Tuesday, December 14, 2010

Curing the Common Cold, Yap Style

Even though we’ve had mostly sunny weather in the mid-80’s this December, just like anywhere else, winter flu season is here. Miranda and I have been remarkably lucky to have avoided any serious medical issues during our time on Yap (knock on wood), but we still occasionally get sick. It must have been my turn, because this week I’ve suffered a debilitating head cold that wasn’t helped at all by the warm weather and sunshine. In fact, I remarked it was too “hot and bright” out.

After making a sizable dent in our dwindling supply of Tylenol and sinus medication, and facing the reality that we can’t just run down to the nearest drug store and pick up some more, I thought a discussion of the available medical resources here on Yap would be timely.

The Yap State Hospital, located about a 2-minute drive outside of downtown Colonia, is a sprawling complex of single-story buildings connected by open-sided covered walkways built back in the late 1980’s. On any given day, you can go to the hospital and see dozens of people, most in local attire, lounging in the main courtyard area between the intake window and the Pharmacy dispensary, waiting their turn for medical care. Usually there are also many little children roaming around, crying, and generally not wanting to be there for their annual check-ups. The hospitals grounds are very clean, thanks to frequent radio announcements and signs posted everywhere warning people to not spit their betel nut juice all over the place, and the floors seem to be in the never-ending process of being swept and mopped.

Given our surprisingly good health, we’ve actually seen only a few areas of the hospital. There is a dental section where I got a routine teeth cleaning. I was relieved when the dental office looked similar to every other dental office I’d been to in the States, including whimsical posters of cats reminding me to “Hang in there!” All the equipment looked modern, and the actual cleaning was done with a pressurized water-pick that apparently was brand new. Although I was tempted to ask about a little handwritten sign posted on the wall saying “Be sure to wipe blood off of equipment when finished”, my dental exam was completed without incident. Considering that constant betel nut chewing is very bad for dental hygiene, I imagine that for many island residents, a trip to the dentist is a painful and much-avoided ordeal. Thankfully, I had no cavities requiring further visits in order to validate my hypothesis. While I was disappointed I didn’t get the standard new toothbrush and sample-sized dental floss, I was quite happy with the price of the service. What would have cost me (with insurance) at least $20 in co-pay back in the States, was only $10 without insurance!

Our next occasion to visit the hospital was due to a persistent rash on Miranda’s chest and stomach areas. She had unsuccessfully tried several creams and ointments before deciding to seek the advice of our local medical professionals. So, she set up an appointment and went and spoke to the Doctor, a middle-aged gentleman trained in the Philippines. After Miranda described her symptoms, he said not to worry, prescribed a gel to apply (only $4 at the Pharmacy!), and advised her to wait a week to see if it got better. Unfortunately, that week came and went without any noticeable change. If anything, the rash spread even further. So, back down to the hospital she went. This time, another Doctor was on call, which required explaining the situation again since detailed chart notes apparently weren’t made for this non-life threatening issue. Since the Other Doctor was unable to get the First Doctor on the phone for a ‘consult’, and was unable to identify the cause of the rash or a course of treatment, he relied on the trusty help of the internet medical site WebMD. After plugging in all of Miranda’s symptoms, and some leading questions by Miranda suggesting that the cause was heat rash (as Miranda’s own WebMD searches told her prior to even going to the hospital), the Other Doctor sagely concurred that the cause was Miliaria, otherwise known as heat rash. Truthfully, it would have been somewhat comforting if he actually used the medical term. He really just said, “Probably heat rash.” Not quite as comforting. Anyway, some other medication was prescribed (strangely enough, WebMD specifically warned against using what the First Doctor recommended), followed by the standard advice to “wait and see if it gets better.” This time, thankfully, the rash did get better, but we learned that next time, a little research of our own could have avoided the trial-and-error approach.

The other, more frequently used medical resource is “local medicine”. Many Yapese people praise “local medicine” as remedying everything from the common cold to more serious ailments. The medicine usually consists of mixtures of various local plants, using time-tested recipes handed down from generation to generation. You frequently see people around town wearing garlands of strong-smelling leaves and other herbs that are supposed to be good for the constitution and overall health. When I asked one of my Yapese co-workers whether he knew of any local remedies for my cold, he told me not to worry, and that he would bring something by for me. He also told me to never, ever go to the hospital, but I couldn’t tell if he was serious or not. Later that evening, he showed up on my doorstep carrying a large plastic bag filled with leaves. He explained this medicine is called “faitzen” (roughly translated: steam bath) and is taken by boiling down the assortment of various local ferns, vines, pepper plant leaves, and lime plants, and inhaling the vapors. Willing to try anything at this point, I thanked him and kept my fingers crossed.

Covering my head with a towel, and leaning over a large pot filled with the plants and boiling water, I tried not to choke on the herb-infused steam. Almost immediately, my sinuses opened up, and I could breathe much easier. I thought that if this plant mixture was widely marketed and used, Vick’s vap-o-rub might have a run for their money! It was really pretty amazing. In the future, I plan to rely on other local medicines, if they work just as well. Even after a single 30 minute session of inhaling the steam (I declined the suggested, but optional, alternative of drinking some of the greenish boiled water), I feel much better.

Hopefully, with a little luck, I’ll have kicked this cold shortly!

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