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The next day went mostly well. I was very drained, but enthusiastic to be better. We decided to check into a nicer hotel on the coast with air conditioning. I had sweated enough in the past few days and wanted a rest from it before the bus journey. We bought the bus tickets for the next day, and headed up to the Msasani Peninsula where we found a much more comfortable hotel and negotiated a reasonable price. There was a bookshop down the road, and a shopping mall, so we headed down to see what we could see. Lunch in a pub, accompanied by a CNN presenter drawing lines on the sand like sports commentary. The book shop was icy, and the sudden change in temperature eventually sent me running for the nearest public convenience, which had been heated up in the sun all day. We bought some books, and headed back to the hotel to rest in the temperature we wanted.

The hotel had a very nice roof terrace where they served a buffet. I quaffed several bowls of carrot soup, and Yuki tucked into some very nice looking crab. Too rich for my condition. Then we turned in, feeling rested and ready for the coming nine hour bus trip north.

And then the stomach pains started again, and wouldn’t go away no matter what I did.

We had arranged for a cab to take us to the bus station at 7, but the driver was a little surprised to see we had no baggage when we jumped in. “Take us to the ISC Medical Centre” Yuki blurted, as I doubled over on the seat.

The ISC Medical Centre was a little more like a British Health Clinic than the Kokni Muslim. Air conditioned, and the staff walked with urgency and purpose. Of course, it cost ten times as much. I was not presented with any match sticks this time. A doctor who looked and sounded like Condaleeza Rice explained that the Cipro I had been given the previous night had not been a long enough course, and the shigella was back. I would have to take a five day course of Cipro, and I must be sure to eat something before taking each twice daily pill.

Back at the hotel I tried to wolf down a dry cracker, and plugged the Cipro into my throat and waited. By lunchtime the pain had become a little more manageable, and Yuki brought me a bowl of soup. The cipro was playing with my taste buds and the soup tasted foul, but I supped it down nonetheless.

In the evening, just before I was due to take the next tablet, I suddenly felt cold and started to shiver. The shiver turned into an uncontrolable shaking, my legs bouncing off the mattress, my arms clutched around me. I was terrified. I was dying! Here far from home, for no reason, from some bacteria in the stomach. The fear fed the shivering fed the fear, dancing around furiously, and Yuki had to talk me down by telling me about her book on the first British man to experience Japan. Eventually I managed to slurp down half a soft banana, and neck the next Cipro in the pack, and lay on my back. When the shivering subsided completely I noticed that the pain in my stomach had gone.

No one should be walking the streets of Dar es Salaam at 3 in the morning, but the wretchedness of the Cockney Muslim hospital had forced me onto them. Cockroaches like shiny black eggs crept into corners in my peripheral vision, a wake disturbed by my passing down the sheltered pavements. The night nurse, whose laughter in her sleep had part set me on my way, had warned me about gangs of children who roamed the night, the time of their rule. “They may try to sell you tea” she said with a shudder, urging me to take a taxi the few streets to our hotel. Shillingless, I was unable and unwilling to take this advice, and felt safe in that I had little to steal. Besides, was Dar es Salaam any more dangerous a city than London, a city I had wandered at length during darkness, experiencing nothing more than new perspectives on familiar locations.

Water dripped in big drops from long dry gutters into long empty puddles, refreshed by an earlier heavy shower that marked the beginning of the long rains. This year the rains were predicted to be light. The air had lost much of its heaviness to the rain. Heaviness that had clung on in the hospital ward, barely shifted by the thunderous ceiling fans. The air and the darkness outside I found refreshing like a cold drink at the end of a long sweaty confined bus journey. The ward’s stark neon strip lights shone relentlessly, although the other patient, the one with the rotting feet, required a torch in order to see the progress he made as he tore deliberate strips away from the scabs. That I could see this with or without the torch was another prompt to escape.

