ABIKU [PREDESTINED TO DEATH]

  ABIKU [PREDESTINED TO DEATH]

(THE EXERTION OF SICKLE CELL ANEMIA)

A MANUSCRIPT BY FOLASAYO AWODUMILA 

INTRODUCTION

In Africa, particularly, in the Nigerian tradition, chaotic interpretation and reinterpretation takes place regarding the concept of ABIKU ( A Yoruba name given to a child who keeps enacting a recurring cycle of death and rebirth.

Over the centuries, the Abiku mythology has seen to the fate of thousands, if not millions of children who and seemingly are reborn through the same mother in Yoruba land.

The myth is of a very strong form of unmitigating and vengeful form of reincarnation. In this case a particular child actively brings him or herself to be born into the same family and by the same mother, usually it is a female child, when this cycle continues for an unbearable length of time, the child is given a mark so that they are sure that it is this same child. It is found out that when this Child dies and reincarnated another time, it often returns with the mutilated parts or with the mark given.

At the turn of the Centuries and with colonialism and empirical sciences making it's entry into the African shoes, most Yorubas began to exercise other explanation for the patterned death and birth known as Abikus. Cases of sickle cell anaemia has been used to explain away what used to be viewed as the torturous reincarnation of an ABIKU.

However, science in it's totality has not been able to explain how a child comes back again with it's mutilated parts or a tribal mark given, the same thing with it's Igbo equivalent known as ogbanje. This is why the issue remains unrested like some other superstitious western Nigerian beliefs.

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After six years in medical school, I was proud to have my MBBS (Medicine bachelor of surgery) certificate, my housemanship completed, eager to know where am being posted to for my NYSC (National Youth Service Corp)

My name is Ibrahim Kada a native of Kogi State and a medical doctor, got a call from one of my course mates in school that the listing for NYSC is out, I was elated so I told him to help me check where am posted to, he checked for me and told me Ekiti State.

I have never been to Ekiti State but in a way I was happy I was posted there, at least I would be able to familiarise myself with new people and particularly a new culture.

I left Lagos in the early hours of Saturday with my luggages, the bad road between Ore-Benin delayed my journey, I got to Ekiti State quite late in the night, the orientation camp was filled with corp members like me, I was quick to locate the hostel I was meant to stay, I placed my luggages on my bunk and headed out to join the others outside.

Two weeks at the orientation camp felt like a month, we were finally done at the Camp, and was posted to our various places of primary assignment, as a medical doctor, I was posted to a remote health centre in Oye Ekiti.

I assumed duty the next day, Ekiti people are quite loveable people, they treated me so well in the small apartment I stayed, Ekiti People and their love for yam and pounded yam, I slowly began to love yam cause everyone I came across would always give me a tuber of yam they got from their farms.

The health center I was posted to was not a really big health centre, it was small, with just two doctors with me making it three doctors and quite alot of auxillary nurses, drugs were in short supply and the equipment were mudane.

I didn't have an office to myself so I sit outside at the reception most of the time with the nurses, patients trooped in slowly, but I made sure I attended to everyone very well, soon any patient that came in requested to see the corper doctor: in no time I became quite popular in that community, Ekiti people value education,no wonder I was loved by most people in that community.

After my normal rounds of seeing patients, I left the health center to go home, I normally stroll through the untiled road to my house anytime am done at the health center. It was quite a distance but I loved using it as an exercise, as I walked past the various small buildings, I noticed a rather disturbing sight, a group of people were seated outside, some standing, the crowd was much that it covered what they were doing, I got interested so I moved closer, I pushed a couple of people to able to gain access into the center of the gathering, I heard the cry of a child, and so I moved inside more, and then I saw a native doctor called Babalawo by the indigenes of the community, I saw him holding the child upside down, the baby's legs were up while her head was down, I almost ran to where the native doctor was to grab the baby from his hands, but I had to understand what was really happening, I asked a man standing close to me, and in his words he explained that the child is a Spirit child (An Abiku) I looked at him and repeated after him "ABIKU" that was my first time hearing that word, I asked what it meant, he looked at me in disbelief like I was meant to know what it meant, he moved away from where I stood and so I moved on to the next person, who happened to be a lady and a little bit educated, I was so curious so I asked her what the whole ceremony was about, she looked at me and smiled, as she said Corper i immediately introduced myself to her as Ibrahim, she went on by saying that an ABIKU is a Spirit Child who is destined to die before reaching maturity, after a child's death the "Abiku" spirit is reborn as another Child, often to the same mother and the Spirit enters an endless cycle, as she explained I paid attention and when she was done, I asked what the native doctor was doing to the child, then she explained again that he is performing some rituals to keep the child alive.

