What really is Apa Afo in Nigeria

What really is Apa Afo? This question has been a great concern for many. Also, the deceitful belief that it cannot be treated by orthodox physicians and medications makes everything more confusing.

However, you don’t have to worry, I have unraveled everything you need to know about Apa Afo which in English is known as splenomegaly (enlargement of the spleen).

APA AFO as the name implies was coined from these 2 Igbo words, Apa which means mark, and Afo which means stomach. One can simply put, “a mark on the stomach”. The mark is gotten as the effect of the hot substance placed on the abdomen to dissolve what they believe is causing the enlargement.

Sit tight and grab some wisdom…

Traditional medicine, often rooted in centuries-old practices and beliefs, plays a crucial role in many cultures and communities around the world. While it can offer accessibility and trust benefits, there are also significant dangers and misconceptions associated with its use, particularly in treating children’s illnesses.

One of these misconceptions is that Apa Afo(splenomegaly) can only be treated by a traditionalist.

In many rural areas, primarily among mothers, this perilous custom of Apa Afo has continued for an extensive period which translates to abdominal scarification for treating an enlarged spleen(Apa Afo).

The traditionalist procedure of treating Apa Afo involves applying a scalding substance to the abdomen in an attempt to dissolve whatever is perceived to be the cause of the spleen’s enlargement. Many believe this condition to be a stand-alone disease resulting from the accumulation of bad blood, worms, or possibly evil spirits.

On some occasions, cuts are made on the skin over the noticeable spleen, perhaps to allow the so-called bad blood to escape. If you observe children under 10 living in the rural parts of Southern Nigeria, it is distressing to notice that this has likely been done to more than half of them.

The fact that these young children are subjected to such intense pain is deeply saddening and concerning thus I am moved to bring light to this bad practice that has become a norm to many families. Never worry, kindly sit tight until the last second of this article.

Dangers of Abdominal Scarification for treating APA AFO

A scarification is a form of body modification that involves scratching or cutting designs into the skin to create scars.

Here are some potential risks and dangers of this practice, particularly in the sensitive abdominal area:


Abdominal skin is prone to bacteria. If the tools used for scarification are not properly sterilized, or if aftercare instructions are not followed meticulously, infections can develop. An infection in the abdominal area can become serious if not treated promptly.


While the purpose of scarification is to create scars, these can be unpredictable. Hypertrophic or keloid scarring may occur, leading to raised, thickened areas that might be uncomfortable or unsightly.


Abdominal skin is sensitive, and scarification can be a painful process. There may also be prolonged discomfort during the healing process.


Cutting the skin can lead to bleeding, and if not controlled properly, this may lead to further complications.

Nerve Damage

If performed improperly, scarification can cause nerve damage, leading to numbness or other sensations in the affected area.

Allergic Reactions

Some people might have allergic reactions to the materials used in the scarification process or to the aftercare products.

Emotional Impact

The permanent nature of scarification means that any dissatisfaction with the appearance can lead to emotional distress.

Interference with Medical Procedures

In some cases, significant scarring in the abdominal area might interfere with future medical procedures, like ultrasound examinations.

Legal and Ethical Considerations

The practice might not be regulated or even legal in some jurisdictions, especially for minors.

5 approaches to curb this practice of Abdominal Scarification

Here are five approaches that can be employed to curb this practice;

Education and Awareness Campaigns

    • Education about the risks associated with scarification, including potential infection, keloids, and other complications, can be vital in discouraging this practice.
    • Collaborate with healthcare providers, schools, and community leaders to spread information about the potential dangers and offer safe alternatives for self-expression if that is the driving force behind the practice.

Legal Regulations

    • Governments and relevant authorities may implement laws and regulations to govern or ban non-medical scarification practices.
    • Licensing and oversight of professionals who might perform these procedures could also be used to ensure that any existing practices are performed safely and ethically.

Cultural Sensitivity and Collaboration

    • If the practice is rooted in cultural traditions, working directly with communities and their leaders to understand the significance and find acceptable alternatives is essential.
    • Encourage dialogue between communities, anthropologists, and health experts to develop alternatives that respect cultural identities while safeguarding health.

Medical Intervention and Guidance

    • Medical practitioners can play a key role in guiding individuals away from this practice by providing consultations and education.
    • They can provide information on proper wound care for those who have undergone the procedure, to minimize potential health risks.
    • If the desire for scarification is related to a mental health issue, therapists and counselors can work with individuals to explore underlying motivations and offer treatment and support.

