Malaria in Zambia

I never understood how difficult village life was like until I got malaria. I never missed a dose of prophylaxis and always sleep under a mosquito net. I'm also a terrible hypochondriac here. In the past year I have convinced myself that I have had ebola and the black plague (having internet can be a curse in the village sometimes). In my defense, it was completely possible that I had been exposed to both illnesses (or at least that is what my internet searches told me). Regardless of these quick forays into madness, malaria has always been what I should have been most worried about.

It happened 4 months ago. I started feeling like body hotness (that is what they describe as a fever here and is coincidentally what I think my stripper name would be as well) around the evening. The malaria parasite is cyclical and so in the day you feel OK and at night you have chills and a killer headache. I immediately took my anti malaria medication and tried to get to sleep as best I could. In the morning my sheets were soaked with sweat and I had a groggy feeling. I got on my bike and went to the road to get a ride to the provincial capital. I wanted to be close to medical care in case things got worse.

I left my bike at my friend Courtney’s house and hitched a ride to Chipata. When I told my drivers that I had malaria they chuckled a bit. This wasn't the sad response that I was expecting. It was like the chuckle you would give after someone told you about how drunk they got on their 21^st birthday. I was passing through a rite of passage. They had experienced it so many times before that it lost much of the danger that it held in my thoughts.

The next two days were definitely a trial. I had a migraine and the shakes. I lost my appetite and took as many ibuprofen as I could get my hands on to keep the pain away. Because I was taking my prophylaxis, the reaction wasn't as bad as it could have been. Villagers will often get malaria two or three times a year and have very little of the comforts that I was able to enjoy from my bed in the Peace Corps house in Chipata. Not to mention that most of the worst cases of malaria are seen in children who don't have the immunity and are often malnourished.

For the last two weeks I have been working on a medical project with Dr. Alan Baumgarten, R.N. Carol Mctigue, and other medical professionals from Asheville and all over the US. In conversations with our Zambian counterparts, there was mention that at times 80% of the patients visiting the hospital are stricken with malaria. We saw a child admitted with a high fever and who was so dehydrated that her veins had collapsed. This made putting in an IV impossible and a needle of fluid had to be put into her bone to reflate her veins. The doctors there tried valiantly to rehydrate her and save her life, but there was too much fluid in here lungs, her fever was too high and she didn't make it through the night. This was only one of the children that we saw on the trip who was near death due to malaria.

For the last day of the medical project, Alan and I put together a celebration for World Malaria day at my local clinic. There were around 500 people who showed up to see the dramas, speeches, a quiz, and a performance of a song about malaria in Chinyanja to the tune of the Kenny Rogers' the gambler (sung by myself and my neighbor Courtney). The people were entertained even if they didn't get everything about the message. There was also a donation of a Zambulance (bicycle ambulance that can carry a patient to the clinic). It was a wonderful day. As we were leaving, Alan was pulled into the clinic by the nurse there. A child with malaria was seizing with a high fever and her eyes rolled back in her head. Alan dove in to help. It has been inspiring to see him work in such difficult circumstances for the last two weeks. He did as much as he could to help re-hydrate her and stop the seizing. With a forlorn look on his face we took the taxi back to the hotel. In the ride back he said that he was pretty sure that she was lost.

It was a difficult end to such a meaningful day, but that is just how up and down things are here. I know how difficult it is to be sick with malaria and it is horrible to watch a child suffer through it, especially because there are so many ways to prevent it. Later in the evening we were having a few celebratory drinks with the District Health Officer who was at the event. He called the clinic to check on the girl. When he got off the phone he said that her fever had dropped and it looked like she would make it. Alan and I both let out a sigh of relief.

It was odd to think that while we were in the yard around the clinic celebrating there was a child in the clinic who was suffering so much. I remembered that while we were talking to her father who sat by her bed, he chuckled a bit when the nurse asked if his kids were sleeping under a net. It would be unthinkable to even smile while your child was near death in America, but that's how things go here. Life can at times be incredibly sad and tragic, but people still joke and keep on living. This can at times be a strength and other times feel terribly frustrating. Tragedy and everyday life are blended and life continues all the same. Let's hope that the future holds less of the sadness and more of the joy for the people here.


