The trouble started with a head cold. Then an allergic reaction to mold in the room, causing rashes and fatigue. Then came the pinworms.
Two weeks after we arrived, I slipped in a drainage ditch in the dark during post-rain flooding and cut my shin to the bone in two places. Despite all the care I could manage that got infected and I had to take antibiotics.
At around the same time, I developed an unrelated viral illness characterized by intermittent fever, fatigue, and serious muscle aches. It lasted 12 days. Just when that cleared up, the mold allergy came back and my feet broke out in rashes so bad it hurt to walk and was difficult to sleep.
I am not alone. Our teammates and daughter have been hit by multiple colds and cases of diarrhea. Ramesh had it worst of all, catching Dengue Fever that spiked his temperature to 105 F and left him suffering from serious fatigue and joint/foot/hand pain for days afterwards.
This is all just in October.
We’ll be fine. My shin is healed, the virus seems to be gone, and I think I’ll figure out how to manage this mold thing. Ramesh is recovered from Dengue and our other teammates recovered from diarrhea. Nothing life-threatening has made its way into our systems as of yet. But my goodness, it certainly has made life harder for a while.
Every time I experience these periods of poor health, which are common here (I’ve caught hepatitis, filariasis, typhoid, amoebic dysentery, salmonellosis, food poisoning, and several unidentified viral fevers), it leads me to reflect on how illness impacts our neighbors.
- Their immune systems tend to be weaker than mine, so they get sicker and for longer.
- Their exposures tend to be worse than mine so they get more serious diseases (like tuberculosis and pneumonia)
- Their reliance on their bodies for work is greater than mine, so their livelihood is impacted
- As a result, losing a job and even risking death due to long-term illness is far more likely
Sometimes you’ll see a chart that will show “the economic burden of disease”, telling you how many work days a year are lost due to malaria or dengue fever or whatever. Those charts give the impression that it is us versus the disease, and maybe if we develop a better vaccine or run a more effective anti-mosquito campaign then that disease burden will go away.
But experiencing these illnesses personally, and watching my neighbors suffer, I don’t think us versus the disease is the right framework. It isn’t the germs that are taking so much off of my neighbors’ lives, it’s poverty. TB is everywhere in India, but only the poor catch it. Viral fevers are everywhere in India, but only the poor are constantly laid up by them. If we didn’t live in a slum, most of this stuff never would have happened to us. The reason all these diseases are so bad, the reason their impact on a family is so devestating, is directly related to poverty.
So long as we live here, I get to experience a bit of that. Just a fraction. And even that fraction of the experience feels like crap.
Stranger in a Slum 
Hi John,
Is there anyone there that performs basic at home treatment for these situations? Some of the conditions you describe could be alleviated with simple remedies. Such as activated charcoal to reduce the diarrhea. The pharmacy might carry pills specifically that threat it (i.e. in Mexico I’ve seen a drug that is both an antibiotic to kill the infection causing the diarrhea and then it had kaolin clay which binds out the nasty byproducts of food poisoning). When we travel in 3rd world countries, we all just started to drink charcoal water prophylactically too after some people in our party got pretty sick. I figure you can have a good stash on charcoal pills on hand and it might help to reduce the diarrhea severity. Have you heard of coining? It’s an south-eastern asian remedy that opens up the pores, I think it works by improving circulation and therefore your body’s ability to fight the disease and then seems to break fevers over night every time I need it! Really easy affordable at home method that has saved my mom’s life on many occasions in wartime conditions. Possibly educating your neighbors on some herbal/non-western remedies and what medications to take might help to reduce the severity of many of these diseases. Just some ideas!
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There’s a pattern in the world isn’t there, as illustrated by these health issues – bad stuff happens to everyone, but it affects the poor more than the rich.
Good on you for your analysis and willingness to endure!
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Thank you Lai. Yes, there is activated charcoal available for cheap and we do recommend that to people to help with diarrhea. Antibiotics are regularly available too. There are also people who have offices in the basti who aren’t doctors but are medically trained to a degree (they have a B.S.), who prescribe simple remedies for people so they don’t have to go to the hospital. They’re good for the basic stuff.
The biggest problems with those sorts of relatively simple diseases is when people are affected by them almost constantly because of water or food quality, so even when they treat the issue it keeps coming back over and over. We’ve tried to work with some households to get cheap no-electricity ceramic water filters (the same kind we use in our own house), in some cases it’s worked for people and in others its a little tough because it’s a big change of routine and requires upkeep on a semi-regular basis.
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