Souvenirs from Hell

Each time I stop in at my doctor's office (a tropical disease specialist with time in Vietnam), he asks me why the hell I do what I do. Yet, he takes great pains to describe the symptoms of the many tropical diseases that await me in the Third World. His lectures usually center around the lifelong pain and debilitation that can be inflicted on travelers who inadvertently ingest an amoeba, get bitten by a mosquito or become the host for a degenerative bug. I take his advice seriously, and I am as fastidious as I can be in adverse conditions. I am very careful about what I eat and how I sleep, and I follow the rules of common sense when it comes to avoiding infection. Despite this, I have spent nights shivering and delirious, lying in puddles of my own sweat on cement floors in the Sahara desert. I pay his bill gladly and trust to the cosmos and good common sense.

With this in mind, do not assume that this chapter is the be-all end-all reference source for tropical diseases. Always confer with a specialist before taking any trip. This way, you understand the odds and the penalties and can make an educated decision on the risks involved. Secondly, always have full medical tests upon your return. This means giving a little bit of yourself to the lab to run blood, stool and urine tests. Your doctor may ask you to come back again due to the long incubation time of some of these nasties. This is not hypochondria, but common sense. Early detection will increase your odds of successful treatment.

The odds of coming down with a bug are pretty good once you leave the antiseptic Western world. If you go off on an extended trip (one month or more) you have a 60­75 percent chance that you will develop some illness or problem, most likely diarrhea. Only about one percent of travelers will pick up an infectious disease. I once thought that the locals had built up resistance to the various bugs that strike down Westerners. But once in-country, you realize what a toll disease takes on the Third World. Not only are many people riddled with malaria, river blindness, intestinal infections, hepatitis, sexual diseases and more, but they are also faced with malnutrition, poor dental care, toxic chemicals and hard environmental conditions. The World Health Organization (WHO), in a recent global survey, reported that much of the world's population dies needlessly from preventable diseases due to a lack of access to health care. Of the 52 million people who die each year, infectious diseases kill about 17 million. Infectious diseases are the leading cause of premature death in Africa and Southeast Asia, according to WHO. Of the 11 million victims who are children under the age of five, 9 million die from infectious diseases. About 70 percent of the deaths attributed to cholera, typhoid or dysentery can be blamed on contaminated food. To make matters worse, 30 new diseases have sprung up since 1976, among them AIDS and the deadly Ebola virus. Antibiotics are becoming less and less effective in treating many of these diseases, because of resistance due to their overuse.