*Stomping Out Malaria in Africa is a Peace Corps initiative that uses strategic partnerships, targeted training Volunteers and intelligent use of information technology to support the local malaria prevention efforts ofer 3,000 Volunteers in sub-Saharan Africa. For more information go to stompoutmalaria.org and follow Stomp activities at http://www.facebook.com/StompOutMalaria*<http://www.facebook.com/StompOutMalaria

**Many thanks to Dylan Trivette for this amazing picture of Beauty, one of the girls in my village.

Peace Corps Zambia Packing List

The following is a packing list I put together with a few other Peace Corps friends. I figured I should put it on the blog for future Peace Corps Zambia volunteers who might not have received it from their program. Cheers!

Intro

This list is a compilation of several lists and edits from volunteers (special thanks to Julie Potyraj, Jordan Blekking, Hannah Lippe, and Evy Adamson). Packing lists are difficult to put together because everyone is different and requires different items. This list tries to address this problem by making the first part of the list general and necessary for the majority of people, and the last part divided into personality types. If you read the personality description and think “that’s me” then you probably want to bring everything on the list. If you say to yourself “I’m not sure what they are referring to, or that's NOT me,” then you should probably consider purchasing or finding the only first half of the list. Enjoy and don't get too stressed about it!

General Tips

Getting things in Zambia

This packing list is mostly reduced to buying things that you either can't find in country or are much more expensive to buy here. Even though you will be close to Lusaka for the beginning of your service, it will probably be two or three weeks before you will be taken there to do any serious shopping. And at that time you will be making trainee allowance, which does not leave much extra for spending money. Bring the essentials and you can get some of the extra stuff after the first few weeks. Most clothing can be found in country at second-hand stands in the market or in stores in Lusaka, except for quick dry items and nice outdoor gear.

If you are really particular about how you look when you go out, then you should bring some nice clothes specifically for that, even though you might be able to find some in country. This is one of the biggest problems for girl volunteers! None of us bring enough “going out” or “looking good” clothes because we think we are going to living in the village all the time. Cute clothes that fit you nicely are a rare find in Zambia. Girls should be encouraged to bring some “going out” clothes that cover the necessary body parts. Because chances are, every girl will have at least a few days when they want to look good!

Advice from a wise volunteer

Though you are coming in to a new (and much less developed) country and may think that you will be “roughing it” all the time, you may still want comforts from America! Zambia will become your life, and your normal life, and anything that you think will make you really happy, you should bring! Examples of this are, stuffed animals, a scented candle, a pink wig, a board game, or a silly hat. Don’t be afraid to bring a few things that aren’t on this list, but you think will make you happy. You are making a home in Zambia, so bring a few things that make you feel at home!

Packing for different programs

Each program has different requirements for their trainees in terms of what to bring. In general, LIFE (Linking Income, Food, and Environment) and RAP (Rural Aquaculture Promotion) intakes will need more outdoorsy gear, while CHIP (Community Health Improvement Project) and RED (Rural Education Development) will need to bring more professional clothing.

Can I have it mailed here?

You can have things sent here but they will take at least two months to arrive. Many volunteers write Christian sayings and bible verses on the outside to deter people from taking the contents of the package.

What size of clothing to bring?

You will probably change sizes and might need to bring some smaller extra pairs of clothing if you are a guy and some slightly larger clothes if you are a lady. Weight for ladies balances out eventually, but it's nice to have at least one pair of pants that are little bigger.  

What if you have too much stuff?

Packing for two years can be stressful, but adequate preparation is important. If you have too much stuff, you need to ask yourself if you can't get it in country or if it's really worth bringing? If you answer yes then you might be able to coerce one of your fellow volunteers to cram it in their bag with extra space, pay the money to have it brought on the plane, or have it shipped.

Discounts

Many companies offer discounts to Peace Corps volunteers for everything from shoes to coffee. Check out the Peace Corps Wiki page for a complete list and instructions. They often require some kind of documentation to get the discount and can take a while, so get started early. http://www.peacecorpswiki.org/Volunteer_discounts

I'm running out of money and can't buy everything I need!

This is a big list and you might feel like you are going to burn through all your savings to get to Zambia and won't have anything left over. You don't need everything on this list and need to prioritize for yourself. You can also sometimes buy or borrow cheap gear from volunteers in country. If you are looking for deals on outdoor gear, check your local Craigslist’s and be sure to mention to people that you are a Peace Corps volunteer and will be serving your country overseas (this normally helps with the bargaining process).

