Wednesday, April 16, 2014

Traditional Healing at Save a Life

This week we (Shawnel & Sarah) were placed at Save a Life Clinic.  We had an absolutely amazing experience at the clinic and on home visits and can both say confidently that we were challenged and rewarded by the work we did there along side Lihana, Ivy, Nasilele, and Annie.  We spent time seeing patients in the clinic, got experience diagnosing and prescribing, taught baby gym classes to babies and families being followed by the clinic, and visited the homes of other patients. During our time at the clinic we noticed the influence cultural traditions had on the community we were caring for, as well as how these traditions affected our practice. There were 3 experience in particular that illustrated this theme: 

When teaching the baby gym classes one of the activities we encouraged the parents and babies to do together was about recognizing their self image.  We had the parents hold a mirror in front of their child to allow them to study their reflections and identify their facial features. One of the mothers was hesitant to participate in this activity because she believed that if the child looked into the mirror they would get diarrhea.  At first we didn’t know how to react as we are not familiar with Lozi traditions and this made little sense to us medically.  This comment introduced to us a barrier for nurses working with this population as their cultural traditions or beliefs can often interfere with treatment.  

Another example of traditional healing would be the use of crushed TB medication to treat wounds, which is popular in villages surrounding the clinic.  We came across one young boy who was brought to the clinic by his teacher with a huge infected and bleeding wound on his foot.  Upon closer inspection we realized that the wound appeared to be packed with a hardened muddy substance, and the boy was reluctant to discuss the state of his wound.  When we soaked his wound and debrided some of the embedded material we noticed that the substance seemed to be some type of powder that had adhered to the edges of the wound. After speaking with the teacher who brought the boy to the clinic we discovered that his parents had most likely been treating the wound with something at home.  We did the best we could to irrigate and debride the wound and dress it with an antimicrobial dressing.  Later on after discussing the situation with the team at the clinic we learned that the boy had actually been to the clinic the previous week.  He had a suspected bone infection from this wound which was actually chronic and was supposed to be taking antibiotics and having daily dressing changes at the clinic.  Lihana explained to us that this community has a strong belief in witch craft and often seeks the advice and treatment of traditional healers, which she suspected might be involved in this case.  

The final experience we had with traditional beliefs affecting the delivery of healthcare involved a young HIV + mother and her baby with status unknown.  We went to visit this family on our home visits as the two had not been attending the feeding program for the last month.  The baby appeared very ill and small for its age.  When asked about why the mother had stopped bringing her baby to the program the mother replied that she was too tired as she had to travel all the way to Lewanika Hospital for her ARVs on the same day the feeding program took place (although Annie let us know that she is not currently receiving her medications).  The mother was also still breast feeding the baby at 8 months although she was aware that this puts her baby at risk of contacting the virus. This was the excuse that she used as to why she did not need to attend the feeding program, because the baby was receiving breast milk. After fully explaining the implications for the way the baby was being cared for the mother still refused to come to the clinic for the feeding program.  Both of us were very frustrated by this experience and could not comprehend the mothers reasoning behind her refusal.  After reflecting on this experience though, we agree that this is a great example of how traditions affect the way that people view and access healthcare here in Mongu.  We recognize that there is still a large presence of traditional medicine in the culture, and there is  lack of trust toward modern medicine, especially in the villages.  We assume this mothers refusal to attend the clinic stemmed in her belief that maybe her baby was not actually that sick or even that there were better methods for treating him. 

These experiences opened our eyes to the difficulties that face Lihana and her Save a Life team every day.  This week we noticed the prevalence of traditional medicine and witch craft and how this can make things difficult for health care workers in this setting.  Thank you Save a Life team for the fantastic experience and making us feel so welcome!

Shawnel & Sarah 

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