Squeamish warning...this story includes a recount of me getting a hookworm. The pictures are included under "Read More".
I walked down the dirt road, carrying a blue felt bag filled with groceries in each hand. Avoiding the ditch that lay bordering the outer edge of the main street, I looked around to make sure I could walk across. That’s how it went here, there were no crosswalks, traffic signals, though later on some started to be created. “Ah!” I cried out in pain and stopped in my tracks. I put down the bags and doubled over, breathing steadily to manage the pain that shot through my thigh. What’s going on, I wondered, as the pain started to cool off. I had been getting foot cramps frequently for the past couple of months, and figured that something must be out of line with how my feet were resting in my sandals. Maybe I am wearing them too much, I have high arches and probably need some more support. Over the last week, the pains in my feet had grown, and I was constantly scratching at the underside of my left foot. There were a couple of bumps that looked like mosquito bites, and they itched like no other bite that I have had. I resisted scratching, knowing that there was already a level of irritation that happened by the level of contact the bumps had just by being on the bottom of my foot.
I wanted to sit down though, my legs felt weak and rest knocked at my door. I opened the gate to the house I stayed at, and entered in guided by a loud creak and a series of metal on metal bangs, who showed no shyness to scream that they had made contact. Sitting down on the couch on the porch, I put down the bags and kicked off my sandals. I bent in my left leg, forming a pretzel shape, and looked at the bottom of my foot. There were red lines covering the bottom, they were lifted and could be felt by running a finger over them. This, is not a normal mosquito bite, I thought. I can’t ride this one out, waiting for it to heal.
I took time during work to go to the doctor, who had no noticeable reaction to the red pathways on the bottom of my foot. He took my foot up, and looked at it, asking if I had been swimming in lakes, and where I had been walking. He tapped his pencil on the counter and looked at me, saying that there was a worm in my foot. “I see it all the time, it is common. I will give you medicine which will take care of the worm within a couple of days.” Grateful, I walked on out and took a boda home, deciding not to cancel my trip to Rwanda later that day. I sat down on my bed shifting items to my backpack in preparation, while texting my brother about the worm. “I must be a good host to my guest”, I joked, and we decided to name my worm guest Luke Footwalker. The thought of taking Luke out myself crossed my mind, but I had read that attempting to take out a worm could spread bacteria that is present within the area, and that there is a higher risk for infection. I thought of how easy it was for me to get this, how uncomfortable it is, and how many people must get diseases that could be treated easily but that require the funds to be able to go to the doctor. Imagine you have 8 kids, and make $580 per year, the GDP per capita in Uganda in 2016.
I did not recognize the name of the worm that the doctor told me, and I spent time googling images, stories, and diagnoses of other people’s experiences with worms. It was similar to the description of a hookworm, though I did not experience any negative digestive symptoms. I did not walk around barefoot, except for in the area that I lived. There was a patch of sand with some beach chairs, and I would walk over and plant myself down, writing away and reading for hours, while making phone calls out to those who were not in Uganda. Worms can be passed on by having contact with infected feces, and warm soil and sand is a good place for them to stay alive. I did not know this before my trip to Uganda, and I learned by getting a worm in my foot. My feet felt itchy after stepping on this sand, and I did not see any animals in this area other than lizards and the occasional large snails that skated up the walls, leaving behind a slimy trail. Later on, I learned that there are cats, and rats the size of small cats that come through the area around the house, and I would see a silhouette of something scurrying when it was dark outside.
I took the medicine as prescribed, continued on my trip to Rwanda, and felt a tightness in my foot. It was like a rubber band being stretched, as I took slow steps up and down the hostel stairs, one step down with one foot, trying to keep my leg as straight as possible, and then I would meet that foot with the other, on the same step. I showed my foot to some people at the hostel, and smiled at the grimacing looks that I received. There were a group of travelers from Kenya, who said that always wearing shows is a rule of thumb in these countries. I had even been taking the care of wearing sandals in the shower, as it was shared and I didn't know what may be hanging out on the floor.
I had returned to Uganda, and after a couple days, just as the doctor had said, the pathways on my foot started to disappear, but something appeared in its place. I had bumps all over my feet, and they itched way worse than the bumps that were on the bottom of my foot before. There were ring-shaped rashes around my ankles, and bumps started to appear on my hands, but not as severely as the tops of my feet bore. Had I gotten bit by something else? I called home and my mother suggested chiggers. Well, sounds like I need to head over to the doctor again.
