Two weeks with an Ékpè Chief

Author: Seann Regan

Occasionally an opportunity presents itself, a brief phone call, a chat, a shared academic interest, and a proposal.

Occasionally you find yourself being led around North West Cameroon by an Ékpè Chief navigating forests and near impassible roads, eating exotic and questionable foods, crossing paths with corrupt army officials, and trying desperately to decode Cameroonian pidgin.

Occasionally you meet a Ju-ju.

Air France Flight 0958 hits the tarmac in Douala. Wait do they speak English here? Shoot no Wi-Fi. Hmm Google translate is out. A welcome sign reads “Don’t worry too much, you are in Cameroon.” Well on the plus side it’s in English, but really wish it didn’t require the “too”…

Perhaps some background is in order.

Image: Eating questionable foods, with an Ékpè elder.

Image: Eating questionable foods, with an Ékpè elder.

A few weeks prior to landing at Douala International I was invited to participate in an ongoing collaborative research project with colleagues from the University of Southampton including Dr. Nicola Wardrop and Professor Pete Atkinson and colleagues from Cambridge, Imperial College London, and Brighton Medical School. I enthusiastically jumped at the opportunity to get into the field and assist in the project. The chief aim was to validate a combined geo-epidemiological approach for the mapping of Podoconiosis (Podo). While the exact cause of Podo has not yet been fully elucidated what is known is that it is a disfiguring and stigmatizing disease. Podo is likely an abnormal inflammatory reaction to irritant soils which leads to elephantiasis or lymphedema of the lower limbs. There appears to be a genetic predisposition, a lifestyle or behavioral element, and a strong environmental element as it only occurs in areas where irritant soils are prevalent and is most common among those who are either too poor to afford proper shoes, or for cultural reasons work barefoot. In addition to the disfigurement caused Podo also carries a huge economic burden as people afflicted become unable to work. It is one of the so called Neglected Tropical Diseases and thus almost by definition is a disease influencing those in poverty and living with little access to healthcare.

Initially we were planning to gather data on individual mobility patterns as the team felt strongly that the location where individuals farmed and how much time spent in different environments was of importance to the onset of Podo. Much of the existing data is at the level of the village, and we felt it would be beneficial to better quantify where people are farming and spending their time from day to day. As can often happen with field work this aim proved unrealistic in the short timeframe and so we focused our efforts on the broader project goals of visiting rural health care clinics, validating previous clinical diagnosis, and mapping and sampling irritant soils across the study area.

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Image: African Traffic Jam

The first week in the field was busy but we were successfully able to set up protocols, meet with local collaborators, and make good progress in validating case diagnosis as well as begin mapping and collecting soil samples across region. One of the great things about the discipline of Geography in my opinion is the collaborations that are often established across disciplines, on this project we had MDs, MPHs, Geologists, Epidemiologists, and Geographers all working together. Data from the rural health clinics on diagnosis, patient history, and future genetic information will be linked with remotely sensed environmental data and geo-chemical analysis of soil data in a GIS for later statistical analysis.

The second week saw the departure of about half the team, and the “skeleton” crew consisting of myself, and a Geologist Jenn le Blond from Imperial, along with colleagues in Cameroon were to stay on in the field for another week continuing the soil sampling and ensuring that the protocol went smoothly. Up until this point the trip had been busy and hectic but despite some last minute protocol changes relatively worry free. After a few days spent in the field in the area around Bamenda taking soil samples and observing quarries for unique geology, we decided to head out with the epidemiology team to the surrounding villages for a visit with two of the more remote health clinics. This is when we met the Ju-ju.

The car picked us up around 7:30am and we headed north towards Kumbo then veered off onto the characteristically rough rural dirt roads that are so typical in the region, then things started to get interesting.

On our early morning departure from the hotel we didn’t know exactly where the villages and clinics were, no problem just ask directions right? Well this proved quite difficult when English and French are translated into the common Pidgin, a language that seems to have no concept of time, or distance, or direction for that matter. We pulled up next to several rural villagers asking for directions and constantly we were told, “go down” for how long? “some time”. When we asked how far in kilometers. The gentlemen just laughed and said “go until you reach”.  My personal favorite was when we came to a T and reversed back up the road to ask a farmer which way should we turn, he just said “yes”, “keep going”…hmm.

Image: “Rural” Road

Image: “Rural” Road

We eventually took a chance and turned right and were making headway when we came to an odd looking bamboo stick protruding from the middle of the road with a symbol on top looking something like a blend between the letter Q and an infinity symbol. The driver slammed on the brakes and the truck came to a stop a few meters from the stick almost knocking it down. A villager came running up to the car and conversed with one of our Cameroonian partners in very quick Pidgin. All I got at this point was that there was to be some blindfolding involved…now keep in mind Cameroon is a relatively safe country but at this point I am pretty sure no one in the car knows where we are. Ok we are in Cameroon check, the Northwestern part check, but other than that no clue. Needless to say blindfolds didn’t seem like the best idea. I was on the verge of voicing my opinion to the group when we were informed not to worry, just the women needed to be blindfolded. Oh ok no worries at all. Right then. Jenn. Blindfold on.

As we drove slowly through the village I was still in too much shock to snap a picture, but I did get a glance of a man dancing in the entrance to a house wearing a large feathered mask, knee decorations, and a grass skirt. We passed through the other side of the village and past another ceremonial stick, and then removed Jenn’s blindfold. We came upon the clinic in after another 15 minutes or so, and began to unload the truck. In the end it was actually a pretty straightforward process, apparently the Ju-ju was blessing the construction of a new house, but what did give me pause was how seriously everyone took the power of the Juju man. I guess better safe than sorry?

All in all we got some good work done while in the field and will await the soil data as it begins to trickle in from Cameroon. But what I took away from this trip was more than what can be easily quantified in tables and graphs. One of the great things about having the opportunity to travel and work in some of the still remote regions of the world where outside influence is felt but traditional cultures remain is that it allows us to reflect on our own experience and lives and to put them into context and place.

While I was unable to get a picture I did purchase a Ju-ju doll at the craft market in Bamenda and while I am the first to admit that the frenzied situation may have altered my perception the resemblance now seems uncanny.

Perhaps the Ju-ju man cast a spell and masked my vision.

Image: Ju-ju Doll

Image: Ju-ju Doll

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