Failure to Thrive

When you’re slidin’ into first, and you’re feelin’ something burst: diarrhea, diarrhea…

My brother and I got a lot of mileage out of this little diddy from the movie Parenthood when we were younger. We could sing it over and over again and make each other laugh every time. I wonder now if we even knew what real diarrhea was.

That song has come to mind many times since we’ve moved here and have had to come to terms with this unpleasant part of living in sub-Saharan Africa. It’s become such a ubiquitous part of life that us expat wives talk openly about it. Each day we catch up on gossip, recipes, vacation stories… and how things are going in the bathroom.

I’ve totally forgotten that this is a taboo subject back home. I should probably be carefully monitored at cocktail parties when we move back. But here, talking openly about “our plumbing,” as a friend calls it, is nearly as common as the weather or the newest restaurants nearby. (Which, often, are tied closely together.)

We all have it from time to time, as do our husbands (sorry, honey), and we want — nay, we need — to know what’s normal and what’s not. Should I avoid this brand of chicken, or that kind of fish? How about the local boiled peanuts? These talks have led us to debate whether vinegar or bleach is best for rinsing local vegetables, whether we need to boil our tap water, and whether the bottled water from Lubumbashi is safe. (Answers: bleach, yes to be safe, and not always.) Swapping stories about who gets sick, when, and how often has led me to skip more and more of the company buffets — or to at least skip the salads when I go. “Boil it, cook it, peel it, or forget it,” as they say.

I’ll never forget the orientation we received our first few months here, and the Congolese trainer who said with a straight face that we should “never shit in the river.” As if we would ever do that. Or the expat doctor who explained that diarrhea wasn’t really serious until you had it three or four times a day for three days in a row. (Yikes!!)

Our frank chats became even more important this past rainy season as cholera hit our area again after several years without incident. That’s when we stepped up our bleach-and-boiling routines. We also noticed these lovely reminders posted around town, re-educating people about the importance of hand washing, and presumably not shitting in the river.



I don’t mean to sound cavalier or condescending about this topic. Quite the opposite. I think this education is incredibly helpful, and necessary. Diarrhea is serious business. It’s the second-leading cause of death for children in low-income countries around the world. (Click here to learn more and, as they say, join the movement! Love their hashtag: #giveacrap)

It’s easy to become complacent about things like this, or to assume that we are immune or isolated from these sorts of problems. But we buy a lot of our vegetables from local farms, just like everybody else. One day our maid was showing me how she prepares the local choux de chine, or chinese cabbage. As she poured boiling water over it to rinse it, which I questioned, she politely tried to explain that the cabbage grows in fields, out in the open, along with produit (product) from the local farmers. Eventually I figured out she meant the produit was fertilizer of the human kind.

None of us expats came down with cholera this season, thank goodness, but Seb and I do suspect we’ve been afflicted with the common long-term expatriate bug known as giardia. Our expat doctor thinks pretty much all of us who’ve lived here for any length of time have got it to some degree. (And he should know. He and his wife are adventure travelers, and figures they’ve caught nearly every bug under the sun. His wife even wrote a book with the compelling title, “Only Brave Men Fart in Kisangani.” I’d like to find a copy.)

Giardia is a protozoan caught from contaminated food or water, and could easily be living in our tap water since the pipes have suffered from cracks from time to time. It’s known as Beaver Fever back home, as people usually catch it by drinking water from contaminated streams. It causes diarrhea, of course, as well as a general malaise, often described as “the failure to thrive.” Which strikes us as funny for some reason. But it sounds about right. Seb and I started a round of metronidazole today. Hopefully we’ll be thriving again soon.


    1. Mark and I hope you will get better soon. How many years do you have their before you move back?


      1. Thank you guys! Honestly I’m hoping we’ll stay here for a couple more years… because Seb keeps saying that I’M the one who will have to work next while HE stays home and cooks!!


    1. You know, Sara, you’ll probably be put in charge of monitoring my small talk at cocktail parties when we return to civilization!


  1. Only Brave Men Fart in Kisangani…. Lol après votre visite en juin dernier je trouve le titre intéressant!!


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