Photoessay: Dengue, personalized

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Dengue fever isn’t fun, as we discovered a couple of months ago. Perhaps the worst thing about it is the fact that there’s actually very little modern medicine can do for you other than paracetamol to alleviate the high fever, saline drips and other fluids to help rehydrate…and if things get really bad, a blood transfusion to boost your platelets and white blood cell count – falling counts are a consequence of the virus and dangerous because secondary infection or haemorrhaging. Beyond that, you’ll feel very easily fatigued for weeks afterwards. Everybody else can’t do much but watch and help you through the normal ablutionary tasks that suddenly become enormously difficult with low energy levels. My wife was unfortunate enough to have gotten it a few months ago – right before we were supposed to go to London, which resulted in me travelling alone – and she describes it as an incredibly bad non-stop fatigue – once the discomfort of the fever goes away, and before the itchiness of the tertiary rashes set in.

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It seems that in recent times the number of dengue cases in Malaysia is on the rise; Kuala Lumpur appears to be specifically bad because most of the city is being dug up to build the new mass transit system. This leaves a lot of open areas with mud and standing water, which are the favourite breeding grounds of the aedes mosquito – which carries dengue. I suppose the only good news is that it isn’t contagious. Whilst the contractors are supposed to take measures to eliminate as many of these breeding grounds as possible – the possibility of having dengue hotspots on site is obvious also bad for worker productivity – it’s difficult duet to the tropical weather and rainstorms, and frankly, the areas are so large that effectively fogging and decontaminating everything on a regular basis would be an enormous undertaking. All we can do as private citizens is ensure that our building management performs pest control on a regular basis, and we spray our own apartments frequently.

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The wife noted that it was odd to be on the other side of the bed at work – she is normally part of the hospital’s management team – and assuming that it isn’t something we want to go through again, I had to document the process…as well as find something to do whilst I was at the hospital and she was resting. At this point I’d normally say enjoy, but instead I’m going to say be vigilant of mosquitoes if you live in the tropics. Eliminate standing water at home. And I find that tiger balm seems to be a fairly effective mosquito repellant. Failing that, a cigar. MT

This series was shot with a Pentax 645Z, 25/4 and 55/2.8 lenses.

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Companion

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Boredom, lethargy and thermal discomfort, when you’re awake

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Eating to regain strength is important. But difficult, because nausea obviously affects appetite…

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…the general blandness of hospital food also doesn’t help.

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A lot of folk cures were tried – papaya leaves, porcupine quills, ling ahi…none of them actually appeared to work.

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Emergence of tertiary rashes generally mark the turning point, but also the start of several days of pain, itching and thermal discomfort.

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Out of bed

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Bears aren’t as picky about food.

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I knew it was *really* serious when she ignored her phone and iPad…and consequently better when she picked them up again.

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Comments

  1. When I visited my Parents in North Carolina in March, my mother told me I had Dengue as a toddler while we were living in Chiang Mai, Thailand. Apparently I had an atypically mild case. I was quite surprised to learn this, but I was far too young to remember that sort of thing when I had it.

  2. Tapio Harju says:

    Hello Ming and all commentators; there is one way to keep mosquitos away while staying outdoors; the ThermaCell repeller, which burns alletrin slowly and keeps all insects away. It covers an area about 4 x 4 meters and functions 2-5 hours, after which a new pad has to be inserted. I have testet this gadget in the Finnish Lapland where mosquitos are numerous and furious. and it worked perfectly. For some reason this appliance is not sold all over the world (e.g. not in Thailand). I use it also when fishing or photgraphing, bearing the appliance in my belt holster, and again it works! Best wishes to you all, and keep yourself well protected!

  3. First, let me say that I am glad to hear that your wife is recovering well.

    Now, as she so graciously “modeled” for your post on Dengue Fever, do you not owe her another post, or at least one image, in a more flattering setting? I am not one to normally post personal images on the web, nor was I eager to have my picture taken during my chemotherapy treatments, despite what people said about how well I looked with a bald head. But, if images of me were to be posted on the web, I would like to be visually remembered with at least one image taken when I was not recovering from an illness.

