I am still recovering from Chikungunya 4 months after my last trip to Timor. CHIKV, that is how literature refers to Chikungunya viral fever is an infection transmitted by mosquito bites that is very similar to Dengue fever. Actually I got both Dengue and Chikungunya in Timor on the last visit, but Dengue goes away after a few weeks of fever, headache, severely painful joints (it translates to 'breakbone fever in many languages). The problem with CHIKV is that it last for months after the acute infection is gone. I had trouble walking, could not lift a teapot and generally was miserable. Drugs helped though and soon I was on very high doses of a kind of anti inflammatory called celebrex, the only problem with it was that rarely it caused heart attaches and bleeding to death without warning. Needless to say I was ready to be off it the day I started it. Eventually, after consulting several doctors both the infectious disease specialists at UW and CDC and a local joint specialist I started on a very old drug used to treat malaria, hydroxycholoroquine, and am doing better now. One of the interesting things was that the joint specialist recommended acupuncture, and some Chinese friends abducted me and took me to Vancouver BC for a treatment by a Beijing trained acupuncturists. It did not make much difference in the pain that day but the following day I woke up pain free, that lasted 5 days! I was impressed, but as she had said it would be temporary. By then the new medicine was kicking in and I can do most things now with only discomfort and it is not so painful that I cant do the routine every day things I need to.
Day before yesterday I started rowing again, first time in 4 months! It felt great to be back on the water. Last night took the canoe out and today other than a few sore muscles feel great. It makes the small joints in my hands a little more sensitive but not so much that I can't type. You get so de-conditioned when not exercising, it will take a while to get back in shape.
The upcoming trip to Timor is exciting. Thursday, Casey Hastings and I met with Ali Mokdad at the UW center for international health metrics and came close to a final design for his MPH thesis project. We will be comparing the impact of primary care vs disease specific programs. There have been huge amounts of aid and aid funding flowing into Timor over the past 10 years and life expectancy has increased by 10 years in the past decade, now well over 60. We will be looking at the reasons for the decreased early mortality in infants, children, childbearing women and the overall population. There is a political edge to the project as well in that the primary care changes were brought about by the Cuban government when they sent Cuban physicians to every district in Timor nearly 10 years ago, took hundreds of Timorese students into the medical school in Havana and started a medical school in Dili with 90 professors. The aid programs from the US and other donor nations has focused on disease specific efforts mostly in the largest towns and more urban districts.
Casey and I fly out of Vancouver on Aug 19th and will return to the US Sept 9th, a short trip but it will allow us to get the core work done, Casey will be headed back later to finish up the data collection. One of the best things about flying to Timor is that you have to over night in Bali both going and coming because there are no connecting flights the same day you arrive! It works well to have the day to catch up on get lag and Bali really is one of those special places where you simply have no choice but to relax and enjoy, it is just the way the place works.
I will try to post regularly off on another adventure there and back again.
Frank
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