Kyphosis (from Greek κυφός kyphos, a hump) refers to the abnormally excessive convex kyphotic curvature of the spine as it occurs in the thoracic and sacral regions. Inward concave curving of the cervical and lumbar regions of the spine is called lordosis. Kyphosis can be called roundback or Kelso's hunchback. It can result from degenerative diseases such as arthritis; developmental problems, most commonly Scheuermann's disease; osteoporosis with compression fractures of the vertebrae, or trauma. A normal thoracic spine extends from the 1st to the 12th vertebra and should have a slight kyphotic angle, ranging from 20° to 45°. When the "roundness" of the upper spine increases past 45° it is called kyphosis or "hyperkyphosis". Scheuermann's kyphosis is the most classic form of hyperkyphosis and is the result of wedged vertebrae that develop during adolescence. The cause is not currently known and the condition appears to be multifactorial and is seen more frequently in males than females.

In the sense of a deformity, it is the pathological curving of the spine, where parts of the spinal column lose some or all of their lordotic profile. This causes a bowing of the back, seen as a slouching posture.

While most cases of kyphosis are mild and only require routine monitoring, serious cases can be debilitating. High degrees of kyphosis can cause severe pain and discomfort, breathing and digestion difficulties, cardiovascular irregularities, neurological compromise and, in the more severe cases, significantly shortened life spans. These types of high-end curves typically do not respond well to conservative treatment and almost always warrant spinal fusion surgery, which can successfully restore the body's natural degree of curvature. The Cobb angle is the preferred method of measuring kyphosis.- wikipedia.

Adeoye Dowo was just 22 years old when he was murdered. His female friend lured him into a bush at Ago Alaye, a village in Odigbo Local Government Area in Ondo State, where he was strangulated and his hump removed by three men.

Taibatu Oseni, also 22, suffered same fate. She was killed and the hunch on her back was removed by her murderers.

Little wonder Saheed Oyedokun lives with the daily fear of being caught in the grisly hands of ritual killers who hunt people like him for ‘quick money.’

When our correspondent met Oyedokun, he was standing on a raised concrete floor amidst the boisterous crowd of traders, buyers, drivers and passengers at Olomi bus stop in Ibadan, Oyo State. Though he agreed to an interview with SUNDAY PUNCH, which was negotiated through an intermediary, he chose a bustling, noisy public place as the initial rendezvous.

After a further phone call from the intermediary and a press identity card was shown to him, Oyedokun was willing to talk.

He explained his initial reluctance: “I know what evil minded people think about me; they see me as a money-making machine. I am careful about where I go and what time I move around. Also, I don’t stay late in my shop. I ensure that I walk in company of someone if I must go to a place and I do my best to avoid strangers,” Oyedokun said.

The intermediary who pleaded anonymity had earlier said Oyedokun might be reluctant to talk to SUNDAY PUNCH, “He only spoke to you because he trusts me. Using hunchbacks for money-making rituals is common. How many hunchbacks do you see around these days? They seem to have been driven underground by the evildoers.”

Dark, barely four feet and easily noticed in the crowd, with curious eyes staring at him, Oyedokun has been carrying the hump for more than two decades. Walking nimbly along a dusty rustic area, he led the journalist to his one-room apartment. As he sat on his modest mattress without the support of a bed, Oyedokun narrated the tale of how he lives with the fear of being kidnapped and used for money-making rituals.

He said, “When I was 10, I fell ill and I was taken to the hospital. When I started recovering, I noticed that my back was growing in a strange way. I don’t know the type of sickness it was. After some months, it had become so big, and then I stopped growing tall. Even though I was young, I knew that something was wrong because people looked at me in a strange way.

“My parents did not allow me go out and if I went out, I could not go alone. When I grew older, I understood why I was shielded for that long. Some people see the hunch on my back as a money-making tool. I have heard different stories about people with hunchbacks being used for rituals, even in Ibadan where I live. I have heard different stories on radio and television.

“The fear of being kidnapped for money rituals is greater than the shame of being a hunchback. If not because my friend assured me that you are an authentic journalist, I won’t meet you. I don’t talk to strangers and I hardly move in lonely places. I don’t want anyone to kidnap me.”

Just like Oyedokun, Mr. Alaba Akinduro lives a sheltered life. Fair-skinned, handsome and neatly dressed, Akinduro, who is the Principal of Puritan College, has a hump on his chest.

“You remind me of an irrepressible reality,” he started slowly, if not regrettably.

“While I believe in God as being the ultimate life giver and taker, I am aware of the fact that people like me are being kidnapped because they are hunchbacks and are later killed with their humps removed. I learnt it is done so that the killers can become rich.

“Knowing this, I try to be careful of how I move about. I usually don’t walk in lonely, quiet and dark places. I always inform my wife and any other close acquaintance if I am to meet a stranger. Before you came here, I had called my wife that someone was coming to see me. I gave her your details in case anything happens.”

