242 Where There Is No Doctor 2011
2. White discharge that looks like cottage cheese or buttermilk, and smells like
mold, mildew, or baking bread. This could be a yeast infection (moniliasis, Candida).
Itching may be severe. The lips of the vagina often look bright red and hurt. It may
burn to urinate. This infection is especially common in pregnant women or in those who
are sick, diabetic (p. 127), have HIV infection, or have been taking antibiotics, or birth
control pills.
Treatment: Douche with vinegar-water (see p. 241) or dilute gentian violet, 2 parts
gentian violet to 100 parts water (2 teaspoons to a half liter). Or use nystatin vaginal
tablets or other vaginal inserts for Candida, like miconazole or clotrimazole. For dosage
and instructions see page 372. Putting unsweetened yogurt in the vagina is said to
be a useful home remedy to help control yeast infections. Never use antibiotics for a
yeast infection. They can make it worse.
3. Thick, milky discharge with a rancid smell. This could be an infection caused
by bacteria. Special tests may be needed to tell this from a Trichomonas infection.
Douche with vinegar-water (p. 241), or with povidone-iodine (Betadine: 6 teaspoons
in 1 liter of water). Also, you can try inserting a clove of garlic every night for 2 weeks
(see p. 241). If none of these treatments works, try metronidazole (see p. 368).
4. Watery, brown, or gray discharge, streaked with blood; bad smell; pain
in the lower belly. These are signs of more serious infections, or possibly cancer
(p. 280). If there is fever, use antibiotics (if possible, ampicillin together with
tetracycline—see p. 352 and 355). Get medical help right away.
Important: If any discharge lasts a long time, or does not get better with treatment,
see a health worker.
How a Woman Can Avoid Many Infections:
1. Keep the genital area clean. When you bathe (daily if possible) wash well with
mild soap.
2. Urinate after sexual contact. This helps prevent urinary infections (but will not
prevent pregnancy).
3. Be sure to clean yourself carefully after each bowel movement. Always wipe from
front to back:
this way
YES
NOT
this way
Wiping forward can spread germs, amebas, or worms into the urinary opening and
vagina. Also take care to wipe little girls’ bottoms from front to back and to teach them,
as they grow up, to do it the same way.