So I've come up with a way for you all to see at least some pictures when I don't have enough data to upload pictures. I've reopened my Instagram (from like two years ago) and changed my username to something that's actually easy to remember. So follow me @bethanyinuganda!
Friday, January 15, 2016
Tuesday, January 12, 2016
Malaria
So I purposefully did not put too much technical information in the last post about my malaria diagnosis and treatment. I feel that is better left to a separate post, as it is a fairly complicated thing. The first think you have to understand is that malaria is a parasite. Mosquitoes are not deadly on their own, and neither is malaria a virus. Second, you have to understand the parasite's life cycle.
Believe it or not, this is the least-confusing graphic I can find. (Found here, good info too!) Super basically, When an infected mosquito bites you, infected baby parasites are taken through your blood stream into your liver, where they grow. When they are big enough, they release into your blood stream and use your red blood cells to multiply. Eventually, your red blood cell can't take it anymore, they burst into your blood stream, which is how malaria makes you sick and eventually kills you. This may happen several times until a mature gameotocyte is formed. (Gameotocytes are precursors to male and female gametes, or eggs and sperm.) Then another mosquito bites you, takes up the gametocytes, allows them to mature, and the parasite's life cycle continues.
There is no vaccine for malaria, just like there is no vaccine for any other parasite. Creation of this particular vaccine has found many obstacles, including the fast life cycle of the parasite, mutation of the parasites, and monetary problems. (I'm going to include this link, which is currently not working, but I'm hoping will come back soon because it's great.)
In order to prevent malaria, I have been taking doxycycline. (Unfortunately, Google is giving me fits trying to figure out HOW it prevents malaria instead of just finding that fact that it DOES prevent malaria.) It is approximately 98% effective in preventing malaria. From what we learned in training, doxy and the other two prophylaxis medications PCVs in Uganda take, malarone and mefloquine, do not prevent a person from getting the malaria PARASITE. Instead, they prevent a person from getting malaria SYMPTOMS. As PCMO explained it, regardless of the prophylaxis a person is taking, the parasite will still be in the person's liver. This, however, does not make a person sick, as I explained above.
So how did I get malaria? Well, I was in the 2% where the prophylaxis is ineffective. I have not missed a dose of my medication; I tuck my mosquito next in every day; and I avoid going out at night. Per usual for my life, I am just in the minority health-wise.
And to be honest with you, whether I actually have malaria or not is questionable. I have had my blood tested three times, with two tests for malaria each time, and of those six tests, only one of them came back positive. (If you're interested in how the tests are run, the CDC's website has some great information.) That means I literally have a 5:1 chance that I don't have malaria, but even with that small chance, they are making sure I finish the medicine to treat malaria and keeping an eye on me.
Why is malaria so deadly, though, if there are such simple ways to prevent it? If I can be blunt, perhaps because the most malaria-endemic nations in the world are also the poorest in the world. Although by an American's view doxycycline is a fairly affordable medicine (about $30 a month without insurance, probably less when you buy in bulk), just because its affordable in the US doesn't mean it's affordable. (EDIT: One of my fellow PCVs pointed out that taking prophylaxis for long periods of time can be harmful to your health, which is very true, so in addition to the cost, the health factor makes prophylaxis simply unreasonable for Ugandans, with the exception of pregnant women during their pregnancy.) This is not to even mention hospital care for malaria. For some, even mosquito nets are not affordable. Thankfully, my host family has and uses mosquito nets, but this is not the norm. To add to the lack of affordability, many do not understand that even if a person grows up in a malaria-endemic country, that person is still not completely immune to malaria. They do not understand the malaria life cycle, how it is spread, how it is cured, etc. Education is lacking in these countries because when your people are starving, are you going to feed them or educate them first? Although I am here to be a PTC tutor, part of my job is still to educate Ugandans on malaria, its life cycle, its treatment, and most importantly, its prevention. Maybe we won't stop malaria completely, but I hope we can lessen its impact on this country.
PS: Here's a picture my sister created of me as a mosquito.
Believe it or not, this is the least-confusing graphic I can find. (Found here, good info too!) Super basically, When an infected mosquito bites you, infected baby parasites are taken through your blood stream into your liver, where they grow. When they are big enough, they release into your blood stream and use your red blood cells to multiply. Eventually, your red blood cell can't take it anymore, they burst into your blood stream, which is how malaria makes you sick and eventually kills you. This may happen several times until a mature gameotocyte is formed. (Gameotocytes are precursors to male and female gametes, or eggs and sperm.) Then another mosquito bites you, takes up the gametocytes, allows them to mature, and the parasite's life cycle continues.
