Five $37 injection fees later...

“There is a general threat from terrorism in Uganda. Attacks could be indiscriminate. Places known to be terrorist targets include places of worship, clubs, hotels, restaurants, airports, and marketplaces.”

TRAVAX® Traveler Health Report (2/15/12)

***

“The lazy person claims, “There’s a lion out there!
If I go outside, I might be killed!” Proverbs 22:13, NLT (1^st Millennium B.C.)

Last Thursday, I sat in a small room at the Mayo's Travel Clinic in Eau Claire while a nurse walked me through all the vaccinations they recommend for those like myself who are intent on traveling to Africa. The only one that is really required as far as the U.S. government is concerned is the yellow fever vaccine. I can't get in (or is it out?) of Uganda without an official stamp on my International Certificate of Vaccination (otherwise known as the “yellow health card” because...er...it's yellow.) The only way to get yellow fever is to be bit by an infected mosquito (why don't they get the vaccination, then?) You can't catch it from a fellow human. If you are so unlucky to contract the disease you'll probably end up in a hospital suffering from fever (duh), flu-like symptoms, jaundice, bleeding from multiple body sites, organ failure and in 20-50% of the serious cases, you could die. So, it's good not to get bit by a nasty, sick little skeeter. She also showed me a map where in Uganda you are likely to contract yellow fever. It was all of it. I suddenly felt like one of those hired hands in The Cider House Rules who after hearing Homer recite the rules about not going up on the roof, or eating on the roof or sleeping on the roof replies to no one in particular, “Why don't they just say 'Stay off the dang roof?'” In other words, the best way to insure against getting yellow fever is, frankly, not to go to Uganda (or so she made me feel.)

If you don't want to get yellow fever, don't go to the places in yellow

But that vaccination was just the tip of the iceberg of several others they recommend for travelers bound for Central Africa. Hepatitis A, Typhoid, Hepatitis B, Rabies, Meningococcal meningitis, Cholera, Influenza, Tetanus/diptheria/pertussis, Measles/mumps/rubella, and last, but not least, polio – all of these vaccines fill the 10-page packet that she handed to me. Oh and one thing more – how could I forget? - you need pills to ward off malaria which you could get in either the “Cadillac”-version, “mid-range” or “bargain basement” variety. She was adamant that I should avoid being bit by any animal while there because more than likely I would have to fly up to Europe to get treated as apparently nobody in all of Uganda is able to deal with that contingency (I'm pretty sure that's not on our agenda.) And finally, she asked me if I had ever heard of Ebola. I wanted to say, “Well, I've seen the movie Outbreak. Does that count?” but all I ended up saying was, “Yes, I've heard of Ebola.” “Well, I just want to remind you that its 100% fatal.” Yes, I get it. If I still have any courage to get on that plane and fly to Africa, like the show on cable tv there are probably a thousand ways to die there and all of them nasty.

I'm not planning on petting any stray monkeys

I asked her if I could call Randy, our team leader, to see what he and his wife, Renee, ended up getting when they sat in one of these little rooms the week before. “Absolutely,” she said as she stepped out to tend to other business. I got a hold of Randy and he chuckled a bit as he ran down the list that they got. “Our insurance will pick up a lot of it,” he remarked. Now, our family is on Badger Care, the state-run health insurance program, and while I had my suspicions that nothing I was about to submit to would be covered I called them anyway. “Is this for your job or something?” the nice lady on the phone asked. “Yes...you could say that,” I replied. She put me on hold – probably so she could laugh for awhile and then regain her composure – and then in a few minutes came back to inform me that none of these shots were covered by our plan. Of course. Where in Wisconsin are you likely to contract yellow fever or malaria anyway?

When the nurse returned I asked her if she could give me a general idea just how much this was going to run me and she very kindly began reciting prices as if she did this every day (and, I suppose, she does): “Yellow Fever. About $100 with a $37 injection fee. Hep A. About $80 with a $37 injection fee. Typhoid...” and on she went quickly adding the note on the $37 injection fee after each price. I felt slight chest pains. Add in $20 for my Wal-Mart variety malaria pills and I'm thinking it would have been better to invest in one of those pharmaceutical companies before I made my appointment at the travel clinic.

