A Trip to Remember

I have to give a little bit of time to one of the best/worst things about service in Niger: malaria medication. There are three types for PCVs in Niger: malarone, doxy, and Mefloquine. The most effective, and thus the one used by most PCVs, also has the most interesting side effects. This post is the Mefloquine nightmare, I hope you enjoy.

I could talk a little bit about my cluster curse, a legendary series of bad luck events that have hit my cluster and resulted in my near-total isolation in Niger for most of my service. For those of you who don't know, Volunteers are posted in clusters within a few kilometers of one another to assist in work and support in a foreign land. My cluster has unfortunately been decimated by a rash of bad luck: early terminations, medical evacuations, problems with village posts, and the occasional "wack-evac," a medical separation based on mental health issues. As a result, for most of my service, my closest neighbors have been 30k away or, when they're gone 120k, a five hour odyssey to the capital Niamey. With the new stage swearing in this week, I'm finally getting new neighbors, and I will no longer be one of the most isolated Volunteers in country.

Unfortunately, the cluster curse nearly hit again. I have two new neighbors, and one of them was accidently dosed with Mefloquine. She spent a horrifying week unable to sleep for three days. To give some kind of reference, Mefloquine is an anti-malarial prophylaxis that causes strange dreams among everyone that takes it, some rare cases of extreme anxiety, and has been known to make everyone a bit crazy at time. We take it once a week, and my new neighbor, Annette, took four at once, and managed to keep them down. Everyone in Niger was horrified to hear about a four pill dose of Mefloquine. The only thing it could be compared to was a mythical story about a stagere who was given weekly Mefloquine instead of daily Doxy and took it for 12 days in a row before he had to be medically separated and sent home for psychiatric treatment. Now, just to clarify, I don't know if this story is true, but it's one of the great legends of Peace Corps Niger.

The best/worst part of this drug is the intense, vivid, long dreams it gives you. While on Mefloquine, I can remember a few dreams, the weirdest of which I'll share. I remember I was at a book signing with my college professor Jim Fisher. It was a book I had written, and he asked me, "Well what do you think about all the Jews?" I looked around and saw a lot of rabbis in different technicolor outfits. Instead of black robes, hats, and shawls, they were wearing a variety of reds, oranges, blues, and greens. For some reason, that I still cannot explain and probably will never be able to, there was a phone that wouldn't stop ringing. I didn't want to answer it because it was in the toilet. Not just in the bathroom, but in the toilet.

In another, I remember thinking that I wanted to steal some green peppers growing in an orchard. In the dream, these peppers were the size of my head and grew from palm/bamboo type trees. It took me about eight waking hours before I remembered that peppers don't grow on trees.

The latest dream that I can remember was my father visiting Niger. My father has been in a wheelchair since he was a kid, so the sand in Niger would usually present a problem for him, but he had an all-terrain wheelchair with some strange independent axle system, which enabled him to roll over rocky terrain like a moon rover. He kept explaining how to kill a goat (this was right around Tabaski) and kept impressing upon me how important it was to do it right. Then he ran me over with his all-terrain wheelchair.

This is only a small sampling, and these kind of dreams are the fun ones. They're not always like that, however. I accidentally dosed myself with two Mefloquine one horrifying day in mid-September. I didn't have a problem sleeping, in fact, it was more of a problem waking up. I took a nap, and I remember waking up and texting my friend Rose from my house in Niger. Then I woke up. My phone was across the room. Then I woke up. My cat was sleeping on my chest. Then I woke up. My cat was sleeping in a corner across the room. Then I woke up. It repeated like this for hours and hours: dreams that were not different from reality and were, in fact, dreams within dreams within dreams. It lasted for three days total, during which time I almost called our medical officer because I could not differentiate dream from reality. The only reason I didn't is because I wasn't sure if I would actually call him, or call him only in a dream. Luckily, this horror show only last three days. Any longer and I would have gone home and checked myself into a mental ward. Schizophrenia and terror for all!

A Note from My Journal

22 September 2008 7:11 pm

I went out exploring my market town (pop. 6000) and discovering the things I should have discovered six months ago. I went to the mayor's office, saw the big mosque, and visited the doctor's office.

The lokotoro kwaara (lit. "doctor's house"), which I just assumed was a school when I first saw it, was a sad sight. The walls were cracked and dirty, it didn't have electricity, and it had only a few taps for running water. Posters from former awareness campaigns hung in the hot, fly-infested waiting area. About twenty people were waiting to see the infirmary workers, two of them and one trainee, but no certified doctor. At least I can say that these workers didn't look overwhelmed.

The hardest part about being there was seeing the children. I suppose children are the main clients due to Niger's sheer number of them and the expense of drugs/treatment. Most adults probably wait it out, for better or worse. But even the children are forced to wait until their condition is severe. One child there looked so emaciated and pathetic that it's a wonder he made it to the doctor.

When I think about the contrast between the poorest of the poor developing countries and what I know of Westen services, I can't overcome the gulf of difference. I lost my phone a few weeks ago. When I went to the police station in Niamey, I felt like I'd been transported back to Mexico in the 1930s. It was like a movie. Concrete walls with chipped, faded paint, no doors, no electricity, red-ink rubber-stamped paper affadavits, goats in the courtyard, a flag bleached by the sun after who knows how many years. I mean I'm surprised there is even enough money for a flag. And it's not like the workers can do much about it (I guess they could get rid of the goats). They just have to keep going and do the best they can with what they have. No wonder there's so much corruption. WHy shouldn't a civil worker skim a little extra when they're powerless to affect change? I don't condone it, but you have to expect it.

The doctor's office is the real issue though, from today's journey. I'd like to start working there a few days a week, if I can stand it. Maybe I can get some information on community health projects. A former neighbor once said one of his most satisfying days in country was when he helped with child polio inoculations. Even if it's just a lot of little things, at least it'd help a little bit.