Working With Environmental Issues
By Fred Koehler - Peace Corps Volunteer: Togo (2002-2004)
I have parasites. They live in my stomach. I can feel gurgling after I eat or when I lie down to rest. It's a bit like how your stomach rumbles when you're hungry. It affects my whole digestive system. I'm not the only one, either. It seems to affect everybody in my village.
My parasites probably came from something I ate or, even more likely, something I drank. Some live in the water, and enter our bodies when we eat or drink, while others can be passed from one human to another, if we shake hands with someone else, for example, when one of us hasn't washed our hands properly. The parasites often start off small, and you don't see them at first. I think mine are the kind that stay small, so tiny you need a microscope to see them. Some parasites, though, get as big as the kind you'd use to go fishing; others grow over a foot long! I can go and see the Peace Corps doctor and take some pills to get rid of my parasites (and I will). But my neighbors can't do that. That kind of service is not available to many people here.
When you say a disease or problem is endemic, it means that it's common in a particular place or among a particular group of people. Lack of sanitation is endemic to Togo, the country I work in; and to Blitta-Gare, the village I live in. Parasites are often picked up from human waste on the surface of the ground or they are transmitted through seepage in the ground from latrines to wells. Some of the parasites live in the dirty, nasty, green and brown sludge that collects on the side of the road. The parasites live in the puddles that form next to the houses and in the paths. We don't drink this water directly, but when it rains, water all runs together and sometimes gets into the wells where we do get our water. Sometimes, our hands touch that water and we eat or drink without remembering to wash them. That's another way we contract parasites.
Parasites affect the villagers, making them visit the latrine a lot, maybe 10 times a day or more, and can prevent many of the nutrients in food from being absorbed by the body. This leads to malnutrition, which gets especially bad with children, and causes giant, swollen bellies and dark, sunken eyes, like those you see in the West on television. Often this is an affliction that children don't survive.
The villagers more or less understand the need to drink clean water and wash their hands. But when there is no other water to drink and no filters to purify it, they are forced to drink what is there. The people with money build wells that are protected from rain and runoff water. Those who are educated might construct some kind of filter out of sand, charcoal, and fabric, but not often. Latrines help to limit waste from entering the groundwater, but then again only the wealthier build them.
The result is a fair amount of disease, and many people die from sickness every year. What we're trying to do through the Peace Corps is find all the aid organizations that work with wells and latrines and gutters, and persuade them to work together to help the villagers in Blitta-Gare. But this is no easy task, because the villagers themselves have to understand the causes of the problems and the need to address them.
Regarding the need to educate the villagers about the importance of hygiene, there's a great talk that one of my friends gives to students in schools. He'll walk in very stiff and rigid and say a sharp "Good morning" to the class as though he were some general addressing his troops. With the students under his spell, he then takes a big, red, fat hot pepper and squeezes it till it bursts, and he rubs the juice all over his hands. He'll then walk up to a random student and offer to shake hands. With others, he'll try to pat their heads or touch their faces. The result? Complete mayhem as the students tear out of his path as though he were on fire. Why? Because, in a sense, he is. They know that if the pepper juice gets in their eyes or on their mouths there'll be a new world of pain because of how much those peppers burn. He uses that introduction to lead into a well-received talk comparing the pepper to parasites, and how important it is to wash your hands often and keep your homes clean.
As for me, I'm learning my lesson. I don't like parasites and I look forward to getting rid of them. In fact, I think I'll go wash my hands right now.
About the Author
As a Peace Corps Volunteer in Togo from 2002-2004, Fred Koehler worked in Community Development and AIDS prevention.