Africa, Development & Aid, Headlines, Health

HEALTH-NIGERIA: Business Booming for Traditional Bone-Setters

Toye Olori

LAGOS, Jul 18 2009 (IPS) - Dressed in a simple buba (Nigerian wear) and black trousers on this particular morning, Lawal Olukole receives patients in a six by six foot consulting room made of plywood.

Olukoye (centre) at work in his Oshodi clinic. Credit:  Toye Olori/IPS

Olukoye (centre) at work in his Oshodi clinic. Credit: Toye Olori/IPS

The consulting room is in front of the main building of Olukoye’s Iya Mallam clinic, a bungalow whose open spaces have been converted to semi-private bed spaces for in-patients.

At the Iya Mallam Clinic, both the conventional and herbal medicines are applied, depending on the choice of the patients, but Olukole claims that herbal medicines heal faster.

“We have different herbs, lotions and balms for different injuries, sores and skin types, so we do not compound the patient’s problems by applying wrong herbal lotions. We have preparations for bones and sores.

“I know herbs to use for different problems through inspiration which I receive at night from God. In dreams, I will be shown different kinds of injuries or fractures and herbs to use.

Traditional bone setting

Olukole asks his patient to sit on a wooden platform that serves as examination couch. Afolabi*, an 18-year old student who has broken his left leg playing football, and had a plaster cast put on his leg at a hospital two weeks earlier, has come to the traditional bone setter's clinic because his parents believe Olukole can heal his leg faster.

Olukole removes the cast, then examines the leg to determine if it is compound or multiple fracture.

Then, with the help of one of his assistants, he tugs at the two ends of Afolabi's leg to align the bones as the boy cries out in pain. The bone setter then applies some herbal portions and bandages the leg, strapping some wooden rulers to the leg to support the fractured bone while it heals.

Olukole directs a clerk to write how much the patient will pay for the treatment. A card at Olukole's clinic costs N5,000 naira – (about 34 dollars), admission costs between N15,000 and N25,000 (102 dollars and 171 dollars) depending on how long a patient will stay at the clinic. The cost of treatment itself ranges from N40,000 to N100,000 (about 274 dollars to 685 dollars) also depending on the nature of the fracture.

"I treat between 15 and 20 patients daily," Olukole told IPS. "Some come for dressing from home after receiving treatment here, others are fresh cases. I put those with serious cases on admission."

*Not his real name

“I sleep with a jotter and pen besides me. As soon as I wake up, I write the herbs down. Sometimes, I am shown where to get the herbs so I go straight there and the herbs are right there.

“Some other times, I am even shown before hand, a patient, his ailment and what to use, before he is brought to the clinic. In that case, I prepare the herbal medicines before he or she is brought in and I go straight to treating him or her,” he said.

Olukole says he does not need an x-ray to know the nature of fracture and how to treat it.

“It is purely God’s gift. By placing my hand on the surface of the injured spot, I will know the type of fracture and position of the bone. I do not need x-ray to treat anybody. I thank God for the gift,” he said.

Though Olukole says he never used incantations to heal, he admitted that he uses some verses of the Koran to pray over the knife with which he spreads herbal portions on fractured limbs.

Satisfied patients

Junaid Adekunle, a 36-year old businessman who had a fracture on the knee, corroborates Olukole’s claim to efficacy of traditional bone setting.

“I had a fractured arm some years back and had to go to Igbobi Orthopedic Hospital, Lagos. They put (plaster of paris) and asked to come back later for operation. But when I got home some people advised that I go to traditional bone setters. I did not regret coming here because under three weeks I was able to use the hand again,” he tells IPS.

“So when I had this multiple fracture on my leg, I came here straight, and just about two months now, I have been able to at least stretch my leg and I can walk with the aid of clutches.

“If I had gone to a hospital, I am sure I would still be on bed with a cast. The only thing though is to be taken to the right TBS. Once you have the right people no matter the fracture they fix it,” Adekunle told IPS at the Iya Mallam Clinic.

