So, Suriname. Travel. Far from home where I don’t exactly speak the languages, and I have no idea how the health care system works (though I do enjoy a few tours around the odd clinic), and where I’d be several hours (at least) from a city for part of the time. What’s a girl to do? A girl is to read the CDC page to get an idea of what they recommend, and then, if that girl is in Santiago, book an appointment with a travel specialist doctor at the Clinica Santa María.
And so I did. I got there, he asked me where I was going, I told him, he asked why, what I do for a living and then he got on the interwebs. Probably looking at the CDC page.
He said: Tetanus
I said: Got it
He said: Yellow Fever
I said: Got it
He said: MMR
I said: Got it
He said: Hep A
I said: Got it
He said: Hep B
I said: Hmmm
He said: To late for Hep B now, it’s 180 days to efficacy (must follow up on that)
He said: Typhoid
I said: I need that one
Then I said: I’ve also had the rabies vaccine, and he said, “why?” and I said, “I was recently bitten by a dog” and he said, “you do have an adventurous life, don’t you” And I said, “That was in Santiago.”
He then proceeded to prescribe me allergy meds in the case of a severe allergic reaction to something, abx for skin infection, abx for stomach woes or a UTI, and a very, very expensive malaria medicine called Malarone, which, given the choice between paying for the expensive malaria medicine and having a lifetime of protazoa swimming around in my blood, sickening me routinely and swelling my brain or causing me to bleed out of every orifice, bring on the Malarone! These items, along with stomach meds, I dutifully packed into a little zippy pouch which in the end had:
Ciproflaxin (vomiting, diarrhea that lasts a long time, UTI)
Cefadroxilo (skin infection, and I think this is what I got when I got a skin infection in Bolivia a few years ago, after I had that great night of vomiting on New Year’s eve, because apparently, my body doesn’t like altitude.)
Rigotax (Cetirizina diclorhidrato, for severe allergic reaction)
Immodium (brought my mom for the Peru trip, this is for diarrhea)
Pepto Bismol (same as above, milder, and not sold in Chile)
Not everyone who goes to Suriname takes malaria medicine. There are no or few reported cases of malaria in Paramaribo, and it has been mostly eradicated along some, but not all of the rivers. However, there used to be as many as 9,000 cases a year as recently as ten years ago, and recent years have dropped to only 700 cases. But French Guiana, which is just across the border, seems to be the malaria leader on the continent, and then I met this guy studying to be a doctor in Guyana (across the other border), and he seemed to think prophylaxis is wise in the region (and has more contact with the general area than my Santiago doctor, who also recommended it to me), so I opened wide, ate breakfast and killed any potential protozoa colonies before they had a chance to get started.
While I was in Suriname, it was announced that they were on the brink of a dengue epidemic. I saw this in the newspaper, and though I don’t speak Dutch, I do speak medi-geek, and was able to discern that it was a growing concern. Dengue is also transmitted by mosquitoes (though not the same mosquitos as transmit malaria, there must be union rules about this, they even bite at different times of the day, dengue mozzies are day laborers). There is no prevention or treatment for dengue, so mostly I ran around in circles and swatted wildly at mosquitoes and used Deet when it seemed prudent. The incubation period is 3-14 days, so hopefully I will not be reporting from my terrarium in the sky (east facing windows, man is it hot in Santiago right now) any time soon that I believe myself to have contracted dengue fever.
More Meds, More Biting
As for the other meds, they sat untouched in my zippy pouch. I hesitated to write about it at the time, but I never, not once got any kind of sick in Suriname. Not a headache, not a fever. I got some insect bites, and they were itchy, but I don’t blow up into a red-blotched, strawberry-in-negative person with mosquito bites. Of all the places I was, the mosquitoes were worst in Nickerie (near the Guyana border), and I may actually have sprayed my bedsheets with deet before getting in one night. This is the rice-growing area, and it has still water everywhere, both in canals and rice paddies. Mosquito heaven! Bigi Pan was also good for getting bitten by angry, giant mosquitoes that looked you dead in the eye and dared you to slap them, before lancing you (which actually hurt) , and I may also have gotten my feet fire-ant bitten a bit waiting for the boat. More on that later.
In Paramaribo I drank tap water the whole time I was there, and in Nickerie I drank bottled, because I hadn’t researched if I could or couldn’t drink the tap water, and I was only there for two days. I did use a coffee cup that I know was washed in a lake, but suffered no ill effects, aside from the fact that the coffee itself was some Nescafé imposter together with Coffee-mate, which hurt every tastebud in my body. Down in the interior I drank rainwater from a variety of sources, and felt no dodgy stomach, no unexpected effects, nothing. Locals brush their teeth and wash their dishes in the river. I am not sure where our dishes were washed, but I did not brush my teeth (though I did bathe) in the river.
I ate whatever appealed to me, including some bami (indonesian noodles) that had been sitting at a street stall for far too many hours, and later, what became known as the “dreaded bakebana” which is a batter-dipped and fried piece of plantain, from the same stall. I think I can safely say that unless you are a very delicate flower, regular caution should suffice to keep you feeling impeque (Chilean slang for impeccable, or great) For example, I didn’t try any of the syrup-sitting fruits or the corn on the cob bobbing in water in the hot sun, (pictures soon) but I did have a shaved ice (almond and ginger flavors), in Paramaribo on the street from a Guyanese guy named Khan (who I later ran into at a fair several km away with his lovely wife) and nothing interesting at all happened, stomach-wise, but great refreshement was had with the schaafijs (shaved ice).
There are some other unfortunate parasites and river ills and whatnot that you can catch deeper into the jungle, but my doctor seemed unconcerned, I didn’t go any of those places, and no other travelers seemed vexed by anything other than the red splotches and oh, the equatorial sun. My zippy pouch remains packed for the next upcoming trip. Where to next? Bring on the tropics!