Water, Water Everywhere, But not Enough to Drink!
I just lay there as more of the day passed by. I tried to get out of bed a couple of times. I'd make it up, then see Kavitha and Monica still dozing, and lay back down. I felt pathetic. I wasn't sick, and we had gotten plenty of sleep that night, but we just couldn't seem to get up.
"I really wish I was inspired to write my dispatch," Kavitha mumbled.
"You really wish Spiderman would write your dispatch?" Monica misheard her, actually taking the energy to roll over and look her way, confused.
"Ok, you guys, I think we're all starting to lose it." I said. "Yesterday I asked Kevin if he had a comb I could borrow. He looked at me like I was crazy, running his hand over his shaved head. And have you noticed that we all keep forgetting simple things, and we can't motivate to do anything? To top it off, last night I woke up with the most excruciating muscle cramps in both my calves. These are all signs that we're seriously dehydrated. It's time for action." I waited. Nobody moved. "Anyone?" Monica rolled back over with a sigh.
At that point we'd only been in Mali for a few days, and the heat was killing us. During the day, sweat poured down my face and back just sitting still! I've experienced mild dehydration before, but this was bad. The signs were clear; we were all spacey, tired, and uncoordinated. I had muscle cramps, and had completely lost my appetite. The entire team was obviously suffering from heat exhaustion. I don't know why I hadn't recognized it earlier.
Fortunately the pharmacy was just a few doors down. "Rehydration?" I asked in English,
since the word wasn't in my French-English dictionary. "Cel pour hydration? Electrolytes?"
Amazingly, the pharmacist understood this crazy looking woman muttering in half French, half English, and he produced small packets of rehydration salts. I bought ten bags of salts and five bottles of water, and carried them back to the hotel. Each trekker was handed a bottle of water mixed with one rehydration packet, and told to drink the whole thing, slowly, before noon. Since then, everyone has been carrying these packets around with them, using them whenever they've been sweating a lot, and remembering to drink lots of fluids and eat salty foods.. It has really helped...even though the heat still makes me lazy!
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Sweat is made up primarily of water and some electrolytes--particularly sodium and chloride (if you failed Chemistry, just remember that salt is NaCl--sodium chloride). On hot days like the ones we've been experiencing here in Mali, we can easily loose 8-10 liters of water. Picture yourself drinking four or five two liter bottles full of water in one day! It's not easy! Luckily, fruits are another good way to get fluids. Mali is good for mangos and pineapples, and sometimes we even find a coconut vendor. The water inside a coconut is tasty, safe, and good for digestion. I've even heard that it's anti-malarial!
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Even if you do take in enough fluids to make up for the loss, the symptoms of heat exhaustion are primarily caused by the loss of electrolytes. You can't just take salt or salt tablets directly, either. Your body will try to dilute it by sending lots of water to your stomach, and then less water will circulate in your blood to help keep you cool-which leads to sweating, which leads to dehydration, etc. So you have to drink the electrolytes slowly but continuously, with lots of liquids. I wish we could buy sports drinks like Gatorade around here, because these rehydration salts taste awful!
Fortunately, our situation only reached the level of heat exhaustion. Even though it's unpleasant, it's easily reversible. If we hadn't dealt with it, though, and spent another day walking through the streets of Bamako, it could have gotten much worse. The next stage of heat and dehydration illness is called heat stroke, which is a life-threatening emergency.
Right now, the air in Mali is very humid, so sweat doesn't evaporate well, and therefore doesn't cool us. Being dehydrated makes your body less able to thermoregulate (regulate your temperature), so heat stroke can be avoided by drinking lots of fluids before the problem starts. If our natural cooling mechanism fails, the core temperature of our bodies rises rapidly. For people doing exercise on hot days, death can occur in as little as 30 minutes after the first signs of heat stroke appear!
Brains only function within a narrow temperature range, and outside of that, they begin to fail (tell that to your teachers next time your classroom is too hot or cold!). Classic signs of heat stroke include becoming disoriented, combative, argumentative, or even hallucinatory. In order to lower the core temperature, your body dilates all the blood vessels in the skin, to force hot blood away from the core. For people in the first stages of heat stroke, the skin becomes RED and HOT, but may still be WET. In more advanced cases, the body has no more water sweat and I guess it just gives up. That's the most dangerous, when a person is dry and pale.
In either case, if you ever see someone displaying heat stroke symptoms, get them to a hospital immediately. You can try to cool them while waiting for the ambulance by submerging them in cool water, but, no matter what, get them to a hospital, where they can be rehydrated with an iv.
The better option is, of course, to drink plenty of liquids and avoid the hot sun... It's a great excuse for us to sit around all afternoon!
Kevin and Jasmine found out that salt used to be traded by the trans-Saharan traders in Timbuktu pound for pound for gold! When I first heard that, I was amazed. But now I think about how miserable we all were when we had lost so much salt through sweating. The people who lived here may have looked good in gold, but without salt in such a hot climate, they would have been physically ill all the time! They never would have gotten out of bed to show off their fancy jewelry!
Another problem with keeping hydrated while traveling is that we have to be very careful about the water we drink. Even though the locals drink out of wells and the tap, it's dangerous for us to do the same. Our immune systems aren't used to the micro-organisms that live in their water supply. Drinking unsafe water could give us any number of icky gut bugs, and leave us with horrible diarrhea or vomiting! I don't even like to think about it! You can loose up to 25 liters of water a day having diarrhea.
Bottled water is expensive, though, and harder to find than the local Malian drinks. Mali has great ginger and hibiscus drinks, for example, that people make in their homes and then sell, cold, in a plastic bag on the street for 50 CFA's (about 10 US cents). I must admit that I've been drinking them a lot. When I'm really hot and thirsty, I've been choosing the immediate gratification of a cool, tasty treat--despite the threat of severe illness in a few hours. It's probably stupid, but I justify my actions by telling myself that what doesn't kill me can only make me stronger.
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Don't remind me of that when I have raging diarrhea, please.
p.s. - Please e-mail me at ...email@example.com
Abeja - Abeja gets M.A.D. - She's Making a Difference!
Jasmine - Not-So-Renewable Resources
Kevin - Beam Me Up, Scotty! Life in Mali
Monica - Corps des Volontaires Maliens: Young People Make a Difference
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