Tuesday, November 22, 2011


There was a shirehe (festival) in a field near downtown on Friday to celebrate the 50th anniversary of independence.  There were booths with food, health teaching, crafts, etc around a central area, with a stage built on one end.  Concern (the water NGO) and Womencraft (the basket making NGO) both had booths.  My students had all come from school that morning to sing on the stage.  I missed that, but many students and teachers were still there in the afternoon and greeted me as I walked around with Ellie and Vanya.  Eventually Breana and the 3 German volunteers from the Diocese joined us.  I was walking across the field when I suddenly got the symptoms I now recognize immediately as dehydration, having been there before: nausea, dizziness and blurred vision.  I was probably seconds away from passing out when I hit Ellie in the back and told her I was going to faint.  She immediately found a plastic chair for me to sit in and I put my head down between my knees.  Vanya gave me some water.  Breana found one of her teachers to give me a ride home, but he was going somewhere else first and would come back "in fifteen minutes" to get me.  Not trusting this, I had Vanya find me a picky picky so I could go home right away.  I drank a lot of water and lied down.

The next day, Saturday, I felt better but not quite up to going to Vanya's birthday party at Garden Pause, a bar with many little thatched roof open rondavels near town.  Beer would be the main sustenance at the party, and I didn't need diuretics.

On Sunday, I got out of bed in the morning and immediately fell on the concrete floor.  I did not lose consciousness, but suddenly the floor was just there.  I crawled back in bed and was assaulted by vertigo.  The room was spinning even with my eyes closed.  Not a good feeling.  I drank more water and eventually went back to sleep, which seemed the safest option.  When I got up again I sat on the side of the bed for a minute before standing and immediately reaching for the wall opposite my bed to lean against it.  I was determined not to fall again.  I left the room, holding on to the walls in what I think of as "the Marge walk" after seeing my mother in law do this many times in the past.

I almost had Bree take me to the hospital, but dizziness improved after I drank some water with about 3 tablespoons of salt in it.  I thought of all the people who have problems walking the trails to the Grand Canyon because they drink plain water when they need electrolytes, which they are washing out of their bodies.  I could not walk on my own at this point, and decided to see how I felt the next day.  I think the saline water gave me diarrhea, because that persisted all night until I took some pepto bismol the next day.  Diarrhea is not a good thing when you have little water and can't flush the toilet.  Meanwhile I was not eating much, since there was no power to cook and little food in the house, not even bread or cookies.  Breana was gone most of the day and ate out.

On Monday I felt a little better.  I texted an Australian doctor I know who works occasionally at the Diocese hospital in Murgwanza and asked her if I should go there or the government hospital which is closer to where I live.  She was homeschooling her kids that day and would not be there, but suggested I go to Murgwanza because the lab was better.

I had a picky picky get me and take me to the hospital.  The driver, Justin, was very helpful and came in with me and got me through registration and told me where to sit.  I was glad to have his help, since all the signs were in Swahili.  The hospital has a one story building of offices built around a central open area.  There are 3 windows as you go in the front door: for registration, medical records, and payment.  There are benches in the central area and along the walls where people wait to be called.  I waited about 20 minutes to see a nurse.  She took my blood pressure, which was fine, and ordered blood tests for malaria and anemia and a stool test for parasites.  I asked for blood tests for electrolytes, especially sodium and potassium.  She checked with a superior but they would not do it.  I was shown to another outbuilding which housed the laboratory and got fingerstick blood tests for malaria and hemoglobin.  After going back to the main building to wait another half hour, I got my test results, which were negative for malaria.  My hemoglobin was 11.5, which is OK but a little low considering I was taking an iron supplement.  I got a prescription for electrolyte salts and waited at another building about 45 minutes to get this filled.

After 24 hours of diarrhea, I was unable to give a stool specimen.  I took the bottle home and brought it in the next day.  Breana had recently been treated for parasites, and I wanted to be tested to make sure this was not contributing to my poor health status.  Happily, it was negative.

My total bill was 3000 shillings for registration (about $2) and 600 shillings (40 cents) for 6 packets of electrolyte salts, of which I used only two, since the diarrhea had stopped.  I was at the hospital about 3 hours the first day and one hour the second.  I saw a doctor on the second day, who told me they would do a blood test for parasites if I still had dizziness after 3 more days.  I was told to eat a lot of fruit.  The treatment was basic but effective.  The minimal diagnostic testing is very different than in the USA, where they do a ton of tests to rule out everything under the sun.  I would have felt better knowing my blood tests (i.e. CBC and metabolic panel) were OK.  I feel better, but not 100%, so I just hope everything is OK.  This is not the place to get seriously ill.

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