Yangon Diaries II: Take a Pill

September 17, 2013

Shwedagon sweepers

GOOD KARMA–Volunteers sweep rain water from the polished marble floors of the Shwedagon Pagoda in downtown Yangon on Saturday. Burmese Buddhists believe that such symbolic gestures of merit-making will be rewarded in the next life.

YANGON–A few nights ago, I didn’t sleep very well. When I began to shiver, Lune checked my forehead and wrapped an extra blanket around me. He said I had a fever.

The next morning, I woke up with a low-grade headache.

“This is it,” I thought, my Woody Allen-ish hypochondria going into overdrive. “Cerebral malaria. Encephalitis. Dengue. Or that other thing you get from mosquitoes. I’m a goner for sure, and I’ve only been here for two weeks.”

Okay, so I was over-reacting. But by how much? It’s the rainy season here in Myanmar. Mosquitoes are everywhere. And Yangon—a cesspool of bad hygiene, with septic tanks emptying into open drains, dust and grime on everything, and poorly discarded trash everywhere—is a breeding ground for all kinds of ailments. Since the alley behind our own apartment is filled with rat-infested garbage, it can’t be a good thing if mosquitoes from all that rubbish are laying eggs in the water basin beneath the pump in our bathroom, can it?

**********

On Sunday last week, a government truck rolled ominously down our street, its loudspeaker blaring an announcement in Burmese monotone. Lune listened in.

“It’s something about mosquitoes,” he said. Then, listening further, he frowned. “They’re giving some kind of pill for everyone to take. They’re going to visit every building and knock on every door to give it. Don’t answer the door.”

A day or two later, I got the full story while editing an article for the local news section. The visit to our neighbourhood was part of a national campaign, from September 9 to 15, to eradicate lymphatic filariasis, otherwise known as elephantiasis. A disease that causes painful and disfiguring swelling of the legs and genital organs, elephantiasis is transmitted to humans through infected mosquito bites and develops into adult worms in the lymphatic vessels. I first learned of this peculiar ailment as a child when, flipping through one of my father’s medical books on rare diseases, I fixated on an image of a man whose balls were big enough to carry in a wheelbarrow.

“Hmmm, maybe we should take this pill,” I told Lune.

But then, maybe not.

The pills are a combination of Diethyl Carbarmazine Citrate (DEC) and Albendezole. The government recommends them for everyone but children under the age of two, pregnant women, people suffering from heart disease, high blood pressure, diabetes, hepatitis, kidney disease, or asthma, those who already suffer from elephantiasis, and the bedridden. Temporary side effects include dizziness, fever, and joint pains if there is too much body movement after taking the medicine. But last week in Yangon, two seven-year-old boys were hospitalized with severe vomiting after taking the pill. In some townships, the pills were being distributed by security guards or local ward administrators, rather than by health officers.

Although the incidence rate for elephantiasis is currently less than one per cent in Magway Region, Sagaing Region, and Rakhine State—and is zero in Shan, Kayah, and Chin states—the government evidently decided on a better-safe-than-sorry response when the Ministry of Health reported a small increase in the number of patients suffering from the disease. Yangon rates were not reported.

**********

The night before my “fever,” Lune bought a mosquito net for the bedroom. At first I thought he was too late. But the next morning, after an invigorating bowl of congee and a hot shower, I felt a bit better. In the afternoon, we visited an old friend of Lune’s near Inya Lake. Her brother, hearing of my symptoms, disappeared into the kitchen for a moment before returning with some pills.

“Here,” he smiled, handing me a ten-pack of Paracetamol. “Take these.”

(Well, better the devil you know, right?)

The next morning when I woke up, the fever was gone.

And, yes, my balls were reassuringly proportionate.

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