Malari-uh oh

Spoiler alert: I'm happy and healthy and well. That's the boring end to this story, but let's start at the beginning, ten days ago, at my cubicle under florescent lighting. March was a really busy month for grant reports, especially for our bigger donors and end-of-grants final reports. So here I was, mid-afternoon on a Friday hunch-backed over my Lenovo working away when I felt the familiar ache-in-the-teeth and down-the-spine chill that signal temperature increase. I finished out the day with a fever, thinking it was a physical manifestation of the long hours and weekend hours I'd put in in the past month. I went to bed early because I'd planned to visit my friend and fellow PiAf-er, Maggie, in Nyumbani Village (a post on that later!) for an extended weekend. I woke up feeling bright and fresh and distinctly un-feverish, so I hopped on a matatu for Kwa Vonza, then met Maggie for a bota (a taxi motorcycle) ride to the village.

Over the next three days, I experienced the same pattern: wake up feeling rested and normal, around midday start feeling weak, exhausted and achey, by 4 or 5PM am so feverish and stiff with aches and chills that I have to lie down and sleep for a few hours. The fever peaked around 103F and plateaued for about 4 or 5 hours. By the time I woke up again in the morning, I was normal temperature and fine, apart from feeling tired from the fever storm that'd swept through. By day three, I knew this wasn't a symptom of stress or being over-worked, so I went to the village clinic where I was tested (finger prick - ow!) and found negative for malaria. Confused, I resolved to go to Nairobi Hospital when I returned to the city. 

I set out early on the morning of my return with the intention and hope of getting home before the fever peaked. Nyumbani Village is nestled in the remote hills of eastern Kenya about 5 hours from Nairobi, and it's a direct matatu ride back to the city from the nearby town of Kwa Vonza. So I said goodbye to Maggie and hopped on a bota for the 30 minute ride to Kwa Vonza (see pictures at right). At this point in the day I was feeling pretty good, the fever was below 101F, and the weather was stunning. I had to wait an hour and a half in Kwa Vonza for a matatu, but I found some shade and a seat, though many of Kwa Vonza's shall we say colorful characters were keen to engage me in conversation. One of the things I love about traveling is meeting people, but on this day all I really wanted was to get home and for these randos to leave me alone. At long last the matatu came and I settled myself into the 'cozy' but least desirable seat in the 14-passenger van - back corner of the last row. Thirty minutes into the trip we got a puncture and had to exchange tires to continue our journey. I was actually impressed by how fast the tire was switched out, so we were back on the road within a half hour. The rest of our ride went smoothly, if slightly harrowing due to high-speed and overtaking lorries on a two-lane highway, until we hit Nairobi outskirts. We proceeded to spend three hours in Nairobi rush hour traffic and moved less than 5km. Wedged in the backseat, grimacing at the darkness falling outside, and totally clueless as to our location in the city, I started playing Which-Voice-In-My-Head-Is-Loudest. A fun travel game that lends itself to decision-making and state-of-mind. Should I get out and flag down a bota to take me home? Should I persuade the driver to drop me in my neighborhood instead of the seedy city centre? How far are we really from the last stop and is it stupid to walk? Is it worrying that I haven't used the bathroom or eaten or had water since leaving the village? I settled on: stay in the matatu and sit out the trip (smart, as it started to pour rain), don't drink more water because getting off to find a bathroom isn't an option for personal safety reasons, get off in the city centre and call a driver to pick you from there to go home. Decision made, I was faced with Part Two of the game, To Stress or Not To Stress. I chose not stress because it would've aggravated the fever, which at this stage was around 101/102F. So I sat. For three hours. We finally arrived at the final stop, a gas station, and I connected with my driver a few minutes later. The drive home was absurdly traffic-free and quick. So after 8.5 hours of traveling I collapsed into bed with a 103F fever and a steeled resolve to go to the hospital the next day. 

And I did; Nairobi National Hospital in Upper Hill is a great facility. The staff were friendly, helpful, efficient; I was seen by a doctor who ordered a host of lab tests. The blood draw was quick, and for the first time in nine years I didn't faint during the process. They too found me negative for malaria, which was underwhelming, but decided to treat me for it as I presented as definitely malarial. This, apparently, is pretty rare - to test negative but still have the virus - but I wasn't feverish when I was tested, which may have skewed the results. I picked up the treatment at the pharmacy and three days later was feeling 100% again. (side-note, I was also diagnosed with severe food poisoning at the same time and received treatment that has me feeling 100% there as well). 

So in all, things have ended well. Malaria's a tricky illness because on the off-cycle hours (no fever) I felt almost fully fine and functional, and on the on-cycle hours I had the worst fever I've had in years, maybe ever. I took all preventative measures I could have done: taking anti-malarial medication, using high-DEET bug spray, and sleeping under a bed net. I could've picked it up anywhere in my outside-Nairobi travels, so the 'how' is beside the point. I am acutely aware of how privileged I am to have access to quality and timely medical care; so many in this country don't and lose their lives to the virus. The treat-ability of it and the minimal recovery time have left me outraged by the fact that malaria takes the lives of so many, even when the cure is known and available. And, of course, I'm relieved to be whole and healthy again, and I look at each experience for the value of what it has to teach my about my being here, my context, and myself.