Down each street I passed cats would run at each other, making brief, noisy but mostly bloodless territorial losses and gains. These howling squeals percussed and rattled from the plain metal doors which hid the identity and purpose of all the shops. Unlike in Europe or America the streets of Africa at night are free of deliberate distractions. One is free to avoid the cracks in the pavement, imagination not drawn to flickering adverts and enticing displays. One is free to evade the tea selling gangs of street children.

I’d had three litres of fluid dripped into my body, and imprisoned by needles and tubes attached deeply in a vein on my right hand I hadn’t had much opportunity to lose much of this. My eyes and skin bulged with the moisture, the street lights cast curving beams that arched out as if the whole world bulged with me. I thought I was on Libya street, but with no shops and this new geometry to get used to I was a little confused and hoped that perhaps a tea selling street gang might be able to give me directions, but the streets were mine alone that night.

I felt elated at my decision to leave the hospital. The doctor hadn’t mentioned anything about Cyprofloxacin IVs, nor about any overnight stays. These had been revealed to me at each step of the way. I had confirmed with the night doctor that I had completed my treatment, and chosen to spend the last few hours of sleep available curled up with my wife, rather than hiding my eyes from the Indian chap’s endeavours with his feet.

I finally saw the sign for the Safari Inn, and made it to bed. Tomorrow would be day of rest, and then on Wednesday we would return to Arusha.

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Now back in Dar es Salaam I still felt rotten, and had come to the end of the erythromycin. We asked the receptionist at the Safari Inn (a much more down-market affair) where we might find a clinic with a laboratory that might do stool tests. She told us there was a place just around the corner opposite the Jambo Inn.

We walked just around the corner and spent 10 minutes searching before we found it next to a sign that said “Kokni Muslim”.

Inside a woman stood at a desk behind a set of bars. “Hello” she said gently. I explained my problem to her and she said “800 shillings”.

I handed over the money and she passed back a receipt and pointed to a door with a doctor’s name on it. We walked over to the door, and I knocked and entered. Inside the doctor was with a woman, so I ducked back out, and took a seat.

Shortly, the Indian man I had caught a glimpse of and assumed was the doctor held the door open for his wife, and gestured for me to enter. Inside the doctor’s face lit up and he started to chuckle. “How are you? How long have you been in Tanzania? Do you speak any KiSwahili? Kidogo Sana? Excellent. What is the problem.”

I explained again, and he said I would have to get a stool and blood sample taken. He scribbled in traditional doctors spider on my notes, and handed them back to me. “Take these to the receptionist then come back when you have the results of the test”.

The receptionist said “3000 shillings”, handed me a receipt and pointed to a window. I took the receipt to the window and the pharmacist handed me a small white wrap containing a sterilised needle. I looked blankly at her. Then the receptionist came out of her cell, and pointed me over to the lab window. The lab technician was also very jolly. He took my receipt and the needle, then jabbed my finger and smeared my blood casually on a slide.

He then opened a drawer, located a match box, shook it, shook out the matches, and handed the empty matchbox to me, followed by two matches. “These are special for picking up the stool” he said, motioning as if he was using two tiny chopsticks to pick up a piece of chicken.

“There isn’t really much to pick up” I said.

He pushed the matches into my hand and turned to his machines. “Where is the toilet?”. He returned to the drawer and passed me a pair of keys and pointed to the right. I looked around and saw two padlocked doors. I unlocked both and checked for a sit-down. No such luck. I opted for the men’s squatter out of decency and respect for the fairer sex, and tried to catch what I could in the matchbox. I didntt bother with the matchsticks.

When the results finally came, I went back into the doctor’s room, and he was still chuckling away to himself. I nearly tripped over a chair entering the room. “Ok, you have a little malaria in your blood, and there is something in your stool. You’ll be ok. We can give you medicine.” We explained we were due to go to Arusha the next day. “You are very weak. You will go on a drip to rehydrate you, and there will be antibiotics then you should be fine.” He muttered something about 3 hours, and spidered some more on my notes and passed them back to me.

