Beautiful, yes, but I fell down the side of a mountain like this.
Afya (Health)
I had malaria for the first time in September, only one month after arriving in Mahenge. Let me rephrase: I thought I had malaria for the first time, and no one did or said anything to make me think I didn’t. In Tanzania, malaria is like being innocent in our justice system: you have it until it is proven that you do not. And with good reason: The Center for Disease Control estimated that, in 2013, there were 198 million cases of malaria worldwide and more than 600,000 deaths, mostly occurring in the African region, and mostly children whose immunity to the disease has not matured. In 2012, the World Health Organization reported that malaria was the fourth highest cause of death in Tanzania, killing 20.9 million people.
It all started one afternoon as I was pacing around my Form I English class. Because of the large number of students in each classroom, I tended to wander up and down the tightly arranged aisles between desks to keep an eye on the students in the back and make everyone nervous that I might steal up behind them. The view from the classroom windows looked out on the rolling plains, as distant as if I was looking at them from an airplane window. Heat shimmered like mist. As I gazed the window, trying to locate the horizon, my head began to vibrate. I felt as if I was in the direct path of the radiating heat waves. I propped myself up on a desk, while one of my students looked on, probably confused, while the weight of my bones threatened to pull me earthward. This spell continued for a few minutes until I made it to the end of class, and then stumbled to the staff room to report my condition. “You have malaria,” I was told cheerfully, as if I had sighted a rare and elusive animal. “You must go to hospital. Go, go now!”
Malaria is a mosquito-borne disease caused by different parasites belonging to the Plasmodium genus that commonly infect a certain type of mosquito. The disease generally begins to show after seven to thirty days of receiving an infective bite (the incubation period), and immediate symptoms include shivering, sweating, headache, vomiting, aching muscles, fatigue, and fever. Here’s where it gets complicated: in many countries, including Tanzania, education about malaria is prevalent and immediate treatment is generally available, but in other places where the disease is common, these symptoms are often attributed to other illnesses, a flu or fever, perhaps, and left untreated. In cases where malaria is not diagnosed or treated within days, serious organ failure and abnormalities in the blood can occur, as well as the onset of cerebral malaria, (potentially causing loss of consciousness, coma, seizure, speech difficulties, deafness, blindness, and ataxia, or difficulty with movement). Pregnant women have an increased susceptibility to malaria, and contracting the disease during pregnancy can lead to severe problems, including low birth weight and a decreased chance of a child’s survival.
Malaria is a particularly detestable disease because it kills so many people, despite the fact that it is almost completely preventable given the right resources. The disease is prevalent in Africa because of many contributing factors: a climate that allows the parasite, and the mosquito that hosts it, to thrive; weak infrastructure to stem the spreading of the disease; a lack of prophylaxis materials, including medication and mosquito nets; and the large financial burden of effective intervention methods. The good news is that the CDC reports the last ten years have brought a 45% decrease in malaria-related deaths due to a growing international effort to control and prevent the disease. Education about the disease, the availability of medication to treat it, and the supplying of mosquito nets and insecticides to prevent it are combining to reduce malaria’s disastrous impact, but the battle is far from over. Malaria was a daily scourge among my students and friend. People contracted it at the same rate, and treated it with the same level of seriousness, as people in the developed world treat a common cold. It was seen as a nuisance, or a necessary evil that rarely did any harm. But I saw my friends in the throes of a malaria-induced fever, and it is nothing to be taken lightly.
I was told I must go to hospital, so I went. The hospital in Mahenge is made up of a series of long, low buildings with corrugated steel roofs connected by covered walkways. There are people around, and a few nurses in lab coats, but mostly it contains a host of mysterious doors and windows into darkened, empty rooms, giving it the feel of a place that has been recently abandoned. I wandered around surprised to find people at work in offices, but more often surprised at the emptiness of entire wings. Bits of grass and leaves collected next to open doors and ancient stretchers stood vacant next to stained and peeling walls. The waiting room is just that: a large, roofed structure under which to wait. About fifteen people were already there when I arrived, carrying the requisite daftari (notebook) for the doctor to use to record my case. Little happened while I waited, save the wailing of a small, ill child and the worried murmuring of her parents. People with various ailments sat quietly with an air of resigned patience, staring vacantly at nothing. The wooden benches were rigid and uncomfortable, and I found myself entertaining the first stirrings of self-pity. My dizziness had subsided, giving way to a general fatigue that I thought surely indicated the presence of malarial blood parasites. I waited.
