Reverie of an Uncertain Future
I can’t help but feel like there’s a lot of people around the world right now having a harsh realization that good health and general stability isn’t a guarantee; it’s a privilege most of the world doesn’t get at all.
Nobody thinks they’ll ever get sick or injured. Until they do.
I worked in Zambia for three years as a Peace Corps volunteer (PCV). I’m not saying this as an accomplishment, or because I’m proud of it. I can’t really say that I am anymore. It feels like a waste, a naive thing that probably made no difference. But I guess most things feel that way to me lately. That is a sign of the times we are in. I’m only saying it now because my life there involved being prepared for and experiencing injury and illness, along with observing (from a position of privilege) patterns of death by preventable disease and the corresponding social response to it.
In the months during and following the rainy season in Zambia, the number of mosquitoes increases greatly due to increased standing water sources. This causes an annual spread of malaria in most areas. Malaria is a parasitic disease spread through mosquito bites, from person to person through the bite of the female Anopheles mosquito. Of the four malaria parasites that exist, Plasmodium falciparum is the most deadly, common in Zambia and most areas of sub-Saharan Africa. The various malaria parasites have bodily incubation periods between two weeks to 40 days, which results in many infections and deaths during this time of year. Each year, I attended several funerals in the immediate community I lived in. Most were due to the malaria disease. After a while, I lost track of them. I thought at first that I was doing some important work keeping track, but it just felt wrong to count something like that. What would I do with that number? “Educate” people back home, like some kind of savior? Try to foster guilt in privileged people to boost my ego? In the end, it didn’t matter. It still doesn’t. It was simply a fact of life there, an annual occurrence.
When I was 23 years old, I got malaria myself. This was around the beginning of my second year in Zambia. Throughout my time there, I was consistently provided with anti-malarial prophylaxis drugs which I took each week. This was our privilege as Peace Corps volunteers; the medical care and medication that kept us insulated from the suffering going on around us.
I was also given an emergency supply of Coartem, which is a drug that flushes your system of the parasite. Since Coartem has powerful side effects, it is only taken after the parasite level causes actual malaria symptoms. I always had some of the parasites in my system (preventing all mosquito bites in Zambia is impossible) but usually the weekly preventable prophylaxis pills were able to keep the parasite levels and corresponding symptoms to a minimum. One night the past December, I had slept under a mosquito net with my right arm right up against the net, easily accessible to the swarms of mosquitoes in the room. I awoke to dozens of bites on my arm. About a month later, presumably once that single large group of the parasite finished incubating, I awoke in my hut and felt somewhat ill. However, as addicted as I was to denying vulnerabilities, I cycled into my town on an errand run. I felt very ill after exerting myself and went to the provincial Peace Corps office.
Even so, I couldn’t look at the symptoms I was having with any objectivity. I was in denial. After some friends at the town’s Peace Corps office encouraged and helped me take a malaria test to confirm, I started taking Coartem. The next two days passed in a haze of nausea, chills, fever, and pain. I remember speaking to people standing over me who couldn't possibly be there; my parents, my dead grandparents, old friends from childhood. Whether it was the treatment or the pills themselves that caused all of this, time passed in a hazy blur. Every hour, I felt a little weaker, a little less in control of my well-being. Even during this time at certain points, I was in disbelief. This couldn’t be malaria, I couldn’t have it. But all of the symptoms fit, and I did get better after taking the pills.
Don’t take any of this as me trying to equate my experience to the Zambians in the village I lived in. Truth is, I never survived anything without help. No PCV does. So last month, when I saw that all current volunteers were being evacuated due to the pandemic, I wasn’t surprised. I understood the decision. As confident and self-assured as I was back then, I had enough difficulties maintaining my health when I had effective medication available to me. The idea that anyone could weather the coming storm in a situation like that without a safety net is just privilege talking.
We all got the vaccines our host country neighbors didn’t. There are plenty of problems with the healthcare provided to volunteers during and after they complete their time in Peace Corps, but debating that seems privileged on its own terms. The healthcare that was provided to me was more than anything my neighbors in the village will ever receive. In addition, we always had the option to leave anytime we wanted, at the expense of the U.S. government, on a paid flight to our home of record. The Zambians I met in my village couldn’t leave. Those people who I got to know, who lived to adulthood, were the ones who survived the multitudes of diseases and environmental hazards of their environment in their lives up to that point, based on a mix of luck and resiliency without any privilege. They all had friends, siblings, parents, children, and relatives who died of diseases America has never known and/or forgot about. Who were any of us PCVs to think we could have survived under the same conditions?
Seeing this virus that plagues the world now reminds me of what I saw and felt in those years in Zambia. There isn’t an effective treatment available and there isn’t a preventative vaccine. Welcome to the rest of the world living without access to vaccines. The whole world is now learning a painful set of truths that most Zambians learn early on; this isn’t personal. The virus doesn’t care about you. It doesn’t care about anybody.
It doesn’t care where you come from, if you can’t even right now, or how hygienic you’ve decided you are. In fact, it doesn’t care about anything you decide, what you’re comfortable with or the cruise you were planning to take. It doesn’t care if you have a family, if you miss your friends, or if you have lofty goals for your career. It definitely isn’t a form of oppression the way some people are making it out to be. It doesn’t have a sense of respect for your traditions or exceptionalism. It won’t avoid infecting you at the supermarket just because you zoom-called your friends instead of seeing them in person. It doesn’t care about belief systems, social constructs, or political opinions. It doesn’t sleep. It only wants to use your body as a home base to infect others.
So, knowing all of this, what am I to do? I remember the routines I made in Zambia. I think there are lessons there.
I’m giving myself things to do. Being creative. Reading books. Studying. Playing games. But with that in mind, I’m also taking time to rest.
I’m studying testimonials from people who have personal experiences with this. Reading and watching what healthcare workers have to say is more valuable to me than any news article. I trust people who are recording their own stories.
Disinfecting my living space goes a long way, both for limiting risks of infection and my own sense of security.
Maintaining my immune system with nutrition and exercising for stress relief. By maintaining myself, I can protect others.
Keeping in touch with family and being as honest as I can be in my communication with them.
If I do get sick, I will try not to blame myself. It’s easy to think I'm special, that my story doesn’t involve this. But I think everyone else is also thinking that. I’m trying to be mindful and avoid stigmatizing anyone. Everyone who has it thought they wouldn’t get it until they did, just like we’re all going to do right up until that positive test result.
I’m trying to maintain the friendships I’ve made. Trying to understand others and let go of what I can’t control. Listening and supporting the people in my life. Making a conscious effort to not take it personally if people need space or are handling things differently than me. And on the other end of that, understanding that not everyone is willing or able to make these kinds of efforts for me.
And lastly, making the most of the time I’ve been given. Being alive is its own privilege. If I am alive, that is reason enough to keep going. I’m thinking about the people who have died from this and the diseases of the past.
If they were alive, they would tell us all to live, and live well.