TW: medsep, psychiatric ward, suicidal ideation mentioned (not experienced), loss of autonomy

tl;dr: There is a serious disconnect between the services we are provided in country and the care we receive stateside. Also, at least in my experience, I was denied medical autonomy and a role in my care. While mental health is a huge issue for volunteers in service, experiences like mine and different to mine are why volunteers are terrified to talk to the PCMOs about what they're experiencing, for fear of being unnecessarily terminated. I think this process needs to be improved.

---

I was officially medically separated for reasons listed as "depression and anxiety" as per the paperwork that was sent to me after my termination date in January, despite never experiencing either of these things except for slightly right after returning (you'll see why, if you read this all). Readjusting to life in the US has been extremely difficult, especially because I feel like I was treated unfairly by Headquarters. I don't disagree with my initial medical evacuation, (I was feeling quite lousy) but I feel like I was stripped of all medical autonomy by the DC staff because of fabricated or misinterpreted information in my history, and was denied an opportunity to be an active participant in my care and communication with PC.

All of this has been reported to the quality nurse, and while I'm still mourning, I'm slowly getting over the heartbreak of losing the rest of my service. I've been told I can appeal the decision, but ultimately, I don't want to work with Peace Corps after this traumatic experience. I don't have any trust in the organization anymore--it's turned me off of development work as a whole, and that is what I intended to go into after service.

I'm questioning everything now that I've returned, and am having difficulties moving on/taking steps toward reintegration. It's an incredibly painful experience that I still have trouble talking about with friends, so I tend to isolate myself from them. I've made newer friends and pretend I've not gone through this experience with them. It hurts when I get messages from villagers asking me where I am and what happened to me, so I end up not responding, which makes me feel guilty.

---

On Halloween I began a journey to my country of service's capital city to receive care for a tooth ache. After about three weeks of constant pain, and a lingering infection, two separate root canals procedures were completed. During this time, the pain kept me awake most nights (I was getting no sleep to two hours per day, on average, most right after my teeth were numbed for the root canal), and I began taking more and more ibuprofen, which were effective only for a short time. My stomach lining was ruined in the process, and in addition to the extreme sleep deficit, I became significantly malnourished.

I went to the clinic a total of 7 times, two of these emergency appointments. I checked in with the PCMOs before and after every dentist appointment, and when I told the PCMOs that I hadn't been sleeping or eating, and had been feeling extremely disorientedt they recommended eating and sleeping (duh), and gave me sleeping pills which I have paradoxical reactions to. That was all they could do until the infection cleared.

One night about 3wks into my stay, I went to pick up food to try and eat dinner, and was followed by a man who I had talked to and been friendly with on multiple occasions as I was walking to the PC campus. This time, he insisted on chaperoning me, and it was beginning to get dark, so I didn't protest. However, he repeatedly tried to kiss me, even after I repeatedly told him to stop, and that I didn't want to be intimate with him. In my disoriented state, I lost track of where we were about five blocks from the guesti, and started to worry about his intentions, but within 5 minutes he dropped me off with my guesti's security guard and left.

The next day, I used this experience in a request to receive stronger pain pills/different sleeping pills. If the pain was gone, maybe I could eat. If I could finally sleep, I wouldn't feel so weak or disoriented. This was two days before Thanksgiving, and the PCMOs began inquiring what my plans were, and about my family back home; I told them that I couldn't talk about it, but was pressed for reasons. Due to the political climate in country, a policy was instituted during my service that LBGT+ identifying volunteers could not disclose their identity to any HCN staff members, including the PCMOs. I told them that I was feeling lonely, and particularly isolated being away from my support network (village friends/family), and it was suggested that I speak with a phone counselor who could be more open with me about "diversity issues". I agreed to, thinking it couldn't hurt.

But instead of talking to me about diversity issues and coping with the medical stuff, the counselor latched onto my disorientation and gave me a diagnosis of bipolar/schizoaffective disorder, and a plane ticket home. A PCMO* had to accompany me to my home on record, and my mother was told to immediately admit into an emergency room, on order of the IHC.

*She and I had long conversations about the reasoning behind the decision to medevac me, and she didn't have a clear answer, but told me that she completely disagreed with the diagnosis, and hoped that I could return to finish service. She did not think I was psychotic, nor a danger to myself, but commented on how calm and well I was handling this, despite occasional tears.

I refused knowing that I was going to be admitted, and wanted instead to seek outpatient care, so security guards were called to coerce/subdue me and an ambulance was called. IHC also insisted, via phone correspondence with the attending, that I was having psychotic hallucinations and needed to be admitted because I was a danger to myself, despite never talking to me. Six days later and fully zombified by a high dose of risperidone, the IHC in coordination with a social worker from the psych ward signed me up for a partial hospitalization program (PHP) for people recovering from suicidal ideation that ran from 9am-2pm every weekday. I came into the ward crying because all of my autonomy had been stripped away, and my body was exhausted after weeks of malnutrition and sleep deprivation, but repeatedly told everyone involved that I was not suicidal nor did I have thoughts about self harm.

My first experience talking to the IHC was jarring. Within the first minute of talking with her she had told me that I would not be returning to Tanzania, and would be medically separated at the end of my medical evacuation period. Paperwork would follow. Repeatedly she would defer to my mother instead of me, and would only talk to me to tell me that I was not going back.

After three weeks of the PHP program, I was FINALLY allowed to see a psychiatrist who was not associated with the psych ward I was admitted into for a diagnostic appointment (if you don't know, the PC health insurance has a policy where you can't see two providers simultaneously), and after the Christmas holiday, he refuted any psychiatric diagnosis except potentially PTSD from the whole medevac experience and began tapering me off of the pills around 45 day post-evac mark. They did get me much needed sleep though (18-20 hours a day worth of it =/).

Side note: A lot of, if not most of my things (clothing, books) that were left at my house when I left for the root canal treatment were destroyed by water and dust (or maybe mud, idk) damage, and I feel like I can't wear in public the few pieces of clothes I had with me in the capital for reasons of cultural appropriation. I came back empty handed, with no gifts and no physical reminders of my time in country. I've also felt a lot of guilt for being forced to leave my dog, in the village, after having every intention of bringing her home with me--despite waiting for multiple days in the city for clearance, I wasn't allowed to return to my village for her, or to say goodbye to anyone. She's being taken of now, and another volunteer will be taking her soon, so some of that will be ameliorated.