Justin, always concerned for my health, had already spoken with a travel agent and reserved us three tickets on the earliest flight off the island. As I lay tired and breathless on the couch, sipping some thin, millet porridge--the first food I was able to keep down in 24 hours--Justin did a 15-minute packing job, grabbing the bare minimum: three days-worth of clothes, Juma's school books, our laptops. We left most toiletries--shampoo, toothbrushes, contact solution--behind, knowing I kept a spare set at our other apartment in Stone Town, Zanzibar. That turned out to be a dumb decision, because we never even made it to our apartment.
The airport is a short taxi ride from our place, and our oldest Pemban friend (also named Juma, and he happens to be first cousins with our oldest Zanzibari friend, Juma) picked us up. Every time I had to walk--to and from the taxi, to and from the airplane--I was completely exhausted. As we made our way to the six-seater prop plane, I felt dizzy and paused on the tarmac, head down, hands on my slightly bent knees. I suddenly noticed how very yellow my toes looked. It was as if the three-month tan on my toes was gone and replaced by yellow dye.
Our Juma, excited as ever to be on an airplane, kept chattering away and asking me to look at this and that sight out the window, but I asked him to please just let me rest, look straight forward, and concentrate on not being sick. After commenting that my eyes looked yellow, he obliged. Sweet thing that he is, this whole time he has been eager to help me out by running errands, taking my temperature, and relaying messages to Justin in the other room. Once on the first day, he gave me the under-the-tongue thermometer with a "here comes the airplane!" in a parent-feeding-baby voice. We both laughed heartily at that one.
Alison picked us up at the Zanzibar airport after the 30-minute flight. She started to ask me how I was feeling, but broke off and simply said, "I can see how you are feeling." In a word, awful. And that was better than the day before!
First thing, Alison brought me to her house and I collapsed on her bed. She gave me a little doctor's exam, and we decided to head to the main public hospital, Mnazi Mmoja, where I would see a skilled doctor recommended by other skilled doctors on the island. (It really pays to have connections here.)
The doctor there took another malaria test by microscope--still negative--but decided to give me an injection of a malaria drug anyway. My anemia came out so much higher (better) than the day before that we thought it must be an error. There was no way that looking like this
I had only mild anemia. I got an IV to fight the dehydration, and the doctor wanted to admit me to the hospital. Alison and I had already agreed that if he wanted me to stay the night, I would be better off staying the night in a clinic in Dar es Salaam on the mainland than here in Zanzibar. They just have better and more lab equipment, better trained doctors, and better overall services.
Justin arranged another set of tickets for yet another flight. I snapped a picture on the plane.
Alison offered to have Juma stay with her and her family of five, which we agreed was the best option. Juma was delighted; he gets along with their six-year-old son, Franklin, like they've been best friends forever. Franklin had just visited us last week in Pemba, and the boys were together for 72 hours without a single fight.
Alison knows the people who run the clinic in Dar, and called ahead to have an on-call doctor meet us there, since we'd arrive after hours. When we arrived, the nurse ushered me into one of their two beds (this is normally only an out patient clinic) and I collapsed into it and wished for unconsciousness. Shortly, the doctor came. The first thing she said, in her thick German accent, was "You are pale!"
Here, for the first time, the providers took my vital signs, took a full medical history, ran a full battery of lab tests, and didn't automatically consider malaria as my one-and-only problem. They did, however, test for malaria using a newer type of test which looks for antibodies to malaria rather than the malaria parasites themselves, which turned out to be "weakly positive." My anemia was bad, and there was talk of a blood transfusion. My billirubin count was high, which accounted for the yellow color--I was jaundiced. Something was going on with my liver. There was talk of hepatitis A, but since I've been fully vaccinated, that was put aside.
They started me on three different types of treatments: for malaria, an intestinal amoeba, and an unidentified bacterial infection, all of which had shown up in my various lab tests. It's possible that all or some of those things had been unwelcome visitors in my body for as long as many weeks, but had been intermittent or asymptomatic.
I got hooked up to another IV, and slept. Too late to find a hotel, Justin camped out on the clinic owner's office bed.
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