18/1/2008
I had never really understood, back in med school, why so much time was spent learning about 'soil micro-organisms'. I think I do, now.
Earth, like air, is an ubiquitous part of life here in rural Timor. Most are born on the bare earth, spend their early years playing in it, expend the major part of their life working it... and finally laid to rest in it.
Not surprisingly, a significant proportion of the sicknesses we treat in our clinic are soil-transmitted.JPG)
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Every other kid has a belly full of worms. The symptoms aren't too impressive: intermittent stomach pain, constant tiredness, the occasional disturbingly mobile bowel movement. The greater, more permanent damage lies in the stunted growth. The worms compete with the already malnourished kids for their limited food.
I dish out albendazole like candy. But the deworming meds don't stop the kids from running around barefoot and picking the worms right back up, the very next day.
Earth also features prominently - and frustratingly - in many traditional remedies.
I spent an excruciating hour last Saturday cleaning out the left ear of a resolutely noncooperative two-year-old. Her mum had packed it to the brim with soil and leaves, to treat a budding ear infection the week before. By clinic day, of course, the infection was positively fruiting. An unappetizing experience for all involved.
Traditional Timorese first aid for cuts while farming: handful of soil, dry leaves, hearty mouthful of spit. Mixed evenly, then slapped onto the bleeding wound before proudly presenting it to the doctor. Bad-tempered doctor then painstakingly cleans away the muck while delivering a long and animated dissertation on 'germs'. When the bleeding is controlled, I just dress the wounds - any attempt to stitch the skin after such overwhelming contamination would only worsen the infection.
Convincing a community that invisible germs exist, that earth is best left on the ground and not on or in their kids, is not an easy task. We teach, we teach, we teach. But until those ideas take root, someone'll have to continue cleaning the ears and the wounds, and dispensing the albendazole and antibiotics.
-raj
I had never really understood, back in med school, why so much time was spent learning about 'soil micro-organisms'. I think I do, now.
Earth, like air, is an ubiquitous part of life here in rural Timor. Most are born on the bare earth, spend their early years playing in it, expend the major part of their life working it... and finally laid to rest in it.
Not surprisingly, a significant proportion of the sicknesses we treat in our clinic are soil-transmitted
.JPG)
.Every other kid has a belly full of worms. The symptoms aren't too impressive: intermittent stomach pain, constant tiredness, the occasional disturbingly mobile bowel movement. The greater, more permanent damage lies in the stunted growth. The worms compete with the already malnourished kids for their limited food.
I dish out albendazole like candy. But the deworming meds don't stop the kids from running around barefoot and picking the worms right back up, the very next day.
Earth also features prominently - and frustratingly - in many traditional remedies.
I spent an excruciating hour last Saturday cleaning out the left ear of a resolutely noncooperative two-year-old. Her mum had packed it to the brim with soil and leaves, to treat a budding ear infection the week before. By clinic day, of course, the infection was positively fruiting. An unappetizing experience for all involved.
Traditional Timorese first aid for cuts while farming: handful of soil, dry leaves, hearty mouthful of spit. Mixed evenly, then slapped onto the bleeding wound before proudly presenting it to the doctor. Bad-tempered doctor then painstakingly cleans away the muck while delivering a long and animated dissertation on 'germs'. When the bleeding is controlled, I just dress the wounds - any attempt to stitch the skin after such overwhelming contamination would only worsen the infection.
Convincing a community that invisible germs exist, that earth is best left on the ground and not on or in their kids, is not an easy task. We teach, we teach, we teach. But until those ideas take root, someone'll have to continue cleaning the ears and the wounds, and dispensing the albendazole and antibiotics.
-raj
1 comment:
Have you ever read Terry Pratchett's Tiffany Aching books? Instead of trying to convince people that invisible harmful beings exist, the witch/village doctor/caretaker tells them that monsters like to stay in dirty water and unclean kitchens. And since that makes perfect sense to them, they obey her. But well. That's not very Christian. Forget I suggested it.
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