Tag Archives: health

…Bhutan

So, I am way late on blogging about our adventure in Bhutan, but, in my defense… I did get pretty sick the last day, and that lowered my motivation level for recalling it. But, it wasn’t Bhutan’s fault that I got sick, but Dhaka’s. I carried influenza with me from here. That gave me a rather novel opportunity to review their healthcare, which, more or less, reminded me of the summer camp nurses’ offices from my youth. Wood paneling… Tylenol… lots of cardboard boxes with handwritten labels. I had an IV, with a latex tubing system. Latex? What is this… 1960?

Regardless, Bhutan was beautiful, very peaceful, and very clean. The air was wonderfully brisk, both because of the chill and because of the lower oxygen content at altitude.

The view from the plane

We arrived on a direct flight from Dhaka, wending through the mountainous landing path before touching down. You really do feel like you could reach out and touch the surrounding mountains, and the pilot cannot land on a straight descent. The planes are all relatively small for international travel, as they have to negotiate the tight mountain terrain. We deplaned onto the tarmac, and all the tourists immediately started snapping pics of the plane, the flight attendants, the views, the tiny airport, etc. So did we. We were tourists too, after all.

On the tarmac. Look at that lovely sky!

Our guide picked us up after immigration. To visit Bhutan, you must purchase a rather expensive daily visa that includes a guide, lodging and meals (though upgrades are available). For us, that included a hotel room with a private bath, a space heater and a private sun porch. It was rather chilly, but the hotel staff was great, and loved taking Neko from us to play with her. The food was decent, if not terribly interesting, though they did have the weird cheese dish that everyone says you must try. I couldn’t face it.

The entrance to our hotel

Our first day we spent visiting some museums, cultural sites, and temples. On the second day, we attempted the famous Tiger’s Nest trail. OMG. There are a lot of stairs. If you’re of a smaller-than-average-American size, you can take a mule/donkey ride half way up to the view point. I recommend it, especially if you’re coming from sea level. If you have a chance to acclimate before the trek, it’s lovely. For me, it was rather challenging. (I didn’t know that I was coming down with the flu either). Neko spent most of the uphill bits complaining, and we had some interesting experiences changing and feeding her along the very busy trail. We all rested at the viewpoint before having lunch and returning to the valley floor. So, no, we didn’t make it all the way to the Tiger’s Nest.

A third of the way up. The first viewpoint. The cafe is another 30 minutes from here.

That night, I started feeling poorly and by the time that Mr Adventure was up, I thought I was going to die. (You know how it is when you’re sick….) The influenza got me, even though I’d had my shot. I piteously requested to go to the hospital NOW, and we eventually got there. I had the slowest IV drip ever (1 liter in something like 7 hours?), and it took forever for me to feel better. Mysterious injections, pills, etc… and a series of doctors who came to look. One diagnosed me with the common cold. Er… who has ever had a severe fever, bone aches, etc. from a cold? Anyway, they were all friendly too, even if relief from the dehydration and pain was slow in coming. The staff also really wanted to spend the day playing with Neko, so she enjoyed herself meeting all her new friends.

Neko with our guide

Our visit to the hospital meant that we missed Thimpu, the capital. We did get to do a little shopping and picked up a temple decoration for Neko’s future room. It’s very brightly colored, and hangs from the ceiling like a valance.

Would I go again? Er… it’s really pretty, but I’m not sure it’s worth the price. The visa fee isn’t as bad as the cost of the flight. 45 minutes in the air at a rate of almost $20 per minute. Kinda steep (lol).

It was a calm and pleasant respite from Dhaka, and something unusual, for sure. It was also good practice for traveling with Neko. She was a trouper and lived up to her reputation as a people lover. Right now, everyone is her friend. She’d rather be at a party than anywhere else. Bhutan was perfect for that.

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…Medicine

This is part of my hindsight series, on things I would have packed if I had known how useful they’d be. Medicine is, of course, available here, but is often tainted or incorrectly labelled. There’s a reliable pharmacy in Gulshan 1, and probably other places, but having a stockpile of over the counter drugs is helpful, especially on Sundays, when Gulshan’s shops are closed. If, however, you want medicine that would be prescription-only in the US, you can often buy it without a prescription in the pharmacies, just know the generic name for it and order up!

