Written by Fassil Teffera
Many moons ago, I was assigned to work at Jijiga hospital. As it was customary at the time one GP is assigned to a hospital of whatever size, with some nurses and several Health assistants. I did the outpatient clinic daily and in patient rounds and minor surgery as well. I also did difficult deliveries though most of the deliveries were made by the competent Health Assistants who must have done thousands before I came to the scene.
I had a wonderful staff of Nurses, Health assistants, Lab and X-ray techs. We were supported by dedicated ancillary services and administrative staff. Of course, we had our dose of Political Cadres who carried their weekly indoctrination of the superiority of the Socialist mode of production over the Capitalist one.
One Friday, a giggling Health Assistant came and told me that a bride is coming to be seen by me, prior to her wedding night. I did not understand what it meant. She told me the Somali men bring their bride to the hospital prior to the anticipated wedding night. I still did not understand the whole idea. The Health Assistant noted my confusion and re assured me that everything will be fine and she will help me handle the issue as she had done with many others before.
Sure enough, there walked in a very handsome bridegroom and his beautiful bride with beaming smile in their beautiful weeding dresses. They got registered and the bride was brought to the OR by the nurses and Health Assistant, and undressed and put on an OR gown.
They all giggled saying that I will be the first man to see the bride even before the bridegroom. The lady was put on the table and the staff explained to me what to do. As it was customary in Somali culture all girls had sutures placed over their vulva thereby completely blocking the vagina except for a small whole for the urine to dribble thru. This was a protection from in inadvertent or deliberate pre marriage sexual performance.
After the lady was put on lithotomic position we figured out where the small hole was located, which was at the distal aspect of the vaginal opening which allowed only a small finger to be passed. The local lady sureon had done a good job of suturing the labia majora of a baby girl around the age of three and completly blocked and entrance or exit from the vagina.This was done to protect the girl and the family from future embarassment.
We asked here whether she would like a local anesthesia but she refused. We applied a Xylocaine spray and put a scissor under the scar tissue that has blocked the vagina opening and made a smooth cut! The tissue was fibrous and there was not much bleeding or pain. We confirmed that the hymen was intact.
The bride got up and put on her weeding gown and led out of the OR and walked hand in hand with her bridegroom with smile! We wished the couple a happy and prosperous life and they in turn smiled and waved back at us. I thanked the staff who helped me go thru this unusual experience and they all laughed and said that â€œI did OK!â€ Despite my staying there for 2 yrs and nine months I never had another chance to perform this procedure.
I am sure another GP in Jijiga must have had similar experience. I had asked the elderly Somalis why they do such a terrible thing to baby girls. The suturing is done around the age of 2 and 3 yrs old. They always answer that, this was the way it has always been done and will be done for ever. If I did not do the procedure another local Somali women would have done it. At least we did it using sterile technique.
The Somalis still amaze me with their pain tolerance. I have never seen among all Ethiopians with such high pain tolerance. Of course, they deal with death and misfortunes with a shrug as well.
If any physician had ever similar experience I would really like to hear from him or her.
Ethiopian Medical History
Photo: Dr. Melaku Beyan. Dr. Melaku Beyan became the first Ethiopian medical doctor to complete his education in the United states in 1935 (Dr. Workneh Eshete became the first Ethiopian doctor to obtain a modern medical education in 1882)
The non-governmental organization, People to People, has just released The Manual of Ethiopian Medical History by Enawgaw Mehari, Kinfe Gebeyehu and Zergabachew Asfaw. The purpose of the publication is to teach the future generation of Ethiopian medical students and health care professionals about Ethiopiaâ€™s medical history.
Mekele University and Bahir Dar University have reportedly agreed to incorporate the study into their medical education curriculum.
Enawgaw Mehari, MD
Kinfe Gebeyehu, MD
Zergabachew Asfaw, MD
Senior Graphic Editor: Matthew I. Watt