Friday, January 4, 2013

Witch Doctor

Before patients ever see us they frequently have already seen the local Traditional or “Witch Doctor”.  Today 7 year old Ibrahim entered my examine room accompanied by his parents.  Ibrahim’s arm was in a homemade sling.  There was an obvious deformity of the proximal forearm and the skin from his elbow to his hand was scabbed and discolored.  Dad relayed that Ibrahim had fallen 2 weeks ago and they knew the arm was broken by the obvious curvature.  Off to the Witch Doctor they went and the arm was covered with medicine followed by a wrap that Dad said was too tight.  A week later when the wrap was removed the entire forearm was blistered and still crooked.  Additionally Ibrahim could not move any of his fingers.  The local health center was their next stop and antibiotics were appropriately prescribed.  With no return of movement at 2 weeks post injury his parents decided the hospital should be their next stop.

Little Ibrahim sat stoically as I examined him.  The prior blisters were all scabbed today and there was no sign of obvious infection.  There was circulation to his hand as it was warm and capillary filling was present.  Unfortunately there was absolutely no movement below the shoulder, likely the result of a tight wrap the week after injury.  Hopefully the nerves in his forearm will recover in the next few weeks and he will regain some function in his hand.  It is difficult seeing cases like Ibrahim’s that could have had a different outcome had they entered the Health Care System through a different door.

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