In addition to the ever-present threat of malaria, HIV and AIDS still claim the highest number of lives in Tanzania, killing more than 73,000 people in 2012 (World Health Organization). Despite the financial and human resources poured into awareness campaigns and education about this disease across Sub-Saharan Africa, its prevalence in Tanzania has not decreased in more than ten years. At Nawenge Secondary School, students were assigned research topics and essays about AIDS, but it was not a commonly taught topic in the classroom, owing to the community’s conservative social and religious beliefs. In my experience, sex education was virtually nonexistent, and an open discussion of preventative measures like condoms or birth control methods was rare. During my time spent in Namibia, condoms were provided by the government and could be found everywhere—in bars, restaurants, grocery stores, schools—anywhere people regularly congregated. By contrast, I did not once see any condoms distributed publically in Tanzania.
After thirty minutes spent waiting in a covered outdoor plaza ringed with wooden benches, a door to one of two consulting rooms opened and a young mother and father with a tiny child walked out, seemingly dazed, but smiling—perhaps they had just received good news, I thought. My neighbor on the wooden bench, an old man who I thought to be asleep, poked me in the shoulder and said, “Wewe,” you, go. As I entered the room, with Megan, my roommate for whom this experience presented no challenge, the doctor smiled and nodded as if he had been expecting me. I later found out that Mahenge has two doctors in residence: one tended to wander through town singing and muttering to himself for the better part of the day until it was time to hit the bar. One late night with Nick and Jonathan at Riverside, I saw him sitting in a white plastic chair in the middle of the dance floor with a large bottle of beer cradled in his arms, swaying contentedly along to the music as people wended their way around him. A few weeks later, on a walk to town, he joined me along the road, happily asking me nonsense questions in English, like, “What do you see over there? Who is it? Why is there that?” I nodded and smiled, walking a bit faster, until someone shouted at him and abruptly turned and staggered down a narrow alley.
The other doctor, luckily, was the man in front of whom I now sat—a smiling, kind figure whose enthusiasm for my basic attempts at Swahili would have been welcomed were it not for the dizzying effects of the blood-borne disease I believed to be coursing through my veins. Megan described my symptoms (“My friend, he is sick, head and stomach”) and he nodded, and I nodded along with him, for lack of anything better to do. After talking to himself in Kiswahili, and scribbling some notes in my daftari, he switched to English: “You must return tomorrow. The lab will test your blood.” Tomorrow? Could I survive another twelve hours with undiagnosed malaria that was surely now infiltrating my immune system en route to my delicate and undefended cerebellum? Sensing my concern, he smiled again (he was awfully jovial for a man who deals with disease and death regularly, I remember thinking) and wrote down the name of a medication for me to take, then said, “Go to the dispensary, just there. Get the medication and start it today, just in case.” I nodded again, ending my consultation with a moment’s hesitation about the fact that surely there must be other questions to ask, were I not limited by my clumsy lack of language knowledge, before I stood and walked out into the fading afternoon sun.
Tanzania is, unfortunately, an easy place to get sick. A quick look through the Center for Disease Control’s list of recommended vaccinations for travelers to the country makes this abundantly clear. In addition to the normal vaccinations, flu and polio and measles, prevention against typhoid, Hepatitis A, Hepatitis B, Rabies, and Yellow Fever is highly recommended, along with the requisite malaria prophylaxis via shot or daily pill. I can report that the Yellow Fever vaccine is particularly unpleasant, with a needle the size of a Number 2 pencil. Once the vaccinations are complete, the CDC has a long list of recommendations for safe travel, among which is the admonition to consume only safe food and water, not including anything that is served at room temperature, from a street vendor, raw or soft-cooked, undercooked, unwashed or unpeeled, unpasteurized, or belonging to a category called, rather unpoetically, “bushmeat,” described as “monkeys, bats, or other wild game.” Other sound advice included avoiding tap water, well water, unpasteurized or fresh milk, and “local alcoholic drinks.” Duly noted, but the CDC did not count on the vehemence and persistence of the local retirees who invited me, every Friday afternoon, to join them in a cup of freshly brewed pombe (beer made from fermented maize) in the front yards on my way to school. (Even still, I heeded the warnings and sadly declined these kind invitations.)
