Tag Archive for 'health'

Malaria Meds and Nairobbery

So for a little under a week now I’ve been in Nairobi for my one-year medical and dental checkup.  Conclusions:

  • I don’t have cavities.
  • I don’t have TB.
  • I have a normal heartbeat.

None of these things were actually in doubt, but that’s just about all that was tested.

I also finally changed my malaria medicine from Mefloquine to Doxycycline.  I did this for two reasons:

  1. Mefloquine seems to me to be bad news in general.  Even if you don’t get any of the common side effects that ~30% of its users report (vivid dreams, hallucinations, anxiety), it still accumulates in your nervous system, where it remains long after you stop taking it, just waiting for something traumatic to happen to trigger who-knows-what residual side effects.  The Peace Corps uses it as the default Malaria prophylactic, and they only switch volunteers to another medicine if problems are experienced or expected.  The US Army actually used to have the same policy, but they changed it due to the overwhelming number of problems, so they now default to Doxy.  This should be reason enough not to take it, but to make the problem worse…
  2. I hallucinated a little bit a few months ago.  This was a bit unnerving, although not at dramatic as it might sound at first.  Basically, I have a constant anxiety about people coming into my house.  When Deaf children or teachers want me to come to the door, they have to clang the metal gate to get my attention, but it’s a faint sound and it blends into the background noise of the metal workshop across the street.  It’s very common that I go to answer the door and no one is there, and vice versa, I don’t think anyone is there, so they grow impatient and they reach around, open the gate, and come right up to my open door, and if I’m napping, kids have even walked all the way into my bedroom and stood there until I’ve woken up, which can be startling, especially because I’m rarely decent when I nap in this equatorial heat.  I’ve also had experiences where I’ve turned the corner from the kitchen and seen a student standing in my living room or in the doorway; again, rather startling.  Add Mefloquine to the mix and not only does the anxiety level go up, but also I started turning corners and out of the corner of my eye, seeing people standing there, watching me, but when I’d turn to see who it is, I’d realize that I was just imagining it.  The worst was when I woke up and thought for a spilt second that a man was standing in the corner of my room.

I hadn’t had any of these hallucinations for a while, but I when I’d think about the general reasons to stop taking it, it seemed that it would be the best thing to do.  So now I’m on Doxy, which means I need to take a daily pill and I need to be more vigilant about sunscreen.  But it also means my complexion will improve!  Check out the Wikipedia page on Mefloquine if you’re taking it and I’ve worried you.

In other news, Nairobi seems to be just as dangerous a place as ever.  I had dinner last night with one of the newer volunteers, who is recovering from a mugging that he doesn’t even remember.  The leading theory at the moment is that he was smashed in the face repeatedly with rocks before he had a chance to see what was happening.  In any case, he looks good considering, and while he recovers, Peace Corps has put him up in, essentially, a mansion (3 stories, 3 full baths, hot running water, full-time security guard, etc).  I already err on the side of taking taxis more often than necessary, but now I feel even more strongly about not walking alone in Nairobi.  Prior to this event, it was easy to imagine myself reasoning with the muggers, slowly handing over money, phone, etc, to avoid any violence, but now that scenario has been thrown thrown right out the window.  The fact that he hid money in his shoe didn’t help this particular volunteer avoid violence. (Although it did help him with the cab fare after he regained consciousness… and yes, the taxi driver did charge him.)

I’m not sure what the percentages are, but it seems like at least one volunteer is mugged every month in Nairobi, although this is the worst one I’ve heard of so far.  I may regret sharing this story and worrying people, especially since I may soon be spending more time in Nairobi, but trust me— I won’t be walking alone at night, or even at dusk!

I don’t have any Nairobi pictures to go along with this post’s prose, since I lent my camera to a friend, but here’s one I took of a fellow volunteer in Malindi, where I spent a couple days before we travelled to Nairobi together:

Image052

3 Responses to “Malaria Meds and Nairobbery”


  • Paul:

    I am COO of Water Charity, a 501(c)(3) nonprofit that does water, sanitation, and public health projects worldwide. We recently started a new initiative, Appropriate Projects, to fund small water and sanitation projects very quickly.

