Cultural differences

Being sick, here and there

1:17 PM

The cold, the flu, and other little normal little health issues that are bound to find you at least once in your life are universal, you will fall sick just the same anywhere on the planet with these, but how people try to gain control over the sadly not so controllable is widely cultural. Each culture has their “miracle cures” for cold, saying, set of advice, what to do, not to do, when to go to the Doctor, when to stay home…
One thing that has surprised me from the start in India for example is how those who can afford it tend to run to the doctor at the first sneeze. And it doesn’t help that getting to see a doctor in India is made quite easy with the no appointment thing going on.
In Switzerland you need to phone your GP, tell the medical secretary on the phone (or the nurse in some practice) what is going on, and she will then book your appointment for a few days later, you won’t get a same day appointment unless it’s urgent and even then you need to stick to the slot allocated to you, most practice reserve the late afternoon and the early morning slot for these emergencies but even then you aren’t really guaranteed to get in, Doctors are booked tight, if you need a doctor after hours, you can call a hotline called “SOS doctor” and they will dispatch a GP that is part of the system and on duty to work extra hours that day/night, they come to your home, but they have limited equipment and you might end up having a paediatrician ring your doorbell to treat you as you can ask for specifics here, and if you are really really sick there is always the ER. Unlike India you can’t see a doctor in a hospital OPD just like that, doctors have a practice on the side to see patients. So if you go to hospital that is ER and that mean you have to go through triage, and can spend hours there, they won’t just go indulge someone that come with a sniffle and a 101 degree fever.
As a result, pharmacies in Switzerland bridge that gap, with pharmacists having a degree allowing them to prescribe basic medicines should the need arise, and train their staff to recommend OTC medicines…noteworthy thing: you can’t under any circumstance get a pharmacy to sell you a prescription medicine simply because you asked for it, it will be a no-go. You need a valid prescription from your doctor and your compulsory health insurance details which will be then entered in the pharmacy’s database. The prescription note is then kept by the pharmacy and sent to your insurance company along with the receipt of purchase (you don’t pay any money at a pharmacy for prescription drugs) the pharmacist then put a sticker on your medicine pack with all the details regarding the dosage your doctor has prescribed. That way you can’t re-use an old prescription the way a lot of people in India do.
If you go to the pharmacy with a cough and fever, they will advise you which cough syrup and pain killers you need, remind you to go to the doctor if the symptoms worsen or persist beyond 3-4 days, and most people will just wait at home, take rest and drink plenty of fluids while monitoring their symptoms, since most companies require you to have a medical certificate for sick leaves beyond 3 days, you end up going to the doctor anyway, but as a regular patient who booked a regular appointment (you are charged extra for emergencies by the way, and insurances would not like it much seeing they have to fit the bill for more than a handful a year).

Doctors in India are antibiotic prescribing happy…in 10 years in India I have been prescribed more of these than I have in the previous 25 years of my life. In Switzerland doctors to not joke with antibiotics, they will not prescribe them unless you are truly sick and in need of them to get better and only after testing you to see if your infection if bacterial, if it is viral antibiotics will not work…at all, yet I have loss the count of the time I went to have a fever checked to rule malaria or dengue out, been listened to my chest as the only diagnosis tool and then told “It’s a common cold (a VIRUS) and here take this 3-4 days antibiotic course. The first few times I fell for it, the cold doesn’t go away because of them, the doctor had to prescribe several other medicines to counteract the nasty side effects of antibiotics turning me into a pill box, when all that would have been needed then was just rest, since no blood test or mucus analysis get ever conducted you get prescribed medicines not knowing what you have. I now just don’t go to the doctor unless the fever last more than 3 days, voice my concern of mosquito borne disease, and once I hear it’s common cold, trash the prescription, I kick the cold in the same 7-10 days with rest, fluids and paracetamol. Antibiotics do not get rid of it any sooner at all.

