December 23, 2009

on "holiday" in dar

This series of blog entries chronicles my time in Dar es Salaam amidst a medical issue I had two weeks into my service. The following events occurred just a few short days before Christmas 2009.

The trip to Dar was uneventful on Mohamed transport, though it was long. You never think bus rides will feel as long as they do until the trip is over. Then, when your brain has been sufficiently fogged by hours stretched to their limit, the unexplicable heat coming from beneath your seat, the perpetual lines of traffic stuck behind cars hesitant to drive over 40 km/hr, and the hunger for a decent meal, you realize 8 hours really feels like 8 hours. Or maybe even more if your travel is less than comfortable.

As I was nearing the city, I was praying silently for a taxi driver to lead me off the bus and sweep me away to my glorious accomodations without any hassle. I was willing to pay just about anything for a safe ride to the hotel, given that dusk was well on its way and safety certainly couldn't be guaranteed beyond then. Luckily for me, this wasn't too far from what actually happened. One solitary driver was standing at the door to the bus, seemingly awaiting my arrival, missing just the sign with my name on it. He escorted me to his taxi, which was marked appropriately and officially to my relief. The fare was 20,000/=, which sounded kind of steep to me, but worth it if it meant I'd make it to the YMCA intact and with all my luggage. His name was Joseph, and he earned his 20,000/= by expertly negotiating the roaring Dar traffic, scooting his way through shortcuts and weaving through narrow backroads lined with vendors and illuminated flourescent tubes.

When we were arriving at our destination, I mistook the Holiday Inn on my left for the YMCA on my right. As if the Peace Corps would really pay to put me up in a hotel like the Holiday Inn, with its spotless white plush couches and automatic sliding glass doors. This is the Peace Corps! My hotel was next to this architectural gem, a drearily-lit hostel with ceramic tile floors and concrete walls, iron bars littered throughout protecting it from the harsh environment around it. After stumbling through the entrance, I followed a sign for the "reception" into a courtyard area, which I mistook as the other side of the hotel. "I've already passed through the entire hotel?" I thought to myself. Then I looked to my right, and found a concrete wall with a window embedded in it. Above it was the word "RECEPTION" painted in giant capital letters.

After filling out a card with my information I received my room key, room 28. "Second floor," I thought, not bad considering the reason for my visit. It turns out the rooms are numbered sequentially, regardless of the floor they're on. So while 28 logically sounds like a room on the second floor, it is actually not so. I climbed the stairs endlessly, thinking "the next floor must have my room." I finally reached the point where I could no longer climb stairs, not because I was too tired, but because there were no stairs left to climb. On this floor I found my room. Certainly not the best start to my stay in Dar.

Getting the door to my room unlocked was no easy task. These skeleton key locks have gigantic openings for teeny keys, and once you've inserted the key into the black abyss that is the keyhole, there's no telling where the other side of the lock is located. After fiddling with the door for approximately ten minutes trying to get it open, I was surprised to find a fairly spacious accomodation. There were two desks that appeared to be drilled into the walls in both back corners of the room, indicating that at one point, this was enough space for two people. Also hinting at this was a dangling piece of string hanging from the ceiling behind the closet in the front of the room, undoubtedly the remains of an old mosquito net that would've hung over the second bed. After tossing my things indiscriminately on the concrete floor, I hunted the switch for the ceiling fan, given the room was hovering at about 375 degrees fahrenheit. Here I found the pinnacle of disappointment.

The fan squeaked obnoxiously and loudly to life, making noises similar to wet sneakers on a buffed and waxed floor, only much more amplified. "Surely this will stop once the fan reaches its final speed," I thought optimistically. It did not, unfortunately, but in fact got louder as it increased speed. It was only set to 3, and I dreaded what it would sound like at the maximum setting 5.

