F*$#(ing pissed off!

I have had it. Today has gone to shit. I am sick of sitting around in airports. I was supposed to fly to Banda Aceh today, and booked it way ahead of time, Tuesday last week – leaving it with our admin person in BA to sort out. So I went off to Salang, and was away for the whole week. Got back about 6:30 Friday night.

But apparently our admin person didn’t get the email (although its in my Sent Items) and so it wasn’t organised. So after going into the office on Saturday and just checking to see if it had been confirmed, and it wasn’t, I tried to reach her – and couldn’t until Sunday afternoon – and by then the UN flight was full, as was the Garuda Indonesia flight from Medan to BA. So they had to do a rushed ticket purchase of the only available flight – Simeulue to Medan – on Sunday. The plan was then to rock up at the Garuda counter (and if they were still full, then try other airlines) in Medan and try and get a ticket.

So that’s what I did. I arrived in Medan at 9am, and have been sitting around trying to get a ticket all day. It’s now 1:45pm. And I had to fork out over 1 million Rupiah to a tout who probably took a massive commission, but it’s the only way I seem to be able to organise a ticket. The normal price is only 500,000 Rp. And the final straw is that I don’t board the f#&$ing plane until 4:30pm!

I think I’m destined never to attend one of these WatSanTechnical Group meetings in BA, the reason I’m trying to get there. The last two meetings, which are a month apart, there were problems with planes not flying. This time we’ve got an incompetent admin assistant.

Anyway.

So we’ll see how much longer my computer battery lasts. I feel like just catching the next plane home. It’s so bloody frustrating.

Apart from all of THAT SHIT, I am actually enjoying being back. On the weekend, Paul (my boss) and I went for a mammoth 4.5 hour mountain bike ride around the island – and I can tell you, this place is NOT flat!!! So many steep hills, and with dirt roads laden with trucks, bulldozers, buffalo, cows, people and motorbikes, it makes for an interesting trek. I guess now I definitely know that I am not fit. I was walking up most of those damn hills! But it was great fun. About an hour before we got back (after getting a bit lost trying to do a round trip and instead turning around and going back the way we came!) it started raining, so it ended up being very muddy. I was covered from head to toe in the stuff, not to mention the bike I was riding! We got laughed at all the way home. I don’t think it is used to being taken off road – it was pretty clean before I got my hands on it, and the gears weren’t very good – they were really difficult to change when your hands are slippery (instead of the ones you ‘click’ up or down a gear, you turn a piece of rubber that is attached around your handlebars…blergh), which isn’t good when you’re trying to change gears quickly going up hills!

So after completely dying, I went home and slept! Early Sunday morning I went for a kayak on Sinabang Bay, which was great. It’s really beautiful, there are lots of little bays and islands to cruise around, and a few ships to check out in the harbour. Unfortunately there is a bunch of rubbish in the water, which is really sad, and I only saw one fish, so I’m not sure how clean the water is! But you can see where the tsunami came through. Usually there would be mangroves growing along the shoreline, and they are absent in most places. But it was a pleasant two hour trip, waving and yelling out to the local fishermen who are cruising around, following the coastline, checking out the little islands. It was really nice.

I also took a drive around the coast to Simeulue Resort, aka Willie's, which is accommodation for surfers about 20 mins away on a terrible pot-holed road. I was picking up a surfboard for a friend in BA. The woman that runs Willie's, Nina (his wife), is lovely. The resort is a beautiful wooden 2-storey place overlooking a nice bay, and is a relaxing place to hang out.

If I ever make it back to Sim (although it seems a hell of a lot easier to get there than to leave it!), I am going straight to Salang on Wednesday after I get back, as Japanese Red Cross is holding a Red Cross festival there all week, where they are handing over their housing and health centre projects. So they’ve invited a heap of JRC bigwigs, Head of Indonesian RC and other NGOs on the island. Should be fun.

Ahh I’ve had enough of typing. I’m getting out of this smoky café (although the mie goreng was great) and paying my $10 to sit out the rest of my waiting time in the rich people's lounge. Only 2.5 hours to go. Hoorah.

Dinghy fever for dummies (ie me!)

For those wanting to know specifics of this bloody dengue business:

Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics, with a geographical spread similar to malaria. Dengue is transmitted to humans by the Aedes aegypti (rarely Aedes albopictus) mosquito, which feeds during the day.

Signs and symptoms
* A sudden onset of fever, with severe headache, muscle and joint pains (myalgias and arthralgias - severe pain gives it the name break-bone fever or bonecrusher disease)

* Rashes; the dengue rash is characteristically bright red petechia and usually appears first on the lower limbs and the chest - in some patients, it spreads to cover most of the body.

* There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting or diarrhea.

