Itching for something…..


An Ominous Silence?

Okay, so I realize I have gone a couple days without an official blog entry…. Or an email to my support group ( that would be – you). I realize that if I ever truly get sick, you will need to guess about it only by my silence, not by anything I announce in my emails…..

 Side effects of malaria prophylaxis

I am still itching a fair bit, to the point where it has been difficult to sleep, and having some muscle pains. Slight edema of hands but not of my face; no wheezing or hives. I get “strangely tired” in the sunlight. When I read the side effects of doxycycline it also includes “urinating less frequently” and come to think of it, that too…..

I am better than I was. How long before this goes away? Was hoping it would be gone by now, it’s been six days…. And yes, I stopped taking this stuff Friday when I became suspicious. I have taken extra aspirin but not gone to buy benadryl. Antihistamines always make me really drowsy so I shy away from them. I have cut my fingernails so as not to break my own skin.

And all this to avoid malaria. Could have been worse. The quinolone drugs, another category of drug, produce hallucinations in some people. That would be my fate of course……. When you have a vivid imagination to begin with, what do quinolones add to the party?

In ICU in Bhairawa they had a patient with falciparum malaria. He was not enjoying himself. I don’t know his details, but it’s not as if I can simply say “O this malaria isn’t really a problem…..” So.

Tibetan Refugee Camp

In a lighter note I took a morning walk to an area I had only previously driven through “Tibetan Camp” which had a lot of rug shops. It’s a shame I am not looking for a carpet. Then I had lunch with a person involved in Aawaaj, an NGO that works on domestic violence and the role of women here but especially in Western Nepal and Western Terai. We talked about thermal injury among other things, and the laws that prevent gender-selective abortions. (In other words, using ultrasound to predict sex then aborting the girl babies, which happens here…….) Also the role of the dowry system in perpetuating DV in parts of Nepal. Fascinating. The dowry idea is part of Arranged Marriage. Intertwined with educational background – a more educated woman is more desirable.

Mechhandranath Spectacle

Also in the late afternoon I walked to the Mechhandranath juggernaut, now parked about a half-mile away. Government officials were there for a ceremony, they had a forty piece brass band, the Ceremonial Gurkhas (dressed in 1840-vintage Ghurkha uniforms, with muzzle-loaders) a Newari band, the whole production. There was a point where the crush of the crowd was tremendous – unable to do anything other than move the way everyone was pushing. Fantastic.

Domesticity at the Guest House

There are two American families here, each with two kids, each mother expecting number three, and dinner time is pleasant chaos. Makes it fun and homey. One of the guys is into recreational slingshot – ala David and Goliath…. They are here from Darjeeling where they are doing Bible-related language work.

www.teachingmedicine.com

There is an anesthesiologist here from Vancouver BC who is teaching critical care at Patan Hospital and we have traded notes. I gave him a copy of my Atlas and six-step guide, he gave me a bunch of stuff on a thumb drive. He also says they are having dengue in parts of KTM presently.

To all my readers: Hoping you are well. Special shout out to my friends who have had recent surgery, or struggling with depression. Keep those cards and letters coming.

Joe

About Joe Niemczura, RN, MS

Experienced nursing educator and problem-solver. I have fifteen years of USA nursing faculty background. Add it with fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. I travel outside of Kathmandu Valley as well. When the recent violence happened, I knew the cities - I had trained people in those locations. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011. Global Health Nursing is not all sweetness and light; not solely milk & honey and happy moms and babies.
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