There is no vaccine for malaria, just like there is no vaccine for any other parasite. Creation of this particular vaccine has found many obstacles, including the fast life cycle of the parasite, mutation of the parasites, and monetary problems. (I'm going to include this link, which is currently not working, but I'm hoping will come back soon because it's great.)
In order to prevent malaria, I have been taking doxycycline. (Unfortunately, Google is giving me fits trying to figure out HOW it prevents malaria instead of just finding that fact that it DOES prevent malaria.) It is approximately 98% effective in preventing malaria. From what we learned in training, doxy and the other two prophylaxis medications PCVs in Uganda take, malarone and mefloquine, do not prevent a person from getting the malaria PARASITE. Instead, they prevent a person from getting malaria SYMPTOMS. As PCMO explained it, regardless of the prophylaxis a person is taking, the parasite will still be in the person's liver. This, however, does not make a person sick, as I explained above.
So how did I get malaria? Well, I was in the 2% where the prophylaxis is ineffective. I have not missed a dose of my medication; I tuck my mosquito next in every day; and I avoid going out at night. Per usual for my life, I am just in the minority health-wise.
And to be honest with you, whether I actually have malaria or not is questionable. I have had my blood tested three times, with two tests for malaria each time, and of those six tests, only one of them came back positive. (If you're interested in how the tests are run, the CDC's website has some great information.) That means I literally have a 5:1 chance that I don't have malaria, but even with that small chance, they are making sure I finish the medicine to treat malaria and keeping an eye on me.
Why is malaria so deadly, though, if there are such simple ways to prevent it? If I can be blunt, perhaps because the most malaria-endemic nations in the world are also the poorest in the world. Although by an American's view doxycycline is a fairly affordable medicine (about $30 a month without insurance, probably less when you buy in bulk), just because its affordable in the US doesn't mean it's affordable. (EDIT: One of my fellow PCVs pointed out that taking prophylaxis for long periods of time can be harmful to your health, which is very true, so in addition to the cost, the health factor makes prophylaxis simply unreasonable for Ugandans, with the exception of pregnant women during their pregnancy.) This is not to even mention hospital care for malaria. For some, even mosquito nets are not affordable. Thankfully, my host family has and uses mosquito nets, but this is not the norm. To add to the lack of affordability, many do not understand that even if a person grows up in a malaria-endemic country, that person is still not completely immune to malaria. They do not understand the malaria life cycle, how it is spread, how it is cured, etc. Education is lacking in these countries because when your people are starving, are you going to feed them or educate them first? Although I am here to be a PTC tutor, part of my job is still to educate Ugandans on malaria, its life cycle, its treatment, and most importantly, its prevention. Maybe we won't stop malaria completely, but I hope we can lessen its impact on this country.
PS: Here's a picture my sister created of me as a mosquito.
January 11, 2016
January 11, 2016 is a very important day for many reasons. First of all, it is the mark of my two months in Uganda. Second, it is the mark of one month until swear-in. It also just-so-happens to mark the end of perhaps the most frustrating week I've had so far in Uganda.
All in all, I'm adjusting very well to my life here. My sentiment from my last post is by no means a lie. This week has had many small challenges that snowballed. As I stated in my last post, my family had not had water for a few days last week, and so on Monday, I was finally able to do laundry. The tap had turned off again, though, so I pulled a jerry-can from the bathroom, one about twice or three times the size of the jerry-can below.
It carries 20 L of water, a little over 5 gallons. Now, I struggle in carrying one gallon of milk in each hand, so obviously this was a lot for me. I took it slow, but I still managed to pull a muscle in my back. Great. With that, walking, sitting, leaning forward...everything except laying down hurt. I took some Tylenol and dealt with it. It was helping with the stress headaches I was having anyways, since we're getting close to LPI (Language Proficiency Interview).
Since getting to my host family, in general, I have not been sleeping as well as I was before. This is likely because my siblings are up late and my mom is up early, but it was really wearing on me this week. As much as my back hurt and as tired as I was, I spent the majority of my free time in my bed. I didn't study much because I just didn't feel like I could focus.
In addition to all of this, or perhaps because of how worn down I was feeling, it has been really wearing on me how much differently I am being treated than the average Ugandan. We have been with our host families, in the community, for three weeks now. We are no longer novelties. And yet when I walk to school, I am honked at, either saying hello to me or asking if I want to go to Fort Portal (which, I'm walking the wrong way for that...). I've had several older women kneel (in practice, it's more like a curtsy) to me this week, a sign of respect for me simply because I'm white. They are the ones who have the life experience. They are the ones who deserve the respect, and yet they kneel to me. It all basically culminated with this article one of my fellow PCVs posted. White privilege is so prevalent all over the world, and it sickens me. I truly want to show as many people as possible that I should not be respected simply for my skin color. It's ludicrous.
