Malaria (and/or other African Illness) Woes

May 5, 2010

While preparing for my year in Uganda, I heard about many other researchers who developed malaria or other ailments while studying in Africa. I was always curious to learn the details of what it was like for these researchers to be sick in a foreign country – so I've decided to write a post about my experience with malaria (and/or other African illnesses).

On one of the last days of March, I went out to the forest and followed chimps like any other day here; I had a mild headache but didn't think much about it. That night when I got home I was preparing my field bag for the following day when out of nowhere – I felt incredibly sick. I started shivering and quickly developed a mild fever. By the next morning (Day 2), I had a 101 fever, a killer headache, and my lower back was incredibly painful. Dean and I (with the help of other Ugandans and researchers) decided that I probably had malaria (despite the fact that I take Malarone prophylaxes daily and sleep under a bed net…) so I quickly started taking anti-malarials. On Day 3, I still had a fever – but I was starting to feel better. I could get out of bed and walk around…I was beginning  to think that I had dodged malaria before it got really bad. But then, Day 4 hit me like a brick…all my symptoms intensified and I could not find a single position that felt comfortable for my back. I could hardly get up to walk to the latrine, and I maintained a 100-102 fever nearly all day. By the fourth night, I was completely miserable. At this point, I was almost done with my anti-malaria treatment and my fever still hadn't broken. Dean and I were becoming increasingly nervous that what I had wasn't malaria after all – or that I wasn't responding to the treatment. So, we decided to head to a hospital in Kampala, Uganda's capital, to visit the hospital.

On Day 5, we woke up early and set off on a five hour drive to Kampala. This to have been one of the most painful car rides of my life. Considering I couldn't sit up or find a comfortable way to lie on a bed,  driving for five hours on a bumpy road was, well…exhausting. We finally arrived at the International Hospital in Kampala and were met by Dr. Andrew, an amazingly nice Ugandan doctor. He ran all sorts of blood tests and gave me a thorough check-up. While my blood tested negative for malaria (potentially because I had been taking malaria prophylaxes for 6 months prior – and I had been taking anti-malaria treatment for the few days before the test), my platelet count was low…which is indicative of malaria. Thus, Dr. Andrew started me on a round of anti-malaria injections thinking that they might be more effective than the anti-malarial pills. He also gave me a shot for pain, which I was incredibly thankful for…and for the first time in several days, I could sit up. Dr. Andrew told us to come back to the hospital on the following two days for follow-up anti-malarial and pain injections. The rest of Day 5 went pretty well. I was still in pain – but all in all I was happy to feel safe in the care of a doctor and to feel like I was improving.

Day 6 provided another good shock for us. By the morning of dDay 6, I still had a fever – and more interestingly – I had developed a splotchy red/white rash all over my chest, stomach, back, arms, and face. When Dean and I went back to the hospital for shots we mentioned the rash to the doctor thinking it might be an allergic reaction to some of the medications (I should mention that at this point I was feeling horrible…perhaps the worst yet). After seeing my rash, the doctor decided to do more blood work. Dean and I were really pleased when the doctor came back to tell us that my platelet count had gone back up. But then she followed that statement up with this: <<Your white blood cell count has dropped dramatically since yesterday and we're concerned about it. This indicates that you have a bacterial infection…likely in your blood. Maybe septicemia. Perhaps it's not malaria after all. We'll run tests to try and figure out what you have and how to cure it. We would like to admit you to the hospital. Don't worry, you won't be here for more than a week.>>  This (coupled with the fact that we had to keep asking nurses to wear gloves when they gave me injections) scared the hell out of me and Dean because all the sudden my ailment turned from what seemed like very treatable malaria to <<we don't know what you have>>.

I checked into a hospital room that night, and fortunately Dean was able to stay with me. We called my parents to update them, and they of course freaked out too. I still had a fever and was out of it, so they talked to Dean a lot. The doctors were all really nice and helpful – but each time I met a new doctor and told them I work in the forest with chimpanzees, they would say  <<Ok, we're really going to have to think hard about zoonotic diseases then>>, which was never comforting to hear. Luckily, the doctors gave me two broad spectrum antibiotics on my first night in the hospital, and I started to improve within hours. By the next morning – I was still glued to my bed – but my fever had (after 5 and a half days!) finally gone down! I continued taking antibiotics, pain meds, and antimalarials (lots and lots of injections…mostly on my bum…aye!). I was also hooked up to a drip to keep my fluids up…all the while Dean was force-feeding me liters and liters of juice (no joke…haha, I must have downed 10 liters of juice in 3 days). After a second night in the hospital, the doctors agreed that while they still didn't know exactly what I had – I was improving. They said I could leave the following day.