As I made my way home from the hospital, I felt an odd sense of pride welling in my chest. I am living with malaria, I thought. I am a survivor. They should make an inspirational commercial about me. Like Hemingway and the Crocodile Hunter, I had come to a wild and untamed place and dealt with the worst things it could throw at me. My dizziness, no doubt amplified by nervousness at the hospital, had subsided and I felt only a vague sense of imbalance, as if my center of gravity was a few degrees off. I should mention that the doctor, the day before, had given me the week-long dose of medication to treat malaria, but since they were out of the adult version, I got the child version, complete with brightly colored instructions and pictures of animals running along the top, as if a friendly giraffe would make me feel better. His instructions? Take two pills instead of one. In order to celebrate my first hospital visit and to nurse my malady, we decided to eat dinner at Riverside and avoid cooking. I sat quietly during dinner, with the righteous poise of a recovering invalid. “It’s not so bad,” I said. “Nothing to be afraid of, really.” How tough I was! How manly and stoic! The next morning, however, proved to be a test of my newly acquired ability to navigate a Tanzanian health-related emergency. Feeling somewhat stronger on my feet, I arrived back at the hospital first thing in the morning and sat down to wait. After a few minutes, I realized I was the only person there, and wondered whether the doctors kept different examination hours, or if I was fated to have an audience before the drunken doctor. I stood quickly and walked back out to the main covered walkway, determined to disappear before he might see me and continue asking me nonsense questions. I wandered for a few more minutes, but found no staff working in the empty whitewashed rooms I passed at regular intervals. One large room contained nothing but five rusty stretchers on thin metal legs.
Before I left for Tanzania, as I was learning the health and safety tips that would allow me to return without any missing limbs, my friends joked about the requirements for eating and drinking. “Whatever you eat, you have to boil it or peel it,” they said, “no matter what.” One even offered to buy me a vegetable peeler to carry with me at all times. As farfetched as these requirements seemed in a place with clean running water and fresh produce available all year, lack of food and water sanitation in Tanzania and much of the developing world leads often to a wide array of illnesses, including typhoid fever and dysentery, as well as the more severe schistosomiasis and Hepatitis A. Typhoid, not to be confused with Typhus, is a bacterial infection caused by Salmonella typhi, a nasty bacteria that spreads in the intestines and blood as a result of eating or drinking contaminated water. According to the CDC, risk factors for contracting typhoid include poor sanitation and hygiene, and traveling in the developing world. Like malaria, it is common in Tanzania, and particularly in Mahenge, due to the lack of adequate supply of clean water. As I watched people drink and bathe in water that collected in puddles or in gutters on the sides of the road, I cringed at what the effects could be, and often were. One of my friends contracted typhoid and I have never seen anyone look so uncomfortable.
Let’s finish up diseases before we move on: Dysentery, a type of gastroenteritis, is caused by an infection in the intestines that leads to inflammation and severe diarrhea with the additional possibility of abdominal pain, muscle ache, and weight loss. Fun! Schisosomiasis, also known as bilharzia, is a parasitic disease spread by infected freshwater snails that literally invade the body through the skin and take up residence in blood vessels. Risks for contracting the disease include any contact with sources of fresh water, including bathing, swimming, fishing, handling or working with livestock, or doing laundry—many of the things Tanzanian people do regularly as part of daily life. Symptoms include fever, muscle ache, rash, itchy skin, and coughing; the disease is propagated by infected people urinating and defecating in common water sources. After years of infection with the parasite, severe damage to organs is possible, including anemia, inflammation, and scarring. That one is a real winner. Hepatitis A, a liver infection caused by the Hepatitis A virus, is caused by contact with an infected person or consuming contaminated food or water. Symptoms include all the big ones common to food-borne illness: fever, fatigue, nausea, vomiting, abdominal pain, joint pain, and jaundice. Many people, including children, who are infected with the disease do not show symptoms.
