By Clytemnestra
If you were reading Dailykos last Friday you may have read my diary on the subject of the Pakistani floods, Pakistan Floods - reporting/working from the inside. It was the first time I ever told Kossaks in a diary or comment that my husband is Pakistani.
During the past 9 years there are varying degrees about how that news is met. Sadly in a too large percentage of time it is met with suspicion, and I am treated as if I'm a naive dupe. So this white woman, born and raised in Denver, CO, just tells people her husband is of another race, and leaves it at that. But I've always wanted you to know him, and the people of Pakistan.
He grew up in the Rawalpindi/Islamabad area of Pakistan. His brother and family are mostly still there (although some live in California). They have been busy for the last few weeks, my brother-in-law, sister-in-law, niece, nephew and extended family doing flood relief work. They are Rotarians. The diary linked above told of the work they were doing and the message my BIL sent us.
When my husband was growing up he listened to Pakistani singers like Nayyara Noor
and Abida Parveen
and many other Pakistani singers. Often he could tune in radio from India and sometimes a western station and he'd hear music from outside the county. He heard the Rolling Stones, Sly and the Family Stone, Linda Ronstadt and others.
Now it's not so hard to hear music and get TV shows from other countries, what with more terrestrial stations, satellite, and the internet. My niece quotes Don Henley's, "End of the Innocence." My nephew "likes" Linkin Park on Facebook and sends me video links like this:
Shehzad Roy is a Pakistani pop star. He is "also the president and founder of Zindagi Trust, a non-profit charitable organization, that seeks to educate the underprivileged children of Pakistan."
My husband did many of the same things children in other parts of the world do. He played Cricket, and Soccer (Football).
With his friends he made crude jokes about teachers behind their backs. Kids are kids, every where.
He studied his lessons, often without any help from his parents. His mother only has a 4th grade education and his father an 8th grade education.
Sometimes, just like kids everywhere he'd tell huge fibs about studying, and be found watching TV.
He was also taken with aircraft as a boy. Military aircraft to be specific. So when an Indian plane came in for a strafing run of a high value target, that unfortunately included his house, he stood and watched, mesmerized. Oblivious, for a few precious seconds, of the danger he was in. He would have been "collateral damage."
In another flare up of hostilities between India and Pakistan he watched a missile fly over his head, heading for that same high value target. He ran for cover in the basement.
I have listened to him talk about those times knowing that the worst man made disaster I faced growing up in Denver was an oil refinery exploding in Commerce City, some 15 miles away (we still felt the blast)
He also contracted Typhoid.
Typhoid fever is characterized by a slowly progressive fever as high as 40 °C (104 °F), profuse sweating, gastroenteritis, and nonbloody diarrhea. Less commonly, a rash of flat, rose-colored spots may appear.[4]
Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. In the first week, there is a slowly rising temperature with relative bradycardia, malaise, headache and cough. A bloody nose (epistaxis), leukopenia, (a decrease in the number of circulating white blood cells). . .
In the second week of the infection, the patient lies prostrate with high fever in plateau around 40 °C (104 °F) and bradycardia . . . Delirium is frequent, frequently calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". . . Diarrhea can occur in this stage: six to eight stools in a day, green with a characteristic smell, comparable to pea soup. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly) and tender . . .(The major symptom of this fever is the fever usually rises in the afternoon up to the first and second week.)
In the third week of typhoid fever, a number of complications can occur:
* Intestinal hemorrhage due to bleeding in congested Peyer's patches; this can be very serious but is usually not fatal.
* Intestinal perforation in the distal ileum: this is a very serious complication and is frequently fatal. It may occur without alarming symptoms until septicaemia or diffuse peritonitis sets in.
* Encephalitis
* Metastatic abscesses, cholecystitis, endocarditis and osteitis
The fever is still very high and oscillates very little over 24 hours. Dehydration ensues and the patient is delirious (typhoid state). By the end of third week the fever has started reducing (defervescence). This carries on into the fourth and final week.
Wikipedia
In his delirium he believed he was Napoleon. Often agitated, he barked out orders to imaginary generals and stands of army. He scared his mother who tended to him day and night.
He almost died.
That Napoleonic delusion proved to be prophetic however as the Typhoid robbed him of his height. He is 4 to 5 inches shoulder than any other adult male in his family. I'm 5'5"-5'6" and he's an inch shorter than me.
The worst illness I ever faced in grade school was a bad case of Mononucleosis.
Living in a third world/developing country has always been tricky. Diseases we take for granted here, kill there.
When I first started getting pneumonias my husband was beside himself. His reaction I couldn't understand, it was just pneumonia, everyone I knew survived it. The first death I had known from pneumonia was Jim Henson. He explained that in his country my survival was the exception, deaths like Jim Henson's were the rule.
Now with the floods Pakistan is facing disease outbreaks that for some diseases we haven't seen here since 1910.
19th August 2010
Sub: Flood relief at Pabbi, Nowshera.
