‘Hat on – hat off’: trauma and trepanation in Kisii, western Kenya

Abstract

In 1957, Kenya's government psychiatrist and director of the colony's Mathari Mental Hospital travelled to western Kenya to investigate the practice of trepanation among the Gusii people in Kisii District. Applied to relieve pressure on the brain by scraping away a portion of the skull with a hooked knife, trepanation was exceptionally rare by the 20th century, but remained common in Kisii where the operations are conducted by a group of skilled practitioners. This article uses materials from psychiatrist Edward Margetts' personal papers, including photographs, diaries and clinical notes, to describe and examine the practice of trepanation in Kisii in the 1950s, concluding with a discussion of the social meaning of trepanation and trauma in modern Kenya.

Keywords:

• Kenya
• medicine
• trauma
• psychiatry
• photography

Funding

This research was supported by a grant from the Arts and Humanities Research Council (AHRC), Trauma and Personhood in Late Colonial Kenya, [Grant # 119246].

Notes

1. The terms ‘Kisii’ and ‘Gusii’ can be used somewhat interchangeably, but in general ‘Kisii’ refers to the town or district and ‘Gusii’ is used to describe the people. It is not unusual, however, for an individual to be described as ‘Kisii’.

2. Papers of Edward Margetts, Criminal Appeal no. 108 of 1958, Nyachuba s/o Ombati and Regina, August 21, 1958.

3. Papers of Edward Margetts, Criminal Appeal no. 108 of 1958, Nyachuba s/o Ombati and Regina, August 21, 1958.

4. Papers of Edward Margetts, Letter from K. K. O'Connor, August 25, 1958.

5. Omobari is the Gusii term for ‘surgeon’ of any sort. Omobari omotwe refers specifically to a head or skull surgeon. For convenience I will sometimes use the broader term ‘omobari’ as well as the plural ‘ababari’.

6. The photographs, negatives and corresponding materials, including correspondence and diaries, are in the possession of the author, having been either purchased from the estate of Edward Margetts or provided by his family. These materials are not, as yet, deposited in a library or archive.

7. Margetts, “Trepanation of the Skull,” p. 677.

8. The wide-ranging literature on trepanation is extensive. Select references for Africa include: Drennan, “Some Evidence for a Trepanation Cult”; Hilton-Simpson, “Some Arab and Shawia Remedies”; Akester, “Tibesti – Land of the Tebou”; and Steele, “Trephining in Tibesti”.

9. Brotmacher, “Medical Practice Among the Somalis,” p. 216.

10. Margetts, “Trepanation of the Skull,” p. 10.

11. Fisher, Twilight Tales of the Black Baganda, p. 61.

12. Roscoe, Soul of Central Africa, p. 300.

13. Gwako, “Continuity and Change.”

14. Ogembo, “Cultural Narratives, Violence and Mother–Son Loyalty”; Ogembo, Contemporary Witch-Hunting in Gusii. See also the newspaper reportage: BBC News, “Kenya ‘Witch’ Case Mass Arrests”; Nyasato and Gitau, “Five Lynched Over Witchcraft Claim”; Odhiambo, “Horror of Kenya's ‘Witch’ Lynchings.”

15. Ogembo, Contemporary Witch-Hunting in Gusii, p. 32.

16. LeVine and LeVine, Nyansongo: A Gusii Community, p. 97. ‘Nyansongo’ is a fictional name used by the LeVines for a set of communities they interviewed.

17. LeVine and LeVine, Nyansongo: A Gusii Community, p. 99.

18. LeVine and LeVine, Nyansongo: A Gusii Community, p. 99.

19. Papers of Edward Margetts, Letter to John Grounds, August 6, 1957, re: trepanation.

20. Papers of Edward Margetts, Letter to John Grounds, March 25, 1958, re: trepanation. Also, Grounds, “Trephining of the Skull Amongst the Kisii.”

21. Margetts, “Trepanation of the Skull p. 686.

22. Papers of Edward Margetts, Letter to Officer-in-charge, H.M. Prison, Nairobi, August 8, 1959, re: Omwenga s/o Mukesa, Prison no. 293 R.

23. Papers of Edward Margetts, Letter to Officer-in-charge, H.M. Prison, Nairobi, August 8, 1959, re: Omwenga s/o Mukesa, Prison no. 293 R.

24. Margetts, “Trepanation of the Skull,” p. 686. This method would have been highly unusual. Most patients sat upright while leaning forward to allow copious amounts of blood to fall into a basin on their laps.

25. Margetts, “Trepanation of the Skull,” p. 688.

26. Coxon, “Kisii Art of Trephining,” p. 263.

27. Mueller and Finch, “Kisii Trepanation,” p. 11.

28. Mueller and Finch, “Kisii Trepanation,” p. 12.

29. X-rays were performed by Dr Leslie Whittaker of the King George VI Hospital (now Kenyatta National Hospital) on behalf of Margetts.

30. Margetts, “Trepanation of the Skull,” p. 688.

31. Margetts, “Trepanation of the Skull,” pp. 688–90.

32. Nyachoti's widowed third wife indicated that he was not a policeman but had always been a labourer (2011).

33. Personal journal of Edward Margetts, February 17, 1958, p. 359.

34. Furnas et al., “Traditional Craniotomies of the Kisii Tribe,” p. 551.

35. Margetts’ personal journal, February 17, 1958.

36. Margetts, “Trepanation of the Skull,” p. 691.

37. Margetts, “Trepanation of the Skull,” p. 690.

38. Interview with Marta Nyabaiga Nyachoti, September 2, 2011.

39. LeVine, Mothers and Wives, p. 218.

40. LeVine, Mothers and Wives, p. 225.

41. Silberschmidt, “Have Men Become the Weaker Sex?,” p. 239.

42. Silberschmidt, “‘Women Forget that Men are the Masters’”, pp. 120–3.

43. Shadle, “‘Girl Cases’”, p. 157.

44. Ogembo, Contemporary Witch-Hunting in Gusii, p. 164.

45. LeVine, “Gusii Sex Offenses,” p. 967.

46. Silberschmidt, “Have Men Become the Weaker Sex?,” p. 237.

47. LeVine, Mothers and Wives, pp. 279–80.

48. LeVine, Mothers and Wives, p. 280.

49. LeVine, Mothers and Wives, p. 282.

50. Margetts, “Trepanation of the Skull,” p. 691.

51. Margetts, “Trepanation of the Skull,” p. 692.

52. Margetts, “Trepanation of the Skull,” p. 692.

53. LeVine, Wives and Mothers, p. 280.

54. Margetts, “Trepanation of the Skull,” p. 693.

55. Margetts’ personal journal, February 17, 1958.

56. LeVine, Mothers and Wives, p. 316.

57. Furnas et al., “Traditional Craniotomies of the Kisii Tribe,” p. 546.

58. Furnas et al., “Traditional Craniotomies of the Kisii Tribe,” p. 548.

Additional information

Funding

Funding: This research was supported by a grant from the Arts and Humanities Research Council (AHRC), Trauma and Personhood in Late Colonial Kenya, [Grant # 119246].