Three Times Too Many
It was a challenging journey, both physically and emotionally. But this I have come to expect from Africa. There were maybe four or five days that I was not struggling with my health. There were a few days I just wanted to go home, to something familiar, something that felt safe.
I can live from a backpack for months without a single thought as to my home in Colorado, but when every drop of liquid in my body is lost to four hours squatting over a pit toilet in the rural farmland of the Rift Valley, it is all I can do to remain positive. I repeatedly explored the deep, rich Milky Way overhead to remove myself, even if for just a few minutes at a time, from my midnight excursion to the outhouse.
Three days of Cypro antibiotics and my digestive system regained composure. But with my immune system knocked flat to the ground by the intense therapy, I was hit with a low grade bronchitis which even today, five weeks later, lingers.
Just three days before I was to leave for Ghana, I was hit with malaria. It seems my decision to forgo the anti-malarial Malarone for the days I was taking Cypro was a mistake, or perhaps my immune system was just not strong enough even with chemical assistance.
Just the same, I was sitting on my foam bed in the wooden post-house, adjacent to Steve’s home. It was 11:30 PM. I was answering email by way of my AT&T cell phone tether. At 11:45 I felt a chill in my lower back and pulled a blanket over my shoulders; not unusual for the cool Rift nights. Five minutes later, I was truly cold and my legs cramped. I uncrossed them. By midnight, I was shaking so violently that it was all I could to do power-down my computer and crawl under the covers.
By 12:15 am I was wearing three layers on my torso and a winter cap, wrapped tight in a sheet and two blankets. I was very scared. The muscles in my back were constricted as though I had fallen into a glacial lake. I tried to remember the breathing techniques I learned as a child in Nebraska, to help me fall to sleep in cold winter nights where a wood burning stove was our only source of heat. I tried yoga as a means to relax, to keep my body from restricting blood flow. But nothing worked. I sweat and shook and remained terribly cold no matter what I did.
By 1:30 am I had regained enough control of my fingers to text my mother and brother, “Please call me. I need help.” My mother received the text, called my brother who ten minutes after my message, called. I tried to maintain control, but was sobbing when I answered, “I … I don’t know what is happening. I can’t sto– … stop shaking … I, I think I have malaria.”
I don’t know if this was a relief or more of a concern, for Jae later told me that when he received my SMS he thought I had been kidnapped and my mother feared I had been thrown into a Kenya prison. Guess they both assume the worst. Rather have malaria than spend a night in a Kenyan prison.
Jae jumped on Wikipedia and read the description of the initial symptoms of malaria, yellow and typhoid fevers. While they all shared some similarities in various stages, what I was experiencing was most likely malaria. We reviewed them again, to make certain.
I just wanted to sleep, but Jae was bold in his insistence that I go to the hospital. I finally agreed, realizing that if by chance it was not Malaria, early intervention was imperative. I took four Malarone to knock the assumed parasites from my blood stream. But if I had malaria, Malarone would not remove them from my liver, for it is a prophylactic which forms a protective, chemical barrier around the liver to keep the parasites from entering. Once inside, Malarone cannot assist, however, a strong dose can clear malaria parasites from the blood stream and disable their rapid reproduction.
Some material I have read states that malaria never leaves the human body, instead lying dormant in the liver until the next infestation. Subsequent material, particular to the drug administered by the doctor later that morning (see below), states that malaria can in fact be destroyed completely by proper treatment.
I made my way the door, fumbled with my shoes and headlamp and rickety stairs, and woke Chris with a shaky voice. It was 2:30 am. Chris woke Steve who called his friend who had a car, the man whom we often rode with on the way home from the Top Market in Nakuru. When he arrived, I was wearing a down jacket borrowed from Steve, my polar fleece, a long-sleeve shirt, and a knit cap. I was prepared for a snow storm, and yet oscillated between chills and overheating every twenty minutes.
On the drive to the hospital the combination of a sleepless night, uneven (to say the least) roads, and extensive dehydration resulted in my vomiting on the side of the road. I grabbed my headlamp to see if I had lost the four Malarone tablets, but they appeared to have been processed beyond the stomach, which was good. I am afraid I was not in the best of spirits for I cursed at Steve and Chris once (maybe twice), demanding some personal space. My apologies to you both.
At the hospital I was met by two young clinicians who conducted the basic heart rate and breathing tests. After a short interview, I requested an immediate blood test, but was denied for there were no technicians in the hospital. I stated I could conduct a basic analysis myself, if given access to a slide and microscope, for I recalled the shape of the deformed cells which I photographed through the eyepiece of the microscope last year when Rie was struck with malaria the prior year. The lab was locked, and so I had no choice but to wait five or more hours.
I remained at the hospital until 7 am when a technician arrived. Steve had gone home, but Chris remained, sleeping on the couch (thank you my friend). I was given a hospital bed adjacent to the clinician’s office. Steve returned at 8 am and shortly thereafter my blood was tested. The doctor saw me at 9 am and while my blood stream was clear of parasites (likely due to the Malarone), all symptoms pointed to malaria. He gave me an Italian made drug (Co-Arinate FDC, comprised of Artesunate 200mg, Sulfamethoxypryazine 500mg, and Pyrimethamine 25mg) which after one horse pill each day for three days cleared my body of the infestation.
By noon Chris and I had returned to Morokoshi and with slow movement, a long-sleeve shirt and sun hat, I assisted with the greenhouse construction. As I was to leave for Ghana in less than 48 hours, I worked to help Chris and the women of the Nina Initiative complete the effort.
I resumed the Malarone treatment on the fourth day and just yesterday concluded the course. Some remnants of bronchitis remain with me, but the best means of healing is just letting my body fight it, rebuilding my immune system one day at a time.
Thank you Chris, Steve, and Jae for helping me, supporting me, and giving me the confidence I needed in such an unexpected event.
500,000,000 Cases per Year
For those of you who have had malaria, which is a good portion of Africans, you know how scary the first bout can be. But what is not commonly known is that malaria sometimes crippled Europeans from their attempts at in-land conquests and it is malaria that remains a greater cause of death than AIDS the world over, with 350-500 million cases and more than 3 million deaths per year, causing long-term health detriment and economic stagnation to the African continent, Central, and South America.