    Be well,

    –Ken

  4. My best thoughts and wishes for her recovery, Ming. Record, record! 🙂

  5. Very intimate shots here, which gives them a lot of strength in this case Thanks for sharing and hope she’s well.

  6. Jorge Balarin says:

    Well, at least she got some nice photos : )

  7. Stefan Aditya says:

    90 % Always love your shots Ming Thein. Particularly the compositions, It seem that you are more than capable to compose things and framing them into your images. Then make it interesting for photographers around.

  8. Photography is a funny thing. There is something about it that touches us. Your 4th photo from the top (your wife asleep) really triggered a sympathetic response in me… Strangers never to meet, connected by an image.

    One question… What was your wife’s response to her hospital photos being splashed across the internet? I guess she has to put up with you, but I bet she wasn’t too happy about it.

  9. Glad to hear that your wife is feeling well now. This is the most intimate photo series that I have seen from you and it shows the closeness between the photographer and subject.

  10. It’s all been said many times in the comments above! I’m glad to hear that recovery is complete – definitely down to that bear!

  11. Glad she’s on the mend. Here in Florida several new (for us) mosquito born viruses have been introduced in the last few years, including Dengue. Definitely have to be aware, but difficult to avoid or think about when going about normal day to day activities.

    • I wonder if eventually we’ll develop some kind of immunity to it because it seems to be unavoidable…or figure out a way of eliminating the mosquito entirely.

  12. Nah, it was the teddy bear’s companionship that really cured her. See, it has more humane uses than being a prop for photo image comparisons. 😉 Seriously, very glad she is fully recovering and will be OK. The softer tone and hues of these images fits more than your usually bitingly sharp imagery. I think you portrayed her and her condition with both loving care (buddhist metta) and concern. Well done, Ming!

  13. Pritam Singh says:

    So sorry to learn of your ordeal . . . I wish you both luck, fortitude and a full recovery for your wife. . . a complete recovery to full strength. All my good wishes . . . good health !

  14. Sid - The Wanderer says:

    Wonderful shots Ming…they show pain and sorrow, but beautifully. Its quite big in my city as well…many deaths so far…

    http://www.sid-thewanderer.com

  15. Happy to hear about your wife’s recovery. Thanks for sharing the good news and -as always- thoughtful photos.

  16. I only started following you a few weeks ago. Then I read this. How horrible! I sold a lens last week to a young man who had just returned from shooting ebola clinics in Liberia for a Wall St. Journal article. It’s remarkable how invulnerable technology makes us feel, and yet, there still exist these possibilities for being struck down. I’m happy to see your wife is on the mend. Good luck. Ken

  17. I too share and echo all of the above well wishes and the relief in knowing of your wife’s full recovery, plus the eloquently stated praise on the tremendous photoessay you shared. I thought it might be helpful since you are hoping to raise awareness of mosquito induced illness to mention that there also is another emerging serious and often permanently debilitating mosquito borne virus, Chikungunya. Though most common in Africa it is spreading and its presence in Malaysia is making itself known. I saw my first case in the US of a woman who contracted it overseas and she has suffered severely from the persistent arthitis it causes. Unfortunately, many persons are left with permanent injury.

    As always, Ming thanks for all you do and the inspiration that you are.

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  20. I’m glad to hear that Nadiah’s recovered fully. I remembered when you first posted about this, along with the pink-casted picture of Nadiah sleeping on her side, which struck me as especially powerful. Thanks for sharing this with us.

    • Thank you. I admit to some deliberate influence over the color grading (and sequencing through the presentation from beginning to end), but the hospital’s own color tones helped me along there…

  21. Dwaine Dibbly says:

    Looks like she’s getting better. I’m thrilled to see that! I should also say that you’re a very brave man, posting those photos. If I had done something similar, Mrs Dibbly would be plotting homicide! 🙂

  22. Frederik van Lambalgen says:

    Impressive story with impressive pictures. Very personal and so universal at the same time, it is so difficult to see a loved one like this and one can do so little, beautifully expressed in this photo essay.

    Thank you,

    regards Frederik

  23. Thanks to you and your wife for sharing and helping to raise awareness of the need for mosquito habitat control. Every time I see standing water…I think “mosquito farm!”…feh.

