Others

One of the ailments my mother feared the most was the onset of diarrhea. The potability of the water could not always be relied upon; fruits and vegetables, even after they had been thoroughly washed, still had the potential to introduce troublesome germs in the gastro-intestinal tract.

If the diarrhea was severe, dangerous amount of water and electrolytes could be lost; this for a small child (or even an adult) could prove fatal if left untreated. My mother treatment was to urge us (Robert and myself) to drink plenty of water (no juice), and to stay away from solid food. The one exception was boiled rice. Actually, boiled rice was a requirement; and we hated it. Bananas were permitted, but in moderate quantities. To put a brake on the diarrhea, medicine was administered, but only after the intestine was given a chance to rid itself of its germs and toxins.

I am not sure if mom understood the principle of electrolytes, but at any rate, if she had the least concern, we were taken to the doctor.

There were 2 conditions she dreaded. Dysentery and enteritis. Dysentery is a severe infection of the intestines causing diarrhea (often mixed with blood, pus, and mucus) and abdominal pain. Enteritis is an inflammation of the small intestine, and it usually causes diarrhea. If either was suspected, we were either taken to the doctor, or he made a house call.

Like many other parts of the world, Egypt was affected by cholera epidemics. The episode I remember goes back to the mid- 1940s.

Cholera is a dangerous infection of the small intestine caused by the cholera bacterium. It causes severe diarrhea often accompanied by vomiting. A phenomenal amount of fluids may be lost, and if not replaced, death ensues within hours. Treatment consists of replacing the lost fluids and electrolytes. If fluid replacement by mouth is insufficient, intravenous infusion (IV) must be used. There is a vaccine that provides some protection against the infection, but precautions must still be taken with drinking water; as well, the immunity provided is for a limited period, about 6 months.

When the epidemic started, strict instructions were issued by the authorities. All water had to be boiled; and fruits and vegetables were to be washed in a diluted solution of permanganate. Food bought on the street was to be avoided. Houses had to be sanitized by washing the floor, sinks, toilets, etc. with lye. Finally, the population was to be vaccinated. Enough vaccine was acquired, and centers opened to carry out the whole operation. I remember my father saying that the whole process was carried out well.

The overwhelming majority of the Egyptian middle-class and the wealthy were spared. So were the Europeans. They had followed the sanitary dictates of the health department to the letter, and got vaccinated as soon as possible. Not so with the rest of the Egyptian people. Most were very poor and lived in unsanitary conditions. Even had they understood what the health officials were asking from them, they could not have followed through. As a result, scores died. It was said at the time in the newspapers that ignorance and poverty, rather than the cholera devastated Egypt.

The crisis acquired a political dimension. Egypt in the 1940s had to contend with a nationalist upheaval. Nationalists blamed the tragic turn of events to Egypt’s status as an underdeveloped and colonized country.

Eventually, a combination of public and private initiatives put an end to the epidemics of the 1940s, and public health reforms were enacted and followed (at least during the period we lived there).

Sources

1) Kidney Pain Kidney stones www.netwellness.org/healthtopics/kidney/faq3.cfm

2) Kidney Stones in Adults Extracorporeal Shock Wave Lithotripsy http://kidney.niddk.nih.gov/Kudiseases/pubs/stonesadults/

3) Episiotomy www.babycenter.ca/pregnancy/labourandbirth/labour/episiotomy/

4) The Canadian Medical Association.

Home Medical Encyclopedia.

Based on the British Medical Association.

Complete Family Health Encyclopedia.

Canadian Edition. Copyright 1992 .

Dorling Kindersley Limited, London.

Published in Canada by The Reader’s Digest Association (Canada) Ltd.

Medical Editor: Peter Morgan, M.D.

Montreal, Quebec

1992.

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