General Packing List

General Clothing

·         Rain gear

·         Good rain jacket or two OK jackets

·         Rain pants- Some volunteers like to use ponchos instead and think that these are a waste of time. If you think you will be doing some long distance biking during the rainy season then you should probably bring some.

·         Kit for fixing holes in rain gear and tent - Duct tape works some of the time.

·         Fleece or light jacket - It does get cold.

·         Long sleeved shirts of choice (2 or 3)- Flannel is the best, has a longer shelf life when being hand washed.

·         Sweater- A simple cardigan for the ladies goes a long way when you are cold but need to look professional.

·         Sweat pants/shirt for warmth, running, sleeping - Long johns are nice to have too and are a little lighter weight.

·         Good-quality T-shirts (3-4)- A few quick dry shirts are really nice to have.

·         Underwear and socks (2 year supply)

·         Men- Underwear can be purchased in country, so don’t worry about bringing too much. Quick dry can be handy for traveling and washing on the go.

·         Ladies- Bring enough underwear, and then get it sent. The underwear here is not something most ladies want to wear.

·         Long socks for wearing boots (3 or 4)

·         Dress socks for business meetings (2 or 3).

·         Regular ankle socks (6 or 7)

·         Bathing suit

·         Shorts for athletics or in your house (2-3)- These can be bicycle shorts, but no short running shorts.

·         Jeans, zip-off, or other comfortable pants (2-3)- For ladies, jeans aren’t always easy to find, even in America, so bring at least two pairs!

·         Pairs of dressy, easy-care, trousers (khaki is good) and dressy shirts (2 or 3) - Try to get ones in a darker color to keep them looking clean. Ladies may prefer skirts or dresses to dress pants.

·         Hat - Baseball or safari-type to shade you from the sun.

·         Quick dry towel - The debate over quick dry items can get very heated at times. Quick dry items come in handy when traveling and during rainy season, when drying things can be difficult. If you can't afford it or can't find it, then don't worry about it.

·         Ladies

·         Lots of bras- Sports bras are nice to have. Bring at least two regular bras for trainings, meetings, and going out.

·         Black spandex leggings- You can wear them under shorts, chitenges, dresses, and skirts. Or just by themselves to sleep in. Comfortable, practical, easy to pack, and culturally appropriate.

·         Small purse big enough to put money and a cell phone in. You will need this when in Lusaka or going out at night.

Dressy

·         Note: Some programs, CHIP and RED, require far more professional dress, whereas LIFE and RAP can get away with only one nice outfit. This doesn't include nice clothing for going out in. Everyone needs at least one nice outfit for meeting government officials or to attend important meetings or functions.

·         Men-

·          Jacket and tie

·         Nice Pants (2)

·         Button up long sleeve shirt (2)

·         Women- No sleeveless, low cut, or revealing outfits.

·         Shirts with collars and short sleeves,

·         Dresses (1-2)

·         Skirts of cotton/polyester (2-3) - Must come to at or below the knee.

Shoes

Note: Volunteers with large feet may have a hard time finding shoes that fit in Zambia.

·         Good pair of sandals - Chacos are always a favorite for their ease of washing and traction in the rain. You can buy cheap sandals here for moving around the house and leisurely walks.

·         Pair of boots - It gets real muddy here and some rain boots or big hiking boots can make a big difference. Boots are crucial for LIFE and RAP to have in field visits and outdoor excursions because of their ankle support and protection against biting things. CHIP and RED may not need to bring them if they don't think they will be doing a lot of outdoor treks.

·         Pair of sneakers/low-top hiking shoes

·         Pair of nice shoes- Male volunteers suggest bucs or loafers. Female volunteers suggest nice sandals/flats.

Personal Hygiene and Toiletry Items

·         Case for toiletries- Great for travelling, preferably one that can be hung up and has a mirror in it. Mirrors are a rarity at most guest houses and bathrooms in country.

·         Sunscreen- Peace Corps provides sunscreen, but normally 30 or 40 SPF, if you want a higher or lower SPF than that, bring your own!

