August 4, 2011
by Tavish Nanda
If there is one field of medicine I’m not sure I can stomach, it may be dermatology. There is something about our most visible organ system that makes me a little queasy, which is why I found my fascination with Dr. Ryan’s lecture on African elephantiasis to be a little out of character.
Elephantiasis is generally a parasitic-born condition, but in central/eastern Africa, it is more commonly known as podoconiosis (podo meaning feet) — a condition caused by micro-particles of silica in agrarian locations. For the hundreds of African farmers who farm barefoot in the red clay soil, infection of the skin, especially when it is dry and cracked, can result in the blockage of the lymphatic system in the lower legs. This results in the massive accumulation of lymph, accompanied by fibrosis and inflammation where the cells of the leg actually multiply into the hard “elephant”-like condition seen below (hence the name).
When Dr. Ryan first introduced himself as a dermatologist, I thought to myself, “What could a dermatologist possibly do in tropical medicine?” Not that the field is any less substantial than the rest, but I wasn’t sure how much help someone could be treating skin rashes or burns, when HIV, malaria, and dysentery are ravaging the very same countries. But with elephantiasis, we learned about more than just the condition — we learned about a culture.
We learned how barefoot farming was more than a lack of shoes, but a cultural belief in a natural connection with mother nature and the soil, where the very idea of blocking one’s contact with the ground doesn’t seem as “logical” as it does in western tradition. We learned about the immobility caused by the condition, and the practice of ostracizing those afflicted from their families and communities. Not to mention the inability to support themselves or, in the most unfortunate cases, a family of their own.
Looking at these legs and feet, the most common question is — is it reversible? To my surprise, it surely is. The cure? A bucket of water.
Yes, after years of medical training, Dr. Ryan has reverted back to the use of our most natural life-source as a means of eradicating the condition — away from pills, expensive surgeries, and therapy. This was the most intriguing aspect of the lecture. With weekly bathing of the feet and legs, light massage to move the lymphatic fluid, and short yoga sessions, all patients have seen dramatic reductions in their condition.
This may be nothing short of a miracle yet it’s the most simplistic regiment I could have imagined. And a true perspective on Global Health.
In the west, we never really think about how important it is to wash our skin. We smell nice after showering, but so what? No one ever thinks about how exfoliating water is for our skin, preventing the very cracks and sores that become infected.
In the west, we always fantasize about the next genetic revolution, the next miracle vaccination, a twenty hour energy drink…but we forget the very miracles that surround us on a daily basis. The miracle cure exists, and it comes out of your shower head every day.
If I’ve learned anything so far, it’s that doctors are more than practitioners and teachers. They are deliverers. I wouldn’t want to be egotistical enough to say the deliverers of miracles. But for those whose miracles are clean food and hygiene, they might as well be.
And after studying Global Health here at Oxford and listening about the thousands of lives being saved by simple, hands-on aid — it’s hard to see myself going through ten years of schooling and helping Hollywood stars with their flu infections.
After all, who doesn’t like to travel?