I turned a corner and approached a covered walkway I had not yet taken, one that led away from the main part of the hospital toward the rear, where a few residential houses stood in the shade of a grove of banana trees. The first door I passed stated “LABORATORY” in large letters on the door. This seemed promising. I passed through an empty waiting room, containing darkly stained and tired-looking chairs and knocked on the glass door that led to the lab. A man in a lab coat looked up from a clipboard and motioned for me to enter. I held my daftari out in front of me as an explanation for why I was there, motioning like an idiot at the page where the doctor had scribbled “malaria.” The whole time, I was convinced that I would get in trouble for skipping a second examination by the doctor and setting out on my own to locate the lab. In case he didn’t get the gist, I said, or perhaps whispered out of nervousness, “Malaria. I need a test.” I never found out if he spoke English because he never spoke, but smiled and nodded as if I had confirmed a long-held suspicion. I could not tell how old he was—for one, I am a terrible judge of age. Once a person hits age sixteen, I can no longer accurately gauge how old they are. There is nothing so dangerous as when people coyly ask me at parties, “Guess how old I am?” I invariably guess on the wrong end of their desired spectrum and receive glares and huffy rebukes. The second difficulty is that people in Tanzania age very gracefully, showing very few signs of aging as I might notice them based on experience here. Their skin rarely shows wrinkles, their teeth are white and straight, and many people are already bald, so hair loss is not a reliable demonstrator of age. Many times I was shocked to find that a person I thought to be around age 30 was well past 50; other times, I realized that someone I took for an mzee, or old person, was much closer to my own age.
The technician pointed to a chair for me and walked to a glass-fronted cabinet across the room, bringing back a colorful cardboard package about the size of a thin paperback book. With a deft flick of his hand, he opened the box and pulled out a few molded-plastic instruments—the basic elements of a MRDT, or rapid-diagnostic malaria test. Now, remember that I was fully convinced at this point that I had malaria, and, with the self-righteousness of a martyr, was mentally prepared to suffer the consequences. The test would just be a formality to confirm my self-diagnosis. The lab technician moved with a subtle grace, the product of performing the same maneuvers and motions many times, and before I realized what was happening, pricked my finger and placed it on a piece of gauze held in an oblong disc of plastic. Smiling again, he removed the rest of the pieces and placed the test pad, now complete with my contribution, on the table in front of me and pointed at the clock. By this point, I was becoming incredibly adept at waiting patiently for indeterminate amounts of time for reasons I did not understand—it was a form of giving up control, a skill I imagine Buddhists try to attain through meditation and mindfulness. I was learning to accept things as they happened without planning, and one trick I developed was to engage in a complete observation of the things around me. Since virtually everything was new, I was constantly presented with a feast for my senses, even if the setting was an anonymous and slightly menacing laboratory room set deep in the recesses of an outdated hospital. Posters advertising health and safety tips in Kiswahili adorned the walls above more glass cabinets that stored medical equipment and supplies, most of which looking new or recently produced, in contrast to the ancient and rusting things I had seen hidden away in disused hallways.
The technician moved with a quiet efficiency, giving off the air of someone who is used to being very busy and doing many things at once. I wondered how he had come to work in Mahenge. Was he posted here by the government? Was he a native who had gone away to school and returned to help his community? Perhaps he was a student, just passing through on a brief assignment? I thought about his day—had he woken up that morning, as I had, cursing the lack of electricity in his house, or was he accustomed to it? Did he make himself a cup of tea on the jiko? As the sun climbed past the mountains, set out on the road to walk to work? These are the questions I never answered, but always had running through my mind. How is my day different from yours? Is it different, or does a place change you and bring you in line with its routines? This man and I had never met, and we would never see each other again, but I found myself sharing time with him in an unlikely place—unlikely for me, anyway. For him, a lab and a white coat and a room full of medical equipment (in whatever form it could be procured) was his normal. Perhaps it was my state of extreme agitation and nervousness, or the remnants of the dizziness I had felt the day before, but I felt a strange and unexpected kinship with this quiet, graceful man. I imagined him here in this lab, hidden away from the rest of the hospital’s staff and patients, going about his daily tasks of conducting research and experiments, testing blood samples for malaria and other diseases, and helping to stop the spread of sickness and pain. It seemed a noble job, one that was likely beset by many challenges, including inadequate salary, an almost certain lack of resources, and the difficulty and inconvenience of living in a remote place. He had almost certainly gone to school in a large city, perhaps Dar es Salaam or even Arusha, and had now returned to the relative backwater of Mahenge. Like many of the teachers who escape to universities in cities, I wondered if he resented being here, in this quiet and remote town. Did he miss the fast pace of life in the city, or its nightlife’s glamour? Perhaps he had a family elsewhere, as many people did—was he able to see them, or talk to them? Were his children growing up without him? Did he dream of working in a hospital, or was it the only opportunity he had? How had he gotten here, and where was he going?
