tropical medicine

tropical medicine

I am encountering tropical diseases here (not yet internally) that are leaving me slightly anxious. The tropics seem to produce some interesting bodily manifestations. I just hope these manifestations stay away from my body.

Practically every week someone from work will come to work with a Boil. These seem to be infections that start internally and then pop out onto the skin in a mass of swollen redness the size of a 10 cent coin. They appear anywhere on the body, often under the arms or on the legs. They will leave a dark scar as big as a two cent coin (they still exist in Fiji). They say hygiene and diet play a big part in keeping Boils at bay.

Then there are tropical ulcers which are infections that start on the outside and work their way in. The infection can take seven weeks to go and again leaves an ugly scar.

Elephantitis is another tropical disease. It is caused by a mosquito which somehow leaves a worm in your body as a parasite. Again somehow (wish I was a Dr and I hope I am not getting any facts wrong - I get my information from the Fiji Times newspaper) this causes the legs and genital area to swell up hence the name Elephantitis. The swelling is mammoth. It can be cured with medication which you may have to take up to 5 years if you have the disease.

A man died of Typhoid last week. There have been several cases recently reported even in the Suva area. It means boiling your water, no ice, washing hands and taking care with hygiene.

I cut my foot quite deeply with a broken beer bottle on the weekend which fell out of the fridge onto the floor. With the certainty of a tropical infection upper most in my mind, I dashed to the bathroom to run copious amounts of water on the cut and kept my foot up in the air for most of the rest of the day, along with antiseptic cream and bandages to aid the healing process. It has healed. Phew.

The other anxiety in my life is food or the effects from eating bad food. I decided to cook for 10 people on the weekend to farewell Robyn my housemate who has returned to Australia after two years here. I am still getting into the groove in terms of local cooking so it was a struggle to think of something to cook that was also vegetarian as some of the guests don’t eat meat. I had a recipe for a Thai coconut prawn soup. Palm sugar, lemon grass and kaffir lime leaves I could not find. I never used kaffir lime leaves in Sydney but I think I once sighted them in a shop one day. The next challenge was finding 2kg of prawns. Thinking Fiji a land bountiful in seafood I thought surely prawns would not be a problem. However when I asked around, people said prawns are not really part of the local diet here like in Australia. All the ex-pats I asked said they were too scared to eat prawns here because they seem to go off much quicker than fish. I was beginning to think that being responsible for the stomachs of 10 people a bit of a silly idea. But being the stubborn person I am, I persisted in hunting down these prawns. The fruit and veg markets sell fish that people they have caught that morning. But you have to scale and fillet it yourself. I have no idea how to do this, never having been a fish eating person when I was growing up and hating the texture of wet slimey things. Shame on me I know. Also by the time I arrive at the markets, it is 9am and who knows how long the fish has been sitting out in the open thinks one who is used to sanitised, packaged, cut up and prepared food sold on ice, in boxes, in plastic and gladwrap. Being a fish novice I am not yet brave enough to take the risk. There is ONE fish shop in Suva which I found out about after asking around. So I jump in a taxi and head off to find it. I walk in and low and behold there are bags of prawns sitting on ice! They are river prawns. I buy them. When I tell Robyn what I have bought she looks worried. She had food poisoning last week which knocked her out for 3 days. The party is in honor of her. I enlist her assistance to help me peel them. We end up with our hands covered in red and brown slime. We sniff each and every prawn trying to identify what the smell is. After much counselling of ourselves and each other we decide it is the smell of the river, as after all we have only ever smelt ocean prawns. Still not sure, we ask one of the Fijian girls next door to check it out. She just looks at them and declares them ok. We insist that she smell them. She rolls her eyes and declares them vinaka (good). I then wash the prawns under 5 litres of water. Shame on me for not conserving the water I know. THEN I cook them. THEN we eat them. THEN we declare them to be delicious. THEN we wait a few hours for the stomach rumbles to begin. They NEVER eventuated. Yay! We have eaten fabulous prawns in Fiji!

The Fiji Association of the Deaf where I work has been lobbying the government to pay for an Interpreter who works at one of the schools interpreting for 3 Deaf students. This is the first time that so many deaf students have progressed onto high school at one time. To date she has not been paid by the Ministry of Education for her work so she has been trying to survive on what she can. In desperation, FAD approached the Fiji Development Bank to see if they could help. They have agreed to pay her for 6 months as part of their community profile and wanting to be seen to help the community. They hand over the cheque tomorrow. This is a human rights issue. No access to education means no access to jobs that pay above the poverty level for Deaf people. The constitution says all people with disabilities have a right to education. The government has said they will pay but they need to find the money. In the past, they have taken a teacher out of the Deaf primary school and used them to become the Interpreter. It means the teacher gets paid, but the primary school is less one teacher. The reality here is, and I am sure the same in other countries, that many governments will agree in paper and in principle to abide by the International Declaration of Human Rights but they actually don’t have the resources to do so. Implementation of human rights is the next step which is much harder to take. If the Ministry if Education is unable to come up with the money in 6 months, we will be back to where we were.

