Around this time last week, I lacked energy. I felt constantly drained and couldn't take a morning jog. Headaches I chalked up to dehydration bothered me mid-afternoon. I wanted to sleep and you couldn't have tempted me with any food; I simply had no appetite.
After seeing the horrible conditions at the hospital I was adamant that I go to a private clinic. Tested positive for one of the most common conditions in Uganda, typhoid.
I had the typhoid vaccine booster about two or three years ago, hence the mildness of my symptoms. But the vaccine is not 100% preventative. I must have been in the first stage of typhoid, because I wasn't yet running a high fever or feeling some of the more extreme, scary-sounding symptoms of 2nd and 3rd stage.
The doctor explained to me (and then I googled some more) about typhoid. I knew I needed to drink boiled water, which I had been doing. But I was reminded about the role of everything related to consumption: the hands that made my food, my own hands that fed myself. The containers that transported and stored water. The methods of washing dishes; these all came into play.
His advice? Vigilance.
Typhoid is a type of salmonella that only affects humans and is transferred person-to-person through contact with and consumption of... feces. Ew. I know!
This means that I ate some particle of poop from another person who had typhoid, and now I have typhoid (and if any body eats my poop; or the drainage of the outhouse runs into someone's water supply and they don't properly boil their water; or I don't properly wash my hands after using the toilet; or a fly flies on my poop and then lands on someone's food; then they will get typhoid from me).
It's about pure, clean water and vigilance is the only defense. And it also means that ultimately, I'm responsible for if I get typhoid or not.
The treatment for typhoid is not fun. While I ingested the typhoid bacteria, it didn't just remain in my digestive system; it went everywhere quickly. And treatment likewise must go through my whole body through infusion or a drip. A 2 inch tube was inserted in my hand and twice a day I was connected to an IV supplying me with medicine, slowly running it through my bloodstream.
Let me tell you; this hurt. Twice I cried, once I screamed so loud and all the children started screaming for a doctor saying “Mzungu! Mzungu!” Or “the white lady!”. On this last occasion I sat in the treatment room alone, but most days there were four or five others receiving the same intravenous treatment for typhoid.
Now I'm on two weeks (give or take a day) of pills and the instruction to drink a lot of sugary drinks. For a person who usually takes tea without sugar and drinks only water, the last of the instructions has been hard to keep. I'm doing my best to drink a lot of juice everyday, but it's a concerted effort.
There's a devotional in there about purity, but it seems pretty obvious: don't eat poop; wash your hands and make sure that whatever you're putting in your body has been sufficiently boiled. If not, it's going to take more than a pill and two days to get healthy; you need treatment that courses through your veins and gets into all the major organs. Just a tiny particle of contaminated poop can be destructive, even fatal.
"24 million people don't have access to adequate sanitation in Uganda, almost two thirds of the population."
And to some, it is a fatal illness. Either they already were weak (old age, young children), or the sickness wasn't caught in time. Sadly sometimes, it is simply because they cannot afford treatment.
"SNV is implementing a community empowerment programme in partnership with five district local governments (including Arua, Uganda), UNICEF and the Embassy of the Kingdom of Netherlands. The programme aims at improving the health and livelihoods of 172,000 primary school going children in 268 schools and 36,400 households through interventions in water, sanitation and hygiene. Our focus is in ensuring equity of WASH services and sustainability of infrastructure and accelerating progress at scale in sanitation."
My treatment (at a nice, probably expensive clinic) included my initial blood test, 6 intravenous treatments, a supply of painkillers, vitamin tablets and over two weeks worth of oral medication. It cost less than $22.00 US.
Diseases from unsafe water and lack of basic sanitation kill more people every year than all forms of violence, including war. Children are especially vulnerable, as their bodies aren't strong enough to fight diarrhea, dysentery and other illnesses.
90% of the 30,000 deaths that occur every week from unsafe water and unhygienic living conditions are in children under five years old. The WHO reports that over 3.6% of the global disease burden can be prevented simply by improving water supply, sanitation, and hygiene.
Prevention is clean water, as sadly there are not enough wells and bore-holes in this community or throughout Uganda. Having the resources to boil water are another need. Having education about proper sanitation and hygiene are further imperative.
I knew all these things, and still I got typhoid.
But for $22.00 for treatment, it's a tragedy anyone would die for lack of funds to pay.