I was travelling in Jumla, a remote district in mid-western Nepal in 1992, when I became acutely aware of how scary diahorrea can be. I was all of 19 years old. I’d flown there on a rickety plane that landed in a small runway. The plethora of tea-shops that I was assured, by the non-governmental organization that had hired me and had sent me out, were in existence and would take care of my food and lodging never materialized. Instead, there were small homes selling a few items-perhaps a biscuit packet, some cigarettes or matches. Tea was still a luxury.
After tramping around the villages for six weeks, and living off fox tailed barley bread sprinkled with salt and chilli, and recording stories of mysterious deaths on the side (“my sister was walking back home to her husband’s house and she fell down dead on the way”, “about seventeen people have died in that village that-a-way, we don’t know why”) my fellow guide suggested we try to climb up to Rara lake. “It will take only half a day,” he said. This sounded like an adventure and I agreed.
Halfway up the mountains, however, two things became apparent to me: first, that I had severe diahorrea. I suspected it could be giardia. And second, our water had run out, and I was quite pleased and happy to sit down on the trail, look at the mushrooms, and not move. A pleasant drowsy haze fell over me. My guide took one look at me and realized the state of affairs: I could hear him crashing down the bear-infested jungle to get to the river to get me that precious bottle of water. After the bottle, and a few sugar candies (how little do people realize how precious those sugar candies are!), I was able to get up and walk again. Obviously, we didn’t make it to Rara Lake that time.
Here’s a description in Wikipedia about the trek, written by travel writer Ethan Gelber. Note we tried to do it in half a day:
Although more trampled than in the past, the road to Rara Lake is still without any of the comfortable services available along more popular trails. Logistically it is not an easy trek; it is hard to get to and from, and it is an organizational challenge, requiring informed guides and porters to tote the two weeks' worth of material that will keep you warm, dry and fed. It is also tough on the bones, involving several 11,000-foot passes. However, once you overcome the obstacles, the rewards are legion: few if any other trekkers, incomparable natural splendor, "untouched" villages, blissful quiet.…
Since that day, I often think about the people who don’t get the bottle of water, and who die from simple dehydration. Nepal often gets epidemics of choleras and diahorrea even now—ebola is obviously of great concern. If ebola makes it to Nepal, legions of people will die due to an apathetic government and unevenly run government health posts and beaureaucracies.
Because of this experience, I’ve often had great interest in medication that can stop diahorrea. Anybody who’s tried the Western medication available on the markets may have experienced what I did—the sense of being “stuffed up,” and which disrupts digestion and well being for a few days. Undoubtedly the diahorrea does stop, but the sense of unease doesn’t.
Recently, a herbal dealer from the same district Jumla sold me an herb called “bhotay khayyar.” It resembles a betelnut, and the man assured me he would pop a small bit into his mouth while he walked, and it had no adverse effects. More to the point, he said, this herb stops diahorrea and “blood in stools.” He titled this condition “Ragatmasi.” I didn’t know anybody who got ragatmasi, but since diahorrea was a common problem, I bought a handful from him. On a recent visit to Kapilvastu, when I again got diahorrea from eating the tempting but dangerous street food from a chat-wallah, I took a bit of the bhotay khayyar. Almost like the Western medication, it stopped the diahorrea-but gave me terrible gas and a feeling of being “stuffed up.”
On the other hand, a cleaning lady who came by complaining that she had blood in her stools for the past month, and uttered the word “ragatmasi,” seemed to fare better with it. I gave her three tiny samples, and instructed her to take one morning, afternoon and night. The next morning I asked her if she was feeling better. “Oh yes,” she said. “I took a tiny bit of that jadi you gave me. The blood stopped completely. In fact, I only took one piece, the rest is still with me. I feel so fine I ate a dozen bananas and a liter of yogurt. In fact, I think the bananas and yogurt cured me, not your herb. How can that tiny little thing act so fast?”
In New York, in one of my forays into interesting ethnic neighborhoods, I came upon a Chinese supermarket. I bought, in this order: a bag of tea titled “Slimming Tea,” a plastic bottle of Siberian Ginseng, and a small bottle of Chinese medication marked with a small label that said it was useful in diahorrea. The “Slimming Tea” apparently did not have FDA approval, because what happened to me after drinking it was quite startling and unprecedented: it felt like my intestines were being wrung out, and I was sitting in the toilet for a full hour till everything was purged. In hindsight, I think it was an extremely strong purgative. Since I didn’t want to be size zero like the fashionable Chinese ladies, I happily threw this slimming tea into the trash. Then I tried the Siberian Ginseng. I had little interest in Ginseng but a lot of interest in Siberia—obviously Siberia sounds romatic when you’re living in New York City, so I bought it and popped a tablet. What followed was again quite startling—vivid nightmares and great aches and pains in the upper arms. I imagine now that I fell into “The White Man Trap”: the bottle was clearly designed for white folks who would be as enamored as I about the notion of Siberian ginseng, and take it without realizing how it could have dangerous side effects. The people from Siberia probably take it in their alchol, or make a medicine with 20 other herbs, with the ginseng being only a small compound. But of course in NYC, it was sold full strength and in a white man’s dose. I advice people not to take it in this form.
But all these mistakes and travails of complementary alternative medicine was worth it, because in the third bottle I hit the treasure. I regret today that I didn’t keep this small nodescript bottle, nor noted down the chinese characters on the label. The bottle was filled with small black balls, which you were supposed to take 3 (or was it 5?) balls at one point. I seem to remember that they were small enough they could be swallowed with saliva during emergencies when water was scarce. Each time I took it, my diahorrea and stomach pains stopped almost immediately, and I felt no bloating, gas or other pains. I would be back to eating a normal diet within 1 to 3 hours.
The point of this story being: there are already thousands of complementary alternative medication that stop diarrhea that have gone through 5000 years of “clinical trails” in ancient cultures. Why don’t we tap them for stopping the ebola crisis? I’m going to assume that bottle was a common enough off-the-counter medication that one can find in a supermarket in New York City. Of course, I told you the story of the Ginseng and the slimming tea to point to the hazards of picking up the wrong complementary medication. But I think its time now to think about effective medicines that already exist in the world’s pharmacopeia—and not just imagine that the experimental drugs are the only way to solve this crisis.