Appendectomy (operation to remove a
person’s appendix) may not be seen as one of the deadliest surgeries but
then, so many people still cringe and even exercise some kind of fears
if they are told the operation would be carried out on them.
By the way, Appendicitis is not even a
contagious disease, so what could be the reason for a situation where
almost nine, out of 10 persons, in a particular community have undergone
surgery as a result of the illness? This was the question that gripped
our correspondent during a recent visit to Agu-Amede, a rural community
in the Isiuzo Local Government Area of Enugu State.
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As
unbelievable as it sounded when our correspondent got hint of the
story, all doubts disappeared within minutes of our correspondent’s
arrival in the sleepy community, which, in addition to the unusual
health challenges faced by its residents, is also characterised by lack
of basic amenities.
Bad roads, lack of potable water, poor
power supply, and clustered habitations signal the level of deprivation
in a community with little or no government presence.
Coming back to the issue of appendicitis –
instant confirmation of tales of the high rate of the ailment in
Agu-Amede welcomed our correspondent into the community.
At
the very first stop in the village – a bus stop which apparently also
serves as a community centre, judging by the presence of small kiosks
and food vendors, and other small businesses – our correspondent
approached a number of youths who were gathered by the motorcyclists’
park. The youths, numbering about 11, were initially suspicious of our
correspondent’s presence in their midst but relaxed a bit when our
correspondent introduced himself as a journalist.
And just as soon as our correspondent
brought the issue of appendicitis up, nine out of them exclaimed they
had had the operation!
In fact, many among the youths, whose
average age was about 35 years, also said they had undergone surgery for
hernia. Some of them said they had had surgery for hernia on multiple
occasions.
The youths informed our correspondent
that appendicitis and hernia were common among members of the community.
They disclosed that several persons have died as a result of the
matter.
However, while (from the accounts of the
youths, and from the testimony of other villagers, including elders and
community leaders who would later speak to our correspondent), it was
beyond doubt that appendicitis was prevalent in the community, the cause
of the high rate of the ailment among the population was not certain in
any case.
Those who spoke to our correspondent
could not agree on a particular reason for the situation, but from the
various responses, it could be deduced that the villagers mostly blamed
their travails on bad drinking water, hardship, hard work and farming.
Interestingly, some of them also seemed suspicious of the medical
practitioners.
Like
most other rural communities, the people of Agu-Amede are mostly
farmers. And, being a particularly poor community, the villagers work
extra hard in order to feed themselves and their families, and also meet
other contingent needs. Daily life in Agu-Amede involves a lot of
physical exertion.
The situation was further compounded by
the absence of potable water in the community. The Ankpe stream, the
nearest source of water, which our correspondent visited, was definitely
not good for drinking but because the Ebenyi River (which has
comparatively cleaner water) was quite far from the village, the
villagers are, most times, forced to drink from Ankpe stream.
Fetching water from the Ebenyi River,
which stretches to parts of Ebonyi State, is a Herculean task,
considering the distance and the nature of the road, but given the fact
that it provides the cleaner drinking water in the community, it is not
difficult to appreciate the level of physical exertion that is involved
in the lives of the villagers.
A native of the community, Augustine Ede,
viewed the matter from a political perspective. Ede, a vulcaniser,
said, “I had surgery for appendicitis in 1993, when I was still very
young. The doctors don’t usually tell us the cause of any ailment they
are treating, including appendicitis, because it is believed that
Agu-Amede is a village that will never be emancipated. So they just do
their thing. But all I know is that I was operated upon, my stomach was
opened and something was removed. Many people in my family have gone
through surgery several times. Many died in the process. It was only by
the grace of God that I survived.
“The problem is that we don’t have good
government hospitals in this place, what we have are private hospitals.
Some doctors move down to this village from the city to open private
hospitals and because they are privately owned, we can’t tell whether
they are genuine or not. We can’t question them.
“The only government hospital is the
maternity clinic, which is just for the women. Although we were told it
was built by the government, it is not well equipped. You can’t find
anything there. The appendicitis operations are done in private
hospitals.”
Emmanuel Ebe, another youth, informed our
correspondent that he had surgery for hernia in 2014. Ebe believes that
strenuous physical activities in the course of their daily lives is
responsible for the plight of the villagers. He, like the others, added
that lack of potable water could be another cause of the illness.
“We do a lot of hard work in Agu-Amede.
To the best of my knowledge, the prevalence of appendicitis and hernia
in this area is as a result of too much of hard work in the farms and
the bad water we drink. We only drink clean water when there is
rainfall, otherwise we fetch from Ankpe stream, running water which is
not very clean,” Ebe said.
A septuagenarian, Clement Ogbodo, took a
break from a game of draft with his friends to tell our correspondent
that he had undergone surgery on two different occasions – one for
appendicitis, the other for hernia.
