The Audacity of Faith and Belief

Over a decade of bedside nursing, I have encountered patients with a stubborn belief in God. I don’t begrudge them because everyone has the right to their belief, and everyone owns their life; they can choose to live it in a way they desire.

The Ghanaian footballer, Raphael Dwamena, who had a cardiac arrest and subsequently died while playing football in Albania, is not an outlier; it is a typical African thing. Many people have died trusting in God to take care of them.

Raphael was diagnosed with a heart condition in August 2017 and advised to quit football, but he refused. He said his heart was in the hands of God. On several occasions, his heart failed him, yet he insisted on playing professional football.

Football is hyperactive sports for 90 minutes and this increases energy expenditure of the body. A player can cover several kilometres on the pitch before a game ends. This strenuous activity involving every part of the body especially the heart, raises the blood pressure very quickly and put too much strain on the cardiovascular system (the heart and blood vessels). Physical activities generally increase the rate at which blood is pumped to all parts of the body and its return to the heart. And of course, an incompetent heart like Raphael’s cannot withstand the constant stress. Yet, he relied on a spiritual God to take care of his physical heart.

In 2020, he had a major relapse and had an implantable cardioverter-defibrillator (ICD) fixed on his chest. He continued to push his heart for three more years until his untimely death.

Sometime before his death, he was advised to get an artificial pacemaker, but he insisted that only God could provide his heart with the needed electrical impulses when necessary. Alas, Raphael died on the pitch with cardiac arrest (sudden cessation of the heart). May God have mercy on his gentle soul. Did God abandon him in the long run? Of course not! There is nothing more fulfilling than dying with a belief or conviction. Death is an important last event and should always be the way of the dying person.

I have cared for a peptic ulcer patient who refused her medication because she was observing Ramadan (fasting) while on admission. Her excuse was that she didn’t want to miss a day. What can I do in this situation except to offer professional advice on the dangers of her actions? Patients have the right to refuse treatment, partially or totally.

The action of this patient was in honour of her God. And I am a nurse, not an imam, to adjudicate between her and her God.

Again, I remember one beautiful, obviously educated young lady rejecting an injection for malaria because she had a boil under her armpit. She believed she was going to die if she accepted the injection. And I couldn’t even convince her that her reservation or belief was not grounded in science.

There was this professional teacher I knew with a chronic wound. He claimed the wound could not be managed in the hospital because it was a spiritual affliction from his family enemies. He took his wound, about 10 cm in diameter, into the wilderness in search of spiritual healing. He returned two years later to the hospital with weeds (yes, green, moldy algae and fungi) all over the entire leg with maggots. The malodorous scent of the wound could reset one’s brain. He was told by a seer that the root cause of his afflictions, and no mere mortal could tell him otherwise.

Every Ramadan, there are people on this app who give out cheat codes to peptic ulcer disease patients on how to observe fasting. Sometimes, these cheat codes come from orthodox medications for ulcers to absolutely crude and ridiculous concoctions. And no one can disagree with these cheat codes because you risk being labelled a heretic. For these people using cheat codes to circumvent their ulcers, they’ve never seen someone in Acute Exacerbation of PUD: a possible outcome of bad management of one’s ulcer. Even though all major religions are against suicide, people are ready to attempt it and get a pat on the back from religitards.

God or belief is a very important factor in healing, and no one can discount its impact on the overall healthcare needs of patients. People, generally speaking, are what they feel. People have been healed by the Quran and the Bible. But it is very important to draw a fine line to what the scriptures or the spirits can heal. For instance, if a patient’s SPO2 is at 70%, what he needs urgently is not prayers but a goddamn nasal prong in his nose connected to an oxygen cylinder. You can’t leave such a patient to the abundance of God’s oxygen unless it is an exclusive request by the patient or his or her power of attorney. Again, when patients have a hypertension emergency, what they badly need is some good rest, not a five-prayer session, each lasting for one hour, from all the groups they belong to in the church.

I am a very religious person, but I don’t allow my personal or colleagues’ religious beliefs to inform my actions in my line of duty. Let me cite some situations.

One day, I was advising a patient on admission to stop fasting after he is discharged. A colleague told me not to say that because when we fast, it is God who takes care of us. “The same God who is taking care of us when we fast (I was fasting too) is the same God who brought him to the hospital. So, God is also indirectly telling him that he is not fit to fast,” I replied to him cheekily. The sad reality is that most of us health professionals who are hardline religious, enforce some unhealthy beliefs in our patients.

Raphael’s decision to continue trying his heart could’ve been motivated by friends and family who are very religious, and some could even have professional health knowledge, yet still cling to a morbid leap of faith and audacity of hope.

Again, when I was a student nurse doing practicum in Achimota Hospital, there was this nurse (Osofo maame) whose husband was a pastor. This woman was very religious and would caution us to be careful of how we interact with patients. According to her, some of the patients could be ghosts. This woman also believed that some chronic wounds are spiritual, and no matter the efforts of the dressing room nurses, the wound will never heal.

As a student nurse then, there was nothing I could say. But you can imagine how such a nurse would approach a chronic wound case. “This is one of the spiritual chronic wounds. I better not waste my time.”

Recently, I was having a conversation on suicide with my colleagues. Some of them think that suicide is spiritual because sometimes the enemy will send the devil to come and tell you to kill yourself. I dismissed it completely. An admission of this statement means that the enemy and the devil will always win, and we have nothing to do about it.

I cited an example. More men die from suicide than women, even though more women attempt suicide than men. Why is that? Is that too spiritual? Of course not. Men use crude not-even-God-can-save-me approaches to achieve their suicide: a man will slit his throat with a knife, a man will run into a car, a man will jump off a ten-storey building, among other brutal methods. A woman, on the other hand, will use gentle procedures to end their life: a woman will take an overdose of drugs, a woman may eat rat poison, a woman may sever her veins, a woman may eat ten balls of kenkey, among other mild approaches that give enough room for them to be saved.

The only time the so-called devil may instruct you to kill oneself is when people with suicidal ideation are left in seclusion or alone in confined spaces. And that’s not spiritual but science through a consistent pattern of observation for years.

Typically, when someone dies of ascites or accumulation of fluids in the peritoneal cavity secondary to liver failure or cirrhosis, the primary assumption is that such a person has been given “poisoned” food by his enemies. Although I appreciate the complexities of the “African electronics,” our hasty conclusions thwart the fine lines in our most important first line of intervention.

I have studied Raphael’s consistent struggle with his heart and how his heart condition deprived him of great opportunities to play his career at the elite level of football. Nonetheless, he found ways to put his heart through a constant stress test. Raphael, through his videos, was very religious. I learned he even formed a group known as Football Players for Christ or something similar. His decision not to quit football amidst all the scary facts about his heart could’ve been informed by his religiosity or better still his pastor who told him how Jesus raised Lazarus from death. We are in a continent where the good, the bad, the ugly, the galamsey menace, the road carnage, and all the corruption are by the will of God. And the sick, their caregivers, and their families and friends ultimately think that “what is written is written.”

As a religious person myself, I believe in the saying that “What God cannot do does not exist,” but please don’t use your exacerbated stomach ulcer and eat kenkey with hot pepper and shito and then turn around to blame your village witches for your worsening stomach problems. And then call on God’s intervention. That’s not fair.

In conclusion, always bear in mind the timeless wisdom encapsulated in the popular saying, “tie your camel first and trust in God.” Before surrendering anything to divine intervention, place it securely in the capable hands that God has bestowed upon you! Moreover, consider the possibility that you might unwittingly become the architect of your own trials and tribulations.

By Hannan-Confidence Abdul