We’ve been blessed by the dreaded Dhaka-itis several times. It takes many forms. In the winter, when they burn the trash and a smoky haze settles around the city, many people develop a harsh, phlegmy cough. Thankfully, I wasn’t one of those happy few. In other seasons, Dhaka-itis might be more gastro-intestinal: you pick up giardia, salmonella, e. coli, and even hepatitis relatively easy here, though the last is predominantly a threat if you eat outside the diplomatic bubble. One of our community members is particularly prone to the tummy bugs, getting horridly sick every month or so. The Mr.A and I go for a 6-8 week cycle, I think.

So, you might think my advice would be to bring Immodium. But it’s not! A lot of these parasites, bugs, etc. need to be purged from your system, not held in. The doctor almost never advises Immodium (never has for either of us Adventures), but he does advise rehydration and Pepto. I thought we had a pretty good stock of Pepto (even though Mr.A. had never had it before!), and brought about 100 chewable tablets. It wasn’t enough for the 2 of us. So, in hindsight, I would have packed about twice the number. We bought some here and ordered some more from the states.

Oral rehydration solution is so necessary to public health here, that it’s available in all major stores and mini-markets for less than pennies. The embassy doctor dispenses it like candy, so we always have a few lying around. The taste is horrid and salty, so if you’re coming with kids, you might want to mix it in juice, or bring something like powdered pedia-lyte. They say the saltiness isn’t noticeable when you’re really dehydrated. I’ve been there, it’s true, it tastes good when you’re really really sick.

Our other #1 medicine has been Tylenol (paracetamol, acetaminophen). We bought an industrial sized bottle at Costco, and have gone through it all, even though we were gone in the states for 4 months. We get a lot of headaches, fevers, etc. We have Excedrin and ibuprophen, but turn to the Tylenol more often, probably because it was the only thing I could take while pregnant.

Allergy medicine hasn’t been as necessary as we thought it would be. There aren’t many plants here that we’re allergic too. But, Benadryl has helped me get through a very itchy night or two when the mosquito bites had been too much for me. (I’m like a mosquito magnet, though…). If you’re allergic to mold, you’ll need your medicine, as there is obviously a lot of mold in this very humid place.

Speaking of mosquitos, DEET helps. All natural bug sprays/lotions aren’t so useful, at least not for this magnet, but they’re better than nothing. You can’t mail these, or take them in the aircraft cabin, so plan accordingly. The commissary has some bug sprays, but not always the most intense kinds.

I also bought some anti-itch lotion. It’s mostly methol water, but boy, is  it brilliant. Those mosquitos really do love me. It’s a miracle I haven’t had dengue yet.

I also recommend cortizone (skin issues are common because of the water issues), flouridated toothpaste, vitamins and possibly an anti-fungal. We’ve not had any need for anti-fungals, but there are some men in the community who do, apparently, so if you’ve ever had issues, bring it.

Again, all of this is available, if you want to put in the effort to hunt for it, but if you’re packing your HHE and can find it readily at the grocery store, that will be way easier than traipsing all over town to 3 or 4 stores to look for something.

…Singapore, part 2

Singapore is known for one thing in this part of the Foreign Service world… it’s the place where you go for a med-evac. (aka medical evacuation). We’re not sure if it’s because of that, but few of the Dhaka-types seem to go there for weekend holidays. The flights are direct and convenient, so it’s a bit surprising that so few go. (Perhaps it’s because the hotels are so expensive?).

Among the 20- and 30- something couples, it’s also a bit of a code. If you’re going to Singapore, you’re probably going for one particular reason. And, yes, we went for that reason too. We’re pregnant!

That’s a big reason for the fall off in postings recently; I’ve just not been feeling ship-shape, and since I started the new job at the same time, it was a tough period of trying to sleep as much as possible whenever I was not working. I’m feeling better now, as we enter the second trimester, and the doctor in Singapore says everything looks good (all the right fingers and toes, organs, brain size, etc.). I’ll be delivering back in the states this winter, so expect some cute baby pictures then.

We passed out sweets at work (a Bangladeshi tradition whenever there’s good news to be shared), but I can’t send any out to you all, so go scavenge up some chocolate and celebrate in absentia.

…Tropical Disease

Quick! What’s the one aspect of foreign service life so glamorous and exciting that we never mention it, lest you succumb to a mad fit of jealousy?

Yes, that’s right. Tropical Diseases. And, the not so tropical ones too. I’m talking parasites, microorganisms, fungi, cysts, burrowing insects, worms…. so many things that make you glitter and shine.

Here in Dhaka, we’ve got your pretty typical Typhoid problem, but that’s preventable with a round of inoculations. What else do we have for the unwary FS-person?

