Malarial mosquito bite

Our victory-party after the beautiful but very tough route from Songea to Masasi progresses less cheerful than we expected. The same evening I feel very bad and go to bed early. We blame the exhausting trip and postpone the party until the next day. But, the next day there is no improvement. On the contrary. High fever, headache, pain in the muscles, pain in neck, arms, shoulders and knuckles are, besides the stomach-ache, sufficient ingredients to keep my bed. Eating and drinking are fatiguing activities, sleeping and moaning are the only things I have no problems with. We guess for the cause and for the moment think it's over-fatigue.

Wednesday there is still no improvement. My temperature rises and drops, with an alarming 40,3 degrees Celsius as winner. To be sure we use one of the self-tests for malaria we bought in Uganda, with a single pink line the result is negative though. One line means the test was successful, but no malaria was detected; that would require two pink lines. Our inflamed wounds still aren't healing as well: despite disinfecting them regularly they keep purulent. My appetite is still minimal, Peter takes great efforts to make me eat some bread and a mango. In the 'bafu' (bathroom) he washed the sour-smelling transpiration of me (I'm not able to do it myself by now) and does the same with himself later. Unfortunately my condition doesn't improve.

Thursday morning we measure a temperature of 40,7 degrees and decide to visit a doctor. At 300 metres from our guesthouse there turns out to be a 'dispensary', a kind of local health centre. Shuffling Peter supports me and with some effort we reach the place. After registering we talk to a doctor who only addresses Peter. Obviously the man is taken more seriously than the woman, even though I am the patient. After having paid the bill I am brought to a small room where I have to lie down on a metal bed with a sagging plastic mattress. My condition visibly deteriorates: walking and sitting upright have ceased to be possible. Before examining me, the doctor wants to improve my condition. Strangely enough he only takes my blood-pressure, no temperature or heartbeat. A nurse misses a few times, before she manages to place a drip. At the same time they administer antibiotic and anti-malarial tablets and medicine against intestinal pains and infections. An injection in my buttocks with a pain-killer causes a lot more pain instead of relieving it. The doctor estimates that the result of the examination will be salmonella-contamination or malaria.

The room I'm in would fit perfectly in an inferior guesthouse: filthy, broken shutters, torn mosquito-net in the window, mosquito-net with enormous holes above the bed, a door that doesn't close and to make matters worse water that enters the room everywhere when it starts raining. Nothing you'd expect in a Dutch clinic. The toilets, holes in the ground, are filthy and stink. There is no running water (yes, except for when it rains).
During the day my condition further deteriorates. When I have to go to the toilet I almost faint, am dizzy and can't stand upright without help anymore. On the toilet it turns out to be diarrhoea-time again. After three hours of lying and waiting Peter asks the doctor to examine my blood; he goes right at it. The communication between the doctor, the laboratory worker and Peter is quite difficult because of the poor English of the first two and the difference in approach. The doctor tells Peter the result of the blood-test will be available in an hour.
In the meantime the drip has stopped, the nurse has to search a new vain. In Syria this wasn't quite easy, here it's a complete drama. After having pricked me for seven times I urge them to stop their attempts. I get cramped from the painful efforts and feel nauseous. The mango that Peter fed me just before is coming out again, in waves. The misery is complete now.

Meanwhile it's pouring with rain, the water enters the room via the shutters, to form a big pool on the floor. Sometimes there are powercuts and we can't stop wondering whether this is a place where it's possible to recover, even if you really want to.
Two hours after the laboratory worker took my blood we still wait for the result. Peter is fed up by now and goes looking for the doctor and laboratory worker. The latter is sitting outside on a bench, reading a paper. Peter asks him whether the result is known. "Yes, of course, just walk with me." Peter hides his annoyance that they didn't come to tell it, it's only logical that you want to know what's wrong? Here it's the other way around though: you don't ask, they don't tell. Incomprehensible.
The laboratory worker explains in a lot of difficult sentences that there are all kinds of malaria, after which Peter asks again what the outcome of the blood-test is. Then finally an answer: a harmless kind of malaria, Plasmodium Falciparum. Not the deadly kind, the Tropica, he says. A relief?
Peter tells me the result and goes to the doctor again to get an answer to a lot of questions, like: medication, progress of the illness, side-effects, contra-indications and other clues. None of the questions is answered clearly. Both doctor and laboratory worker are not used to patients that are interested in details. The doctor prescribes medication, we hope it is right. When the rain stops we'd like to leave and ask for the medicine. With a short statement in writing about the illness and the treatment received we leave the dilapidated premises, very slowly. Do we normally attract quite some attention, now it's party time. The people almost drop from their bicycles. After ten minutes we've covered the 300 long metres and are back in the guesthouse. We immediately take out our book with tropical diseases in which we read that Plasmodium Falciparum indeed is the deadly Malaria Tropica. Luckily enough the doctor prescribes the right medicine…pfff.

