This is me in traditional Indian garb, 1968*
A recent conversation with my dentist brought back some interesting memories. The first was of an encounter I had with a dentist when I was a Peace Corps volunteer in India back in the late 1960s. And that took me back to a few other experiences I had during my sojourn on the subcontinent.
My encounter was not with an Indian dentist but an Irishman! I was directed to him by the Peace Corps office, which, when I reported a toothache, told me to go to a Catholic mission near the city of Indore. It was a daylong, 350-mile (565-km) journey on a series of buses from the village, Rajnagar, where I was living and working.
There, the dentist introduced himself as Brother Michael (name changed to protect the not-so-innocent – and because I no longer recall what he was actually called). He sat me down in what appeared to be a relatively well-equipped facility and, after he looked at the problem tooth, promptly started drilling. Initially this didn’t faze me too much, as I was accustomed to forgoing local anesthesia if the drilling was not going to be too extensive. I figured if he got too close to the nerve he’d offer to numb me. It never happened. I think either he believed painful experiences build character and strengthen the soul or, perhaps, he’d been trained by a relic of the Inquisition.
Recalling my experience at the hands of Brother Michael brings back several other medical memories. Before recounting them, however, I should provide a synopsis of the briefing we received from the Peace Corps doctor, an American, on the August 1968 morning our group of volunteers first arrived in India.
“Boil it, peel it or forget it!”
The “doctor’s orders” were easy to remember: “Boil it, peel it or forget it!”
The reason for this advice, he explained, was that due to the widespread lack of modern sanitation – in rural India, many people routinely defecated by the roadside and in other open areas – we should assume that everything we saw and touched was covered by a microscopic overlay of fecal dust carried in the air.
That led to the following elaboration. “Think about the day you were born,” he said. “Out of every hundred babies born in the United States that day, 99 are still living. However,” he continued, “of every hundred babies born that day in India, only 60 to 70 are alive today. The ones who didn’t make it succumbed to diseases that are endemic here, many of them spread by feces. The people you will meet and work with – the survivors – are those with robust immune systems. This group of volunteers has a mix of strong and weak immune systems, none of which were ever challenged by the kind of bugs that are ubiquitous here. That means if you’re not careful, a lot of you are going to get very sick.”
And so we did. In fact, I got started right away.
The building in which our group had its arrival briefings was a clean, modern structure that would not have been out of place on any American college campus. Its purpose, we’d been told, was to serve as a home away from home for Western researchers and others, such as World Bank and Ford Foundation representatives. As we stood in the lobby awaiting room assignments, I spotted a water cooler that looked just like hundreds of such devices I’d seen in buildings all across the USA. I was hot and thirsty. Surely, I thought, in a place like this, the water is safe. So I took a big drink.
I’m convinced that’s the moment I contracted ameobic dysentery. I didn’t feel sick for a few days, however, and by the time I did, we were all in a training camp in a rural area. I was sent to a nearby clinic run by Canadian missionaries who gave me a notoriously powerful antibiotic, Flagyl.
A few days later, needing a haircut, I ventured into the nearest town, Itarsi, and found a barber. Relaxing in his chair, I looked in the mirror and saw someone who looked just like me, except for an extra pair of eyes. I’d never experienced double vision before and was worried. Fortunately, the Peace Corps doctor came down from New Delhi to see us a couple of days later. I told him what had happened, and he took me off Flagyl, replacing it with something of lower megatonnage. That was the last time the amoebas got the better of me.
Not the worms, however. I’ll spare you the details, but I will say this. I feel sure I got those worms because I generally felt pretty healthy and began taking calculated risks. At home, I always boiled all the water drawn in buckets from the large open well about 100 feet from my door. I kept the boiled water in large, spherical, slightly porous earthen pots. As it seeped slowly through and evaporated from the surface, it nicely cooled the water inside.
After a month or two during which I drank only boiled water, I threw in the towel and began drinking unboiled water whenever I’d visit someone’s home. I felt that by drinking safe water at my house, I was giving my immune system a respite from fighting the bugs I’d ingest elsewhere. Anyhow, drinking boiled water when out and about was a hit-or-miss proposition.
I recall an occasion when a farmer offered me water and my friend, co-worker and protector, Jagdish Prasad Mishra, the Agriculture Department’s extension agent in Rajnagar, spoke up unbidden and said, “Howard Sahib drinks only boiled water.” One of the women in the farmer’s family then boiled some water and served it to me, scalding hot. When Mishra explained that I drank boiled water that had cooled, they poured it into a wide metal pan – not sparkling clean! – and hand-fanned it to hasten cooling. With great thanks, I obligingly drank it, realizing that bugs were inevitably making their way into my gut.
All things considered, though, I remained generally healthy, a fact I attribute to my being among those born with a robust immune system. This was not the case with everyone, though. Tom, my best Peace Corps friend and 60-miles-down-the-road neighbor, was often sick.
A dusting of sulfa powder
Once, walking in sandals along the unpaved road back to Rajnagar from a nearby village, I stubbed my big toe on a rock badly enough to eventually lose the toenail. After reaching Rajnagar, I felt it would be worth visiting the small government “hospital” – really just a simple clinic.** When I got there, the only person on duty was a young orderly who took a look at my toe and, making no pretense at cleaning it or even dusting it off, tapped some sulfa powder onto the road dust that covered it. So I hobbled home, cleaned the road and sulfa dust off my foot with boiled water, and let nature begin the healing. It worked out fine.
Medical care in Rajnagar was of two kinds. The clinic was staffed by a non-resident (as I recall) doctor. Once, he invited me in as he was completing an examination of an elderly woman’s foot. He gently tapped her sole with a needle. She didn’t respond. “See,” he told me. “No feeling in the foot. It’s probably leprosy (Hansen’s disease).” Toto, I don’t think we’re in Kansas anymore.
The other kind of medical care – leaving aside ayurvedic medicine – was also Western, but not delivered by a physician. Instead, if you felt ill, you might go to the village bazaar. There, in the row of stalls surrounding the fruit and vegetable sellers, was a merchant in his early 20s whose wares were bolts of cloth, sold by the yard, for shirts and other apparel. But if this young man – doubling as a “bandee doctor” – thought you needed a shot, he’d administer it right then and there … with an unsterilized needle that had clearly been used before … and medications that hadn’t been refrigerated.
Needless to say, I never took any aches and pains to the bandee doctor!
But I survived the Irish dentist, amoebas, worms, Flagyl, unboiled water and the loss of a toenail. What more could I ask for?
* Traditional Indian garb means a dhoti (a type of sarong, long enough to be wrapped around one or both legs individually) and kurta (long shirt). I didn’t often wear this outfit, except, occasionally, on holidays. I normally worked in a short-sleeved shirt and shorts that I’d brought with me from the U.S. I had my clothes regularly washed by a dhobi (a member of the launderer caste), who would beat them against a rock at the edge of a stream or “tank” (reservoir). I never did go to see where he did it; had it been the local tank, which filled with water during the monsoon, then shrank in the dry season, creating an ever-widening defecating place for bi- and quadrupeds alike, it’s better that I didn’t know for sure.
** Rajnagar, larger than most surrounding villages, was home to government services – i.e., the “hospital,” veterinary clinic, elementary school, post office – for the local area.