Mosquito Madness in Muisne

from Ya Mismo: Thirty Seconds North of Zero

“Roni, can you hear me?” The distant voice seeps through the dark fog inside my head.

“Yes, I can hear you,” my brain responds, but I can’t move my lips. My mouth is so dry it’s sealed shut. Every bone screams in agony, as if they’re being crushed. Clothes touching my skin are unbearable. A headache pounds behind my eyes. I can’t open them. When I try, the light sends searing pain through my head.

The first indication is tiredness. I’ve been feeling flat for over a week, but put it down to fatigue. Unable to sleep because the new bar next door blasts the beach with electronic music every night until five a.m., I don’t realize I’m actually sick until the Monday I go shopping in Atacames. It begins like a normal day. I take the six a.m. bus to town to pick up groceries; wholegrain rice, quinoa, honey, dark chocolate. Things you can’t buy in Mompiche. At the bank, a headache rams against my forehead. Usually I never get headaches. I buy more water thinking I might be dehydrated, but the headache rages on. While checking emails, I notice sore muscles in my legs and wonder what I’ve done to cause the stiffness. Accustomed to daily exercise, it seems odd, but I still don’t twig that I’m seriously ill. Eventually I’ve had enough. With a throbbing head and an aching body I’m ready to go home. The bus ride seems endless, the pain increases with each kilometer. Fever sets in. The cool breeze blasting through the window feels like icy needles piercing my skin. By the time the bus arrives in Mompiche I’m barely conscious.

Safely inside my cabin, I leave the door unlatched. Then I drag a branch of bananas and a five gallon bottle of water across the floor to the bedside, before flopping onto the mattress. Alternately burning up and freezing, I slip in and out of consciousness. Unable to walk, I slither out of bed and cross the floor to the bathroom to pee and vomit. Eventually I’m so dehydrated that nothing comes out. Three days pass before anyone comes. It’s Lelelo, looking for the ten dollars I owe him. He takes one look at me shivering uncontrollably under the mosquito net and races to the clinic.

“Roni, can you hear me?” The voice belongs to Doctor Raul, the village medic.
Incapable of answering verbally, I try to move to indicate I can hear him. Excruciating pain shoots through my limbs. Raul puts a thermometer in my armpit. The cool glass burns my sensitive skin. He puts his hand on my forehead. It’s on fire.

“Her temperature is up to forty two. I suspect dengue. Get a saline drip going,” Raul tells Kelsie, his nurse. “I’m going to call an ambulance.”

Dengue fever is a potentially life-threatening viral disease transmitted primarily by the Aedes aegypti mosquito. Worldwide, around 50–100 million people are infected yearly. In Ecuador, around two thousand people contract dengue every month. Each case must be reported to the Ministry of Public Health. Due to its symptoms which include fever, headache, muscle and joint pains, it’s also called “breakbone fever” – romper hueso.

While Raul goes out to look for a stronger phone signal, Kelsie finds a vein in my hand and touches the point of the syringe to my skin. It feels like a thick knitting needle going in. Soon after, I drift into unconsciousness again.

“Roni, how do you feel?” asks a new voice, her fingers gently holding my hand.

“Like I died and went to hell,” says my brain. I struggle to move my lips. The room reeks of strong disinfectant. Hospital smells waft up my nose.

“Water,” I croak weakly. She almost doesn’t hear me. She bends lower to listen. “Water.”
“Do you want some water?” the nurse asks.

My word quota used up, I squeeze her fingers once: yes. She catches on quickly. Then she pours a glass and holds it to my lips, carefully lifting my head so it won’t spill. A few drops wet my tongue. It’s not enough. I want more. A few drips more, then a few more. It’s never enough.

“Thank you,” I murmur before slipping back into unconsciousness.

For another forty eight hours, I hover precariously on the precipice between life and death. Oblivious to the goings on in the women’s ward, I don’t notice frowning doctors extracting blood or concerned nurses replacing the saline solution. During the second night, a nurse swings by bed M4 every fifteen minutes to see if I’m still breathing. The next time I wake, it’s Saturday.

“Welcome back! We thought we were going to lose you. It was touch and go. How do you feel? Are you hungry?” asks a smiling nurse, chatting as she inserts a thermometer under my armpit. “The doctor is on his way.”

My stomach feels as if two large fists are playing tug-o-war. Under the pain lurk sharp pangs of hunger. Aside from a few bananas, I haven’t eaten anything for six days. My whole body aches. My head throbs. I’m nauseous. I want to sleep, but my stomach won’t hear of it.

“I’ll have the chef bring you some soup,” says the nurse, checking the saline drip and making a note on my chart before clopping down the hall towards the kitchen.
The soup arrives a few minutes later. Noodle soup with cheese, potatoes and rice.

“Oh. Do you have anything else?” I ask, disappointed. “I can’t eat wheat or dairy.”

“This isn’t wheat,” replies the chef, indignant. “It’s noodles! It has cheese in it!”

