I have a digital thermometer that beeps efficiently when it is finished calculating the temperature under my tongue. Along with the rape whistle and a ready supply of Tamiflu it is one of my favorite novelties inside my Peace Corps-issued medical kit. My health handbook, titled, “Staying Healthy in Senegal,” is another treat filled with helpful chapters on skin infections, depression, and snake bites (beware the green mamba). The book has spent many sweaty nights next to me on my bed, as I weigh how bad my symptoms are against the sicknesses described in the book. Without it, I wouldn’t know how to treat Larva Migrans, an infection caused by the ova of the hookworm that penetrates human skin on contact. Or Schistosomiasis, a disease caused by “tiny fork-tailed creatures” in fresh water that penetrate your skin and eventually reach the liver, becoming half-inch long worms. Or a host of other ailments I hope I never get here.
A random sampling of my collection of medical supplies
“38,” the thermometer read, which translates to about 100 degrees Farenheit. A low-grade fever. Can I just say, it is amazing that even while my body feels like it is raging with heat, it is still at least 10 degrees cooler than the overall temperature outside? And even more bizarre is to be having fever chills when it’s 110 degrees out, as if my body was finally playing tricks on me that only an air conditioner could mimic.
There is something unsatisfying about a low-grade fever. Especially when accompanied by diarrhea, which mine was. But the fever, it’s just never enough. It’s physically debilitating, yet not quite grave enough to warrant a worried call to the medical staff. A low-grade fever is a mediocre warning, a signal to go ahead and wait. I did wait, thinking optimistically that it would just go away.
• • •
Sickness here, both among volunteers and locals, is a major part of life. Quite often, the conversation topic among volunteers is a new staph infection, bout of Dengue fever, or brush with Schisto that someone has. I’ve become completely desensitized to talking about formerly gross things like diarrhea, which is so normal it’s like the common cold. Though no one actually wants to get sick, I’d argue that it is a covert badge of honor to have conquered exotic afflictions like blister beetles or malaria.
When I first read the book, So You Want to Join the Peace Corps?, the following passage, written by a former Peace Corps volunteer, startled me:
I was one of the most anal volunteers when it came to hygiene… Yet, within my two years, I still managed to get giardiasis, bacterial dysentery, amoebas, malaria, chiggers, tumbo worms, fevers, diarrhea, and strange bites, marks, scratches, and rashes that came and went with the winds.
Now, re-reading the quote, I have such a mild reaction to it. It sounds so run-of-the mill, and therefore bearable, in terms of what friends and I have experienced. Far from being regretful, the ailments I’ve suffered have taught me how impressively my body can handle sickness and how infrequently I actually become ill given the perceived threats around me.
Despite what seem to me like my death-bed experiences, sickness in my community is far more serious than anything I undergo. Small children are visibly malnourished, stunting their brain development and life expectancy. My host siblings get malaria every few years or so and thus have partial immunity to it. People get cuts from playing soccer or from accidents, and think nothing of the massive infections that ensue afterward. It goes without saying that dentistry is nonexistent, and I cannot even imagine the amount of pain people endure from ignored cavities year after year. For me to complain about feeling ill is to make a small asterisk to my enormous privilege; I have every type of medicine I need and a medical staff in Dakar ready to help me at any time. If I come down with anything too serious, the Peace Corps will medevac me to the U.S. at no cost to me. By contrast, most Senegalese people must depend on the kindness of others if they require money for a hospital stay or need to get a prescription filled. They are far less likely to live to old age or survive childbirth.
• • •
During my most recent illness, the fever actually did escalate. Within a day I had a high-grade fever, intense body chills, and strange thoughts. At night I couldn’t sleep because I had to get up every 30 minutes to use the bathroom.
The next day, I knew I needed to bathe but had zero willpower. I had been puttering around like an old lady, hunched over; it hurt my stomach too much to stand up straight. It took enormous effort just to pour oral rehydration solution (ORS) into my water bottle.
At one point in the evening, I finally mustered the strength to cool off by pouring well water all over myself while my clothes were still on. I then somehow migrated to my outdoor hammock, a sling I made a few months ago out of large rice sacks. I lay draped in my hammock, drenched in water and barely conscious, my arms dangling off the side. My body finally started to cool with the evening wind and my eyes rolled back into my head. For a few hours my mind slipped away. My host mother later came to my side, and I remember barely being able to communicate with her that no, I would not be able to eat that day.
Within another day or so, I was better. I started eating again. Cooked carrots with rice. Bananas. More ORS. My mind was lucid and I finally looked in the mirror. I looked like a skeleton; I had lost so much weight in just two days. Just for fun, I tried on a swimsuit. I couldn’t even fit into it properly. Little by little, I got rest and ate, and felt like myself again. I rallied.
• • •
In the U.S., getting food poisoning is seen as an failure in hygiene, an avoidable, idiotic mistake made by someone in food preparation. When you go to a restaurant and your stomach doesn’t feel quite right afterward, it’s a major let-down and source of anxiety. Now, it is such a normal part of my life to feel mildly ill; the symptoms usually pass fairly quickly. Half of the time, it’s not that I drank bad water or contaminated food, but that for once I ate dairy or lots of meat and my stomach cannot handle such strong ingredients that I eat so infrequently. At the regional house, we recently roasted a whole pig in the ground and ate it with homemade barbecue sauce–so delicious, though I did throw up that night.
When I do suspect that I ate contaminated food, it’s hard to explain that to Senegalese people. If I’m sick, they say it’s because I’m “still adjusting” or that I’ve been working too hard. Rarely do they acknowledge that the bean sandwich vendors should wash their hands or that it’s risky to serve eggs that have been sitting in the sun all day.
Still troubling is that only in a serious, persistent case would I do a stool test to send to the lab. Thus, I can never know exactly what makes me sick (virus? bacteria?) and from which food or drink. Instinct says it is the most recent thing I ate, but that is not always the case. There is a mystique around getting sick: it could strike when you least expect it, and you may never know what to do differently next time. So goes the saying, coined by Darren Watkins of Kolda, “Don’t judge a meal until ten days later.”
I have learned to stop being paranoid about everything, including the fact that other people do not wash their hands. I would rather enjoy street food, fresh vegetables, and ice-cold tap water than avoid them out of fear. I would be missing out on so much cuisine if my main goal here was to not get sick. I am thus much more thankful now for the times I am healthy, something I rarely acknowledged in the States.
Yet every time I get sick, I have the American reaction of wanting to know exactly what it was that caused it. And in most cases, just like with a low-grade fever, the only thing to do is just wait it out.