Beautiful Rafiat, 19, also lives with the same fear. With big, fitting eyeballs, she does not appear as someone who carries the burden of two humps — one on the back and another on the chest. She tried to speak slowly. Ope, her older sister, who was beside her vehemently resisted the request to interview Rafiat in spite of all entreaties.

“She can’t grant you an interview. She is so precious to us. It is only our mother that can decide that. Though you said you are a journalist, we live in a dangerous society. You may be pretending to be a journalist so that you can hurt my sister,” Ope said.

Efforts to speak with Rafiat’s brother, Akeem, to allow her talk to our correspondent were also rebuffed.

For Ope and Akeem, who would rather do the talking than allow their younger sister talk, there is no letting her out of their sight — for the fear of kidnap and ritual killing.

“We love her. We know how people in her condition are viewed by ritualists. They view hunchbacks as individuals they can easily use to make quick money. We hear about hunchbacks being kidnapped and killed and their corpses later found to be without the humps.

“We have heard and read in the papers how hunchbacks are used for money. Even though you look responsible and someone from this neighbourhood brought you to interview Rafiat, we are sorry you can’t talk to her,” they vehemently stated while refusing to disclose their surname.

The myth

Ritual killings in Nigeria are not uncommon. Usually, the victims are kidnapped in public buses and taken to a secret location where they are dismembered.

In March 2014, a forest said to be a ‘slaughterhouse’ for ritual killers was discovered at Soka in Ibadan, Oyo State, where scores of decomposing human bodies were found while about 23 other victims were rescued alive by security operatives and people in the neighbourhood.

Soka is one of the many places used for ritual killings in different parts of Nigeria.

Apart from kidnapping people without disabilities for money rituals, the notion that hunchbacks are bigger money-making machines is quite rife.

A traditional doctor, Mr. Fagbemikola Olugbode, told our correspondent that Obatala (regarded as the father of all Yoruba deities) had a wife who had a hump on her back. According to him, she was driven away from the palace because of the deformity.

“Alone in the bush, far away from the kingdom, she made a success in farming. Before long, the deity-king requested that the wife should be brought back to the palace.

“From that moment, she was treated as a special person. People with a hunch on their backs are very special and that is why particular rites follow the death of a hunchback. In fact when they die, they are not buried like ‘normal’ people. They are buried upright; not lying down.

“Even though they are special, some other herbalists started killing hunchbacks believing that they are money-making machines. I don’t do such and I don’t know how they concluded that they can get money from hunchbacks,” Olugbode said.

However, a consultant and spine specialist doctor, Dr. Emmanuel Iyidobi, debunked Olugbode’s claims.

According to him, having a hunch on the back or on the chest can be as a result of tuberculosis infection.

He said, “It is very sad that a medical ailment has dangerous connotations in Nigeria. And this great misconception is common in the South-West, South-South and South-East. Some even say humps are filled with diamonds hence families have to chaperon family members with the condition.”

But most of the people contacted by SUNDAY PUNCH were not born as hunchbacks.

Similarly, the Medical Director of the National Orthopaedic Hospital, Enugu State, Dr. Cajetan Nwadinigwe, noted, “Having a hunch on the back could be congenital — what can be called inborn error. Or, it can be acquired due to diseases like tuberculosis of the spine. I must also mention that in some cases, the cause is unknown. When the hunch manifests on the chest it is called pectus excarinatus.”

Stigmatisation and discrimination

Apart from living with the fear of being hunted for money, Muhammed Umar had to relocate hundreds of miles away from home to avoid stigma and discrimination. But he was wrong.

Observed from afar, he looked like a six-year-old. A closer look revealed an adult in his forties. When he stood, he barely measured up to four feet. The outline of his physical posture presented a protrusion at his spine.

As our correspondent extended a hand to him, with a wad of N50, his eyes glistened. He mumbled in gratitude. Handing him another note of N200, he was ready to talk to him but in a brief and in an almost unintelligible English language.

“I left Sokoto State in the North because of the way people were treating me but people in Lagos see and treat me same way I was treated in Sokoto. But at least, I make more money from begging in Lagos. There is money in Lagos,” he said.

In a quivering voice and tears almost breaking through his eyelashes, Akinduro also described the disgust he feels looking at the hump on his chest anytime he takes off his cloth.

“My physical condition made my mother to become poor because she spent all her money on trying to find a solution to my problem. She did her best as I am the seventh of her eight children. I was six years old when the hump on my chest developed.

“I can’t lie to you; each time I look at my condition, I often feel depressed. The pain I feel deep in my heart does not make me feel really happy. Why me? Why did this have to happen to me?” he asked.

If he is contending with shame within, the stigma from the society, the college principal said, is paralysing.