The offended expression on her face tells me there’s no point arguing. Ignorance regarding food and its subsequent allergies is widespread and the small regional hospital in Muisne is no exception. Trying to explain food allergies here is akin to speaking Japanese. Despite lactose intolerance, I can normally get away with eating a bit of cheese every so often, but today my delicate stomach isn’t up to the challenge. The best I can do is be as diplomatic as possible – or risk starvation.

“Okay. Do you have any fruit? I’m super hungry and just soup won’t be enough.”

After hearing I haven’t eaten anything for almost a week, she vanishes and returns shortly with a handful of bananas. Halfway through the third banana, Doctor Byron shows up.

“You’re lucky to be alive,” he tells me. “You have dengue fever and typhoid.”

Dengue fever is common on the coast. Looking around, I note there isn’t a single mosquito net in the twenty-bed hospital. As the doctor speaks, I wonder about the ratio of luck to destiny. There are four strains of dengue. Survival of one strain is awarded with lifelong immunity to that type, and short-term immunity to the other three. Subsequent infection with another strain of dengue increases the risk of severe complications including dengue hemorrhagic fever, or dengue shock syndrome. There is no vaccine. This is my second round with dengue. In both cases, I don’t know which types I’ve contracted.

“We really didn’t think you were going to make it,” continues the doctor.

“I’m not if this is the only food they’re serving,” I joke, indicating the untouched and now cold soup. “It would be a shame to die of malnutrition in hospital,” I laugh, then explain the problem.

“I’ll talk to the chef,” promises the doctor.

While he takes notes, jotting down my answers to his questions, I polish off the other two bananas. After the usual questions; full name, age, nationality, occupation, marital status, religion and ancestry, he asks about my home situation and lifestyle.

“Your organic diet probably saved your life,” he states, tapping his pen on the chart.

Doctor Byron explains that because my body is normally full of natural disease-fighting antibodies and packed with wholesome nutrients, the lack of chemicals and pharmaceuticals in my system allows the powerful drugs they’ve administered to get straight to work. The lucky part is the timing – one more day at home and I’d have been pushing up daisies now.

“You were beyond the usual point of survival when you came in,” he says very seriously. “And the typhoid made it even more complicated and confusing to diagnose and treat. At first, we thought it was a liver infection.”

Typhoid is a bacterial disease transmitted by the ingestion of food or water contaminated with fecal matter containing the bacterium Salmonella typhi. Humans with poor hygiene habits and flying insects that feed on feces can spread the disease. In Ecuador, typhoid kills around thirty people annually. Something I ate on the way to Atacames caused the high fever, raging headache and severe abdominal pain typical to the disease, and confused laboratory technicians with an unexpected decrease in white blood cells not typical in dengue.

“Wake up! Time for breakfast!” announces the chef.

She places a crumpled white bread roll and a glass of milk on the table beside the bed. She’s kidding, right? What part of ALLERGIC to wheat and dairy doesn’t she understand? To my body it’s not food, it’s poison. I say nothing. There’s no point. When she returns to collect the tray, she’s surprised.

“Aren’t you hungry?” she asks.

“Yes. I’m very hungry. But this food will make me sick. I can’t eat it.” I smile ruefully and pretend it doesn’t matter.

“But you have to eat something!” she admonishes. “What can you eat?”

Aha! Now we’re getting somewhere. Shortly, a bowl of soggy fruit salad; mostly watermelon and cantaloupe, and a glass of heavily sugared tree tomato juice arrive. Unfortunately, we go through a similar theatrical routine again at lunchtime when Chef Dodo brings me a plate of limp spaghetti.

Later in the day, when Nereyda shows up with a change of clothes and some toiletries, a large bag of fresh tropical fruits, a big block of dark chocolate and a pre-paid card to put credits on my mobile phone, I could kiss her.

“Did you talk to the chef yet?” I ask Doctor Byron when he comes in to check on me late in the afternoon. I already suspect that he hasn’t.

“Oops, no! I forgot. I’m sorry. I’ll go and see her now.”

Dinner arrives soon afterward. A few thin shreds of tired lettuce with a smattering of transparent tomato and lost-looking onion slices are afloat in the bottom of the bowl.

“This is it?” I ask Chef Dodo.

“The doctor said this is all you can eat.”

“Do I look like a rabbit to you?” I ask, extreme hunger overriding diplomacy. “I need food!”
“Doctor’s orders,” she sniffs and then vanishes.

My stomach is ready to go to war. But how do I go into battle when I can’t walk ten steps without passing out? That’s when I spy the wheelchair. I get in, drop the saline bag in my lap and zigzag down the hall. Who knew you need skills to drive a wheelchair? In a back-to-front hospital gown, barely able to control the wheels, and dizzy with the effort, I strap on my fighting gloves. Further down the hall, I bang into a narrow doorway the chair can’t pass through. Undeterred, I rattle the glass door. At that moment Doctor Byron exits his office. I wave him over.

“Yes, my darling? What’s up?”

“I don’t know what you told the chef, but all she gave me for dinner was lettuce.”

“No! Salad!”

“No. Lettuce. A whole spoonful of it. Come and look.”

He pushes me and my rebel wheels back to the women’s ward. I gotta say the ride is much smoother with an experienced driver. When we arrive at bed M4, he peers into the bottom of the bowl searching for any sign of sustenance.

