Last week I had the opportunity to visit Egypt and, among other things, take part in some medical clinics. The medical care in Egypt is reasonably good in many areas, but not so much in the very poor section we served outside of Cairo. Looking out of the window of the little bus as we rolled into town, it was hard not to notice garbage everywhere; it floated over the little canal that divided the road and littered the road itself. In the end, it was part of the health challenge of this Egyptian town.
At the end of seeing a day’s worth of patients filing in, I was struck with the fact that there health challenges are similar in many ways to ours. Like us, they suffer from arthritis, congestive heart failure, diabetes, headaches, hypertension, and bronchitis.
But there are some different challenges as well. At least in these poorer towns, access to routine care for some of the more chronic problems is almost impossible. So while we could identify high blood pressure, diabetes or heart disease, we could do little to effectively manage it with our one-time visit.
Another challenge these folks face that is not major for us is routine access to clean water and food. Many of the children and adults had parasites sapping their energy and giving them various gastrointestinal complaints. An anti-parasite medicine, albendazole, was one of my most frequently prescribed medicines; I can barely recall prescribing it while in the states. And when I prescribed it in this little town in Egypt, I knew I was only temporarily reducing the worm burden in these patients. Without a change in their water supply and food handling they would quickly be re-infected.
A couple of children were covered from head to toe with red bumps and blisters. It took me a good while to realize this was not some infestation of mites but just severe chicken pox. Here in the U.S. I rarely see chicken pox anymore and they are usually very mild cases. Likewise Egypt still has some of the more serious vaccine-preventable diseases like polio.
So while the people were in many ways similar to those I see here in Tennessee: many delightful and a few a bit more cantankerous, some very sick from advanced congestive heart failure and others just needing reassurance that a small skin lesion wasn’t cancer, there were some clear differences in the overall systemic health challenges they face.
It left me with a heart for these folks and a thankfulness for the blessings we have in this country: ready access to clean food and water, a sanitation and waste system that works, availability of effective vaccines against many of the diseases that used to plague our children and adults, and access to routine health care to manage and minimize the complications of serious chronic diseases.
Our challenges are more of excess – excesses of food, entertainment, alcohol, and tobacco. Choosing the healthier foods in reasonable portions, finding ways to bring regular physical exercise back into our crowded lives, not neglecting or mistrusting the available vaccines, and avoiding toxic habits – these are more the challenges of our world in the U.S. They don’t account for every illness, but good choices in these areas drastically impacts the epidemics of chronic diseases in our country. These are not meant as judgments, just observations to focus our efforts and count our blessings.