I set out for my Mid-Service Training (MST) with what I thought was anxiety about seeing my cohort, the group of people with whom I arrived here in South Africa 16 months ago. The purpose of MST is to fuel Peace Corps Volunteers during a notoriously emotional slump, provide a midpoint medical check up and propel us to succeed in the second leg of PC service. In some ways, I looked forward to the milestone and anticipated boost, but mostly, I felt I was lagging behind. Struggling to find my fit has been a theme during my service. On my third site, living with my third host family, not feeling like I quite fit into my assigned organizations and not feeling at home amongst my peers has been a challenge. What was supposed to be a time to recognize ourselves and our service quickly devolved for reasons other than the diagnosis I didn’t see coming. Maybe one day, post-service, I’ll speak more freely about MST.
Fast forward several days when I travel to the hospital for the aforementioned chest X-ray. Upon entering the room, I voice my anxiety and the friendly clinician tells me I have nothing to worry about. As I relay my blood result, she exclaims, “oh!” runs out of the room, rightfully returning in a surgical mask with a bit more hesitancy than before. Luckily, my chest X-ray is clear. Two days later, I’m offered a pamphlet on TB and 2 different treatment options. As I read about the symptoms of active TB, the fatigue and labored breathing I’d been experiencing for the last several months jump off the page. I urge further testing to determine my TB status, which is thankfully granted. The subsequent days are filled with multiple doctor and hospital visits, the low point being a lab tech pounding on my back for what felt like an hour in an effort to force sputum-producing coughs behind closed doors that earned me unabashed stares from the entire waiting room upon my exit (yes, as anxiety-provoking as wading your way through that sentence). Fortunately, my poor lungs are spared further trauma when I’m sent to the physiotherapist who administers proper sputum-production techniques over the next two days. I await results, which come back negative and point to a diagnosis of latent TB. I opt for the 4-month, rather than the 9-month course of treatment. I take half a dose, as instructed, and awaken at 3am with nausea, vomiting, vertigo and a whole host of misery that makes for one of the scariest experiences of my life.
A desperate call to my second Mama in the States prompts a even more desperate 4am call to the Peace Corps Medical Officer who at first diagnoses food poisoning, then tells me to refrain from my morning dose of the Rifampin and come to the office in a few short hours. I’m sent for a second opinion where we explore some of the other strange symptoms I’ve experienced over the last several months, including night sweats and joint pain. Additional blood tests and another sputum test is ordered.
As I await test results, the days and weeks go by, I am further disconnected from my village, my host family, my current projects and my support systems. My guilt mounts as I can’t effectively communicate my current health status, as I myself don’t have answers. Text, Facebook and WhatsApp messages increase as I press “pause” on my life. I experience some dark days as my fatigue is compounded by a lack of answers.
I bounce in and out of each of the stages of grief - denial, anger, bargaining, depression and acceptance, as I clamor to cope. From questioning the validity of medical tests to analyzing interpersonal interactions to feeling as if I’ve made a mistake pursuing the Peace Corps in the first place to finally recognizing the empathy cultivating within me for folks who endure chronic diseases, partner and family notification of medical issues and obstacles of all kinds. I dig deep to remain connected to the light within and around me.
I am diagnosed with schistosomiasis, the second most common tropical disease next to malaria, that somehow no one’s ever really heard of. Schisto, as it’s so lovingly referred to among those of us who now know it well, can live in the body for up to 40 years. The parasite can cause some major damage. Amazingly, the treatment is only one day, but as the worms die, the body can react in a variety of ways. I spend the next several days asleep. Doctors tell me it will be months for my body to adjust to life without the schisto present in my body. Unfortunately, I have to start the TB meds before then. It's likely I won't feel like I've got my body back until the TB medication finishes. More days pass. During a follow up appointment at which I’m expecting my new TB treatment, I leave with a prescription for a broad-spectrum antibiotic because something is still out of balance. The doctor determines that I’ll try the 9-month treatment for latent TB once I finish the course of antibiotics. I’m told I can return to site.
Panic sets in. Many conversations take place. I decide that starting TB meds back at site, in light of my reaction to the last medication, is a non-negotiable. Living in a rural village several kilometers off a paved road precludes me from accessing proper medical care should another reaction occur. I will start the TB meds in the capital. The antibiotics are uneventful until I get what feels like a cold during the last two days of the therapy. The doctors attribute the symptoms to my body being “drug naïve” and the medication increased my susceptibility to illness. Three days later, symptoms disappear and I start my 9 months of TB medication without incident.
I return to my village this week, I speak with my current and former host families to notify them of my diagnosis, the reasons for my absence and my lack of communication. I fear stigmatization and blame and, instead, am greeted with acceptance, understanding and words of affirmation. The dynamics among myself and others in the village shift positively in the direction of curiosity and appreciation. I look forward to the work to be done, the relationships to be forged and health, wellness and balance to be regained.
Through these illnesses, I’ve learned to recognize my privilege. Many people don’t get treatment for latent TB. As a Peace Corps Volunteer, I need to take the prescribed medication to prevent my latent TB from progressing to active TB. After taking the regimen, there is a 90-95% chance that I will never get active TB in my lifetime. I’ve taken an active role in educating myself over these last few weeks. Spending countless hours of internet research combined with conversations with friends who have connected me with friends and relatives who have lived with (and survived) TB has been invaluable. I’ve had the luxury of a second opinion, self-advocacy, additional testing and support and urging others to listen to the wisdom of my body. Had I not had such a severe reaction to the first TB medicine, I would not have discovered the schistosomiasis and remedied symptoms that have been plaguing me for months, maybe years.
