Indigenous surgical practices in rural southwestern Nigeria: implications for disease prevention

Abstract

HIV can be transmitted through contact with contaminated blood and blood products. Efforts are therefore under way in Nigerias formal health sector to protect blood supplies and improve the safety of health worker practices but little attention has been paid to the indigenous health care network where a majority of people seek help. Indigenous surgical practices of concern include circumcision medicinal blood letting and scarification or tattooing. A qualitative community-based study was conducted in the rural community of Ago Are southwestern Nigeria to learn about such indigenous surgical practices and their potential for disease transmission. Community leaders helped identify two types of indigenous practitioners whose work involves blood contact olola and onisegun. Olola are surgeons who specialize in circumcision and make traditional facial markings while onisegun make incisions into which medicinal herbs are rubbed. Observation of the practitioners found that the olola used the same knife for all operations and cleaned it simply by rinsing it in a bowl of water. Although the onisegun used a clean blade for his procedures he rubbed the herbs into the cuts with his bare hands. The potential for HIV transmission between practitioner and clients and among clients during these procedures is discussed as is the potential for health education to reduce the demand for female circumcision and training indigenous healers in hygienic methods.