A few days ago I started running up the mountain. With it being so hot it’s difficult to find time that’s cool enough to run, so when it started pouring rain I threw on my shoes and headed off, confirming for the whole village that, yes, I am totally barking. My comeuppance was quick to appear, as predicted by all the Thai people who had shaken their heads at my folly, this morning I couldn’t get out of bed.

This is not an uncommon occurrence for me, being definitively NOT a morning person. But even my addled morning brain could detect this was something different, and a slightly extreme reaction to having inflicted one little mountain run on my poor  unfit body.

My back feels like it has collapsed, any strength or power I had there is gone completely and my legs and hips felt like they belong to the dingly dangly scarecrow, disconnected from my body’s centre and barely under its control. I drag myself through the morning washing of body parts, wrestling with t-shirts and scrubbing of faces before moving like a zombie to the car and going slowly through the motions necessary to get Clear Sky to school.

Only when I am at home again, and despite the mountain of stuff I’ve got to do today, know that I am only fit to fall back into bed, does it dawn on me that my bones are aching unaccountably all over. I remain prostrate in the bed for the rest of the day, adamant this can’t be Dengue Fever because I’m not hot, until Shrimp comes in, feels my head, and says actually I am on fire, burning up. At which point I begin to consider that this might well be Dengue.

Aedes Aegypti Mosquito

And so it begins, the days of lying inert, pained, unable to move, unable to look at anything due to stabbing pain behind the eyes, so just staring at the wall. The doctor confirms I have dengue and runs blood checks to see how low my white blood cells are, if they drop below a certain level I could be in danger of developing Dengue Haemorrhagic Fever, which can be fatal.

I ride out the wave of the illness in bed, sweating it out, alternately hot and cold, cold and hot, bathed in sweat and shaking with chills. As the virus runs through my body I develop agonising head pain and swellings all over my skull, an insistent nagging pain like toothache, but consuming my entire head.

When I start to feel better I crawl out of bed and eat some dry crackers, everything tastes like metal and makes my stomach turn but I force down the food and water as best I can. After a couple more days the nausea leaves, although the head pain remains, debilitating and frustrating me from being able to concentrate or write.

What is more disturbing when the illness finally leaves, is that I find I have sunk into a lethargic depression, from which rousing myself is proving virtually impossible. I can get up and fake that I’m okay enough to get Clear Sky off to school, but that saps all of my energy and as soon as she’s gone I’m a teary heap, unable to tackle even the smallest of tasks. Apparently this is quite common with dengue, but it is so demoralising and frustrating to feel almost well, but puffed out and exhausted from just climbing up the stairs.

Apparently there has been an outbreak of Dengue, with 26,000 cases throughout the country and six deaths in the last week alone. Dengue is transmitted by a small daytime mosquito, one of the really pesky ones that it’s hard to swat. There are around 40 million cases of Dengue each year globally, and several hundred thousand Dengue hemorrhagic fever each year.  By the late 1990s, dengue was the most important mosquito-borne disease affecting humans after malaria, in Africa and Asia.

There is currently no vaccine or treatment for Dengue. It’s hard to imagine a disease being this common, and this devastating, in a western country without serious effort and funding being put into finding a cure, treatment, or some kind of adequate prevention.

Just saying.

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{UPDATE: Golf is doing really well, her foot is healing well though she is now feeling sad at the loss of her toe. We’re hoping that she will still do really well on her exams and can try to get into medical school next year. Thanks everybody for the kind words and support.}

On Saturday Golf came off her moped and seriously damaged two toes on her left foot. The clinic on our island patched her up and sent her to Samui to the main hospital. They estimated that if she had surgery within a few hours she would keep her toes.

Golf is an incredibly bright, beautiful, hardworking young girl whose ambition is to be a nurse in the army because (though she’s got the grades) Crab and the family can’t afford medical school for her. Yesterday at the age of nineteen she had her toes amputated.

Golf, Egger, Way, and Crab in the kitchen

The first time she saw the doctor on Samui was at 5pm in the evening, in surgery. He was notified at 10am that she needed emergency surgery. She and crab sat on the ward, while the doctor on-call failed to show for seven hours and Golf’s toe died. When he did finally grace them with his presence he didn’t even check her first to assess the damage; fully unqualified to perform surgery, he met her for the first time on the operating table, where he proceeded to butcher her foot.

Then Golf was left for twenty-four hours with a blackened, gangrenous toe hanging off her foot. No doctor checked her after surgery, no dressing was changed. When I arrived at the hospital there were four nurses sitting behind glass, with four patients in the entire ward, yet Golf had dirty bandage hanging off her foot, hair stuck in her wound, and a clearly dead body part rapidly spreading gangrene and poisoning her bloodstream.

Once Shrimp and I arrived, you’d better believe things changed fast. Because we have the confidence to kick up a fuss and we are given this right by the fact that we are educated and I am a farang. What makes my blood boil is that Golf lost her toes because she is a young, poor, Thai, with the wrong skin tone and is thus afraid to speak up to authority.

Had I been there it would not have happened, had I been there the doctor would not have treated her body part as disposable, and her surgery as a non-priority. But I wasn’t there and Golf was not deemed important, wealthy, white or powerful enough to warrant basic medical care. She lost her toe because she lives in a country where a young, poor, dark-skinned girl has no right to anything and certainly not to ask when the doctor will arrive.

I will not rant here too much. It suffices to say that I am meditating on responsibility, that I have been resistant to for a long while, that I need to step up and accept; because I do have responsibility to those whom I take care of who are not able to stand up for themselves, and who lose their toes if they don’t have someone like me to speak up for them.

It suffices to say that the doctor, the hospital administrator, the director, and the ward nurse are hopefully all meditating on their negligence, their wrong decision-making, poor management and blatant disregard for humanity. As well as the lawsuit that is coming their way.

Golf is doing well, in a private international hospital that we can’t really afford, but which I blagged her into and into amputation surgery. We will deal with the rest as it comes, she is safe, though minus a body part. As is typical of her resilience, not a tear was shed, not a drama, not a histrionic in sight, her main concern was that I might be tired running the kitchen, and that Clear Sky is happy.

The private hospital have done everything they can to help us and to smooth things over. The director has personally asked us not to sue the negligent hospital as we will be taking resources away from those who need them and doctors are scarce. I hear and respect this point, I don’t believe in litigious societies, but I do feel that this doctor was not only negligent in the extreme, but that he was negligent based on a class judgement, a reality that is common in Thailand and which he admitted to me face-to-face.

This is why while I don’t believe in the lawsuit culture we’ve come to expect in the West I do believe in accountability, and I will be thinking very hard about the best way to achieve accountability on a nineteen year old girl’s behalf, in a classist, racist, elitist, corrupt society such as this.

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1. Golf is off to university…..