Some cases develop much milder symptoms, when no rash is present, be misdiagnosed as influenza or other viral infection. Thus, travelers from tropical areas may inadvertently pass on dengue in their home countries, having not been properly diagnosed at the height of their illness. Patients with dengue can only pass on the infection through mosquitoes or blood products while they are still febrile.

The classic dengue fever lasts about six to seven days, with a smaller peak of fever at the trailing end of the fever (the so-called "biphasic pattern"). Clinically, the platelet count will drop until the patient's temperature is normal.

Diagnosis

The diagnosis of dengue is usually made clinically. The classic picture is high fever with no localising source of infection, a petechial rash with thrombocytopenia and relative leukopenia.

There exists a WHO definition of dengue haemorrhagic fever that has been in use since 1975; all four criteria must be fulfilled:

* Fever

* Haemorrhagic tendency (positive tourniquet test, spontaneous bruising, bleeding from mucosa, gingiva, injection sites, etc.; vomiting blood, or bloody diarrhea)

* Thrombocytopaenia (<100,000 platelets per mm³ or estimated as less than 3 platelets per high power field)

* Evidence of plasma leakage (hematocrit more than 20% higher than expected, or drop in haematocrit of 20% or more from baseline following IV fluid, pleural effusion, ascites, hypoproteinaemia)

Dengue shock syndrome is defined as dengue haemorrhagic fever plus:

* Weak rapid pulse,

* Narrow pulse pressure (less than 20 mm Hg)

or,

* Hypotension for age;

* Cold, clammy skin and restlessness.

* Treatment

Increased oral fluid intake is recommended to prevent dehydration. If the patient is unable to maintain oral intake, supplementation with intravenous fluids may be necessary to prevent dehydration and significant hemoconcentration. A platelet transfusion is rarely indicated if the platelet level drops significantly (below 20,000) or if there is significant bleeding.

The presence of melena may indicate internal gastrointestinal bleeding requiring platelet and/or red blood cell transfusion.

It is very important to avoid Aspirin and non-steroidal anti-inflammatory medications. These drugs are often used to treat pain and fever, but in this case, they may actually aggravate the bleeding tendency associated with some of these infections. If dengue is suspected, patients should receive instead acetaminophen preparations to deal with these symptoms

Prevention

1. Mosquito control
* Eliminating or reducing the mosquito vector for dengue.

* Public spraying for mosquitoes is the most important aspect of this vector.

* Application of larvicides such as Abate® to standing water is more effective in the long term control of mosquitoes.

* Initiatives to eradicate pools of standing water (such as in flowerpots) have proven useful in controlling mosquito-borne diseases.

Promising new techniques have been recently reported from Oxford University on rendering the Aedes mosquito pest sterile.

Recently, researchers at the Federal University of Minas Gerais, in Brazil, have developed an world awarded new technology to monitor and control the mosquito, using traps, chemical attractants, handheld computers and GPS georeferenced maps. The MI Dengue system can show precisely where the mosquitoes are inside the urban area, in a very short period of time.

2. Personal protection
Personal prevention consists of the use of mosquito nets, repellents containing NNDB or DEET, cover exposed skin, use DEET-impregnated bednets, and avoiding endemic areas. This is also important for malaria prevention.

Finally, back in Indo.

Well. Wasn't that a fun little jaunt back to Australia?

I have to say, I don't really think I needed that long to R&R from dengue fever, but I'm not complaining - the last month or so back in Radelaide has been great. While I haven't done a lot, went insane due to lack of exercise, and was pretty bored during the week when everyone was at work, it has been great.

It was a nice time to be back in Radelaide too - the weather was great, and lots of things have been happening: My boss from my life at DWLBC had his first child; I watched the AFL Grand Final (sucked in Port Power!) and the Rugby World Cup; I went to visit my parents back at home in Jamestown; and I got to catch up with a whole bunch of people that realy I miss while I'm here in Indo. Not to mention downing a few Pale Ales to make up for lost time :)

Some f&%#ing w&$#er stole my bag while I was out at Mojo's one night, so I no longer had a phone, keys or anything of value from my wallet. I think the most annoying part was the loss of my keys, which meant I couldn't lock up my bike, which is normally my main mode of transport. So it was on to the bus I went. Good for reading or listening to music, but no form of exercise and not half as enjoyable!

And THEN, a blood test at the travel doctor revealed something very curious: apparently I didn't have dengue fever at all. I had dengue antibodies from a past occurrence (news to me! it must have been VERY mild as I have never suffered symptoms of dengue), but it was another mysterious virus, not dengue, that had me in hospital on a drip. To be honest, I didn't believe it. All the classic symptoms were there. I would think that Jakarta would deal with dengue cases a hell of a lot more than Radelaide. So I'm sticking with the Indonesians on this one.

