Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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4 Surgery and Healing in the Developing World
with a number greater than 15, Tums, (or its equivalent) an ointment for rash,
simple bandages, a tweezers, lip balm, an ear syringe if you are prone to wax buildup,
You may wish to ask your dentist for CAVIT to temporarily replace a lost filling. A
Swiss knife provides one with many handy little tools. Post 9/11 this should be
carried only in checked luggage. Carry with you your eyeglass prescription in case
your glasses are lost, broken or stolen.
The matter of your water supply is of great importance. In much of the developing
world, available water sources cannot be relied upon to provide safe water. It
may be wise for you bring along a water purification device. There are many of these
available, coming in all shapes, sizes and prices. At least one company has a “travel
cup” available; it purifies water poured into it in 30 seconds and can be used over
and over to a total of 60 gallons. This can be purchased from TEALBROOK in
Hastings, MN. Their fax is 612-480-8786; email is tealbrook@aol.com. In general,
any drinks made with boiled water, (tea, coffee, etc.) can be safely consumed; this
should be true also of bottled beer or soft drinks. Ice cubes are always suspect since
you cannot know their water source. Bottled water too must always be viewed with
some question in that bottled water is no safer than its source, which may be very
questionable.
Planning for leisure time is important. Take along tapes and cassettes but do take
along a player which is or can be battery powered. (and take extra batteries). Electrical
power in developing countries is usually not available on a full time and dependable
basis. In one of the countries in which I have worked (the name of the country
will remain unmentioned) the power company was named NEPA; on the basis of its
sporadic performance, we took this acronym to mean “never enough power always”.
Take along enough books and magazines to carry you through as well.
A journal will help you very much in recalling details of your experience after
you return. This may be a written journal or you may wish to dictate your journal
into a recorder, which again should be battery powered. And take plenty of photos
and or videos. Video has the advantage of timely narration. These will be priceless
for you personally and will help you very much in sharing your experience with
interested friends. When you get your photos back, write pertinent details on the
back immediately; details become fuzzy much sooner than expected. Before taking
photos however, be certain that doing so is acceptable to the people you are interacting
with. Certain cultures believe that picture taking will bring a curse upon the
person being photographed. Other cultures believe that these photos will be presented
in a demeaning way in the First World and therefore are not at all interested
in being photographed. One way of encouraging cooperation is to take along a
polaroid camera; if you can show immediately what you have captured on film and
can give them a copy, this will break down a lot of resistance and produce a lot of
rapport. And do allow them to “dress up” for pictures; you will have many opportunities
to get photos of everyday activities in everyday dress.
Malaria is a very real problem in many parts of the world. For many years, all
four of the Plasmodium species were susceptible to chloroquine, which was well
tolerated and quite inexpensive. It was used both for prophylaxis and treatment. As
time goes on, however, more and more areas are showing resistance to chloroquine;
this is especially true of P. falciparum. Therefore, the recommended antimalarial for
prophylaxis in most areas no longer is chloroquine but Mefloquine. In the US,
Roche markets this under the trade name Lariam. It is quite expensive. It must be
taken once per week and must be started one week before arriving in a malarial area