Saturday, January 14, 2006

Sam is diagnosed with Dengue Fever

On Tuesday morning we caught a tourist shuttle bus directly to the clinic in Kuta. I was examined by an Indonesian female doctor who diagnosed that I was extremely dehydrated from not eating and not drinking enough and that the rash was probably an allergic reaction caused by the oils and scrubs used during the massage at the resort. She did not think that I had Dengue Fever but she would run a blood test to be sure. In the meantime, she wanted me to spend at least the next three hours attached to an IV in order to rehydrate me at a cost of $30 an hour. Daniel rang our medical insurance people in Sydney to check whether they would pay for it. To my great reluctance, the nurses installed an IV feed into my left hand/wrist at great pain to me. A nurse wheeled me up to the second floor where she installed me in my own private room complete with cable television including the channel ABC Asia Pacific. However, I was mortified to think that (after all my suffering) all I had was a dehydration problem. I began to cry telling Daniel what a fool I was to think I had Dengue Fever and that my health predicament was all my own doing. He comforted me and told me not to be silly as he held cans of “Pocari Sweat” (electrolyte fluids) to my mouth encouraging me to drink.

Within the hour the results of my blood test came back, indeed, I had Dengue Fever and my blood platelet levels had dropped below 100,000 when they should normally be between 150,000 and 450,000. The hospital refused to discharge me and said that I would have to remain in hospital until my platelet levels crept back up to over 100,000. They predicted I would be in hospital at the very minimum for two days and after discharge I would need to remain in Bali for at least a day or two so that I could return for more blood tests. Therefore we would need to delay our return to Timor. They also said that if my platelets dropped to 50,000 or below, the hospital would evacuate me to Singapore for a blood transfusion! All of a sudden, things became very serious indeed.

Daniel got back on the phone to our medical insurers to see whether they would cover the cost at $30 an hour x 24 hours x 2 days minimum and they agreed upon being faxed a medical report from the clinic. He also called Merpati airlines to change our return flight and discovered that all seats were booked until the 13 January; ten days after we were due to return. We accepted what was on offer.

In the middle of the afternoon, I had to endure another blood test and they had to find another of my difficult to find veins. The results came back that not only had my platelets dropped again but also my haemoglobin levels. The doctors were growing concerned and again threatened me with evacuation to Singapore. I started to panic and believed for a few brief minutes that I was going to die and started to cry. I looked at Daniel and thought: I love him too much to leave him and our future life together now, deciding I didn’t want to go just yet; but I knew that Dengue was serious and can be fatal.

There is no prevention (other than not being bitten by the mosquito carrying the virus which is near on impossible) and no cure. Every year throughout the tropics many people die from Dengue due to the complications associated with haemorrhagic fever. Mostly these are children and older people and they die because they take too long to (or cannot) seek medical help usually in the form of a blood transfusion. The under fives are the most in danger. The clinic staff told me they had had a number of Dengue patients with haemorrhagic fever and this coupled with my decreasing platelet levels was why they were concerned (more than 1,000 people in Indonesia died of Dengue Fever in 2005). Again, Daniel comforted me and told me that I would be all right because I was in a Western medical facility (another example of when Western medicine is beneficial).

After I had calmed down a bit, Daniel went off to find an Internet café to email our family back home, our NGOs in Timor and AVI to tell them what was going on. He also needed to find something to eat. He returned early in the evening to find me watching either Star World (mostly American sitcoms) or ABC Asia Pacific (Australian and British shows) and about to eat an Indonesian version of minestrone soup. At the time of putting in the IV, they had injected me with an anti-nausea drug to make me eat again, so my appetite was returning slowly.

Daniel was allowed to spend the night in my room in a fold up bed. He helped me as much as he could (when he wasn’t asleep) to get in and out of bed and to go to the toilet. As I had an IV in me and was instructed to drink lots of “Pocari Sweat” and guava juice (supposedly, it helps increase platelet levels: traditional beliefs combined with Western medical facilities how apt) I was constantly needing to pee. However, I had to pee into a measuring jug so that the nurses could record how much output I was making. I also had to try and poo into a very small specimen cup but as I hadn’t eaten for nearly a week, that was much more difficult. I had to wait until I had a very small amount of diarrhoea before I could give them what they wanted but then they also instructed me not to mix it with my menstrual blood! Ugghh, it was all so bloody difficult. And often when I went to the toilet because my arm with the IV was down not up, blood from my body would start rushing up into the IV lead and I’d have to rush back to bed and call the nurse to come and fix the problem.



Because my first blood test was done at 11am, I had to have them every 12 hours so that meant an 11pm taking of my blood. These I came to dread as they struggled to find a vein and were now taking upwards of one hour to get the blood! At one point, they obtained it from my foot and that hurt like hell. (As I write this, despite it being a week since I was discharged, I am still bruised in four different places from where they took blood). The nurses had to take my vital signs every three or four hours so this made it near on impossible for me to sleep. I was absolutely buggered beyond belief.

