February 2016. Playa Larga – Cuba
The spartan consulting room has rather grubby walls sporting posters about how to wash your hands, the symptoms of Zika and a skeleton with the bones labelled in Spanish. I sit in a plastic chair opposite the doctor and my eyes are drawn to the wall behind him where the unprotected elements of the old air conditioning unit are covered in sticky looking grey dust. I feel small and despondent in this shabby, unfamiliar place and find myself judging the doctor as being too young to be diagnosing and advising me. He wears a grey hoody and jeans, beneath a short sleeved white coat that looks a little too small for him. There are just a few lines between his eyes on his otherwise smooth, baby face as he frowns at the paper I have given him outlining the last four days of fever, diarrhoea, debilitating nausea and the antibiotics I have been self-medicating. He looks unsure as to how to proceed and this does not instil confidence. Maria, the sweet and caring host of our guesthouse and David stand either side of me acting as my sentinels. He starts to write a prescription on flimsy, grey paper. Despite the words being in Spanish they are easily translated in to the familiar advice of rest, rehydration, paracetamol and metronidazole – my despondency deepens. This is not what is needed from you I want to shout at him. Having been doing this for four days with no improvement what I want is a stool sample. Trying not to allow my impatience to overspill I deliver the sentence for this request which I memorised from an earlier search of the dictionary. I think he is refusing me but I can’t be sure. He speaks quickly and converses mainly with Maria. Asking him to speak slowly I catch more words, but I find it hard to concentrate. I am weak, dizzy and want to know where the nearest loo is. Dengue is mentioned. I don’t have dengue, I have a bowel infection, but I meekly go to another bleak room and have my finger stabbed for a drop of blood. The only colourful, cheering thing is the leggings with a Union Jack pattern that the plump technician wears. It makes me think of home.

We retire to the uninviting hard plastic chairs that are bolted to the walls of the waiting room where a couple of women with dyed black hair, permed and cut in the same style, are waiting to see the child doctor. There is a desk with a phone which rings. There is no receptionist, no nurses, no staff at all, so the ever helpful Maria answers it and bustles off to deliver the message. We soon get the results of the blood sample which confirm dengue is not to blame for my sickness. Again I bring up the need for a stool analysis and this time my name is added to a list and I am told to present a sample tomorrow – I start to relax. In the UK a discrete little blue bottle for my ‘deposit’ would be handed to me, but when this isn’t forthcoming I find the word for sterile bottle in my dictionary and request one. The doctor looks at Maria for help and she gazes back at him. A few sentences rattle between them and we are ushered out. Still no pot but I imagine something will materialise in due course. After a prompt when we return to the house Maria does indeed produce a small glass pot and with an impressively accurate aim I fill it.

The following day in the early morning coolth we return to the clinic, the golden light of the sun softening the bleak, boxy, concrete building. The doctor and several others are gathered at the security post at the entrance. It seems an odd place for them to be, but I don’t have the words or energy to question it. He nods in acknowledgment as we pass, his face just visible beneath the hood he now wears over his head for warmth. The hospital itself seems deserted, but finally the woman with the Union Jack leggings appears and takes my proffered jar. In Spanish she asks, “Where’s the paperwork?”. What paperwork? David sprints back to the house to get the scraps of paper we were given yesterday. No, this is not what she wants. She looks at me unhelpfully and shrugs. I would like to say, “You’re the staff member, I’m the sick foreigner who doesn’t know your system, help me out here”, but I don’t have the language for that. I mumble something about the doctor, hoping she’ll call him in and move this along. She doesn’t. It’s pretty clear that the onus is on me to to supply the appropriate paperwork. She will do the bare minimum of her job, nothing more. We have come across this same attitude in other Cubans who work for government establishments such as banks and state-run restaurants. Unsmiling, surly behaviour which goes against all the other encounters we’ve had which have been welcoming, friendly and warm. So, David and I go back outside and beckon to the hooded doctor. He looks weary, probably having been on duty all night, but he responds and on reaching his office he makes some medical shorthand squiggles on another piece of poor quality paper which I present to the leggings. She adds the details to her list and I leave hoping that my unlabelled sample will not get lost in all this bureaucracy.

I shuffle slowly back to the house and whilst David tucks in to a breakfast of fruit, eggs and coffee I nibble on some bread and honey. I tried some soup a couple of days before which went straight through me so I am nervous about eating, but having had no sustenance for four days I feel hollow and diminished. Maria is thrilled by my efforts and beams at me, then pulls my head to her bosom and stokes my hair, finally kissing the top of my head. I am moved by her kindness and the care she has shown us. Even so right now I just want to be in my own home, my own bed, able to make hot, soothing tea and have the food I feel able to eat. Being this sick in a foreign land is hard.

Miraculously my test results are available soon after midday and we make our third visit to the clinic. There’s a new set of staff, but with no uniforms or badges they are difficult to distinguish from the few patients who loiter in the now all too familiar waiting room. In faltering Spanish I manage to find someone who retrieves my form from the awaiting pile. Again, we receive no help or indication as to what to do next. Obviously I need to see a doctor for an interpretation and a treatment plan, but where is the doctor? More waiting and gesticulating and then I see a young black woman in a white coat who has a reassuring air of authority and I wave the form at her. She confirms what I had suspected all along – amoebic dysentery. Nasty little critters, parasites to be exact, that can live in the large intestine and in some cases can cause cysts and ulcerations. It’s unpleasant knowing I have a parasite and frustrating not knowing how or when I picked it up. Without being overly cautious and putting unnecessary culinary limitations on our travels we are sensible about what we eat and drink and from where we get our meals. I wrack my memory for the moment I might have ingested this unwelcome travel companion, but nothing comes. Just bad luck I guess.

Fortunately I have been taking the right antibiotics, and we visit the small but well stocked village pharmacy to buy more so I can up the dose – knowing what it is I am fighting I attack with full force. I feel reassured that I will get better and this makes me feel more upbeat. Mind over matter helps for a few hours, but it takes several more days for me to be eating normally again and a good couple of weeks to shake the nausea and feel my energy returning.

I write this not to garner pity, but to share my observations of what is just another travelling experience. To write only about the fun and amazing times would create a false picture of what this trip is giving us. Travelling will never be all highs and wow moments and I wouldn’t expect it or want it to be. The lows, the tough times that really challenge my reserves and ability to be with what is, adds depth and contrast to the other times, be they mediocre or utterly amazing. They can provide different insights in to myself and the way a country works and whatever the experience there’s always something to gain from it – even if it’s just a good story!