Stiff like stock-fish
A patient with fracture of the neck and spinal cord injury was managed by a traditional bonesetter. The bonesetter constructed a cage for him and had him strapped down for months, waiting for the boneS to heal.
It did. But not very well!
When he was released from the cage, he was smelly: like a pit latrine, with horrible bedsores over his back: as stiff as stock-fish (Panla) and unable to be rehabilitated into a wheelchair.
Oh, he was still paralysed!
A useless arm
Another chap, Peter, was seen at the Federal Staff Hospital, Jabi, Abuja. He fell off a bike 2 year previously and fractured his arm. The bone was broken and it damaged the nerve to the forearm. He was unable to use his hand. Being a menial worker, he had no choice but to visit the local traditional bonesetter for treatment. Big mistake! The arm was splinted with sticks and strapped with strips of cloth material.
Here is what they did to him!
The management by the traditional bonesetter!
When we saw him, he had been unable to work with the arm dangling by his side. The fracture had not healed as shown on the x-ray of his arm. The ends of the bone had rounded off and there was no union whatsoever. He looked miserable and life was truly upside down. Worse, he had spent so much in return for nothing!
Picture showing the ends of the bones: not healed after 2 years!
Well, we could not leave him alone, now, could we? We had to prove that orthodox medicine was superior and a much better alternative in this case. Moreover, how could we refuse a plea to help a fellow Nigerian? Even if previously misguided and misinformed!
We did this
Some patients are not even as lucky as Peter. Many have gangrenous arms and legs and need amputations. The doctors at the Federal Staff Hospital, Jabi, Abuja see many cases like this in their clinics daily. They are also in a great position to remedy the mishap in this case and we facilitated the operation. Therefore, Brain and Spine Surgery Consortium stepped in as part of our corporate social responsibility and paid his bills for the operation.
It was the least we could do!
Peter underwent successful repair of his non-united fracture a few months ago. The operation took a few hours and he was home a few days later. Five months after removing the plaster cast, he is undergoing rehab and smiling again. The long forlorn look and miserable affect long gone!
The picture showing the arm well healed and better
The charlatans
Let us talk about this properly and find a way out.
The practice of traditional bone setting is extensive in Nigeria and it enjoys enormous patronage from the people. Traditional bonesetters are number 3 in the hierarchy of duplicitous ‘health practitioners’ coming after pastors and the herbalists. Patent chemists and pharmacies are a distant fourth.
Regardless, Nigerians continue to throng to these cons in their millions disregarding the devastation often left behind. In focus, the outcome of the intervention of bonesetters’ treatment is usually poor with profound effects on the patient. The methods of treatment vary, and so complications of treatment are usually a function of the method applied.
Massive complications
The problems caused by them are usually significant with extremity gangrene being the worst. For example, where splints have been applied, compartment syndrome, extremity gangrene and Volkmann ischemia are the regularly occurring complications. Where massaging and pulling are the preferred treatment option, they usually lead to abnormal bone ossification and non-union as in this case. Where scarifications have been performed, chronic osteomyelitis, sepsis and tetanus often occur.
The traditional bonesetters are worse than a hurricane in the misery they cause.
But, what are we to do as these people see the majority of Nigerians seeking healthcare? The fact is that they are cheaper, more accessible and local to the populace. They are therefore not going to go away and will remain regardless of their poor performances and track record.
Okay, what is the way forward?
Solutions
The solution is to regulate the practice and offer training to improve the care rendered. Though a number of deficiencies of the bone setters have been highlighted above, it is possible that they can be trained to function at the primary level especially in the rural areas. The Federal and State governments therefore need to take urgent steps to regulate the present practice of the trade in Nigeria.
We cannot throw away this baby with the bath water.
NB: The BASS consortium takes its corporate Social Responsibility seriously and we help when we can to improve access to Neurosurgery and help make high end complex operations affordable. In October, as part of the Independence Day Celebrations, we will offer 5.7% discounts for operative care.
The idea of training them is important It was done for the Traditional Birth Attendants However it has its own pitfall You are likely to find some over zealous ones who will remain adamant and create more problems please