A cesarean section is a surgery used to deliver babies through incisions in the mother’s abdomen and uterus rather than via vaginal birth. In the 19th century, whereas mortality rates for these operations in European nations like Britain neared 85%, they were being performed regularly and successfully in Africa’s Great Lakes region, notably within the Kingdom of Bunyoro-Kitara (in present-day Uganda).
It is unclear how far back these surgeries date. However, the earliest sighting and recording of such a procedure by a European was in 1879, by the Scottish missionary and medical anthropologist Robert W. Felkin in his book The Development of Scientific Medicine in the African Kingdom of Bunyoro Kitara. In a place called Katura, Felkin observed a 20-year old woman delivering her first child with the assistance of traditional healers:
“… The patient was intoxicated with banana wine. The surgeon made a quick cut upwards from just above the pubis to below the umbilicus, severing the whole abdomen wall and uterus so that the amniotic fluid escaped. Bleeding points were torched with red hot irons… The surgeon completed the uterine incision, with the assistant holding up the sides of the abdomen wall with his hands and hooking two fingers into the uterus. The child was removed, the cord cut and the child handed to an assistant… The peritoneum, the abdominal wall, and the skin were secured with seven sharp spikes. A root paste was applied over the wound and a bandage of bark cloth was wrapped around it. Within six days, all the spikes were removed.”
Similar reports were also made of birthing operations amongst communities in nearby Rwanda. Once published, Felkin’s account was received with shock in Europe where, unlike Bunyoro, surgery was only considered an extreme, emergency childbirth measure at the time.
Today, the cesarean section by which babies are delivered the world over is not unlike the Bunyoro operation, albeit with newer anaesthetics and surgical implements.
By Nnenna Onuoha