Anyway, seems like it was much easier to get out of Jakarta than it was to get back here! Firstly, Aust Red Cross booked me a return ticket from Jakarta, so I had to go back through it - when normally I would fly directly to Singapore from Radelaide and then to Medan. Plus, being the end of Ramadan (Idul Fitri), and everyone on holidays, I had to go to Banda Aceh because no-one was working in the Simeulue office; yet the expats are working in the BA office 17-19 Oct. So here I am. And annoyingly, instead of booking me on a flight from Jakarta to Banda Aceh (a direct flight) they booked me in at a hotel in Medan for a night and then a flight the next day to BA, when the same flight continued on. It would have saved them the cost of a night's accommodation, and me another leg of the journey and f$*#ing around in airports. Stupid. Not sure why the Melbourne office is so illogical. Adding insult to injury I now have to fly back to Medan to go to Simeulue, because to get back before Monday, I have to fly with Susi Air (which only flies from Medan); the UN planes b/t BA and Simeulue don't resume til Monday due to Idul Fitri. So ANOTHER two flights to go on Fri and Sat, before I even get to Sim. Bloody hell!!!

Ok, enough complaining. I'm back. Finally. And it has been a cruisey few days in hotels, even if the airport thing is a pain in the ass. And today after 'work' - which entailed a few hours in the office catching up with the other expats here - we went to the 'cement factory beach' (so called because of the massive, ugly cement factory built right on the beach there! boo!!!) for a surf. I can't surf to save myself, but I was out there giving it a go. It was pretty hard work, but nice to get out amongst it, and also to get some bloody exercise! I'm looking forward to that part now that I'm well enough. Feeling pretty knackered tonight though, I can tell you!

Scarily enough 5 Indonesians died at that beach last week. The current, waves and rips are quite strong and unpredictable, especially since the tsunami so I've been told, and it's hard work swimming there. When we first went out I got dragged a fair way on my board and ended up barreling straight towards the rusted out hull of an old tanker shipwrecked there. Not somewhere I'd like to be, to be honest. Managed to avoid that obstacle and get back on the beach, so we moved further up. Still got pounded by those waves. They're dumpers!

So, will see how things go at work next week. Looking forward to arriving in Sim, and getting back into it.

Dinghy fever

ok. So I had dinghy fever. All I felt like doing was fishing all day. Har Har! Well, kinda - I feel like sleeping. Apparently that's how you're supposed to feel after getting dengue.

Seriously, all the crap I had to go through with this bloody dengue fever. Stupid mosquitoes! What I can't work out is how the little bugger managed to bite me - dengue-carrying mozzies apparently come during the day (malaria-carrying ones come at dawn and dusk). They do like my blood though. A lot. I am always covered in bites.

Let's start from the very beginning, a very good place to start.... well my last post was actually the beginning. The results of the second blood test showed no malaria, which was good, but what was actually wrong with me?

Still feeling shite, went and slept at home, and then with my temperature fluctuating left right and centre and achy muscles continuing, they decided that I needed proper medical care and so put me on a plane to Jakarta. Flying business class for the first time would have been way better if I could enjoy it! D'oh! Oh well. Garuda's business class wasn't that different from the economy anyway :(

So, straight to the emergency department at the hospital in Jakarta and straight onto a drip. The doctor took one look at my results and other symptoms I'd developed since then and said, quite matter-of-factly, 'you've got dengue fever.'

Thank goodness my colleague Sue was with me, she was great. Not that the hospital staff didn't look after me, in fact they were great too, but it was nice to have someone there who was an Aussie, and great company. Not to mention willing to get me nice food and drinks and chocolate! Sushi beats hospital food hands down any day.

Well, being on a drip for 4 days was kinda boring. And a pain in the ass to try and carry the drip around everywhere. My one foray down to the cafe (in order to break the boredom of lying around in the same room/bed all day and night) was an adventure in itself ... everyone had a good stare at the bule (foreigner), plus getting myself + drip in between all the tables in the cafe was fun ... I made people get up and rearrange themselves.. hehe! I should have got myself one of those white gowns and had my ass hanging out the back, that would have been more authentic! :)

Anyway, a hundred blood pressure, temperature and blood tests later, I was finally discharged on Saturday night, once my platelet numbers had reached the safe level of 100,000 (in fact I made it to 101,000). It had got down to around 50,000 (the normal level is 150-400,000) which meant I managed to avoid the need to fly to Singapore for a blood transfusion. Hoorah! So they put me up in the flashy Park Lane Hotel where I could relax by the pool :) A couple of days later another blood test saw my platelet levels at 213,000 so I was ready to get out of there - on a plane straight home to recover.

So now I'm just enjoying being home, it's almost like a holiday... apart from the fact I feel tired. All day.

So who knows when I'll go back to Simeulue. Maybe in a couple of weeks. Think I could scam time enough to see the AFL Grand Final? I'll work on it.