The next week I still felt incredibly run-down and I began to experience intense aches and pains in my arms and legs. Apparently this was from a build-up of lactic acid from the chills early on in my sickness – and then the fact that I stayed in bed for days afterwards meant the lactic acid had nowhere to go…so it led to muscle soreness. Slowly slowly ("empora empora" as they say here in Rutooro) I began to feel better…only to come down with the flu a week or so later. Ha. When Dean and I finally got back to the field site – I developed a bad cough and felt sick (albeit on a much more manageable scale) all over again. I think Dean and I both caught the flu from the hospital. Rough luck. All in all – I missed about a month of field work. But – I am proud of my platelets and white blood cells for finally kicking that mystery infection's bum. Yes – I am once again healthy :)

Consortships and other sexual advances in the forest

March 21, 2010

Today I followed Outamba – an adult female chimpanzee who has five kids (that's a lot for a chimp)! Outamba had a small swelling, and being that she is extremely prolific for a chimp – she must be attractive to the males in the community. Mokoku, an adult male, probably saw this as an opportunity and attempted to sneak her (and her large family) away from the other chimpanzees for a sexual consortship (i.e. an extended period alone where he would have exclusive access to mate with her). I had never seen a male initiate consortship before – so it was pretty cool to see everything play out…and it was especially interesting because Outamba seemed incredibly resistant to the idea of leaving the community – particularly during one of the peak fruiting seasons.

The day started with Mokoku shaking branches at Outamba (yes, male chimpanzees "invite" females by shaking branches at them…sometimes quite aggressively). While Outamba stalled and seemed resistant to Mokoku's invitations, her children were all too eager to hang out with a high ranking male – especially her young son who continually moved with Mokoku and watched his every action. After much branch shaking, Mokoku finally led Outamba and her family away from the central area and towards the periphery of the community home range. Everyone fed on fruits and leaves and the kids played a lot. This lasted for about an hour or two – when suddenly, Outamba was nowhere to be found. I don't know how she did it, but she slipped away and hid somewhere without anyone noticing.

Once the other chimps realized that Outamba was no longer around, things became chaotic. Her son began frantically running (back-tracking) through the forest, and his little sister trailed behind him screaming loudly. Mokoku – followed quickly behind them displaying aggressively by dragging branches, banging on trees, and making loud vocalizations. After running a good distance, Outamba's juvenile son and daughter both climbed a tree and frantically looked around the area while interchanging screams with whimpers. All the while Mokoku waited nearby and occasionally displayed. Finally, he gave up and left, returning to the central area while Outamba's kids remained whimpering in a tree. After nearly ten minutes of this – Outamba appeared from an area of dense vegetation. Her kids quickly climbed down (their cries ceased immediately) and there was a short grooming session before they all traveled together back to the central area.

By mid-day Outamba and her family came to a tree where Mokoku was feeding. After an hour or so of eating fruits, Mokoku violently attacked Outamba – hitting her and eventually pushing her down and stomping on her back. He then briefly groomed her and inspected her genital swelling (an indication of how fertile she is). Then it all started over again. Mokoku shook branches, Outamba stalled and would reluctantly follow, all the while her young son eagerly kept up with Mokoku. For a few hours it went on like this: Mokoku would move ahead of Outamba a few meters and branch shake, Outamba would sloooowly follow – very much taking her time, Mokoku would violently branch shake, Outamba would finally walk over to him, Mokoku would groom Outamba briefly – and then he would move another few meters and start to summon her again.

After a couple hours of slowly moving like this, Mokoku, Outamba, and her children reached a feeding patch (what we call THV or "thick herbaceous vegetation", jargon – I know) where they spent several hours eating. Near the end of the day, several of the other females and their children arrived at the same THV patch. Afterwards, the whole party of adult females, kids, and Mokoku moved in a single-file line down a trail to a nesting site. Mokoku was at the front of the line, and Outamba stalled and joined the line last. While Mokoku and the other moms were walking along the trail – Outamba and her kids slipped away without anyone noticing. They moved quietly and quickly and fed alone in a tree before nesting. Shortly after the Outamba family separated from the rest of the group, we could hear Mokoku displaying from a distance – probably once he realized she had snuck away again.

