Ibadan, Nigeria - The wail of 6-week-old Quari Babaola cut through the air like the blade that had just sliced through his chin.
His mother, Kafilat, shuddered but kept a determined grip on his tiny limbs as a traditional healer chanted incantations and smeared a sticky black paste of ground-up charcoal onto cuts on the baby's hands, feet, back and chest.
"Marks will help him to be part of the family . . . all the family used to do it," the baby's mother said in her native Yoruba, as a line of mothers cradling their infants nodded their agreement.
The women say traditional scarification has healing powers and is an important part of their tribal identity.
Originally used medicinally and to distinguish friend from foe in times of war, the custom offers many Nigerians a sense of continuity in a rapidly changing world. But the once common practice is gradually declining.
"In the last one to two decades, it's been mostly restricted to rural areas," said Tolu Fakeye, head of the government's traditional medicine development program. "The origin of the practice -- to identify people in the tribal wars -- is no longer relevant, and the people who identify it with cultural beliefs haven't had so much contact with formal education or urbanization."
Still, in a country of 135 million, with one of the highest population growth rates in the world, there are plenty of new babies to keep traditional doctors such as Razak Ahmed busy. Known locally as an Oola, he is part healer, part tattooist and part keeper of tribal traditions. His family has performed the ceremonies for generations, and he knows all 14 women waiting to see him on this recent day.
Ahmed has made some concessions to modernization, such as adding a splash of antiseptic to the plastic bowl of water used to wash his knives and insisting that mothers return with their infants for a checkup. Fakeye said the government has begun to register traditional doctors and encourage them to sterilize their instruments and perform noninvasive techniques, but Ahmed said he has had little contact with the Ministry of Health.
These days, Ahmed said, tribal marks are more about fashion than providing an instant visual history, he said, pointing out parents with elaborately carved faces who have opted for a simple dash-dash across the cheeks for their children.
"It makes the face beautiful. . . . They cannot stop it, it is our culture," he explained.
Quari's mother said her baby's teeth will grow in painlessly after his chin is cut. Another of Ahmed's customers requested that he cut her wrist and smear on the black paste before he circumcises her son, believing that she could take the pain of her child.
"That's the way we do it in our father's house," said Ganiyat Azees, 35, cradling 2-month-old twins. Both had a deep incision on each cheek blackened by charcoal and herbs. "If we don't do it for the children, people may not know they are from this family."
Scarification is no barrier to success in most of Africa. It is a tradition in all three of Nigeria's major tribes, and former president Olusegun Obasanjo has faint parallel lines scoring his cheeks. Tribal scars can even be a form of individual self-expression, like tattoos in the West.
Faruk Lasaki, who has produced a book and a film on the practice, said: "I know one woman who had the scars done as an adult, because she liked them. . . . My problem is when they do this to the children so young that they don't have any choice about it."
But in a country with no social security and not enough functioning clinics, some Nigerians see scarring as a reassurance that help and health can still come from within the tribe.
"If I am in another place and I see someone with marks like mine, of course I will have a soft spot for that person," said Ade Muyiwa Adegoke, a well-known Yoruba actor with triple lines radiating from his mouth.
Adegoke said he is not ashamed of his scars, which along with a bracelet of beads mark him as local royalty. But he has decided not to mark his children.
"These days, it is not necessary that anyone can look at your face and tell where you are from," Adegoke said. "And I did not want to hurt my children."