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A friend of mine in Nairobi has Hepatitis A. It's been a bit of a cautionary tale as far as vaccinations are concerned.
She is not the first person I have heard of to have it. In fact a little girl in my youngest daughter's class had it (she recovered quite quickly) and the husband of a friend (he rather shockingly walked around with a stick for ages afterwards). The problem is that the older you are the longer it can take to get over. While a lucky few might have mild or slight symptoms, others can take up to 9 months to get over it - which is most inconvenient for an adult, especially if you are self employed etc.
Another friend had Typhoid about 18 months ago. At this point I marched the entire family down to the clinic and began the process of topping up our vaccinations and diarising boosters.
What happened in this case was that my friend complained of flu like symptoms when I saw her. She was dosing herself up with Cold caps then blaming them when they didn't seem to help. I was sympathetic, but it's funny how you convince yourself that you can self diagnose (especially in this place). She said, 'I think it's this flu thing that is going around. A few people I know have had it.' and I said, 'Oh yes? Poor thing. Hope you get better soon.'
Unbeknownst to me she later progressed to vomiting and diarrhoea while her husband was away travelling. The local surgery diagnosed flu and gave her antibiotic injections. Finally she turned yellow, her husband returned and she eventually got to a hospital. The incubation of the illness can be two to six weeks and the yellowness comes after that.
The way I heard about her plight was that I sent her an sms saying 'can you come to our party? I haven't heard from you yet.' and she replied, 'I've been SOOO ill, I'm in Hospital so probably won't make it!!' Needless to say I felt awful. Especially when she told me about the doctor sending her hoem saying she'll be fine and her 13 year old son who had to cope with a very sick mother and a younger sibling for a whole weekend!
The nasty thing is that there is no treatment for Hep A. Hospital can only give you a drip, make sure you are hydrated and give you plenty of rest. The disease attacks the liver specifically and your body must process the virus on its own. A fecal/oral transmission, it can be passed on through infected water or food - so pretty hard to dodge for even the most conscientious.
About 10 days ago I visited my friend in hospital and she had lost more than 5 kilos. She's a slip of a thing - a rake, one of those annoyingly slim types who never put on weight - so certainly cannot afford to lose any. She's probably lost loads more weight by now. When I popped in to see her at home to drop a ready-cooked meal or two I didn't see her, she was sleeping. Her recovery involves one month bed rest, a totally non-fat diet (how will she ever put the weight back on?) and no alcohol for at least 6 months. I have heard that milk thistle tablets are a good herbal/healing treatment for the liver.
All this can be avoided by a vaccination. The first covers you for four to six weeks, then the second booster given between 6 months to within one year will cover you for up to twenty years. The problem is that many people get the first jab then forget to go for the second. That happened to me when I first arrived in East Africa. Every time I was due for the booster I seemed to be pregnant, so put it off.
My friend's husband says today that she is recovering.... slowly. On the upside, I had a flash of inspiration and recommended the fabulous cook, Phillip, who turned up at my gate just before Christmas (see previous post). As chance would have it he rang me again yesterday - so I've passed on his details to my friend's husband and fingers crossed he will have a bit of work and also help them out of a tight spot. The problem is that my friend is a bit of a domestic goddess and so no one else in the house has a clue (or has ever really needed to know) how to cook.
I was telling Florence who works in our house all about Hep A and she said she wasn't vaccinated. I told her to visit a doctor or clinic and get the jab, but it turned out to be unavailable at the Kenyatta National Hospital and hugely expensive at the private clinics I know. In the end she rang me while I was away and I advised her to go ahead and got the first injection (Hep B was rolled in too) from a private clinic at the cost of 4,000 shillings! How could I quibble? I will need to go there and settle the bill in due course, which (to be brutally honest) is a little hard to swallow coming so swiftly after handing over said employee a sizeable loan - but there we go.
She also told me today about her brother who is a trained accountant with a degree who has been out of work for ages and is desperate enough to be looking for any kind of job now -messenger....anything. Living here it's like one step forward, two steps back....