On a trip like mine through Africa, Malaria presents a problem. Conventional wisdom says to take an “anti-malarial” pill in the hopes of preventing infection, though for a number of reasons that’s not really practical. All anti-malarial tables come with an increased sensitivity to the sun (they advise staying out of the sun. I can tell you that’s very difficult in Africa), and they are hard on your liver in the long-term. All the advice is not to use them for too long, though nobody can quite say how long is too long.
I think two years is long.
One of the options requires taking a tablet daily, and is extremely expensive. Not only would I spent thousands on these tables alone, it’s extremely likely the first border guard to find a stash of 700+ tables will confiscate them.
One of the other major options comes with side effects, usually related to severe, severe demented dreams and interrupted sleep. A friend said he’d much rather get Malaria than have those dreams again – they upset him that much!
I had originally planned to go with this option, though upon reading further, the US military issued it to all personnel for many years, and only stopped when they discovered that 10% of all people on it long term develop permanent psychosis.
While Malaria sounds bad, I think that sounds worse.
The final option is to use bug spray, cover up at dawn and dusk (when the particular type of malaria-carrying mosquito is active) and really hope for the best.
I’m sure by now you can see where this is going.
On my first afternoon in Bamako I venture into the city with a new local friend, and really am not thinking ahead. We are still out and about as dusk turns to evening, and I am wearing shorts. I get a lot of bites that night.
Fast forward about a week, and around midday I start feeling pretty crap. Kind of like a cold with an upset stomach. Really tired, headache kicking in, kind of out-of-body numbness. Grumpy too. I lay down for a while and things get worse and worse. As luck has it a Doctor is staying at The Sleeping Camel, who takes one look at me and says “I think you’ve got Malaria”.
I don’t want to believe it and am in denial for 20 minutes while we talk about options.
It’s possible to do a “quick test” which can be bought in any Pharmacy (there is one on every corner in Africa) – the problem is that it’s not all that accurate – if it says positive then you have it, but if it says negative maybe you have it, maybe you don’t.
The other option is a full-on blood test at a clinic, but the results take a day, and I wouldn’t be able to go until the next morning anyway.
Quickly Sara, the Doctor, lays it out for me. We are not certain I have Malaria, but that doesn’t change our approach. I should start on the “cure” medication immediately regardless. If I have it, the sooner I take the medication the better. If I don’t have it, no harm done. The cure is vastly more effective the sooner you start taking it, Sara explains. The “cure” is commonly called Coartem – more info on Wikipedia here.
For about $12 USD we buy the medication and I take the first round. I get a room with air conditioning, and even still I am sweating profusely. Before I fall asleep my fingers and toes start to tingle, and I get a bit loopy (classic Malaria symptoms). During the night I wake up a few times bathed in sweat, even though the AC has the room very chilly. I have a pounding headache, but manage to sleep most of the night.
By morning I feel much better, really just a bit crap and by the afternoon actually feel mostly OK. Two days later I’m perfectly good again, and finish off the last of the medication, extremely thankful Sara had me take it when I did. We still don’t know for certain I had Malaria, though it seems the most likely explanation. I few days later I don’t feel great again, so I go to a clinic and get a blood test for both Malaria and Typhoid, which is negative on both counts. It’s just a regular upset stomach so I take some general purpose antibiotics and feel fine again.
During and after the whole thing I talk to a lot of people and learn a lot about Malaria. It turns out it’s not nearly such a big deal as the Western media makes it out to be. Every single local here gets it every year, often a couple of times per year. Every single foreigner living here is the same (Matt and Phil at the Camel have both had it more times than they can count). As I learn, virtually everyone that spends more than a few months in Africa will get Malaria at some point – and guess what – they’re fine.
The “cure” medication is cheap enough, and every single street corner in every single town has a pharmacy that stocks it. You just stumble in and say “Malaria” and they will hand it to you. Now I have a course in the fridge, along with my other medications.
Malaria – an experience I was hoping to avoid, but which turned out to be much different than the hype.