With the week weighing heavy on me, I had my language group and trainer over to my host family's house on Saturday for a fun day of cooking one American meal and one Ugandan meal. It went swimmingly! Except...
About halfway through the cooking, I started to feel sick to my stomach. It was completely out of the blue, and I actually ended up throwing up, something that I actively, consciously, avoid. I went to lay down, ate just one pancake from our feast, rested the remainder of the day, slept nearly 12 hours, and still did not feel well in the morning. After breakfast, I thought everything was going to be okay, but I ended up feeling sick again. This time, I got some Pepto Bismol, so I didn't throw up, but I called PCMO (medical), and the doctor requested I go to a clinic. Since I am so new to Uganda and to the area, the doctor sent our language trainer with me, and I was more than thankful. I didn't particularly want to see a doctor, but I went along anyway.
The visit to the local clinic went about as any other doctor's visit goes. Vitals, saw a doctor, then the doctor order some blood work as a diagnostic tool, since my symptoms were very common. Blood drawn, tests run, I wasn't expecting anything to come from it. Then, sitting in the doctor's room, he asked if I was on malaria prophylaxis.
"Yes. I take my medicine every day."
"Well, that's interesting because you have malaria."
"Malaria?!"
I was completely taken aback. I had no idea what to do with this information. As exhausted as I was, my first response was honestly to burst into tears. I held back tears as the doctor talked to the PC doctor about what to do next. I knew what it meant. I paid attention in training. It meant I had to leave language training to go to Kampala until they could prove I don't have malaria. It meant I had to take Coartem to kill the malaria that may or may not be in my system. After a bit of talking back and forth between the two doctors, my language trainer, and I, it was decided that I needed to go to Kampala that night instead of waiting until the morning, much to the credit of my language trainer, so a private was arranged, and I was off!
The private driver gave me the seat which reclines so that I could sleep if I wanted to, a difficult feat due to the speed bumps, but I was definitely able to rest. Once in Kampala, the PC doctor drove me around personally because she didn't think it right to call the driver into work on a Sunday when she lives so close to the office. I had more blood taken, although the lab was closed for the night by that time, which would be used to repeat the malaria test as well as other tests.
Trying to find a room for the night was more difficult than it should have been, but I ended up staying in a hostel. The room I had was shared only with two others that night, but although the room was quiet, the traffic was not. The hardest part of the night, though, was the hot shower that I was so looking forward to was basically scalding hot...
I spent the majority of the day yesterday in the PC office, updating my computer (well, it's still downloading, but you know), updating my phone, updating my virus protection.... I took a nap, and it was generally just a good day. Thankfully, the local hotel had a room for me last night, and so I enjoyed my solitude while listening to the Ugandan news. It literally didn't matter how loud the TV was, though. When I got to the room, I immediately crashed for a two hour nap. In addition to the best night of rest I've had in probably a week and a half, I feel pretty great today. I am having more blood work done, mostly to look at how my white blood cell count is progressing, as it had been very low at the hospital and still low yesterday. Provided these are better, I will be headed back to training tomorrow! Fingers crossed!!
Sunday, January 3, 2016
Happy New Year!!!
Happy New Year from Fort Portal Uganda! Okay, so it's a few days past, but we're celebrating that and a few birthdays today. We spend a bit this morning looking for kitenge, local fabric out of which to have dresses made for swearing in, and now we're chilling at a cafe. We had good food, and now we're enjoying the wifi. (EDIT: The wifi quit before I could post, though. Such is Uganda.)
Life has been going great. We are in the midst of language training, learning all about the ins and outs of Runyoro-Rutooro.
Included in our language training is culture training. I swear, half of Ugandan culture is bananas, and so we learned about those this week.
Along with the New Year has come dry season. Unfortunately for me, this means many sunburns and lots of sunscreens. It also means my host family was out of water for the last three days. I was elated to hear the sound of water dripping outside my room this morning, since it means I can finally do that laundry that's been piling up!
All in all, I'm having a great time!!
Edit: I haven't had wifi until now, but here are some pictures of the remainder of our time in Fort Portal. We saw baboons on the way home!!!
Life has been going great. We are in the midst of language training, learning all about the ins and outs of Runyoro-Rutooro.
Included in our language training is culture training. I swear, half of Ugandan culture is bananas, and so we learned about those this week.
Along with the New Year has come dry season. Unfortunately for me, this means many sunburns and lots of sunscreens. It also means my host family was out of water for the last three days. I was elated to hear the sound of water dripping outside my room this morning, since it means I can finally do that laundry that's been piling up!
All in all, I'm having a great time!!
Edit: I haven't had wifi until now, but here are some pictures of the remainder of our time in Fort Portal. We saw baboons on the way home!!!
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