·         Three month supply of your prescriptions- Never hurts to bring ibuprofen, pepto, laxatives, non-drowsy allergy medicine, either.

·         Vitamins and supplements- If you are a vitamin or supplement fiend, then you can bring your own specialty supplements, Emergen C, olive oil extract, etc... Peace Corps will give you vitamins when you get in the country if you are not particular about it.

·         Men- Unless you have favorite brands you can’t do without, you should be able to buy what you need in Lusaka and provincial capitals. These include cosmetics, soap, toothpaste, general cleaning products and deodorants, hair conditioner, good razors and razor blades, Q-tips, and hair-care products. Bring only enough to get you through training to start with.

·         Ladies-

·         MAKEUP! - Almost impossible to find in this country. And when you do, it’s disgustingly expensive. If you are a makeup wearer, bring eyeliner, mascara, any facial creams or powders, lipsticks, brushes, EYEBROW TWEEZERS and nail clippers TO COUNTRY, also, earrings, jewelry, etc., bring things that you can afford to lose or have stolen. You can buy earrings here, but if it will make you happy, bring a few pieces of jewelry from home.

·         DEODORANT AND COSMETICS- Almost impossible to find in Zambia for a decent price. Ladies deodorant is awful here, and expensive. BRING FROM HOME!!! Also, any lotions or perfumes, body splashes (which are really nice to wear at the house or while going out) cannot be found here. Bring from home if you have a preferred scent!!

·         Razors-These are expensive to buy in country so you should probably bring some from America.

·         Hair elastics and Bobby Pins- Can be hard to find in the country.

·         Diva Cup

·         Three month supply of tampons and birth control

If You Are Like This.... Then You Should Think About Buying This.

The following are items you may wish to have but you will need to prioritize and choose for yourself. They are organized by personality type and in order of importance.  The first half of each list should be considered by everyone and the second half should be considered if you identify with the title of the list.

General (you are a human)

You should bring

·         Bed sheets - Since bed sizes vary, double-size flat sheets are the best choice. Don’t get anything that is white. Fitted sheets can be really nice, too and are hard to find in the country.

·         Large backpack. Even if you don't see yourself doing big trips into the bush, these are really helpful for moving around in country and going on trips in country

·         Camera with accessories - Preferably one that is USB chargeable.

·         Combination lock - Comes in handy for staying in hostels and locking up your hut.

·         Ear plugs - Buy a pack of ear plugs so that you have some spares.

·         Small sewing kit

·         Good-quality sunglasses -You can find crappy ones here if these get lost or break.

·         Flash light and/or headlamp- Most volunteers swear by their headlamps even if they're not the outdoorsy type.

·         Pictures or posters for hut decoration - Pictures of family are nice and can be hung on a string for decoration.

·         Small solar charging system - Try Solio or Goal Zero for small charging units. You will probably want to buy at least 10 watts to charge all of your electronic devices without a big hassle. 

·         You can buy a more permanent solar setup for your site in country if you would like, just bring some extra cash. These run from $100 to $400. The more permanent setups can run lights in your house and give you a constant, easily accessible source of electricity.

·          At least eight color photos of you for IDs - Photo booth type is okay, for visas, work permits, and ID cards. You can purchase photos here if necessary. Make sure you dress professionally for them.

·         Journal - Might want to bring nice pens, too. The ones in country are not the best.

Think about bringing

·         Wrist watch - Nice for timing and alarm functions. Don’t get ones with the cloth bands because they will get really stinky.

·         Books- Many volunteers prefer kindles, but there is something about a nice book. The provincial houses have libraries of books to borrow from. Because of their weight, I wouldn't recommend bringing too many.

·         Games - Cards, chess, Scrabble, etc.

·         Bandanas (3 or 4)

·         Moth Balls - Good for keeping out rats and insects

·         Money belt

·         Guitar or musical instrument - Bring extra strings and picks. Good quality instruments are hard to find in the country so you are better off just bringing one. Harmonicas and ukuleles are also volunteer favorites.

·         Koozie - Cold things are a rarity in this country, so why not prolong their frigidness with a Koozie! They are lightweight and also help to distinguish your beer from other people's beers so that you can reduce your exposure to germs. These are my personal favorite - http://www.freakerusa.com/

·         Sports equipment - Football, volleyball, baseball glove, basketball, Frisbees, etc. Cleats and shin guards are a good idea if you think you will be playing a lot of soccer.

