Friday, July 4, 2008

Amoebic Dysentery; Work in Morocco and other stuff

So it’s been a while since I’ve posted and it seems as though there’s a lot to report.

Amoebic Dysentery

First, I’ve been sick and I’m here to report that it’s not a lot of fun. I’ve been tired a lot and spending a lot of time resting. It’s my own fault; I drank water from a spring, which I know I shouldn’t be doing. I’ve had diarrhea for nearly a week now and it’s recently been diagnosed as amoebic dysentery. Fortunately, there is effective medicine available that should clear things up quickly.
Being sick has exposed some of the interesting myths in the culture about the causes of illness and simultaneously provided me with an excuse to give a little health lesson. My host mom has said repeatedly that I have diarrhea because of the hot sun. I tell her no: the sun does not cause diarrhea, there are small bugs (microbes) in the water that made me sick. I’m not sure that she believes me. Then, the other night, we were having something hot to eat for dinner. I went to drink some cold water and she tried to make me stop. She said that the cold water and warm food in my stomach would give me diarrhea.
Apparently, I’m not the only one in the village who’s been sick with diarrhea recently. Everyone says, ‘oh, people have diarrhea now because the sun is so hot right now.’ My theory (The Microbe Theory) is that it’s really hot right now, so people are drinking more water from the springs and irrigation ditches, which is the actual cause of the illness. The thing is, people are convinced of The Hot Sun Theory and it’s difficult to convince them otherwise. And that’s my job for the next two years, advocating The Microbe Theory (something you can’t see or touch) and disproving The Hot Sun Theory.

Work in Morocco

People are starting to harvest barley now. Let me just take back anything I ever thought about Moroccans not working hard. It is hot out now and everyone is harvesting barley. All summer long there will be crops to harvest.
Everyone loves to give Moroccans a hard time, mostly Moroccan men, for not working. I’ve touched on this before, but people love to say, “Moroccan women do all the work, the men do nothing.” I’ve heard it from Peace Corps Volunteers and I just heard it from the president of a Spanish NGO (more on other aspects of that meeting later). In front of a Moroccan friend of mine, the Spanish guy was telling me how little the men do. I happened to know that my friend had gotten up at 6 to work all day in the fields, meanwhile this Spanish guy was lighting up a hash cigarette after having eaten my friend’s food, his feet all over the sofa, and thinking of himself as a savior of rural Moroccans everywhere.
The thinking seems to be, “if only the men would work harder, the country wouldn’t be impoverished. But they just sit around all day drinking tea. It’s the women who keep the families from collapsing.” It’s easy to fall into this trap of blaming the ills of a country on its sexism and gender rolls and ignoring other factors. This allows us to reaffirm our own superiority for our supposed liberal society (now, it’s been a while since I left the country, but my recollection is that gender roles and sexism still existed in the States). This line of thinking also makes for easy attacks on Islam; the thinking seems to be, “men justify their superiority because of their religion.” I’m not saying the gender inequality isn’t an important issue in Morocco (it is), but it isn’t the main cause of an underdeveloped economy.
Maybe people think that the men do no work because they are very public with their leisure time: they spend it all in public spaces, chatting with their friends. Many Americans spend their leisure time in their houses or other private spaces. Now, no doubt women work really hard, but let’s lay off the men, OK? My 72 year-old host dad is waking up at 4 (four!) tomorrow morning to go and harvest barley.
(In my criticisms of Western attitude toward Moroccans, I’ve noticed that I often make sweeping generalizations and say things like, “Americans think this about Moroccans.” Given I’m often criticizing Americans for make generalizations about Moroccans, this is the height of hypocrisy, and I’m going to try to stop it.)

Other Observations

Next on the docket of issues is a trip I took to a neighboring douar (community), some 17 km away. I’ve been to this douar twice before. The second time was when I accompanied the doctors on their evaluations of the kids and gave my hand washing lessons. So I know a little about the community and I know the moqadem (local authority guy).
First off, I found out a little more about the impact of the doctor’s trip. While giving their evaluations, if a child had a serious problem that the doctor could not address at that point, she wrote up a little slip describing the problem and saying that the kid should go to Tounfite (the nearest big town) to see health professionals there.
It turns out she wrote all of these evaluations in French and gave them to the moqadem. It was his job to distribute the evaluations to the parents. Now, I’m pretty sure no one in this community speaks French, let alone can read it. So while I was there, the moqadem had me go through all the slips and explain what was written and whom it should be given to. Crazy. Then I walked around with the moqadem and he gave some of the slips out to parents that we saw while we walked. I gave a little explanation of the kid’s problems and told the parents that the kid needed to go to a health center. Now, this is pessimistic of me, but I’m pretty sure none of the kids will be taken to Tounfite. So none of the kids that really need help will get it.
The original reason that I’d gone to this douar was to get a picture of this little sick girl there. I need to send the picture to a doctor in America in order to get authorization for the medication she needs. Her illness, if it is what I think it is, is very severe. It’s caused by generations of inbreeding. (Its shorthand is XP, if you’d like to look it up.) All of the girl’s siblings have had the illness and they all died. The girl started showing symptoms 5 months ago. I don’t totally understand the disease, but it’s some kind of skin cancer. The skin is extremely sensitive to the sun and is damaged by exposure. Eventually nasty sores develop on the face and blindness ensues. I guess the medication is some kind of oral, mild chemotherapy. There’s another Peace Corps Volunteer who’s been monitoring some other cases and, from her report, it sounds like even with medication, it’s a pretty miserable life to lead as the patient should be shut up in a dark room all day for healing. So that’s pretty sad.
In addition to wanting to help this girl, I thought it would be a good way to get to know a community and to get them to think of me as a health worker. Well, that worked. Sitting in the moqadem’s house, some people came and knocked on his door with more doctor’s notes to translate. Also, the moqadem had me look at his little son, who is very sick. The kid has had diarrhea for a month. He’s become very skinny with a distended stomach and while I was there, he was completely unresponsive. I told the moqadem he had to take the kid to a health center or he might die. The moqadem said a) God will help him and b) that the health center was very far. Later in the conversation, I asked the moqadem about his children. He said he had three (living). I asked how many of his children had died. He said two. I’m pretty sure that it will be three soon. And this guy is the moqadem, who is a community leader and better off than most in the douar.
In my douar, which is the central douar in the larger community and perhaps the most well off, there aren’t such glaring, drastic health problems. There’s definitely a lot of work to do, but it’s a little more subtle and is going to take more research and patience to address. I’ve definitely been a little impatient about not having any real “work” to do at this point. It’s fair to say that I was disappointed there wasn’t more to do. But now having found a place where there is so much “work,” I see how silly that wish was. Being a health worker and having lots of work means that lots of people are suffering.


Mark said...

Duncan, is XP xeroderma pigmentosum? A brief description from my genetics text (Tamarin, 1999) reads: "xeroderm pigmentosum is caused by mutations that inactivate the mutation repair system that corrects UV-light damage; exposure to the sun results in skin lesions that often become malignant."

I hope you get rid of your bad microbes soon.

Love, Dad

Anonymous said...

Next time don try to drink again in spring because you dont know what kind of bacteria there.

Laby[alligator shoes]

Alan Abraham said...

find dermatologist in Delhi, you can get the right solutions for your skin.