Malaria in camp

The really unique element to the Ruwenzori Mountains, is the vegetation. We walked through three vegetation zones today. The Ruwenzori circuit follows a river until its confluence with an additional one. Near the confluence, we take the right (north) branch. The return will come in on the left branch. The initial day will be re-visited on the exit to the park gate.

The day was a blur of photos and gentle rain slowly moving in. To add some spice, we ran across some occasional boggy ground. The definition of trail here, is sticks and logs laying on/in the ground so you can walk, rather than wallow. You would be unable to go far with out the ground preparation. I did the best I could to stay on the logs, but as many disappear underwater (muddy water), there is an element of faith that some prankster did not saw the invisible part out. In fact, that must have been the case each time I found myself boot-topping in wet mud. The type that is trying to pull your boot off your foot. The Muckboot must have been designed for here, because it is ...pretty... mucky. With the frequent high steps, my Marmot Precip rainpants were mud up to the crotch, on the inside of my legs.

Tomorrow, we will hit the more extensive bog.

When arriving at the John Matte hut, I tried to log a GPS location, but the satellites were not cooperating. The steep ridges on both sides of us block out any satellites near the horizon. I am also sending out daily SPOT Satellite Messenger notes. Africa is a new area for SPOT.  

In review, all the 'pings' worked well. 
 
The SPOT Messenger is a very cost effective device and seems very dependable. Messages also include Google Earth links to our location. When I sent one from a summit, I heard wails of complaint from a friend, neck deep in school. Sorry Bill, I didn't mean to rub it in quite so hard. I was trying to be gentle. My intention was to alert family and friends that we were doing well.

A second button will call for help and the operator is allowed a moderate length message. The message is pre-written, having been uploaded online, with the email and text message addresses prior to the trip. The crux is what to say on the help message. Finally, there is the 911 signal. I can only guess that, here, they send out the National Guard. For 911, there a single contact person, with phone numbers. Here, you can also write up a profile of the participants, for the rescue folks. The SPOT Satellite Messenger is a valuable piece of gear. I think it would be negligent to not have one as a professional, with paying clients, or students. It is the least expensive way to ensure communications.

While I am milling around with various pieces of technology, Vittario approaches me with, "One of the porters has Malaria. Do you have any medicine for him?" No, I don't have any Malaria treatment medicine, just our daily pills. After a moments thought, I pulled out my Kindle. On it, there a couple of medical books. After lots of reading between the lines, it became clear the same medicine for prophylaxis is used for treatment. The book called for 1 gram in treatment, of course of a different drug than we were carrying. I am sure our meds are new to the area, so the Malaria is not resistant to it. The info that came with the drug, Doxycycl, from the pharmacy was consulted as well. None gave any guidance for our situation....


My partner and I concluded to give the porter some of our meds. The devil being, how much? If 100mg is a daily prophylaxis, a gram of Old Standard is treatment, then,.... let's try 200mg of new-on-the-block Doxycycl. Give him some Mortin for the fever (it's all I had) and lets give him 2 hours. We'll give him more D if we need to.

I kept the medical record on the Kindle, as a note in the Malaria information of Medicine for Mountaineering, a standard medical text. Over the years, I have likely read it 6 times. I still can't remember a thing in it.

                 26 yr old pt
                 lost his appetite. vomited a small amount. chills.
                 fever/headache. has history of malaria. with last
                 about 1 year ago.
                 vomited 15:00
                 we were notified 17:15.
                 elevation...11,000ft?
                 rr 16/18 easy and regular. he is well acclimated.
                 carrying here often.
                 sctm color good. temp warm. moist.
                 pt complains of fever. I do not feel a significant
                 warmth. we have no thermemeter.
                 last oral intake. drank a liter of water, hoping to
                 reduce the headache.
                
                 17:30 gave pt 2- 100mg doxycycl
                                       2- 200 mg Motrin

                 18:15 pt feeling better
                 19:15  pt was encouraged to get up join crew by fire
                 drink some tea and eat something. i was told he did.
                 20:30 pt was given 3rd doxycycl. 3 for day, from
                 17:00 to 20:30

             ....plan
                 pt and strong friend will begin walking out in the
                 morning. rms will send up porters to help with the walk
                 out.
                 we will send the pt with doxycycl for 3 sets of two
                 caps. we will send equal amt of motrin.
                 send off with- food
                                      foam and sleeping bag
                                      sufficient clothing
                                      meds record

23% of folks in Uganda have Malaria. it is common knowledge here.
The moral I walk away with, 'learn the common ailments of the country you are visiting. Carry some meds for these ailments. A unique book, for just this situation is, Where there is no Doctor. There is no digital copy for the Kindle- hear that Amazon? It is an important resource, akin to John Muir's, Keeping you Volkswagen Alive.