This is not unusual Chelsi thought to herself. I’ve suffered from motion sickness most of my life. She was scrunch up in the window seat, her new friend Kate, a volunteer from Northern Provence, was seated next to her along the aisle. “I wish these windows opened.”
“Yeah, but at least the air conditioning is working. How many buses in Zambia have you been on where the air condition worked!”
“Ahh, none,” Chelsi let out a weak smile. Kate had a bag filled with small sandwiches on her lap. She removed two. Mmm, breakfast. Chelsi thought of her own bag of snacks, when the bus rumbled causing her stomach to seize with nausea. She rested her forehead against the back of the seat in front of her. “I do want to let you know though, I’m not feeling to well and I have been known to vomit from motions sickness before.”
Kate chewed through the last bit of her second sandwich. “Okay, do you need a bag or anything? Maybe a Dramamine? I can try and find mine.”
“I think I’m alright for now. I took a motion sickness pill when we got on a couple hours ago.” Chelsi closed her eyes and felt inside herself. “I think maybe it’s just a combination of long bus ride from Solwezi yesterday, and then not sleeping enough last night. Maybe I drank more than I thought at Sara’s birthday party, too. I’m just gonna try to sleep through it for now.” The early morning light was still dim and she was exhausted. Over the past few days Chelsi had attended functions to say good bye to the COS-ing, or leaving, intake, settled back in the boys she had brought to a leadership training the week before, and exhausting week in and of itself, cleaned and prepped her house for a long stay away, packed for vacation and the following week of Mid Service Training, refinished the floor of her house, biked to town, celebrated her friend’s 30th birthday, then at 4:30 in the morning got on the 14 hour bus to Lusaka. Just 33 hours to go and we’ll be there. We’ll be Namibia and I’m sure I’ll feel much better.
It couldn’t have been much more than an hour when Chelsi was jostled wake, no, not by the bus. She reached for the plastic bag she had tucked in the pocket in front of her.
When she was finished she was surprised by the heaviness of plastic bag. Had I really eaten all that? She thought about the chicken she had eaten the previous night for dinner. It was delicious. And though her cheeks were flush and sweat beaded a bit on her brow, she did feel a bit better. She tied closed the bag containing the thick brown mass and tucked it under the seat in front of her. I’ll throw it out at the next stop. Glancing towards Kate she was thankful to find that her eyes were closed and her headphones were in.
It wasn’t soon after though that Chelsi felt it again. First a rumble in her belly and a burp, followed quickly by a heave. She searched quickly for a second bag. She knew she had one somewhere. Just as it was coming up she found the bag and spread it open. This mass was smaller, a little looser than the first but still she was shocked by the amount. Images of her insides as a black hole flashed through her mind, but were quickly collapsed by another heave. This time mostly liquid. Well, at least it’ll be over now. She took a swig from her water bottle. The iodine she had used to treat the tap water in Lusaka covered any bad taste left in her mouth.
“Aubrey! AUBREY!” Chelsi shouted from the cramped bathroom stall. “Can you also bring me a couple of kwatch to pay the toilet fee! And PLEASE don’t let the bus leave without me! THANK YOU!” She leaned over the toilet, still unsure which urge remained strong: the one vomit or the one to poop. Poop, at least if I get all the poop out of me now I’ll probably be able to hold it again till the next stop. So, she turned back around to squat. After a few moments of nothing, she boldly decided that this time she really must be empty. How much can one person hold afterall? For that last couple hours she had vomited a handful of time every 15 minutes and about half way between this rest stop and the last her body had started to insist that she also begin to void her bowl. Now she stood up, straightened her skirt. She would have loved to wash her hands, but alas the water in bathroom facets never ran in Zambia.
Aubrey met her halfway back to the bus and quickly paid off the bathroom bamaama. “How are you? Are you okay?” There was strained worry in her voice.
“I am for now.”
“Okay, then lets hurry. I had to yell at the bus driver to not leave you.”
They settled back into their seats. This time though Aubrey was situated in the aisle seat beside Chelsi. Kate had relegated it to Aubrey after Chelsi had snatched her sandwich bag almost before she could save her last sandwich.
“What was it that PCMO said when you talked to them last?” Aubrey asked.
Oh, the Peace Corps Medical Office, “well, Dr. Kim is great, for one. I’m really glad he’s the one answering the duty phone. He said I need to be drinking ORS, Oral Rehydration Salts, to take Phenagen, the anti-nausea, again if I vomit within 20 minutes of taking it. Also that I could try taking some Peptobismol and to keep him up dated.”
“Okay,” Aubrey began to dig through her bag of medications. “Did he say anything about starting Cipro?”
“No, not yet. I also asked him if this could be related to that cloud of tear gas we walked into at the bus station in Lusaka this morning. He said no.”
“That’s strange, cause whenever I see videos of people being tear gassed they’re usually vomiting.” They sat quietly for a while. Chelsi thought that maybe, if she just kept her mouth shut everything would stay in. But no such luck.
Within minutes she was frantically searching for another bag. Her abdomen cramped with pain as she tried to hold everything in. But, yellowy bile spilled from her mouth in three great heaves. I’m running out of bags.
Aubrey looked at her, her face lined with concern. “You’re probably just really dehydrated. You really need to just pound water.” Every sip of water Chelsi took left her crippled in pain and vomiting. More than exhausted now, she was weak. Her skin tingled, lips cracked, eyes heavy. All she could muster in response was a furrowed brow in Aubrey’s direction. “And when we get to Namibia we can go to the apothecary and find you some better drugs. Maybe call PCMO Namibia.”