[snip]
Our observation was that the school premises were kept quite clean but still every other person was catching the viral diseases like eye sore, skin rash and stomach upset.
- report written by my husband's cousin to Rotary District Governor of conditions found in Pabbi, Nowshera, .
One of those diseases is Cholera
PABBI, Pakistan — Zahir Khan and his family have survived the floods that have killed at least 1,500 people and left 17 million others in need of help. But on Sunday his wife, Sumeira Zahir, came down with severe diarrhea.
"Many people in our village have diarrhea now," said Zahir, 35, who has joined other farmers in as yet fruitless attempts to pump away the standing water near their homes.
Whether the illness plaguing their village outside Islamabad is a passing ailment or not is the difference between discomfort and disaster, said Asad Ullah, a physician with the London-based medical emergency relief group Merlin.
"The sewage system has mixed with the drinking water," he said Monday. "We haven't seen a cholera case, but, if there is an outbreak, it could be massive."
USA Today
We mention Cholera quite a bit but living in the developed world we may have only a vague idea of what it is and how bad it can be.
What is Cholera?
Cholera[1] is a severe infection caused by the bacterium Vibrio cholerae, which primarily affects the small intestine. The main symptoms include profuse watery diarrhea and vomiting. Transmission is primarily by the acquisition of the pathogen through contaminated drinking water or infected food. The severity of the diarrhea and associated vomiting can lead to rapid dehydration and electrolyte loss, which can lead to death. Cholera is a major cause of death in the world.
[snip]
The primary symptoms of cholera are profuse diarrhoea, severe dehydration and abdominal pain. Cholera may also cause vomiting. These symptoms start suddenly, usually one to five days after infection, and are the result of a toxin produced by the vibrio cholerae bacterium that compels profuse amounts of fluid from the blood supply into the small and large intestines. [2] An untreated cholera patient may produce around 10 litres of diarrhoeal fluid a day.
[snip]
People infected with cholera suffer acute diarrhea. This highly liquid diarrhea, colloquially referred to as "rice-water stool," is loaded with bacteria that can infect water used by other people.[9] Cholera is transmitted through ingestion of water contaminated with the cholera bacterium, usually from feces or other effluent. The source of the contamination is typically other cholera patients when their untreated diarrhea discharge is allowed to get into waterways or into groundwater or drinking water supplies. Any infected water and any foods washed in the water, as well as shellfish living in the affected waterway, can cause an infection.
Wikipedia
For those thinking that the world won't pay attention until the death toll is high enough, that nightmare may be about to come true:
This video from Doctors Without Borders was posted four days ago
These are reports from today:
JAFFARABAD: At least eight people including two children died of breakout of Cholera and other epidemics after deadly floods multiplied sufferings of already ravaged people in Jaffarabad District in Baluchistan, Geo News reported.
The News(Pakistan)
6 children die of waterborne diseases
QUETTA: Six children died and more than 150 have been admitted to the Government Hospital in Sibi, as waterborne diseases are spreading in the flood-hit region of Jaffarabad. Hospital sources confirmed that more than 150 patients, mostly children, are reportedly suffering from gastroenteritis and 70 of them are admitted daily as their conditions are precarious. According to the sources, Zara, 2, Yasin, 3, Ashique Ali, 3, and Talib, 4 – suffering from gastroenteritis – had been brought to the hospital where they breathed their last. Around 70 patients were admitted to Sibi Hospital, while 80 to Civil Hospital, Dera Murad Jamali, who according to doctors were suffering from gastroenteritis. Four children are stated to be in critical condition. mohammad zafar
Daily Times (Pakistan)
and a report from yesterday
.Food supplies have run short in several areas and officials say there is an urgent need to step up the provision of healthcare to prevent the rapid spread of diseases like diarrhoea and cholera.Several deaths caused by waterborne diseases like gastro-enteritis and cholera have been reported from the northwest and central parts of the country.Nearly 30 people were killed or reported missing after a Peshawar-bound bus was swept away by flood waters in Punjab province. Five persons, including four children, died of gastro-enteritis at a hospital in Sibi in Balochistan province.Officials said 200 people suffering from the same disease had been admitted to the hospital. Nine other persons died of gastro-enteritis and cholera in Dera Murad Jamali, Subhatpur and Dera Allahyar areas of Balochistan, officials said.
IBN
Just trying to get to high ground 
through the flood waters that have had flooded sewers/latrines and septic systems flow into them can infect one with bacteria to cause Gastroenteritis.
Gastroenteritis (also known as gastric flu or stomach flu, although unrelated to influenza) is inflammation of the gastrointestinal tract, involving both the stomach and the small intestine and resulting in acute diarrhea. It can be transferred by contact with contaminated food and water. The inflammation is caused most often by an infection from certain viruses or less often by bacteria, their toxins, parasites, or an adverse reaction to something in the diet or medication. Worldwide, inadequate treatment of gastroenteritis kills 5 to 8 million people per year,[1] and is a leading cause of death among infants and children under 5.[2]
At least 50% of cases of gastroenteritis due to foodborne illness are caused by norovirus.[3] Another 20% of cases, and the majority of severe cases in children, are due to rotavirus. Other significant viral agents include adenovirus[4] and astrovirus.