The receptionist said “25,000 shillings”. I handed over the money, and a nurse led us up the stairs. The ward had 5 beds in it. The one facing the entrance was occupied by a rather broad Indian looking man with has naked hairy back turned to the rest of the room, and what looked like a pair of underpants draped over his eyes to allow him to sleep.

Another bed was occupied by a frail looking boy in denim on a drip asleep under his mother’s gaze.

I was lead to a bed with terrible stains all over it, so I walked past it and lay down on the cleanest bed I could see. I looked to see Yuki’s face which was clearly taking in the rattling ceiling fans, the Indian man, and the stains on the bed I had evaded.

I decided I would have to try and charm the nurses best I could. After all, they would be sticking needles into the back of my hand.

“What is your name?” I asked, smiling.

“Mary” she said. She took my pulse and noted it down on a clipboard. She walked away.

Another nurse, this one in a dark blue uniform walked over. She had a pronounced limp on her right hip which rotated that whole side of her body around a different axis to the other side when she walked. “Are you matron?” I asked.

“Yes” she said. She gestured to Yuki to come over. “What are you doing over there? You are the first nurse!” she said friendlily and limped over and carried a chair back despite Yuki trying to carry it for herself. I asked the Matron her name. “Mary” she said.

The first nurse walked over with a tin plate containing some boxes, some tubes, some bottles and the needles. They lay it down on the stainy bed and then the first nurse started looking around for a drip stand.

The mother of the young boy lifted one of the stands that held her son’s drips to show they had one spare. They awoke the little boy a little, and he stared at me from his pillow.

The first nurse fetched the drip stand and they started sorting through the paraphernalia. I craned my neck desperately searching for evidence that the butterfly needle they would be stabbing into my vein was still wrapped and therefore sterile. I saw the packaging and breathed a sigh of relief when they tore it open. Then they tied a plastic tube around my wrist, and waited for a vein to show on the back of my hand. Soon enough they found it, and they took my hand. I winced and looked away, not wanting to see them puncture me. Yuki later told me that the small boy watched this, and smiled before going back to sleep quietly.

The needle in place the nurses had to fix it. Someone had forgotten to bring the tape. Matron Mary sent Nurse Mary to find the tape, and I tried to make more small talk and not to look at the green plastic flaps that marked where the needle was buried in my vein up to. Nurse Mary returned with the tape, and started to cut off a piece about a foot long. “Economi, economi” Matron Mary shouted, which I guess means “Economy, don’t use all the tape!” in kiswahili.

Nurse Mary proceeded to cut the foot of tape in half, then again down the middle. Matron Mary then taped the needle to my hand with two strips, then attached the drip tube to the needle’s tube, and taped that to my forearm.

She took one of the large plastic bottles (it held about a litre) and hung it upside down from the drip rack. She stabbed the neck of the bottle with the other end of the drip tube, and then took out another syringe, this one with a long, coarse looking hypodermic.

“We are going to give you some vitamins.”  The hairs on my neck did a Mexican wave around the stadium at the thought of being given an injection with that elephant needle. But the nurse took the needle, and stabbed the base of the drip bottle with it, to allow air in. She then filled the syringe, and injected it’s contents into the drip bottle. It was a dark yellow colour. The only thing it looked like was urine. The corners of my mouth turned down, but they started the drip dripping, and I lay back in the bed.

Yuki clearly needed a brief change of scene and asked me if there was anything I needed from outside. “Some Bananas and a copy of Newsweek or something” I said. She headed off.

I lay back and watched the fan turn, listened to it whir violently. In Iraq bombs were dropping. Terrible things were going on. I was completely detached from it, sitting in the Kokni Muslim Medical Centre, trying to see if I could feel the yellowy liquid rehydrating me…

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Today we were to fly, yet despite having drunk the rehydration salts, and guzzling the anti-biotics and spasmodics I was still feeling queezy to say the least. Dr Bob was detained in Kilondoni by a Caesarean section birth, and we had to decide whether to stay another day or leave on our allocated flight. I was keen to leave, although I think the hotel would have let us stay on for free. But better health care exists in Dar Es Salaam than on Mafia Island, plus we had things to take care of in the North.

