Drinking to your health

ISLAMABAD: The white drums are in abundance in Jabri. They are sold at makeshift stalls, lugged up the mountains on villagers’ heads, stacked up in Suzuki pickups. Their large numbers stick out curiously in the tiny hill top village, with its feeble dirt roads and quiet beauty. But their presence isn’t so out-of-place, at least for those who have come to believe in an alluring claim that is drawing thousands to this village of around 4,000 people in district Abbottabad from all corners of the country.

Hauled away in these containers everyday is water many have sworn contains the power to heal diabetes.

Amir Ali, 12, who sells the plastic drums on a road that leads up to the spring, vouches for the water’s fame and claims to transact with 1,500 people a day on most weekends.  Fateh Muhammad, 60, with a walking stick and a weather-hardened face, sits panting on a rock before his uphill climb towards the well. The water is authentic, he promises. It never goes stale.

And so the claims go. People from Swat, Rawalpindi, Mianwali, Karachi, even a family visiting from Saudi Arabia, all guaranteeing the spring water’s miracle effect on a person’s health. Abdul Haq’s sugar level dropped from 380 to 123, the 55-year-old from Mansehra said. Muhammad Afzal, 63, from Dera Ghazi Khan, couldn’t urinate properly for a long time until he drank this water. For two years, Liaqat Ali, 22, ate poorly because of a stomach disorder. Now, he boasts of eating up to six rotis a day and has even set up a pakora stall right next to the well.

A young passerby offers an explanation hesitatingly, “Doctors say it has a lot of iron...”

“Malik ki kudrat hai,” Liaqat interrupts. It is God’s bounty.

A stone crusher is cured

The word-of-mouth story of the well’s discovery goes back to excavation work in the area some eight months ago. An hour-and-a-half’s drive from Ghora Gali, Murree, people’s livelihood in this village next to Haro River includes farming and stone crushing in the surrounding mountains.

Villagers narrate that during digging for a new road, a spring suddenly gushed out. A stone crusher who was suffering from diabetes was part of the excavation team. For two months, he worked on the site without being able to take his medication. When he finally went back to a doctor for his medical checkup, he was told that his diabetes had been entirely cured. “What have you been doing?” the doctor asked.

“Eating, sleeping on the earth, and drinking from a well,” he responded.

Malik Taj Abbassi, former nazim of the Jabri union council, who owns the land on which the well was found, says the story of the miracle water traveled fast. At one point, he sent the water for a test to a laboratory in Chak Shehzad. The results showed that it contained a lot of iron and calcium, he says. “The government should carry out comprehensive research here. So many people have benefitted from this water and have faith in it,” Abbassi says.

Living with diabetes

For eight-year-old Moeed, it is more or less about faith as well. Quiet and doe eyed, with two front teeth missing and hair neatly pasted on one side, Moeed developed diabetes two and a half years ago and no one could explain why.

It started with unexpected tantrums and quarrels with his little sister. Then, a pattern of uncontrolled urination began. His hunger increased to a point that he ate half a chicken one day and asked for more.  When he developed fever and diarrhea, his parents rushed him to the childrens’ ward at Pakistan Institute of Medical Sciences (PIMS).

The doctor told them that their son’s blood glucose level was 570 mg/dL (a healthy post-meal glucose level is recommended to be less than 180 mg/dL).

“Did you not know he had sugar?” the doctor asked. Type 1 diabetes, a chronic condition characterised by the body’s inability to create insulin. Their world turned upside down.

Now, Moeed’s frequent headaches, dizziness and small needle pricked fingers have drawn a seriousness upon his face far beyond his years. He understands when his little sister Zainab hides her toffee wrappers from him. He knows that the dates he loves to steal during Ramadhan are forbidden to him.  He gets ice cream twice a month, but insulin shots four times a day. He also knows to extend his arm bravely when it is time.

