Monday, July 20, 2009

Flu and germs in Cambodia

(H1N1 virus photo from US CDC, linked below.)

I was sick with the flu for a week. It was funny how many people told me maybe it was swine flu, since there have been four reported cases of swine flu infections in Cambodia. Cambodian Health Minister Mam Bun Heng told reporters all four cases were students who arrived from Texas on June 19. They ranged in age from 16 to 20.

I wasn't particularly worried even if it was swine flu, since for most people, it's mild. If you are interested to learn more about swine flu, the US Centers for Disease Control and Prevention is a good site. You may also like to read how H1N1 was traced to US factory farms.

Many people over-react to swine flu, as Newsweek's Fareed Zakaria writes in "The Sky Is not Falling". I loved this comment from a poster: "90 people get the Swine Flu and everybody wants to wear a mask. A million people have AIDS and no one wants to wear a condom." Hahahaha! This is so true in Cambodia, where so many people wear face masks to avoid air pollution but are lackadaisical when it comes to using the condom.

Now that I think about it, in the three years I have lived in Cambodia, I've hardly been sick. A Singaporean friend joked at a party back home how I probably have the strongest immune system among the Singaporean friends present, because I'm exposed to more bugs.

I've become much, much less anal about hygiene since living here. Singaporeans are typically paranoid about hygiene, and I say paranoid, because I think you can be too uptight about these things. For instance, Singaporeans will not place food directly on a table, but on a buffer, such as a piece on tissue paper. I was like that too. I was amazed and appalled when an Australian, a champion triathlete I knew in Singapore, would make his sandwiches directly on the kitchen counter, a place we are told is teeming with bacteria. Is Andrew the worse for it? Not if you ask his doctors. Singapore doctors were routinely blown away by his heartbeats -- so slow, they indicated a super-strong, super-human heart.

On my last visit home to Singapore, I joined a picnic at Pasir Ris Park with a group from the Singapore Vegetarian Society and the Singapore Kite Association. It was great fun, flying kites and eating veggie burgers. Anyway, what I remember was how the only person who was like me, leaving our burgers on an exposed surface, with no tissue or paper napkin, was a Singaporean lorry driver and part-time kitemaker. He reminded me of Cambodians in his casual way of handling food. (I have to write about this lorry driver some time. I really respect the guy, bringing up four children delivering goods by lorry to Malaysia and back. To supplement his income, he makes kites from recycled umbrellas and plastic).

I'm not at all advocating abandoning hygienic practices, only that there should be some sort of balance. I know paranoid young Singaporean parents who do not allow their children to go to the playground or let a dog lick them for fear their precious children will catch something. Exposure to germs can be good for you as Scientific American notes in "Strange but True: Antibacterial Products May Do More Harm Than Good": "What doesn't kill you makes you stronger" is the governing maxim here, as antibacterial chemicals select for bacteria that endure their presence."

I did fall sick often when I first relocated to Cambodia. I had flu-like illnesses once a month for the first three months. I remember because I wrote to a friend about it and she was worried. But it looks like my body was just getting used to new bugs.

(The last time I fell sick was in Oct 2006 when I contracted dengue in Phnom Penh. I was put on a drip for a couple of hours and was fine after that. I did write about that dengue experience and the funny trip to the doctor.)

Many Khmers asked me: "Why are you sick now? Usually people have stuffed nose (p'da sai) during the cold season (November to February)". They have a point. There is such a thing as Seasonal Flu, which is most prevalent from December to March according to

Khmers believe it is the change of the weather, from hot to cold, that bring on the sickness. Many do not understand the flu is caused by a virus and not from the weather. Khmers will cover up, bathe in hot water, and stop drinking cold drinks when they get a cold because they think the cold weather is the cause, so they must somehow keep warm to fight the disease.

None of these things will make a virus go away. There is simply no cure for influenza. You can take medication but these only alleviate the symptoms. Tamiflu is one such medication.

In fact, because the virus is passed from person to person, one of the simplest ways Cambodians can avoid spreading the flu is to stop sharing food. I always, always tell the Bloom team to use a serving spoon instead of everyone dipping their spoon into the common dishes, but old habits die hard.

Because I know there is no cure for the flu, I did not bother seeing a doctor. Which is the other thing Khmers do - they all asked me if I had seen the doctor because they believe medication will cure it. Our housekeeper offered to make me the Cambodian concoction of some boiled herbs but I did not try.

Anyway I'm listing Flu symptoms below. They are only symptoms and people should know that many illnesses share the same symptoms, so if you are not convinced you have the flu, but something else, go see a doctor.

1. Loss of appetite
2. Fever. Childhood flu fevers are often more severe, but it's not at all uncommon for any adult to run a fever in the 100's when they have the flu. Often a low fever - and the weakness and chills it causes - are your first hint that the flu is about to hit you in full force.
3. Congestion that turns to a runny nose.
4. Sore throat.
5. Cough that turns productive.
6. Exhaustion and weakness.
7. Muscle aches and pains.

To get over the flu, it is recommended you:
1. Drink plenty of fluids - water and sports drinks
2. Take over the counter medications to relieve symptoms
3. Sleep as much as possible
4. Eat when you feel like it, but don't worry about it as long as you are drinking plenty of water
5. Avoid alcohol and tobacco use

That was how I got over my flu. Just sleep and sleep and drink water. I was well after a week.

(Flu information from who says its Health's Disease and Condition content is reviewed by its Medical Review Board).

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