I was travelling in Jumla, a remote district in mid-western
Nepal in 1992, when I became acutely aware of how scary diahorrea can be. I was
all of 19 years old. I’d flown there on a rickety plane that landed in a small
runway. The plethora of tea-shops that I was assured, by the non-governmental
organization that had hired me and had sent me out, were in existence and would
take care of my food and lodging never materialized. Instead, there were small
homes selling a few items-perhaps a biscuit packet, some cigarettes or matches.
Tea was still a luxury.
After tramping around the villages for six weeks, and living
off fox tailed barley bread sprinkled with salt and chilli, and recording
stories of mysterious deaths on the side (“my sister was walking back home to
her husband’s house and she fell down dead on the way”, “about seventeen people
have died in that village that-a-way, we don’t know why”) my fellow guide
suggested we try to climb up to Rara lake. “It will take only half a day,” he
said. This sounded like an adventure and I agreed.
Halfway up the mountains, however, two things became
apparent to me: first, that I had severe diahorrea. I suspected it could be
giardia. And second, our water had run out, and I was quite pleased and happy
to sit down on the trail, look at the mushrooms, and not move. A pleasant
drowsy haze fell over me. My guide took one look at me and realized the state
of affairs: I could hear him crashing down the bear-infested jungle to get to
the river to get me that precious bottle of water. After the bottle, and a few
sugar candies (how little do people realize how precious those sugar candies
are!), I was able to get up and walk again. Obviously, we didn’t make it to
Rara Lake that time.
Here’s a description in Wikipedia about the trek, written by
travel writer Ethan Gelber. Note we
tried to do it in half a day:
Although more trampled
than in the past, the road to Rara Lake is still without any of the comfortable
services available along more popular trails. Logistically it is not an easy
trek; it is hard to get to and from, and it is an organizational challenge,
requiring informed guides and porters to tote the two weeks' worth of material
that will keep you warm, dry and fed. It is also tough on the bones, involving
several 11,000-foot passes. However, once you overcome the obstacles, the
rewards are legion: few if any other trekkers, incomparable natural splendor,
"untouched" villages, blissful quiet.…[6]
Since that day, I often think about the people who don’t get
the bottle of water, and who die from simple dehydration. Nepal often gets
epidemics of choleras and diahorrea even now—ebola is obviously of great
concern. If ebola makes it to Nepal, legions of people will die due to an apathetic
government and unevenly run government health posts and beaureaucracies.
Because of this experience, I’ve often had great interest in
medication that can stop diahorrea. Anybody who’s tried the Western medication
available on the markets may have experienced what I did—the sense of being “stuffed
up,” and which disrupts digestion and well being for a few days. Undoubtedly the
diahorrea does stop, but the sense of unease doesn’t.
Recently, a herbal dealer from the same district Jumla sold
me an herb called “bhotay khayyar.” It resembles a betelnut, and the man
assured me he would pop a small bit into his mouth while he walked, and it had
no adverse effects. More to the point, he said, this herb stops diahorrea and “blood
in stools.” He titled this condition “Ragatmasi.” I didn’t know anybody who got
ragatmasi, but since diahorrea was a common problem, I bought a handful from
him. On a recent visit to Kapilvastu, when I again got diahorrea from eating
the tempting but dangerous street food from a chat-wallah, I took a bit of the
bhotay khayyar. Almost like the Western medication, it stopped the diahorrea-but
gave me terrible gas and a feeling of being “stuffed up.”
On the other hand, a cleaning lady who came by complaining
that she had blood in her stools for the past month, and uttered the word “ragatmasi,”
seemed to fare better with it. I gave her three tiny samples, and instructed
her to take one morning, afternoon and night. The next morning I asked her if
she was feeling better. “Oh yes,” she said. “I took a tiny bit of that jadi you
gave me. The blood stopped completely. In fact, I only took one piece, the rest
is still with me. I feel so fine I ate a dozen bananas and a liter of yogurt.
In fact, I think the bananas and yogurt cured me, not your herb. How can that
tiny little thing act so fast?”
In New York, in one of my forays into interesting ethnic
neighborhoods, I came upon a Chinese supermarket. I bought, in this order: a
bag of tea titled “Slimming Tea,” a plastic bottle of Siberian Ginseng, and a
small bottle of Chinese medication marked with a small label that said it was
useful in diahorrea. The “Slimming Tea” apparently did not have FDA approval, because
what happened to me after drinking it was quite startling and unprecedented: it
felt like my intestines were being wrung out, and I was sitting in the toilet
for a full hour till everything was purged. In hindsight, I think it was an
extremely strong purgative. Since I didn’t want to be size zero like the
fashionable Chinese ladies, I happily threw this slimming tea into the trash. Then
I tried the Siberian Ginseng. I had little interest in Ginseng but a lot of
interest in Siberia—obviously Siberia sounds romatic when you’re living in New
York City, so I bought it and popped a tablet. What followed was again quite
startling—vivid nightmares and great aches and pains in the upper arms. I imagine
now that I fell into “The White Man Trap”: the bottle was clearly designed for
white folks who would be as enamored as I about the notion of Siberian ginseng,
and take it without realizing how it could have dangerous side effects. The
people from Siberia probably take it in their alchol, or make a medicine with
20 other herbs, with the ginseng being only a small compound. But of course in
NYC, it was sold full strength and in a white man’s dose. I advice people not
to take it in this form.
But all these mistakes and travails of complementary
alternative medicine was worth it, because in the third bottle I hit the treasure. I regret
today that I didn’t keep this small nodescript bottle, nor noted down the
chinese characters on the label. The bottle was filled with small black balls,
which you were supposed to take 3 (or was it 5?) balls at one point. I seem to
remember that they were small enough they could be swallowed with saliva during
emergencies when water was scarce. Each time I took it, my diahorrea and
stomach pains stopped almost immediately, and I felt no bloating, gas or other
pains. I would be back to eating a normal diet within 1 to 3 hours.
The point of this story being: there are already thousands
of complementary alternative medication that stop diarrhea that have gone
through 5000 years of “clinical trails” in ancient cultures. Why don’t we tap
them for stopping the ebola crisis? I’m going to assume that bottle was a
common enough off-the-counter medication that one can find in a supermarket in
New York City. Of course, I told you the story of the Ginseng and the slimming
tea to point to the hazards of picking up the wrong complementary medication. But
I think its time now to think about effective medicines that already exist in the
world’s pharmacopeia—and not just imagine that the experimental drugs are the
only way to solve this crisis.
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