Before heading off to Ghana, I was given the impression from past volunteers with whom I spoke that most of the cases in the village clinic of Mafi Seva would be relatively simple ones of acute illness or injuries. This turned out to be not entirely accurate.
The cases were simple in the sense that they were fairly straightforward. Unlike my own practice where many patients have chronic degenerative diseases, autoimmune illness or complex mental states often complicated by medical and dental interventions as well as multiple prescriptions, the people I saw in the village presented with conditions and histories that were less involved. There were fewer strands and influences to untangle, and overall responses to the remedies seemed to be more immediate.
Nevertheless, the vast majority of the people I treated presented with problems that were of a chronic nature. Even the injury cases stemmed from incidents years or decades earlier, or involved structural issues as a result of repeated strain, lifting and carrying.
Like most rural areas in the undeveloped world, the labors of farming, construction and other chores of life are not mechanized. There is a great deal of physical stress placed on their bodies. The women also have the additional effects of bearing and giving birth to large numbers of children.
Ghanaian villagers, again especially the women, are remarkably skilled at carrying things on their heads like large trays bearing piles of cassava root or a substantial piece of luggage. It is not unusual to spot a schoolgirl walk home in the afternoon with her books on her head. But years of such burdens can take a toll.
(I can’t resist describing my experience of disembarking in Accra from a tro-tro van with a heavy suitcase. It was suggested that I hire a porter to help transport my bag the half-kilometer or so to another bus station. Of course, in my imagination I had pictured something equivalent to railway porter or skycap with a cart. To my surprise – and, if truth be told, my embarrassment, it turned out to be a woman, albeit a tall young woman of sturdy build who also happened to have a baby bundled on her back. With the assistance of two or three other porters, she hoisted the suitcase on her head, steadied herself to gain balance, and jauntily took off into the crowded streets at a pace I could hardly maintain.)
But more to the point, the perception that the cases were simple was probably more a reflection of how the practitioner worked than of the patient. Given the opportunity and inclination to understand the full symptom picture along with the accompanying physical and mental states, as well as explore the medical and personal life history, one finds a fair amount of complexity indeed. Put more succinctly, you get what you are looking for.
In this regard, two cases come to mind. The first was of an older man who complained of chronic back and buttock pain that extend down his left leg. At first it seemed like a case of sciatica, probably from strain or injury, but the patient told us it all began with the repayment of a loan. “The fellow who owed the money handed me a wad of bills which I stuffed in my back pocket”. That was all the explanation he offered.
Being a little slow on the uptake, I asked if he felt that sitting on the wad had injured him.. The man seemed a bit discomfited by the question and didn’t reply straightaway, at which point my translator Dodze felt it appropriate to point out that implication was that he was a victim of ‘juju’.
This wasn’t the first time the ‘juju’ had come up during a case. We are more familiar with its Caribbean pronunciation, ‘voodoo’, and no doubt the concept was brought to the islands by West African slaves. Apparently, despite the widespread Christianization of the population, it still is powerful belief throughout Ghanaian society.
The question at hand was what to do with the information. It would have been easy enough to ignore the concept and treat the man despite his belief. On the other hand, such a strong belief – regardless of its validity from my own perspective, was an integral part of who he was and thus an integral part of the case.
So, I engaged him further in a conversation about why the person had placed the curse, if it had every happened to him before and so on. What I discovered was that the patient was quite suspicious by nature, worried that people were envious of him and seeking retribution. More than the particulars of his pain, these character attributes became the core of the case.
The homeopathic repertory is truly a wondrous thing. This remarkably extensive compendium lists upward of 200,000 ‘rubrics’ – the various signs and symptoms related to disease states as well as constitutional dispositions, along with the remedies that are related to each rubric. That is a lot of data – perhaps the largest medical database in existence.
An entire section of the repertory is devoted to mental and emotions phenomena. Within it were quite a few rubrics quite descriptive of this man:
- SUSPICIOUSNESS, mistrustfulness
- DELUSIONS, imaginations; injury; injured, of being
- SUPERSTITIOUS
- ENVY
Based on these, the man was prescribed a dose of Lachesis, a well known homeopathic preparation made from the venom of the South American Bushmaster snake.
The other case was of an older woman who complained of palpitations, shortness of breath, dizziness and general fatigue. On examination, her blood pressure and pulse were fairly normal but a careful history revealed that the onset of her complaints was synchronous with the death of one of her adult children a number of years before. In fact, within a period of several years, she had lost three of her children.
She was a reserved, serious person, loath to complain or share with others the burden of her losses. Thinking of her children always aggravated her symptoms, but she would only allow herself tears when alone.
Although there was a significant cardiac component, this was clearly a case of what is listed in the Repertory as ‘ailments from grief’. More specifically, it was a case of ‘prolonged and unresolved ailments from grief’. Based on this rubric as well as a few others related to her general demeanor and general physical symptoms, she was given a dose of Natrum muriaticum, the homeopathic preparation of sodium chloride.
Due to the short length of my stay in the village I was not able to have any follow-up on these patients. But I felt confident that they were given deep acting remedies that addressed the underlying causes of their complaints.