For the most part, I think I had a fairly good set of expectations about living and working in Afghanistan. I understood some of the security procedures, I knew the basics of the housing and living situation, and I knew that the work would be by far the most challenging thing I have done in my career for a variety of reasons. Of course, there’s no way to be completely prepared for this kind of adventure.

And at this point (2.5 weeks), I know there are two subjects that I didn’t fully comprehend when I got here. Worse still, I’m still coming to grips with them.

This post is about one of those subjects: illness. To be completely honest with you, I was told, “everyone gets sick here,” and I fully expected to get traveler’s diarrhea or a cold, possibly both in my time here. Between not preparing your own food and living and working in such close quarters, I knew my time would come. I also know that I don’t have the most stellar immune system so I shouldn’t rely too much on that. So before leaving the US, I bought multi-vitamins, iron supplements (now that I see how much meat is eaten here this seems overkill), Emergen-C, Zicam, and a variety of medicines to take when the inevitable happened.

My first night here I met a co-worker who had been here for about 2 weeks. She lives in my house, works in the same location, and had already met my counterpart. She was excited to give me a lot of background documents as well as contextual information the next day at work. However, a full 4 days after my arrival, I finally saw her again at dinner (need I say looking terrible). And it was a full 7 days before she was actually at work. Initially, she had a debilitating kidney infection, which when treated moved to her bladder, which left her with terrible back pain.

Then a day ago, a mentor emailed me relaying the following about her work with two other gals in Egypt, “we had pneumonia to bronchitis to giarrdea to scabies to every possible infection you name!  Do everything you can to keep your immune system up given the change in habits, diet, and surroundings.” Wow, seriously?! That many illnesses for 3 people in probably 6-8 months time. It doesn’t make sense.

Not only do underdeveloped countries have a lot of diseases and viruses that have been eradicated in first-world countries (hence the multiple vaccinations before coming), but there are other problems, which become clearer once you look over our balcony.

From Wikipedia: “Urban dumpsites are used in lieu of managed landfills in KabulKandahar and Herat, often without protection of nearby rivers and groundwater supplies. Medical waste from hospitals is disposed in the dumpsites with the rest of the cities’ waste, contaminating water and air with bacteria and viruses.”

I would add to this that having flies indoors is way more common and generally accepted than in the US, again, adding to the spread of germs.

So I have learned that the reason “everyone gets sick” is because, unlike in the US where its mostly about washing hands, the air itself is full of bacteria. We know not to drink the water, but how do you avoid breathing? Our bodies are constantly fighting off things unseen, which in turn makes us more susceptible to those bizarre illnesses we rarely hear of.

I can now add one final reason that expats get so sick. Antibiotics are amazing in fighting off bacteria, but they don’t necessarily fight only the bad bacteria in your body. They also affect beneficial bacteria, making one, again (are you tired of this yet?), more prone to get sick with something else.

This is where I come in. I took a round of antibiotics, and now I have, what I’m hoping is only, a cold.