Monday, February 11, 2013

Nepal 2012 Ostomates Only - Disposals

Traveling in the 3rd world. Moving every day for 36 days. Staying in tents and lodges. What do I do with poop and used ostomy supplies?

Toilet facilities are a difficult adjustment for many people, especially for non-ostomates. Many times, members of our trekking team would wish for an ostomy, so they could avoid using these toilets.

Here is an example of a typical, clean toilet. For non-ostomates, the procedure is to squat on the 'bear paws', and dump in the porcelain bowl. The plumbing cannot handle toilet paper, so 'soiled tissue' is tossed into the red basket (to be later burned by the proprietor). To flush, you fill the red jug with water from the black barrel and swish it down the bowl.  Any 'misses' are to be cleaned with the brush.  Even after weeks, some people don't really adjust.
Plumbing in Nepal is weak. The pipes are small, and flushing is low volume. Hence the need to burn 'soiled tissue paper' rather than flush it, because it plugs the plumbing pipes. 

At home I used Convatec single-use closed-end pouches ... 1 per day. Normally I get 5-6 days use from a flange (with the exception of heat and cold problems. See Ostomates Only - Heat Induced and Ostomates Only - Cold Induced).

From my experience in Nepal the year before, I knew that disposal of a pouch every day was difficult. I experimented at home and decided to use the the ColoMajic liners. I used 1 liner each day, and a pouch lasted 5 days. Disposal would be much more convenient and environmentally-friendly, and I would carry fewer ostomy supplies.

In practice, in Nepal, the ColoMajic liners were an amazing improvement over single-use pouches. Following is my experience on disposals during my Nepal 2012 Adventure.

Sit Toilets 
At home, I would just drop the liner and contents into the bowl, flush, and its gone ... never a problem.  With the weak Nepalese plumbing, a single 'flush' was seldom enough. Of course there was never a plunger, and after my first event I learned to squeeze to remove part of the contents before dropping the liner into the bowl.  

Bear Paw Toilets
I just dropped the liner and contents into the bowl. Usually a single 'flush with the water jug' was enough. Sometimes it took 2-3 flushes, but the bowl always cleared.  

Pit Toilets
Colomajic Liners were easy ... just drop them into the pit. It's all biodegradable, like the rest of the contents of the pit, except for the small amount of plastic in the liners. Colomajic is now developing a new biodegradable liner, made of cornstarch, that I will take on future adventure travels.

Trail-side Stops
Natural cycles didn't always match our trekking schedule. I pass most volume between 9am and 10am and prefer to change liners at mid-morning.  But we often started trekking at 7am, so by mid-morning we were nowhere near our tent site or lodge toilet. Sometimes I was lucky and found an unlocked toilet and used that for disposal. Usually I just stood to the side of the trail, did the change, and carried a sealed bag of poop in my backpack all day... discarding it that evening at our new lodge or tent site toilet. Sometimes it was tempting to just fling it beyond the trail... but I never did.

Overflow Stop
Just once, I had a nasty case of diarrhea, and nowhere convenient to stop to change. I had waited too long, and the bag was completely full and pressurized. I hoped there was some gas that could be released, but it was all liquid. When I detached the bag from the flange, the contents spilled, and I dropped the bag. I felt terrible leaving the mess on the ground, so I covered it with rocks. I put on a new bag&liner, then sealed the old bag&liner and carried it the rest of the day to be burned that evening at our new tent-site.

Normal Flange Changes
I changed flanges in the lodge toilets or in my own tent. I put the old flange, wrappings, and toilet paper in a plastic bag, tied the bag tightly, and left it with the garbage to be burned. Sounds awful, but I have talked with local Nepalese, and I have had personal experience burning poop-bags in a cabin wood stove and on campfires ... the contents dry, burn, and disappear very quickly in a hot fire... and without a noticeable smell.

Mountain-Top Flange Failure
Near the top of a mountain my flange completely detached. I put the flange and pouch in a Ziploc bag and carried it down the mountain to be burned. This story deserves it's own post - see Ostomates Only - Skipping Stones.

Use of these varied toilets was often discussed by our trekking team.
The general consensus was that 

My (ostomy) disposal methods 
were more pleasant than 
Their (original equipment) disposal methods :)

                                  You can read more about ColoMajic here 

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