    It’s kind of funny that you used the 645Z. It’s probably the least likely “hospital documentary” camera (the opposite of unobtrusive). How was shooting with it in this environment? Why did you choose it for this series?

    • We’re a bit paranoid about it now, too. Checking all bathroom/kitchen etc. surfaces to make sure there isn’t any and drainage works, or we wipe things down.

      645Z: why not? At that point I’d just taken delivery and wanted to shoot with it; plus somehow I’ve always found the medium format rendering more suitable for people/ documentary.

  24. Peter Boender says:

    A very personal account. Quite courageous of Nadia for willing to share this with the world. Good to know she’s back on her feet and doing well. It could have been <a href="http://www.bbc.com/news/world-asia-29320119"<much worse… I’ll make sure to skip by on my next KL visit. Cheers guys!

  25. Hi Ming, Sorry your sweetheart had to experience this malady. Thanks for sharing the photos. My father worked in South Vietnam and northern Thailand in the 1960s and knew people who got Dengue, though he was lucky to escape infection.

    Scientists in Australia are working on using a strain of Wolbachia bacteria, which interferes with Denge virus production in mosquitos, which prevents them from infecting humans. The Wolbachia also gets transmitted from one generation of mosquitos to the next, so it might be a very good weapon against the disease. See: http://www.eliminatedengue.com/our-research/wolbachia

  26. Thank you and your wife for sharing and our raising awareness! We modern people never expect to be attacked by Mosquitos, virus, or other maladies – especially those which we associate with primitive places or ‘others’ – those far way ‘others’. Thank you for posting such that we can see the worst is over! Prayers on the way!

  27. Gary Morris says:

    A terrible experience! I hope the recovery is/was complete (i.e. this doesn’t just “get better” but in fact is only in remission).

    Parenthetically, the last time I was in Cambodia (2008) as we were driving around Siem Reap we passed a large group (hundreds?) of people lined up in front of a clinic building (it once belonged to the UN on an earlier visit I had made there but had seemingly changed hands in the intervening five years). I asked what they were doing there and we were told that there had been a steady flow of people from the jungles around Tonlé Sap coming to receive preventative injections (from the Gates Foundation) for Dengue.

    I guess a question would be if preventative injections are available in Cambodia, does this exist in KL as well?

  28. Such a painful experience. We’re so happy to have you back, Nadia!

  29. Peter Wright says:

    Glad to know your wife is back to normal. That is one of the downsides of being self employed and having commitments – it is hard to take a time out for family emergencies. So you did extraordinarily well at the London WS – wish your birthday could have been more fun though!. Good that you had others at home to give a hand.

  30. Ladipo Soetan says:

    Glad your wife is better. Please thank you for us for allowing you show the photographs.

  31. Jamie Zartman says:

    Helluva way to gain immunity, at least from one of the five varieties of Dengue fever. Please thank your wife for permitting the photos used in your, as always, high quality essay. Were these GR photos, which probably eases the intimacy of photographing in a hospital environment? Thank you both for sharing this, and wishing your wife a speedy and full recovery.

  32. Father Raphael says:

    Dear Ming
    Characteristic of a wife who suffers her husband in love, something that men often need to learn and be grateful for. God grant her complete recovery and both of you good health.,

    +Father Raphael

  33. Thank you for sharing this horrible experience your wife has had to suffer through. Sometimes we take life for granted. Glad the outcome has been favorable and wish the best for you and your wife. I have to travel for my profession, pilot. And it seems when shit happens I’m on the road somewhere far away. However, this past week my wife admitted herself to the hospital while on her way to a social function with some chest pains and pain in her left side. (She’s a retired RN). Fortunately I’m home this week and I was able “hover” over her this time. She’s home now and all her tests came back normal.

    http://blog.duanepandorf.com/2014/09/25/the-patient/

  34. My prayers for your wife and continued recovery. Photos as always were moving. Everyone needs a bear, and apparently an iPad when bedridden!
    God Bless.
    There is a very nasty new virus that has made its way here just this summer carried over from the East finally through the Virgin Islands by tourists/ travelers by way of plane and cruise ship. Has taken quite a while to get here but they knew it was coming and first cases affected my home state of Florida few months ago. The name is lengthy…Chica..something or other…mosquito the carrier.

