Things we don’t worry about

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.

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19 Comments

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19 responses to “Things we don’t worry about

  1. What percentage or how many billions don’t have access to clean water on the globe?
    Living in the Southwest, water is a BIG issue and we’re having a local water conference in just a couple of weeks to talk about very related issue like our city water treatment facility, the effects of drought and lots more of course.

    Water is one issue where taking things for granted can be a big mistake. Thanks again.

    • You’re welcome. In the Southwest, the issue is abundance, or rather, the lack thereof. The reality is that a rather sizable percentage – the majority, even – doesn’t have access to clean water.

      For example, in this area, I can draw water from any stream or most lakes, and by simply filtering it or boiling it, it’s safe. My worries are giardia at worst, or maybe a random bacteria. In the rest of the world, I’d have to not only filter out the dirt, I’d have a lot of other things in that water like chemicals, and the odds are pretty good that I wouldn’t have “filters,” boiling it would use valuable fuel, and I’d likely pick up something just getting the water in the first place.

      • so many to choose from…. and let’s throw in dengue fever, Marburg Hemorrhagic Fever, or my fave, spongiform encephalopathy (good at least for a spelling Bee) 🙂

        Because water is such an issue here I try not to take water for granted. I have a collection of scavenged rain barrels, painted by a local teenager/turned 20, and converted for about $15 to water collecting/disseminating barrels (now if it would only rain!)

        • Dengue is mosquito borne, and we don’t know about Marburg (or Ebola). Yellow fever once caused huge numbers of deaths, even in Philadelphia. What people don’t realize is how close some “tropical” diseases really are. Leishmania has been found in Oklahoma, for example, and Chagas’ disease (American trypanosomiasis) has been found in animals as far north as Maryland.

          • West Nile Virus, mosquito borne also and has been a big problem out here in the South West & further north. My daughter has dealt with patients who had severe illness from this and even died in a Denver hospital despite all modern medicine.

            It is a much smaller world than we like to believe.

  2. Excellent Norbrook! I just posted this diary link to my daughter. She’s an epidemiologist who has worked in both Africa and South America. I’ve spent some time in both places myself. We do take so much for granted here in the US.

    There were not so many years ago when some of the parasites you mention were not uncommon among people here, especially rural poor.

    • Oh, absolutely.

      Testing in the 1900s revealed very heavy infestations in school-age children. In Puerto Rico, Dr. Bailey K. Ashford, an U.S. Army physician, organized and conducted a parasite treatment campaign, which cured approximately 300,000 persons (one-third of the Puerto Rico population) and reduced the death rate from this anemia by 90 percent during the years 1903–1904.

      On October 26, 1909 the Rockefeller Sanitary Commission for the Eradication of Hookworm Disease was organized as a result of a gift of US$1 million from John D. Rockefeller, Sr. The five-year program was a remarkable success and a great contribution to United States public health, instilling public education, medication, field work and modern government health departments in eleven southern states.

      We have much better drugs now, but the control measures are fairly straightforward: Proper privies, good shoes or sandals, and treatment.

      One of the things that most people don’t know about the military is that they’re one of the premier research organizations when it comes to tropical or other “not our problem” diseases. That’s because over the course of this country’s history, our military has ended up in some places where it is a problem.

      • Absolutely about the military and research in disease for which they don’t get credit. Our military does a tremendous amount of scientific work that people never hear about.

        As to hook worm, that was still an issue among rural children when I was a child and trust me on this, I am way younger than 100 years ♥

        • Exactly. For example, malaria is a major health problem for much of the world. Until Bill Gates decided to drop a few hundred million on it, the major funding source for research, or work on the disease being done in this country was the military.

          One of my early lessons in humility came when I, as a cocky young college graduate, first reported for work, and realized that the people I was working with were the world experts in their fields. 😳

          • LOL! “cocky young college graduate” We have probably all been in that space at one time or another until we heard in one form or another:

            “Don’t try to teach your Granny how to suck eggs!”

  3. LOL! “cocky young college graduate” We have probably all been in that space at one time or another until we heard in one form or another:

    One of the new people we had come in bitterly complained because the job we handed him his first day was “clean the lab and organize the shelves.” 😆 His gripe was “I shouldn’t have to do this! I have a Masters degree!” My response was “In this unit, that makes you average. Everyone here already has one, is getting one, or has a Ph.D. You know what? Everybody gets told to clean the lab and organize the shelves on their first day. So just get to it, and shut up.” 😆

    • LOL! You need to stop! Hubby spent 20 years in the military. He started out with his BS and got his PHD along the way & he can tell stories just like yours. One of the best ones he tells is when some newbie reported to his lab and found Hubby doing some “menial” tasks and assumed Hubby was a “nobody” until the rest of the crew started reporting that morning & the newbie found out that Hubby was the officer in charge. Years ago but he still laughs about this.

