For the anthropologically curious I paste below a few key quotes from a study of the practice of uvulectomy in Africa. (Not as OT as might appear at 1st glance -- one of the explanations for the practice is to facilitate breastfeeding). Regards, Helen Katz S. (1989) Uvulectomy: A Common Ethnosurgical Procedure in Africa Medical Anthropology Quarterly Vol. 3, No. 1. pp. 62-69. Abstract The partial or complete removal of the uvula is a procedure considered almost obsolete by cosmopolitan physicians. Antibiotic therapy is now accepted as the treatment of choice for most enlarged, infected uvulae, and modern medical evaluation is considered essential to rule out the possibility of life- threatening conditions such as tuberculosis or cancer as the underlying cause of symptoms. However, traditional African practitioners continue to perform uvulectomies at the request of their patients and to claim safe alleviation of symptoms, despite severe complications noted by physicians. I postulate that uvulectomy, a procedure recognized by Africans to be therapeutic rather than religious, may have been beneficial when modern health services were unavailable and may have been the treatment of choice in pre-antibiotic days. Selected Quotes: “In contrast with areas in which cosmopolitan medicine dominates, uvulectomy continues to be common in large parts of Africa and some neighboring regions. How widespread the practice is, is difficult to determine, since our knowledge of it depends on the accuracy of reporting in the literature. The procedure does not appear to have ritual or religious implications in the places where it is performed (as does, for example, the removal of the front incisors among some East Africans or circumcision in many groups), but rather is viewed as a simple health measure (Good 1987:281-285). For the procedure to have persisted across a significant expanse of Africa and southwest Asia among ethnically diverse peoples indicates at least the possibility that a form of experimentation and long-term observation showed at least temporary beneficial results without too many unacceptable side effects. In this brief report I survey the evidence for this possibility.” “Uvulectomy has been documented as a common procedure in Nigeria, where the uvula is believed to be the root cause of all throat problems (Ijaduola 1981). It is a prophylactic routine among the Bedouins of the South Sinai (Nathan et al. 1982), and has also been observed in Lebanon (Barakat, Itani, and Zaytoun 1986), Sudan (Anderson 1908:3 17; Arkell 1936), Mali (Imperato 1977:76), Zaire (Pieters 1977), and Ethiopia (Abdulkadir 1986; Bonnlander 1980). Authors have also described it among a variety of ethnic groups in East Africa (Good 1987:28 1-285; Roles 1967; Tanner 1959).” “In Kenya, according to one report (Jarvis and Mwathi 1959), the incidence of uvulectomy ranged between 16% for the Kamba and 56% for the Kikuyu. Among the Kikuyu the majority underwent the procedure before the age of five. In 1977 an active clinic operated by two closely related traditional medical practitioners was observed in Nairobi. These dakatali wa kilimi Swahili) specialized in uvulectomies, "cutting" anyone from toddlers to grandparents to prevent coughing, tonsillitis, hoarseness, and general weakness. In children the uvula was completely excised because they believed that otherwise it would regrow. In adults it was only partially removed because of fear of hemorrhage (Good 1987:283-284).” “The uvula may also be removed in neonates and young children, prior to the onset of symptoms, as a prophylactic measure. In Ethiopia the uvula is "felt to obstruct breathing or swallowing in infancy" (Bonnlander 1980). Among the Berber of northern Morocco it is done to "facilitate breast feeding and speech" and to improve health throughout life (Apffel 1965). Almost all children of the Bedouins of the south Sinai are subjected to the procedure during the first or second year of life. The operation is performed by the same individual who circumcises males. The indications mentioned for the procedure are medical rather than religious and include increased ability to tolerate thirst (Rubenstein 1979), prevention of upper respiratory diseases. and elimination of mechanical difficulties (such as obstruction due to hypertrophy) (Nathan et al. 1982).” “In Nigeria Fleischer noted that 95.8% of Fulani and Hausa children admitted to the hospital had been uvulectomized (1975). Among the Hausa this is usually done by a "barber" when the infant is between three and seven days old as part of the naming ceremony. They believe that the uvula will swell and rupture, causing coughing, gasping, and eventually suffocation if not removed. The indication for "barbing," according to a group of Nigerian herbalists attending the 1983 conference on Traditional Healing in Contemporary Medicine of the National Council for International Health, is to prevent overgrowth, which will block the oral cavity and prevent the passage of food. Sixty percent of barber surgeons questioned by Ijaduola in Nigeria felt that such prevention was an adequate indication for the procedure in neonates (198 1).” Conclusion “The persistence of uvulectomy as a therapeutic or prophylactic surgical procedure in Africa, despite other medical options now available, may be the result of both sociocultural pressures and pragmatic observation of its effectiveness. This small structure, considered by some to be vestigial and by others to have a role in phonation and deglutition, is easy to reach and excise. It is therefore available to traditional practitioners in a way that tonsils, even when enlarged, are not. If, as has been claimed, the uvula and lymphoid tissues of the tonsils and adenoids are interconnected, uvulectomy may actually be the treatment of choice in situations where the lymphoid defenses have been breached and foci of infection established, and where cosmopolitan medical care (including antibiotic therapy) is not available. With increasing education and better access to antibiotics and to modem ear, nose, and throat services, the incidence of uvulectomy should and undoubtedly will decrease. Further research into the role of the uvula, with particular reference to the body's defenses against infection, may or may not be undertaken. We will probably never know whether this indigenous surgical procedure was by and large helpful, as traditional practitioners claim, or harmful, as many physicians assert.” *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]