Since we moved to Bangalore in October last year I have suffered pretty much continual bouts of Bangalore Belly (which sounds much better than diarrhoea let’s face it). I had brief respite on my return trips to the UK and when I caved in a few months ago and went to the hospital. They gave me antibiotics, probiotics and pain killers and sent me on my way. I had a few weeks of normal life after that. Then the Bangalore Belly returned.
What is it?
Unless you have been really lucky you will know what this is. Put plainly it is having at least three loose or liquid bowel movements each day. (I smirked at this. ‘Only’ three I thought. I could probably live with that). It often lasts for a few days ( ha ha ha ha ha ha – I wish!) and can result in dehydration due to fluid loss (I drink bottled water like no one else). Signs of dehydration are the loss of the normal stretchiness of the skin (mine seems ok) and irritable behaviour (guilty as charged) and also a fast heart rate (yes again) amongst other things.
How do you get it?
By living in India.
Ok, ok, not everyone gets it who lives here but most westerners have a bout or two by being here.
The most common cause is an infection of the intestines due to a virus, bacteria or other parasite – a condition known as gastroenteritis. The infection is most often acquired from someone else who is infected or (and more vomit inducing when you think about it) from eating food or drinking water which has been contaminated by a ‘stool’.
Yes, let’s just think about that for a moment. The reason I am so ill is potentially because I keep eating someone else’s poop. Bleurgh!
There are three types of diarrhoea (it’s been an education I can tell you!) and I won’t detail them in case you’re eating your breakfast. I’m no doctor but ‘persistent diarrhoea’ sounds likely after 7 months of it on and off (more on than off ).
Prevention: Hygiene and sanitation
It’s pretty obvious but washing hands with soap should do it. Increased sanitation and clean drinking water. Let’s look at those in turn for India. Don’t forget that I am living in Bangalore- the Silicon Valley of India – and a developing city.
Washing hands with soap
*sigh*. I have witnessed first hand how ladies exiting toilets in shopping malls (so we’re not even talking about slum conditions yet) walk past the sinks, or run one hand under cold water then walk out. It is rare that I have seen anyone wash both hands with soap and water. If I have, it has been someone in their early twenties. I witnessed once a child desperate to wash their hands and the mother batted their hands away from the tap, scolded them and grabbed their arm and marched them out of the toilets. It is thoroughly depressing the lack of basic hygiene amongst people who are wealthy enough to shop in a western style mall but lack the basic hygiene education.
Increased sanitation: Men urinate at the side of the road everywhere.
And I mean everywhere and at anytime of day. They don’t hide. They just pull it out and pee. It’s disgusting. I don’t want to see that thank you very much and neither does my 9 year old daughter either. Now it does baffle me that a nation who censors any sort of kissing or touching in movies, and has such a Puritan attitude to public displays of affection, accepts men urinating in public. A penis on public display is acceptable but oh my gosh don’t be seen kissing in public or even holding hands (unless of course you’re both heterosexual men, which is completely acceptable here.) How is that ok? In addition it is considered rude here to talk about toilet habits etc. But clearly it is ok to see men pee at the roadside? Anyway, my point being, there’s definitely no handwashing going on there. It’s just grim.
Increased sanitation: Slums.
How on earth anyone is supposed to keep clean when they are living in a tent made from tarpaulin and bamboo is beyond me but they manage it. The ladies look immaculate in their sarees and hair shiny, healthy and well groomed. The grim reality is that there are no toilets or washing facilities (or refrigeration of food for that matter). Teeth brushing is done outside the front ‘door’ with drinking water. I don’t have any clue how they toilet or bathe. It can’t be hygienic. There are no public facilities available usually.
Increased sanitation: Public toilets
There is a whole separate blog post I could write on this. Public toilets are rare. And I mean rare. Any long journey is planned around the road with an available public loo. There was just one available on our journey between Bangalore and Mysore and only two ( one of which was a well dodgy garage loo) between Bangalore and Pondicherry (a 9 hour trek in the end). The lack of public toilets mean that women in particular are vulnerable. As I have stated above, men merely pull it out at the side of the road. I don’t fancy squatting in public for a pee and I am quite sure other women don’t want to either.
I genuinely do not understand why there is a lack of public toilets, especially on known highways. The places that do have them are a magnet for travellers and they have cafes attached making them lots of money. Service stations on motorways in the UK are at regular intervals and it is something, and a huge business opportunity, that has simply passed by this nation.
The public toilets that are available vary vastly in terms of quality and cleanliness. Generally it is a squat loo with a tap and a bucket and jug. Toilet paper is rare and usually only found in western style toilets in shopping malls. Soap is also rare and again only usually found in western style malls. What is common is filth and flooding. Toilets are usually filthy dirty and generally flooded with water so that you have to wade through waste in your sandals before using the loo. It really is as grim as it sounds.
Clean drinking water
With men urinating in public and slum dwellers defecting in the open the ground water will be contaminated. The tap water here is contaminated and has to be filtered before boiling (we have a filter in the kitchen). We only use it for tea/ coffee and boiling vegetables. We buy bottled water for drinking and cooking with anything that absorbs water (e.g. rice). We have a delivery every week of bottled water from a well known online supermarket – a hopefully secure and hygenic source. We crush all our used water bottles so that they can never be refilled.
There is a drought in India at the moment and the price and availability of bottled drinking water has dramatically changed. Supply is sporadic – although by regularly changing brands and buying from several sources we have never run out (yet). That is not the case for a lot of people here and especially in the villages where opportunists are controlling the supply and hiking prices for locals. It’s criminal. Clean, safe drinking water is a basic human right that is being denied so many people.
I attended Columbia Asia hospital again. It’s never a good sign when the consultant recognises you and states “I’ve seen you before” before you’ve even sat down. I was poked, prodded, sampled and tested. Results awaited but in the meantime I have antibiotics to kill off this latest infection. Hopefully the test results will be helpful and identify an underlying cause other than just being “unlucky” – as the consultant said that’s difficult to deal with when you’re here a long time. If I’d had been feeling better I would have mustered up a sarcastic comment in reply.
In the meantime I wrote this blogpost whilst waiting at the hospital and now I am back at the house I sip my peppermint tea and scratch the mosquito bites I picked up whilst waiting in the hospital. Incredible India indeed.