita hospitals in Mombasa, then we tried herbal medicines, we even visited witchdoctors out of desperation then took him to church for prayers. Nothing worked,’

This mother of five had reached her wits end but to add to her distress, rumours about why her child was ill begun. ‘Umiweka mtoto kiti cha majini’, some said to her. This is a popular belief at the Coast that people who are well off in business make a pact with ‘majini’ (spirits) so that the ‘majini’ make them rich in exchange for the life of a child. Either the child dies or his brain is affected so that he/she can never function normally. So, for an otherwise healthy growing child with no physical disabilities to suddenly begin to act as though they are mentally retarded, is highly suspect in such an environment.

‘A lot was said, too painful to recollect and I felt bitter because my husband and I did everything we could for this child’

At the end of the interview, this woman broke down. It was hard to find the right words to console her with.

Such stories abound in Kenya. When we don’t understand health issues, the devil becomes our scapegoat. Families often hide their mentally handicapped so people don’t start to talk ill of them. As our disease profiles moves from communicable diseases to non-communicable diseases, we shall see an ‘increase’ in mental illnesses. The three largest contributors to global disease burden (measured using DALY’s) are in order: lower respiratory tract infections, diarrhoel diseases and depression. The common communicable diseases – respiratory tract infections and diarrhoeal diseases will, without doubt, go down in the coming decades and depression will surely rise higher up the scale. Looking beyond the devil, as the cause of these illnesses, will lead to a more embracing approach to those affected by mental illnesses.