Thursday, November 4, 2010

Parasites, Infections and Diarrhea, Oh My.

For those of you with a weak stomach this may not be the post for you.  Also, if you’re a eat-on-the-go type of person you might want to set aside that bowl of chili before you read any further. 

Before leaving for Africa I had the chance to speak with a couple in their mid 20s who just returned from some missionary work in Kenya.  Their main advice was to be ready for anything as far as ailments go.  The nugget of counsel that stuck with me was when they talked about never really feeling above 80% of their best health.  Turns out they’re right, after this last year It’s amazing how much I appreciate feeling “pretty good”. 

Let’s start from the beginning.

July 10th, 2009, I arrive in Africa happy and healthy weighing a normal 195lbs.  We spent a few days within the protective walls of the Peace Corps training center drinking filtered and bleached water and carefully prepared food. 

Spirits were high; Africa was lovely.

Mid July, after a few days of living with my homestay family I was introduced to what Malians call kono boli, which literally translates as running stomach.   My stomach never ran so fast, or so often.  The pounds began falling off. 

A couple weeks later we all regrouped back at the PC training center to debrief and attend more group sessions.  This also marked the beginning of my courtship of Meg, my current girlfriend.  I’m not sure if was her captivating swagger as she hobbled around on her crutches or how her left foot looked so cute all swollen up to twice it’s size, but I knew there was something special there.  A week before she got a small cut near her ankle that got infected and promptly resulted in a giant club foot/leg situation.  Romance was in the air.

Another week later, back in my homestay village.  My stomach was running more than usual one day and I felt noticeably worse than my normal state of “general malaise” so I went to bed after barely touching my dinner of greasy pasta and gristle. 

I woke up the next morning and felt even worse.  There was a naming ceremony in the village for a family who just had a new baby and I walked across town to hopefully sit in on it.  It was early, and as soon as the ladies busted out the spicy beans I was on my way home as quickly as my emaciated legs could take me.

I laid in bed sweating for about half an hour when I got the call.  My stomach was running, but this time in a different direction.  I threw open my screen door, ran through my families concession, made it to the open-air outhouse type toilets just in time.  Well, just in time not to vomit on one of my little host brothers.  The hole in the ground is difficult enough to strike when all systems are a go, in my sweaty delirious stupor I repainted the floor with what little I had eaten over the last day or so.

I’ll chalk that episode up to some level of food poisoning.  After a visit from our PC Dr. and a day of rehydration salts I was feeling great, back to a solid 65%.

Training finished up in the first half of September and I swore in as a Peace Corps volunteer weighing a strapping 170lbs.  I had surrendered 25 pounds to African acclimatization in two quick months.

Fast -forward about six weeks.  It was the end of October.  I had enjoyed six weeks of semi solid stools and a fair bit of weight gain.  I was nearing 180lbs and feeling great, so great that I took a trip to visit Meg for Halloween.

It was my first chance to explore a different part of Mali and we took advantage of it by going on a great hike up a “mountain” near her village.  We climbed as high as we could and camped there for the night. 

Halfway through our descent the next day we realized that we had grossly underestimated how much water we needed.   We ran out with about 30 minutes of the hike left and once we made it to the tiny village below we were desperate for something wet.  Conveniently, the two “shops” in the village didn’t have any sort of drinks for sale but on our second try the gentle shopkeeper did offer us some water from his calabash.  We inhaled the few cups he gave us and graciously walked away. 

Death by dehydration avoided, but thirst not remotely quenched.  The other catch to this trip was that to get back to her village we had to wait on the side of the road that leads to Timbuktu and try to hitch a ride back into town.

An hour passed and no prospects.  We had a deal with the guy who brought us out there but he wasn’t due for another hour or so.  Lying under a thin veil of shade, I noticed some women taking trips to a well not too far off.  Intense thirst makes a man do crazy things and throwing caution to the wind I took off for that well and a few pulls later I had two nalgenes full of the most beautiful gold colored water I’d ever seen. 

the "toilet"
The next day while I was curled up on Meg’s floor, writhing in pain and unable to keep any trace of fluid in my body I couldn’t help but wonder if chugging that well water was the best idea or not.  

According to our medical handbook, Meg diagnosed me with bacterial dysentery.  I was out of commission for a solid four days, didn't eat a thing, barely kept any fluids down, took approximately 80 trips (not exaggerating) to the "toilet", and lost every ounce of weight I had gained back plus another five to ten pounds. 

I never weighed myself around this time but I’d guess I was around a trim 160-165lbs.  I hadn’t weighed that since my sophomore year in high school.

Then the holidays came, times were good.  It’s truly amazing what our bodies can adjust to and it seemed as if my body was finally getting used to all that Mali had to throw at me. 

So fittingly, it was time to go back to the US for my sister’s wedding.  Seven and a half months of a stripped down diet made all the cheese, dairy and desserts of the US look like heaven.   Unfortunately, the preservatives made my stomach feel like hell because I spent many a night sitting awake with a burning esophagus.  You’d think I’d learn my lesson but our days were numbered in this land o’ plenty and I indulged with no fear of what each night would bring.

A month after returning and my stomach was once again training for a marathon.  This time it was accompanied with comically long sulfur burps.  This meant it was time to send in a stool test.  As if feeling horrible wasn’t enough, we then need to collect some of our feces and place it in a bottle to send off and get analyzed.  The details of this process are reserved for fellow volunteers. 

I thought that one was giardia but it turned out to be amoebas, all those parasites feel the same to me…

Nearly three illness-free months later Meg had a bit of pain one night around what looked like an insect bite near her eye.   We didn’t think much of it until the next morning.   She woke up and her right eye was nearly swollen shut.  It wasn’t too painful for her, which was fortunate because the ailment provided countless joking opportunities. 

Ever since the George Foreman eye there haven’t been any interesting physical impediments to speak of, but just when you get comfortable, Mali sneaks in a sucker punch.

Last week Meg broke out in a rash that covered her entire torso while I had an extremely painful rash type situation concentrated under my arms.  We did go camping the week before, and for better or for worse we’ve become quite calloused to these more tame situations and took care of it ourselves. 

Which brings us to today, and it’s my pleasure to report that we are both in relatively good health. I feel like a body builder at a massive 182 lbs and there are no rashes, parasites, or swollen limbs and my stomach is moving along at a steady gait.