Friday, March 7, 2014

Dealing with discomfort in the rainforest. Foot rot.


Is there a downside to rainforest field work?  Maybe more than one.

There is a downside to field work in rainforests, well maybe several.  As much as the knowledge of natural history or skills at finding elusive critters, a key to success is the ability to put with, endure, or thrive with discomfort.  Not just the discomfort of, say, an uncomfortable mattress or the occasional splinter; I'm referring to constant, inescapable, drive-you-crazy-if-you-let-it discomfort.

Humidity that we escape with air conditioning, dehumidifiers and fans can hang cloyingly weeks on end in a camp.  Nothing is dry.  Put your freshly washed clothes out to dry and basically the liquid water drips out; the fabric stays damp.  Each morning it feels like putting on clothes someone else wore during a workout at the gym. 

The best tactic is to just accept it; change your expectations.  With discipline you can get to the point where wringing out your socks before putting them on is sufficient.  But at the end of a field day one must dry out some, otherwise fungi find the epidermis an ideal substrate.  To combat this, it is best to keep the skin exposed to the open air and liberally apply powder.  A big canister of powder is an essential for a long stint in the rainforest.  The airy Sera field station was ideal-- I'd wear a laplap (the PNG version of a sarong) and dangle my powdered legs off the verandah to dry as I sipped my evening tea.

At Sera we had to wade several rivers in the study area; wet feet were a constant.  There really is no point in being overly concerned if your socks are dry when you then put on wet shoes.  Shoes are impossible to dry, especially when the water is sealed in with a quarter inch of gluey mud.  Rubber boots could keep your feet dry if you took them off for each river crossing, carefully dried your feet with a towel and a bit of powder kept in a plastic bag, then repeated at the next crossing.  Usually that was just too much time wasted; data awaits.  By afternoon water seeps down into the boot from wet vegetation or collected sweat.  You end up squishing around the forest sounding like a moving washing machine.

The constant wet feet could be ignored.  It's just a little water, right?  But after too many long wet days and short dry nights (especially if going out at night to look for nocturnal beasts), a peculiar burning sensation would begin.  It usually began on the soles and between the toes.  Left untreated within a couple days the entire foot could become a matrix of raw red sores.  The pain can become unbearable and you simply cannot walk anymore.  Foot rot laid up Alfred Russel Wallace, who persevered through almost anything, including his ship burning at sea and sinking with all his specimens after seven hard years in the Amazon.  But foot rot stopped him and it used to stop me at times.  Until I found a way to nuke it.

Our hosts, the Pawai'ia, were plagued with a skin condition called grille.  It is a fungus and it can spread over the entire body in finely spaced lines, like contour lines of a topographic map.  These white lines stood out on the dark skin of the Pawai'ia and looked unbearably itchy.  Whenever I felt a little sorry for myself about itching, I'd think of the Pawai'ia dealing with grille their entire lives.  If you cure it, you have to destroy all your clothes and bedding and start with new, something no Pawai'ia could afford. 

We learned that there were two treatments.  An oral pill and a lotion.  Deb and I would purchase these in large quantities at the pharmacy in Goroka.  Unlike pharmacies in the US, we could go in and purchase prescription drugs in lots of 500 or 1000.  One pharmacist told us "We're allowed to sell you almost anything, except the stuff that's really fun."  In our secondary role as health care providers in the upper Wara Oo, we dished out these medicines as much as we could.  The grille pills would go to guys with really bad cases, along with some heavy duty soap and instructions to thoroughly scrub anything that had touched their skin.  This could buy relief for many months.  The milder cases we treated with the lotion.

One day I was stuck in the station because simply putting on shoes was too painful due to foot rot.  It dawned on me grille was a fungus, foot rot is a fungus...  I went to shelves with our tupperwares loaded with medical supplies and found a bottle of the lotion.  Maybe this would help.

I soaked a bit of cotton and wiped the brown liquid (looks like vanilla extract) across the tops of my cherry red toes.  I discovered a new kind of pain.  It was instantaneous and it was an entirely new experience, and I'm not a stranger to pain.  It felt like driving a lit cigarette into an open wound, only worse.  Fortunately I was alone in the station, so my histrionics went unobserved.  Brilliant F#$%ing idea Einstein.  The parts of the foot untouched by the lotion now felt like soft baby skin caressed with silk in comparison.  OK, I thought, a sample size of one is enough for this experiment.

But within a couple minutes an odd thing happened.  The lotion savaged skin stopped to burn.  Completely.  Now in comparison the rest of the foot felt worse.  Two minutes of severe pain could end hours to days of just good ol' ordinary pain.  I resumed my treatment, endured the pain and in a couple minutes was ready for the field.  It was an amazing transformation.  Closer inspection of the label revealed the lotion was a mixture of benzoic acid and salicylic acid (no other ingredients).  That night big hunks of dead skin peeled off, revealing soft, but uninfected new skin below.  The problem of foot rot was solved.  This discovery bought me many more days of productive field time in the years since.

But the biggest joy was sharing this technique with newcomers to the station, experiencing their first bout of Sera Foot Rot. 
I'd tell them "This might hurt just a teeny little bit, but I promise in a couple minutes you'll thank me." 

Oh the expressions on their faces!  From surprise to anguish, then raw hatred.  My best friend's curses would have shocked the Exorcist.  One friend, normally a mild gentle soul, had to be held down to finish the treatment as she tried to kick my teeth out.  But then came the dawning realization that ALL the pain was going away, not just the acid-induced burn.  Meryl Streep couldn't match the range of expression from surprise, to murderous loathing, to puzzled relief in 120 seconds.

Indeed there are some discomforts associated with rainforest work.  But it can be extremely gratifying to teach others how to cope with that discomfort.