Dr Gopee

Where ignorance is not bliss – and reason is thrown out!

— Dr R Neerunjun Gopee

Reminiscing about the Royal College Curepipe in my article of last week seems to have touched a chord of nostalgia in some friends, who told me as much. And triggered further delving into pleasant memories of those days gone by. This was reinforced today by the arrival of my copy of National Geographic, to which the library at RCC subscribed, and which used to be one of my favourite magazines – and is to this day, of course. Amongst others were Scientific American, Nature, Discovery, The Illustrated London News. The latter two are no longer published, and if I am not mistaken Discovery has morphed into New Scientist – but even if I am wrong and it hasn’t, meaning that New Scientist is an entirely new publication, that’s fine too!

We all know that travel is great education, but if one does not have the opportunity or the means to travel widely, then reading can to a great extent make up for that as far as getting to know about other lands, peoples and cultures are concerned. Of course there’s nothing like finding out for oneself at first-hand, but travel-writing, biographies and autobiographies do provide one with material which is as exciting – if only because imagination has to supplement the reading and learning from those who have actually lived through what they are frank and bold enough to put down for the benefit of others.

As WHO representative for some time nearly ten years ago, I had the opportunity to meet colleagues from all the countries of Sub Saharan Africa, and many years earlier I had traveled to three southern African countries as a Commonwealth Fellow. Subsequently I have visited some other African countries. I have been privileged to exchange views and make friends with some outstanding professionals, and as a result whatever happens on the African continent is of great interest to me. It is no surprise that this interest is enhanced when it comes to countries whose citizens I have in particular befriended, Mauritania for example, and I still cherish the hope that I may one day be able to visit my friend Dr Hasen Mohamed – who happens to know Mauritius and the Mauritius Institute of Health quite well too – at his home in Mauritania, where he is now happily retired. From my Niger colleague, then WHO representative in Senegal, I learnt about a practice that is akin to our own Raksha Bandhan custom, and I did write an article about this encounter when I returned from a meeting in Harare in the year 2000. So true indeed that diversity is the spice of life!

Since I belong to the medical profession it goes without saying that everything that relates to medicine and health is of primary concern to me, as it is too to other doctors in a similar situation to mine whose main focus is on the health and medical problems of whole populations. One such issue is the practice of Female Genital Mutilation, FGM, also known as female circumcision. It has featured continuously on the agenda of WHO, and this is especially the case in the African region. I will come to it shortly, but first let me refer to an article that has appeared in the March 2010 copy of the National Geographic that I hold in my hand. It is about Ethiopia’s Omo Valley, ‘still a place ruled by ritual and revenge.’ Uh? – the next line, ‘but change is coming’ did not quite mitigate the impact of the first line, and I was curious to find out what it was all about.

Change must come fast! Here is the text in larger font in a window that stands out on the page, ‘If children are born deformed, or if their top teeth erupt before their bottom teeth, tradition dictates they must be killed.’! This practice is known as mingi killing – mingi being a kind of very bad luck, and the killing is to prevent the spread of mingi. Who knows that this may be a hunch to prevent the transmission of defective genetic traits, and perhaps this is how we must view the practice rather that see it a barbarian one. We must remember that we are here amongst people who have no access to modern medical facilities at all, and we should refrain from taking the moral high ground especially when we consider some of the cases of killing of babies and young children that we have been reading about regularly.

Whereas in the case of OMO Valley residents, one is confronted with ignorance about abnormal medical conditions, let us ask ourselves how far away we are from the woman who killed all her 12 children because they were born out of wedlock, and in ways which are not much different from what we hear about? Such as ‘sometimes the child is abandoned in the bush, its mouth filled with earth; sometimes it is hurled into a river.’

One could ascribe this practice to lack of education or reason. But what to say of the cases of paedophilia about which the pope has recently held a meeting with accused bishops from Ireland? Or the US pediatrician charged with serial molestation of 103 children, all of whom but one are girls? On Monday a grand jury has returned a 160-page indictment against him, with 471 counts of sexual crimes which include rape, sexual exploitation of a child, unlawful sexual contact, continuous sexual abuse of a child, assault and reckless endangering.

And as far as FGM goes, one has only to google and land on so many websites dealing with the subject. FGM refers to a number of practices which involve cutting away part or all of a girl’s external genitalia, for social or religious reasons mainly, between the ages of 4 and 14 years. It is a practice which affects more than three million girls every year, and is present from Africa through the Middle East to as far as Indonesia, despite the presence of feminist groups and the interventions of the UN which are striving to dissuade its protagonists.

It is frightening enough to hear about it at large forums which deal with the subject in terms of statistics, geographical distribution, instruments used, prevention strategies, educational programmes and so on. But reading about the pain and suffering from a victim was quite a trauma – just imagine what it was for the victim herself, as I have read in a book that I completed recently, and which came to my mind as I was going through that article in National Geographic.

Here is how she describes what took place, in Somalia where she was born: ‘I was next. Grandma caught hold of me and gripped my upper body… two other women held my legs apart. The man, who was probably an itinerant traditional circumciser from the blacksmith clan, picked up a pair of scissors. With the other hand, he caught hold of the place between my legs and started tweaking it, like Grandma milking a goat… then the scissors went down between my legs and the man cut off my inner labia and clitoris. I heard it, like a butcher snipping the fat off a piece of meat. A piercing pain shot up between my legs, indescribable, and I howled. Then came the sewing, the long, blunt needle clumsily pushed… my loud and anguished protests… when the sewing was finished, the man cut the thread off with his teeth.’

Definitely, from a medical point of view, this is nothing short of butchery, whatever be the reasons advanced for the maintenance of that tradition. But clearly, the very societies in which it is upheld are now raising an alarm about it not only in their own countries, but are gaining international support to bring about the needed change that will eventually, one hopes, lead to stoppage of the practice and avoidance of unnecessary suffering that it entails.

There are many more unacceptable practices based on superstitions and irrationalities, such the belief that having sex with a young child will cure one of HIV/AIDS and other sexually transmitted diseases. This is one of the reasons for the spread of child trafficking and prostitution, and in India it is certainly a matter of great concern, according to information available in the print media.

Sorcery practices are not uncommon in our country either, as we all know and from time to time there are lurid reports of incidents which are almost unbelievable in this day and age, except that they are true. How long will we go on throwing out commonsense and reason, when there is so much that they can throw light on and allow us to lead better lives, with less suffering inflicted? The answer is in our own hands…

RN Gopee