Dying from Igituntu: The Push for Dynamic Cultures
“The most common disorder that I can treat successfully is igituntu, uvula disease, in children. I take a knife and a spoon, to cut and catch the uvula. When it bleeds, I use herbs to stop the bleeding.” A traditional healer (mpfumu) in Burundi continues to explain his healing practices, “the problem is when there is epiglottis disease. I do not like doing that cutting, but I will remove it if I have to.”
Kigutu is a small rural village two hours south of Bujumbura, the capital of Burundi. One locally developed clinic, Village Health Works, is the only access to medical care in the six surrounding provinces. Out of their almost 10,800 child patients, 62% have had their uvulas or epiglottis cut by a traditional healer. Some children develop infections and respiratory complications with blood filling the lungs.
In 2005, up to 53% of Burundian children under five died, with malaria, diarrhea, respiratory infections and complications of malnutrition as the main causes of mortality and morbidity (UNICEF). Uvula cutting is contributing, as many children are reported to have died from hemorrhage or infection secondary to the cultural practice. The mpfumu’s beliefs about the etiology and cures of illness give him order, meaning, purpose, and status to his life (in addition to financial wealth).
My first time working with traditional healers was in a Zulu village of KwaZulu/Natal at the peak of the HIV/AIDS incidence. They cut the arms of people with a razor to relieve the bad spirits, then reused the razor. Now, more than a decade later, I am working with a traditional healer here in Burundi, who uses scarification and prescribes sex with him, to treat HIV/AIDS. Unfortunately seemingly little has changed.
Cultural relativism, the view that beliefs and ethics are relative to the individual in his own social context, has long been debated. But what happens when some members of the culture (such as Burundian physicians who see the aftereffects ofigituntu) decide that the current practice needs to change? Burundians become entrapped in the struggle to adhere to cultural practices and beliefs, which are also injurious and potentially lethal.
It is easier to marginalize, ignore, and disregard the mpfumus. When fighting the war against malaria, diarrhea and respiratory infections around the world, paying attention to these cultural practices are crucial, as we are missing a large population of children who carry additional unnecessary burdens of traditional practices. Possibly, we can help support local beliefs as well as the dynamic changes in culture that lead to less harmful practices. Under the guide of my Burundian co-workers, we will attempt a brokerage, as I failed to do in KwaZulu/Natal 12 years ago. There are too many children and adults being subject to violent practices for me to sit around ranting descriptives of harmful practices. Tomorrow it is.