    • Thanks to air travel, every time there’s a local epidemic, or quickly becomes international – just look at the current ebola outbreak…

      But we both agree that a bear is essential to recovery.

  35. Carlos Esteban says:

    Just yesterday I heard about a research here in Brazil (Fiocruz research in fact) about dengue mosquito’s: they are developing a kind of bacteria to be inoculate in the mosquitos and them the mosquitos are set free to contaminate the others. May be in near future we’ll be free of aides.
    By the way, the color transition of pics is really marking the involution of fever.
    Regards.

  36. I feel somewhat bad for saying that some of these pictures – specifically those with the bear – actually made me smile. I don’t at all mean that to diminish what must have been a pretty miserable experience for your better half, but to show how a sense of humour in such situations is so important. A few years ago my own wife was in hospital for 6 weeks with something much nastier than dengue, and I realised that it was at least partially upon me to keep the atmosphere fun and positive. Seeing these very human pictures brought some of that back to me.

    Needless to say that I, along with everyone else, am happy to hear that things are OK now.

    As an aside, they’ve started finding cases of dengue in Tokyo now, specifically in Yoyogi park, which has been getting sprayed dusk to dawn for several weeks. I’m heading to Tokyo in December, but the mosquitoes should hopefully all have buggered off by then….

    • Don’t feel bad at all. A bit of home and something cheerful to make a positive mood are just as important for recovery as medication (or not, as may be the case here since dengue has no medication)

  37. Thank you so much for sharing this very personal side of your life. So happy that your wife and you have come through this and prayerfully will not have to endure this ever again.

  38. I am relieved that she is better, Ming. A good documentation to raise awareness!!

  39. …hopefully Mrs Thein is now fully recovered. The hospital bed etc seems to be somewhat more modern and comfortable than our own NHS equivalents in the UK. All the best.

  40. Incredible suffering just for one single mosquito bite. Thanks God everything turned out good in the end.
    We that were in London have to be thankful your marriage can envelope you showed up alone with her staying back home seriously ill. Must anyhow have felt frustrating.

    I am unfortunate to live along the Danube flat lands on the Balkans Europe. People are facing bigger and bigger problems with mosquitoes. In the summer period the mosquitoes are uncountable and literally the air is fogged with them. Authorities keep spraying from the air and streets, but the bastards seems to have become more immune to the poison. I am not kidding when saying I am only able to do photography during summer during daytime hours and shooting during the Golden Hours is impossible. They appear the moment the sun rise and sets: Dinner Time.
    My cigar consumption is vastly higher during summer time 🙂

    Amazing set of images and than you for sharing.

    • Gerner – you should experience the Scottish midges! I sometimes have to wear a motorcycle crash helmet simply in order to stand for five minutes to admire a view – taking pictures is impossible.

      • Is it that bad !!! Uhh… Perhaps the industry should think out a transparent protection wear for photographers:)
        I am not too fond of applying the chemical Autan to the skin, which works of course, but is an awful experience too.

      • How do you see through the viewfinder?

    • Thanks Gerner. I nearly didn’t make it to London – she was originally supposed to come with me.

      • You stood up extremely well and nobody could even feel there was a crisis ongoing the efficient way you locomoted the whole course. Pity she couldn’t attend your Birthday either. Only couples with strong love, ties and space for each other would be left undamaged.
        Just to admire.

  41. I’m glad your partner is much better now, and also surprised she would let you show her to us at definitely not her best. I didn’t really know what dengue could do so this was quite surprising…! Fantastic documentary style shots. Thank you for sharing.

  42. Aside from the fact it’s great your wife is getting better, what a fantastic set of images. Not only is your wife good to let you leave
    her side, it’s good of her to allow you to share these images of her. I guess the fact they’re so atmospheric and empathetic helps.