Different species of bacteria can cause gastroenteritis, including Salmonella, Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli, Yersinia, Vibrio cholerae, and others. Some sources of the infection are improperly prepared food, reheated meat dishes, seafood, dairy, and bakery products. Each organism causes slightly different symptoms but all result in diarrhea. Colitis, inflammation of the large intestine, may also be present.
Risk factors include consumption of improperly prepared foods or contaminated water and travel or residence in areas of poor sanitation. It is also common for river swimmers to become infected during times of rain as a result of contaminated runoff water.[5]
Wikipedia
I haven't even gotten to the subject of waterborne measles.
"Our worst fear is the outbreak of waterborne diseases like cholera and waterborne measles," said Sami Malik, a communications specialist at UNICEF in Islamabad, the capital.
I have emailed my in-laws asking them to give all the Tylenol, Advil, etc. that I normally send every 6 -10 months to the doctors if necessary be. These supplies are not readily available in Pakistan. It is why we send an almost regular care package. It may not be much, but hopefully it will help bring down fevers. I will send more in a few weeks.
They may not read the email for a few days because I have been told my another one of my husband's cousins, via Facebook, that they are putting in long hours of relief work.
Why would we take such a special spotlighted view about fevers?
Around 4.6 million people are still without shelter following the wave of destruction wreaked by the worst flooding in Pakistan's history, the UN said. It estimates 20 million people have been affected and a fifth of the country is under water with the risk of cholera, typhoid and hepatitis growing.
Dawn (Pakistan)
To quote my brother-in-law in the last email I received from him
We desperately need help,
Please help
Doctors without Borders (MSF):
DONATE
(August 17, 2010 field report)
UNICEF:
DONATE
Toll free: 1-800-FOR-KIDS (1-800-367-5437)
"Text FLOODS to 864233 (UNICEF) to donate $10"
Shelterbox:
DONATE
• • • • • •
Greg (Three Cups of Tea, Stones Into Schools) Mortenson's non-profit (CAI) recommends supporting a local (Pakistani) group to which donations will likely have a large, immediate, and lasting impact-
Human Development Foundation
http://www.hdf.com
(800) 705 1310
DONATE
• • • • • •
Other groups that deserve support as well.
Doctors without Borders (MSF):
DONATE
Mercy Corps:
DONATE
OXFAM:
DONATE
Islamicrelief
DONATE
UNICEF:
DONATE
Toll free: 1-800-FOR-KIDS (1-800-367-5437)
Text: "Text FLOODS to 864233 (UNICEF) to donate $10"
Shelterbox:
DONATE
ShelterBox tents in Shishkat upper Hunza, Pakistan
• • • • • •
From the US State dept.
How You Can Help:
Text "FLOOD" to 27722. Your $10 will go to the State Department Fund for Pakistan Relief that Secretary Clinton announced August 19, and is part of a new effort to bring attention to the need for aid.
Text "SWAT" to 50555 ; $10 goes to United Nations High Commissioner for Refugees fund for flood victims
Previously recommended relief diaries about the floods in Pakistan (with the Help Pakistan tag):
Aug 24: They're Dying (sister diary to this one)
Aug 23: Forgotten Humanity: Tragedy Continues in Pakistan
Aug 23: New flooding in the south, thousands more displaced - Help Pakistan
Aug 22: Aid Pakistan With Money or Action
Aug 22: Why?
Aug 21: ... and a river runs through it: Pakistan's WaterWars
Aug 21: Help-Pakistan!: Devastation
Aug 20: Pakistan Floods - reporting/working from the inside
Aug 20: Pakistan Relief: Just watch the video
Aug 19: A slow moving Tsunami ....
Aug 19: Anti-Muslim Bigotry: Not just for wingnuts anymore
Aug 18: Pakistan Floods... Please Help
Aug 18: Chaos is the new Normal {Earthship Wednesday}
Aug 18: EcoAdvocates: A green model in the Gulf
Aug 17: Please Help Pakistan... Please ... Update: New Flood Warnings
Aug 16: pakistan III: the human face of climate change: ecojustice
Aug 16: Pakistan still needs help; lots of it. Floods displace 20+ Million
Aug 14: Pakistan: 6 Million Without Water (How to Help)
Aug 9: Media ignores "Worst Humanitarian Disaster In Recent History"
Jul 31: Pakistan needs help. Floods kill 800+, displace 1 Million
We are looking at what may be the worst humanitarian crisis the world has seen in a century, and the worst Climate Change disaster yet.
Some of us at Daily Kos use a Google group to help organize for the crisis in Pakistan. Anyone who would like to get involved or get alerts when a new HELP PAKISTAN diary is posted, please join
( CLICK THE PIC )