    I am a Returned Peace Corps Volunteer (Bolivia ’66-’68), and am well aware of the difficulties Volunteers face in the field. Appropriate Projects is an addition to our regular Water Charity model that is allowing us to provide project resources to PCVs in the field immediately.

    Often there is that little project that must be done now (before the rains start, before school begins, or in response to a critical need), but there are no funds available. Traditional funding sources are cumbersome, and there are long forms, detailed requirements, limited resources, and long delays.

    PCVs working in water and sanitation usually have potential projects lined up. For those working in other program areas, there may be water components to their projects, or improvements needed where they work or teach.

    Sample projects may be: a rainwater catchment, handwashing stations for a school, water for a clinic, piping, tanks, pumps, sinks, latrines, wells, etc.

    We like to “finish” projects that have been started, and “fix” things that have ceased to function.

    We encourage follow-up projects that expand upon the successful completion of the first small project.

    If you have a project in mind, please fill out the application form. We want this to be easy for you, so we have developed a simple form that you can fill out in one sitting.

    If you have any questions about the appropriateness of your project, or you need some time to get it together, just let us know.

    We pre-fund projects, so you don’t have to wait around for donations to roll in.

    If you do not have a project that qualifies, please pass this message on to your fellow Volunteers who may have an interest. Finally, if this initiative resonates with you, please let others know what we are doing through your social networks, websites, and blogs.

    I look forward to hearing from you.

    Regards,

    Averill Strasser

    Appropriate Projects
    http://appropriateprojects.com

    Water Charity
    http://watercharity.org

  • This entry was really fascinating. (100% not being sarcastic.)

  • look ma, no cavities! (finally). Glad you’re on doxy now.

Revenge of the Infection

WARNING: I won’t get into all the gross details, but this is mostly a medical post.  You’ve been warned.

So I wish I could say that I’ve been a good, effective teacher and that I’ve been focused on exams week, but it’s not true.  In fact I’ve been missing quite a bit of class recently.  Last Friday, two weeks after I finished taking antibiotics for the staph infection on my arm, I finally got tired of the area around the infection becoming more painful every day.  Additionally, and only possibly related, I had been fighting a general sickness around the same time, blowing my nose a lot, etc, and I found myself sleeping more than usual and taking deep breaths for no apparent reason, as if I’ve been holding my breath, which I might attribute to stress were it not for timing—the infection had definitely started growing again.

The doctor that the Peace Corps normally uses was unavailable, so I visited the Mombasa Hospital Outpatient Facility (AKA the ER, or as it’s known here colloquially, “Casualty”).  In my first real experience with hands-on medicine in Kenya, the doctor suggested that it would be best to take a culture sample from the infection to have tests done, since it’s apparently resistant to the first antibiotic I took.  That sounded like a good plan, and he did the procedure himself, which was quite disgusting.  After he finished cleaning the wound and bandaging it, he looked down at the biohazard bin where everything had been thrown away and said, “Oops.  We forgot to get a sample.”

So I left the hospital with bloody gauze on my elbow and a "best-guess” antibiotic prescription in hand.  That was Saturday.  Today I went back for my scheduled cleanup/gauze replacement, but also armed with additional questions about what appeared to be some smaller infections developing around my mouth, and was treated to a confusing game of find-the-paperwork, in which I was asked questions like, “Who bandaged that for you?”

“You did.” I would say, “Here, at the hospital.”  They would look confused as to why that wasn’t in my file, and then send me back to the waiting room.  Eventually I was taken back to the same room where the doctor “forgot” to take the culture sample.  Upon removing the gauze, it became quite clear that the infection was gaining ground again, as —SKIP TO THE NEXT PARAGRAPH IF YOU’RE SQUEAMISH— SERIOUSLY — okay really, move along if you don’t like gross stuff… dark red blood and puss immediately began oozing out of two separate places and dripping onto the bed where I was sitting.  The nurse moved to clean it, and I stopped him and asserted, “TAKE A CULTURE SAMPLE NOW.”