The time drew near, and I decided we should go for it. Dr Bob arrived and suggested I take a Loperamide – a blocker – for the journey. I took it. We said our farewells to the hotel (I bear no grudge, it is a good place, and they were keen on hygiene, but these things can sneak through no matter what you do)

The drive to Mafia Airport was extremely bumpy. Every corrugation made me brace myself for a dreaded flush, but the blocker held fast, and after an hour of holding my breath and my belly we arrived at Kilondoni.

At the airport I needed to toilet badly. I was rushed through to the departure lounge (full of dewy eyed American J Year students lounging around like in a Tommy advert) and shown the toilets. I selected the one marked Male, and then opted for the sit down rather than the squat. I wasn’t sure how long I might need to be there, and I wasn’t feeling particularly strong in my calves and thighs at that time. Surprisingly enough what passed wasn’t shocking or dreadful. I won’t give you any details.

What was shocking and dreadful was that the toilet door had developed that fault where the handle on the outside turns the bar, which slides the latch, but the handle from the inside no longer makes the required contact. It merely gives the impression of working due to the spring mechanism still being intact. Like one of those human mouse traps – you can get in easily, but you can’t get out on your own. I sighed, took a breath and tried again, watching the latch through the catch to see if there was any movement. Perhaps if I shook the door a little the bar inside might just slide a milimeter enough to engage.

I started knocking on the door. “Hello!”

“Hello!”

Nothing.

I paused, and looked around me. I saw louvered windows, and wondered if I was going to have to slide the louvers out of their metal clips and collect them together, then climb out of the window and present them at the front of the airport – “Your toilet door is broken sir”.

I turned around and started hammering on the door with my fist. “Hello”. “HELLO!”. I could hear American laughter in the waiting room. Were they laughing at me? “Is there anyone there?”. “Is no one going to come?” “HELP!”

Eventually a Tommy came and I told him the door was bust, and I needed him to open it from outside. “We didn’t hear you” he said. I stormed out into the waiting room. A scene of pretty American’s pop quizzing each other on aquatic life in the Indian ocean, in their large number unaffected by the surrounding environment or its other inhabitants.

I stormed through to the check in desk, and insisted that the man accompanied me to the toilet. “I see” he said unconvincingly.

Back at the security check the man scanning our luggage said “What do you think of Tony Blair?”

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Today I am in the midst of an encounter with the most hideous and painful shigella bacteria one might ever have the bad luck to face.

Typically, this bacteria was picked up in the most expensive hotel I have ever stayed in, although its effects were not so genteel. I don’t know if it was the goujons of fish, I don’t know if it was the chicken in sweet tomato sauce, I don’t know if it was the salad or the soup or even the water. For all I know it swam into my mouth of its own accord while I was diving in the Coral Gardens off Mafia island.

Whatever it was, it allowed me one more dive, gave me a few warning kicks before I went on a snorkelling trip (excellent puffer fish), before surging through me as a 10°F fever and diarrhoea determined to expel every drop of moisture from my body.

I writhed under the mosquito net, hoping the stomach cramps would desist, and only found solace in changing position from right to back to left and back again every 15 minutes. Thus would be my fate for the next 7 nights.

On that first night the hotel had called a doctor from the capital of Mafia, as at least two other guests were reporting illness (so much for my Shigella Marines assault theory, one hadn’t dived). Dr Bob came into the room and greeted me gently. He took my temperature by placing his fist onto the side of my throat (next time you check for a fever try it, it works better than a palm on the forehead), then my blood pressure, and confirmed that I was sick. He gave me some rehydration salts, some Erithromycin antibiotics and some anti-spasmodics to take, and said he would come back in the morning.

I tossed and turned all night, the first night of feverish dreams of war, SCUBA equipment, and a proud old London family of traditional pornographers who live above a high class Italian restaurant which uses their stairwell for cheese production and spaghetti drying. Surreal yet vivid.

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