Thursday, May 14, 2015

Health & Wellness

When dad and I journeyed to Mongolia last summer, it didn't require any special vaccinations or health considerations beyond taking an OTC anti-diarrheal along for the trip. Since it's a generally colder place, we didn't have to worry about tropical illnesses or nasty bugs. Though they do have mosquitos much like our own. But now that I'm looking to LIVE there, the health considerations have expanded. After visiting my doctor for some regular preventative measures today, I learned I have a few shots coming my way!

First, I will get a tuberculosis test and a Tetanus shot early next week, back at my doctor's office (and covered by my insurance). They couldn't do it today because the TB test, if positive, presents in 72 hours and therefore they don't do the test on Wednesdays or Thursdays. I haven't had a tetanus shot since I went off on my deployment in the late 90s (at which time I also got the Hep A vaccination). 

My doctor was kind enough to go to the CDC travel site to see what is recommended for Mongolia (for an extended stay). The doc encouraged me to call El Paso County Health for a nurse consultation to find out exactly what I needed. He couldn't imagine that I'd really need the rabies vaccination.


Black dogs in UB
BUT...he was wrong. Come to find out, it is HIGHLY recommended, especially for those staying longer than a customary tourist visit, to get the rabies vaccination. It does make sense .....considering the country has 45 million domestic livestock alone. And don't get me going on the dogs! There are dogs everywhere. And I couldn't tell you what breed they are...but they come in all colors. Black, red, yellow, brown, blonde. Most seem like a mix of some sort of hound and border collie....or rather a breed I recently encountered, the Anatolian shepherd. And in my estimation....black dogs dominate! And yet, not a cat in sight. Dad and I saw well into the triple digits for canines in our three week stay, but I saw just two cats. SO...I will also go next week to get the first of three shots towards my rabies vaccination (1 x week for 3 weeks), and will also get a vaccination for typhoid (probably NOT covered by insurance...though I will submit them anyway, just in case). 

The nurse also encouraged me to periodically get a tuberculosis test once I'm in country. Sure enough, Mongolia "is one of the seven TB high burden countries in the WHO Western Pacific Region." It is interesting to compare the incidence of TB per 100,000 around the world. In the U.S....we have just four cases per 100K, but Mongolia and a number of other countries are 100-200 per 100K. This is NOT an astronomical number or anything....but I am a bit alarmed (there ARE some countries in the thousands).  (If you want to know more about the state of health in Mongolia according to the World Health Organization, click here and you can access their 2011 report. Looks like I have my weekend reading.) 

As I made my calls today to get information and to make appointments....I confess I got scared. Particularly about the tuberculosis piece. Though I do need a test to present as part of my "application to marry a Mongolian citizen" (stay tuned for a different post on that topic), I hadn't known it was something that I could/should be concerned about. So I'll get the test and have the proof that I don't have it (I'm assuming, of course), but I will also heed the nurses advice to steer clear of people with a serious cough, especially on public transportation or in confined places, and will also get tested on a regular basis. 

This made me reflect on our safe and sanitary existence here in the USA. I go everywhere and anywhere and never really think about getting a disease from others. There are doctors and hospitals everywhere and we feel so safe with our health insurance and access to information and government agencies. I'm sure I will miss the familiarity of these places and organizations. I suspect I will find myself frustrated at some point that healthcare there doesn't work like it does here--as familiarity is its own type of security. And maybe we don't worry about TB or typhoid or rabies....but what about all the Americans that are on medications for any host of issues: obesity, diabetes, high cholesterol, high blood pressure, autoimmune issues, etc? Are we not suffering from "first world" health problems--poor eating and exercise choices, and an ignorance around stress? 

So...while I wrestle a new fear into submission, I'm focusing on the fact that I will perhaps need to be aware of those around me and stay on top of TB testing, but I will trade this in for a way of life that is easy-going. Mongolians DO NOT over-schedule themselves or get wound up about the little things. In fact, my female Mongolian friend in Denver laughed at me when I tried to schedule a dinner with her a month ahead of time. She kindly advised me that Mongolians don't plan so far ahead. When I asked her three days out....no problem! :) 

Yes, I will have some adjusting to do and will require a paradigm shift. I will have to let go of my assumptions and expectations about life in the West, to embrace and enjoy a new life in the East. Every option or choice has its advantages and disadvantages....and my love and future is in Mongolia. 

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