  43. Oh, this is so horribly familiar 😔. I contracted dengue about 3 months ago. I was very lucky, due to an enhanced immune system which is due to the powerful as all heck new antibiotics administered when I (almost died..in fact, heart did stop in the ambulance) contracted MDR pneumonia about 5 years ago. 4 weeks in intensive care…long story, a horrible experience. So my platelets never dropped below 165, but hydration was an issue so I spent 4 days in hospital on the saline. And hospital food…😣 doesn’t help you get better!
    Then last month my wife contracted it. Platelets down to 64, and more severe symptoms. Another 5 days in hospital, and 2 weeks to get strong enough to go back to work (only this week is she fully recovered and free of the tertiary itching which she got really badly)
    So, my best wishes for your wife, and agree totally that everything possible should be done to prevent getting bitten…but you know how it is, just one unlucky bite, when at home (where we both almost certainly contracted it) or out at an outside cafe, friends house, etc. So impossible to completely prevent. My doctor wears a “patch” containing repellent which is seemingly effective.
    At least your wife is now immune to this strain of dengue, which is relatively mild compared with the strain in Africa at the moment- a pilot I know was comatised by his attack of African dengue, and lost several toes due to gangrene! So in a way we are fortunate.
    Best wishes, in health, always.

    • Just to add: *everyone* thinks they know a “cure” usually crushed and drinkable papaya leaf juice. None of it works, but will people be told? Of course not! My wife’s mother insisted on her trying papaya leaf juice, collected by a doctor (!) from a kampong. After one “dose” she, who had not until then felt nauseous, almost threw up, and said “next person to suggest papaya leaf juice can drink it first before daring to offer me any”!
      And also had the same experience: loaded her iPad with movies…not interested. 3 days later..”watched everything, can you download some more?” Definite sign of recovery 😉

    • Ouch – wish you didn’t have to experience that first hand. Unfortunately not much you can do since as you say, all it takes is one bite…even if you spray regularly, you can’t spray everywhere you go or cover everything in repellant. And I’m really not sure those chemicals are good for you, either…

      African dengue also has gangrene as a side effect? Whoa.

  44. Marco Borggreve says:

    Poor girl! Hope all is well again. Looks like she is being taken good care of. But she took the Pressmosquito quiet well!

  45. hi ming,
    thanks for sharing. trust your missus is fine and all is well now.
    you have a very understanding, strong and independent lady, agnes would never have allowed me to travel under a similar situation. this dengue threat within klang valley is really becoming a bane now, our local community just mooted a gotong royong project to clean-up the surroundings to keep the dengue threat in check. i will also be more careful shooting in the woods for now, no bermuda shorts for the moment, strictly long pants and a spray of citronella mosquito repellant. wishing you and yours a good weekend.
    ken

    • Yep, all back to normal. I think Nadiah got sick of me hovering over her!

      How are we going to fix the dengue problem when the government is happy to leave drainage infrastructure a disaster? Standing water everywhere, not helped by mass construction projects, either. Tiger balm helps repel mosquitoes, by the way. And for insurance, smoke a cigar at the same time. Bugs can’t stand the smell…

      • great, good to know 🙂

        In my opinion, i dont think it is purely the local authorities who is at fault here, the community also need to play its part.
        Yes, the local authorities need to be more efficient in delivering its maintenance services (clear up the clogged drains, fogging) but the community should also have the awareness and pro-activeness to act, by putting a stop to their irresponsible waste disposal/littering, and ridding their property/home of stagnant water pools.

        Cigar is too expensive for me, my friend. Anyway, i do not smoke. Made in Thailand citronella mosquito repellant works for me, cheaper an healthier too 🙂

  46. I’m glad she is on the mend. It must have been a miserable time for her. Thanks for sharing these.

  47. So glad that she is doing better! Best Wishes to both of you!

  48. Father Raphael says:

    You should have remained with her. +Father Raphael

  49. Thanks for sharing this endeavor. I hope the wife will regain her strength. What causes the rash actually?

  50. Thank God for a happy ending.

  51. So sorry to hear (and see, thanks) that your wife is ill. You might try using some homeopathic remedies…Gelsemium (30ch or 200ch) for the fatigue and for the rash Rhus toxicodendron (30ch or 200ch). Also try Eupatorium perforatum (30ch or 200ch).

  52. Glad your wife seems to be on the mend! Definitely doesn’t seem like much fun. Such a tricky problem to solve- there seem to be lots of politics involved too. My father’s actually directing tropical disease research + the global malaria programme with the WHO- and now the problem seems to be less about scientific capability and more politics and funding. Such a shame. Anyway, really nice documentation- reminds me a little of a softer version of Avedon’s shots of his father.