“I was operated upon twice; I had to
travel to Anambra State to do the surgery. I was told that my problem
was due to hard work. We do a lot of hard work in Agu-Amede,” he said.
For Chiagozie Maduabuchi, a youth who
said he is yet to experience appendicitis, the unusual rate of the
ailment in the community is due to hardship.
Maduabuchi said, “Bad road is one of our
biggest problems and we also lack potable water. We drink water from the
Ebenyi River, which is very far. We usually use bicycle to get the
water to the village. Because the road is bad and the river is far,
fetching water is very difficult, it is hard work. Whenever I go there, I
experience pains and body ache.”
Admitting the high rate of appendicitis
in the community, Maduabuchi said, “Agu-Amede people usually suffer from
appendicitis, but honestly I don’t know why it is so. I think it is
because of the bad water. I am yet to have it (appendicitis) but so many
people I know have had surgery for appendicitis.”
The councillor representing Eha-Amufu
Ward 1, Isu/Agu-Amede/Odenigbo ward, in the Isiuzo local council, Hon.
Prince Emmanuel Eze, admitted that appendicitis and hernia are unusually
common in the community.
“Most of our people who go to hospital
are there because of appendicitis or hernia but I don’t know why it is
so. But if I am to comment, I think too much hard work can cause
hernia,” the councillor told our correspondent.
But as many of the villagers blamed the
lack of potable water and perhaps, strenuous work they undergo, as the
reason for the rapid rate of appendicitis among them, they also seem to
have reservations for the private hospitals in the area.
From encounters with some of the
villagers, it was apparent that they are not happy at the absence of a
standard government hospital in the area, and as a result, tend to view
the private hospitals, where the surgeries are usually carried out, with
a degree of resentment.
In several, separate encounters with
different villagers, it was not uncommon to hear comments like ‘I was
told I had appendicitis’, or ‘my stomach was opened and something was
removed’.
Meanwhile, a medical doctor, Doctor Chidi
Nebo, Chief Medical Officer, District Hospital, Ikem, Isiuzo Local
Government Area, which Agu-Amede is also a part of, gave an insight into
the problem.
Nebo, who spoke to our correspondent on
the phone, described the people of Agu-Amede as “surgically aware” and
“unusually brave” when it comes to the illness.
According to him, the villagers have got
so used to the cases of appendicitis and as such, do not cringe at any
form of surgery, and would sooner undergo appendectomy, and thus get rid
of appendicitis and its accompanying discomforts, so as to go back to
their farming activities.
However, he said that although it
appeared as if there was a higher rate of appendicitis in Agu-Amede than
other places, it was not necessarily so.
Nebo said, “Why it looks as if it
(appendicitis) is common here is because of the fact that it is a
community that is localised. It appears as if it is common here because
the awareness rate, or the health conscious rate, among the natives here
is high. So once there is a medical condition, the person concerned
wants to go for surgery.
“In the olden days, they used traditional
healing remedies to treat appendicitis, but the high mortality and
morbidity rate among the population as a result of that form of
treatment led to an urge to turn to expert care to remove appendix.”
The medical doctor noted that diet was a
factor in appendicitis. He listed the consumption of guava fruits,
parboiled rice as major risks.
However, Nebo added that a specie of
beans, known as ‘uzuakoro beans’, which is commonly consumed by the
people of Agu-Amede, could be a major cause of appendicitis.
“They eat it (uzuakoro beans) a lot. Some
people tend to break it in their mouth and subsequently swallow without
chewing it,” he explained.
He doubted the villagers’ belief that bad drinking water could be responsible for the appendicitis cases.
He said, “The water here is contaminated
but it wouldn’t lead directly to appendicitis, it could lead to water
borne diseases like cholera, typhoid and diarrhoea. The water they take
is not the best because faecal droppings are washed by the rain into the
river.”
Noting that a person cannot have
appendicitis twice, as claimed by some of the villagers, Nebo pointed
out that there was even a much higher rate of hernia in the community.
He also noted that hard work, or physical exertion, could be responsible for the high rate of hernia.
The doctor said, “Most of the people of
Agu-Amede ride bicycle to fetch water. They ride about five kilometers,
going uphill and then downhill. This could result in abdominal pressure,
which could lead to hernia.”
He pointed out most of the villagers are
engaged in some form of manual labour, especially through farming, which
is the vocation of about 97 per cent of the population.
“It looks as if every household has had
up to two or more people that have had it (hernia). These two things
(appendicitis, hernia) combined together, make it appear as if Agu-Amede
have more cases than any other place,” he added.
Describing the people of Agu-Amede, Nebo
said, “They are very surgically aware, unlike people of other areas,
they are very brave when it comes to surgery. They always want to get
the surgery over and done with very quickly so as to go back and attend
to their farms.”
