Vaccines are an important part of traveling in the developing world. Our pampered immune systems are simply not accustomed to some of the ailments in other countries. As preparation I have been drinking from the toilet and eating raw pork. This is the first of at least two parts about my experience getting the necessary immunizations for a two year trip to Central and South America. Part II will be more informative whereas this is mostly my observations on the whole experience.
The modern health department is not designed as an institution of luxury or even comfort. It is purely utilitarian. In an America that I can only explore the relics of and know within the confines of faded black and white, these buildings were once constructed as icons of the growing wealth and power of great cities. Take one look at the now abandoned Herman Kiefer Hospital in Detroit. It is hard not to wonder…. if we put so much more care into the buildings that housed the sick then, did we value human life more then as well?
The southwest Utah Public Health Department building in St. George is the antithesis of these monuments and represents all that is soulless in modern construction. Faceless brick exterior. Square. Awkward white corrugated steel cap. The first thing I noticed was that there were no bike racks out front. For a “Health Department” this seems a bit ironic, but for a town that is running full steam to make America great again it makes perfect sense. I circle the tarmac filled with antiquated internal combustion powered machines and lock my 21st century horse to a stair rail.
The main entry is not worth noting except that it makes you wonder if you’re in the right place. Jump in the elevator to the third floor and notice the sign that says the travel clinic is in suite 300. Doors are marked 301-360 and when you ask a woman where 300 is she points you to the desk in the corner of the lobby and looks as if she feels a bit sorry for you. Signs note that the waiting room is “breast feeding friendly” and the children look well fed. Misread a “Medical Reserve Corps” pamphlet as “Corpse” and get a little chuckle. Take your ticket, fill out massive pamphlet in which you have to rewrite your name, phone number, and birthdate no less than six times. Wonder how many other people are here to ensure their bodies are properly encapsulated from viruses for world touring.
“Number 60 at window 5.”
That’s me. I walk up to the desk and hand the woman my packet.
“Como estàs,” she said before correcting herself with a slight Mexican accent. “I’m sorry. I don’t know why I said that. How are you?”
“Bien bien. No es una problema. Yo necesito practicar mi Espanol.” She compliments my Spanish and we chat for a few. I try to tell her about our trip and get a bit of beta on Mexico. She has a funny way of switching between asking serious questions about my medical history and excitedly telling me about Jalisco and Guadalajara. She asks for my vaccination records from childhood. I don’t have them. This appears to be a major issue, but I get in to see the nurse anyhow.
In order to get the vaccinations, you’re required to pay $65 for a travel consultation. This is quite possibly the best deal in all of medicine. The aforementioned questionnaire prods a variety of personal medical topics as well as travel plans. They want to know what you will be doing and where you will be down to the day. This is impossible to fulfil when planning a two year trip and I merely give her a list of 15 countries where I am likely to be. She seems a bit worried by this. I’ve found that your average Southern Utahn likes for all boxes to be checked and that required fields be filled. Despite their unquestioning faith in the merits of free markets, my laissez faire approach to life does not go well here.
The nurse has a collection of slides that she takes you through based on your answers. Most of it is common sense; practice reasonable hygiene, don’t share needles, don’t eat from the taco cart with the woman that has chapped hands and no gloves. There are a few nuggets of wisdom. It did not occur to me that parasites could crawl into my body through my feet, and apparently some countries will not let you enter without proof of a yellow fever vaccine……. Mostly it feels like warnings from people about places they’ve never been to.
Water is one that people love to warn you about. “Don’t drink the water, don’t even eat salad because the lettuce gets washed in the water.” I successfully avoided the water in Nicaragua for a month. If you understand Nicaraguan hospitality, you realize how great of a feat this is. Within 30 seconds of entering any home you will be given a drink. Within 10 minutes you will have a plate of food. Usually they give you soda to drink. I take it to be polite, although it’s not my thing. One day I was given a glass of water. I cringed when it was placed next to meet. How could I get out of this? Knock it over? Walk outside and pretend to take a call and then dump it in a plant?
Somebody finally asked me if I wasn’t thirsty. I tried to explain the thing about gringos and Latin American water. Everyone laughed and I assumed it was because of my novice Spanish. “Nica……..Agua,” the host says to me. “Our country has lots of water and it tastes very nice.” Everyone smiles and nods. I give in to peer pressure. The next 3 hours were spent in great stress and close proximity to a toilet, but I never had a problem. Apparently most of their water is treated to a very high standard. I drank the water for the next month and was fine…… Except for a few days on a remote island…….. Long story short I could not go more than 100 feet from a toilet. I never actually felt sick, but I would just get a desperate feeling in my gut every hour or so.
I personally think that avoiding the water completely when traveling long term is unreasonable. My advice is to lock yourself in a hotel early in the trip and just drink from the tap for a few days. It is going to be rough, but by the end of it your colon will be clean as a whistle and your body will have made the necessary adjustments. If you have an embarrassing moment just remember that everyone shits their pants at some point….
I tell the nurse that I will be drinking the water, walking barefoot, interacting with livestock, not showering daily, riding busses with sick babies, and that I would rather get malaria than carry a two year supply of pills. She seemed to get it.