The pilot turns and shouts "are we all strapped in?" over the hum of the engines as they come to speed. The EMT confirms and monitors my vitals as we speed down the runway. We are in the air and ascending quickly when she tells me to get comfortable and I'm free to nap on the way to Lusaka. The cool air of elevation was the greatest relief I'd felt in days and was quickly catching up on three sleepless nights.
When the sun came up the next day I was lying in a pool of sweat and sore with a tense back from shaking the night through. I wrote this off as my annual sickness, which some time or another has come since childhood; normally a fever or a nasty flu stateside. Feeling better as the morning progressed, I was on with my daily chores: washing clothes, scrubbing dishes, sweeping the grounds and the dust that drifted in the house the previous day. I had no pain and only mildly lacking any energy or strength. That afternoon it was showing itself again. I called my closest neighbor to share my troubles of the day and see what was happening in his village, 15 km away. Luckily for me, he showed more concern than I ever would have for myself and told me to get my ass inside and take a malaria test. I brushed it off as a motherly statement and went beginning to prepare my fire. As this simple task proved troublesome, his words came creeping back into my head and I was off to the med kit.
The kit is three easy steps of prick, dribble and wait. Well, I was in such bad shape that three failed attempts to draw blood from my clammy, cold fingertip led to success. I was able to draw the three drops needed and add the provided liquid and the clock began. I felt like a teenage girl waiting for that blue line to not show. But, low and behold, two little red ones came up when I hit with the headlamp. Positive. Full on malaria. With the help, or more abrasive advice of my PC neighbor, I now knew what I was facing. Or so I thought.
The policy goes, for a positive test, call PCMO (Peace Corps Medical Office), start coartem and make your way to the house to rest and recover. Simple as that. Well, this, as they say, is Africa.
Medicine missing from the hut, sun down and I’m hit again with full on symptoms. Luckily, my host dad comes to check on me and I’m able to have him go to the market and grab the drugs. Within ten minutes I’d be set and on the path. But, they were out of drugs and a two hour search ensues and he is successful. I take the first four pills and set my alarm for eight hours, when I’m to wake and take the next dose. With three days of treatment I will be on the road to recovery.
A quick word about this Malaria and what lovely gifts it brings you. First, for me was a headache; simple fix drink some water and rest a bit. Not for this one. The gang also includes a fever that could cook a meal, sweat to drown you in, body aches that lay you out in bed, and once you’re in that nice prone position the shakes set it. These were not any little “brrrr it’s cold” shakes, but pay a quarter at a cheap hotel vibrating bed shakes. Double that with body aches and headache, and you’re in a pretty bad place.
Now, due to the remoteness of my village, reliable transport is found only Monday, Wednesday and Friday. This was now Friday night, three more days of this pain until I was able to get on a truck to get to Mbala. The Peace Corps office in Kasama was informed of all of this as the events unfolded. They are the ones in charge of my well being and any mishaps that may unfold in during my service. As it was night when I was calling and getting this all settled out, it would be a suicide mission to drive to my place. The sun would be up upon arrival, so I told them to wait till morning. Come round 10 hours I see the glowing white streak that is the Land Cruiser to my rescue. With assistance of my younger brother carrying my bag and one to lean on, I ease my way on the truck.
This truck in enclosed, has 4wd and, much to my surprise, air-conditioning. By this time I had had a temperature of over 103 degrees F for about 70 hours, and this was the best set up a guy in my condition could ask for. Though I am only 65 km from town it will take an average of 3 hours to arrive. This ain’t no leisure drive through the bush taking in the scenery, though it truly is amazing. This is a lock in the front tires, hit the low 4wd and hold on kind of ride. I have seen as many as 4 trucks axle deep in mud during the rainy season on this road. You couldn’t drive 40 meters without another hole in the dirt and sand road. Now, I get to do this with a headache that pains me to look to the side and the air-conditioning that is just beating out the blazing sun that is slowly creeping overhead. Three hours of a gut busting flex staring at a spot on the dashboard to keep the tears of pain from streaking with one stop, we were at the pavement. We stopped to see my neighbor who had the right thinking enough to get me to check myself out. A short visit of me thanking and admitting he was right and we continued.
Finally, we made it to Kasama and the house where I’d have access to amenities that should ease my pain: running water, electricity, decent food and a comfortable bed. The troubles of the ride behind me and I was feeling fairly decent, as one does in the daytime hours. Support from other volunteers and nap made things better. My fever was still above 103 but I was functional as a person, until nightfall. The fever pushed up to 104.5 and a walk of 20 meters down the hall pushed me from normal to pale sweaty mess that collapsed on the concrete floor as last ditch effort to cool down. I remained there, with the assistance of others bringing me water and light snacks, for the better part of the forenoon.
By the afternoon I was showing no signs of improvement and they made the call to take me to the Kasama Hospital. They checked the vitals and did some blood work. They confirmed it, it was indeed malaria. The concerning part for them, was that I had finished my coartam and should have been showing signs of strong improvement. I wasn’t. In an hour they had pumped four liters of liquid through my IV and started me on a quinine drip. The fever had made me severely dehydrated and quinine, an ingredient found in tonic water, is the supposed fix all for malaria. Peace Corps Washington DC was fully involved with my handling now and strongly opposed the use of this, and for reasons unknown to me, I was stopped half way through the treatment. If it wasn’t for the help of my PCVL (Peace Corps Volunteer Leader) at the hospital, the experience would have been much more troublesome. She stayed the night in the hospital and was up hunting the nurse with the dedication of a guide on a safari on a moment’s notice. I can’t thank her enough.
In the morning the call came in, from Lusaka that I was having a plane sent up to take me to the big town hospital. An 11 hour cruiser ride drains the liveliest of folks; I was not in that state. I was released from Kasama hospital and taken to the local airport to find my chariot alone on the runway awaiting.
By this time I was feeling a bit better and able to support myself walking, much to the surprise of the flight crew. So, I boarded the plane and was off. Awaking from a short 2 hour nap, I arrived in Lusaka to an ambulance to take me to the hospital where volunteers go for treatment. This would be my home for the next three nights.
The majority of my time there was simply for observation. My fever had cooled and the mains were mostly gone. One little flair of fever the second night extended my stay for a third. They were monitoring my liver functionality and blood platelet count. Each of these were in the danger region and of concern to the staff. I had been on so many different meds of the course of the past week that one could hardly expect to be completely normal. With one last review of my charts and history with the fancy doctor I was released; thus, ending my week long saga of persisting malaria.
Coming into Peace Corps one hears these stories of the awful side effects of malaria prophylaxis. What terrible nightmares mefloquine produces and the horrifying long term effects, or how their Doxy makes them burn in the sun and it’s so hard to remember to take every day. Well, what is lacking in these mystifying horrendous stories is the severity of malaria itself. It can and does kill. It is painful and frightening to have anywhere, yet alone, alone in your hut miles away from a place where you can feel relaxed and in the company of others who will willingly help to ease your troubles.
It is a serious situation that should not only be a concern to volunteers who have this support system, but is a jeopardizing problem to the people in the rural areas who face this daily and seasonally, year in and year out. It’s said we don’t learn not to touch the stove until we’ve been burnt. Well, I’ve touched it, and sure enough, it’s not fun.
So here’s to all of us who think we can beat it, or it’s not that bad, or we can’t get it. We can get it. It is that bad. It don’t play no games. Take your meds. Stay healthy.
