Ignoring Doctors’ Orders, Some Pregnant Women in Uganda Eat Clay

KAMPALA, UGANDA─ Veronica Nakizito is seven months pregnant, but she hasn’t yet had a prenatal checkup.

She says she doesn’t need one because she already has her solution to any pregnancy-related problem: clay bars, sunbaked with herbs. The bars are known as emumbwa in the Luganda language.

“I take emumbwa twice a day to get rid of my morning sickness, saliva gathering in my mouth and to get energized,” she says.

Nakizito crushes the bars of clay into dust and adds water into it. The herbal medicine will help relax her pelvic muscles during delivery, she says.

“With all my children, the delivery process has been quick and easy. It wouldn’t have been so if it were not for emumbwa,” Nakizito says.

Many pregnant women in Uganda drink this clay and herb concoction to manage morning sickness and treat illnesses including malaria, syphilis and candida. Some believe the herbs can alter the sex of a child and cleanse them from curses. But as the traditional remedy retains popularity, health experts warn that it could be harmful to mothers and their unborn babies, because it’s never been studied to determine its chemical components.

Traditional medicines are widely used during pregnancy and birth in Uganda. About 80 percent of mothers interviewed in a study on the incidence of cleft deformities among newborn babies at Mulago National Referral Hospital, the country’s largest health facility, said they had used emumbwa during pregnancy.

The clay in emumbwa is believed to contain minerals like iron and calcium, and it preserves the herbs mixed into it. A bar of clay with herbs can be stored for over a year without going bad, says Cissy Namwezi, a member of Uganda n’Eddagala Lyayo, an association of traditional healers and herbalists.  She goes by the name Maama Namwezi. Maama is a term of respect.

Some mothers in Kampala say the clay bars relieve symptoms that conventional medicine fails to treat.

Christine Anena, a mother of three, says she drank the medicine during each of her pregnancies. The medicine inhibited saliva from accumulating in her mouth, she says.

“I was warned by my doctor to stop taking emumbwa, but none of the drugs they gave me at the hospital would stop the saliva from gathering in my mouth, so I ignored him and continued taking it,” Anena says.

Anena believes the same medicine can alter the sex of an unborn child if administered by a knowledgeable traditional healer.

“If the traditional healer is authentic, I believe she can work her miracle with the right herbs, and the child’s sex is changed,” Anena says.

Yusufu Boiler, a trader who hawks traditional herbs in Kampala streets, says he sells clay bars to at least 10 pregnant women every day.

“The emumbwaI sell for pregnant women is for those who are experiencing heartburns, hot flashes in the stomach, skin nodes, syphilis, nausea, join pains and swelling of some body parts,” Boiler says.

Some women have come back to him to say the medicine worked for them, he says.

“These women heal,” Boiler says.

Women around the world have reported eating clay and other non-food substances during pregnancy. The craving for dirt, chalk and other non-foods is known as pica, and is commonly noted among pregnant women. Research on the causes of pica are inconclusive, but some indicators suggest it’s on the rise: Hospitalizations for pica in the U.S. jumped by 93 percent between 1999 and 2009, according to the Agency for Healthcare Research and Quality, which is part of the U.S. Department of Health and Human Services.

In Uganda, some health experts warn pregnant mothers against relying on clay bars as medication.

Dr. Emmanuel Mwesigwa, a gynecologist and obstetrician consultant at Comfort Home Care Consultancy, says there has been no scientific study done on the clay bars to determine whether they heal such illnesses.

“No one knows what the emumbwa does to these expectant mothers,” Mwesigwa says. “No one knows what it contains. No study has been done to prove that it treats illnesses or softens the pelvic muscles so the woman can have an easier and quick delivery, as they claim.”

But others say anecdotal evidence suggests that the clay bars are, in some cases, helpful to pregnant women.

Dr. John Bosco Mundaka, a gynecologist and obstetrician at Kamuli General Hospital in the Eastern Region of Uganda, says women who take emumbwa during pregnancy have easier births.

“I see increased contractions in women taking emumbwa than [in] those who don’t,” he says. “But no scientific study has been made to reach the conclusion that emumbwa causes this.”

On the other hand, he says, women who take emumbwa experience uterine rupture more often than those who don’t.

And, he says, the clay bars could be unhygienic.

“Clay itself may not cause a health problem, but we know that emumbwa contains sand and small stones,” he says. “It’s also sold in worrying places like the streets, markets, and is never wrapped in any form of protective gear.”

Herbalists dismiss doctors’ warnings. Ugandans have been taking emumbwa for centuries without any trouble, they say.

“The problem with Ugandan medical doctors is that they are trained to believe everything that isn’t conventional medicine isn’t good enough,” Namwezi says. “Different emumbwas are used to treat different illnesses in pregnant women, and we have testimonies to that. That’s why it’s consumed by all classes of people in Uganda, from the urban educated to the rural uneducated, and is affordable to everyone.”

But Namwezi does agree with doctors on one point: No mother can change the sex of her baby by consuming the clay bars.

“There’s no way any emumbwa, no matter the amount or type of herbs it’s mixed with, can change the sex of a child,” she says. “Only fake traditional healers and herbalists will lie to desperate women that they can change the sex of a child.”

Nakizito, the woman who hasn’t had a prenatal checkup, says doctors should research clay bars instead of disregarding them.

“Not everyone is comfortable with taking Western medicine,” she says. “Emumbwa is an alternative for people like me.”

Nakisanze Segawa, GPJ, translated some interviews from Luganda.