Malarone!

One of the very first things that happened when I arrived in Senegal was that I started taking anti-malarial medication. People who grow up in areas where malaria is endemic can acquire some degree of resistance to malaria infections, but PCVs definitely don't have any sort of immunity. While there are a places in northern Senegal where malaria is practically non-existent (mosquitoes can't live without water and it's the desert up there) it exists on an epic scale down here in Kedougou, particularly during the rapidly approaching rainy season. 

The go-to malaria prevention drugs in West Africa are doxycycline (doxy, as we call it)and mefloquine (AKA Mephaquin, Lariam). Doxy is an antibiotic, sometimes prescribed to people in America for acne. You have to take it every day and it has mostly mild side effects, like upsetting your stomach and making you more sensitive to the sun, but most PCVs here tolerate it well and for a few it's even helped keep their complexions clear. However, due to an allergic reaction I once had to a medication in the same -cycline family of drugs the Med Office (quite rightly) decided that it was off-limits for me and I was put on mefloquine. 

Mefloquine (one of the generic versions of the much-maligned Lariam) is made of a chemical that disrupts the development of malaria parasites. It doesn't tend to upset your stomach, you only have to take it once a week, and, like doxy, it's pretty cheap. However, in some people it can cause things like extremely vivid dreams, insomnia, anxiety and/or depression. More rarely it can cause hallucinations, odd behavior, and self-destructive thoughts. My first few months on Mefloquine I had bizarre, incredibly vivid dreams (all of Peace Corps in a strange pageant at an Under-the-Sea-themed middle school formal; being menaced by lazy, helmeted urban dinosaurs, etc etc) but that was pretty much it and I didn't mind. 

Then, as the weeks went by, I started getting weirder. Slowly, like the proverbial frog, I went on with my life as a tight, angsty knot began lacing itself around my sternum. Back in America I wasn't exactly an carefree ray of twenty-four-hour sunshine, but I also didn't get all squirrely about making eye contact with my neighbors. It took awhile for me to decide that the anxiety I was feeling wasn't justified (from scary transport to aggravating cat-callers,  there are so many anxiety-making things here) but eventually I listened to other PCVs and gave Med call. It didn't take long for them to decide that I shouldn't be taking mefloquine anymore and (because my -cycline allergy ruled out taking doxy) they set about getting authorization from the Washington, D.C. Medical Office to switch me to Malarone. 

The most valuable thing in my hut. 

They needed official permission from D.C. because Malarone costs a lot of money. The Cadillac of Chloroquine-resistant malaria prohylaxsis medications, it's known for having almost no side-effects, and also for being crazy expensive. Because it's a generic drug Mefloquine is pretty cheap (I think brand-name Lariam can be more expensive) and an entire month's worth of doxy only costs about $10 USD, but Malarone costs about $5 USD per pill, or about $185 USD per month. That's considerable, particularly at a time when budgets are getting slashed left and right. In any case, they sent me a bottle of Malarone, I stopped taking Mefloquine, and after a couple weeks the big ball of anxiety in my chest started to loosen. It took a couple more months for me to really feel like I was getting back to normal, but it happened eventually and life is much better now. There are still plenty of stressful things (student loans, rainy season transport, project funding, garage weirdos, government paperwork...) but they no longer feel like they're consuming me, and I have a new appreciation for what people who struggle with serious anxiety issues have to deal with. 

Also, I was sitting in my hut the other day and realized that the bottle of Malarone I was holding probably cost about five hundred dollars, making it the most expensive thing currently in my possession, worth more than my netbook and my iPod put together.

Bikram Lunch

So, a lot of people in America are into yoga these days, and Bikram Yoga, where people do all that stretching and posing and whatnot in a humid room heated to 105°F (≈ 41°C), has caught on in some places. From what I understand the idea is that doing this is cleansing, that it builds endurance, that it stimulates good stuff in your body, and that it warms up and loosens your muscles. I like yoga and I like steam rooms, and it seems like a fine idea to me.

However, I was thinking about this the other day, when the temperature was about 42°C (≈108°F), while I was perched on my little stool under the mango tree, quietly sweating, waiting for Gaulo and Bailo, my host sisters, to bring over our lunch bowl (steamed rice with peanut sauce, as usual). I was thinking about the heat, and hot yoga, and what we like to call "the face-sweats" (which is happens when you eat during hot season) and how people would react if, after they finished their hot yoga workout, they were presented with a steaming bowl of rich, salty rice and sauce and told to dig in. It's funny, but not the most appetizing thought.

Pre-Lunch Face-Sweat Levels

I've made plenty of hot-season jokes about how I should have called this blog "Bikram Life" but sitting there at the bowl, spoon in hand, perspiration trickling into my eyes and dripping down my calves, "Bikram Lunch" seemed to do a better job of summing it all up.

