Tuberculosis, Peru & Me

I was cuddled up in bed last night reading a great book, Mountains beyond Mountains. I was about half way through the book about an amazing doctor who was working to alleviate infectious diseases in Haiti. This man had a love affair with Haiti and didn´t have a big desire to spread his focus. That is until, and I quote, "MDR [multi-drug resistant TB] claimed a close friend who had been living in a shantytown on the outskirts of Lima, Peru". That was the last sentence in that chapter. I had to put down the book as I processed what I just read. The process consisted of my inner dialog letting out a big Whooooaaaaaa.

I totally live in shantytown on the outskirts of Lima. I picked up the book and read the next chapter of the Author describing his first experiences with Peru. Here are some exceprts of how Tracy Kidder recounts his first trip.

"I gazed out the car window at hillsides smothered in darkness but doted with twinkling lights, as if by Japanese lanterns, pretty in the night. "Lima doesn`t seem like the third world" I said.
"Oh, yes it is," said Farmer. "You`ll See"
Lima is a vast coastal city, vast and dry. In the daylight the northern neighborhoods seemed like an endlessly spreading slum, the roads chocked with traffic and with motorcycle rickshaws and minibuses that served as public transportation, and the banks of roads littered with broken-down vehicles and garbage, and garbage on fire, and with ramshackle-looking development, like American strip malls that had moldered before being completed...the sun filtering down through thin fog from the Pacific, then through the perpetual ground level strata of dust and hydrocarbons.....The Hovels were perched on the sides of steep, gray-brown hills---giant heaps of sand and rock and nothing growing on them, except for the shacks....The air carried a strengthening smell of urine."

I don´t know if I could have described such a desperate scene so elegantly. I feel like I have tried, but reading this gave my sentiments words. The reason the book turns from focusing on TB in Haiti to Peru is not because of an epidemic or improper health care. The World Health Organization actually claimed that Peru was the most successful of all developing countries at following the recommended proceedure by the WHO to eradicate the disease. The problem they found in Peru, is that strains of medicine resistant TB were more present than the current government would like to admit. This part of the book took place in the mid nineties. And I haven´t finished the book yet so I don´t know what type of treatment they have come up with for MDR TB.

Then I remembered my site visit back in August. My PCV predecessor told me that our doctors informed her she had some kind of TB. This isn´t that big a deal necessarily, she told me something along the lines of having TB antibodies in her, and it wasn´t the full on disease. The doctors were putting her on 9 months of medication to prevent it from turning into anything serious. I didn´t really understand what that mean, and to be honest, I still don´t fully understand it. I know now from reading this book that 2 billion, approximately one third of the worlds population, have some sort of TB in their system. But what I realized last night, is that MDR TB is common in Peru. Perhaps my predecessor had one of these strains that wouldn´t be cured by her 9 month treatment.

What`s even more scary, is that I took her place. During site visit I stayed in her bed and eventually moved into her home and into her life. I lived with the same family and worked with the same kids. TB is airborne and it is likely I have come into contact with whatever she had. I`m not saying I`m terrified, nor am I that worried, really. It`s just something I never thought about. Getting some crazy disease was my worst fear joining Peace Corps. TB is not something we think about much in the US and therefore never even crossed my mind as something I could get. I have my one year med checks in August and will find out then if I have contracted anything. Strangely enough, since I leave the day after my med checks, if they do find something, I will likely be in the states when they get the results. I`d hate to have some fiasco like that guy on vacation in Italy who sneaked into the states through Canada when he wasn`t permited in the country after he contracted TB. Again, highly unlikely, but you never can be sure.