I'm going to write about some of my experiences being sick in Latin America. As someone who's collectively spent more than 2 years of their 33-year life (~7%) in Latin America, I've had my fair share of physical maladies. I've had parasites and upset stomachs. I've been sick with regular fevers, and I've accidentally "Drank the Water". I've offended people by informing them where I believe I've gotten ill, and also sent them into a frenzy trying to find out how to help out because of the unwritten socio-cultural contracts of Latin American hospitality.
This could offend my Latin American friends but please know: This is a cultural critique. We're just different. That's all. Now, this is how things go down:
THE CULTURE OF ILLNESS IN THE UNITED STATES
In 1996, the US passed HIPAA, the Health Insurance Portability and Accountability Act. In this act, the federal government laid down a massive amount of laws that govern how medical information is spread. I'm not sure US culture regarding illness is caused by it or reflected in it, but they seem to be parallel. When you're sick with something personal in the US, say, you're shitting a lot, have massive boils, or dealing with infections that deal with private areas, many people keep this information to themselves. If they DO share the information, it's not to be out in the open for everyone to discuss without "patient consent". When initially discussing medical issues, they are private unless we know the person with the ailment is okay with us discussing it with others. This is a socio-cultural practice that DOES NOT translate to Latin America.
THE CULTURE OF ILLNESS IN LATIN AMERICA
I'm painting a broad brush with Latin America here, but it seems to be the theme from Mexico all the way on down to Panama. I don't know about South America, but I can only guess they're not much different considering all nations in Iberio-America seem to have more in common culturally with each other than they do with the US.
Back in 2010, a few months into living in Costa Rica, I came down with a stomach virus. It was causing me to shit at random times of day and was coupled with cramps and pain.
(The American reader will now begin to cringe "stop sharing the details!", as the Latin American reader may be reading intently.)
I made the mistake of informing my friend AT A DINNER PARTY my symptoms, but I didn't tell her I didn't want it discussed with people at the party. She turns to the table of adults and informed them ALL of my symptoms, how I was feeling, and how I was shitting uncontrollably at random instances.
The whole table then gathered around the topic, discussing the symptoms at length, coming up with solutions, and hypothesizing root causes. They even started to make jokes at my expense, which I was too new at Spanish to understand. This event ended up becoming catalyst for a massive week-long depressive episode of culture shock, where I began to think I wasn't fit for this world and wanted to go home.
A table of strangers were discussing, and LAUGHING, about my personal health problems without my consent, I didn't know who they were, and they all wanted to illicit unwanted advice. It was then I learned that the US and Latin America have quite a gulf between them when it comes to discussing medical issues openly with strangers.
THE 'EXPERTS' COME OUT
When you bring up medical advice, whether it was in the US during the Pandemic or Latin America when I was a temporary home for Honduran parasites, you can really tell who respects the science and who doesn't. Many don't. Of those who don't, all of the sudden, they become a fucking medical expert. Completely unsolicited, medically unfounded, 3rd-hand "I know someone who knows someone" stories come down like an avalanche.
In Latin America, I've been told to "take these pills", "drink this juice", "do those exercises" or even "be subject to a jarring 'massage' where thumbs are dug into your forearm past your elbow to help with the pain". The remedies come without sources, medical experience, and some are downright cultural 'old wives tales' that have zero basis in medical theory. They're all personal and anecdotal, but you're expected to weigh this advice with the same level of respect and legitimacy as medical science.
You're subjected to a barrage of pseudo-remedies, and you smile and nod your head thinking, "I wonder where they get this shit." "Is there any kernel of truth to this?" "What about this would actually help, or is it just trading blows for something else?" "Do they even know what's wrong with me? What if it's something completely different?" Ask any follow up questions, you'll fast find that the advice that they'd given works for a range of maladies, no matter how unrelated. This sets off my bullshit alarm but I keep a straight face.
It gets worse.
You need to listen to every one of them, no matter how wacky or crazy they sound. THEY WILL FOLLOW UP. They will ask if you'd 'done this or that' wacky remedy after giving you explicit instructions on where to find that "ginger root to cut into slices and rub on your chest" or "certain kind of fruit pulp to mix with Canada Dry."
If you make the grave mistake of admitting you had NOT taken their advice? THIS MAY OFFEND THEM. They will scoff and say "well, it's your fault now that you're feeling shitty." or "You don't know what you're talking about. My experience has always worked with this." Condescension will reign, pseudoscience is law, don't come to ME when you're hurting ever again because we know YOU DON'T TRUST ME OR MY JUDGEMENT.
THE BLAME GAME
Another story- during my first few weeks in Costa Rica, I saw that my host brothers and mother were drinking water right out of the tap. They wouldn't boil it, filter it, or get water from the delivery men that would go on rounds in the neighborhood twice per week. I've always heard about 'not drinking the water' in Mexico, or Montezuma's revenge, but Costa Rica? Maybe it's different.
When I drank the water it was fine, but it actually started to cause a little knot in my stomach. I didn't have major issues, it didn't send me to the toilet with screaming meemees, but it gave me a bit of a stomach ache. LATER, I would find out that it's just an adjustment period, it's happened to me half a dozen times on trips back to Costa Rica. San Ramon DOES, in fact, have good tap water compared to the rest of Latin America. Some of the best, in fact.