I was suggested the best dermatologist in Kampala, so I hopped on a boda and made the trip to the heart of the city, seeing streets that I had never ventured to before. I took a ticket and sat down with about 5 other people, waiting for our turns to see this doctor. Finally, I was called in. I sat down in a dim office, with stacks of papers feet high laying on a desk to my right. I looked towards the doctor and showed my feet. I was relieved that I could communicate in English, as I explained how I had just taken medicine for a worm in my foot within the past week. "Hmm.." the doctor pensively said as he flipped through what looked like a type of medical dictionary with thin pages. "I think you have eczema." I stared forward, knowing that this was most likely not the case, and I knew that there may be a difference in power relations when someone challenges a doctor's diagnosis, but I continued to say, "I really don't think it is eczema." He looked back at his book, and flipped to the next page "Hmm...I think you have syphilis." I gave up. I did not have eczema, or syphilis, and I am not sure I would have whatever would be on the next page of that handheld medical library. "Okay, thank you." I said, as he scribbled out 3 medications for me to take, all of which I knew I would not. I wondered how many people are misdiagnosed, and given medications that they may not need to take. I decided to go back to the doctor that had originally looked at my feet, who expressed that I was probably having an allergic reaction to the medicine or the worm. When I took the medicine, my body broke down the worm, and it was absorbed.
My supervisor in Uganda suggested that I may be slightly allergic to mosquitoes, as I showed her the welts that grew out of the little needle pricks that covered random parts of my body, but collected around my feet. It has made me more concerned, the love that mosquitoes have for my blood, while I was in areas where they are prone to carry disease. I had sat down in a travel doctor's office, going over the risk of different diseases in the areas I would be going to, and we went over different brands of malaria prophylaxis, trying to find one that would be good to take for 3 months with the amount of money I had. I got a yellow fever shot and took medicine for prevention of typhoid. Meningitis, a serious disease that causes inflammation of the membranes that surround the spinal cord and brain, was more prevalent in Northern Uganda, which was exposed to the Meningitis belt that spreads across Africa.
I took a full supply of the anti-malarial medicine over with me, and felt no side effects for the first week, and was relieved. Well, this felt easy... Until the nausea set in. I started a daily experimentation governing how and when to take it. If I drank a full bottle of water in the morning, waited 30 minutes, took the medicine, and sat up in bed for about 30 more minutes, skipped breakfast and didn't have coffee, then I wouldn't throw up. It was touchy though, I would be sitting up regulating my breathing so that I wouldn't hurl. Slow, deep breaths, think about something else than what feels like my stomach either attempting to become acquaintances or forge war with my mouth, and all my sinuses for that matter. I would frequently find myself bent over the toilet, tasting the medicine that I tried to keep down. I stopped taking it altogether after a month of this ritual. Apparently the mosquitoes that carried the strains of malaria were very rare at the elevation in Kampala, and the treatment for it was more readily available if you had access to the costs of medical care. If you showed flu-like symptoms, the assumption was that you may have malaria, since it is common in areas of Sub-Saharan Africa. Upon my return to the United States, I got violently sick, throwing up so much until I was dry heaving, as there was nothing left that could come out of me. Do I have malaria? I wondered, and confessed to my aunt that I hadn't been taking the medicine. After a couple of days, I started to feel better. I figured that my body was adjusting to being back in the United States.
I know that there are a number of factors that contribute to whether someone is more prone to getting bit by mosquitoes, such as having type O blood, being one of the 85% of people who secrete a chemical through their skin that signals their blood type, being pregnant, drinking beer, wearing certain color clothes, exercising, secreting different hormones while sweating, bacteria present, and breathing out carbon dioxide (you're screwed with that last one). It depends on the mosquito and the person. Some are attracted to going after feet, some the neck. I remember me and multiple people I knew in Uganda would have trails of dots all around our ankles, where the buggers were attracted to the bacteria around our feet. Mosquitoes seemed to love me, to my demise. I recalled times in Morocco where I had over 65 bites at once. "The fresh air is great!" my roommate in Morocco would emphasize as the white curtains gently glided from the push of the breeze. At night, it was hot. Way too hot to be covering yourself completely. But I was desperate enough to have made the habit of making a cocoon out of my thin sleeping bag to shield myself from being bitten. My nose would pop out of a little hole for air, and I would feel a spike of anxiety every time I heard a buzz, wanting to cry. From the balcony outside of our flat, we could see a giant fountain that never ran unless the king was in town. Therefore, it was a mosquito breeding ground, and I was their protein shake. I finally convinced my roommate that it was a good idea to close the balcony window at night, and the number of posts left from my predators steadily decreased, making me look a little less like a pepperoni pizza.
Thank you for visiting! This is my personal blog, where I write about social justice, geography, culture, and my own encounters and reflections from around the world.