MuzunguMan

February 27, 2010

This is a short post, but I thought this was pretty funny. White people here are referred to as muzungus (moo-zoong-goos).  Ugandans use this nickname often and commonly say "hello muzungu!"  "how are you muzungu" – essentially, I am referred to as a muzungu at least 10 times a day. Dean went to town a few weeks ago and asked the grocery store to hold his box of groceries while he ran some errands. When he went back to pick up his groceries – the store assistant had labeled the box "muzungu man."

Akiiki and Amooti

March 5, 2010

Empaakos (or "pet names" as people here call them) are used daily by the Batooro and Banyoro tribes  who live around Kibale Forest. Most people here are given an empaako a few days after they are born by their parents, and Ugandans in this area tend to address each other by their empaakos as opposed to their 'official' names. The amazing thing to me is that there are only twelve different empaakos (Akiiki, Amooti, Adyeri, Atwoki, Ateenyi, Abwoli, Apuuli, Araali, Abbala, and the twelth – the only one not starting with A – is reserved  for the King . This empaako is  Okaali) – so everybody here has one of these twelve names as a pet name.  Dean has been given the empaako Amooti and I am Akiiki.

Another interesting aspect of the naming system in this region of Uganda is that people don't take their mother's or father's last name like we do in the US. Last names (which are actually called First Names here) are different for every member of the family and tend to have some meaning. For example, I have a friend named John Sunday. Sunday is his "first name" and he was given the name because he was born on a Sunday.

Non-Chimpanzee Forest Encounters

February 21, 2010

When I first arrived here at Kibale – I was so focused on learning as much as I could about the chimpanzees that everything else in the forest somehow faded into the background. As I spend more time at Kibale though – I am slowly noticing and recognizing the other amazing aspects of forest life. I have become fascinated with the butterflies, moths, and insects here. I sometimes find myself distracted by their stunning colors and wing designs while I'm trying to watch a chimpanzee. The caterpillars here are also amazing (even if I hate them because they continually find their way into my clothes and give me rashes). The caterpillars tend to be very vibrant with "don't touch me – because I'll make you itch like hell" colors or camouflage incredibly with their surroundings. Thus, here are some photos of my non-chimpanzee forest encounters.

First, some butterflies:

Caterpillars...some of these are surprisingly good at resembling sticks, but pretty much all of them are capable of making my fingers swell up for days if I accidentally touch them. The caterpillar with yellow spikes particularly scares me!:

Frogs! These guys are hard to spot - and even harder to chase around for a good photo...but the end result is worth it:

Spiders. Okay, I only have one spider photo posted - but this one was really cool. You may need to click on the photo and zoom in to see it, but the spider is black with neon yellow markings. The web had two parts - one vertical wall-type part (shown), and then another horizontal floor-type web. Both webs were white with neon yellow strands interwoven through them. I noticed on a later encounter (after accidentally walking through one of these) that the neon yellow strands are shockingly sticky...shockingly:

Moths. Dean and I have fun capturing photos of these guys outside our house at night:

Flowers. I just have one...but it's a beauty:

Miscellaneous Insects: (anybody know what the blue one on the bottom is?)

Murchison Falls National Park

April 26th - 28th, 2010

Sooo, it's been a while since either of us published anything, but now I have some exciting photos to put up!  I went to Murchison Falls National Park at the end of April and it was SPECTACULAR!  I saw giraffes!!!  This may be my favorite large animal.  I think they remind me of the magic in life. Seeing them makes me feel as though life is fantastic without needing special effects in movies.  Surreal!  Speaking of them, here's a couple of photos of these magnificent long-necked beauties:

 

Unfortunately, this was a trip I took without Julie because she's making up for lost time having been sick for nearly a month.  She's all better now though!  Our safari group was into the giraffes, which made me happy that I wouldn't be the only one obsessing over them.  This place was incredibly beautiful.  It's located in northern Uganda but not so far as to be near Sudan (though it did have Congolese guerrillas living in it in the '90s).  It's between the Victoria and Albert Niles, on Lake Albert.  The southside of the western flowing Victoria Nile is mostly semi-scrub forest, but the north side is primarily savanna ecosystem with lots of Acacia ssp. and palm trees.  Definitely cool!  Here's a picture of me near the delta region of the Victoria Nile flowing into Lake Albert.  The Albert Nile flows north (right in the picture) out of the lake.