“Though I am happily married now to a beautiful young woman, so many ladies recoiled at the thought of my dating them while I was single.

“I have been insulted. I have been described in various unprintable terms; some of those words still ring in my ears. There are times one just finds life almost impossible to live,” Akinduro lamented.

If stigma dogs people with humps, discrimination is like adding insult to injury. Akinduro, a graduate of Marketing, claimed he had been denied employment opportunities because of his physical deformity even though he was qualified for the job.

“I am good at marketing; I’ll be the best; I have great ideas but many people don’t believe in me,” he asserted.

Oyedokun, on his own part decided to grapple with the harsh reality of his condition. He owns a small unlicensed pharmacy.

“Many people avoid my shop just because of my back but I get by through the patronage of those who do not mind my circumstance,” he said with a tone of resignation.

‘Condition medical not mythical’

An orthopaedic surgeon at the National Orthopaedic Hospital, Dala in Kano State, Dr. Francis Awonusi, explained that having a hunch in the back is often a manifestation of tuberculosis infection.”

He said, “The spine is forced to protrude when the infection is not well treated or treated on time. The infection destroys the bone in the back. The condition can be corrected. However, this will require a complicated operation.”

Iyidobi, the spine specialist at NOH Enugu also described hunched back as a colloquial name for the medical condition known as kyphoscoliosis. In this condition, the back bone or spine, especially the thoracic spine bends sideways and forward to produce the deformity seen as a hunch in the back. According to him, the hunch itself is composed of ribs pushed backwards due to the deformity in the spine.

Parents who are hunchbacks may give birth to children with the condition, the medical experts said. To prevent this, Iyidobi said, “Pregnant women should not take teratogenous medications. All medications should be as prescribed by a doctor especially in pregnancy. Early detection and proper treatment of slight bending of the spine will prevent obvious and severe hunched back. Immunisations against tuberculosis, safety on the roads and at home are also preventive measures that should be adhered to.

“Let me also add that the idiopathic kyphoscoliosis is commoner in adolescent girls while those caused by neurofibromatosis is commoner in boys. There are no racial predispositions.”

The condition is not known to affect reproduction adversely. It is also ordinarily not a fatal illness unless in very late stage of neglected cases when the individual may die of respiratory failure.

Iyidobi added, “The hunch can be arrested depending on the cause. Most will require surgical intervention. National Orthopaedic Hospital, Enugu, runs a spine unit where these complex spinal deformities are treated.

“The congenital and the idiopathic types have hereditary tendency. The acquired type is preventable by drugs and vaccination. But the condition does not affect their ability to reproduce.”

Pain can be a constant feature in the lives of hunchbacks especially if the hump is severe.

In mild cases, the orthopaedic surgeon said no one but very intimate relatives will detect the problem when the person undresses.

“Moderate to severe disease is obvious to all. Apart from pain, the person may also have exercise intolerance and thus becomes breathless when subjected to moderate to severe exertion. In neglected cases, paralysis of both legs is possible.

“Majority of hunch backs have idiopathic causes, that is, causes that are unclear. There are some that have clear causes including: congenital or inherited, neurofibromatosis, tuberculosis of the spine and trauma. A hunch primarily manifests in the chest or thoracic region. It is the bending of thoracic spine and crowding and protrusion of the ribs that manifest as hunched back.”

Speaking on the possibility of hunchbacks living a normal life, the Vice-President of Joint National Association of Persons with Disabilities, Mr. Iyke Ibe, encouraged them not to look down on themselves even though the society may look down on them.

“There are people in Nigeria who use their fellow humans as sacrifice to become wealthy. Politicians are known to be involved in this kind of rituals; they can do anything to get power and to make money.

“I will urge those who have hunches to be alert at all times. They should bear in mind that they are objects of target. Nevertheless, I will want them not to be too restricted so as to enjoy a normal life,” he said.

Waiting for disability bill

For hunchbacks and many other disabled persons, they may have to wait a little longer for governmental authorities to pay them the desired attention they deserve.

Though the Disability Bill has been passed into law by the National Assembly, President Goodluck Jonathan has not assented to it. Nigeria is a signatory to the United Nations Convention on the Rights of Persons with Disabilities, which requires that member states should pass national legislation on disability.

Though the Nigeria Police are yet to unravel the ritual killers behind the death of Dowo and Oseni, the Force Public Relations Officer, Emmanuel Ojukwu, urged persons living with the condition not to live in fear.

He said, “The police are there for everyone’s protection. If they are afraid, we urge them to pay particular attention to their personal safety and welfare. They can also report any suspicious person to the nearest police station.”

In spite of the assurance of protection from the police, Oyedokun said since some people like him had been used for rituals and the police could not save them, it was a situation of “every man for himself.”

“I am not sure I can rely on the police for my personal safety,” he said.

PUNCH