Wednesday, 11 April 2012

Discovery in Africa: the limits of certainty

Challenges to deep-seated convictions can come from unexpected quarters. 

So it was with an account by Thérèse Awada, a Strasbourg plastic surgeon, of a medical assistance mission she accompanied to Benin.  

Beware, beware, the Bight of Benin,
Where few come out though many go in
And it's a testing ground for strongly held convictions too
The team travelled along the Niger river in open canoes, trekking inland as necessary to different villages to provide surgical services. Their form of transport made it difficult to carry equipment and, by the end of the trip, they were low on consumables.

As they started their last day’s surgery, a young boy was brought in. He had a strangulated hernia, a potentially life-threatening condition. The team decided to rearrange their schedule for the day and operate on the child immediately, even though the supplies they would use meant possibly jeopardising their ability to carry out planned surgery on an old man’s lipoma in the afternoon.

I would have absolutely no quarrel with this decision and I’m sure most of us in the West would feel the same. A life-threatening condition has priority over a matter of discomfort; a child has priority over an adult. It seems absolutely self-evident. And there’s nothing casual about my use of the word ‘absolutely’: this is the kind of principle that my feelings tell me is absolute, if any is.

Well, nothing could be further from the truth. Even though in the event the old man had his surgery, the villagers were appalled by the team’s decision. So much so that they expressed their dissatisfaction firstly in expostulation, secondly by letting the team wait half the next day before agreeing to take them back to the river.

What was their complaint? Well, where in the West we see the old as reminders of decline and mortality, to them an old man is someone who has got through all that life can hurl at him. He is an exceptional figure, and he is the keeper of the community’s memories, its wisdom, its knowledge of how things should be done because this is how he learned from his predecessors they had always been done.

That made the old man far more precious than the boy. Running the risk of not being able to help him, in order to treat the child, was a horrifying reversal of the natural order of things. I’m sure, if asked, they would have used the same language as I did before: they would have found the truth of their view absolutely self-evident.

Now Awada makes it clear that she and the rest of the team, faced with the same circumstances, would take the same decision, and I agree with them. But the villagers would feel just as strongly about their own convictions. And, to be honest, in their terms their position is not without merit.

So what’s the lesson? It’s surely another powerful response to those who would have us believe that there is, out there, something that is true in some absolute sense. Pronounced by a god, written in scripture, carved on a tablet. Whereas in reality there are only a culture
s shared convictions. Strongly, powerfully felt, perhaps. But always open to question by someone else, whose own convictions are as strong as ours.

With no possible grounds for deciding that one set is right, the other wrong. 

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