African Medical Pluralism

By William C. Olsen; Carolyn Sargent | Go to book overview

9
Ear Infections, Malnutrition, and
Circuitous Health Care Treatments
in Zaria, Nigeria

Elisha Renne

Child here, I don’t want to hear you crying,
When you cry, my mind is upset, my heart is broken.

    —Song, Baba of Karo

IN AUGUST 2007, when Salimatu took her son, Musa, who had a painful ear infection, to the recently opened tertiary care hospital, Ahmadu Bello University Teaching Hospital (ABUTH), at Shika, just north of Samaru and Zaria, in Kaduna State, Nigeria (Figure 1), she participated in a new system of health care in Zaria which linked primary health care with ever more specialized healthcare provision. This revised system has advantages—attendance by trained specialist doctors and better diagnostic facilities—and disadvantages—Salimatu made a total of three trips to healthcare facilities, with the costly trip to Shika to and from her house in Zaria City taking an hour each way. Whether she would have gone to Shika without financial and logistical backing, but rather would have resorted to her first avenue for treatment at a nearby pharmacy shop, is unclear.

Almost twelve years earlier, in January 1995, Hawa’u, the two-year-old daughter of another family who lived in the same house in Zaria City, was unable to walk. In order to diagnose the source of her problem, she was taken, first by her father and later by her mother, to Ahmadu Bello University Teaching Hospital, which was then located in the nearby neighborhood of Tudun Wada in the larger town of Zaria. After seven trips to the hospital, a doctor established that she was suffering from malnutrition and not TB; nutritious food and antibiotics were prescribed, the latter obtained from the hospital pharmacy. The expenses incurred as well as the costs of a high-protein diet would likely not have been possible without outside intervention. Despite improved biomedical diagnosis and tests, the constraints of poverty made following recommended treatments unlikely in both cases.

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