Fiji does not have servants or even slaves but a left over from colonial days, has ‘house-girls’. Most houses have extra rooms or one-room ‘houses’ for the house-girl to live in. The house-girl is paid to clean the house. Walls have to be washed every 6 months, mattresses and pillows put out in the sun to dry once a week, leaves regularly raked up so mosquitos can’t breed - these are some of the things a house-girl might do. She might be the baby sitter or cook as well. There have been ex-pats who refuse to use house-girls because they are uncomfortable with the concept and because it does seem like an outdated colonial concept (ironic to think that now that many Aussie households are starting to employ cleaners to do the chores we don’t like or have time to do now anyway). There is a shortage of housing for people here so employing a house-girl or allowing a woman to live in the attached one-room house is actually helping local people out. Often when ex-pats have not done so, they get broken into repeatedly so house-girls often provide extra protection as they are always around and have a vested interest in protecting the property which is also theirs. Eta has moved into the one-room house attached to mine. I don’t pay her as yet because I am too used to doing everything myself and I am not quite comfortable with someone doing my washing for me or having someone I barely know roaming around in my house. But it will probably happen when the new house mate arrives to live with me in April.

Eta’s boyfriend works as a security guard for the parliament house which is at the end of my street. While my street has metre wide potholes and no street lights, the parliament house street is pristine clean and smooth! Fair enough. Last sunday I was able to get in to have a look at parliament house after hours when it was closed for business. It is in the shape of the traditional Fijian bure (chief’s house). Set up high off the ground with high roof showing its beams on the inside. I have not been inside any other parliament house so I have nothing to compare it to really. What I was really interested in seeing was the war club of Ratu Seru Cakobau who was the King of Fiji when he ceded it to Great Britain in 1874. He gave it to Queen Victoria and it was returned to Fiji in 1934 by King George the 5th. Cakobau used the club to kill and he may have eaten a few people he killed as well. Unfortunately the club is only taken out to open parliament and for special occasions. I got given a poster of it instead. The visit was ended with a bowl of kava in the security room. It was easy to imagine how the coups happened with a very relaxed security operation!

The issue of language comes up often in this country. English is the official language and the language of instruction in all places of education. People have expressed the view that Fijian children who learn Fijian at home as their first language, then start to go to school and have to learn another language are already disadvantaged. Having teachers who although trained may only have completed up to Year 10 equivalent at school themselves could be part of the problem. Having to be educated in a second language is cited as the reason for a lack of academic proficiency. People I work with will be fluent in spoken English but have trouble writing a letter let alone grant applications. The Indians here who don’t go to a Hindi school cannot understand the Hindi used in bollywood films because Fiji-Hindi has a strong English influence. People have started to realise that if you really want people to understand say the Gospel, it has to be done in their own language. When people get emotional or want to talk from the heart, they will revert to their first language. Yesterday I went to the ordination of 3 new bishops at the cathedral where my Dad used to work. Two of the bishops were men my Dad worked with and who I looked up to as a 14 year old. One bishop was Tongan, one Indian and one Fijian. The ordination was a move to recognise that the different racial groups need leaders who can speak their own language. The service was pretty amazing in that we sang Fijian songs, Tongan and Hindi songs along with bible passages being read out in the same three languages. The service started with the conch shell being blown which makes a bass-like deep mournful sound. This was followed by the beating of a Fijian drum. The floors were covered in finely woven mats. The Diocese of Polynesia is the largest in the world (most of it is water) so there were people from the Solomon Islands, Samoa, New Zealand, Tonga, Kiribati and other places. Interesting that although Fiji is a Melanesian country, it is part of the Diocese of Polynesia and this happened simply because some fellow from New Zealand was drawing up a map of boundaries and just drew a line that caused Fiji to be part of Polynesia. Funny to think that countries and national/regional boundaries are made simply by drawing a line on a map. The amazing thing about living in the Pacific is the exposure you get to so many different cultures and languages and how accepting people are of these groups.

After the service I went up to these people that I looked up to to say hello - 20 years has gone by - the reactions were mostly “oh yes, you”. I have to remember that an adult is hardly going to have the same feelings as a kid once had, that people do move on and what may have been a significant memory for you does not mean it was the same for the other person. I wonder if locals get tired of white people coming back all nostalgic for this time they had in a tropical country. Finding my feet in this country where so much is familiar and memorable and yet where I am an outsider and so much is unfamiliar has its moments. A good dose of tropical medicine for me!

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Have a good week all.

Kate