When Jackie and Neema, Field Officer and Clinical Officer from our Community Based Rehabilitation outreach programme, first reached Sara and her father in the village, they didn’t know what to expect. One of the Community Health Workers who work closely with Kamanga Health Centre and the outreach team suggested they visit the girl who was newly arrived in the ward as he had heard that the girl had physical impairments. When Jackie and Neema arrived on their motorbikes at a tiny bricked house they encountered an 18-year old girl with feathers on her leg and suspiciously looking mashed green leaves on her head. Sara didn’t speak or smile and her father chased Jackie and Neema away as soon as they had introduced themselves. Seeing the girl in such a bad condition however was really hard on Jackie and Neema who always put all their effort into improving a patient’s condition. They were not willing to give up just like that and returned the next day. Gently, they tried to speak to Mr Raja to find out what happened to his daughter. Though still reluctant, he explained that he was separated from Sara’s mother, who was located in a different ward, and said that as soon as he learned that his daughter was not well, he took her to live with him. Mr Raja assured the outreach team that Sara was bewitched. He explained that she was under treatment from a traditional healer and that there was nothing they could do for her.
Typical housing in Kamanga - the largest village in Nyamatongo Ward
All over Tanzania a widespread belief prevails that people with a disability are bewitched or suffer from an act of God’s will. It is not the first time that our outreach team have encountered resistance to or disbelief in conventional medicine. It took quite some time and several more visits until Mr Raja had built enough trust towards our Clinical Officer and Field Officer to allow them to examine Sara. After being examined by Neema it became apparent that Sara had mental as well as physical disabilities but there was no way of telling what caused her condition. She suffered from spasms on one side, and had severe anxiety and speech impairments. Furthermore, she had a huge burn wound on one leg. This stemmed from a particularly cruel traditional practice whereby the person who is believed to be possessed by a spirit is covered with large cloths and a fire is made at their feet to expel the spirit with the flames.
The outreach team saw an urgent need for treatment and asked Mr Raja for permission, which he finally granted, under the condition that they would not give any injection as this would mess up the traditional medicine. Although the outreach team pointed out that the traditional medicine is not suitable to heal the wound or improve Sara’s overall condition, Mr Raja insisted. Jackie and Neema were not discouraged but kept visiting Sara and her father on a daily basis, continued to dress the wound and started occupational therapy exercises. To support their efforts, a weighted bag which functions as an assistive device was built. This helps Sara to sit more comfortably and independently, reduces the spasms, straightens the spinal cord and improves joint mobility. On top of the medical treatment, the outreach team persistently educated Mr Raja on the benefits of their medical approach, rights and needs of people with disabilities and causes of disabilities.
When Mr Raja saw the rapid improvement of the wound on the leg of his daughter and positive development of her overall condition he finally believed Jackie and Neema. Jackie says: “Baba Sara (Mr Raja) is now very supportive and if we miss going to their house even once he seems to be disappointed”. Seeing his daughter smile again makes him happy and he is very thankful for the good care and quality medical services our CBR outreach team provides. Sara’s father has stopped the local treatment now completely and only relies on the medical service provided by the outreach team.
By the way, the mashed green leaves on top of Sara’s head and the feathers on her wound are traditional medicine prescribed by the local traditional healer. Thankfully, the outreach team managed to convince Mr Raja that this was not adequate treatment for his daughter.
(Patients’ names have been changed to protect their anonymity)