But each time I dare saying I got sick I have many friends and neighbours asking if I went to the doctor, would it be for me or Ishita. A small tummy upset in the middle of the night usually also warrant an urgent trip the next morning to the hospital’s OPD without even giving light food or plain water a try for some. And apparently unless a doctor prescribe the no brainer “Take rest” you are as an individual not educated enough to know that when you just came down with a fever the best thing would be to at least wait 24hour and the occurrence of more symptoms before panicking…been there on a trip to Lucknow with Ishita who triggered instant panic in my in-laws house the minute she started sleeping off a fever that I pointed out might just be viral…no dear off to the paediatrician we must go. Doctor who pointed the exact same thing to FIL and said that without any other symptoms she could only conclude it was a viral fever, asked us to let Ishi rest, give her crocin to reduce the fever if it got to high and call her back if things change. Not surprisingly my in-laws started questioning the doctor for not prescribing antibiotics, my BIL even said we had to go to ER to see a better doctor, at which point both me and my SIL told him it was a stupid idea because kids do get fevers now and then and going to a germ infested place such as an hospital would make things worse. For 3 days MIL, FIL, BIL and neighbouring relatives all went about how it would be better to seek a 2-3-4-5th opinion, watched over Ishita like hawks for the first sign of her passing out and being ICU material, I got sermoned…ok no scolded silly by MIL about not having her in thick woollens, a thick quilt and possibly a few more layers on top of that because you need to feed a fever with more heat, hearing that my SIL ran after me urging me not to do it as it would only steam Ishita and give her a heat stroke, I knew it and reassured her I planned to ignore that one, DH was pulled in all direction, and pretty much sure that we were all incompetent to deal with Ishita’s sickness, but at the end of day 3 Ishita was her old usual normal self, proving that the doctor we saw was as right as both my SIL and I were.

And of course let’s not forget the folks cures, in Switzerland interestingly the relief treatments for a cold and flu are all thought to be deadly in India. I grew up being told even by doctor to eat yogurt and popsicles to treat a sore throat and make it more comfortable, soothing the fire. In India apparently eating yogurt, and ice cream or even drinking cold water is a big no no many will actually go as far as cold water is what CAUSES you to catch a cold…when a cold is a virus that has been named the common cold because it’s more prevalent in Winter month due to the fact the air in indoor space is stale, more humid and offer a perfect breeding ground for these seasonal aliments.
Another common doctor recommended soothing technique for when you are coughing your lungs out is to go in your bathroom and have a nice steaming shower that will warm your chest, dilate your lungs and let you breathe easier, then dress in your clothes, dry your hair and head to bed. In India apparently even taking a shower after sunset when you are healthy and the temperature is 90 degrees it is considered bad and will lead you to have a cold…but then taking a shower in the morning in the Winter is less dangerous than taking a midnight one in the super hot Summer. If you dare question it, people will tell you that India is dirtier than Switzerland and therefore showers at night must be avoided….yeah bringing an entire day of sweat and grime and pollution to bed is of course far safer!
Then there is the things like drinking tea and soup that is accepted on both side, but lead to more cultural divides, in India the food must be hot but bland, unless you are South Indian at which point Rasam is said to be a cure for cold by some, but has North Indian shake their head because of the “no spicy food while sick” rule. In Switzerland we believe into “grogs” or hot water mixed with a cheap spirit like brandy and topped with honey, in India well alcohol is that thing you drink but should not socially acknowledge. Kids in Switzerland rest assured do not get brandy, we have paracetamol and lemon powders to mix with hot water should the cold be too extreme, and herbal infusions of all kind if it is not. India has Tulsi, which works as well as anything really, since all these treatments are only there to offer relief from the cold symptoms at the default of curing it (there is no cure for cold, you let it run it’s course). In the soup department, there is chicken soup, which is not a good option for many in India, and has the vegetarian option of tomato soup (Rasam being a South Indian version of it).
It seems that in India the emphasis is on eating things that are believed not to exacerbate the cold with a one size fits all approach, while in Switzerland the approach seems to be more of a “whatever rocks your boat” with the emphasis on eating and drinking what will go down and make you as an individual confortable, some like hot drinks and foods and that works, some prefer sucking on popsicles and eating fruit yogurt and that works too, in the end when it comes to a cold the only saying that is true is the good old :

“Go to doctor for your cold and it will be gone in 7 days, wait and do nothing particular at home and it will last a week”.

