A Further Note on Insect Bites

The amount and variety of bites I accumulate from insects on a daily basis astounds me, and has, over time, made me slightly obsessed with repellent. I used to find bites on my body and think to myself, “What bit me? And how did it get there?” After months of observation, I have become something of a connoisseur when it comes to insect bites: how each insect’s bite feels, how each insect’s bite looks, and how long it will last. For example:

I believe everyone is familiar with the bite of the mosquito. You rarely notice a mosquito until it’s too late – if you start to feel a slight itch, the mosquito is most likely finishing its meal. Immediately after, the itch will greatly increase in intensity, and the site of the bite will swell and redden (the amount to which it swells will depend on your level of allergic reaction). If you can resist scratching the bite, it will disappear quickly. Scratching the bite only causes further itching and swelling; if you scratch long enough or hard enough, you can break the skin and cause the bite to become infected with the bacteria living under your nails.

The sand fly is a tiny insect, but its bite packs a punch. Without warning, you will feel a sharp pain, mixed with itchiness. For me, this sensation fades as soon as the insect is removed from the skin and there is no lasting physical evidence. However, I have heard that some people have allergic reactions to this insect bite, and will experience waves of intense itchiness, with small red bumps.

The ant bite, on the other hand, feels like burning. It is extremely painful, and this pain will endure past the removal of the ant – up to an hour or two. The skin will swell slightly and become red. Rubbing alcohol applied directly to the bite will help reduce the pain and swelling.

The flea bite is generally not felt, but evidence of fleas manifest as small, itchy red bumps that can last up to a week on the skin. The fleas themselves can be hard to detect (tiny, jumping, black or brown specks), and nearly impossible to kill without the use of pesticide (even if you are fast enough to catch one, their hard little bodies are nearly impossible to smash with a finger).

As mentioned in the previous post, the yellow fly (also called the red fly, though they are in fact always yellow) leaves quite a mark. You most likely will feel little as the fly bites you, yet the site of the bite may bleed, and it will certainly swell. And turn red. And grow hot. The bite itself will itch a lot. It may even hurt. As with the mosquito bite, refrain from scratching – this will lead to days of unnecessary suffering.

I’ve been lucky enough to avoid run-ins with some of the other blood-sucking insects inhabiting Pearl Lagoon and the rest of Nicaragua.* I’ve been told that the bite of the black fly is even worse than that of the yellow fly, and that grass lice burrow under the skin and break out later, leaving itchy red bumps. There are stories of ticks in more rural areas that, in sufficient quantities, can kill even large animals. I hope I never have to find out if the stories are true. I’ve also seen what bed bugs can do (lines or clusters of small red bites, usually on the extremities or abdominal area), but have been fortunate enough to never have done battle with them.

As I said, I’ve become quite knowledgeable on bites. Yet I still fail, from time to time, to discover the answer to “how did they get there?”

Words of the Week: Los que chupan sangre – those that suck blood, hinchado – swollen, escondido - hidden

*This is not to say that these insects are only found in Nicaragua; there are simply more opportunities to experience them when one lives in homes that are not sealed or even screened in, when wooded areas are not maintained or sprayed with pesticides, and when domestic animals are not treated for fleas or ticks. Nicaragua, however, does have the added benefit (for the insects) of having a consistently warm climate, with forests, jungle, and fresh water sources.

A Fable in the Flesh

The Goods and the Ills

All the Goods were once driven out by the Ills from that common share which they had in the affairs of mankind; for the Ills by reason of their numbers had prevailed to possess the earth. The Goods wafted themselves to heaven and asked for a righteous vengeance on their persecutors. They entreated Jupiter that they might no longer be associated with the Ills, as they had nothing in common and could not live together, but were engaged in unceasing warfare; and that an indissoluble law might be laid down for their future protection. Jupiter granted their request and decreed that henceforth the Ills should visit the earth in company with each other, but that the Goods should one by one enter the habitations of men. Hence it arises that Ills abound, for they come not one by one, but in troops, and by no means singly, while the Goods proceed from Jupiter, and are given, not alike to all, but singly, and separately; and one by one to those who are able to discern them.

Aesop was a wise man.

The stress of going from Pearl Lagoon to Managua and back in a four day period definitely takes its toll on the body; after 14 hours of self-imposed dehydration, heat, dust, and bone-jarring bumps, I arrived in Pearl Lagoon exhausted. Three days later, I had to make another trip – this time to Bluefields. Although the second trip was far less extensive (a one-hour boat ride), it was made in the rain, then followed by a sleepless overnight stay before returning home the next morning. The combined travel resulted in a fresh cold – nothing too bad, but enough to slow me down and make me mildly miserable.