As I stood there watching the whole ritual rites being performed, I noticed the child looked sick and quite unhealthy, I turned to the lady who I had seen at that point in time as my main translator, I told her that the child looks sick then she responded and said the child has been a sickling since they gave birth to her, and has cost her parent quite alot of money buying different traditional herbs to make her well but all to no avail.

I was curious to know if she was ever taken to the hospital, but she gestured with her head saying no that it's obvious she's an "Abiku" cause she's reincarnated, reincarnated I repeated after her, how do you mean I asked her, she has died before and she came back through the same woman, I asked how possible is that, she smiled and walked away from where i was standing, after a while I left the place but I kept wondering how possible all I had heard was.

"Reincarnation" is there anything like that I said to myself as I laid on my bed, I took my phone and googled the word "Abiku" and I read  through my phone- "It could sound primitive, but it is real especially the Yoruba race, some children over time reborn to the same mother with previous look, sex, complexion and structure. Owing to ephemeral nature of ABIKU life, Abiku completes several consecutive life cycles with one another. In some reality cases, the Yorubas, in one of their traditional ways of deterring Abiku from death after reborn is to deface such children either by cutting their finger, ear or a deep mark in the face or back, to a great surprise in most cases, the Abiku on reborn would have those marks whether on the face or at their backs. The Yorubas also call Abiku some pleading names like, Duro-orike, Durosinmi, Durojaiye, igbokoyi, Jokotimi, Malomo, Kosoko etc to plead with them not to die again and to allow them stay with their parents"

As I read through my phone I began to understand what the lady I spoke with earlier on that day was trying to explain to me but I still felt this thing is just mere superstitious, that baby looked very sick to me and all I think she needs is a good medical care.

The next morning as I walked past that particular house I had a very strong will to speak with the parents of the child, luckily for me I saw the lady that I had a conversation with the evening before, I saw her washing some clothes outside the house, I walked up to her and asked if it was possible I speak with the parents of the child, she looked at me surprisingly and asked why, I told her am just curious about some things.

She offered to take me to their house, while we walked towards the child's house I asked for the lady's name then she said her name is Alice and that the parents of the child is Mr and Mrs Aluko, she told me they are illiterates and might not really understand me , I pleaded with her to stand as my translator, she smiled as usual and said it's ok, I followed her as she led the way to where they lived "Ekaaro" she said as she knocked the door to their very small house, a pot bellied man came out and said in Yoruba "Alice Bawo ni, Karo" she responded to him by saying okunrin yii so wipe ohun fe seleye awon nkannkan fun eyin ati mummy Kashimawo"

The man responded and said, shey kin se Corper ton sise ni health centre adugbo lohun ni yii, if I couldn't pick anything in what they had been saying, I was able to pick the health center he mentioned, she nodded in response to the man,  surprisingly the man  was kind enough to offer me a seat, I sat on the bench across their entrance door, so did Alice.

I told Alice to please tell them to bring the  Child for me to see, The child was brought and she looked so fragile and was very light, I could easily carry her with just one hand, I saw cowries tied to her ankles and several incisions on her body, I looked into her eyes and noticed it was a bit yellowish, then her feet were a bit swollen,her belly was protruded like a child suffering from kwashiorkor.

All the signs I saw in this child made me believe she had Sickle cell anemia, I told Alice to help me ask them in Yoruba if both the parents knew their blood genotypes, she asked the man and his response showed they don't even know what a blood genotype meant, I told her to ask them if they don't mind I conduct some test on the child, Alice explained to them in Yoruba but the man said there's no need that the Child is a "Spirit child" reason she is like that, I had to persuade the man for hours before he agreed for a test for the child.

The first test I needed to conduct was to know the child's blood genotype, the child was taken to the laboratory, and a test was conducted, when the result came out the baby was truly diagnosed with Sickle cell anemia, I had the result in my hands, but how do I explain to her parents that the child isn't an "Abiku" as believed but that the child is just suffering from Sickle cell anemia, which came about cause her parents were ignorant of their blood genotype.

I decided to start an outreach in that community enlightening the people on the importance of them knowing their blood genotypes, so many children labelled "Abiku" are just Children with Sickle cell anemia, if their parents knew their blood genotypes before getting married to each other they would have saved these children the trauma they are facing now.

Alice and the child's father Mr Aluko were both waiting for me at the reception lobby, I carried the child and placed her in her father's hands, I looked at Alice cause I noticed she was staring at me all through apparently waiting for me to tell her the test result. Alice was a bit educated at least she completed her secondary school but I learnt from her that she hasn't been able to get into the University because of lack of money.

I told Alice that the child was diagnosed with Sickle cell anemia, she opened her mouth in total shock then turned to the child's father (Mr Aluko) to tell him in Yoruba, obviously the man didn't understand cause he just shoved what Alice told him aside and went away with the child.

