TomG
Apr 5, 2004, 1:19 PM
Post #6 of 12
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I would not put this up for a subjective vote by interested parties.
If you live in a city in the USA of much size you should be able to find a doctor who specializes in or sidelines in Travel Medicine. Settle for a sideliner only if you are comfortable with that. Some people will describe health risks as subjective. Travel Medicine specialists get their information from places like the Center for Disease Control and travel advisories from the State Dep't. both of which use reported cases of disease to identify where problems exits.
I have a Peruvian friend who, along with his son, got 3 weeks deathly ill when visiting home after eating seafood. Last year I traveled to Mexico with him, if you think I am making too much of this you should have traveled with him. I had to wait through him rubbing limes on toilet seats, then between his toes, then a second pass with alcohol, followed by a lecture of what his grandmother in Peru taught him. Then he wasn’t going to eat – well maybe just eggs. Then I got him to eat seafood soup, based on the fact that it had the holy hell boiled out of it. He liked it, reminded him of Peru. He vowed to eat only it. Gradually as I got him into homes of family of immigrant friends he was caught between rudeness and eating up. Being Hispanic he ate, rudeness being to difficult for him to do. Although with certain dishes he found himself to be absolutely too full to eat another bit, and padding his denials with the most outrageously florid string of cooking compliments, he squirmed out. I couldn’t have said some of the stuff he said if I had been a Nobel Prize winning Latin American poet – I would have chocked. It was easier for me to eat.
Your concern about the bathroom sounds like a fear of getting diarrhea and vomiting. It is actually funny how this topic is avoided in all the advice about living and vacationing in the tropics. But remember, Typhoid, Malaria, amebic dysentery, Dengue Fever and such are much more serious that the trots. You shouldn’t lump them together as travel inconveniences.
A Mexican government survey I heard quoted here on Mexconnect a number of times said a few years ago that 60-some percent of food in street stands was contaminated. Some experienced travelers actually think that your chances of getting diarrhea are greater in more expensive tourists’ restaurants than in a popular low end cheap restaurant. My Mexican son-in-law got a sorry case of diarrhea in a trendy self-conscious vegetarian restaurant in Patzcuaro, Michoacan. I personally eat in mercado stands, farm homes, and in the houses of relatively poor people in small villages in central and southern Mexico – but not carelessly. Certainly I, personally, wouldn’t be more comfortable in an expensive tourists’ restaurant – decidedly less.
We have a good Mexican friend who was a low-priced restaurant owner and cook who does not eat in other peoples houses as a matter of policy – our house is her new exception. This is not just a gringo disease or gringo fear. I can show you hand painted signs on the side of houses in villages tourists never go to saying diarrhea cured here. The daughter of my campesino (poor farmer) friends gets it just like a gringa. People in the USA get it recently from eating imported Mexican green onions that came from farms where the workers didn’t have adequate hand washing facilities near the bathrooms. All you have to do is step into a bathroom in a Mercado in Mexico and try to figure out where the toilet paper, soap and hand washing water is. While there are some publicly accessible bathrooms in Mexico where all the steps from toilet paper to hand soap and towels function, there are an astounding percentage that don’t.
Recently my wife refused to pay 2 pesos to the male bathroom money collector for use of a bathroom that had toilet seat (frequent occurrence), no toilet paper, running wash water, hand soap, or towels. He was amazed at her lack of manners in telling him so. He was not amazed that he was attentively collecting 2 pesos per person for a big gas station bathroom that he put absolutely no energy maintaining. He was drinking a just opened 5 pesos Coke (about the price of a bar of soap) – but I’m sure he didn’t see the linkage.
