A Piece of Cake

“It’s uta” Frank said gloomily. Such an innocent, little word. Yet one which every researcher who sets foot in the Peruvian rainforest dreads to hear. We looked in dismay at the ulcer on his wrist. The sinister thing about it was that it had stubbornly refused to heal despite weeks of cleansing and periodically sticking on new plasters. It was actually getting deeper day by day, and it was this that had finally prompted Frank to go the doctor. Now he was back with the verdict.

Uta, or leishmaniasis, is a tropical disease caused by a protozoan which is transmitted by forest dwelling sand flies. If left untreated, a second type of leishmaniasis develops in up to 80 per cent of cases, attacking the mucous membranes around the mouth and nose. The doctor had enthusiastically shared some graphic photographs of the leprous disfigurement that can result, and Frank had immediately headed for the nearest chemist.

The treatment for uta is a form of chemotherapy, involving daily injections of an antimony-based compound for anything up to sixty consecutive days. Side effects include aching joints, a grinding sense of tiredness, and loss of appetite. Also, you can’t drink any alcohol for six months. Since Frank and I were about to embark on a field trip to Manu National Park, in south-eastern Peru, and since a medic would be unavailable for weeks at a time, Frank had stoically accepted that I would be nurse.

I relished this chance to make a true, hard-bitten field ecologist out of me, like the ones you see on TV. I wasn’t going to be tranquillising a cheetah for radio collaring, or darting a charging elephant - nothing as glamorous as that. But even the prospect of injecting Frank every day was exciting.

Though I privately considered it unnecessary, Frank persuaded me that it would be sensible to ask a professional nurse to demonstrate how to get the 15 millilitres of fluid into his bloodstream. The following morning, Frank submitted to his jab from me, under supervision. A piece of cake! We departed for Manu later that day, feeling pleased that we were dealing responsibly with the situation.

On Day 3 we began cheerfully, gradually becoming philosophical - “Obviously yesterday was a fluke, you can’t expect to get it right first time, every time,” - but by the fourth attempt, the strain was becoming apparent on Frank’s averted face. He suffered seven punctures before I finally succeeded with the eighth. There wasn’t much left in the syringe at that stage, most of the liquid having formed telltale lumps under the skin. We consoled each other that this failure was just a one-off but my confidence was badly shaken and that night I lay awake for hours, brooding about what was to come.

I was sweating nervously the next morning. After breakfast, the farce continued. When I bungled my fifth effort, my resolve faltered. I was going to kill Frank, not cure him. Our two Peruvian field assistants hovered in the background, watching us covertly with doubtful expressions. Later, they took Frank aside and worriedly advised him not to continue sleeping in the same tent with me. Didn’t Frank know that that was the surest way to recover from uta? They also counselled treating the wound with battery acid or banana skin pulp to quicken the healing process.

Matters did not improve over the next few days and I began to seriously consider returning to civilisation where I could release myself from this burden. Frank’s arms were beginning to look like he had been mainlining for weeks. But then we met a tourist who happened to mention that he worked in a hospital. I confessed my problems to him and he told me that it was just a question of getting the knack, a comment I viewed with a degree of cynicism. Watching my technique, he showed me how to push the tip of the needle deeper into the vein and then to follow along it for a bit before depressing the plunger of the syringe. The next day, I succeeded in my first attempt. The sweet sensations I felt then must be like scoring a goal for one’s country in the final of the World Cup.

The following weeks I delivered Frank’s shots with a panache that I thought even a real nurse would have envied. Until the awful day arrived when, back home, Frank’s mother decided she wanted to see me in action...

J Groenendijk

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