At the time, however, before I'd adjusted, I naively and openly blamed my stomach pain on the water. I thought it was a potential cause. (It was.) This caused an uproar amongst the family. "Costa Rica has the best water in Latin America, and we have the best water in Costa Rica. That's not possible."
"It's probably because of the Nicaraguans that live next door. They probably are to blame because they carry illnesses" (my host family members were openly racist against Nicaraguans).
It turns out, my blaming the water, no matter how accurate, means that I am offending them. It's not ME that's not maladjusted to the water, it's that Costa Rica has bad water, therefore, it's a reflection on their identity. I'd never thought of this before, but I'd soon learn in other instances that you have to be careful about what you blame for the cause of your physical maladies, no matter how accurate.
I mean, when you think about it, our bodies are ~70% water, so I was offending quite a majority of their mortal being.
So for example: if I ate a moldy half-eaten rancid sandwich out of the fridge of Family A, do NOT tell Family A that it's the fault of the sandwich in their fridge. Tell them you're feeling sick and let their imaginations go wild. It's probably the open sewage culvert on the property of FAMILY B, or the dog shit from FAMILY C must've dried up in the sun and blown around our property and got on our food.
It is never, EVER, the fault of your host. You're just going to put them on defense.
THE WORST POSITION YOU CAN BE IN
This will happen to every traveler that dives into the culture of the locals. It's happened to me. At some point, you will be forced to have a choice, and what you do will change how your night goes, or how the people you are with will view you. You will have to chose between 1 of these 2 options:
1) Eat your host's food and get sick, ruining your day or week with pain and an unstable GI tract.
2) Do NOT eat your host's food, and offend them, ruining your social experience with your host for as long as you are around them.
You must decide how to socially navigate these situations. If you decide Option 2, come up with reasons why. "I just ate." "I'll try a little bit but not much." "I'm not a big fan of [INGREDIENT HERE]".
How you decide to move forward is up to you. Food is a massive part of culture, therefore it is a part of identity. If you refuse your host's food, you will offend them. It's best to point the blame inward, even if it's not real.
PUTTING IT IN PRACTICE - THE PERFECT OUTCOME
At the Motofiesta rally in León, food got me sick at TENT B. When I felt sick, I didn't tell TENT A, where I was hanging out and parked, right away. When they started dishing out food at TENT A, I still had to eat their food to not rouse suspicion.
NOT eating would offend TENT A, So I had bread and ate it slow, then slowly added things to it. Even worse, if they asked me why I wasn't eating and I said I was sick, it would send TENT A into a frenzy with remedies, root cause analysis, and potential anecdotal pseudoscience that I'd have to both commit to listening to and lie about following. It's happened to me EVERYWHERE in Latin America. I knew it would here, so I kept my mouth shut, and again-- I ate slow.
I started to feel worse. I knew that I was going to probably throw up at some point, but I didn't want to admit it. I kept going on as if everything was normal, even accepting beers and nibbling on food here and there. I waited until I was absolutely certain this feeling wouldn't go away before I told anyone about it.
Actually, check that-- I waited until I was 100% certain I was LEAVING before I told anyone about it.
I went for a quick walk and a systems check and came to the conclusion I was going home to vomit. The feeling was too strong. I couldn't even finish my beer. When I got back to TENT A after that walk, I started loading up my bike to leave without announcing it to anyone. Someone swung by to see what I was up to and I informed them. Like I imagined, they immediately they ran to tell the rest.
The Gringo is sick and we don't know why. Just like I thought it would, the medical experts all came out and everyone wanted to know my symptoms.
Luckily, I had an alibi. I told them TENT B had offered me food and made me sick. This was a slam dunk because:
1- No one was at fault that I was informing.
2- My blame was placed on someone else that wasn't there.
3- No one needed to speculate because no one was offended that they were the cause. No crazy deflections needed. We know who to aim the blame at and they're not here.
It shut down all debate on root cause, but, of course, the remedies started coming out. I DID NOT WAIT TO LISTEN TO THEM. I told them I have pepto at home, plenty of water, pills I'll take if it gets worse, and electrolytes tomorrow. I didn't wait for remedies. I didn't want to hear it. I told them exactly what I was going to do, UNWAVERINGLY, and I said I felt too shitty to hear advice. I needed to go home to vomit, time was of the essence, and their remedies would have to wait.
I navigated this situation like a professional. Here's how:
-I didn't tell anyone right away when I felt sick. I waited until there was no choice but to act. It was the last minute when I had already decided to leave. Therefore,
-I didn't wait to listen to any advice, therefore,
-I didn't have to offend anyone by NOT taking their advice.
-I had my plan set in motion based on how I know my body and I socially gave no room for debate. Tick tock, Jimbo's gunna vomit.
-No one was offended as to the cause of illness because the blame was elsewhere.
-I didn't offend anyone by not eating their food, I muscled it down and ate it slow.
The next day people were of course concerned, but there were bigger things going on. I didn't make myself the center of attention by informing everyone early, no one felt a social responsibility to take care of me, and I was doing much better after I had tended to myself as I had planned.
There will be more instances of this and I'll unfortunately have to live through them. If they're good enough, I'll put them here again.
Just know that it's a minefield out there, and depending on where you step, it could be on someone's toes, down a deep hole of illness, or a landmine of social rejection.
-JT
3/2/2022