(Written on Saturday (Day 2) in a rare moment of lucidness…)
I knew it was only a matter of time before this happened. I'm living in a country where more than 90% of the population live in malaria-endemic areas, and my job involves travel to areas where malaria is highly endemic. Furthermore, I've watched my staff, friends, colleagues, and husband all experience the effects of malaria; at least once a month, I have a staff member who is "down with malaria" and misses up to a week of work as a result.
The onset: Thursday night (in Mubende) I was unusually sleepy at an early hour (8:00pm), and with a headache setting in, I decided to turn in early. My alarm went off at 7:00am Friday and I could not get myself out of bed. Even though I'd had an astounding 11 hours of sleep, my body would hardly move. I felt nauseous and spent the next few hours fighting the urge to vomit, willing myself not to vomit (luckily, I never did). I lay in bed for several more hours, overcome by achey muscles and that pin-pricky feeling you get when a fever is setting in. Since my home is in the same compound as the Mubende office, I gathered up the strength to pull myself at of bed at around 11:00am and put in a few hours of work. I had to excuse myself from the office when I realized that I was lightheaded, dizzy, not thinking clearly, and had a throbbing headache. After a two-hour nap, little workaholic me, convinced this was just some sort of "strange African bug" that would pass, I went back to the office and put in a few more hours of work. The nausea had subsided but I still had no appetite. I finished up what I was working on a 6:00pm and almost collapsed into my bed.
"Come on," my Ugandan housemate and co-worker, Lilian said, "let's slope down to the clinic to see the doctor." My reply? "No, I think I'll be fine. I just need to rest. I'm sure I'll feel better by morning." But she wouldn't take no for answer. "The doctor travels back to Kampala later tonight; if you don't see him now, you won't get a chance the whole weekend. Come on, we're going." I caved. Got dressed, put on a jacket, grabbed my AAR health insurance card, and we slowly made our way to the AAR clinic in Mubende (a private clinic, by far the nicest clinic in town). I was surprised by how quickly and easily I got winded and how slowly we had to walk.
To be honest, I had agreed to pay the doctor a visit more out of the interest of checking out the clinic to see what is was like in case in the future I was actually sick and needed to go there. I was still convinced that this was nothing, that I was wasting Lilian's time by making her accompany me to the clinic. Afterall, this was Lilian's third trip to the clinic in two days; she had spent the last two nights sleeping at the clinic with a friend who had such a bad case of malaria she had to be admitted on a "drip" (IV fluids). I described my symptoms to the doctor: nausea, fatigue, achey muscles, fever, chill, headache. He took my blood pressure and pulse, then sent me off to the lab. The lab technician asked me if I "feared needles" and when I said no, pricked the tip of my ring finger with a needle, squeezed my finger, and smeared a few drops of blood on a glass slide. A few minutes later, she handed me a slip of paper with some sort of lab jargon scribbled on it and sent me back to the doctor.
"You have malaria," he told me. "Uh oh," I said. "I've never had malaria before." (Which was actually a lie because I did have malaria when I was two years old and my family was living in Uganda in the 1980s, but I didn't want to go into all those details. The point was, I hadn't had malaria in twenty-something years, and thus have no immunity built up to it, like people living here do because they're constantly exposed to it.) Anyways, I think the doctor thought I was joking when I told him I'd never had malaria before; that was just unfathomable. When I asked him whether this was going to be really bad because I'd never had it before, he didn't quite no how to respond. A lot of questions were unanswered.
He prescribed me Artequin, a new artemesin-based combination therapy, along with panadol (Tylenol) and multi-vitamins and sent me home. (I didn't have to pay a shilling, thanks to my health insurance coverage.) I thanked Lilian profusely for having insisted I visit the clinic; had I delayed getting treatment, the outcome could have been a lot worse. Lilian insisted I drink an entire pitcher of freshly squeezed passion juice with my first set of tabs before going to bed, saying I needed the hydration and the energy. I obliged and then slept, waking up every hour or so from the burning muscles.
This morning the nausea has somewhat subsided, although my stomach is still cramped up. I mostly just feel completely devoid of energy, have a splitting headache, am still sweating and chilling from a fever, and all the muscles in my body ache so badly I want to scream. I keep cat-napping, and every hour or so Lilian is bringing in another glass of juice and another plate of food for me to at least try to eat even though I have no appetite. It's too bad I don't have appetite because it's lots of yummy Ugandan things: katogo (chopped and boiled green bananas cooked with tomatoes and beans), millet porridge with milk and sugar, pineapple and bananas.
Anyways, that was probably way more detail than anyone cares to know about the first bout of malaria that I have memory of. I do feel like this was a long-time coming, and now at least as a public health person and a future doctor, I have lived experience of what malaria actually feels like. I'll update again tomorrow or the next day. For now, I'm going back to sleep.
S e n t f r o m m y B l a c k B e r r y ® s m a r t p h o n e
