Apart from sunrise, sunset is my favorite time of day. So as I sit on the porch of the medical clinic, waiting the thirty minutes for my Malaria test results to come back, I enjoy streaks of the day's waning light against the passers by. The busy dirt street this evening is for me ubiquitously Ugandan, with its boda bodas zipping to and fro, men and women carrying their loads, and children everywhere playing.
Paraphrasing my computer dictionary, Malaria is defined as an intermittent and remittent fever caused by a protozoan parasite that invades the red blood cells. The parasite, transmitted by mosquitoes, is found in many tropical and subtropical regions throughout the world, including Uganda. The name Malaria originally comes from the 18th century Italian term "mala aria," which referred to the 'bad air' caused by fumes promulgating from marshlands. These fumes were originally thought to be the cause of the illness we now call Malaria.
As I sit watching people pass by I reflect on the consequences of my test results. Oddly, I'm split between which fate is better. The obvious downside of having Malaria is, of course, that you have malaria, and will always have it. On the other hand, I will also get drugs that should swiftly relieve my symptoms. If I don't have it I'll have to wait out my time in purgatory without a clear idea of what my ailment is or when my fever will end. On top of this is the added shame in coming to the clinic without the vindication of a serious illness; "No, it's not Malaria you Mzungu weakling." In any case, I had already managed to coach my football team throughout the entire weekend with the same sickness. Wouldn't Malaria have prohibited that?
While I wait two, toddlers approach me from next door. Even within the incredibly cute demographic of young Ugandan childrenin these two rank among the top decile. One of them, the older girl, is an institution on the block and regular instigator of the ever-popular "Mzungu, how are you" chant/singalong. Her bright eyes and excited smile are irresistible, and if it weren’t for the 20 plus year age difference between us (me being 24, she being around 4)I think I would have a serious crush on her. The other, I assume her slightly younger brother, shares her wide-eyed expression of continual awe and amusement. Together, Spik and Span converse with me, me reciting small words and phrases and them shouting incomprehensible commands at me in baby-talk Luganda. Behind me another adult patient laughs at our babelian discourse. Seemingly satisfied with talking, the younger brother begins to strip off his clothing, one article at a time (incidentally, he is only wearing a shirt and pants). First comes his shirt, which for a while stops to serve as a sort of turban as it makes its way over his head. When it finally does come off it transforms into a "terrible towel," swung around the head and against the ground for added emphasis. Incredibly amused but slightly embarrassed I chuckle to myself as I make continual side-long glances at the little sideshow act beside me. The older sister, not one to be left out as she observes both her younger brother and my reactions, raises her shirt to simultaneously reveal her full tummy and shield the bottom half of her face. Obviously inspired by my reaction, the boy proceeds to drop his shorts for his mixed audience of fellow toddlers, clinic patients and passersby on the street. I cannot contain myself, and my chuckle boils over into a full-on laugh, which reinforces the laughs of the fellow patients on the waitingroom-porch and the antics of the two kids. I laugh and laugh until I'm crying, the tears streaming down my face. And I welcomed the laughter of others around me. Together we enjoyed the ridiculous of everything.
My diagnosis, when it came, was both a relief and a sobering experience.
"Yes, you have Malaria."
"I do?"
"You even have Malaria plus."
"Malaria plus? What’s that?"
"You have Malaria plus more Malaria."
"Malaria plus more Malaria?"
"Yes. But, you will be ok because you will take this medicine."
Without a clear explanation of what this diagnosis signified, I eventually took it to mean that in fact I had been infected by more than one strain of Malaria. The treatment, apparently, is the following:
Metakelfin 500 mg, two tabs once after dinner the first night
Ciprofloxacin 500 mg, one tab twice a day 12 hours apart (morning and evening)
Various painkillers, multiple times a day
In addition I am continuing to take the weekly Larium dosage I got in the States.
I remember the first time the reality of the possibility of getting Malaria struck me. It was last spring while I was reading the blog of a Danish UN worker stationed in Uganda. Her account of getting the parasite, and especially her account of having dealing with reactions to having it hit home the reality of getting it. I think in part it was because I was reading her accounts at practically the same time that she was experiencing what she was writing about. Somehow the relationship between experience and account affected my interpretation of its consequences on me. It's not the first time blogging has had this impact on me, and in fact I think it is part of the reason why I find the medium so interesting. Real people wil real problems writing in nearly real-time.
Every time I get the feeling that Malaria isn’t so bad, Malaria seems to want to remind me of itself in yet another way. Yesterday it was my skin's hypersensitivity. Today it's stomach pains and diarrhea. Luckily, I have companions close by, some of whom have already experienced Malaria and even one who was diagnosed with it for the first time a day before me (Ian for those of you who'd like to know). I'm glad that I'm sick here, where Malaria is as much a part of life as chickenpox is back home. Still, I hope that this isn't the type of Christmas gift that keeps on giving.
