Friday, January 29, 2010

what's in the water?

Sorry its been a long break between posts. I have had so many observations in public health this month that I can't wait to share.

My adventures in Panama and Nicaragua were quite enjoyable. I was able to travel a great deal, and to spend time at Michele's site in the mountains of Jinotega. I learned how to milk a cow, make cheese, produce coffee from tree to cup, and to surf. Michele and I went surfing on one of our last days and we were both able to stand up on our boards a couple of times, which we were quite proud of. I have so many fun and wonderful experiences to share. The interaction with the children was one of my favorite parts...but that is for another blog post.

As for now, I'm quite reflective on why my energy and interest has been consumed with learning about safe water management. Up until this trip, I understood the importance of water from a spoiled American's perspective, with most of my passion based on what I have learned in text books and class. I've traveled a bit, I know not to use the tap water and what the consequences are when you forget and rinse your toothbrush in the tap water. Or so I'd thought.

The last few days of my trip, I started having spells of stomach sickness (to put it nicely), and figured it would go away on its own. Now, 3 weeks later, I believe I may have a visitor who has made a cozy home in my intestines. Naturally, as a public health student specializing in safe water and sanitation, it irks me to think that I was not careful enough with my water consumption. How could a parasite or any form of contamination enter my body?

Then, I reflected on what I ate, drank and was exposed to, and I realized how extremely difficult it is to avoid exposure to protozoa and other pathogens when the water of a community is not safe. The only things I can come up with were coffee in a local's home (which I assumed was boiled) and juice at a restaurant (who uses bottled water, but perhaps the ice cubes were from the tap???) Imagine what it must be like for those who live with such conditions. I'm sure their bodies adapt and for many, immunity builds and they are not always this sick. I know you can build tolerance to certain bacteria, which is why that's what I thought this was (as Michele did not get sick and has been there 8 months now). But I tested negative for a bacterial infection, and was given antibiotics just to be safe...which do not seem to be working.

I'm not certain of the immunity one can build for parasites. Perhaps its more of an adaptation to the lifestyle of constant exposure, where you always have symptoms. There is only so much any digestive system can tolerate before its too much and unfortunately, survival of the fittest often dictates the outcome. Most of the time, children are the ones in a community who suffer the most, with severe illness and death. I now understand why so many children -- between 1.5 & 2 million a year -- die from diarrhea related illness. When someone spoiled, like myself, who is educated on the consequences of dehydration, and who has access to a flush toilet and adequate safe water and sanitation...and warm showers for that matter...has difficulty staying well with this, one can only imagine how a child in an underdeveloped context, with parents who are not educated on the consequences of dehydration, can so easily die.

The bittersweet part about this experience for me is that even though I am miserable, and shamefully have been throwing myself a pity party, I now have first hand experience on why it is soooo incredibly important to teach people about safe water, and to bring it to as many as possible. A great life truth really, that I had to get ill myself in order to really see what I'm investing in this education for. And for now, I have self diagnosed with having Giardia, which is a parasite with quite a few unpleasant symptoms, all of which I have. Nothing has shown up in my lab results yet though, and I've been told by several (including doctors) that Giardia seems to be one of the most difficult to diagnose, as it easily sneaks by undetected in labs. Many are warning me of the long road ahead on the path to feeling better...which I am refusing to believe. Perhaps they'll find something and treat it. Perhaps there really is nothing there, and I'm just a hypochondriac who is self diagnosing.

Or perhaps I'll get tough and tolerant in the meantime.

Consider it: being grateful for clean, safe water that is easily accessible.

Unlearn it:
that nice solid, healthy looking poop is what everyone in the world must see everyday, because you do. Or for that matter, that some people ever see it or get that satisfaction.

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