·         Travel alarm clock - Most people just use their phone or IPod.

·         U.S. stamps - Letters may be mailed in the States by people traveling home from post.

·         Maps of the United States and the world - Good teaching aids and wall-hangings.

·         Hand sanitizer

·         Solar shower- Some people bring these and never use them and others swear by them. I would say if you can't go without a hot shower, then bring one. Otherwise, don't worry about it. You can also often find them left behind from older volunteers at the provincial houses.

Kitchen (You have been referred to as Emeril or Paula Dean)

You should bring

Note: you can get a lot of prepackaged things here now (drink mixes, seasonings and ramen noodles). However, you can’t get calorie free drink mixes that are any good and taco seasoning is expensive. Bring it if it will make you happy and you think you might not be able to find it in country.

·         Spices - You can get most of the regulars here, but if you are a cooking buff, you should probably bring some extra that are more obscure.

·         Ziploc storage bags (gallon size) - Ants and roaches can eat through them but can be nice for keeping things dry.

·         Sturdy Tupperware with screw on lid - Great for transporting lunches and snack. Nalgene makes some solid ones

Think about bringing

·         French press - Preferably one of the unbreakable plastic ones. They make small travel mugs with a French press included that are pretty awesome. http://www.rei.com/product/792857/rei-double-shot-press-mug

·         Can opener - You can buy in town but you might want an awesome one if you are a big cooker. Most Leatherman come with a can opening tool.

·         Hand crank blender - A little overboard, but awesome for smoothies and salsas in your hut. http://non-electric.lehmans.com/hardware/Hand%20Crank%20Blender

·         Cookbook - Download one on your e-reader. Peace Corps will also give you a basic cook book for Zambia.

·         Brewing yeast - Some people get into brewing different kinds of wine here. You can bring little packets of brewer’s yeast and really enhance your village creations.

·         Sharp knife- Good addition if you love cooking and are particular about those things.

Tech (You are a level 30 wizard on World of War Craft)

Note: make sure whatever electronics you bring are both 120V and 240V compatible. Most new electronics are, but you might want to check the plug on older items if you are not sure. Look at the following article for more information on the plug type and electricity supply in Zambia

http://www.adaptelec.com/index.php?main_page=document_general_info&products_id=326

You should bring

·         Conversion plug for Zambia - Look at the article above for details on the plug type. Might want to get a conversion plug with a voltage adapter if you have electronics that will need it.

·         Music - Bring as much as possible. You will be happy you did when you are alone at your site.

·         Podcasts, e-books, and movies (please download legally) - There is internet here but it is too slow to do any major downloading. Radio lab, This American Life, The Moth, Freakonomics, and Fresh Air are Peace Corps favorites.

·         Computer - Bring one with as much battery life as possible or an old one you don’t care about. You can also bring an extra battery to stretch it out. Many people have computers in there huts for work or to watch movies in their leisure time.

·         Mini-speakers - USB chargeable. Some people use battery powered speakers because they can be easier to take when travelling and plugs are hard to find.

·         Shortwave radio (3–7 band) - Nice for hearing international news on the BBC and VOA (Voice of America).

·         Kindle or e reader - Buy a case for it to keep it concealed and protected. They sell some e readers with large screens that can be nice for reading PDFs.

·         IPod touch, IPhone, or android - Helps with computing capacity and can hold different language learning software. Useful also for downloading messages when there is access to internet and then reading and replying to them later.

·         Unlocking IPhones - There is someone in Lusaka who can unlock IPhones, but you are better off getting it done while still in America.

·         Headphones (2 pairs) - Bring extra because you are sure to lose or break at least one.

·         Extra memory cards and flash drives - Great for sharing files and backing small things up

·         Batteries - You can buy them here, but they are expensive. Rechargeable ones are a good buy

·         Unit for recharging batteries

Think about bringing

·         Programs and things to download before coming - Download as much as you can in America. Speeds here are so slow and will drive you crazy waiting for them to finish.

·         Calibre - Download this to add books or PDFs to your e-reader without the internet.

·         VLC Video Player – Helpful to play different formats of video you are likely to find here

·         Handbrake- Allows for a computer to change the format of a video so that it can be watched on an IPod. This is really nice for travelling and when power is an issue.