      • I ended up drawing more “military stuff” than most people in my MOS or unit. As I said to the people in my last assignment, where I was not only the senior tech but also the department NCOIC, “Look, I’d much rather be just one of the guys who works in the lab. Please don’t make me remember that I have these stripes on, because you really wouldn’t like Sergeant Norbrook.”

  4. Shortly after I got back from my first tour in Afghanistan and went back to college, I ran into this kid who wanted to know what I thought of his idea to bring the internet to people in rural Afghanistan. The Internet would further the education of children and connect them to the world and bring their untapped potential to us and the world to them and so on and so on and on. I pointed out that there was no power generation capacity to speak of, no transmission infrastructure for power or data at all, almost no content on the internet that was usable by a Dari- or Pashto-speaker, nor facilities to teach Afghans to code in HTML or maintain computers to produce that content either. I suggested he work on getting wells dug because people routinely died of amoebic dysentery, typhus, and cholera.

    He called me a racist-colonialist and stomped out of the coffee shop.

    • Yes, how dare you try to stop his wonderful idea by throwing practical ground reality at him! 😆

      More seriously, there are places in this country where power generation or data transmission infrastructure aren’t present. I used to work down in the Four Corners area, and there’s a lot of it off-grid. Heck, even here in NY, I can go a few miles from my place and find some very nice places that have to run generators for electricity. Up until 7 years ago, we didn’t have broadband, we had dial-up.

      It’s that sort of thing that many people don’t grasp. You can’t say “oh, they need the Internet” if a lot of infrastructure isn’t around them to use it, and if they’re dying because no one has clean water or proper sanitation measures, then they really couldn’t care less about what’s going on the Web. 🙄 It’s stuff like that you have to think of – digging wells to provide clean water, digging pit privies and building outhouses to properly dispose of waste, all come before the other stuff.

      Back when the Haiti relief effort was getting under way, some of the “left” over at Daily Kos were complaining about the “militarization of the effort.” 🙄 I said to to them “there are a lot of problems you’re not thinking of, there is no infrastructure to handle it. The military not only thinks of those problems, they have solutions and the ability to handle it. That’s why they’re in the lead.”

      • My brother was in Haiti with a public health org when the quake hit and he was damn glad when the military showed up so they could handle stuff like getting people out of their houses, rescue & so forth. Then his group could concentrate on treating the casualties.

        He said at first it was just chaos with terrified people trying to shelter in remaining buildings where they could easily be trapped by after shocks. His group was desperately trying to treat the injured and prevent any more from getting hurt. The military did a lot to free victims from rubble, clear roads so aid could get to those in need.

        Just, imo but there are some real dim bulbs over on the ‘dark side.’

        • They see a uniform and a gun, and freak out. 🙄 Haiti was a great example. No electricity, rubble, no airport, no port. All damaged or destroyed. You need to move in supplies, along with restoring the airport, setting up security, hospitals, and clean water and sanitation for aid workers. The military does that stuff before breakfast. It turns out that all those plans, equipment, and training to go to foreign countries and fight work out just dandy when you have to go to a foreign country and help. As we saw from the Indonesian earthquake, and later Haiti and Japan, those big aircraft carriers are terrific mobile airfields to work helicopters from, and get them close to where they’re needed.

          • If there was anything that I learned in the Army that has an application to problem solving anywhere, anytime, in any circumstance, it’s logistics.
            Figuring out what you need, how you’re going to get it to where you need it, how you’re going to procure it, repair it, replace it, and remove it are all the questions you have to answer before your cool idea ever becomes more than a single human interest story on the evening news.

  5. If there was anything that I learned in the Army that has an application to problem solving anywhere, anytime, in any circumstance, it’s logistics.

    One of the axioms I learned was “Armchair generals think strategy and tactics. Real generals think logistics.” 😆 Looking at a lot of the “radical left” as they like to call themselves, most of them are the “armchair generals” of politics.

    True story: The unit I was with was supposed to have a capability to deploy a response team(s) within 24 hours. The reason we found out this was that we got a new CO, who went through the organizational plans and missions, and decided to test that. Which was a disaster, of course, since most of us had never heard of that or knew that we were on one of those teams. 😳 Which was corrected, although not without a huge amount of bitching and griping. 😛