Blue Cross with Antelope Horns

The case was serious enough to warrant a specialist, so into the Nairobi headquarters of the African Physicians' Association strode Dr. Symon Thuita to handle it. As Dr. Thuita well knew, the best way to begin any examination is by taking the patient's pulse. "If the pulse leaps like a frog," he explained, "the problem is in the throat. If it jumps like a cow, it is in the gastric system, and if it is smooth as a snake, then it is in the belly."

To protect himself against infection, Dr. Thuita slipped an antelope horn into his trousers, carefully allowing the prong to protrude from his fly. Then he tested the patient's credibility by placing a live toad in his mouth. If the toad jumped down the patient's throat, he was clearly a malingerer. If not, he was truly a victim of that all too common African malady, nightmare. The toad stayed put, so Dr. Thuita smeared acacia gum across the patient's brow, slapped on a dried snakeskin, and advised him to take a long swim. Prognosis: excellent.

Tools of the Trade. Symon Thuita is an M'ganga, which is Swahili for witch doctor, and he is one of Kenya's best. His adept handling of the Nairobi nightmare case marked another step forward for the fledgling A.P.A. Its ultimate aim is to mold the new republic's 6,000 witch doctors, as well as 100 or more Indian ayurvedics, or herbalists, into a kind of copy of the American Medical Association which will carry black magic into the 20th century, just as Africa's politicians have done for tribalism.

Kenya's witch doctors are an impressive lot. Clad in ostrich plumes, tarbooshes, beaded caps, seashell belts and fur aprons, they emit noises even stranger than their appearance as they stalk along with pebble-filled antelope horns, porcupine quills and fly whisks. Their satchels of leopard or monkey skin bulge with the tools of their trade: magical elixirs (miti-shambd), dead and living animals, hammers, chisels and dung. They represent the only form of medical attention paid to nearly 80% of Kenya's 8,000,000 Africans and Asians, despite a government program that has spent $9,000,000 in the past year to erect 160 modern medical centers and 266 dispensaries. Even some whites turn to the resident M'ganga now and then.

On the Spot. The A.P.A. is headed by a pair of grizzled Nairobi medicine men, M'ganga Ngari Kinyugo and Ayurvedic Vaid Bhagwandas Patel, and has attracted 2,000 members from Lake Victoria to Mombasa, charges dues of 280 a month, holds monthly meetings, forms committees and clashes with the government, just like medical associations elsewhere. It also feuds with rival organizations, notably one called African Repairs, whose aim is simply the repair of Africans but whose choice of name is unfortunate. Said one almost-member: "It sounds too much like a society of garage mechanics."

In order to appear up to date, A.P.A. discourages the title of "witch doctor," preferring the more prestigious "African physician." Mask- and feather-bedecked grass huts with their omnipresent bowls of fire are now called surgeries. On the flyspecked window of the A.P.A. headquarters in Nairobi, a partial list of curable diseases has been posted: asthma, hysteria, lunacy ("cured on the spot"), hernia, gonorrhea, epilepsy, outsized genitals and acid indigestion. Neither Blue Cross nor medicare has yet reached Kenya, but prices are fixed and moderate, ranging from 700 for treatment of kidney trouble to $28 for a sleeping-sickness cure.

Not What, But Who. Last week the A.P.A. co-chairmen were busy treating tough cases in their surgery. Techniques vary from case to case, of course, but usually they are more reminiscent of Dr. No than Dr. Kildare. When Kinyugo recently examined a young boy suffering from elephantiasis, he first seated his patient on antelope horns filled with crushed rock from Mount Kenya, then hammered on his crusted, waist-thick legs with hammer and chisel, and passed bowls of fire around him. Patel's patient, a woman with diarrhea, was suspended from a crossbar and swung gently to and fro while Patel mumbled incoherently.

Clearly, neither man was that bane of the A.P.A.'s existence, a false M'ganga. The organization has taken great care to weed such phonies out. The test is foolproof: applicants for membership must recite the complete family tree, back to great-great-grandparents, of someone they have never met before. It is this mystical ability, according to the M'ganga, that proves the unquestioned superiority of African medicine over European. Where white medicine merely tries to find out what caused a disease, African medicine finds out who.

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