A VISIT TO THE BONE SETTER.

Last year I went to see a bone setter for a report (I referenced it here) I was writing for a publication, unfortunately they didn’t use it and it has been on my laptop since then. I decided to upload it here for two reasons: the first is, I can’t leave it to languish on my laptop, I spent too much time on it. The second is I am supposed to write a piece on Benin art but the ginger hasn’t been there, maybe uploading this will give me the push or in Terry G’s words it will ginger my writing swaggah to finally start the piece. The things we do for our art abi?

My final year project was on traditional medicine and it involved interviewing traditonal medicine practitioners and I enjoyed every minute of it. They know soooo much and we have barely scratched the surface of the knowledge of indigenous medicinal use of plants. Writing this piece was a big pleasure for me and I hope you’ll enjoy it too.

Before I start this piece, I want to throw this open here. I’m going to Badagry in Febuary, one of the weekends but I’m not sure which though. It’s a visit to the slave port and other historical centers. If you want to come, let me know so I can know how to plan for transport, food and other logistics.

 

THE BONE SETTER.

It is the screaming that shows you’ve arrived Taju Thompson Drive on a Monday or Thursday or Saturday. Confessions of long forgotten sins, pleas for mercy to God, to mothers and to the person inflicting the pain get louder as you progress down the short street. You walk into a small veranda and see various people with bandaged body parts, you’re in the bone setter’s clinic.

 

Mrs. Nkwocha is the head of the team at the Immaculate Traditional Bone Setters and they are based in Lagos with their headquarters in Imo State of Nigeria. The team is strictly comprised of members of her family- her children, cousins and siblings, outsiders are never employed. She says it’s a gift from God to her family and only blood descendants of the family line can go into the business. She doesn’t train outsiders either.

 

“Even my husband cannot do this job even though we’ve been married for over thirty years” she said when I asked her if she trains people who are interested in the profession. She’d been in the profession since she was a girl and other members of the team had also shown aptitude for the vocation since their own childhood.

Her patients come from various parts of Lagos and other parts of South West Nigeria, She’s often seen as a bone setter of last resort, the one who can handle the most complex bone issues and injuries, she receives referrals from different parts of Lagos. When patients come in, they are assessed for extent of injury/damage by Mrs Nkwocha; rarely do the other setters assess new patients. Sometimes the patient is asked to go for an x-ray but this also occurs very rarely and this is usually done to reassure anxious patients/relatives and to exhibit their own expert knowledge. The x-rays usually confirm her initial diagnosis.

 
The patients I met there were very confident in her abilities, most of them were directed or referred to her by former patients and they’ve also seen massive improvement in their own cases. A man who’d fallen into a gutter and fractured his tibia told me how much he’d have been encased in a Plaster of Paris and hung like a chicken if he’d gone to an orthodox hospital and he wouldn’t even have seen the kind of improvement he’d seen in the three weeks he’d been coming to the bone setters.
 

The resident doctors at the National Orthopaedic Hospital in Lagos and other federal tertiary hospitals are on strike over unfulfilled promises made by government and non-payment of three months salaries to doctors at one of the Federal Medical Centres. With strikes like this as a common occurrence in the Nigerian healthcare sector and private hospital facilities out of the reach of most Nigerians due to their exorbitant charges. Many Nigerians have begun to resort to alternative/traditional medicine to meet their health challenges.

 
After the assessment of the patients for extent of injury/damage to the affected part, treatment commences. She charges monthly fees but treatment can begin if they pay a deposit of 50% of the full charge. Clinic days are Mondays and Thursdays for massaging and setting while Saturdays are mainly for steam therapy.

The typical treatment procedure begins with untying of the patient’s bandages and examining the progress of treatment, for cases like arthritis, bandages are not used. After the untying, the patients wash off the clay that has been used to coat the injured part in the previous treatment.

 
The next stage is the massage of the affected part, a bone is used to press against the skin in this procedure. When I ask her about the origin of the bone used in this process. “Was it animal or human?” I asked. She smiled and told me she couldn’t pin down the exact animal the bone came from as the bones are sourced by her father and she hadn’t really thought about it. She admitted that it might be human because the bone had to be durable and human bones were very strong. I asked her if animals like cows and goats can be used and she said those bones were brittle and would only last for a week.