“Oh, no!”

“See?”

“Okay. What do you want to eat?”

“Proteins; fish, eggs, beans. Any kind of fresh fruit, and any kind of fresh vegetables raw or cooked. At this level of starvation, I will even eat odious white rice.”

Fifteen minutes later Chef Dodo turns up with a plate of boiled eggs and a real salad. She also brings some more bananas and a glass of freshly made lemonade. Grateful, I thank her.

The following day a new chef appears on shift and, on alternate days, hospital food becomes surprisingly edible.

“Roni!” whispers a voice. “Wake up!”

I open my eyes to see Cristhian Garcia outside the window, leaning against the vertical security bars.

“Hi!” I’m delighted to see him. “Why don’t you come in?”

“They won’t let me in. It’s not visiting hours. Hospital rules.”

It sucks. Every morning friends travel from Mompiche to visit me in hospital and the security guards won’t let them inside. Visiting hours are late in the afternoon, long after most Mompicheros have caught the last bus home. Countless times I have to pull a chair up to the barred window, rearranging the drip stand and trying not to fall on my face from dizziness, so I can spend time with people who care. In the healing process, and because of the absence of my family, this is more important to me than any medication.

Unfortunately, someone has removed the wheelchair from the room hoping to curb any further outbreaks of rebellion. When I’m able, I get out of bed and wobble down the hallway on bare feet, dragging the drip stand along behind me, to protest the insensitivity and unfairness of rigid hospital regulations.

“I need my friends more than I need your drugs!” I tell the hospital staff.

Most of the attending doctors don’t mind bending the rules a little to accommodate my needs and some of the nurses let friends sneak through the ward to spend a few minutes helping me get well just by being there. They all bring big plastic shopping bags bursting with fresh fruit which I consume as if there’s no tomorrow. Some bring dark chocolate. Froilan turns up with a takeout container of delectable shrimp encocado – my favorite – which flusters Chef Dodo so much she actually produces edible vegetable soup for dinner.

My parents and youngest sister call, forbidding me to kick the bucket in Ecuador. They’re worried. Rightly so. I nearly died fifteen thousand kilometers from home, and this is not the first time.

“Even cats only have nine lives,” scolds my father. “How many have you used up now?”

“Don’t worry, Dad. Wild cats have more lives and I have the heart of a tiger.”

The joking soothes their fears, and helps me feel better. In this fragile state of health, I miss my family more than usual. Between regular visits from friends and sporadic calls from family, my recovery is coming along swimmingly . . . until Nurse Naaasty comes on duty and forbids all manner of cheerfulness.

“Take off those pants and put on your hospital gown,” she barks. “And clean that muck off your feet!”

Sure. When they loaded me unconscious into the ambulance, I remembered to pack acetone and cotton balls. I ignore her ridiculous orders and roll onto my side, ready for a nap after a hard morning of defying Nurse Naaasty. The offending pants are comfortable sweats that don’t reveal my naked butt to the whole world and the bright blue polish on my toenails has failed to bother anyone else for the past five days. They both stay.

A while later Nurse Naaasty returns to change the drip. I scream in agony when she rips all the hairs off my wrist while removing the tape. Merciless, she ties a latex glove around my arm so tightly that my fingers turn blue. She sharply smacks another vein, then roughly digs the needle into my the back of my hand like an apprentice seamstress learning to use a pin cushion.

“OUCH! Hey! I’m a person, not a dartboard!” I protest. My hand throbs in pain.

“Shut up. I’m trying to change your drip so the vein doesn’t collapse,” she snarls.

“How about leaving me alive at the end of the procedure?” I shoot back sarcastically. “I didn’t survive dengue just so you could kill me!”

I do not like this nurse. She’s cruel. Her bedside manner resembles that of Little Red Riding Hood‘s wolf. Vinegar is sweet compared to this withered, bitter creature.

One morning Nereyda brings more clean clothes, a bag of citrus fruits and tidbits of news from Mompiche. Nurse Naaasty walks into the ward and sees her sitting on my bed.

“Get out! You have no business here!” she shouts, startling both of us mid-giggle.

Reluctantly, Nereyda collects the bag of dirty laundry from under the side table and leaves.
Nurse Naaasty stresses me out. She isn’t conducive to a speedy recovery. When he visits on his rounds, I complain to Doctor Byron.

“Hang in there, sweetheart. She’ll be gone in a day or two.” He tweaks my nose.

“Let me go home. I can get better care in Mompiche.”

“Sorry. No can do. The typhoid is almost better but we’re still treating you for dengue.”

Eight very long days after I’m admitted to the Carlos Del Pozo Melgar Hospital, I’m finally discharged on the promise that I’ll continue taking the medication for another week. Froilan picks me up from the hospital in a moto-taxi and takes me home in his fishing boat.

Cruising back to Mompiche through the lush mangrove jungle is highly therapeutic. I’m still quite weak and need friends’ help to feed and bathe myself for a few days. Naturally, the prescribed medicine sits on a shelf in my cabin while I immediately embark on an intensive raw food detox to rid my body of unwanted chemicals and drug residue.