But as long as I’ll be in India, I’ll have people asking “Did you go to the doctor”? the minute I cough and ask if I got tablets for it.

12 comments

  1. Beatrx2:34 PM

    Even though I am a physician my Indian husband will not believe me that your typical upper respiratory virus ( and or flu) simply has to run it's course. Yes, we can give you things to alleviate the miserable symptoms that accompany the virus - but that's about it.

    Like most Indians he will go to the doctor for the slightest ailment & of course expect to be seen by the doctor in minutes.

    He does not believe me that in the US unless you are darned near dead & it will take you usually a 2 week wait to get an appointment to see an actual doctor.

    I too am still shocked at the overprescription & random choice of antibiotics by Indian physicians.

    Ciprofloxacin seems to the the antibiotic of choice for EVERYTHING- from toothaches to tuberculosis . Yes, Cipro is a broad spectrum antibiotic but it is also contraindicated in the US for kids & pregnant women.

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  2. Another thing I find super disturbing with antibiotics is that they are sometimes prescribed as a preventive medicine...just in case you get a secondary infection from a virus, and sometimes even said that taking the antibiotics will prevent the secondary infection. With how casually antibiotics are prescribed I really worry about bacterial resistance, there is already a antibiotic resistant TB thanks to ill-prescriptions and patient not following medicine courses properly, I see the problem getting only worse if that attitude doesn't change.

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  3. Krishanu8:58 PM

    So true, so true!

    The myth of contracting a (common) cold, when you are out in the cold (weather) is never, ever going to die. Even Indians who live in outside India cling on to this balderdash.

    "..and therefore showers at night must be avoided….yeah bringing an entire day of sweat and grime and pollution to bed is of course far safer!" - oh boy, the numerous conversations I've had with people trying to make them "see" the truth in front of them!

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  4. A few months ago, in the dead of Mumbai Summer I was at the playground with Ishita and she was having a blast playing with the sand and getting all messy. Then a lady asked me how I deal with the sand before bed time at home and I said "We get a shower" and she replied by "But she will be sick, you can't do that". To whcih I replied that in Switzerland we all shower before bed and it never even get as hot as it is now. But apparently "That's different Switzerland is clean" oh dear! I told her that in 4 years Ishita had never been sick from a after sunset shower, but the lady was not convinced, she kept yelling at her 2 years old to keep away from the sandpit because it's dirty instead, leaving me the deranged firangi to do it all wrong.

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  5. apple1:38 PM

    India basically is hot and humid most of the time. Evening shower is relatively safe in scorching summer months because of the dry heat. Evening showers in humid conditions often lead to cough and cold because the air is already filled with all kinds of viruses. The air is hot but the sweat makes you cold. This fluctuating temperature is ideal to make someone sick. India's hot climatic conditions are conductive for breeding of all kinds of germs. That is why it is easy to fall ill in India and then contracting something deadly like typhoid or chicken gunea. That is probably why people are hyper about going to doctors. Western houses are climate controlled most of the time. People are also impatient and do not want to spend a week in bed which leads them to take antibiotics.


    Chemists prescribe medication for cold and stomach upset which is probably not the right thing to do. Though homeopathic medicines are good for children as they do not have any side effects. If they are used in the beginning of the ailments why symptom appear, they are very effective.

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  6. srcgreen014:36 AM

    Somewhat true, but all bets are off when you're dealing with a sub-tropical climate and especially a country that is urbanizing far too rapidly. Bacteria proliferate in India that would eat your Swiss bacteria for breakfast. Heading off a secondary infection is very, very important. A virus may run its course in cooler, temperate climes but will most likely turn into some serious bacterial infection in sub-tropical, highly polluted urban India.

