Never, would I have pictured myself eating for two after 3 months of living in Rwanda. Currently, I am writing this post from the twin-sized bed nestled in an average dorm-sized room. With the onset of rainy season, we have seen rain approximately half the week; today is one of those rainy days. I am draped in a sweatshirt and jeans that are stained from the red dust of the dirt roads. The most delicious accent of banana bread crumbs adorn my chest- four slices consumed because… well… I’m eating for two now.
I arrived in Rwanda mid-July, filled with excitement and anticipation of what my upcoming year would entail. Through a fellowship awarded by the Global Health Corps, I was selected as part of a group of 126 fellows from 22 countries. Partners In Health – Inshuti Mu Buzima was my chosen site simply because of the notable impact they have contributed to around the world. For the next year, I will be working as their Monitoring, Evaluation, and Quality Officer. In my first weeks, I quickly learned this role comes with many responsibilities, including providing support to a little more than 22 programs at PIH-IMB.
This role requires energy and I was losing much of it bit by bit. Around my second month of being here, I noticed I was fatigued more than usual and flatulence increase among other symptoms. My co-worker urged me to go to the hospital, so we went together. Rwanda Health Care System has been praised for their achievements over the past 10 years. They have instituted national health insurance, expanded services to include mental health, and opened the doors of its first cancer center in 2012. Thus, I felt I would receive good quality care and I did. I arrived at Rwinkwavu District Hospital, which is a few meters from the PIH-IMB Training Center where I work. I was welcomed by a physician I was accustomed to seeing around the village. He asked questions to assess the problem, determined the best course of action, and ordered some tests. Smooth sailing through the process.
About two hours after my visit I get a phone call:
(ring)
Me: Salut
Doctor: Muraho Petera! Amakuru?
Me: Comme ci, comme ca
Doctor: Well, I have your results.
(silence)
Me: Ok. What is it?
Doctor: Entamoeba histolytica
Me: I’m sorry. Is that English?
The doctor informed me that I have a visitor in my body. An amoeba. Now to someone who hasn’t spent much time in low- and middle- income countries, hearing something like this birthed a host of questions. What is it? How did it get there? Can we get rid of it? Is it fatal? I wanted answers and an explanation. By far, the doctor did a phenomenal job at putting me to ease and directing me to online resources like the NIH website. Literature says that the amoeba (scientific name: Entamoeba histolytica) can live in the large intestines without causing any major damage. Additionally, there are a number of blogs from world travelers that offer options of home remedies. As for me, I will take a small monthly dose of metronidazole to maintain the growth and a full dose at the end of my fellowship year.
Getting parasites in a low and middle income country is inevitable. Therefore, since Amelia the Amoeba has made her home in my large intestines, I will be eating for two from now until the end.