Dengue: A popular disease among the teaching staff at the American school this year, and several Embassy folks as well have opted for “the Dengue.” Like malaria, it’s a mosquito borne disease, but, not curable, so you have to run the whole sickness through. And, its mosquito prefers the city life, and cooler times of day, so they hit you while you’re sleeping. Then, you get a fever, headaches, pain, rash, and possibly some hemorrhaging. Fun times!

Flesh-eating snails: aka schistosomiasis. These microscopic snails live in bodies of water, waiting for an unsuspecting hand or foot to touch it. Then, they start to eat you, inside and out. Yummers.

Garden-variety Rabies

Amoebas: aka dysentery, famed for its history on the Oregon Trail (game). Found in the public water supply.

Cysts: Again, microscopic things that eat you, and everything you dined on. Transmitted by fecal contamination. EEW.

Worms: Primarily a problem from undercooked meats

And: Salmonella, Hepatitis, AIDS, Tickbite Fever, Malaria, Pink Eye….

Don’t you wish you had one? I did. Not anymore.

…Water Distillers

While we arrived in Dhaka late last week, we hadn’t got strong access to the internet yet, so I couldn’t post anything.

Tonight that changed!!

Our adventure of the week has pretty much been dealing with the new life, but there’s not much more to that than dealing with the slow pace at which tasks are accomplished, the chaos of speaking pidgin Bangla with someone else who speaks pidgin English, and the general confusion of learning a new city’s streets, shops and traffic patterns.

Last night we learned that 7 pm is not the time to drive from our neighborhood to the American club, for example. We also learned that the internet to wifi there has been very patchy in the last few weeks… and it takes about an hour to send a quick email.

One of the exciting new things in our life is this cool water distiller. In the Foreign Service, if you’re posted to a country with poor civil water quality, you might get issued a water distiller that will purify all the water you care to drink, or brush your teeth with, or rinse your contacts in, etc. And who _wants_ to get Cholera, right?

The "Still"
The "Still"

Our water distiller happens to be bran’ spankin’ new. We’re the first to use it. It’s a relatively big responsibility, as it requires monthly descaling, and a few other maintenance tasks. It comes with two white chemicals that are used for cleaning it, both of which are also used to clean home brewers and wine kits. Maybe we’ll have to branch out in our still-ery. I doubt it.

The department also provides many homes with a handy water dispenser to make the distiller easier to use. (If you use the distiller without the dispenser, it’s a bit like using a hose for your daily tasks). Our dispenser has a hot and cold tap, but it’s not running yet, because the plug outlet and the counter space are not aligned. We put in a request for a dispenser stand, and it should be here, like the internet, sometime this week.

The water it produces is the best water I’ve tasted, significantly better than most city water or bottled water. It’s close to the sweet mountain spring stuff. The main drawback for families with children is that the distiller provides water free of _all_ impurities, even those, like fluoride which we in the US add to our water to strengthen our teeth. Thus, children have to use fluoride toothpastes even though they are usually not recommended for the very young due to issues of ingestion poisoning. Yet, a little fluoride toothpaste is better than a lot of arsenic, the other exciting water surprise in Bangladesh.

Did you know that the leading cause of death in this country is arsenic poisoning from ground water contamination? Yikes. Considering the diet, disease and accident rates, there must be a considerable number of people with white fingernails (a symptom of arsenic poisoning) out there.

In other words, I am grateful for my distiller, even if it makes brushing my teeth a strangely long process every day. Once we get a few pitchers to put in the bathrooms, that should be a lot easier.

…language exams

Mr. Adventure took his end-of-course language exams this week and passed with flying colors, exceeding the requirements for his upcoming post. He’s one inch away from a 3/3 and they recommend he do a few more weeks of one hour classes while he’s in another course and then retest before we go. He agreed, even though they start at 7:30 am. More power to him, those early mornings are not my style.

To celebrate, he checked himself in for some surgery at the local hospital and we’ve been sitting on the couch watching movies to recouperate. He looks a little bit pathetic with his big bandage, but he’ll fit right in at FSI when he gets back. That place is a rehab center, everyone seems to get their elective surgeries and major accidents out of the way while they’re stateside between posts. You can’t turn around without seeing someone in a cast or sling.

We made some last minute plans to head out to the beach at the end of next week, and got one of the last rooms available in Ocean City. Supposedly the place is supremely tacky touristy, like Dollywood at the beach, so I am excited to visit. I gotta love me some tacky touristy stuff.