I was brought back from these reveries when he touched my shoulder and pointed to the white plastic dish in his hand. My blood was smeared across its mouth and had faded to a rusty brown, the color of the clay soil near the river. “No malaria,” he said, pointing to the test strip next to my blood that could indicate the presence of Plasmodium falciparum, the nasty parasite I believed to have infiltrated my body. “Negative,” he said, holding the test closer. I sat up with surprise, thinking I had misheard him. It must have only been ten or fifteen minutes since I had arrived, but it felt like hours. “No malaria,” he said again with a small smile. “No malaria,” I repeated, probably sounding a bit slow. “So can I go?” He nodded with another patient smile pointed to the door. I stood and slowly walked toward it, my head spinning now with a rush of confusion, relief, and exhaustion. I turned back and said, “Asante,” thank you. He looked up from a pile of tests he was arranging on a shelf and said, “Asante na wewe.” Thank you, too. In a heady haze of relief, I navigated the same covered hallways and corridors, sunlight already streaming across them and casting long morning shadows on the concrete floors. The heat had risen during my short time in the lab, as it did every morning on my walk to school, and my shirt stuck to me after a few minutes. I made my way back to the road in front of the hospital. People had already begun to line up to see a doctor—babies wrapped in kanga fabric held close to mothers’ breasts, old people balanced on canes and held up by their children, a few students in school uniforms standing apart, knowing they would not have to attend school, at whatever cost it might bring. I who had (seemingly) escaped the clutches of a disease that afflicted so many of my neighbors, I wished them all well. This happened many times in many places in Tanzania, when I felt a bit of my love and my energy and my heart go out to people I had never met, and to whom I could not lend assistance apart from a kind word or a smile. Traveling sometimes is being an observer, a witness to the lives of others.
I had not contracted malaria, it was official. After a few days of rest and careful hydration, I began to feel better. My entire hospital visit, including the consultation, medication, and MRDT, cost me about 4,000Tsh, or somewhere around $2. Take that, corporate healthcare industry! According to the World Health Organization, malaria diagnosis free in Tanzania, and all patients should receive a diagnostic test. The WHO also confirms that ITNs, or insecticide-treated nets, are distributed free in Tanzania, but I did not see any evidence to confirm this. Most often, I saw nets for sale in markets and along the sides of the road. The CDC reports that ITNs can reduce malaria and other insect-borne diseases in children by up to 20%, which is a wonderful thing. Most homes in Mahenge that I saw personally were equipped with mosquito nets, including nets for children. But I also saw nets strung up between wooden stakes in a few front yards to serve as makeshift chicken coops, the bright blue netting a strange contrast to the brown earth. This does not mean that the people in those houses were not protecting themselves properly—I hope that they were, but undoubtedly the nets that prevented the chickens from running away could have been put to better use and might have prevented people from getting sick.
Apart from the constant threat of disease, other dangers lurked everywhere in Mahenge: slippery and muddy roads, bus rides, falling off the side of the mountain, standing water, snakes, large animals, dehydration, vitamin deficiency, sunstroke, lack of access to emergency medical care or evacuation—the list goes on. Proper hygiene is expected in Tanzania, perhaps to combat the spread of sickness or disease, and apart from the fact that not everyone bathes every day, leading to some pungent aromas in the classroom, everyone you pass on the road or in town will have neatly pressed clothes and look presentable. (Ironing was commonly done with a metal iron filled with hot coals that had to be kept at the perfect temperature to avoid burning or blackening clothes. Think of that the next time you complain about it.) I have mentioned before, numerous times, that my standards for personal hygiene fell precipitously. While I wore clean, pressed clothes to school every day, and was never seen in public looking less than respectable, I hardly ever felt clean. Why was this? A few factors included dirt roads, frequent walking and climbing, nearly constant sweating, as well as bucket showers and hand-washed clothes.
Let’s talk about bucket showers. They are exactly what they sound like, and many people who have gone camping (or perhaps lived in a commune) might be familiar with them. The mechanics are thus: take a large bucket, preferably one of the red ones containing clean water, and place it next to the tub with a smaller, hand-held bucket accessible. Proceed to fill the smaller bucket and dump it over your head. For the full experience, make sure it is 5 am and completely dark outside, and that the bulb in the bathroom has burned out. Better yet, imagine that the power is out and you are attempting this by candlelight. Romantic, right? Right up until the neighbor’s pig starts squealing from outside the window. I assure you, you’ll be wide-awake after the water hits your skin, and until you start shivering uncontrollably, you have about two minutes to clean your entire body and hair. Soon, you’ll have the whole thing down to a science that involves using shampoo as soap and somehow bathing while keeping half your body dry.
