The Grand Tsingy and My Medical Mishap

In the Grand Tsingy

October 7 -- It was my last day being 29 and, looking back on it, it was fitting (in an ironic way) that I should leave my twenties in much the same way that I spent them -- that is, having grand ambitions, making poor choices, trying to do too much, and ultimately ending up on my back, miserable, vomiting, and cursing my stupidity.

To say that I didn't sleep well the night before is an understatement.  Though I had to be awake for breakfast at six so we could leave for the Grand Tsingy at 6:30, I slept little after 4:00.  That's when I woke up in a cold sweat, feeling horrible.  Nevertheless, this hike through the Grand Tsingy -- which Kati not-so-affectionately calls "the death hike" -- was the impetus for planning this whole adventure through Western Madagascar.  I was not about to miss it because I didn't sleep well and didn't feel great.  At breakfast, I could barely eat anything.  That should have been yet another sign that I was making the wrong decision, but I ignored it and pushed on.  Meanwhile, Kati was still sleeping and dreaming of her coming day relaxing by the pool.

Faly and Mark picked me up at 6:30 and we headed into town to grab Tivy on our way to the Grand Tsingy.  Driving through the residential side of town was very interesting because I got to see how the Malagasy actually live when no one is watching.  Most shockingly, I saw a butcher chop the head off of a newly killed, hanging zebu as he prepared to cut it up for the day's product.  We also drove by a brick works and a very primitive (and entirely manual) quarry on the outskirts of town.

The drive to the Grand Tsingy took about an hour, and I was feeling a bit better.  I loaded my backpack with nearly three liters of water for the upcoming trip and had been drinking constantly in hopes of replenishing the fluids that I had sweat out the night before.  By the time we reached the "base camp" for the Grand Tsingy hike, I felt good enough to eat half of a cliff bar that I brought.  Tivy showed me the path we would be taking on a large stone map.  It was a 3 km hike that was supposed to take no longer than four hours.  He expected us to finish in two.  On any other day, I suspect he would have been right on the mark.

The first kilometer consisted mainly of walking through the woods, descending into the rock maze that erosion had carved out in the bowels of the tsingy, and then pushing through an extended (and narrow) cave to the base of the true tsingy.  I found myself sweating profusely not even halfway through that first section, but I chalked it up to the heat and exerting myself too hard when I had eaten so little.  After asking for a break, I felt good enough to continue and shrugged off my condition.

The maze was incredible.  We must have been 50 meters below the tops of the rocks, walking through abnormally shaped passages created by Mother Nature herself.  The system of ladders and make-shift rock footholds we used to go up and down the maze were a ton of fun.  The cave was also cool (both figuratively and literally), but by the time we reached the end of it, I was feeling bad again and took another break.  This time, however, I didn't feel fully recovered when I started back up.  I also couldn't bear to eat any more of my cliff bar because my mouth was too dry.

As we started through our final section of forest before we hit the first climb up the tsingy, Tivy spotted a troop of at least eight or nine red-fronted brown lemurs.  They were on a mission to do...something.  I used the lemurs as an excuse to take another break in the hopes of regaining my strength, taking a few minutes to snap some pictures of them leaping from tree to tree and playing with each other.  Then it was time for the climb.

I took a few big gulps of water, clipped myself into the safety lines provided on these sections, and followed Tivy up the side of a 50 meter rock face, taking each step with care.  About halfway up, I lost my strength and tried to catch my breath.  After a few minutes of waiting, Tivy said that there were other groups behind us and that if I needed a rest, we needed to back down to the base.  As I started my descent, I felt it coming and quickened my pace in a panic, only just making it to a ledge out of the way of the trail before I lost what should have been my breakfast, but in reality was only neon-yellow water.  Tivy and Mark were very understanding  and helpful, dousing me in cold water and giving me as much time as I needed.  They asked if I wanted to turn back, but I insisted that I would be ok and wanted to move forward.  After all, when in my life will I ever be back here?

Fifteen minutes later, after I had obviously emptied my stomach, I said that I was ready to go.  Mark kindly offered to carry my backpack, and I started the ascent again.  This time, with significant effort, I made it to the top!  But it took everything out of me.  I had to break at the top, under the shade of a rock for quite some time and had to admit to myself, and Tivy and Mark, that I couldn't go on.  Tivy took me up the additional 15 feet to the viewpoint so I could at least see what the climb was all about. It was incredible!  Unfortunately, being in the hot sun exasperated my illness and made me very faint, so I had to back down right after Tivy pointed out a Decken's Sifaka way in the distance.  I was even too faint to ask Tivy to take a picture of me in front of the tsingy.

The descent was not fun.  We took it slow and Tivy made a point to clip me in and out of all of the safety lines as Mark carried my gear.  Luckily, Tivy knew a shortcut that allowed us to circumvent the maze and take a pretty easy walk through the forest.  Though, it was still long and wore me out more than it should have.  Back at the car, they put me in the front seat and laid it all the way back for the drive to the hotel.  As the day progressed, I felt worse and worse.

By the time I made it to the hotel, I felt like death.  I found Kati relazing by the pool, explained why I was back early, and plodded off to the room to lay down.  Not long after, Mark came to talk to Kati, very concerned about me and what disease I had contracted.  He insisted that I be tested for malaria, so the three of them loaded me into the car and drove me into town to see a Malagasy doctor.  The office was like many Malagasy buildings and not necessarily clean or sterile, but the doctor pulled out an official WHO-issued malaria test (scary that I know what those look like).  She spoke only French, and Mark's English, while good, does not extend to medical issues, so the language barrier was difficult.

The Doctor's Office

The general consensus was that I was very sick because she had to prick my finger three times just to get enough blood for the test.  Luckily, the test came back negative.  I told them that it would, because we had only been in the country for six days and it takes at least seven days after being infected for malaria to manifest.  The doctor ultimately gave us a number of medications that she insisted we take and charged us 50,000 ariary (~$15.38).  It's ridiculous that a doctor visit, anti-malarial test, and medications cost less than my copay to see a doctor in the US!  And, she called Mark on our drive back to suggest adding an antibiotic, which Mark just picked up at the pharmacy without any prescription or anything.  Still, we had no idea what the meds were, or any side effects or risks.  Luckily, we have a top-notch pharmacist on call.  Dr. Powell gave us all of the information we needed and told Kati exactly what I needed to do.

The remainder of the day was a painful blur.  I ate nothing.  I drank my body weight in fluids, but lost all of it almost immediately, either through sweat or otherwise.  Staring down the face of a 12-hour trip back to Morondava along a bumpy dirt road the next day was unpleasant at best.  Yet, if we didn't make it to Morondava in time for our flight on October 9, we would be stuck here for three or four more days.