I got to see a couple of ungulates that I'd never seen before.  There were lots of Uganda Kob (much like the Impala from Lake Mburo), many Oribi (little ungulates) that I never got a good picture of, and Jackson's Hartebeest, which seemed to be out of a movie (or at least that's what others said).  Here are the Kob and Hartebeest:

Jackson's Hartebeest:

Uganda Kob:

And then, what seemed to get even the driver and ranger excited, lions!  We spotted two females lounging in the shade because two groups of Kob were staring at each other across the open plain.  What were they staring at?  Certainly not each other!  Our guides deduced that lions must be nearby, and viola!

We also saw some savanna monkeys, called Patas Monkeys:

After lunch, we took a boat ride up the Nile to the base of Murchison Falls.  Along the way we saw elephants, hippos, crocodiles, and many many birds.  Here are some pictures from the boat.

Elephants with a Goliath Heron taking off:

Hippos out of water (these guys ran for the water everytime the boat approached):

Now some fun bird pictures.  It was a bit difficult being the birder and photographer, as I wanted to see the bird with my binoculars first, then photograph it.  This is harder than you'd think in a moving boat with live animals.

African Jacana:

Yellow-billed Stork:

Abdim's Stork:

Sacred Ibis:

Rock Pratincole:

My friend and fellow Kasiisi Project volunteer, Chris Mayo-Smith:

And finally, Murchison Falls in the background:

Enjoy!
Dean

Zebra, Impala, much more, and birds galore!

12-15 March 2010, Lake Mburo National Park

Okay, Julie and I went on safari last weekend (my first!) at Lake Mburo National Park in southeastern Uganda for her birthday.  It's a scrub shrub/savanna habitat mixture.  Our armed ranger guide told us it used to be more savanna, but since the elephants were extirpated, they no longer are around to eat the acacia, which is taking over.  Fundamental ecological principle, some species are critical to habitat persistence... remove one, and everything can change in the long run.  Anyway, we saw zebra four days in a row!  WOW!  They make no sense to me, being easy to spot.  We got an array of answers about why they have stripes and are so "obvious" looking.  One was predator disorientation.  They travel in family groups of 3-5 individuals by day and come together as around 10 individuals at night (two families).  We did see some groups of up to 12 though!  Another explanation we were given, neither Julie nor I could really understand.  I think it was a language barrier thing, but it seemed our guide was indicating that perhaps there stripes make predators not attack them, b/c the predator thinks the zebra is a predator also (think spotted leopard, or aren't there striped leopards somewhere? Siberia maybe?).  I think this was a basic mis-communication though.  Decide for yourself and chime in on the comments, b/c we'd love to know. What do you think is the reason for their stripes?  They are disorienting to look at.  See for yourself!

Zebra!!!

Evidence we were there (zebra far in the background)!

Between our walking safari and a game drive, we also saw lots of fun ungulates including: waterbuck (Defassa or Common?), bushbuck, impala (only found at Lake Mburo in Uganda), topi, African buffalo, and even some Ankole cattle.

Male waterbuck:

Female bushbuck:

Male topi:

Impala butts (notice the "m" on their butts. this distinguishes them from Uganda Kob):

Impala male bachelor:

And nearby, a male with his harem (notice the buffalo munching in the background):

African buffalo:

Our guide said the male with his head down was the largest spread he'd ever seen on a buffalo! HUGE!

Ankole cattle (check out those horns!):

On our boat ride in the lake just after we arrived in the evening, we saw some hippos, small crocodiles, and lots of cool birds!

Two apes in a boat :)

Hippos!

Crocodile:

Here go the birds.  Now, while some may be blurry, they're identifiable and worth showing (I think).  Hope you enjoy!  I should mention that all of these were seen from the boat.

African Fish Eagle (these guys were everywhere!):

Malachite Kingfisher:

Pied Kingfisher (these were everywhere too!):

Woodland Kingfisher (you're gonna have to trust me on this one!):

Weaver (I forget which kind, check back soon for an update):

Hamerkop:

African Finfoot:

Heron (I forget which, check back):

Wattled something (I left my notebook at home!):

Okay, here are a few more pictures for fun.  Enjoy!!!

Vervets on a Toyota:

Purple flower:

White flower:

Acacia stem:

Lepidopteran:

Overlook:

Sunrise:

Love,
Dean and Julie