Nigeria Memoirs – 8 .. Health and well being
Probabilities of good health versus sickness won’t take you far. As far as falling sick is concerned, usually men are convinced of their invincibility. I think it has something to do with high levels of testosterones. Here, I recount my trials and tribulations with health in Nigeria.
HYGIENE & SANITATION
It was a revelation when I joined at Lagos that the first half of 4th Saturday of every month was earmarked as Sanitation Day. All residents were expected to clean up their nearby areas including the approach road. No movement was permitted. Defaulters were penalised on the spot. Only those involved in emergency duties were permitted to travel. For settling disputes, magistrates were readily available in the earmarked areas and would invariably order confiscation of vehicle and remand to prison in case one defaulted on instant payment. The Sanitation Day was not necessarily same in every state. However, it was a common theme across the country and strictly observed in metro towns.
MALARIA
…is the biggest killer in Africa with Nigeria having the largest global burden of 27%. 1.9 Lakh deaths were reported from malaria in 2021 which is a global malaria mortality rate of 40%. When I had travelled to Angola as part of UN Observers, we were advised to be on prophylaxis anti-malaria drug – Mefloquine, to be taken once a week. However, in Nigeria after the initial few weeks, I discontinued the regime when I came to know from my health professional colleagues that it can have serious side effects too viz. seizures, depression and psychosis. I remember in the UN days, a number of guys including all the Russians, would not subscribe to it because, on the sly, the word was that it also affected your libido. However, I had to rely on active aggressive measures to ward of the menace in Nigeria when the anopheles mosquito got the better of me twice.
A heavy spray of strong mosquito repellent twice a week in the residence and use of our very own Indian Good Knight mosquito repellent every night to ward away any potential danger, became my unchanging routine. It’s a standard practice in Nigeria that any fever is treated with anti-malaria medicine by default. I would carry a full dosage of Doxycycline and later Artemisinin as part of my medical pouch contents on a permanent basis. Touch wood, I did not suffer from Malaria again in my two decades of active work.
The first time, I fell sick was in 2003 with classical symptoms of fever and shivering every 18-24 hours that lasted for 2 – 3 days. The second time in early 2004 was tricky. I would have none of the symptoms except head ache in the evening. The anacin/ disprin/ panadol were effective but when the headache repeatedly continued for more than 7 days, I was advised to take a complete dose of anti-malaria meds. Lo and behold, I was free of the headaches. I believe that malaria parasite has mutated in so many different forms in Africa that virtually all illness have something to do with Malaria, however tiny bit it maybe.
DIARRHOEA
Traveller’s Diarrhoea a common occurrence, due to my frequent travel routine, nagged me once every 6-8 weeks despite all possible precautions. From my very first day in Nigeria in 2003, we used bottled Water. Commonly available even in rural areas, the first thing we would do is purchase, a crate of 12- 1 litre bottles and then keep replenishing the stock.
FROZEN SHOULDER.
I was travelling long distances over rural unpaved roads often. A shoulder muscular internal injury afflicted me due to over reliance on hanging on to the grab-handle on the ceiling of the AC Pick-Up truck to cushion the turbulence when navigating uneven patches.
A frozen shoulder literally put me out of action for 3 months in 2010 on a shoulder brace with a sling. At its peak, simple tasks like tooth brushing and eating food had become a painful affair. Base Hospital, Delhi Cantt with its physiotherapy exercises, electric nerve stimulation and ultra sound therapy came to the rescue and proved to be a life saver.
EBOLA VIRUS
…gets transferred from African fruit bats to humans. It is highly contagious and an infected person can transmit through all types of body fluids including sweat and urine. Fatalities are very high in the region of 75 – 90%. In early 2014, it spread across West Africa including Nigeria. We had to devise innovative ways to avoid, prevent and yet carry out our activities. Hand sanitisers, face masks and separation (social distances) became a way of life long before Covid struck. In 2014, while returning from Nigeria, I had to create a ruckus at IGI Airport Delhi when, I found no checks and contact tracing were in place for flights arriving from Africa. India was living in a silo much removed from the realities that could afflict. The lessons learnt served us well when Covid struck in 2019.
TYPHOID
….a water borne disease, is quite rampant in Nigeria. I suffered from Typhoid in 2016 and it turned out to be a close call. Fortunately, our work was specific to health and hence, expert help from qualified doctors was always available at hand. My high fever and inability of the stomach to hold anything for 5 continuous days even made these doctors worried and air medivac to India/ UK was barely averted. For 5 days I was on intra-venous Ringer Lactate and other fluids. The catch was to have antibiotics and remain hydrated, hydrated and more hydrated. I remain convinced, it was Divine Grace that came to my rescue.
A colleague of mine had to be sent to India on Medivac when he suffered a major heart attack. He had not shared his exact medical condition before taking up the assignment though it was mandatory to submit TMT and 2D echo doppler results prior to joining. Somehow the HR missed it and this error turned out to be a touch and go affair. Most reputed companies put you on a reliable medical cover and insurance that covers medivac by air. We must ensure this aspect of health insurance if our children pick up a job in Africa.
The persisting high fever and liquid diet unbelievably burnt away 2.5 kgs of my unwanted flab in a weeks’ time. This was in 2016 and this is when the truth struck home. So far, I was living with the Monte Carlo Fallacy (Gambler’s Fallacy) wherein you believe an event is unlikely to happen just because it has not happened so far or the other way about. After Ebola and now Typhoid, I realised not to play with increased probabilities of falling sick. I requested for release from my responsibilities. It took me another 3 years to position a suitable replacement, stabilisation of the projects and COVID to part amicably. I continue to be an esteemed member of the TCF community.
WELL BEING
Good health is not a prerequisite for Well-Being of the spirit. However, the path from good health to well-being, a rigorous state of mind steeped in conviction of what you are and why you are, is easier. The concept of a prayer room in the office turned out to be a boon in my case. Our Trustees had permanently set aside a hall, a part of my NGO’s office complex, for prayers on Azare Crescent in Apapa, Lagos. A similar prayer hall was also maintained in their commercial office in Victoria Island on Adetokunbo Ademola Street.
Initially, I wasn’t overtly spiritual and would only join at the end, enticed by the lovely home-made prasad which the Indian families would distribute every Friday evening after the prayers. Reminds me of Col HarPratap Singh (Arty – 46/48? NDA) with whom I would occasionally team up, solely, for the prasad lunch organised every Sunday in Victoria Island. But soon, I started looking forward to meet the Indian community in my office compound and attending the prayer bhajans and reading of scriptures for longer periods. The pinnacle was when we were invited by the ISKON temple management to chant Vishnu Sahstranam on the consecration day of Sri Chaitanya Mahaprabhu’s murti. It was a calming experience and indeed a happy one. I am thankful for it. It instilled in me a habit of reading scriptures, however little, once a while.
In retrospect, I am convinced, that this acted as my beacon of light, an anchor in times of turbulence and a soothing balm in distress and solitude. I feel, I am blessed to have had no reason to question my decision on PMR and subsequent supposedly kalapani in Nigeria serving the disadvantaged. All along it had been a conscious choice that allowed me to walk upright on a righteous path, be it in the uniform or out of it.
By Colonel Akhil Gupta Retd
