Did you know Caesarean operations were carried out perfectly in parts of Africa before Europe Started?

For example, as Dr Van Sertima noted in Blacks in Science. The Banyoro people of Uganda were carrying out Caesarean operations – antiseptic surgery with such precision and this was recorded and drawn by Dr. Felkin in 1879, at a time when such operations were rare in Europe.

He noted them to be carrying out the surgery with routine skill and using antiseptic surgery when the same was just invented in Europe 2 years before by Lister and was far from common in operating rooms around Europe. Not only did the African surgeons show an understanding of the sophisticated concepts of anaesthesia and antisepsis, says Dr Felkin, but they demonstrated advanced surgical techniques, especially with the cautery iron.

Uganda is the only country in Central Africa where the abdominal section is practised with the hope of saving both mother and child.

The operation is performed by men, and is sometimes successful; at any rate, one case came under my observation in which both survived. It was performed in 1879 at Kahura.

The patient was a fine healthy-looking young woman of about twenty years of age. This was her first pregnancy … The woman lay upon an inclined bed, the head of which was placed against the side of the hut.

She was liberally supplied with banana wine and was in a state of semi-intoxication. She was perfectly naked. A band of mbuga or bark cloth fastened her thorax to the bed, another band of cloth fastened down her thighs, and a man held her ankles.

Another man, standing on her right side, steadied her abdomen (fig 1). The operator stood, as I entered the hut, on her left side, holding his knife aloft with his right hand, and muttering an incantation. This being done, he washed his hands and the patient’s abdomen, first with banana wine and then with water.

Then, having uttered a shrill cry, which was taken up by a small crowd assembled outside the hut, he proceeded to make a rapid cut in the middle line, commencing a little above the pubes, and ending just below the umbilicus. The whole abdominal wall and part of the uterine wall were severed by this incision, and the liquor amnii escaped; a few bleeding-points in the abdominal wall were touched with a red-hot iron by an assistant. The operator next rapidly finished the incision in the uterine wall; his assistant held the abdominal walls apart with both hands, and as soon as the uterine wall was divided he hooked it up also with two fingers.

The child was next rapidly removed, and given to another assistant after the cord had been cut, and then the operator, dropping his knife, seized the contracting uterus with both hands and gave it a squeeze or two. He next put his right hand into the uterine cavity through the incision, and with two or three fingers dilated the cervix uteri from within outwards. He then cleared the uterus of clots and the placenta, which had by this time become detached, removing it through the abdominal wound.

His assistant endeavoured, but not very successfully, to prevent the escape of the intestines through the wound. The red-hot iron was next used to check some further haemorrhage from the abdominal wound, but I noticed that it was very sparingly applied. All this time the chief “surgeon” was keeping up firm pressure on the uterus, which he continued to do till it was firmly contracted.

No sutures were put into the uterine wall. The assistant who had held the abdominal walls now slipped his hands to each extremity of the wound, and a porous grass mat was placed over the wound and secured there.

The bands which fastened the woman down were cut, and she was gently turned to the edge of the bed, and then over into the arms of assistants so that the fluid in the abdominal cavity could drain away on to the floor.

She was then replaced in her former position, and the mat having been removed, the edges of the wound, i.e. the peritoneum, were brought into close apposition, seven thin iron spikes, well polished, like acupressure needles, being used for the purpose, and fastened by string made from bark cloth.

A paste prepared by chewing two different roots and spitting the pulp into a bowl was then thickly plastered over the wound, a banana leaf warmed over the fire being placed on the top of that, and, finally, a firm bandage of mbugu cloth completed the operation.

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