Chelsi looked at her watch; 29 more hours to Windhoek… She took a deep breath through her nose, held it for a moment, making sure she had all her words lined up, and only words. “I’m not going to make to it. I have to get off the bus. I have to get to the hospital… What’s are next stop?”
“Ummm, are last stop was Choma, so next is Livingston. We should be there in ummm, 45 minutes. I’m going to go talk to Chad, and the rest of the group, let them know what’s going on and that we’ll probably have to get off at Livingston. Are you okay here for a few minutes?”
“Yeah,” Chelsi fumbled for her phone, texted Dr. Kim about hospitals in Livingston. When Aubrey returned Chelsi pushed her phone towards her. “We should be getting hospital and some treatment information soon. But I can’t focus on it.”
“That’s okay, I’ll take care of it. Okay, so Chad is going to get off the bus with us in Livingston. The rest of the group is going to go onto Windhoek. He’s going to call the car rental agency and change our reservation. Let them know we’re going to be late. Do you think you still want to go on to Namibia after we get you fixed up at the hospital?”
“Yes!” the word came out of Chelsi with more force that expected. I’m not going to totally cancel my first vacation in nearly a year, just because I might be dying.
“Okay, we’ll look in to when the next bus to Windhoek comes. Chad thinks its Wednesday. And he’ll look into getting us a refund for the last part of this trip.”
Still on their way to Livingston Chelsi began to lose control over her bowl. When it cramped with pain, Chelsi let out a few whimpers. Aubrey shouted at the bus driver until he pulled over for them.
Climbing back on the bus Chelsi asked, “How much longer? Until we’re in Livingstone?” If I have to make the bus pull over all the time, we’re never going to make.
“The bus driver said we were only five kilometers away. That’s why he was reluctant to stop.”
And sure enough ten minutes later they were rolling on to the platform of the Livingstone bus station. There was a buzz of commotion on the platform. People pawed at them, the conductor ignored their pleas for their luggage and the taxi driver kept urging ‘let’s go, let’s go.’
Chelsi began to feel a great force grow within her, one which would have worried her a few moments ago on the bus but now she realized was a power. The people around her first took note when she squatted down. Just as she hiked up her skirt around her hips and she stopped fighting the belly cramps, her bowl voided. A few papery brown chunks were carried with her liquid runs. It touch no fewer than two other people’s shoes. Everyone took three steps back.
“Now! Get our bags, so we can go to the hospital!”
The taxi dropped them off at the building with the sign High Cost Care Clinic, all the words PCMO used to describe what their final destination should be. But they were given the run around at every turn. They were told ‘This clinic isn’t open on Sunday.’ ‘It’s open, but only for pediatrics.’ ‘NO, we refuse to give her fluids.’ ‘Adults won’t be seen on Sundays. Go to the General Hospital up the hill.’ But their luck there wasn’t much better.
‘Where are you going?’ they were asked upon walking through the doors. ‘There is no High Cost Care Clinic here, you have to go back down the hill.’ ‘The Emergency room isn’t open on Sundays.’ ‘You can’t be seen unless you register. But we can’t do that.’
“The sign right above your desk SAYS REGISTRATION!” Aubrey roared. “DO YOUR GOD DAMN JOB!”
“Ahhhh,” the man sighed. But Chelsi had already left, following the signs that said Emergency. A large women, dressed in a nurse’s uniform, circa 1910, sat behind a small table and stopped her from venturing further. The woman’s tone was harsh in tell Chelsi that she would need to process her registration papers before she could be seen. Then she would have to wait. Chelsi looked around the room. Chairs sat in neat rows, empty of occupants. Wait for what?
She was done with words. Chelsi took a gulp of water, knowing what would follow. Moving a small bowl she found sitting on the floor up on to the table. As Chelsi heaved thick yellow bile into the bowl the woman cringe and pushed away.
“You can come in,” Chelsi heard a voice from behind her. A man in bright red scrubs motioned to her from a doorway around the corner. Chelsi followed him into the small room and immediately lied down on the exam table. “These people, I tell you…” He pulled on a pair of rubber gloves. “What seems to be the problem? Tell me your symptoms.”
After defecating on the exam table a couple of times and shelling out 1,200 kwacha, Chelsi was moved up to the ‘High Cost Care Ward.’ A private room not unlike a small motel room, with a much nicer shower head. From her window they could see into the ‘General Ward.’ Admission there was 45 kwacha.
“If you weren’t sick when you admitted there you will be by the time you leave.” Aubrey said turning away from the window, just in time to see Chelsi pushing up the flow on her IV again. She turned it down. “If it goes to fast you could end up getting to much fluid and over hydrate. This is already your third bag.”
“What would happen if I get too much?”
“Well, you’re young, so you would probably be fine. But you will swell up. Okay I’m going to tell the doctor to bring you that anti-nausea that PCMO suggested. It’s going to come in the form of a shot that goes in your butt. Then Chad and I are going to go find somewhere to spend the night. And I’ll call you later.”
“Thank you Aubrey, for helping me so much.”
“No problem friend. I miss doing nursing stuff and patient advocacy. So thank you for letting me help you. And don’t worry about Namibia, Chad and I will figure it out. You just get better.” She gathered her sweater and purse heading towards the door. “And think of it this way; No Peace Corps experience is complete without at least one trip to the hospital.”