Illness and pills.

Today, February 15th, marks the official start of Lassa Fever season in Togo. Lassa Fever is a viral illness endemic to our area of West Africa. I'll be honest, I had not heard of Lassa Fever before I started preparations for this trip and received pages of information concerning the disease.

Yellow fever, vaccine required. Mine had expired so was redosed. check

Meningitis, vaccine required, booster recommended. check. (We are also currently in meningitis season and have had multiple deaths at the hospital in the past 6 weeks due to meningitis. Glad I got that booster!).

Typhoid, vaccine recommended. check. (Personally, with all the typhoid perfs I've sewed closed, I would have made this one required.)

And then there's Lassa Fever. No recommendation, nor requirement. Just pages and pages of information and education concerning what level of alert the country is currently at.

Here in Mango, one of the founding doctors of Hospital of Hope died of Lassa Fever a few years ago, making the threat very real to long term missionaries that have that personal connection. When a suspected case is in the hospital, the isolation and level of protection required for providers, is reminiscent of COVID in New York for me. The season lasts through the end of the dry season, which coincides with my current tentative end date here at HoH.

On a side note, I found it interesting that considering all of the information I was provided about Lassa Fever, I was not provided anything about Ebola, which is also endemic in the area, and actually significantly more deadly.

Lassa Fever season is not affecting the way anyone is conducting themselves in nor out of the hospital. It's just part of the way of life here.

Kind of like Togo Tummy. Even the long-term missionaries will have their random sporadic day of GI upset, lasts a bit and then back to normal. It's expected, even normal. Through conversations with the long-term missionaries, I've learned that over time they can rather readily determine the etiology and self-treat (amoebas, bacterial, worms, etc).

Or even like Malaria. It is so normal most missionaries have their coartem treatment in the medicine cupboard already. It's ready to go, and when they recognize the symptoms, they don't always even bother getting the test.

The surgery team has repeatedly been effected by both of those. As much as I am thankful for the visiting surgeons who come for a week or two, I am always cautious about how much they will actually be able to participate as Togo Tummy inevitably takes them down for a few days. And as for Malaria, Dena (the other longer short-term surgeon) was taken out of commission for about two weeks due to the nasty parasite. And she had actually been compliant with her prophylaxis! (Not all of the long-term missionaries are compliant.)

Then the other week, surrounded by all of this new disease and rising temps, as the Harmattans start to slowly dissipate, I came down with a cold. It really is frustrating when you can't make it through surgery without sneezing into your mask a bunch of times. I had thrown some meds in my bag, just because I figured, why not, hadn't actually expected to need meds for a sinus cold. Now if you include my malaria prophylaxis and my iron/multivitamin, I feel as I have taken more pills in the past 6 weeks than probably the past 6 years combined, and the cold was just to add some icing on the cake.

In summary, the adjustment is real. My body is reacting in ways that I don't even realize. The water and chemicals used to wash and sanitize affect our health, as does the air quality, which makes me shudder if I think about it too in depth. The physical aspects of culture is not limited to language, dress and behavior, but extends to the microbial level.

Here's a nice sunset photo. Just because I didn't want to end the post still talking about illnesses and microbes.

And another, this time just because, why not.

Much Love.