Blogging for PeaceCare

All the PeaceCare team members and the PCVs took turns writing entries for the PeaceCare Blog  and this is the thing I wrote for my day.

Saturday Feb 4^th 2012

PCV LaRocha LaRiviere (ou bien Adama Souaré)

Today we woke up, greeted the family hosting us, and unsuccessfully looked for bananas on my way over to breakfast at the Saraya hospital’s housing area. We had an oatmeal can filled with village-style peanut butter, a plastic sack of hard boiled eggs, and a big pile of fresh loaves of tapalapa, handmade village bread. The water was on, so I sipped my instant coffee and filled our water barrels and watched a big class of kids doing their stretching on the basketball courts. The water went out after a little while, and the doctors headed over to the hospital for rounds. A couple of the Peace Corps Volunteers worked on translating and editing the team’s PowerPoint presentations, and there were a series of meetings were we mostly talked about meeting we’ve had and arranging for more meetings in the future.

Of course, it wouldn’t have been a day in Senegal without a massive schedule disruption. Unfortunately, last night there were two serious accidents involving multiple fatalities on the Kédougou road last night, and all senior members of the Kédougou medical staff were working on that past six in the morning. Obviously, getting on an early morning car to come to Saraya for a day of training and discussion was not going to happen after that. We did our best to salvage the day’s productivity, so we strolled over to the new Saraya hospital to ogle all the shiny fancy new things that JICA (Japan’s international development agency) has built and brought to Saraya. There were so many pristine rooms and pieces of equipment - a maternity ward with state-of-the-art birthing tables and little infant beds with sunlamps for jaundiced babies; a pristine specimen collection room, with the little wall-portal for passing cups back and forth; an operating room with brand new basins, lamps, and tables, capable of accommodating Cesarean sections and other surgeries; fancy facility maps with little red arrows declaring that VOUS ETES ICI. Sadly, the hospital won’t be able to begin seeing patients until the Senegalese Government finishes their contribution to the project, specifically building living quarters for staff, a morgue building, a driveway, and a low wall around the whole complex. It looks like construction’s starting on the wall, or a trench has been partially dug, but it may be awhile before the lovely new hospital is open for business.

After the tour wrapped up the group braved the mid-day sun and walked back down the (amazing, smooth, lovely, evenly paved) road to the current Saraya hospital. While we sat around waiting for lunch to be served Amish taught us all the “Zoo” game, which basically involves a lot of clapping and snorting and making funny animal gestures. Lunch was yassa sauce, made with diced onions, little bits of carrot, and small chunks of meat (beef? or maybe mutton?), over steamed rice. It was pretty good, but my favorite part, was the amazing selection of delicious juices. There was sweet, dark red bissap (like hibiscus) juice, thick, creamy baobab juice, light, spicy ginger juice, pale green kiwi nectar-ish ditakh juice, bissap with fresh mint, bissap mixed with baobab, and Foster Clark’s Orange, which is basically really strong Tang.

(PHOTOS: Ivy and the juice)

After all the juice and yassa I fell asleep for a bit, sitting up in the afternoon heat, and then spent the rest of the afternoon translating stuff from English to French. My netbook’s battery was running low, so I went inside the hospital’s living quarters to plug in, and people were watching a TV show about people with extreme gigantism and that disorder that makes children age horrifically rapidly. It was surreal but entertaining background noise, and I wrapped up my form translation just in time to watch Dr. Isaak Manga give a PowerPoint presentation on malaria in Senegal. After the malaria talk Dr. Nate gave a presentation on EKGs and the electrical goings-on of the heart. A lot of the jargon-heavy parts were alphabet soup to me, but it was neat to have a heartbeat explained in detail. After the EKG talk we headed over to dinner, which was lovely. They made the best thing, which is meat and fries and salad with dressing and tomatoes, and also more juice. After dinner we set up the projector and had a little outdoor screening of Babies, which went over really well. We’d set up plastic chairs for all the hospital staff, but when it was over and the lights came up we realized that during the movie a decent sized crowd had gathered to look on. Everybody loves babies!

Village/Other People's Blogs

It's been a busy week or so, and now I''m headed back to village for a few days.

I'll be back next week to help welcome the new Agriculture PCVs when they arrive for Installs, but in the meantime if you want to read more I've added more links to my list of blogs written by PCVs in Senegal. 

Under African Skies...

Last night walking back to my room I looked up at the stars and saw Orion. It's always the first constellation I see, and it made me think of home and camping and Lake Tahoe. And Fievel going West.

Maybe I should have called this thing A Senegalese Tale: LaRocha Goes to West Africa...