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  7. Houses are not that climate controlled in Switzerland, there are laws about when buildings are allowed to start heating it and we have no AC, so basically the heating is allowed in buildings from November until March, not beyond. And this whole change in temperature is what makes one sick is the biggest idiocy ever, no it's not, it's your body strength, if you are tired, and stressed your immune system can't cope and is not going to fight viruses as efficiently, nothing to do with the outdoor teperature at all, change of season means the body need a few days to process the information and can make one more prone to catching a cold, but it's not the cold that triggered the disease, never by a long shot, yet this myth has an enduring life. In 10 years in India, I haven't been more or less sick than in Switzerland, I still do about one cold or two a year and that is about it, a clear constant in my life, the colds I had in India were by no mean worse than the one I got in Switzerland either.

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  8. Funny then that in 10 years in India I have been no more sick than in Switzerland and after two trips to the doctor for a cold and a course of antibiotics that never worked I gave the whole institution the finger. My colds in India are behaving exactly the same as in Switzerland, viruses the world over run their course, the risk of secondary infection in India is no higher...clearly I would have been sicker if that was the case. And no taking antibiotics before a secondary infection strike will not prevent it from happening, it will destroy all the good bacterias in your body instead, the reason why doctors prescribe stomach medicines when they do prescribe antibiotics. The biggest risk from this antibiotics craziness is the developping of super bugs, there is already a strain of antibiotics resistance TB out there, created through both doctors and patients not taking antibiotics adequately.

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  9. Yes, these things can be treated with herbs like Giloi leaves but these are not readily available. People would rather take antibiotics than go on a wild goose chase to find such herbs. Secondly, herbal treatment is typically slow. You cannot afford to lie in bed for six days and let the infection run its course when you have important meeting in office. That is why people take antibiotics.


    Children are more susceptible to these infections and they probably need more protection. I fully agree that there has to be an alternative for antibiotics. You must be exceptionally strong but most people have become weak eating adulterated food and inhaling poisonous air. We are suffering from aches, pains, allergies which were not even there 20 years ago. According, to reports urban Indians are suffering from Vitamin D, Calcium and other deficiencies. Children and adults spend their times in ACs rooms, eat junk food, thereby weakining their immune systems.

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  10. Reason why I let Ishita play in the dirt and spend hours outdoor.
    that said cold and flu are VIRUSES they do NOT respond to antibiotics at all, antibiotics can only kill bacterias from a bacterial infections, so they are a useless waste of money when one is dealing with a common cold, the two times I took them on dorcotrs advice in India for a common cold, my cold still did last the same 7 days or so with zero improvement from them over the 5 days course, when I have taken antibiotics to treat a bacterial infection correctly (as in a mastitis) the effect of antibiotics usually kick in 2 days and the course must be completed regardless.

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  11. Letting Ishita play in the dirt is the single best thing you can do for her to help build her immune system at this age. Here in the US we had a lot of news reports a few years back about people taking too many antibiotics and how this had increased the resistance of the germs to antibiotic treatments. We used to give people antibiotics for everything too but found it to be a bad idea in the long run. So now people are not as likely to take antibiotics because they know it could only hurt them later. I think India may need some campaigns like that. I was handed antibiotics for just about everything. One western educated doctor I saw had a standard package of medicines he gave everyone, regardless of their ailment that included antibiotics. Needless to say when I realized what he was doing I quit going to see him but still it's a twisted practice.

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  12. There are also the cases where antibiotics are needed but not prescribed correctly. I had that happening to me when I got my first mastitis, the Doctor that saw me quickly just scribbled the name of a medicine, asked me to take it for 5 days, reminded me to continue breastfeeding and left. The antibiotics managed to help clear the infection 5 days later the course was finished and I was feeling ok, a few days later the mastitis came back in the same breast and same spot with a vengence, this time I saw the head doctor of the department who was the one who also filled in when I gave birth and upon seeing my previous prescription could not hold her tongue and say "What an idiot that woman was! She prescribed the wrong antibiotic" then upon checking my breast said the infection recurred because it hasn't been treated well before and worsened to the point of her wondering if the abscess would actully need a surgical drainage, but decided to first try to treat it agressively with super high dosage of the correct antibiotic for 4 days and telling me to come back after that, then upon my second visit told me to continue the same antibiotics at half the strenght for another 10 days, this was the only way to clear the infection to the root. And I could have been spared the agony of going through a second mastitis should the first doctor I saw cared to prescribe the correct medicine.

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