I slept intermittently that first night, amidst the horrible screeching of the fan and the mosquito net, which was obviously too small for the bed selected for it, pulled so taut my head pushed it upward. There was no headroom or footroom within the bounds of the net, but if I chose to sit in the middle of the bed, I could do that quite comfortably without it touching me at all. After attempting to sleep for about 6 hours, I decided to get up and turn off the fan, of which I had decided its annoyance outweighed its actual function to circulate air. I laid back in bed thinking I might sleep a bit more, but ended up locked in a staring contest with the ceiling, waiting for the alarm to go off. I arose to start my day.

My first challenge was to obtain a towel and soap, which is normally provided in the room (at least, that's how it's been at all the hostels I've stayed at in Tanzania so far) but was mysteriously lacking on this occasion. Upon arriving downstairs, I decided to go ahead and take my breakfast first. Once I was filled up on two eggs, some white bread and chai, I headed back to the reception to ask for the bathing items. "Njoo," the housekeeper beckoned me to follow her through a maze of concrete to the laundry area. She handed me a shaggy green towel and told me the soap was at the reception desk.

I felt infinitely better after a shave and a shower. After going without bathing for a few days, riding in an oven for 8 hours to Dar, and sleeping in one under a squawking turbine blade, washing off the stink of moments past was a wonderful feeling. Especially considering I had been without running water for almost a month, having a shower that actually functioned was nearly miraculous. I put on some (mostly) fresh clothes, tottered downstairs, dropped some laundry off at the reception, and I was ready for my appointment.

Normally when you get picked up, the car arrives in front of you and you jump in the front seat. The driver assigned to pick me up had already arrived however, parked, and went looking for me within the hotel. An odd thing to happen, considering I was early getting ready and Tanzanians are notorious for running late to everything. My escort came out of the hallway from behind me and called my name. We greeted each other and then piled into the vehicle.

The security checks at the Peace Corps Office never fail to amaze me; it doesn't matter what vehicle enters the front gate, you put it in park and shut off the engine. Then you wait while they inspect the engine, check the underside with a mirror, and search the trunk. This is a Peace Corps vehicle, mind you. They don't take any chances, that's for sure. I showed the security guard my Peace Corps ID and she lifted the gate so we could enter the compound.

I had a short appointment with the PCMO, in which she confirmed her hunch that I had something called Foot Drop. It's basically what it sounds like; your foot droops when you lift it off the ground, and walking with it produces slapping sounds as it limply hits the floor. At this point, it is unknown what exactly has caused the condition, though based on the events that transpired very close to realization of the injury, an educated guess is probably a good prediction of what the test results will reveal. The PCMO thinks the peroneal nerve is the root cause, as do I. The peroneal nerve is a long nerve that runs down the leg below the knee, and at the moment that part of my leg is quite numb.

Following the appointment we discussed what the future is likely to hold, the basic gist being a medevac to be treated somewhere else. An MRI could be done at the office, but that isn't the kind of test that will help determine the cause of the condition; a nerve conduction study needs to be done, and that is a test that cannot be performed in-country. Normally, the medevac would come right after diagnosis of the condition and determination of inadequate medical care in-country, but in this case, the evac will probably be postponed for a week. For one, Foot Drop is not a critical medical condition. Second, it's close to the holidays, and all the doctors in South Africa are on leave. Third, Washington DC is in the midst of a winter storm, making travel into the US a bit cumbersome. The Peace Corps HQ in Washington DC has the final say however, and it is their decision that the PCMO is waiting for.

In the meantime, I spent some quality time on the Internet in the PCV lounge near the office, catching up on College Football, marvelling at Maryland's 2-10 performance this season, among other things. I then returned to my room at the YMCA on my own accord on a daladala. I didn't realize that beyond the ride to the office, I was essentially on my own in Dar es Salaam. Back in the room, now somehow at 425 degrees fahrenheit, I cranked the fan up to 5 just for kicks. As I suspected, it was louder than ever. I still maintain that the car alarms that went off throughout the evening in the parking lot were caused by its arhythmic fits of plastic grinding against plastic. The second night, I attempted to sleep without the fan on, more for the sake of the poor inhabitants around me. After 20 minutes, I could feel the sweat dripping off the hairs of my legs. "Maybe I'll consider changing rooms tomorrow," I contemplated quietly as I drifted to sleep.