I looked at Alice who was still with me at the reception lobby and told her what that child needs is an urgent medical attention else she might die.

Since Alice was an indigene of Oye Ekiti and a slightly educated one, I decided to work with her in sensitizing the people of that community on all they need to know about blood genotype and how important it is for them to know their Blood genotype before getting married and also sensiize them on what Sickle cell Anemia is and what causes it.

In a couple of weeks, I started the sensitization outreach, meanwhile I checked on Mr Aluko to know how the child was doing, only to be told she's dead, I was deeply pained cause I knew it was something we could have averted if the parents gave me the chance to treat the child.

As patients came into the health center I gave them a pep talk on why it's important for couple to know their blood genotype before getting married I explained to them that if they don't know their blood genotype before getting married, it could result to them having children with Sickle cell anemia and I further explained to them that such children become very sickling children and thus die eventually.

Quite a number of people were interested in knowing their blood genotypes, so we started off by conducting free blood genotype test to the people in the community, they were sensitized on what blood genotype can marry each other, this went on for months and I was able to contribute something meaningful to that community.

After nine months I noticed Mr Alukos wife had taken in again cause she came to the health center for her anti-natal monthly routine, in one of the periods I was the doctor on seat so I attended to her, she couldn't really communicate in English so I had people around to translate our words to each other, she was due to deliver the next month, unfortunately I knew the child she was carrying might still be diagnosed with Sickle cell anemia cause Mr Aluko and his wife had taken the blood genotype test and they were both AS, which means they have a very high possibility rate that all their children might be diagnosed with Sickle cell anemia.

I was in the lobby one afternoon when Mr Alukos wife was rushed into the health center, I knew it was time for her delivery, she was taken into the delivery award and I was the only doctor around at that time, I proceeded with the necessary examination  and I was assisted by some nurses, we were able to deliver Mr Alukos wife of her child, but to my utmost surprise, the child I delivered was a girl and she looked exactly like the child I brought to this health center 12 months ago to run some test on her and she also has the same incision on her body at the exact places it was on the child that died 12 months ago, I was in utter shock as I carried the child in my hands, how is this even possible???

NB : Genotype - This is the genetic make up of an organism: in other words it describes an organisms complete set of genes, in a more narrow sense, the term can be used to refer to the alleles, or variant forms of a gene, that are carried by an organism.

A Blood genotype indicates the genetic makeup of an individual's blood in it's entirety. Typically, there are five (5) distinct types of blood genotypes, they are AA, AS, AC, SS and SC. While the first 2 pairs (AA & AS) are normal, AC is rare and the latter two (SS,SC) are irregular and anomalous, commonly causing Sickle cell disease, which means someone with AS blood genotype cannot get married to another person with AS blood genotype.

Sickle cell disease occurs when an individual's blood cells are shaped in a deformed and abnormal manner, potentially blocking blood flow, causing pain and damage to vital organs.

Normally, the red blood cells are round and flexible and can move easily through blood vessels, however, in Sickle cell disease, the red blood cells are shaped like Sickles. these rigid, sticky sickled cells can get stuck in  small blood vessel thereby slowing (or blocking) blood flow and oxygen supply to parts of the body.

SICKLE CELL ANEMIA: Sickle cell anemia is a form of the inherited blood disorder called sickle cell disease. Sickle cell anemia changes your red blood cells shape, turning round flexible discs into stiff and sticky sickle cells that block blood flow.thanks to early detection and new treatments, about half of all people who have Sickle cell anemia live into their 50s.

WHAT IS SICKLE CELL ANEMIA: Sickle cell anemia affects your red blood cells, turning them from round flexible discs into stiff and sticky sickled cells, the sickled cells don't live as long as normal red blood cells. In the past babies born with Sickled cell anemia rarely lived to be adults, now thanks to early detection and new treatments, about half of all people who have Sickle cell anemia live into their 50s.

People who have Sickle cell anemia still face potentially life threatening medical complications, However, healthcare providers have treatments that reduce the risk of complications and ease symptoms when they happen, unfortunately there are many places in the world where people still don't have access to effective medical treatment for Sickle cell anemia.

Sickle cell is mostly affected by people whose ancestry links back to parts of the world where many people have malaria and carry a gene that provides partial protection against anemia, this gene also causes Sickle cell anemia.

Babies born with Sickle cell anemia may not have symptoms for several months, when they do, symptoms include extreme tiredness or fussiness from anemia, painfully swollen hands and feet, and jaundice. Babies may also have spleen damage that affects their immune system and increases their risk for bacterial infection. People with Sickle cell anemia inherit the disease from their biological parents, in Sickle cell anemia, the gene that helps make normal red blood cells mutates or changes, people who inherits the mutated hemoglobin protein gene from both biological parents have Sickle cell anemia.