Then I started to feel a pain in my lower left leg. Within two days, my ankle area had become swollen, red, and hot to the touch. Cellulitis! I was prescribed a course of antibiotics and told to notify the Peace Corps Medical Office in the event that the situation failed to improve, or worse. Praying that my infection would not turn out to have been caused by the multi-drug resistant form of a staph bacteria known as MRSA (no more trips to Managua for me, please!), I took my first pill and sat down on the porch with a book to relax.

At which point I was bitten on my palm by a yellow fly, and my hand and arm swelled like a balloon. An itchy, burning balloon. I slathered myself with hydrocortisone and called it a night.

 The next morning, another yellow fly bit the back of my thigh while I was washing clothes outside. Again, massive amounts of swelling and itching. “You’ve got to be kidding me!” I thought to myself, as I once again reached for the hydrocortisone.

It’s now a little more than a week later. The effects of the viruses, bacteria, and insects that ganged up on me have faded, and I’m more or less back to normal.

“So where’s the Good?” you’re probably thinking.

Well, just take a look at these awesome sandals I found in Managua! A steal at only $6, they are durable, easy to clean, and (trust me when I say this) quite Nica-rific.

Oh yeah, and my SPA application was accepted!

Words of the Week: Lo bueno y lo malo – the good and the bad

So...what have I been doing, exactly?

During service, every Peace Corps volunteer has the opportunity to apply for grants to assist in the realization of capacity-building projects. The funding mechanisms differ in their focus area, application requirements, and funding limit. For those of us in the health arena here in Nicaragua, there is the Volunteer Activities Support and Training (VAST) mechanism, the Peace Corps Partnership Program (PCPP) mechanism, and the Small Projects Assistance (SPA) mechanism.

The idea behind this provision of monitory support is that, in the right situation, this resource (though relatively small, with a maximum of $10,000 USD in funding) can make a tremendous impact on community development. When we talk about “the right situation” we mean one in which 1) the problem and its solution have been identified and prioritized by the community itself, 2) the community can build on its own strengths and abilities to solve the problem, and 3) that the community can continue to actualize the solution in the absence of external support (the solution is sustainable). To quote the Peace Corps, “A cornerstone of the Peace Corps approach to development is the belief that success is achieved by helping people develop the capacity to use their own skills and resources to improve their lives. Identifying assets and resources from within the community and building on such assets to increase self-reliance and sustainable development are critical elements of the Peace Corps philosophy. While sustainable development efforts depend first and foremost on local commitment, resources, and skills, outside resources may help expand a community’s own asset base and strengthen an activity’s positive impact.”

As anyone who has ever worked on a grant application knows, a lot goes into the process. Writing the application itself can take weeks to months; after a project is identified and developed, one must carefully craft a convincing argument, complete with evidence, as to why that project deserves to be funded. Data is gathered; price quotes collected; letters of commitment from community partners secured; plans, timelines, budgets developed. There are rounds of edits to the draft before the final application is presented to a small grant committee, who reviews the application and determines whether or not it is worthy of funding. Before an application is accepted, however, the volunteer and a relevant colleague must travel to Managua to defend the application before the committee. A successful defense results in a final round of edits, followed by transmittal of application to Washington, DC, where funding is awarded. And then the real work begins.

This all to say that I’ve spent the last few months working with my colleagues on a SPA proposal to implement a series of trainings on three strategies developed by the Nicaraguan Ministry of Health (MINSA) that are designed to prevent maternal and infant morbidity and mortality through an increased understanding of maternal child health and the promotion of institutional care, promote healthy infant and childhood development through proper nutritional practices, and increase women’s knowledge of and access to family planning methods. We’ll be conducting these trainings with over 100 lay community health workers, or “brigadistas,” from three of Pearl Lagoon’s more inaccessible communities. If this project accomplishes what we intend it to do (and we certainly hope it does!), the brigadistas will serve as the communities’ first line of defense in the protection of maternal and child health, working autonomously in places that MINSA cannot reach with any regularity, and keeping MINSA informed of the health of their community members. This is extremely important work, as these communities all suffer from relatively high rates of high risk pregnancies (such as those among adolescents and those who have already birthed numerous children), obstetric emergencies, and childhood malnutrition.

While this is not all that I’ve been doing, it is without a doubt the project I am most excited to be working on. I was in Managua on May 3 to defend the proposal, which went very well. There are still several hurdles to jump, but I’m cautiously optimistic that things will work out. Keep your fingers crossed for me!

Words of the Week: recursos – resources, desarrollo - development