So This Is The Aftermath

So This Is The Aftermath

John had been on a medical mission to Africa and was barely getting used to the living conditions. He had been immunized with literally 22 different vaccines and he wondered if it was all worth it. He really wanted to make a difference and it seemed that he was helping a lot of people. He had been trained as a physician’s assistant. He saw patients that did not speak any English but they could motion with

their hands and facial expressions as to what really was wrong with them. He had lots of the most common types of medicine that might help. He was thrilled to not keep any medical records and did not have to sign anything. He could move so fast between patients that the only thing that kept him from the next illness was the language barrier. He remembered his girlfriend Martha did not want him to go and even went so far as saying that she might not be there when he gets back in 2 months. She was worried he would bring back disease to her and she did not want to be part of it.

John was asleep when a nearby mountain exploded in a fiery ball of flames. He did not remember being told of volcanic activity nearby. Rumbles of thunder followed by unusual bursts of lightning followed.

He noted it was unlike anything he ever experienced. He went outside his tent and it was raining dust that made it difficult to breathe. He tried to start his jeep to get out and it would not turn over. He was trapped.

He found that the rest of the missionaries were stunned. One villager came by and motioned that they needed to get out and away from the explosions by foot. They gathered a few things and left. They were without communication, food and water. They slept in a forest and the next day they tried to head toward where they thought the next village would be. With little to eat by leaves and berries, John realized that the water that was around could be infectious. Over the next several days he managed to survive but developed nausea, vomiting and then diarrhea. He knew that he probably picked up something infectious but he did manage to have his medical bag. He thought of cholera and took a tetracycline– the drug of choice for cholera.

The recent catastrophe in Haiti with the massive earthquake raises the same questions that John was facing. After the initial trauma injuries of broken bones and crush injuries can be treated. The resulting infections that occur without proper medical care are the next wave of deaths. Proper drinking water is critical in disasters and we all need fluids that are not infected many times a day. We can live without too much or any food for days but liquids are critical. With the water supply nonexistent in disasters, it must be brought in as soon as possible. In remote areas, this is a very difficult task. With Haiti being near the United States it can be reached fairly quickly. In more remote islands and distant inland jungles and rainforests such as in South America and Africa, the relief efforts may never reach them as they may not know about them for weeks.

Cholera is caused by a bacterium (bacteria) that is caused by Vibrio cholerae. It is picked up by drinking infected water or eating bad food. It produces a poison or toxin that causes our intestines to just leak out all the water in our body. It is not the usual diarrhea that we sometimes have from eating bad food in the US. It causes such a severe diarrhea that we can go into shock within an hour. It causes our blood pressure to drop and you can die within 3 hours. This is certainly not what we are used to hearing about. Intravenous fluids in large quantities must be given to resurrect our fluids. It is difficult to keep someone alive with this disease even in a medical intensive care unit. Antibiotics must be given through the IV and fast. In a more common case , the disease can progress form liquid stool to shock in 12 hours and the patient dies in a few days. If oral rehydration is done with fluids there is a chance for survival. Water, sugar, salt baking soda and fruit can be used for rehydration. Tetracycline is the most common and a very inexpensive antibiotic that can save your life. Untreated the death rate is 50%.

With a disaster the most effective prevention is providing safe clean water. Prevention is proper sterilization of waste of victims and burning or sterilization of all clothes, bedding and utensils etc of victims. Chlorine bleach is the most effective agent. Boiling water alone kills the bacteria and can be done in the disaster area with a simple fire or heater/stove. Adding tiny amounts of chlorine to water, or fluoride also kills the bacteria. There are vaccines but in disaster they usually are too late to try and difficult to obtain. People with type O blood are the most susceptible with type AB being the most resistant to the infection. The rice water stool of cholera is characteristic. People on antiulcer medications or non acidic stomachs are the most likely to be infected.

John managed to treat his infection with his antibiotic and the knowledge that large amounts of fluids would keep him going. Finally, he managed to reach a village where he was able to telephone for help.

He was lucky that he was an American and his missionary group headquarters flew in and brought him to a hospital. When he was better he went back to the mission. He did not think that Martha really cared too much and stayed several more months. She was not waiting when he returned.

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