Monday, July 17, 2006

Malaria Central.

Malaria. I wake up around 9h00 in the morning, uncommonly late for Ghanaian standards, and for my household standards. My sisters are already up, singing, washing clothes. And all I remember thinking is, holy bananas, I’m freezing and I feel like I’ve been hit by a bus. Every limb, every finger, my eyelids – they ache. Throbbing, powerfully weakening pain. And my head? Its about to explode. Like the smallest dwarves are mining for something in every blood vessel in my brain. I try to turn, and feel like I’ve biked 50K just doing it.

What the hell? Last night I went to bed fine; we watched Angola vs. Mexico – a phenomenal tie by the way, and the first point for the African countries in general, way to go for their amazing goalie João Ricardo – and read some “Farewell to Arms” and slept. Bam.

The doctors are on strike, the power is cut, its rainy season and the entire sky is falling down on our small courtyard; Mme. Janet has rushedly handed me some tea, some bread and sent me to my room. Now I’m reading the “artemisinin – artemether in soyabean oil” insert by my flashlight and wondering; so I have malaria? And if I do, how the hell am I going to lie to my mom about this? She was supposed to call in the last few days – if I tell her I have malaria…. Or might have?

The sketchiest part is the self diagnosis. I don’t really believe in self diagnosis, although with my foot infection, it did me well – all I keep remembering is my friend Doug, an emergency physician, misdiagnosing himself with appendicitis. How the hell am I going to fare? Anyway, better to take the drugs than not take them…err on the side of caution and all that.

[And luckily, my thermometer became a sort of fun scientific toy in the last few weeks, and I’ve taken my temperature daily and graphed it. A solid 36.4 degrees Celsius. The thermometer reads 37.7 right now; hardly a fever, but a fever. My eyes are burning and red and I had difficulty getting out of the bathroom standing up. I’m wearing the pink sweater – the only sweater I brought – that I always joked was “in case of malaria”. Well, its doing its purpose now..]

Its been almost a day since I last began writing this, and now I have not even a small doubt in my mind I have malaria. Wave after wave of intense chills; I have every single blanket in my house on my bed right now. And the chills – you feel your body, its burning, its abnormally hot, but you feel like someone has put you into a tank of icewater; a cold that sinks into your bones. And then like a flash, you fall asleep and wake drenched in sweat; its hot, its so hot, you throw off all the blankets, all of your clothes. At some point delirium began to set in; I decided there were chickens in my room and got up and began chasing them….there were no chickens. I thought my mosquito net was suffocating me, that my room was filling with water..

It upsets my family, they’ve seen malaria no doubt countless numbers of times, but they didn’t expect that I’d get it – they know I take the doxycycline preventative every morning, have a mosquito net, use the mosquito repellant…how? Madame Janet walks into my room to see how I’m doing – I’m awake, so I try to greet her, try to move the mosquito net with my right hand; I grasp and I grasp feebly, struggling to hold the net so I can move it.

A few hours, advil, and malaria pills later, I text message Bryn. “I have malaria!”. He is watching the Ghana vs. Czech Republic game with Ian in Wa. The game I had waited all week to watch. If I could get out of bed, if I could walk, I’d be watching it. He replies, telling me we’re winning, currently 1 – 0 for Ghana. Hooray! This gives me enough strength to get out of bed. I wander over to Mme. Janet and Boncat’s room, and lie down on the bed, watching momentuous Ghanaian football history as we beat the Czechs, whammo-kablammo 2 – 0. Fantastic. But, the second the 93 minute buzzer rings, my energy runs out. I hobble back over to my room and collapse on the bed.

Its night time. Megan has come to sleep in my room with me. Around 2 or 3 in the morning, I realise I have to get up – I have to throw up. The nausea is slight, and I contemplate “thinking” my way out of it for a few minutes – I’m barely strong enough to get out of bed – but then it becomes intense. Somewhere, some splash of adrenalin helps me grab my glasses, torch and slips my feet into slippers. I reach the door – its locked! In desperation I turn the lock, once, twice, three times, I’m out! But making it to the latrines, about .5 kilometre away, in time, is out of the question. There, 4 feet from my door, I begin throwing up. Nothing. Of course, I have barely eaten all day. But I can’t even kneel to throw up, the energy is too much. So I fall over on my back, onto the cool stone floor. I lay there for a few minutes, imagining a weaving shuttle going back and forth, comforting monotony. Then again – nausea. But I can’t get up. I begin to throw up and realise, if I don’t get up, I’ll choke on my own vomit. I can’t call out to Megan. At the last second, I manage to kneel and empty the nothing and fluid that was in my stomach.
I crawl back to my room and fall onto the bed.

And now? Its morning. My fever has dropped considerably (at its peak though, it wasn’t high – only 39 degrees), and I’ve managed to get up and move to my chair. The artemether seems to working…..I think. My biggest fear is that this will last into the week and hinder my second (and more important workshop) and the tight schedule I have for work. I’m tremendously weak. I don’t even think I can get to, or on my bicycle let far alone ride it anywhere.

But, its getting better. Small-small. Hopefully the worst of it is over. Except for the delirium and hallucinations and nausea, this was pretty similar to the scarlet fever I had in 11th grade. The horrible irony of it all is that indeed, its “all part of the African experience”. Truly, it could not get more authentic. When you read this however, I’ll be better and this will be at least 3 weeks past. I won’t die, I have powerful drugs helping me. But for millions of Africans each year, this is a reality, and then they die. There is no “artemether – artemesinin in soyabean oil” for them, not even a blanket. And they lay there, in huts, or by the side of the road, shivering, until the malaria hits the brain, becomes cerebral malaria, and the end is in sight.
It was hard to truly understand until I finally got it myself – and I think, every five minutes; if you get this twice a year, with no drugs, with no comfort of any kind? If you have to go farm your field to feed your children, and you’re suffering? Incomprehensible. As for diseases like AIDS, much preventative work can be done; even universal condom use would drop the statistic hugely. But malaria? Treated mosquito nets reduce the chances a lot, but in the end.. This disease wears down the Ghanaian economy, hinders development to a tremendous degree, and in general, bites. I would like each middle aged to old man (for, its always them who hold this view..) who has ever told me that “Africans are too lazy to get out of poverty” to come here and have for at least one day, this horrible fever. Malaria is not this continent’s only enemy; there are the other diseases - HIV/AIDS, yellow fever, Marburg and Ebola and their lot of viral haemmorhagic fevers – and the fact that soil fertility is just generally low here, and the fact that colonialism has established weird country boundaries which group warring factions within the same nation. The list goes on (the author/anthropologist Dr. Jared Diamond has a lot to say on this subject) but the point is “lazyness” as a quality and hindrance is hardly more prevalent here than in any other place on earth.

So now, counting myself lucky, I’m slowly eating bananas and limes and drinking tea and practicing walking up and down my house. I’m imagining the small “schizocytes” or whatever having their endoplasmic reticulums and in general membranous structures disrupted and become unable to synthesize proteins thanks to my medication. I’m making plans for Tuesday, and my life will go on. Counting myself lucky, very very lucky.


At 7:35 p.m., Anonymous Anonymous said...

That's scary!!! Man now I feel bad about griping about my mono. It would be scary to experience delirium and have to go through that!

At 10:31 a.m., Anonymous Anonymous said...

I get some great drugs to treat malaria where I get my Viagra Online Prescription .


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