How deadly teething traditions are claiming children's lives in Ukambani

Dr Dorcas Kavuli, a pediatrician at Kibwezi sub-county hospital in Makueni county attends to baby Michael*, who is admitted following a gum cutting incident. [Philip Muasya, Standard] Inside a hospital ward at Kibwezi Sub-County Hospital, little Michael (not his real name) faintly opens his eyes and fixes them on the strangers standing beside his bed. Startled by their presence, he lets out a whimper and clutches his frail hands onto his mother, as if seeking protection and reassurance. The mother, barely out of her teenage years, picks him up and cuddles him, gently patting his back. Feeling safe, the child buries his head in his mother's bosom, his tiny body clinging to life. With the baby now comforted, the mother's face lights up with a guilt-laden smile. She is the reason little Michael is admitted here, or so the medics say. The one-year-old has been hospitalised for five days after being subjected to gum cutting, a brutal cultural practice still rife in parts of Ukambani. The practice involves slicing open a child's teething gums with crude tools, ostensibly to cure teething-related diarrhoea and fever. Ann Mutindi, 22, the child's mother, admits to lacerating his gums with a razor blade and applying soda mint, just as she had seen done to many children in her village of Kambu. By the time she arrived at the hospital, the child had stopped breastfeeding due to a gum infection. He was dehydrated and his life was slowly ebbing away. "I've seen it done to children when they start teething and develop diarrhoea. I didn't know it was harmful," Mutindi says forlornly. Dr Dorcas Kavuli, a paediatrician in charge of the children's ward at Kibwezi Sub-County Hospital, believes the child was lucky to have arrived in time. Otherwise, he might have joined a long list of children who have died at the facility-and across Makueni County-due to this retrogressive practice. "When baby Michael arrived, he was in critical condition and anaemic, prompting us to give him a blood transfusion," says Dr Kavuli. "The child has improved but still requires another transfusion and a few more days of observation before he can be discharged," she adds. Gum cutting-also known as gum lancing-is a traditional practice among some Kenyan communities in which a child's teething gums are pierced open using crude items such as thorns, needles, razor blades, nails or hot iron. The belief is that this alleviates teething-related diarrhoea. The aftermath is devastating. Most children suffer serious infections, severe bleeding-and in many cases-death. In Makueni, the practice, passed down by grandmothers and traditional midwives, runs deep. And it's deadly. Harrowing experience Some practitioners dig into a baby's tender gums and gouge out the so-called "false teeth", leaving gaping wounds. The procedure is often done under unhygienic conditions, without anaesthesia, amplifying the horror. Medical experts insist the practice has no scientific basis and is extremely dangerous. Dr Kavuli warns that risks include bleeding, severe infections, and malnutrition as the child cannot feed properly. She reveals that the hospital has treated dozens of such cases recently-some arriving too late, in hypovolemic shock and requiring urgent intensive care. "It's heartbreaking. We're losing children to ignorance. Gum cutting should never happen-it's equivalent to killing the child," Dr Kavuli laments. She explains that teething gums become soft and itchy, causing discomfort. At this stage, children are learning to crawl and often put dirty fingers or objects in their mouths, exposing them to germs that cause diarrhoea. She advises that instead of lacerating the gums, mothers should instead use soothing/ numbing gels to arrest gum itching. For diarrhea, they should use oral rehydration solution (ORS). The numbers are grim Data from the county's Department of Health shows that between 30 and 50 children die each year due to gum cutting. At any given time, there are children admitted in the county's health facilities - some in ICU - after undergoing the procedure. Between January and June this year, Kibwezi Sub-County Hospital admitted 34 children with gum-cutting complications-three of whom died. In 2024, 32 cases were recorded, resulting in six deaths. At the neighbouring Makindu Sub-County Hospital, 66 children were admitted in 2024 due to the practice-six died. Between January and May this year, the facility has handled 44 cases where seven children have lost their lives. Dr Patrick Musyoki, the Medical Officer of Health for Kibwezi West Sub-County, a region deeply affected by the practice, says gum wounds provide entry points for bacteria, leading to complications like cellulitis, abscesses, and sepsis. He notes that once a child develops sepsis - where infection spreads to the blood stream, and causes organ failure, the critical body organs such as the liver and kidneys shut down. "At this stage, there is little chance for survival. We end up losing the children," regrets Dr Musyoki, saying some die at home and aren't counted in hospital data. Reversing the trend To reverse the trend, the county government has launched an aggressive campaign targeting remote villages, where even traditional midwives still practise gum cutting as a source of income-charging between Sh2,000 and Sh3,000 per child. Leading the charge is Deputy Governor Lucy Mulili. With the help of trained Community Health Promoters (CHPs), she is spreading anti-gum cutting messages across the county. "Gum cutting among infants is a serious public health concern in our county and we have decided to confront it head on. We are mapping out the gum cutters and engaging them directly," says the deputy governor. She notes the practice has not only claimed young lives but also strained the county's health budget. "Treating these cases is costly. But we are determined to end the vice through educating the public," she affirms. Mulili says the county is using a multi-pronged, persuasive approach to win hearts and minds-spreading awareness via CHPs, churches, schools and public barazas. The county is also helping traditional gum cutters find alternative livelihoods such as poultry farming. "Some of the gum cutters and midwives have abandoned the practice and become champions against the vice," says Mulili. Among them is Lena Kitheka, 63, a revered midwife from Mbui Nzau who once sliced open hundreds of children's gums. "I would prick the gums with a nail or needle and apply salt or soda ash but that was in the past. I am now a champion against gum cutting and I am educating others to ditch the practice," says the mother of eight. But Mulili insists more needs to be done. "We need legislation akin to the anti-FGM law-specific laws outlawing gum lancing-to protect our children and save lives," says the deputy governor.

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