When I woke up a week ago over a third of the stories on CNN’s mobile news app were about Ebola. I’ve been following this outbreak since April, because I studied abroad in West Africa and have friends there. I also contracted Typhoid Fever while I was there, despite getting my mandatory vaccine. The people in Guinea, Sierra Leone, Liberia, and now some in Nigeria (the country to do business in) who have come forward for Ebola treatment usually know how they got sick — lack of safe water, or caring for a sick family member. I got sick from a lack of safe drinking and cooking water. Adding to the ease of which it can be contracted is the severe lack of flushing toilets. Without running water infected feces are not safely disposed of. When toilet paper is a luxury you clean yourself with your left hand, and hope there is some wash water nearby.
Ebola, like Typhoid and Malaria (from mosquitoes), can take up to three weeks to present any symptoms. The early symptoms are also consistent with Meningitis and the plague. (yes, THE plague) When I got sick, I had been sad for two or three days — supposedly letting my immune system down — but went to bed feeling fine. In the dead middle of the breeze-less night I woke up drenched in sweat with a migraine, and every muscle and joint in my body aching beyond what I knew was humanly possible. I managed to find my flashlight (we didn’t have electricity then, a recent heavy rain had knocked us off grid for the last few days) and I found my class notes in a stack on the floor. “Day 1: visit from a doctor to talk about Malaria, Typhoid, Cholera. Symptoms of Malaria and Typhoid are identical: worst flu of your life. Stay hydrated, wash hands often, go to hospital ASAP.” I took my temperature, and dry swallowed Advil since I was out of water, and collapsed my fevered body back into the bed.
I alternated which side of the double bed I laid on — I would drench one side and then roll over and have the chills on the dry side until I sweated through the sheets, and rolled back over to the mostly dried out side. At sun up I called my translator and told him that I thought I had Malaria and needed his help. When he finally arrived about 3 hours later (he could have walked over in ten minutes) he was entirely unconcerned. He went out and bought me drinking water, and when I asked if he had ever had Malaria he said “I don’t know.” Apparently whenever he’s had symptoms he “goes into the bush to collect the herb to fix it.” I remember begging him to go get this herb for me, because it was Sunday, the power had been out for at least three days, and no pharmacies were open nearby.
He came back hours later with a pack of three day Malaria treatment from a pharmacy. He had ridden his motorcycle the hour drive to Togo, and the hour back, just to find an open pharmacy for me. Giving me bush herbs would be an automatic firing from his best paying job. I spent that day trying to drink water, trying not to puke, and repeatedly barely making it to the water-less bathroom to have diarrhea. The manager of the guest house I was in was very creepy — but he was kind enough to fetch water from the well in the yard and leave it outside the bathroom so I could fill the back of the toilet and flush. I had also stopped closing the door to my bedroom all the way so it locked — I was afraid I would lock my soon-to-be-immobile body inside the room.
|How I got back to the capital — by tro tro (a large van)
I was slightly better the next morning, I had originally planned on going back to the capital the day before. I managed to bathe, and my translator packed my backpack. We took a taxi to the market and he got me the last seat on that morning’s ride to Accra. By some miracle I didn’t vomit on anyone along the bumpy ride. When I finally made it to the University Student’s hostel I collapsed on the lobby floor and waited, feeling half dead, for someone I recognized to walk by. When they did, they immediately called the program director, put me in a taxi, and gave me all the cash they had on them. One of my teachers met me at the hospital nearest the program director’s house, and sat with me while I waited over four hours to be seen by anyone. I was dry heaving badly and he got a plastic bag for me to throw up in, since trash cans literally don’t exist in public places there. When I finally saw the doctor he informed me that I was pregnant, and that nothing else was wrong with me. He didn’t believe that as a girl I had a beer belly, therefore I must be pregnant. He insisted that I have blood drawn to prove that I was indeed pregnant. The tech had no gloves to wear when he stuck me, and the doctor told me I was fine and not pregnant when I saw him an hour later. Within seconds of leaving the hospital property I began vomiting yellow bile, and was half-carried to the director’s house to lay under a fan and eat a handful of rice. A taxi took me back to the hostel, and I stayed in bed for the next few days. My friends were coaxing me into eating bread or rice, and begging me to drink water every day, despite my vomiting and likely incoherent talking. Our group had three rooms of four people each at the hostel, and we were given our own hall bathroom. Four of us staying there had typhoid, but two were nearly all better. The hostel designed bathrooms to have constant running water. The water ran in the building one day out of nearly two weeks. Our hall bathroom literally became toxic. There was a single tap in the courtyard that you could fill up a bucket with, and there were at least 300 people living there.
I tried to go to the University and start writing my paper, but by the afternoon my fever was clearly back and I was white as a sheet. Again, I was put in a taxi with all the available cash my friends had (of course to be repaid, after I was well enough to walk a mile to the ATM) and they called the director for me. This time our “Africa Father” Papa Attah met me at the hospital. We sat on the same church pews, slowly sliding down as people went back to be seen by the doctor. I wrapped myself in a long piece of fabric since I had the chills, and we waited for over six hours this time. Severe Typhoid Fever was the blood test’s verdict. Cipro, an antibiotic that kills viruses that don’t need oxygen, was the easy fix. It was also about twenty times more expensive than the Malaria treatment was. Again, I went back to the hostel, and back to my little bed, for the next few days. I sent goodbye texts home (of the “I’m dying” variety) and had hallucinations of my friends coming and going from the room, talking to me, when they were really miles away. The morning that I was scheduled to take a taxi to the International Hospital I woke up without a migraine or fever. While I still couldn’t eat more than a handful of rice, I was able to drink water. I honestly felt like it was a miracle, because I had been laying on my death bed.
|there are often no water and definitely no sewer lines
in the all too common overcrowded neighborhoods
Obviously, I was lucky. My friends recognized how sick I was, and were able to give me the money to go to the hospital. They sat with me and sometimes nearly force-fed me, knowing that they might be thrown up on.
How could this have been prevented? Two words: running water. Or, more specifically, flushing toilets. When popping a squat over an open street sewer is acceptable behavior because there are no real toilets, people will spread diseases. When it rains and these sewers overflow, who knows what deadly epidemics spread, and how far they spread. In the heart of the capital city Cholera was breaking out with the start of the rainy season. I was so lucky to be able to leave, and return to the states. So lucky to go home to running water, flushing toilets, and showers. To a place where I felt I could safely receive IV fluids if I needed them. My three weeks post-Cipro blood test had to be sent to Atlanta to be tested at the CDC, since it’s so rare that it comes to the US. I very well could have been contagious on my 5 movies long plane ride home, but I am 100% confident that I didn’t give Typhoid to anyone– because I washed my hands regularly, and was able to flush my poop away into sanitizing chemicals.
There will never be an Ebola outbreak in a developed country where our water runs 99% of the time. However, Ebola can easily spread across the underdeveloped region, and perhaps by innocently plane to other underdeveloped regions of the world. Africa, Latin America, and Southern Asia should be afraid. Europe, Canada, and the US should not be. As for the volunteers transported to Emory last week with Ebola, shame on anyone who said they should not have come home to IV’s and safe water — they couldn’t create an epidemic here if they wanted to.