Hand-washing clothes is another treat. It involves two buckets on the kitchen table, one for washing and one for rinsing, and a great quantity of powdered soap. There’s a scrubbing method that I picked up after a while that involves using your palms to grind the material against itself and thereby remove dirt grime, and chafe your hands beautifully. At the outset of the year, we hung all of our clothes on a laundry line strung between our house and the remnants of an old wooden gazebo in our yard, but when that went missing, I tied up my own laundry line across my room. Underwear cannot be hung outside to dry because it’s considered inappropriate to display it (and they really don’t like my collage of Victoria’s Secret models), so I have to set up a chair in my room and let it air-dry, hoping in vain for a cross breeze. (I once hung a load of underwear up that took four entire days to dry.) Jeans and sheets are the toughest part because they take an eternity to dry, but I think I washed both things once over the course of a year, so overall I didn’t mind. And I would still say hand-washing is preferable to sitting in a Laundromat.
Toward the end of the year, I grew very concerned about the fact that I could not get out of Mahenge. Quite literally could not get out, even if I wanted to. This was not a matter of lack of will. Cowboys on bad TV shows often say, with a forlorn look of self-pity, “Oh, we’re all stuck in this town, baby,” while trying to get into the pants of the flashy New York lawyer who found her way into the bar while researching a family law case (I just invented this plot, by the way, but I think it has some promise), illustrating the plight of a someone who might feels literally trapped by his situation. In reality, he has a large number of methods of egress available to him: he could hop on a Greyhound bus, call a taxi, charter a boat, steal a car, purchase a plane ticket, or ride the rails ‘til judgment day. In short, he has options. I had a few measurable skills! I had ambition by the truckload! But unlike the bad TV show guy, I was stuck with no way out.
During the rainy season, the roads are all but gone, turned to soupy mud, and buses and cars cannot get through. If something happened to me (or anyone else, but toward the end of the year I was selfishly focused on my own health), adequate emergency care was completely inaccessible. Even if I was able to get to the hospital in Mahenge, many medical authorities discouraged it, given that the standards of care were not anywhere near global standards. (I heard stories of men with broken bones being given a stick and some rope to fashion their own casts.) What an idea, this remoteness! This disconnectedness! Even in remote areas in the United States, medical assistance is almost always available via whatever means necessary, including helicopter evacuation in extreme circumstances. Was anyone going to chopper me out of Mahenge to get to a hospital, if the need arose? I think not. This played all kinds of tricks on my already tired brain, including one memorable psychosomatic instance of chest pains for which I, in a state of panic, called a kindly doctor in Dar es Salaam who reminded me, over and over, that he could not diagnose anything over the phone and if I wanted to see him, I had to come to his office. He said the address a few different times, and I struggled to explain that I could not get there, even if I started walking that very minute. In order to make it to Dar, I would have had to get some kind of transportation out of Mahenge, which in itself would be tricky, given that not many people had cars and the daily buses were not running daily due to the muddy roads. They would get stuck and have to be pushed the remainder of the way, churning wheels-deep in glutinous, sticky brown mud, or abandoned until the road dried up. If I did get on a bus, I ran the risk of getting stuck in the bus, as happened on the night I returned to Mahenge from Cape Town, and worse, not receiving a refunded ticket.
I experienced all kinds of aches, pains, cramps, spells of dizziness, bites, and scrapes, and each time I grew convinced that this particular symptom was the long-expected harbinger of my doom. Due to my perambulatory commute to school every day, I was getting excellent amounts of exercise, and I drank copious amounts of water. Undoubtedly, my lackluster and unbalanced diet of carbs in many forms did not play a starring role in my good heath, and I sometimes felt weak and dizzy, but I chalked it up to hunger and lack of protein. In my room, I kept a small book of travel health tips, listing common illnesses and how to treat them. After a few months, I hid it away in a corner to keep from consulting it hourly and pronouncing my own diagnosis (undoubtedly I had contracted jaundice, diphtheria, or some other crazy malady and would walk around the house declaiming the symptoms one by one and confirming that yes, I had experienced leg tremors, heart palpitations, difficulty breathing, and a tendency to fall unexpectedly asleep—or whatever they happened to be). I constantly created contingency plans for how I would get myself, or one of my friends, to medical care. They went something like this: “Okay, so if I fall down and break a leg, I’ll call Nick at the mine and he can maybe drive down with the Land Rover and pick me up, but the Land Rover will get stuck on the way from the mine, so maybe I can haul myself up and get a big stick to use to pull myself along . . .” and on and on in endless permutations. Luckily, nothing terrible happened to any of my friends, apart from a few chipped teeth on rocky rice and some bouts of malaria. I made it through relatively unscathed, apart from both malaria scares (the other while on safari in Selous Game Reserve), a cough and a cold every now and again, and the story that I will now relate of how I found myself on, and subsequently tumbled dramatically down, a mountainside in Arusha in the middle of a rainstorm. I sustained an injury during this tumble that plagues me to this day—a lasting reminder of the potential dangers that lurk everywhere, and a testament to my good fortune that nothing worse befell me.
