Life lately has been a little crazy, and has definitely favored the low side of the scale. They warn you about expat acclimation that your highest highs and your lowest lows will come within like five minutes of each other, and honestly that is the truest thing I’ve experienced. One minute you can be so happy and excited to be in your new host country, and then the next you’re angry, confused, upset, anxious, and just plain unhappy. Acclimating as an expat is very tumultuous. You prepare for it as much as you can, but for the most part you just have to experience it.
I just want to add a *disclaimer* that none of the negatives mean I don’t love being in Uganda or my time here, but the hard moments are very real. Uganda is the greatest blessing I’ve been given in my life. I’ve already grown like never before and a huge piece of my heart will forever live here. This country has truly helped shaped me into who I am, and I know this job and time here will continue to grow me. I am so grateful for Uganda, but that doesn’t mean hard moments don’t exist.
Probably the biggest thing that has happened recently is that I’ve had malaria for the last two weeks. It was nothing like I expected, but it was awful none the less. I didn’t know a ton about how malaria actually works before I came here, so here is a little insight on how it works (just remember I’m not a doctor, click here and here to read about it from doctors). Malaria is a parasitic infection of protozoan Plasmodium that is most commonly transmitted through mosquitoes and causes cyclical infections. There are four different types of Plasmodium parasites humans can contract, P. falciparum (the most commonly seen one in Uganda, accounting for more than 95% of infections), P. Malariae, P. ovale, and P. vivax. When a human is bit by a mosquito infected with malaria the infection is spread through the saliva of the insect (so appealing right?) and the parasite first goes to the liver to grow and multiply in the liver cells before it makes it’s way to the blood stream, where it starts entering and attacking your red blood cells. Once in the blood the parasites grow and multiply inside of the red blood cells, destroying them by bursting the cell. This causes the symptoms of malaria. The biggest thing I’ve learned about malaria since being here is that it is a cyclical infection, meaning your symptoms are cyclical as well. You’ll have bouts of feeling awful, where every symptom hits you and then you’ll feel relatively okay for a period before it starts all over again.
This really messed with me because it made me feel like it was all in my head since I would have periods of relief. I felt lazy and was mad at myself for not being able to power through the symptomatic episodes, and felt crazy for feeling so back and forth all the time. Malaria presents differently for everyone and in every body, and I was told my symptoms presented fairly atypically. My symptoms were primarily gastrointestinal with extreme nausea, gastroenteritis (i’m just using this word to make it less gross), chills, sweating, shivering, headache, extreme fatigue, dizziness to the point that I almost passed out many times, loss of appetite, and then other flu like symptoms. What made it different from what I expected was that because of the cyclical nature, I overall felt better than I would’ve expected. Now when I had those episodes where all the symptoms happened at once, I felt like I had a very severe flu. When I didn’t though, I was able to push through the general discomfort and pain of it. I expected that when you got malaria you wouldn’t be able to “push through” anything.
Although I knew it was a possibility, I did not think I had malaria because my symptoms were so focused on my GI system. I was suspecting I had a parasite liked Giardia, so I first went to the doctor to check for that and was honestly so discouraged when she told me everything was perfectly fine, because I felt so awful. She said if I still felt sick to come back in a few days and test for malaria, but I was sure I would be better and it was probably just a virus. During this week I kept coming to work because I didn’t think it was anything serious and figured if I could push through it I should. My roommates and co workers are so sweet and kept encouraging me to stay home and rest, but I was having none of it. Looking back I absolutely should have listened to them. Self care is a huge thing here, and something I’m terrible at, but it’s crucial. I was sick for a full week before I took an at home rapid diagnostic test for malaria on Saturday. I did two because I wasn’t sure if I did it right and one came back positive and one came back negative. My roommates and I were both sure I didn’t have it, but I knew I needed to go to the clinic and get that confirmed. I did a microscopic blood smear analysis and when the lab technician called me back to give me my results I said, “I know it’s totally negative right?” and she just looked at me and goes, “No I saw malaria. Very early stage malaria, but malaria.” I was so relieved. It’s not that I was relieved to have malaria, because early stage or not it is a serious parasitic infection to have, and can go from bad to worse really, really quick. But, I felt relieved because It made me realize I wasn’t crazy for feeling sick, and it wasn’t in my head after all. I got three days of oral medication and was on my way.
I took the weekend to rest and then was back at work on Monday, which again looking back, was a terrible idea. I didn’t give my body the rest it needed and it set me back and made my recovery so much slower. I would show up at work and then have to leave because I couldn’t handle “pushing through it” anymore. I finished my medicine Monday but continued to feel sick through the whole week. I was so frustrated that I wasn’t getting better and felt like I was doing something wrong. I ended up leaving work early twice that week, and completely missed work two other days.
On Friday I finally went back to the clinic, feeling like the most dramatic person that ever existed. I told the doctor how I was still sick and had finished my meds but figured it was completely normal and thought it would get worse before it got better. She told me I should have been symptom free by then, and if anything at that point my symptoms were worse than before. I was constantly feeling like I was about to pass out, with one day actually seeing black spots and having to grab the wall for the support because I couldn’t stop shaking. The doctor thought I still had malaria and that the treatment just didn’t work. She explained that even though it was caught in the early stages since I’ve never had malaria before my body wouldn’t know how to fight it. She retested my blood and couldn’t find any malaria parasites but told me that wasn’t uncommon and they might’ve just migrated out of my blood stream. I honestly have no idea if this is true or not, but i’m not a doctor and at this point all I wanted was to feel better. She said when you’re foreign and have never had malaria before your body doesn’t know how to respond and can mean that even an early case is severe. She told me I would need three IV treatments, one every twelve hours and then three more days of oral medication. I honestly have no idea what I’ve put in my body, and just said do whatever you need to lol.
The first round of IV treatment happened at 11:35 AM, which meant I needed to find a way to get back to the hospital/clinic at 11:35 at night…not the easiest task here when you don’t have a car. The IV medication made me start shaking really bad and left a weird metallic taste in my mouth. I got slightly dizzy but just went home to sleep it off. I felt much sicker after the first does, which seemed promising to me, like it was actually doing something. I slept that entire Friday, or if I was awake was watching movies in bed. My headache went from bad to awful and I was so fatigued I felt like I weighed 1,000 pounds. Since it’s not the best idea to go out at night alone and since I had to call a Boda (motorbike driver) to pick me up late at night to take me to the clinic and wait for me, my sweet roommate came and waited with me at 11:00 pm. The clinic was dead, except for the treatment room. I walked in for my treatment and a kid is violently vomiting. If you know me you know that is one of my worst nightmares. I had to sit in there for 15 minutes while he puked over and over and there was nothing I could do but listen to it and try not to let my mind think, “Ebola?” hahahaha.
I woke up on Saturday, after officially two weeks of being sick, and finally felt better and like a human again. Because I was so dizzy and had so much brain fog I did not feel human or normal for the whole two weeks. I was so glad the IV treatment worked, because being sick for so long (which, is minor in comparison to so many, but add in living in a new and developing country, and it’s a lot) really took a toll on my emotional state. Thankfully i’m feeling so much better, not 100% but I think that after so long of being sick and after taking so many different medications, it’ll take a minute for everything to get back to normal. Life lately has simply looked like a lot of resting, bed, and malaria.