Subtle Parasites and Public Health

Last month, while I was home for Canada, I had my first ever stool sample. (Note: picture omitted…this time.) Realistically I should have had one before – I lived for a summer in rural Zambia in 2007, and then have been in Malawi since early 2009. However, I’ve always put it off.

Regardless,the results are in: I have no less than 5 separate intestinal parasites. I have yet to do the research on what these are, or how I got them. They all have long latin-sounding names, and none are particularly familiar. However, one guess I’ll safely hazard: my behaviour is to blame.

Despite working in public health, I’m pretty easy going when it comes to my own exposure. I drink untreated tap-water in Malawi’s cities, and, generally, whatever everyone else is drinking in rural areas. I walk around barefoot in villages, including daily for 4 months when I was living in the village in Chikwawa. (The inspiration for this blog’s title actually, now that I think of it.)

One incident in particular comes to mind. It was the start of mango season, so probably around September of last year. The bus route from Salima to Lilongwe is the best place to buy. During one trip, I got a beautiful grocery bag full for K50 (maybe $0.35) and, having not eaten lunch, I immediately started digging in.

A guy at the back of the bus stops me. “Excuse me. I noticed that you’re eating those mangos without washing them.”

Yes…” (“I’m on a bus. There’s no tap…”)

In Malawi we sometimes think it’s important to wash them first.”

I’m not too worried.” That was my blurted out reply. I’m not too worried. Off the top of my head. The blunt truth.


Stock photography of mangos from earlier in the season.

And that’s the thing. I wasn’t too worried. See, I almost never get sick. Even as I type this, with 5 parasites inside me (or maybe some of them are bacteria, I’m not too sure actually), I feel fine. And I’ve had them since at least November, maybe much longer – no reaction. I went for a run yesterday. Health = more or less ok.

Therein lies the tricky thing with working in health. I pursue a bunch of risky behaviour, get sick, but my body fights it off and I barely notice. In fact, had it not been for the test, I wouldn’t even have noticed at all. Someone else does the same thing, and gets sick. Extrapolate this to a whole community, and we have a serious disconnect between cause and effect. Behaviours that we know are risky, like not washing your hands, improper disposal of faeces, drinking unsafe water, or, yes, eating unwashed mangos on a bus, don’t always lead to negative health effects. And thus the need to change those behaviours isn’t always that obvious. If it was, I think ideas like handwashing would have taken off long ago, and working in public health wouldn’t be even a tenth as challenging…

23 responses to “Subtle Parasites and Public Health

  1. Very interesting piece. I am from Nigeria (but currently reside in Canada) and the picture of the mangoes is making me salivate! I haven’t had mangoes in almost 4 years. This is not to say that I did not read your piece and noticed only the picture of the mangoes…:) You are right when you say that behaviours we know as “risky” do not always lead to negative health effects. Thinking back to when I lived in Nigeria, I am amazed at some of my own “risky” health behaviors and like you, I rarely got sick. Perhaps it was because my system had become immune to some of the infections. That being said, if I where to visit Nigeria today – having lived in Canada for almost four years – I am not so sure that my immune system will be as tolerant as it used to be.

  2. Rosemary Leslie

    Hi Owen,

    Thanks for the posting about your 5 parasites!!

    Yes, it is interesting the Russian roulette game that some people play with their health, in the ‘West” and in the global South. You never know what will happen because we don’t don’t know everything yet…surprise! surprise!
    One month you see your aunt as an outgoing health person who exercises and eats well and then the next day you learn that she has terminal cancer. Another person (me included!) drinks untreated tap water for months and experiences nary a tummy rumble! Life is like that…live it while you can!

  3. i really don’t miss untreated tap water, at least I was in boarding school and it was expensive to constantly load up on bottled water, and tap was the norm, well except when I got typhoid, and stocked up on bottled water for about 2 terms.

    Anyways wash your mangoes at least. but I can’t point fingers, I procrastinate a lot even when it comes to health.

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