WHEN a baby is born there are two things which are very delicate and must be handled with care; the navel (guvhu) and the fontanelle (nhova), the soft spot on top of the head.
The navel falls off within a week, at most two weeks, but the fontanelle takes about a year or two to harden.
In an infant, the space where two skull-bone sutures join forms a membrane-covered ‘soft spot’ called a fontanelle. The fontanels allow for growth of the skull during an infant’s first year. It should feel firm and very slightly curved inward to the touch.
While there are scientific ways to treat nhova, there are also traditional methods.
Dehydration is the main cause of a sunken fontanelle while various factors are cited traditionally.
The African Journal of Traditional, Complementary and Alternative Medicines says the illness called nhova (fontanel) is a serious one amongst the Karanga people, particularly children. Chepamusoro (that which is on top of the head) is due to malicious witches who interfere with the human head. As a result, the Karanga apply different medicines on the delicate part to combat this illness.
Nhova has varied symptoms diagnosed by elders or special diagnosticians. The child may vomit after suckling milk from the mother and becomes weak. The eyes turn white. Other symptoms are the presence of sores on the upper part of the mouth. When these symptoms have been positively diagnosed, herbal treatment is prescribed.
Herbs are made from leaves of the Mubvamaropa (bloodletting) tree which are burnt. The ashes are mixed with fat obtained from the seeds of the mufute (castor oil) shrub.
The mixture of the ashes and oil is then rubbed onto the affected part of the head and health is restored.
As the name of the herb mubvamaropa (bloodletting) suggests in Karanga, the tree oozes a ‘bloody’ substance and thus its addition to the concoctions ensures draining of filth. The fat component implies perfection and thus soothes pain.
The problem of the fontanel is two-fold. In particular, the gap in the central upper head should be a normal one, neither too wide nor too narrow, since ‘malicious’ beings can manipulate it. When the gap is abnormally wide, an unspecified thorny tree is used to derive the medicine.
The roots are taken and systematically pounded and are mixed with water. The mixture is then stirred using a stick with two branches (chimuti chine mhanda) until foam is produced. The general term used by the Karanga to refer to grass, shrubs or trees whose roots produce foam is ‘chifuro-furo’.
The plant is used as curative medicine. Actually, the foam is rubbed against the head of the child using the stirring stick. The rubbing of the foam, being part of the therapeutic process, is not done haphazardly. The conception of the illness is instrumental in determining the movement of the stick.
The foam is rubbed from the sides of the head towards ‘nhongonya’ (centre of the head). This is held to be the genesis of the disease and also its focus of attack. After this process, the gap narrows and the child is healed.
When the gap is narrow, the child will be suffering. Therapy consists in symbolic actions. A chick is taken and an appeal is made to the ancestors to enable effective healing. It is then used by the oldest member of the family to scratch the head of the patient, moving from the centre of the head, the perceived source of the illness, towards the sides.
Through this action the gap widens to a normal position and healing begins. The use of the chick is significant. In the same manner as it scratches earth (teta), pushing all dirt out of the way in search of food, it is also able to eliminate causal factors and restore the health of the patient.
Nhova is a dreaded disease in the Karanga communities. As a result, parents seek powerful protective medicines for their young children. Unfortunately, however, those children who have been medicated pose a serious threat to the health of other children.
The unprotected child is believed to fall seriously ill in the presence of sick children. Thus, in the Karanga traditional setting, it is imperative that the infant should not be unnecessarily exposed to others of the same age lest they become ill.
In almost every Karanga village there are women who can neutralise this threat if approached in good time.
However, scientifically, a sunken fontanelle can be prevented if the baby is hydrated by having plenty liquids and is kept in a cool place during hots days.
If the baby is not eating or drinking well, liquids should be offered often. The baby should be fed whenever hungry and if the baby suffers from malnutrition be aware of how much he/she should be eating at that age and weight.
And a tense or bulging fontanel occurs when fluid builds up in the skull cavity or when pressure increases in the brain (increased intracranial pressure).
When the infant is crying, lying down, or vomiting, the fontanels may look like they are slightly bulging, but they should return to normal when the infant is in a calm, head-up position.
In rare cases a bulging fontanelle can be linked to meningitis and other serious conditions hence the need to see a doctor.