Friday my condition seems to improve somewhat, the next days are horrible though. My temperature is very high and I'm in bed the entire day. I sleep a lot, am not able to eat anything and even have difficulty drinking. Almost the whole day a moaning sound escapes from my throat, when I'm awake I have a haggard look in my eyes. Even talking is a problem. I scarcely react on questions and remarks Peter makes, have difficulty forming sentences and seem to loose my ability to think. Walking is only possible with a lot of support, at the Turkish toilet it takes me ten minutes to lower myself, after which the usual shit squirts out. Like a male nurse Peter has to clean me, I can't do it myself anymore.
For Peter it's incredible to see his partner like this, it's like seeing a demented old woman. He worries more and more, about the effects of the medicine, the progress of the illness and the lack of improvement. Where can he go with his worries though?

Sunday the situation still hasn't improved: the fever runs higher, talking, eating and drinking are almost impossible. I'm in bed the whole day, soaking wet from transpiration despite the fact that the fan is on topspeed. The only sounds I make are moaning, groaning and crying. Luckily I do sleep a lot. Despite their promises the doctor and laboratory worker don't come by once to examine me.
Peter decides to arrange for transportation to Mtwara, a bigger town near to Mozambique with a lot more and better facilities. This isn't easy: everywhere he informs for the possibilities to rent a pick-up with a double cabin. There are a lot of those cars here, but all of the owners ask about 150 US-dollars for 200 kilometres. A ridiculous price, since the price for diesel is very low and the average wage in Tanzania is about two dollar per day. Even knowing the reason for the ride they try to profit as much as possible from these so-called white dollar-strews. Finally Peter reaches an agreement with a friend of the owner of the guesthouse: 65 dollars. On the arranged time he doesn't show up, for hours we wait in vain with all our things packed in our bags. The day passes without our departure.
Monday afternoon we succeed to arrange transportation. In the meantime my condition has improved somewhat: I am approachable and even eat half a mango, although it comes out half an hour later with a big cramp.
In the afternoon Peter loads all of our belongings in a pick-up with double cabin, bicycles tied on the back, me flat on the rear-seat. It's a real death-ride. Almost. The driver is a reckless boy who, despite his age, seems to be weary of life. At the start of the expensive ride he wants to eat an extensive lunch, while I'm groaning with pain on the rear-seat. Peter can't restrain himself and calls him names for even having the guts to propose a thing like this. With a packet of biscuits and a bottle of soda we drive on. Driving at least one hundred kilometres per hour and sounding the horn like a madman he roars through the small villages, where cows, goats and small children seek safety in flight. Peter asks him to lower his speed, two minutes later we're going one hundred again.
Half-way during the drive it starts pouring with rain and the winding tar-road becomes a streaming river. The window-wipers can't handle the violence and our visibility becomes less and less. Despite the amount of water the driver presses the accelerator to the bottom. The situation becomes life-threatening and Peter has to shout at him again to keep the car on the road. My God, what would it be wonderful to sit on our bicycles again!
After almost three hours we arrive in Mtwara. I am absolutely dead-beat, so we put up in the first guesthouse we can find. This results in us having to move again the next day, because our guesthouse serves as an indoor-swimming pool when it rains very hard. The owner doesn't give a damn and provides us in the dark - of course there is always a powercut in these situations - with a bucket.

The next morning we are taken care of in a superb way in the Lutheran mission, where we're given a room for four persons and breakfast for a very affordable price. I feel a bit better, but my condition still gives cause for concern. Peter visits a doctor, specialised in malaria, in the hospital around the corner from the mission. The doctor completely reassures Peter: the worst symptoms of this illness appear after having taken the medicine, I am not going to die at the moment and will surely improve the coming weeks. The doctor thinks the wrong diagnosis of the doctor in Masasi is unforgivable, but at the same time indicates that this doctor did prescribe and administer the right (amount of) medicine (Metakelfin).

My condition improves a bit every day the following days. At first I'm very weak and get tired very fast, but am completely approachable again. I drink a lot of sweetened tea and keep my food inside. Normal life slowly returns: I independently walk to the toilet, start nagging about our lack of reading-material and steal Peter's puzzle-book when he isn't watching.
The days pass like in a hospital: slow, waiting, resting, bored of inaction. As far as the situation permits we enjoy the great rest and silence in the Lutheran mission. The staff is sincerely concerned and helpful.

Peter manages to extend our visa, that definitely expire Wednesday February the fourth, with some power of persuasion. The immigration-clerk thinks we should just travel on to Mozambique, his boss shows a bit more compassion and permits us to stay another month, which is very rare.