the concept of Falling

Doc I have fallen….

In my 10 years of practicing medicine and certainly in the last 8 yrs in Samoa, I have had a mixed relationship with our peoples ideas if sickness and disease. Especially when it comes to , local superstitions and on some occasion local healers. At the moment, I do feel there is a big gap between traditional and western medicine. The two do not always work hand in hand and perhaps there is a road there to improve this in our health system. I think us western drs tend to see much more of the  dire scale of things when it comes unwell patients who were previously treated by local healers. But not being able to actually quantify the possible help that these traditional healers give is perhaps what leaves us ?ignorant.

Anyways, back to my topic. Since I began practicing in Samoa, I have often been dumbfounded by the things our people put weight on when it comes to a person being sick.  A classic example which is at the top of my ‘leaves me bewildered’ list is this concept of falls- leading to all sorts of disease. Even a simple skipped a step, landed on his bottom, type fall is often etched in the memories of mums, or children of elderly people. A common scenario in my clinic is a young person being brought in, who sits there breathless, and when he coughs his chest rattles away like the v8 engine of an elcamino ( and later on is found to have double pneumonia) , and the parents are spending 15minutes explaining, that a month ago he fell. On the ground. He hit his left arm and chest. There was no bruising, or scratches sustained. He cried and got up. Since then he was fine. But NOW…now hes feverish and is not eating and is tired…and of most importance is that I take into consideration the fact that a month ago he fell.

They completely ignore the fact that…his nose became runny a week ago, he developed fevers, a cough followed and now he is breathless. No, that information was not readily provided until dragged out of them…instead most of their focus and concern is the fall and fevers and how the two are absolutely intertwined. 

I spend a lot of time trying to teach people some really basic rules. Like pay attention to symptoms…signs from certain parts of the body that may indicate something is wrong with that part (ie if you are coughing you may have an infection of the throat/chest if you are spewing from both ends maybe a tummy bug  etc ). Unfortunately there are so many common scenarios amongst Samoan kids that a general immunity to those symptoms can sometimes result in a complete dissociation of what is actually wrong with the person. An example is…in a big family…there are often..snotty nosed kids running around. From time to time  those snotty nosed kids may ‘cough’…but generally…these symptoms are ignored as just normal things for kids. Luckily, kids here are pretty robust and Im sure are exposed to all the elements from a young age..often most viral colds and coughs resolve without actually needing much intervention anyways. But when they do deteriorate, it bewilders me how parents continue to ignore these worsening symptoms and instead are focused on age old myths and beliefs … I can understand how if you fell off the roof of your house or the back of a moving car and broke a few bones  or even developed some  internal bleeding -you'd be pretty beat up and sick. But to not even have a scratch and still believe this could riddle one so ill…and so long ago?? Baffles me….

I even heard of a family, whos young child (2 yrs old) had died mysteriously. When I asked a relative what had happened (ie had he been unwell etc) the answer was…well, we don’t know but when he was a young baby, he fell out of his cot and so we think it was from that time that he must have started to get sick and resulted in his death ( a year and a half later?) …..

So, my point is- people , please help me spread the word..... If you fall, you can physically do harm to yourself AT THAT TIME. And it will be visible and physical (most of the time- unless you are unlucky enough to be a tiny percent of people who donk their heads and have a small internal bleed- which will manifest usually within the next few days/weeks at most!) ….it will not kill you a year later…or make you cough a week later…or give you this fever 3 months later. Lets stop the cycle of this belief right here now so that people can start WAKING UP…and paying attention to what their kids/loved ones/relatives might ACTUALLY have.

Uma loa iga. Have a great weekend guys