Traditional bone setters charge much less than orthodox hospitals for care. This has attracted many accident victims to patronise traditional bone setting clinics.

Many patients abandon hospitals to go to clinics like Olukole’s, complaining that they had stayed in hospital too long, or claiming the doctors there told them they would need to have limbs amputated due to the seriousness of the fractures.

Like many other traditional bone setters in Nigeria, Olukole did not train as an orthopedic surgeon. Some learn the art as apprentices to master setters but for Olukole – who claims his birth was surrounded by mystery: he was delivered following a two year gestation – his skills as a healer are “inborn and God’s gift”.

He is a trained football coach, who was training under-13 and 16 boys’ clubs in Lagos before taking up bone setting as a profession. Even while coaching, Olukole worked with his mother to heal bones.

“I used to bring footballers who had fractures to my mother to be helped. And while I was doing that, I also engaged in the act of setting bones,” he said.

“I had to resign as in 1996 after about a decade as a coach, due to pressure from my mother to join her in the bone setting business.”

No shortage of work

Statistics from the Federal Road Safety Commission (FRSC) show that in Lagos 10,471 accidents involving motorcycles were reported.

Motorcycles, popularly known as "Okada" after a leading domestic airline, fill a vital gap in the city's inadequate public transport system. They easily - and terrifyingly quickly - cover routes that are inaccessible to buses and cars, navigating bad roads that leave four-wheeled vehicles in difficulties.

But Okada riders often get involved in accidents because of speed and their reckless driving.

The motorbikes are typically owned by retirees or people retrenched from their jobs who can afford to buy a motorcycle but the riders are mostly young unemployed boys who care little for traffic rules - the faster they ride, the more fares they’ll collect by day’s end.

Accident victims are undeterred by questions about Olukole’s training or qualifications. Abayomi Fakola, a 33-year old driver, who had an accident at Kagara, near Minna, northern Nigeria, was transferred to the Lagos Orthopedic Hospital with a fractured arm. He claimed he was told at the hospital that the arm would be amputated from the shoulder to save his life.

“My friend’s wife who knows this place insisted I should be taken to the (bone setters’) clinic. I came here five months ago. It is here that ‘Coach’ saved my arm but he could not do anything about my wrist, which was totally destroyed at the accident site.

“Now I can move my hand. I am still here because though the wound has healed, I want the colour of my skin back to normal before leaving.

“One cannot compare the hospital with this clinic. The bone setters are far better. They do not amputate except the limb is totally dead before getting here. I believe they are better than orthodox hospitals. Coach has done a lot to save accident victims from amputation,” Fakola said.

Just helping nature?

But Charles Uzordinma, a trauma and orthopedic surgeon at the National Orthopedic Hospital, at Igbobi, argues that the traditional bone setters (TBS) are not professionals.

“The TBS take advantage of adherence to old custom and the ignorance of patronisers, 90 per cent of who are illiterates, that if you go to orthodox (hospitals), they will cut off their legs.”

He said while the orthodox hospitals ask for deposits before treatment, the TBS allow installment payment; it is this affordability that explains why so many patients are attracted to their clinics.

According to him, the bone healing is purely the work of nature.

“When a fractured bone is rested and when it is kept in one place it heals. That is why the TBS keeps the person in one place and the bone heals.

“But the orthopedic surgeons monitor the healing process to ensure that it heals perfectly and they also give other medications and provide the active ingredients or substances that are required for the healing to take place fast and at the most efficient manner to make it as solid as it should be,” he said.

Uzordinma listed the risks attendant on relying on a traditional bone setter as unequal length in healed limbs, angulations, toes pointing inwards or outwards and dangerous obstruction of blood flow in the course of trying to keep fractured arms or legs still, leading to the death of such limbs.

His advice to Lagosians is to stay away from traditional bone setters. He claims that 60 to 70 per cent of those who go to clinics like Iya Mallam eventually return to the orthopedic hospital, while others just accept the imperfect healing from the TBS clinic.

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