After he took the culture sample, another nurse came in and asked me if it was a bug bite.  They suggested making a larger incision, and they were surprised that the first doctor hadn’t.  I refused to let them touch me any more until they found all my files, because as long as I’m still getting questions about whether it’s a bite, no one’s doing anything.

Eventually all was found, a doctor I liked was brought in, and they made the larger incision.  The test results on the culture will take two more days, so in the meantime I’m in the same situation—bloody gauze on my elbow, soaked through onto my shirt, and best-guess antibiotics in my stomach.

This whole experience hasn’t been good for my moral, and it’s even worse now that the infection is apparently attacking tiny little shaving cuts on my face.  So, much like my last bout of Giardia, this whole thing has been accompanied by a lot of movie-watching in my house.  Transformers 2 was terrible, by the way, in case you haven’t heard.

I’m supposed to attend a local wedding on Sunday, so I really hope things clear up by then, so I don’t need to show up with a Phantom of the Opera mask.  I’ll have a better idea on Wednesday when the results come back.  Stay tuned…

4 Responses to “Revenge of the Infection”


  • Paul,

    Can you tell us that the names/amounts of the meds they have give you and what you are currently taking. Can you also give us a time-line.

  • Larry (doctor friend of Josh A)

    Paul,
    I am a friend of Josh A. My son is in Peace Corps in Lesotho. Josh called me and seemed concerned about your infection and forwarded your blog link.
    With regards to your infection:
    If you are better great. If not, it would be helpful to know what medications / antibiotics you have been taking (dose strength, pills per day and number of days) and the culture results. If you email me photos of the wound and mouth lesions, I have an infectious disease colleague who may be able to give additional insight.
    Larry

    • Thanks Larry (and Josh). Timeline and drug info is in my latest post. Self-consciousness dictates that I don’t take pictures to share with you. The doctor in Nairobi is apparently the regional specialist in such things, so hopefully it’ll be OK.

  • FYI. I am worried. And thinking very healing oriented thoughts…. I’m from santa cruz after all…

Apple-Cat Part 2

A short while back I did some experiments with making my own workbooks for my students.  They were absolutely a success.  I had conversations with my students like (and I am of course translating), “If a cat is eating a cat, then there are two cats involved, so why wouldn’t I use the plural ‘cats’ in the sentence?”  A completely logical question, and one that I failed to anticipate when I designed the workbook.

My fastest vocational students needed about three hours to get through the workbook and the corresponding review sheet, and it was time well spent.  I could tell from the questions I got that the first workbook was ten thousand times more effective than any previous approach I had tried.

Here are links for the revised workbook and the review sheet:

The downside is that it’s difficult to whip up the energy necessary to draw all the pictures, photograph them, and then clean them up on the computer.  Part of me regrets bringing a normal laptop instead of a tablet.

Because of the time and energy  problem, I’ve been applying the workbook’s methods to more conventional blackboard teaching.  The method is basically to use very few words, but just shuffle them around and observe how the meaning changes.  I typically write sentences on the board and have the students come up and draw a pictures that they think correspond.  It can be kind of fun, and it’s easy.  In the last couple classes, we’ve been dealing with “to” and “from,” like:

  • The boy runs to the girl.
  • The boy runs from the girl to the house.

Etc.  And so far so good.

In other news, I’m in phase two of my arm infection, which means that it’s getting smaller on its own.  Also, as I type this, the school is being painted in preparation for another big competition that will take place here when the term ends.  Someone donated new mosquito nets, too, which will make the dorms a lot nicer.

The school is also going to clear out a room to make the new computer lab.  I met with Camara a while back, and it seems pretty easy to get computers from them.  This is very exciting for me, so I’ve been doing a little work to make sure the kids can use the game software that they’re used to, even if the new machines don’t have floppy drives.

0 Responses to “Apple-Cat Part 2”