The Essential and Exquisite Pleasure of Pissing

The shortest day of the year is nearly upon us – 21st June marks the middle of Winter, and another excuse to celebrate at the Yacht Club. So far we have celebrated quite a few birthdays and a batch of Wednesdays. Wednesdays deserve a celebration because they come after Monday and Tuesday, and the kitchen is closed on those days.

For me, every day is a celebration. Since my triple-whammy of two malaria strains at once followed by prostatitis I've found life is pretty good now that I can piss more-or-less normally again! I came down with a dramatic fever and chills a few weeks after returning from Australia. Fever, chills, and a universal body-ache are distinctive signs of malaria so my fellow yachties carted me off to the local Aga Khan clinic to get tested. It turned out I had not one but two strains of malaria: falciparum and another strain they couldn't identify. It is not unheard of as having one strain weakens the body's ability to fight off others. My theory is that I picked up the unknown strain in SE Asia. I had a few strange episodes before I left that I put down to 'flu, but in retrospect were clearly relatively mild malaria. I figure that set me up for the big double whammy when I got the falciparum here in Tanzania. Falciparum can be fatal. It can get into the brain and then you've had it.

Fortunately, I am in a place where falciparum is common. That might sound strange but it means that the local medical system is finely tuned to its treatment. The doctor prescribed Lumerax, which is an Artemisinin Combination Therapy (ACT) containing Artemether and Lumefantrine. Malaria treatment is tricky. Some drugs work in some areas and not in others. The plasmodium parasite rapidly acquires immunity to drugs, so it is important to get a drug that works well in the area you are in. That said, Lumerax is a fairly standard prescription for 'uncomplicated malaria', that is, not affecting the brain.

The fever and chills were gone in three days, just as the doctor forecast, but that was just the opener. I was finding it harder and harder to piss. I knew it was prostatitis as I've had it several times before and landed in hospital every time. Finally, I couldn't piss at all. I carry a Foley catheter on the boat for just such an emergency. The doctor had also prescribed Cephalexin, an antibiotic, but it didn't seem to have much effect. I emailed David, my GP in Australia and he suggested Norfloxacin, for which I am eternally grateful. (One of Norfloxacin's long list of possible side-effects is damage to tendons! I seem to have been lucky not to experience any side effects.) Drugs in Tanzania are readily available from a pharmacia without a prescription and Mebs, a club member who owns the International Pharmacy, supplied a large packet for me.

I have now been taking the Norfloxacin for five weeks. It was a week before I could piss without a catheter. That week was the hardest because there was no indication the treatment was working and there was little any doctor or hospital could do that I wasn't already doing.

It was two more weeks before I was sure things were really improving. Trapped on the boat because I had to pee frequently and in intense pain every time I did, things slowly got better. After another week I stopped taking paracetamol and was able to walk into town. The exercise was wonderful but I was so weak it took me two days to recover from the walk!

Five weeks have now passed and I finally feel well again. My fitness is not what it was and my center of gravity has dropped to my belly and bum, but that is something I can correct with time and exercise. The main thing is that my energy has returned and the beautiful cool winter weather helps enormously.

The 'long rains' coincided with my illness and are now over. Days are sunny and clear with a strong southerly day-time breeze blowing 20 knots. The anchorage is protected but when it gets over 20 knots there's a bit of slop. At night the breeze drops to 10 kn or less and the boat is quiet. It is 28°C in the day and 23°C at night. Perfect.

But not everything is as perfect as the Tanga weather: Tanzania is in the vanguard of countries 'returning to normal after Covid-19' but there is no confidence that this is a wise move. You can enter the country today, as a tourist, if you can get here. During the height of the fever international travelers were quarantined, everyone wore a mask, washed hands before entering a building, and kept their distance. All those precautions are now gone and it is business as usual. The problem is simple – there are no figures for coronavirus infection. The early figures were unreliable and so they stopped counting at the end of April. There were 509 cases then and there are 509 cases now, which is clearly wrong. On the other hand, most of those cases were in Dar es Salam, Zanzibar and Arusha – the tourist centers. There are cases here in Tanga but I cannot see any evidence of a crisis. I walk past the Regional Hospital several times a week and there are no rows of coffins – it's the same outside the hospital now as it was when I first arrived in Tanzania. I know that's not very good evidence, and I hear things in the club from medical practitioners but even those with a sense of drama don't give me the impression that there is any sort of crisis. Without figures, who really knows?

Tourism here is opening up again and I am hoping to arrange a few safaris. Safari is a Swahili word that simply means journey. It has become synonymous with mzungu (whites) in Land Cruisers chasing wildebeest, elephants and lions. I am hoping to avoid the prototype and am exploring other possibilities for getting up-close and personal with Africa, while keeping the risk of Covid-19 to a minimum.

But the dilemma is how to combine some tourist travel with the need to see a urologist for some surgical plumbing work. The choices I see are:

• Visit a urologist in Dar es Salam, but I'm reluctant to have surgery there.
• If I had my way I would sail to South Africa for a urologist, but South Africa looks as if their doors will remain closed until next year.
• Another possibility is to sail north thru the Suez Canal and into the Med. Several countries there are accepting yachts, including Italy. But that's a hard journey with some risks attached.
• I could retrace my route to Thailand, who are accepting yachts. This would make it easy to get to Malaysia when they open up, and Penang is famous for its medical tourism industry and the high quality of service. But I am reluctant to retrace my steps and who knows when Malaysia will reopen. I have since heard that Thailand is NOT yet open to yachts. Thanks Ben.
• I could head back to Australia. That's a long and difficult trip and it would be hard to leave Oz again, both for practical and emotional reasons.

Right now, flying is out of the question but if flights restart then other options will present themselves. So, for now it's watch and wait.

The yachties here in Tanga have been massively supportive. They have taken me to the clinic, shopped for me, advised me, listened to me, and never hestitated to help. I needed them and they were there. I am very, very grateful, especially to Karina and Gerhard on Cameron, and Beattie and Ken on Petra.

Life is good so long as you can still piss!