6th of September Tashiling clinic in Sonada, which is sponsored by Shenpen Tibet Aid, had a health talk about deworming. 150 hostel children and people living in the Tibetan settlement attended the program. By the end of it, everyone was keen to get medicine to get rid of intestinal worms, which is very common in India and poor countries due to lack of sanitation. More than one billion people in the poorer countries have intestinal worms, mostly children. So deworming is a very important part of preventative medicine in these regions.
The lecture, done by dr. C. L. Sherpa and nurse Ambika Rai, focused on the worm cycle. Due to lack of good sanitation, people go to the toilet outside, the feces mixes with the soil, and eggs from worms can easily be digested when eating vegetables that are not properly washed. The eggs grow within the body, and adult worms live their lives inside the intestines of people and animals. Some can even travel to the brain!
The audience learned about the different kind of earth worms (helminths), the importance of hand washing and washing vegetables properly, to avoid undercooked meat and ultimately improve sanitation.
Having worms can lead to malnutrition, iron and vitamin deficiencies, and almost surprisingly; lack of mental development and school performance in children. Worst case scenario is having a large number of worms causing intestinal obstruction which requires surgical intervention.
Urgyen Tsering translated the lecture from Nepali and English into Tibetan, and I told my story of getting a worm myself after having been several years in the Himalayas working for Shenpen. I told them about the shocking diagnosis I got back in Norway: Worm eggs in stool test, round worm, the most common of them all. Then the easy medicine and the happiness of getting rid of it.
How did I get it? Probably from forgotten hand washing, or perhaps from eating food where the cook did not wash the hands or the vegetables properly. Maybe the water was bad. In certain situations, even if you see that the kitchen is filthy, it can be difficult to say no when warmly invited to eat in a poor home. Either you take the food, or you break someone´s heart…
The children were curious; – Can I get a live worm directly from others? Answer: No. – Can I get a worm from going swimming? No, not in India, but in many parts of Africa there are water borne worms (schistozomes) that you can get from swimming outside. Quick minded teenagers asked: How can we eradicate the whole problem of worms in the environment? Answer: Deworming medicine, then improve sanitation, stop defecation outside so that soil does not get infected by feces.
The lecture was “hot”, this was not irrelevant information. Children and adults listened intensely and eagerly lined up to get medicine, one dose of Albendazole. The smallest children got their medicine in liquid form. Not really necessary, according to WHO, who states that children down to one year old safely can take the tablets. Our doctor Sherpa likes to give small children more easily digestible medicine in liquid form. One hostel worker had recently suffered from acute hepatitis B, and was advised to wait with the medicine. We had no pregnant or breast feeding women, or weak elders with liver or kidney impairment, who should be careful with medicines.
WHO and other organizations are conducting huge deworming programs in Africa and Asia, – unfortunately not in the schools in Sonada. Even when sanitation is not improved, deworming whole schools will drastically decrease the number of worm eggs in the environment, as one female worm is hatching more than 200.000 eggs per day.
Yes, one could almost say luckily I got a worm. With it I got awareness of the huge number of children who suffer from long term infection when medicine is so cheap. We can easily help removing a great obstacle to development for so many children and adults. Studies about deworming have shown that getting rid of worms as a child improves both the ability to understand and learn, as well as the ability to make a living as an adult.
I felt great when the worms came out of the children. Many passed several worms, the highest number being seven. One little girl, who passed five, was looking rather pale and is getting vitamins in the clinic. This week we are getting more vitamin- and iron supplements for the children who just had someone else eating their nutrients.