Tuesday, November 08, 2005

Sally, Agosto, Ciah, Wisnu


While having a coffee in the school staffroom, I got talking to Sally, a friendly, middle-aged Australian lady who acted as school nurse. I told her about Agosto and Ciah and asked her what might have led to Ciah's death. I explained that Ciah had previously been in hospital with hepatitis.

"Did Ciah do farm work?" asked Sally.

"She washed clothes for people. But she lived in a rural area, with goats and rice fields and fruit trees."

"People living besides rice fields and using river water can get repeatedly infected with bugs that affect the liver. I remember a student who'd been on a holiday trip in a farming area. He got an illness that gave him jaundice and encephalitis. The doctor found he had a big red spot on his thigh, a purpura. There was blood in his sputum. Eventually the hospital diagnosed Weil syndrome, resulting from Leptospirosis."

"Leptospirosis?"

"You can get it from the urine of animals, like goats or rats. It used to be called swineherd's disease. It's common among people working in rice fields."

"Did the student get better?"

"He recovered after a long stay in a hospital in Australia. The death rate from Weil syndrome can be as high as ten per cent in wealthy countries, but much higher in poor countries."

I told Sally about Wisnu and about him not being able to get into Wisma Utara.

"I can see the point of view of the Wisma Utara staff ," said Sally. "They really couldn't have taken him in without first consulting a doctor and their board of governors. The child might be full of bugs and parasites."

"How do you avoid bugs and parasites?"

"Eat lots of raw cloves, raw ginger and raw garlic," said Sally, with a cheerful grin.


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