After waiting what seemed a long time, the doctor finally came in and began the process all over again of working through the travel packet and slightly applying professional pressure in recommending a whole work-up of vaccinations. “It's good to be prudent especially if you're going to be spending any time with orphans.” Well, I couldn't deny that we plan to spend some time with Ugandan children be they spoken for or not. He then repeated the warning about not getting bit by any stray dog for fear of rabies. While he talked on I suddenly thought of the movie The Pagemaster, one of Macaulay Culkin's lesser known films wherein he plays the little boy, Richard Tyler, who is paralyzed by fear. Where most 10-year old boys might be able to rattle off the stats of their favorite quarterback, Richard can just as easily tell you the statistical probability of getting seriously injured from any variety of household accidents (like falling from a tree house.) When he is forced to go to the hardware store to pick up some nails for his dad, he rides his bike there which looks like a mini-version of one of those heavily armored Strykers that our boys drove all over Iraq. He is ready for anything be it earthquake or solar eclipse. So as the doc continued to work through the travel packet and I seemed to balk at a certain vaccine he was quick to underscore what could happen to me should I be so foolish not to take what to him were prudent precautions.

Richard Tyler's Mini-Stryker

When he was through, he looked at me, shook my hand and said, “Well, good luck and have a good trip” and then left and shortly afterward the nurse returned with her clipboard and began filling out my vaccine cocktail as if the matter was concluded. I realize it's their job to alert travelers what they may run into “over there” but that moment brought to mind a similar moment back in 1985 when I was still in Bible college. On a bitterly cold winter day my Chevette had overheated and I ended up cracking the block. Under the suggestion of my future brother-in-law, I had it towed to Wheeling Auto Clinic. It turned out to be a real shady place. (When the mechanic is a guy whose shirt is open to his belly, has a match sticking out of the corner of his mouth and in the heart of February wears aviator sunglasses, I should have known better than to trust my business to him.) But he assured me that it was a relatively easy fix but every few days when I called he had found something new that needed fixing. When I finally raised my voice a bit and suggested that maybe I should simply have it taken to another place he said, “Fine. Your engine is all over my shop floor. When do you want to pick it up?” He had me over a barrel. The only way out was to see the matter through and $700-some dollars later I was driving my little four speed again. That's how I felt looking at the nurse in room #26 last Thursday. She and the doctor had properly conjured enough images of blood coming out of my nostrils and eyesockets that I finally concluded that whereas I don't want to be dead yet and I probably will be going back to Uganda or somewhere else in Africa in the future, the better course of valor was to bend over and let them have at it.

Exactly how I felt

After my order was made up, the nurse left and then a few minutes later another nurse came in with a tray of needles. In the end, I got five vaccines – yellow fever, typhoid, Hep A, meningitis and polio. When I was a kid I had been vaccinated against the measles, when I worked at a daycare in the early 80s I had got chickenpox and I still have a year left on my tetanus. I also received a prescription for malaria pills. Even though I felt I just had been stuck somewhere south around my wallet-region, I got three shots in my right arm and two in the left. Every time she stuck a needle in, in my head I could hear a little cash register go cha-ching and the figure $37 show up. When I jokingly asked if I needed to sign a promissory note of some kind, the nurse laughed in return and said, “No. We'll bill you and you can set up a payment plan. So long as you make your payments it'll be fine but miss one and...well, you know.” Yeah, maybe it would be better to get Ebola.

Well, you know what they say, “In for a penny, in for a pound.” Now that I have been vaccinated against all kinds of diseases I might as well as go. Again, I'm all for wisdom and prudence but I could just as easily step off a curb into Second Street on a busy summer day and become roadkill courtesy of some Illinois driver. I'd be just as dead as if struck down by typhoid – except it would be quicker. If you think about it, every day we take our life into our own hands as we hop into our car and drive off to school or work. Every day lots of potentially cancerous cells flow through our body. And every day, if you live around here, you could slip on the ice, crack open your head, take a very expensive helicopter ride that you'll never remember and acquire a staff infection while you're recovering in the hospital. It's a jungle out there, right? Just like Uganda. So, as far as I'm aware 10 out of 10 people still die. And like Malone in The Untouchables says after seeing the Canadian mounties riding down the hill prematurely before their trap for Capone's men has been properly set, mounts his horse and quips, “Oh, what the he**? You gotta die of something.” I'm hoping it's not from Ebola.

Death by a charge of the RCMPs might be a kinder, gentler way to go...