 

 
Screams of pain always accompany the massaging, I watch a mother tell her son not to cry too much because she’ll cry too. The son is in twenties and he came for a fractured middle finger, eventually his mother gives in and cries too, she’s still crying even when the massaging ends. It is the son who consoles her, he tells her not to cry and it’s even over- at least for today.

 
Amaechi- one of the bone setters and Mrs Nkwocha’s first son, almost loses his temper at his friend who’s crying because of the treatment.

 
“Be a man” he tells him, “if they call for men, will you not come out?”

 
“I am not men for now, after this thing goes I go be man but for now I be woman sef” he says and the whole room erupts in laughter.

Amaechi laughs too even though he mutters “she men” under his breath. Pain has no gender we all agree. Another patient tells of his first experience with the massage, his leg had been almost crushed by the tire of a coaster bus. He didn’t feel any pain on that day but his first treatment made him realise that labour pains must be horrible and it made him respect his wife much more.

 
Most of the patients arrive by the motorcycle taxi known as okada. Ironically these taxies are the leading cause of orthopaedic injury in Lagos but they are the most accessible and affordable means of transport for most of the residents. A particular patient causes a stir when she’s brought in by a female okada rider, in this part of the country, female riders are a rarity.

 
After the massage comes the application of clay, the clay is meant to relax the veins of the patient. The wound healing process is aided by the increase of blood flow to the injured site and the relaxing of the veins creates more space for the blood to flow within them with increase in blood flow as the resultant effect.

 
She uses two types of clay- The red clay and the black clay. The red clay is used for almost all the clients, the clay is supplied by a man in Ikotun. She doesn’t know how the clay is sourced- just like the bone used in massaging, she’s more interested in results. Clay is not used for open wounds due to the risk of infection, she manages the open wound with shea butter until it heals and does light massages before she can start the normal treatment procedures

The black clay she sources herself from the bush, she adds certain herbs to it and applies it in special cases. Black clay is used for patients with flaccid paralysis whose nerves need strengthening as she puts it. I ask her if she incorporates herbal mixtures in her practice and she said apart from the herb infused clay, she only uses herbs for arthritis treatment and her brother makes that concoction. She actually recommends orthodox drugs for her patients, like chymoral (an anti-inflammatory drug) for the swelling that is common in injuries and pain relieving drugs for the pains.

 
The clay is applied and left to dry, at this time most of the patients have stopped crying, some can even be seen smiling. Her patients range from infants to very old people and in the three hours I spent there, I saw more than fifty patients including a three month old baby who had a fractured right humerus (upper arm bone) and an eighty five year old woman who came for arthritis treatment.

 
She has facilities for admission but she only admits patients with leg or hip injuries who live faraway or for whom mobility is practically impossible due to the nature of their injuries- those with femur and hip fractures fall into that category. She insists that a member of the patient’s family stays with them and she does not provide meals for such patients. Patients have to source for their meals themselves, she doesn’t have time to prepare meals- she says.

 
After the clay dries comes the retying of the wound with bandages. Gauze bandages are used and they are available for sale at the clinic. Wooden splints are used to support the limb before the bandages are used. In this clinic bamboo is the source material for the splint, it is prized for its flexibility and durability. I ask if plywood can be used instead and she said the stiffness of plywood renders it useless for the task, it is essential for the wood to be flexible because this flexibility and strength mimics that of the skin and the patient doesn’t feel extreme discomfort.
After the splint application and the tying of the bandage, the patient is free to go. At this time discussion of the progress of treatment is usually done and the patient is given advice on further management of the wound and the next appointment is scheduled.

 
The patients sing her praises and tell me how much their cases have improved, some of them have had the injuries for years. There’s a nine year old boy with a fractured humerus that occurred two years ago and wasn’t properly handled at the private hospital. He’s lost flexibility of his elbow and his upper arm had been shortened, his father explained that after one month of treatment with the bone setter, he began to move his elbow a little.
“A major breakthrough” his father said.

 
I lingered a little and watched people come and go, all of them happy with the services provided by the bone setter. It occurred to me that our disdain for traditional medicine is not only sad but a betrayal of who we are as a people.