Thursday, July 3, 2008

Ancient Remedy: Modern Outlook

As the heat wave struck the west coast of America, farm workers had to cope with temperatures upwards of 90+°F. Many such workers are what they euphemistically called undocumented, a term describing illegal immigrant workers who has helped to keep fruit and vegetable prices at about half of that of the UK and most of Europe.

Disaster struck last week, one such 17 year old girl collapsed with heat stroke and died two days later. She was said to have a core temperature of 108°F when admitted, and also found to be pregnant. Her employers instructed the family to tell the hospital staff that she was out jogging. In a vineyard in California. How creative!

Governor Schwarzenegger attended the funeral and said: “This land gives us a lot of opportunities but gave her death, and we have to make sure this doesn't happen again."

Such happenings are not limited to the US. In 2004 some illegal migrant workers from China drowned while picking cockles at Morecambe Bay in England.

Chinese farm workers have always worked in the heat of the fields but heat stroke seems to be rather uncommon. I wonder if our dried preserved plum has something to do with this.

Preserved Plum---Batou
The Chinese preserved plum is said to quench thirst, and as a child I could never really understand the rationale. Now I know. It is preserved with salt, sugar and herbs such as licorice by a complex process. If you suck one of these plums and then drink water, you have the combination of sugar and salt that carries the salt back into the system. Why plums? Like a lot of fruits, plums contain potassium. This is oral rehydration therapy (ORT) the ancient Chinese way, before the science of modern ORT.

It has to be said that the diet of many such Chinese workers was generally higher in sodium, from dried salted fish and vegetables. It is likely that the serum sodium of many such workers would have been at the high end of the normal range. Modern advice on cutting down sodium often does not take account of sweating in hot countries. A friend of mine with hypertension had an epileptic seizure when he went to work in Singapore. Luckily the medical services there were alert to the problem and he survived. He was on a low sodium diet and on diuretics amongst other medications.

I also remember one very hot August day when we hiked down Grand Canyon to Angel Point. There were warnings everywhere of the risks and even fatalities on such walks. The National Park did have clean drinking water taps along the way and one particular girl overdid the drinking. She had a narrow escape, as the Ranger fortunately knew a thing or two about rehydration. He put some salt in a can of Sprite and reverted a potentially serious situation.

When the first public golf course was opened on the beautiful island of Kau Sai Chau in Hong Kong, drinking water was provided along the course. One player drank so much that he nearly died of water intoxication (result of drinking excessive amounts of plain water which causes a low concentration of sodium in the blood leading to amongst other problems: ‘brain’ swelling---cerebral oedema). Marathon runners are at greater risk than most as reported by the New England Medical Journal. There have been other notable cases of water intoxication elsewhere. I remember one of my professors telling us: the body survives dehydration much better than drowning. How right he was, as water intoxication is in a sense a kind of drowning.

The first time we went to Thailand the most amazing dip was simply a bowl of sugar that has been mixed with salt and some chopped chilies for good measure. This dip was used for serving unripe mangoes, papayas, guavas and other local fruits, and gave me a taste sensation that was unforgettable. Same principle as ORT.

In Thailand, workers in rice fields, fruit orchards and vegetable patches manage to survive temperatures of over 100°F.

Governor Schwarzenegger did legislate in 2005 and had stringent rules for farmers regarding health provisions such as toilets and water stations for their workers. However, rules get broken often because of cost. Technology is there for safe rehydration. Remember Gatorade? If Governor Schwarzenegger was to legislate for the employers to supply Gatorade, imagine the impact on the price of fruits, vegetables and wines: probably doubling or tripling!

On the other hand, Chinese dried plums are such neat, little, easy to carry things. Perhaps we should try to popularize this ancient remedy for the benefit of all. Be warned, only those made with sugar and salt work, not the ones with artificial sweeteners.


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