·         Anki or Flashcards ++ - Great apps for learning the local language. Sets have already been made for a couple of the local languages. These can be downloaded on your smart phone. Read more about this software by following this link – http://www.wired.com/medtech/health/magazine/16-05/ff_wozniak?urrentPage=1

·         External hard drive - Good for bringing more music and swapping digital things with folks.

Outdoors (you wear a friendship bracelet and know what Outward Bound is)

You should bring

·         Large backpack - A solid, large backpack is always a good travel item because of the amount of time that you will be spending moving about the country. If you are a backpacker, then it is extra important because you can actually take it out in the woods. Look for the ones with the removable top for extra functionality.

·         Sleeping bag - It does get cold in Zambia and in the surrounding countries, so you will probably want a fairly warm bag. However, in the hot season a big sleeping bag is cumbersome to carry around and too hot.

·         Sleep sack- This is a nice travel item that basically two sheets sewn together (You can make this if you are short on cash). They are great for hostels or places where you don’t trust the sheets.

·         Sleeping pad or yoga mat - Can be bought in Lusaka but can be expensive.

·         Two good water bottles - Wrap them in duct tape to cut down on your packing space and increase the utility of your water bottle.

·         Small backpack/bag - Good for bringing things to meetings and smaller trips.

·         Headlamp - Get one with a long battery life. Worth the investment for buying a nice one, Petzls are great, and last!

·         Leatherman or Swiss army knife

Think about bringing

·         Bicycle saddlebags - Get the kind that can be attached to a rack on the back and not the one that attaches to the seat. These are awesome for keeping bike tools with you and hauling things around.

·         Tent - Important item to bring even if you are not outdoorsy. When staying at other people’s houses it can be really nice to have another sleeping spot.  Some people buy just popup bug tents for staying with people, too.

·         Carabineer - Often comes in handy for putting hammocks up or hanging things.

·         Light weight hammock  

·         Camel back canteen

·         Nice work gloves - These are great for reducing blistering and keeping your hands cleaner when you are working with some funky dirt.

·         Binoculars

·         Rope - Good for hanging things up around the hut when you first arrive, though once you get to town you can buy just about any kind of rope you can imagine.

·         Fishing equipment

·         Bicycle handlebar extensions - Only buy if you are a huge biker and know that you want them.

Organizational and Professional (you’re a dork and like synergizing things)

You should bring

·         Daily planner - Can be found in Lusaka but you should probably just bring one if you think you will need it.

·         Accordion folder - Helps to keep together the thousands of things they give you in training.

Think about bringing

·         List of addresses from America

·         Hanging shelving units - Great for organizing clothes and shoes for the first couple of months

·         Photocopies of your important documents and forms of ID

·         List of passwords to important accounts

Just for Fun and Small Gifts (what I am going to do with that extra space in my pack?)

Note: Host family gifts and gifts for villagers can be nice, but keep them very small and don't give them right away. It sets up some unrealistic expectations about what you can give them.

·         Wildlife guides on Zambia - Wildlife guides are awesome for spotting dangerous and beautiful animals around your site. Guides to Zambia are plentiful and can be found in great numbers to borrow at the provincial houses.

·         Pop rocks or altoids - Kids love and are also terrified by them.

·         Bottle of good bourbon

·         Stickers

·         Those things that expand in water and turn into dinosaurs

·         Other people’s extra things - Email the group to see if anyone needs some extra space if you find yourself with an empty pack.

·         Vegetable peelers -Nice gift for villagers

·         Glow Sticks - Great for Peace Corps parties or village nights.

Reading List (good books to read before or during your service)

·         Dead Aid by Dambisa Moyo

·         Guns, Germs and Steel by Jared Diamond

·         AIDS, Sexuality, and Gender in Southern Africa by Baylies and Bujra

·         Living Poor: A peace Corps Chronicle by Moritz Thomsen

·         Into Africa: The Epic Adventures of Stanly and Livingstone by Martin Dugard

·         Poor Economics by Banerjee and Duflo

·         End of Poverty by Jeffrey Sachs

·         When the World Calls: The Inside Story of the Peace Corps and Its First Fifty Years  by Stanley Meisler