‘This sickness is not hospital sickness’: a qualitative study of the evil eye as a source of neonatal illness in Ghana

Abstract

Previous research has described the evil eye as a source of illness for pregnant women and their newborns. This study sought to explore the perceptions of the evil eye among mothers whose newborns had experienced a life-threatening complication across three regions of Ghana. As part of a larger, quantitative study, trained research assistants identified pregnant and newly delivered women (and their newborns) who had survived a life-threatening complication at three tertiary care hospitals in southern Ghana to participate in open-ended, qualitative interviews about their experiences in March–August 2015. All interviews were audio-recorded and transcribed verbatim into English and analysis using the constant comparative method of theme generation. A total of 37 mothers were interviewed, 20 about neonatal illnesses and 17 about maternal illnesses. Six of the 20 mothers interviewed about their newborn’s illnesses spoke at length about the evil eye being a potential cause of newborn illness. The evil eye was described in a variety of terms, but commonalities included a person looking at a pregnant woman, her newborn baby, the baby’s clothes and even the mother’s food, causing harm, even unintentionally. Prevention required mothers covering themselves while pregnant and keeping the baby away from others until it was old enough to ward off the evil eye. Treatment required traditional medicine, yet some indicated that allopathic medicine could help. The evil eye appears to serve a social control mechanism, encouraging pregnant women to dress modestly, stay indoors as much as possible and behave appropriately. The evil eye is a pervasive, universally understood phenomenon across three regions of Ghana, even amongst a hospitalized population receiving allopathic health care for life-threatening complications of childbirth. Understanding the role of the evil eye in newborn illness attribution is important for clinicians, researchers and programmatic staff to effectively address barriers to care seeking.

Exploring communities’ perceptions of the etiology of illnesses in newborns and young infants 0–59 days old in 4 counties in Kenya

“…Erroneous beliefs about causes of illnesses in SYIs such as linking illnesses to a child's given name were also common. Our findings are similar to studies conducted elsewhere in low-and middle-income countries where illnesses or death to children have been attributed to PLOS ONE the 'evil eye' or malevolent spirits [7,10,[29][30][31]. A study in the Ashanti Region of Ghana revealed how caregivers attributed pregnancy loss and newborn mortality to a local illness called asram-believed to be caused by evil spirits [11].…”

“…Studies on this subject have noted that perceptions of causes of illnesses in SYIs may vary across socio-cultural and economic contexts [6][7][8]. In some communities, newborn and young infant illnesses and deaths are attributed to supernatural forces such as evil spirits or punishment from God [7,[9][10][11]. Individuals, families, and communities may also attribute illnesses to natural or biomedical causes such as poor environmental and sanitation conditions, personal hygiene, and biological factors [12] as well as social-related reasons such as violation of taboos [13].…”

Concealed pregnancy as an act of care? A qualitative analysis of motivations for concealing and non-disclosure of early pregnancy in The Gambia

“…While several studies have identified concerns about evil spirits as a driver for women to conceal pregnancies in Gambia and elsewhere across SSA [ 27 ], the context of evil spirits have been under-explored in in-depth qualitative terms as they relate specifically to ANC access. Better understanding of how such spirits are held to operate, drawn from anthropological literature and ethnographic studies, may help healthcare practitioners identify the women most likely to fear such situations and who accordingly choose to conceal their pregnancies.…”

Unravelling the Ghanaian “pull him/her down (PhD) syndrome” of malicious envy

“…Duly handicapped by the blinders that envy places on them, enviers are therefore unable to see that “escape” is possible, and that those who succeeded in “escaping” did so without pulling others down. The unfortunate consequence of these “pulling down” behaviors on a society's development is to foreclose the exchange of knowledge, creativity, and economic resources at both the individual and systemic levels since individuals, organizations, and identity groups operate from a fear of falling victim to the evil eye or witchcraft (Apostolides & Dreyer, 2008; Bell et al., 2020; Schoeck, 1966; H. F. Stein, 1974) should the knowledge of their possession of an ability and/or accomplishment of envy become public.…”