More years ago than I like to admit to, I joined the military. I was a young college graduate, and what I thought I was going to be doing in the military turned out to be not quite what I ended up doing. I thought I was going to be working in “medical entomology.” Instead, I ended up in parasitology. It’s a long story, but one of the things I learned is that many of the things we think are “normal” or “what everyone has” turn out not to be the case for much of the world.
My lesson in this came when I was tasked to analyze the stool samples sent back from one of our field teams in a rural area of a South American country. What was it like? Everyone had hookworm, and most of them also had roundworms. There were a few other things, like Entamoeba coli, which weren’t something you’d see here. If I’d seen this in anyone here in the States, I’d have had them immediately referred to the nearest doctor for treatment. In fact, if I’d seen this in my dogs, I’d have been at the veterinarian’s. But these were the “normal” for this area.
One other thing I found puzzled me. I saw a number of “little worms,” which on closer examination turned out to be hookworm larvae. That made me question how these were sampled, because you don’t see these in fresh stool samples. The answer? The people there had simply stepped off to the side of the path to and from their fields, gone to the bathroom on the ground, and scooped up the sample for the team. Which, I was told by members of the team down there, was “the usual” for that place.
Now consider our daily lives. We turn on a tap, and clean water comes out. We go to the bathroom, we have toilets which take the waste away to be treated. If we’re “roughing it,” there’s usually an outhouse around. Our paranoia about water comes from whether or not chlorination might cause problems, or whether the expensive bottled water might have plasticizers in it. We we don’t think in terms of “will this give me a diarrheal disease like cholera, dysentery, or giardiasis?” Most of us don’t have intestinal parasites, or if we do, they’re easily treated. If we go swimming, or wade in water, we don’t worry about picking up a disease like schistomiasis or guinea worm.
One take-away from this is that what we consider “normal” isn’t for a good part of the world. The “problems” that some groups obsess over here aren’t even considered by anyone else. They have much bigger problems. But we also need to think about how that factors into how we “help” people. It’s been called “appropriate technology.” We might think in terms of sewage treatment plants, but a pit privy is more practical and solves a problem. We think in terms of water treatment facilities, where a good well works.
The other take-away? There are a lot diseases out there that most people have never heard of, or worry about in this country. But for the rest of the world, they’re “common.” What we think of as “simple measures” or “cheap treatments” aren’t to them. While we’re confident we have “an answer,” the reality is we don’t – because it’s something we don’t worry about.