A series of interesting events led to my presence on this mountainside in Arusha, in northern Tanzania, long before I slipped and tumbled heels-over-head down its vast and gelatinous slopes. I was on winter break with friends in Arusha, home to Mount Meru, the second tallest mountain in Tanzania after you-know-who (4,562.13 meters/14,968 feet). Consequentially, my friends wanted to hike. It seemed like the thing to do. We booked a day hike at a tourist office in town. The night before, we stayed out til 5:30 am and drank very minimal amounts of water. You’re nodding your head knowingly. We have all been there.
Fast forward a bit: my room at the hostel was the size of a coffin, if a coffin was triangular and had a window overlooking the busiest street in Arusha that came alive at 6 am with honking, yelling, and singing. (Traveler’s Note: If you ever find yourself in Arusha, Tanzania, don’t stay at the Arusha Backpackers. Sleep on the street before you sleep there.) We had to be ready to leave for the hike by 6:30 am. (Again, we got home at 5:30 am. Like got in the door. Like didn’t even make it into bed.) Next: shouted entreaties through hostel doors to see if everyone was still alive and hike-ready, a bumpy taxi ride, a miles-long (seemingly) walk to a house with a brocaded couch and a multitude of tiny kittens, a rigidly polite Tanzanian breakfast of chai and bread with butter, and the kind of tiredness that throbs in waves through your entire body. Keep in mind that there was no water, only milky chai. I might have had Africafe in hopes of caffeinating myself sufficiently to endure what was to come, but honestly, who remembers.
The day was beautiful, all sunny skies and swirling clouds backed by the crumbling peak of Mount Meru in the distance. But because we were in the mountains, things changed quickly. Our guide, John, for whom I still possess a range of apologetic-to-angry feelings, was enthusiastic in the way that comes from having to deal with cranky tourists who are forced to walk through forests and talk to the locals. By those standards, we were probably the best tour group he’d had in months . . . until I almost scissor-kicked him to certain doom. As we climbed, dark rainclouds rose over the mountain and we soon found ourselves in a deluge, struggling to find shelter under the trees. It quickly passed, but came around again. Those rainstorms, especially in Mahenge, were always coming around again, and again, and again. Then it passed, bright sunlight dappling the trees, kids running shyly alongside us, then it came back again and drenched us once more. The clouds were incredibly complex and beautiful, especially right before it rained. Because of the high elevation I could see storms coming across the plains until they were right on top of us. I watched the clouds pile up over each other like layers of icing on a cake.
The path we were to take down the mountainside was set at about a 90-degree angle to the horizon, and now it was wet. Did this stop our fearless leader? He had a safari hat and comfortable shoes! Nothing stopped him. Down we went, and down I went. I tumbled down the incline for about thirty meters, repeatedly losing my footing and falling again, until I grabbed the curve of a sapling to steady myself. I felt a slight popping sensation, then a twinge of pain, and there went my shoulder. I heard a rip and everything. That was about it for me, or so I thought. “I’ll see you jerks later,” said I. “I’ll be right here, under this shady grove of trees, where I will ponder my place in the universe and soon succumb to devastating dehydration. Do alert my kin.”
No sooner had I nestled myself against a tree than a little dude, probably about 7 or 8, popped up over the hill and asked me, in Swahili, if I was coming. I answered in the negative. He repeated his question and pulled me up by my hands. I heard the guide calling me, a smile in his voice, barely audible down the path. Fine, I thought. If this is how I go, fine. Navigating down the slippery, treacherous path, riddled with false turns and drop-offs and mud the consistency of melted Ghirardelli, roots and branches sticking up like the severed and discarded limbs of my predecessors, I had a fair time keeping my mental energy up, let alone my physical. This kid saved me, truly.
