Department of Health Promotion and Development (HEMIL), University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
, Dar es Salaam, Tanzania.
J Ethnobiol Ethnomed. 2022 Apr 29;18(1):35. doi: 10.1186/s13002-022-00533-9.
Amputation of the uvula by lay providers, so-called "traditional uvulectomy", is common in parts of Sub-Saharan Africa. In Tanzania, the procedure is a treatment of persistent cough, and in some areas of the country, one in three children have been cut. Previous research from Sub-Saharan Africa suggest that uvulectomy by lay providers can increase morbidity and mortality in children, but few studies have examined the cultural ideas and practices that are linked to this form of lay surgery.
This ethnomedical study took place in Dar es Salaam. Ten focus group discussions with a total of 43 caregivers in three different administrative districts were carried out, focusing on their perceptions of uvulectomy, the folk illness kimeo, and their experiences with taking a child for cutting. Four folk practitioners who carry out uvulectomies were interviewed individually, with a special focus on their background, and their perceptions of kimeo and uvulectomy.
Caregivers in Dar es Salaam typically take children who suffer from cough, vomiting and weakness to a professional health provider as a first recourse. If the child does not get well relatively quickly, some start fearing that their child may suffer from the folk illness kimeo. Kimeo is perceived by some to be an acute, life-threatening illness that professional health providers are incapable of treating. Folk practitioners treat kimeo by amputating the uvula using forceps. The four interviewed practitioners had learned their skill in apprenticeship, and two of them were third generation uvula cutters. Caregivers regard the folk practitioners as experts who offer a service that is perceived as both efficient and safe.
Efforts should be made to improve the quality of professional health services for children presenting with cough, including more open communication with caregivers about the folk illness kimeo. More research is needed to establish the clinical conditions that children who are taken for uvulectomy suffer from, to what degree the practice delays professional health care for underlying illnesses like pneumonia, and the negative effects of the cutting itself.
在撒哈拉以南非洲部分地区，非专业人士施行的悬雍垂切除术，即所谓的“传统悬雍垂切除术”，十分常见。在坦桑尼亚，该手术是治疗持续性咳嗽的手段，在该国的一些地区，每三个孩子中就有一个做过这种手术。来自撒哈拉以南非洲的先前研究表明，非专业人士施行的悬雍垂切除术会增加儿童的发病率和死亡率，但很少有研究检查与这种非专业手术相关的文化观念和实践。
这项民族医学研究在达累斯萨拉姆进行。在三个不同行政区，共对 43 名看护人进行了 10 次焦点小组讨论，重点关注他们对悬雍垂切除术、民间疾病 kimeo 和带孩子去做手术的经历的看法。对 4 名施行悬雍垂切除术的民间从业者进行了单独访谈，特别关注他们的背景以及他们对 kimeo 和悬雍垂切除术的看法。
达累斯萨拉姆的看护人通常会首先带咳嗽、呕吐和虚弱的孩子去专业医疗机构就诊。如果孩子没有很快好转，一些人开始担心他们的孩子可能患有民间疾病 kimeo。一些人认为 kimeo 是一种急性的、危及生命的疾病，专业医疗机构无法治疗。民间从业者用钳子切除悬雍垂来治疗 kimeo。接受采访的 4 名从业者都是通过学徒制学习的这门手艺，其中 2 人是第三代悬雍垂切割师。看护人认为民间从业者是专家，他们提供的服务既高效又安全。
应努力提高为咳嗽就诊的儿童提供的专业医疗服务质量，包括与看护人就民间疾病 kimeo 进行更开放的沟通。需要进行更多的研究，以确定接受悬雍垂切除术的儿童所患临床病症的程度，这种手术在多大程度上延迟了对肺炎等潜在疾病的专业治疗，以及手术本身的负面影响。
