Lovina is seven years old, thin, and quiet. She sat with her mother in the exam room on one chair, while Mrs. Musa, wife of the previous ECWA president, sat beside them on another. The Musas had heard about Lovina somehow and had arranged for her to come to Evangel Hospital for possible help.

Lovina has quite a few scars and sores on her face and knees, a clue to her problem: she has had frequent seizures ever since she was three months old. Sometimes several times a day, sometimes every few days, she falls down in convulsions. Apart from a brief period when she was very little, she has never had medical treatment. Early on, she took some medicine that made her sleepy, and the parents did not keep giving it to her. Since then they have tried some herbal concoctions, but without success. As I tried to get more details from the mother, I discovered that she did not know many details, because Lovina has been living somewhere else, away from her mother, for a long time.

The neurological exam was normal, and I prescribed an anticonvulsant and explained what to expect. Then Mrs. Musa asked if I would please explain to the mother that this is not a spiritual problem. That is what the family have been thinking all along, that somehow a “witch” put some kind of curse on the girl. First I tried explaining a little about seizures, then I realized I was probably not making any sense at all to this village woman. So I backed up and said simply, “You know how we have a brain and heart and stomach and chest, and they can all get sick. When we get a sickness in our chest we cough, when we get one in our stomach we get a stomach ache or diarrhea. It’s just the same with the brain … when we get sick there, we can have convulsions.”

The mom seemed to understand, somewhat, but later I saw the main weakness in my explanation: undoubtedly the mother sees a spiritual dimension to all illnesses, so my comparison probably did not really help her understand our distinction between physical and spiritual causes. (See Watch and Pray where I talk about the African worldview and how our patients see illness).

Lovina lives fairly far away, so rather than burden the family with the expense of another clinic visit soon, I tried to explain how to manage the medicine (carbamazapine) for the next four weeks. My hope is that there will be a rapid and clear improvement, something to encourage the mother to continue with this new type of treatment that is rather alien to her way of living and thinking.

Thanks for praying with us for Lovina … I hope to have an update in a month!

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