He held my hand every step down the mountain, cutting footholds for me with a sharp rock and telling me when to wait and when to go, and pointing with a stick at the exact spot to place my foot. He, and a few of his confederates who I found when I arrived at the base of the ravine, for that’s what it was, had accompanied my friends and stayed with us the whole time we walked in and around a snaking, shallow river (in Vans slip-ons, don’t forget, or barefoot, as I was the entire way down the mountain, uncomplainingly carrying my shoes and saturated socks) to find the fucking waterfall that was our destination.
Anything less than a majestic cataract of epic proportions would have been a waste of my time and not worth withstanding dehydration, a determined hangover, and numerous very real threats to my bodily health and mental fortitude. But we made it and it was beautiful. Oh, and situational update: now we had to make it back before the rains, which were mildly bothered on our descent but had now worked themselves up into a boiling froth, re-soaked the path, and made the ascent nearly as treacherous as the way down.
Our faithful guide, ever optimistic, to his credit, pulled us into an unplanned pit stop at a small guard station, a hut, really, on the side of the path. The guards, about five of them not counting the one passed out asleep, were there to protect the coffee plantations in the area from marauding coffee thieves, I suspect. The hut, two rooms decorated in the typical Tanzanian style of not at all, was a welcome shelter from the rain, but I felt bad for sitting on someone’s mattress in awkward silence while the guards leered at my female friends. The rain continued, unabated, for quite some time, but still the slumberer slept on. I am convinced he knew we were there and feigned sleep just the same, but who can blame him. They, or actually the unluckiest of them, were cooking ugali on a fire outside under a corrugated steel shelter, with the familiar stirring and kneading of the frothy white concoction, but the situation didn’t seem as if an invitation to eat would be forthcoming. Unperturbed, we departed about thirty anxious minutes later into the forest, waving goodbyes to our newfound, silent friends.
A roundabout walk through the forest that had, only that morning, seemed so idyllic and friendly followed, including, in no particular order: the passing of a rogue cow, rain-saturated goats bleating stupidly in small groups, and a spell of waiting under the holey tarp roof of a Masai church, complete with a cruficix of branches and a rudimentary pulpit, during which I watched water drip through the rents in the fabric and contemplated the dangers of trying to drink them to stave off my dehydration vs the diseases I would undoubtedly contract as a result. I remember that the tarp was blue and the sky was slate gray with white patches around the edges, as if lit from within.
Once we made it down the main road to the starting point, after what seemed like (and probably was) hours, our guide insisted, in his typical indomitable fashion, that we end the tour with the requisite trip to a Wa’arusha home, part of the “cultural tourism” aspect of the trip that was only “thirty minutes” away on foot. I think our groans told him that a joke of that nature was liable to get him assaulted, or just tipped a lot less, so with haste he led us through winding fields of corn and cabbage to a traditional Wa’arusha domicile and proceeded to narrate the entire situation of the family—while they were sitting there cooking and going about their business. We were encouraged to go inside, to see the dark, smoke-filled living space, smell the odor that occurs when animals cohabitate with people, and gawk at the small sleeping spaces and primitive cooking supplies. It was very odd, especially considering that our guide hailed from the same town and was of the same tribe. He even suggested I take pictures, which I did grudgingly, though oddly, none of them seemed to have survived. The woman of the house sat proudly stirring her cooking and not looking at us in the manner of someone who has ignored certain things for a long time and will continue to do so. I was faintly comforted by the knowledge that a portion of our tour fee went to help these families, but I still can’t quite square “cultural tourism” with the de-humanizing effect it often has on the people it is meant to celebrate.
Once we made it back, for good, to the house from which we began, tipped our guide (generously, for after all else, he had led us out alive), and declined any further (strongly suggested) donation to the local schools (seeing that they were in much better condition than the schools at which we already taught), we piled in the taxi and I trained my eyes out the window for the first duka with water. My dehydration at this point had passed the stage of a theory and become a fervent belief (accompanied by my own belief that I did not want to end up in hospital). We finally located one, after a ride down a dry and corrugated road, and our friend was dispatched to get water. After a little agonizing wait during which she shopped around for banana prices and surveyed the kanga selection, looking for gifts, she brought it to us, in big, shiny, blue plastic bottles, and at long last, with a pain in my shoulder and a dizzy head, I held in my hands the key to my salvation.
Later that night, showered and rehydrated and feeling very proud of myself, I realized that the kid who had helped me down the mountain, carrying my shoes and holding my hand, was now the proud owner, intentionally or otherwise, of my dirty black socks.