My platelet levels dropped further but then started to creep back up again. My temperature was starting to return to normal. I broke out in a rash (the correct Dengue induced one, not the one caused by the massage) which meant that the fever was breaking. However, as my platelets had still not reached the elusive 100,000 mark, I was told I would have to stay in the hospital for at least three days. So I willed my platelets to rise as I simply couldn’t bear the blood taking anymore and the hospital food was dreadful. I also just wanted to sleep. I couldn’t read a book because I couldn’t use my left hand and despite my love of television what was on offer was boring me silly (I watched the 100 Hollywood break ups of all time, the 50 best bodies in the world, Oprah Winfrey, The Bold and the Beautiful, Becker (which was really funny and it was such a relief to laugh), the ABC news from Australia (so good to see), a repeat of one of my favourite British detective dramas Dalziel and Pascoe which I’d already seen and Daniel was too tired himself to watch and fell asleep, and the Australian detective drama Stingers).

While in hospital Daniel’s mum and my Aunt both called to see how I was doing. It was so nice to hear their voices and to be able to tell them all my woes. I really appreciated their calls. I also experienced a visit from three AVIers working in Bali whom I had never met before. Our AVI manager had contacted them and asked if they would pay a fellow AVIer from Timor a visit in hospital. It felt a bit strange at first to be sitting in bed opposite three people I’d never met before chatting about our respective experiences as AVIers and I for some reason was incredibly chatty and couldn’t stop talking. (Daniel had fled the hospital for some respite in the outside world and perhaps I was a bit delirious from lack of sleep.) Anyway, I also really appreciated their visit. All three were working on environmental projects in Bali, which is of huge concern given the number of tourists the small island receives, and the impact that has on the natural world.

Finally by Friday morning my platelets had just surpassed the 100,000 mark and I was free to go. Thank goddess! But I was instructed to return the following morning for another blood test so Daniel booked us into a hotel in Seminyak. Before going to our hotel, we spent a few hours at the shopping mall and duty free store across the road from the clinic and bought a small electronic dictionary, which translates Bahasa Indonesia into English and vice versa for my Timorese friend who is studying English at the National University of Timor-Leste. We went to the English store Marks and Spencer (which I adore and is one of the things I miss about living in London) and Daniel purchased two shirts, boxer shorts, and I bought a shirt. In the tourist gifts section of the duty free store I purchased two hand-painted t-shirts by Balinese artists. (Some of the clothes we brought with us to Timor now have holes in them due to wear and tear over the years and no doubt, the hard water, and harsh sun.)

During my stay at the hospital the Balinese nurses (as many males as females; in Timor more men than women are nurses and the same goes for teachers) were just fantastic. One nurse, upon telling her what sort of NGO I worked for in Timor, couldn’t hold herself back from telling me what a patriarchal culture Bali is and how the men just expect the women to wait on them hand and foot. She was so animated, it was lovely to watch her talk (she also moved like a classical ballet dancer and had the most beautiful big brown eyes and long straight black hair – just gorgeous). I said that all countries are patriarchal; it’s just that some are more so than others and it’s the lot of women to live in them but to also challenge the prevailing culture and demand greater equality (and therefore less patriarchy).

We duly returned to the clinic on Saturday and my platelets had continued their ascent so I was told to rest, keep drinking and eating and report any further symptoms to them. While we were waiting for my appointment we saw a number of other Westerners also waiting in various states of undress. One young girl and her mother were wearing bathers, very short shorts and high platform shoes. One Aussie bloke was wearing board shorts and thongs and the patch on his chin told me he had had a surfing accident. But the problem was that he was wearing no shirt; he was naked from his navel up (the following morning en route to Ubud I saw him again on the streets of Kuta with two of his mates, all of whom were shirtless)! The Balinese absolutely detest this utter disrespect for their culture (they’re modest in their dress). Westerners walk around Bali as if every little piece of it is their private beach or garden. And who in their right mind turns up to a doctor’s clinic in their home country shirtless or attired in little more than a bathing costume? So why do it in Bali? Normally one dresses up not down to visit their GP.

We spent the remainder of the day at the same shopping mall and duty free store across the road from the clinic and bought a few more things like books in English (very limited selection available but better than what can be obtained in Timor), along with Harry Potter number five in Bahasa Indonesia for one of Daniel’s Timorese colleagues who is rather a fan but the books aren’t available in Timor. Daniel purchased for himself a cheaper version of the electronic dictionary I purchased for my Timorese friend as he had really got into learning yet another language and had had access to such a device while living in China which he found invaluable. I also purchased two beautiful hand made batik sarongs from the tourist gift section of the duty free store (at home in Dili, I live in sarongs and the beautiful Indian cotton one I bought with me from Australia (and purchased from Timor-Leste (East Timor)

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