Plastic teeth
A week ago our medical team was chased away from the village near the coast. Angry, dangerous looking men threatened us with spears and bows and arrows.
Later when tempers had calmed some of the team carefully approached the village again.
The villagers were angry and frightened because they thought we were a family planning team entering their compound. In 1985 some of our Kenyan people believed that family planning teams would kill or steal babies and small children. Many men didn’t want to use birth control anyway. They liked to have several wives and wanted plenty of children to look after them in their old age.
When we explained that we were a medical research team, not a family planning clinic, the village leaders agreed to listen to what the team leaders had to say and arrangements were made to return the next day with the full team.
The following morning, early, before the sun was too hot, the truck was loaded up with specimen pots, blood taking equipment, weighing scales, height measuring stadiometers, medicines, examination couches and all the other gear for the clinic. The doctors from England, the enthusiastic paediatrician, the fierce parasitologist, the trim nutritionist, and the African technicians and nurses all piled in. We crossed the Kilifi river on the trusty old ferry, bought freshly roasted cashew nuts from the riverside vendors, and the long drive up the coast road began.
This time when we arrived in the village although the reception wasn’t exactly friendly we were not threatened. The day was hot and dry and the drive had been dusty. After we drank some coconut water the white paediatrician stood up under a large shady mango tree. The elders, men and women, sat quietly in a group on the ground under another tree at a safe distance of ten or fifteen yards. An excited group of younger women sat separately. A few older children played around the mud and wattle houses but the young children and babies were kept safely out of the way.
The white doctor speaking in very bad Swahili went through the ritual he had learned. Jambo. Habari. Salamat. The elders nodded.
Then through the lips of the interpreter he said that we wanted to help the people by finding out more about malaria, schistosomiasis and the other diseases that affected them and we hoped to find better treatments and vaccines. But first we needed to know more about which diseases were the main problems in the area and so we needed to examine the people and take specimens of blood, urine and faeces. He said we would see any sick people in the village and give them treatment.
After some heated discussion amongst the elders the big man of the village stood up to speak and the interpreter translated for the foreigners. Politely he welcomed the team to the village and apologised for the previous day’s attack. He said that the elders were interested in what the doctor had said but that there had been no mention of their main health problem which was that many of their babies were born with plastic teeth. The village people were very worried about this. The government was doing nothing about it and the local medicine men were removing plastic teeth from most of the babies in the area. This was done in the early months otherwise the babies became sick at around six months of age with diarrhoea and vomiting and many died. The villagers wanted to know why this was happening and what could be done to prevent the problem.
The foreign doctor was puzzled but we local health workers of course knew that village doctors were removing milk or deciduous teeth from under the babies’ gums saying they were plastic teeth. We thought this belief had started some years earlier in Uganda and had spread. People did not understand that it was normal for babies to have unerupted teeth under the gums. They believed that infant teeth started to grow only at the time they appeared through the gums.
Many babies had severe infections or bleeding after the operation and some died.
Of course the real explanation for the many babies who died at about six months of age was gastroenteritis caused by bottle feeding which was often introduced at that age. The foreign doctors and we African health workers said these teeth were normal and not the cause of the babies’ illnesses but the villagers of course didn’t believe us.
Three days later I was walking along the village road in the morning with my baby Margaret, feeling very scared. The rest of the team drove past and when they saw me they stopped the truck and said “Hey Nurse Elizabeth where are you going with your baby?” I was ashamed and didn’t tell them where I was going. But I could tell they knew. Well of course we all knew that the plastic teeth epidemic was based on a myth. We health workers taught that all the time. But I knew that most of the team had had their babies’ teeth removed to be on the safe side, just in case the medicine men were right. I was terrified that my baby would get sick after the operation. But what else could I do? I couldn’t afford to take any chances. If she died at six months and I hadn’t had those teeth removed, I could never have forgiven myself.
Later when tempers had calmed some of the team carefully approached the village again.
The villagers were angry and frightened because they thought we were a family planning team entering their compound. In 1985 some of our Kenyan people believed that family planning teams would kill or steal babies and small children. Many men didn’t want to use birth control anyway. They liked to have several wives and wanted plenty of children to look after them in their old age.
When we explained that we were a medical research team, not a family planning clinic, the village leaders agreed to listen to what the team leaders had to say and arrangements were made to return the next day with the full team.
The following morning, early, before the sun was too hot, the truck was loaded up with specimen pots, blood taking equipment, weighing scales, height measuring stadiometers, medicines, examination couches and all the other gear for the clinic. The doctors from England, the enthusiastic paediatrician, the fierce parasitologist, the trim nutritionist, and the African technicians and nurses all piled in. We crossed the Kilifi river on the trusty old ferry, bought freshly roasted cashew nuts from the riverside vendors, and the long drive up the coast road began.
This time when we arrived in the village although the reception wasn’t exactly friendly we were not threatened. The day was hot and dry and the drive had been dusty. After we drank some coconut water the white paediatrician stood up under a large shady mango tree. The elders, men and women, sat quietly in a group on the ground under another tree at a safe distance of ten or fifteen yards. An excited group of younger women sat separately. A few older children played around the mud and wattle houses but the young children and babies were kept safely out of the way.
The white doctor speaking in very bad Swahili went through the ritual he had learned. Jambo. Habari. Salamat. The elders nodded.
Then through the lips of the interpreter he said that we wanted to help the people by finding out more about malaria, schistosomiasis and the other diseases that affected them and we hoped to find better treatments and vaccines. But first we needed to know more about which diseases were the main problems in the area and so we needed to examine the people and take specimens of blood, urine and faeces. He said we would see any sick people in the village and give them treatment.
After some heated discussion amongst the elders the big man of the village stood up to speak and the interpreter translated for the foreigners. Politely he welcomed the team to the village and apologised for the previous day’s attack. He said that the elders were interested in what the doctor had said but that there had been no mention of their main health problem which was that many of their babies were born with plastic teeth. The village people were very worried about this. The government was doing nothing about it and the local medicine men were removing plastic teeth from most of the babies in the area. This was done in the early months otherwise the babies became sick at around six months of age with diarrhoea and vomiting and many died. The villagers wanted to know why this was happening and what could be done to prevent the problem.
The foreign doctor was puzzled but we local health workers of course knew that village doctors were removing milk or deciduous teeth from under the babies’ gums saying they were plastic teeth. We thought this belief had started some years earlier in Uganda and had spread. People did not understand that it was normal for babies to have unerupted teeth under the gums. They believed that infant teeth started to grow only at the time they appeared through the gums.
Many babies had severe infections or bleeding after the operation and some died.
Of course the real explanation for the many babies who died at about six months of age was gastroenteritis caused by bottle feeding which was often introduced at that age. The foreign doctors and we African health workers said these teeth were normal and not the cause of the babies’ illnesses but the villagers of course didn’t believe us.
Three days later I was walking along the village road in the morning with my baby Margaret, feeling very scared. The rest of the team drove past and when they saw me they stopped the truck and said “Hey Nurse Elizabeth where are you going with your baby?” I was ashamed and didn’t tell them where I was going. But I could tell they knew. Well of course we all knew that the plastic teeth epidemic was based on a myth. We health workers taught that all the time. But I knew that most of the team had had their babies’ teeth removed to be on the safe side, just in case the medicine men were right. I was terrified that my baby would get sick after the operation. But what else could I do? I couldn’t afford to take any chances. If she died at six months and I hadn’t had those teeth removed, I could never have forgiven myself.
posted by Steve Salfield at 3:58 PM
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