Cultural situation analysis: Mexican women coming out of the same bathroom emerged with great personal dignity intact, showing . They were middle class or better (because they were car passenger at a gas station). They did not confront the money collector, but they didn’t appear to like the bathroom condition judging by facial expression and chatter. Mexican society is thought to be non-confrontational and polite, and my wife was deliberately confrontational and direct with her comments when she did not pay on her way out. The attendant was not getting his public health consciousness by Divine Intervention. Nor was the attendant functionally dumb, but he probably was quiet passive aggressive (an irresponsible assumption on my part due to the lack of a proper clinical setting, and time for testing and analysis). I signaled to him that I backed my wife up. This was culturally insensitive, and designed to make him feel like he was below acceptable standards. I hoped by linkage he might conclude that not all gringos are nitwits handing out money. The absence of a toilet seat is probably excusable in his case due to it being somewhat standard practice in the trade. The absence of toilet paper is inexcusable because in many cases where toilet paper is not provided on-site a given sized wad is handed out with the 2 pesos collection (he had a Coke in his hand, but no toilet paper to hand out). The fact that the water did not run in the sinks was not a condition that came on as a recent surprise to him (the toilets flushed from the same water supply) – he knew about it and thought it had no relevance to his collecting 2 pesos per person. The fact that there was no hand soap could actually have been a step of logic on his part, as the hand sink water wasn’t working anyway. But that logical step would have included a portion of bad faith (hand soap would have showed he cared, even if things were not up to snuff and he could not do very simple plumbing, but had contacted one a long time ago who was coming manana.). Our failure to appreciate Manana: Manana is far too romanticized. Our failure to be home and show up at the doctor’s grandmother’s house for an afternoon comida a few months ago with daughter and son-in-law has severely impeded our friendship with the doctor and his wife. My best friend here, J___, is my age, educated and unemployed for 3 years. At least 80% of his future dates with us are under the manana concept. It doesn’t irritate me, and I am always glad to see him when he shows up. He is a good person and does not wish us bad luck. He has a visa and wants to go to the other side, I will discourage him. As his wife says (she has crossed over and worked 2 full time jobs at once), he would never make it (cut the mustard).
On the other hand, some people actually wish you bad luck. Some people believe that there is honor in screwing others, but no honor in getting screwed. There is a popular song about this. The bathroom money collecting attendant might very well subscribe to this belief. He was a very fit looking middle-aged man who looked to be quite suited to construction labor. He could have been thinking along these simple philosophical lines when he was on-the-job (so to speak). No one will ever know because he failed to say so directly to any of the customers who could have documented the statement. But people like that exist….and people who think like that (both rich and poor) sometimes affect public health in secondary ways by leadership slackness and personal derelictions. I first encountered elements of the screw or be screwed philosophic vein in the United States Military as a young lieutenant in the mid-sixties – many of the proponents were also very racially prejudiced. It was easy to see that they were very much like lapdogs – as soon as the matron went into the kitchen they jumped down and bit you on the heel, then when she walked back into the parlor they jumped on her lap and purred. It took no intelligence to see that the only way to deal with them was to be firm with them. It is very difficult to be nice to these types because they perceive it as weakness and soon get squirrelly. But if you treat them nasty they tow the line very nicely and actually seem to like it – “Yes, sir!” and “No, sir!” It sounds kind of kinky, but they really do seem to like being beaten on, so to speak.
I doubt that in such a short time we did the bathroom (non)attendant much good, but every little bit helps. It is hard to do reverse toilet training later in life – as you will find out when you get here and you find it difficult to get your hand to bring the toilet paper back up out of the stool, fold it neatly, and drop it in the little basket or box next to the toilet. You can’t drop the toilet paper down the stool; Mexican pipes aren’t adequate to handle it. This is not a criticism – the whole world would be better off with less sewage. But separating the soiled toilet paper into little baskets and sending them of with the kitchen garbage to the truck where they are dumped above ground, blow in the wind, and are sometimes (around big cities) picked through by the poorest people – well, that doesn’t sound like an improvement either. Big government around the world is going to have to step up to the plate with solutions where private initiatives seem to conflict into chaos and local governments can’t handle it.
So everybody down here is double handling their soiled toilet paper, folding it, and depositing it in the little basket. This greatly increased the advisability to wash with soap and water afterward to maintain an acceptable level of public health. …. There! It’s not easy to verbally deal with this subject matter-of-factly, which is why you read so little about it except with passing verbal cute winks and “Oh, you know”. It is not just whether you personally think it is icky, you’re betting on everybody else to be doing it correctly every time, and with the handicap of no water in the sink facets, no soap, etc. mentioned above. And who said the other guy even had 2 pesos. As Romeo always says, "A peso is a lot of money."
Public world health issues are extremely serious in a global village world of speed and movement. Repercussions travel fast and furious. Head in the sand attitudes by people who should know better is a contributing factor. The people at School of Public Health at Harvard and other top public health institutions have taken a pessimistic view of the world’s serious disease prospects. Personal sanitation is the bedrock of public health, and the only thing individuals can actually do simply.
Anyone who thinks I am personal sanitation nut and habitual hand washer has never met me. I’ll bet every reader here changes his clothes more frequently and uses more water than I do.
(This post was edited by TomG on Apr 5, 2004, 1:34 PM)
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