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.”
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