Saturday, 2 May 2015

The Indochina Revenge

I’ve lost count of the number of time I frequent the toilet and the amount of time spent sitting on the toilet bowl due to diarrhea after I came back from Cambodia. In fact, each time when I return from Indochina – namely Vietnam, Cambodia and Laos, I’ll be having the same agony the moment I touch down in Malaysia. However, I never experience any form of discomfort when I am there, thus, in a way, I am very thankful.

It is fun and rewarding but comes with a price to pay - diarrhea!  
This has been going on for years, since my first trip to Vietnam in 2007. Then, there was a time when I have to visit Vietnam and Laos frequently for work and upon return, it is a sure thing to happen till my personal assistant will automatically include a few days of medical leave to my schedule. It will be a miracle if it didn’t happen. The same problem haunts my colleagues too and due to this, we will joke among each other that being sent to Indochina is a form of “bully”, “punishment” and even “banishment” by the seniors towards the juniors.

Knowing that hygiene is way out of civilization in these countries, I’ve been very careful with the food and water that I consume, no matter how tempting the aroma of some snacks from the roadside. For some time, we thought that it is the water that is the cause of the problem but even after spending a huge amount on water from the French Alps just for brushing the teeth, I still found myself in trouble.

Finally, today, I have a partial answer to my problem. My doctor attributes this to Strongyloides stercoralisis (S. stercoralisis), a human parasitic roundworm that lives in tunnels in the mucosa of the small intestine.   S. stercoralisis can be found in areas with tropical and subtropical climates and has a very high prevalence in societies where fecal contamination of soil or water is common. This roundworm is not something new; it was first described in the 19th century in French soldiers returning home with severe diarrhea from expeditions in Indochina.

S. stercoralisis penetrates the human body through the skin. They are more commonly transmittable through textiles than treated water. This explains why even the bottled water from the Alps didn’t help at all. As to why S. stercoralisis only cause diarrhea upon reaching home environment is still something that need to be studied. I still consider this as something very strange even after knowing of the existence of S. stercoralisis and I call this whole diarrhea mystery “The Indonchina Revenge”. It is a price to pay for enjoying the gigantic temples of Cambodia, scenic Laos and whimsical Vietnam. 

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