Wednesday, September 26, 2012

Personal Health in Haiti

So... I hope it isn't awkward to talk about one's personal health on a blog. But everyone always worries and wonders about health and safety and whatnot when people travel to developing countries, so I thought I'd just enumerate my brushes with less-than-perfect health while I've been here.

I came with the knowledge that there was a huge number of big, scary things that could happen to me here, health-wise. There are the obvious, well-known ones - malaria, cholera, tuberculosis, dengue, etc... and then there are some lesser-known ones like leptospirosis and histoplasmosis (and I forget the rest of the long list). Before the trip, I had to make sure I was vaccinated against all the usual routine things, plus Hep A, Hep B, typhoid, and rabies.

I escaped the cholera because it seems to be a bit less of a risk these days (or at least around Jacmel) and because we're always very careful about only drinking the super-clean, treated drinking water. I escaped all those nasty mosquito-borne illnesses (malaria, dengue, etc.), although I haven't got a CLUE how I did that*. There were days when I would look at my calfs and count over a hundred little pink bug bites - it was truly awful! Despite my use of Permethrin and DEET (on clothes and body, respectively), it wasn't until a couple weeks before I left that I started to feel that the mosquitos were starting to get tired of me. Ugh. That wasn't fun. (*I was taking chloroquine as a malaria prophylactic the entire time I was in Haiti, although I guess there's still a small chance of getting infected. Especially if you get bit as much as I do/did.)

Despite all the warnings about traveler's diarrhea and the like, I arrived and was essentially in perfect health for about 4 weeks! I suddenly got hit with a bad stomach bug that kept me in bed, unable to eat anything, and having diarrhea (even vomiting once) for about a day. It took me a couple more days to recover fully, but I was eating normally after that first day. It was far from pleasant, but it didn't last long. Melinda and Sarah took good care of me, and gave me pills of grapefruit seed extract and activated charcoal to kill off the bad bacteria in my gut. Not the end of the world, and not dangerous.

A couple weeks after that, I had the strangest experience! I was in the clinic, late at night, and we had just finished up with a birth. I had eaten plenty, and I'm always sure to stay super well hydrated, and I've never fainted. But as I was standing in the birth room, I very suddenly felt as if all the blood had just rushed, or dropped, right down out of my head, and I was certain that I'd fall over if I didn't go sit myself down first. I left, sat down, put my head between my knees... it helped a little. I drank water and lay down flat for a while, dozing off for almost half an hour. When I woke up, I thought I still felt a bit weak, but normal enough to go home to my real bed and sleep. The moment I sat up, I instantly felt SO cold and got goosebumps all down my entire body! I started shaking with cold... and this is Haiti, mind you, where shaking with cold in the summer is out of the question! The other really disconcerting thing was that my face was pasty white, and my hands were ghostly white, with a bit of bluish-purple under my fingernails! I was seriously cold. The way I felt at the time was like all the blood and heat from my head, arms, and legs had rushed out of them and into my core, which made my extremities SUPER cold and weak (or at least I perceived them to be) and made my core way too hot, as I discovered later. After curling up in a quilt, drinking some Emergen-C, and huddling into the smallest ball on the floor that I could, I gave up on getting warm enough. Instead, I curled up in a clinic bed, triple-wrapped myself in quilts, and finally went to sleep. I woke up asking Melinda for another quilt, but she correctly guessed that I was, in fact, just way too hot and needed to extract myself. I eventually was able to get the blankets off and started to feel more like a normal person in Haiti with a tiny fever. (By the way, this entire time of shaking and teeth-chattering, the thermometer showed that my fever was never very high! so weird.) I woke up the next morning feeling mostly fine, and by midday was feeling completely myself again! I had a slightly runny nose for the following 5 or 6 days, so I'm guessing it was just a crazy weird virus... There was a moment in the middle of the night that Melinda suggested it might be the beginning of malaria, but it THANKFULLY turned out to be a much nicer pathogen than that. whatever it was.

Other than all the mosquito bites, and those two bouts of short-lived sickness, the only other thing was this weird rash on the top of my left foot. It's about the size of a quarter, and only itched sometimes (very rarely, in fact), and has taken its TIME to heal up! Around the time it started, Sarah and Melinda were both struggling with a bit of scabies (i.e. teeny tiny bugs living in your skin, and whenever they pop up out of the surface, it makes a red/inflamed bump... hence the rash. gross, I know)... so I figured I had just caught a bit of that. Everyone agreed that that's what it looked like. Melinda came back from Canada with some permethrin cream, which is supposed to kill scabies off after a single application, so I used that on my foot and sandal (and also changed my sheets). Nothing happened. I used it probably 4 or 5 times over the course of maybe 4 days, and it didn't do anything! I tried a few other things, and... gave up. Time went by, and it eventually dried out and seemed to go away. Then it came back. Then it looked like it dried out again... We realized, as it was fading, that it was pretty round - it might be ringworm! gross again. My seemingly untreatable scabies/ringworm/mystery skin rash has taken its time but appears to finally be on its way out, after countless weeks!

...exciting! (?) gross! But all in all, it was really all quite manageable and low-impact. :)

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