Promote Alternative Forms of Expression

    • If scarification is being used as a form of self-expression, provide information and access to alternative forms, such as body painting, temporary tattoos, or other artistic pursuits.
    • Engage with local artists, cultural centers, or community organizations to hold workshops or classes on these alternatives, so that individuals who are drawn to scarification for aesthetic or expressive reasons can find other ways to achieve their goals.

What really is Apa Afo in Nigeria

Anatomy and Normal Function of the Spleen

The spleen is an organ located in the left upper quadrant of the abdomen. It’s part of the lymphatic system and plays a vital role in the immune response.

Its functions include filtering blood, removing old or damaged red blood cells, and helping the body respond to infections.

What really is Apa Afo in Nigeria

In children, splenomegaly is considered a symptom rather than a disease itself, as it often results from underlying diseases or conditions. Understanding splenomegaly in children requires examining its causes, symptoms, diagnosis, and treatment.

Causes of splenomegaly

  1. Infections: Many infections, such as mononucleosis, malaria, or bacterial endocarditis, can lead to splenomegaly. Viral, bacterial, parasitic, or fungal infections can all contribute to spleen enlargement.
  2. Hematologic Disorders: Conditions that affect the blood, such as sickle cell anemia, thalassemia, and leukemia, can cause the spleen to enlarge.
  3. Liver Diseases: Liver diseases, like cirrhosis, can increase pressure in the veins, leading to splenomegaly.
  4. Inflammatory or Autoimmune Conditions: Diseases like lupus or rheumatoid arthritis can cause inflammation of the spleen.
  5. Metabolic Disorders: Various metabolic disorders, such as Gaucher’s disease or Niemann-Pick disease, may cause splenomegaly in children.
  6. Congestive Splenomegaly: Conditions that obstruct the normal blood flow from the spleen can cause the organ to enlarge, such as congestive heart failure.
  7. Cancers: Lymphoma and other types of cancers can cause the spleen to enlarge.

Symptoms of splenomegaly

Splenomegaly itself may be asymptomatic or have mild symptoms. However, underlying conditions causing the enlargement may present with other symptoms. Possible symptoms of splenomegaly include:

  • Pain or fullness in the upper left abdomen
  • Fatigue
  • Anemia
  • Frequent infections
  • Easy bruising or bleeding

Diagnosis of splenomegaly

Diagnosing splenomegaly involves a thorough medical history, physical examination, and various diagnostic tests:

  • Physical Examination: A doctor may be able to feel the enlarged spleen during a physical examination.
  • Blood Tests: Blood tests can help identify underlying infections or blood disorders.
  • Imaging Studies: Ultrasound, CT scan, or MRI may be used to visualize the spleen and assess its size.
  • Biopsy: In some cases, a sample of spleen tissue may be taken to diagnose underlying diseases.

Treatment of splenomegaly

Treatment for splenomegaly focuses on addressing the underlying cause:

  • Medication: If an infection is responsible, antibiotics, antivirals, or antiparasitic medications may be prescribed.
  • Management of Chronic Conditions: Ongoing treatment and management of chronic conditions like sickle cell anemia may be required.
  • Surgical Intervention: In some cases, surgical removal of the spleen (splenectomy) may be necessary, particularly if the spleen is ruptured or if the underlying condition does not respond to medical treatment.

Dangers of Traditional Medicine

  1. Lack of Standardization: Traditional remedies can vary widely in composition, potency, and quality. Without strict regulations and standardizations, it’s challenging to ensure the safety and effectiveness of these treatments.
  2. Potential Toxicity: Some traditional concoctions may contain harmful substances, such as heavy metals or toxic herbs, leading to adverse effects.
  3. Interaction with Conventional Medications: If used alongside conventional medicines, traditional remedies may cause unexpected interactions, leading to reduced effectiveness or harmful side effects.
  4. Delay in Seeking Professional Medical Care: Relying solely on traditional remedies may lead to delays in seeking evidence-based medical care, potentially allowing a condition to worsen.

Misconceptions Leading to the Belief in Traditional Concoctions

  1. Cultural Beliefs: Cultural traditions and beliefs can deeply influence people’s attitudes towards healthcare. The trust in traditional healers and remedies might stem from longstanding community practices.
  2. Distrust in Conventional Medicine: A lack of faith in modern medicine or previous negative experiences with healthcare systems may push people towards traditional practices.
  3. Perceived Naturalness Equals Safety: Many believe that because traditional remedies are natural, they must be safe and free from side effects. This is not always the case, as natural substances can still be harmful or toxic, particularly in incorrect dosages.
  4. Anecdotal Evidence: Personal stories and testimonials may support the effectiveness of traditional remedies, even though scientific evidence may be lacking. This reliance on anecdotal evidence might foster an unwarranted belief in the efficacy of traditional


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