“Being a mom and pricking your own son with needles everyday is the hardest part,” his mother said.

Moeed’s parents were first told about Jabri’s water in March by a close relative. When his father brought some home for his son, he noticed something extraordinary. Part of it was its psychological effect on the child. Believing the water would cure him, he drank it religiously, finishing the drum of 15 litres in one week and insisting that his headaches had subsided. But his parents say they were also astonished to discover that his glucose level had never been as normal as it was by the end of that week.

He has been drinking the water for around three months now. Sometimes, his mother says, Moeed’s glucose level drops so low that she reduces his insulin dose and offers him sugary treats, something Moeed says he doesn’t mind in the least.

Lack of scientific proof

Conventional medicine, however, rejects claims of any environmental components that could be consumed to control blood glucose level. Epidemiologist and Public Health Specialist at the International Diabetes Federation (IDF), David Whiting, told The Express Tribune that no such phenomena has been documented in medical history as far as IDF is aware.

Dr Gulbin Shahid, child diabetes expert at PIMS, adds that a controlled study is needed to substantiate the water’s claim, since at the moment it is unclear how regularly patients consuming the water are monitoring their blood sugar level.

One other problem with such unsubstantiated claims is that there is a selection bias, explains Dr Bin Cheng, Associate Professor of Biostatistics at Mailman School of Public Health, Columbia University. “The fact that these people are willing to go long distances for this water shows that it is a biased sample and not representative of the general population.”

The claim of the special water, however, could be verified through a randomised trial, he says. “You could take two groups of an equal number of subjects and test their blood sugar level. One group is given the special water and the other is given regular water, without both groups knowing the difference. After they drink it, their blood sugar level is tested again, and this is repeated over a period of time.”

“If there is a significant difference between the two groups after taking into account the placebo effect, then it is authentic. Otherwise, it is superstition.”

Dr Cheng adds, however, that clinical trials measure by hard outcomes only. “Scientists are beginning to realise the importance of psychological effect, which should also be measured.” This is not routine at the moment, he says.

Some research material is available to suggest that minerals and herbs have a blood glucose lowering effect. A 2003 study conducted in the Department of Human Nutrition, Agricultural University, Peshawar and Beltsville Human Nutrition Research Centre, Maryland, concluded that a few grams of cinnamon a day “improve blood glucose level in people with type 2 diabetes.”

Another 2001 study, Ayurvedic Interventions for Diabetes Mellitus; A Systematic Review, by Southern California Evidence-based Practice Centre, says that there is “evidence to suggest that herbs such as holy basil and fenugreek [have] a glucose-lowering effect and deserve further study.”

Chromium and magnesium supplements have also been studied for their effect on glucose control; the Jabri water contains magnesium and calcium, among other minerals, according to a test by the National Institute of Health, Islamabad.

But scientists say these studies were not well-designed enough to scientifically prove that dietary substances could actually control glucose levels. Replacing conventional medicine with alternative therapy, it is feared, could lead to serious cosequences.

The spiritual element

Dr Ejaz Akram, associate professor of humanities and social sciences at Lahore University of Management Sciences, offers another dimension to the argument to explain the inability of scientists to offer conclusive evidence supporting such “miracle water” claims: the spiritual realm.

In all traditional societies, water has had spiritual significance, associated with all that is pure. Arguing that not all phenomenon had to be “rational,” he says modern medicine was “fascist” by its very nature, with its biggest flaw being that it ignores the significance of the “subtle;” the reality that could not be measured by virtue of our five senses.

“There is reason to believe that Jabri’s water may have special alchemical properties of healing people,” he says. Controlled studies could never attest to such an idea, as “matter is a veil upon our senses, limiting our capacity to reveal the truth”.

He calls for sceptics to believe in the mystery of the water, as he did; for Moeed, his parents, and for all those people trudging up to Jabri, convinced of having received shifa from it.

Published in The Express Tribune, July 12^th, 2010.