home

Dr Sneh's diary: Aquatic tactic

Although the villagers don’t think I’m a good doctor until I give them some pills, educating them about the danger of things like dehydration is still one of the most important aspects of the clinics.

 

We were charged by a water buffalo this morning. And it was terrifying. These normally docile creatures, who look like they could only move very slowly, can in fact pick up considerable momentum and speed when they feel cornered. When faced with such a large animal heading towards us, panic set in and we scattered, luckily unharmed. The villagers all found it a terribly amusing event, and we were the subject of much mirth and laughter.

The Vietnamese are a happy people by large. The adults work well together, seldom having reason to raise their voices or to have dispute. The children enjoy playing together and are overwhelmingly delighted at the sight of foreign visitors, and the babies only cry with good reason rather than as a semi-permanent state of being.

I am seeing also how a real community should function. Everyone has their place and does their own bit to sustain the group. Each person’s, or each family’s, role is clearly defined – some are the rice growers, some the chicken keepers, some the buffalo tenders. And each person accepts the allocated role and fulfils it, occupying an equal and respected place within society, not wanting or needing promotion. A legacy of Ho Chi Minh, I wonder?
 

The dizziness mystery

However, the people here have the diseases of a working society. The most common complaints are backache, knee pain, and dizziness with headache.

The first two are easy to explain. Toiling in the rice paddy fields, collecting heavy loads in the baskets that are strapped to the head, over 10 hours a day for a working lifetime of 30 years is just cause for arthritis to develop. Human backs are not designed for such work. The oldest of the villagers all have a very impressive stoop, whereby they permanently lean forward at a 45 degree angle at the back. The reason for this is a chronic spinal stenosis that comes from compression of the lumbar vertebrae under 30kg baskets, and the stoop affords them just that extra few millimetres of space in between the vertebrae to avoid the pain of compression.

The headache accompanied with dizziness was at first a mystery to me, and I wondered why so many had this rather non-specific complaint. An easy reason to justify coming to see us? A manifestation of the community? A pandemic of brain tumours? No, no. Silly me. I only had to take a look at myself. On this morning’s 28-kilometre hike up and down the hills, I got dehydrated and had a headache with dizziness - and that was with three litres of fluid. The villagers must be going without water, as I don’t see them carrying backpacks ready to drink from.
 

Peace and fulfilment

So, we return to the basic tenant of this health programme – education. In today’s clinic, I have spent countless patient sessions explaining the need to rehydrate regularly when out to avoid this headache and dizziness. But it seems to be working, and the nodding of heads from my patients suggests understanding and acceptance. Although they still don’t think I’m a good doctor until I give them some pills; prescribing multivitamins, the colourful placebo, has become my new speciality.

Tomorrow is our last day in the clinics. We have already seen over 1000 patients, flourided 500 mouths, treated 200 helminth infections, checked 50 newborns, diagnosed 10 serious cancers, and probably saved a handful of lives (and a partridge in a pear tree).

I am blissfully unaware of the rest of the world and have settled into the village mentality. Look after those close to you, and the world will look after itself. Real happiness comes from finding peace and fulfilment in your own particular community and not trying to conquer the world. Goodnight.
 

Next steps