On Tuesday morning I was walking over to my office after rounds. Andrew (the Project Director) called me over to his office. There had been a man here the previous day telling us about an outbreak of some kind in a village about an hour and a half away. He seemed very worked up about it and apparently the village chief was making quite a fuss. Now the government health desk wanted us to go with them to see what was going on. We have the only vehicles in the area, so the health desk “invites” us to go places with them quite often.
The description that we got from our government source was 10-15 people with large wounds that wouldn’t stop bleeding. The man didn’t seem to know any more information, though he claimed to have been there and seen it himself. These symptoms could be a lot of things around here: anthrax, relapsing fever, yellow fever. There was no way to know without more information. So, one of our lab technicians and I got lab supplies to collect samples: we also got as many gloves and surgical masks as we could find (strange diseases are interesting only when they happen to other people). We could test urine, blood, and even skin scrapings. We were all sorts of set and I was really excited to be going out to the front line of an epidemic. Andrew and I decided that we were going to call the disease McSparron Fever.
The three of us (Andrew, Mechullo, and I) got into the Land Cruiser and drove into town. There we waited for the other members of the expedition team (as well as a bunch of other people who wanted a ride in that direction). We started on the road not knowing how far we would be able to get. It was the beginning of the rainy season and the road was notoriously muddy. Fortunately, after picking up and dropping off about 8 people, we were able to get all the way to Angela, the first village afflicted. Downtown Angela consists of 8 mud huts with grass roofs. We stopped at the local watering hole (ten women sitting on the ground outside the mill drinking honey wine out of gourds). We asked them where the sick people were and they directed us down a path. Everyone seemed to know about the outbreak. We walked down the hill and approached a number of huts until we found the right person. When we asked her to show us the lesion she stuck out her hand a pointed to a small sore near her wrist. She went on to explain that it had been a bump, then someone cut it open and pus came out, and now it looked like this. What it looked like was a healing abscess. We told her to go to the local health post for an antibiotic and decided to move on.
As we drove down the road people came rushing out to see the car, and the white people inside. Bezu from the health desk would stick his head out the window and ask people about the illness. They would run off or call out to their family to bring everyone over. Soon people crowded along the side of the road to see what the verdict would be. We were shown four people with the mysterious disease. Two had ring worm and two had impetigo (a minor bacterial skin infection). Not a drop of blood among them. Again, we suggested that they visit the nearest health post.
Finally, we arrived at the area hit hardest. We stopped in front of a mud building with a tin roof which apparently was the regional seat. There we were told about many people who had been very sick and some who had even died after contracting this illness. When we asked to see the sick people everyone kind of looked lost. It seems that everyone had heard about the condition, but no one could think of anyone specifically who had it. Finally they brought out a health looking middle aged man who explained that he had ear pain and drainage. Sure enough, he had an ear infection. So much for McSparron fever. We did take a sample of his blood and a scraping from a small rash on his face. Mechullo turned out to be even more interesting than the white people when he pulled out his gloves and syringes.
After a lot of gawking, we all piled back into the car. No anthrax, no relapsing fever; just a couple of villages full of people with poor sanitation and little access to health care. While I may have been a bit disappointed, it did make a good point about my experiences here. Everyone thinks of medicine in Africa as strange and exotic, which it can be. But, for every person with anthrax or leprosy, there are hundreds with minor illnesses that can be prevented with good sanitation or treated with very basic medications. That is what medicine in the developing world is about; treating and preventing the most basic illnesses so that people have a chance to live a healthy life.
