Seriously Funny: Part II, The Malaria Chronicles

Malaria:
Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected Anopheles mosquitoes, called "malaria vectors", which bite mainly between dusk and dawn.

In 2008, there were 247 million cases of malaria and nearly one million deaths – mostly among children living in Africa. In Africa a child dies every 45 seconds of Malaria, the disease accounts for 20% of all childhood deaths.

- Malaria is preventable and curable.
- Malaria can decrease gross domestic product by as much as 1.3% in countries with high disease rates.
- Non-immune travelers from malaria-free areas are very vulnerable to the disease when they get infected.
-World Health Organization, 2011

Malaria is one of those things that you grow up hearing about, but in an intangible way. A missionary from your neighbor’s cousin’s best friend’s aunt’s church had it. Or you heard about it in a history or social studies class. Maybe you even took a class in college where infectious diseases were discussed. But it’s an experience isolated to people in foreign countries – like owning a pet tiger or eating crickets.

Like with so many things, malaria is a disease directly related to privilege. Without the right environmental conditions, diagnoses and medications, or if it is piled on top of other complications, malaria is a killer. But factor in access to healthcare, both prior to contraction and at the time the disease presents, and it’s a bump in the road – a mosquito bite gone bad.

Right?

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After getting home Thursday night, I had just fallen asleep when I woke up to what felt like lava landing in the middle of the bed. It was, in fact, Ava getting in bed with us, burning with fever and shaking with violent chills. After some Advil and an hour or so or chattering teeth, she fell asleep – but clearly, something was wrong.

There was no question the next day that she needed to be tested for malaria. This, however, presented an entirely new set of issues. It’s one thing to go to the pharmacy and stumble my way through a diagnosis by pointing to various body parts and making faces. But going to an actual medical clinic to request blood tests and provide a medical history does not typically involve the word “cheese” and was, therefore, well beyond my French vocabulary. Fortunately, Chris has an amazing team of co-workers and they, unanimously, look out for us – especially the girls who have become mascots of sorts for the group. And so, mid-morning, Chris and Roger, our wonderful French-speaking friend, showed up to take us to the clinic.

I should explain a little something about Libreville. The Bord de Mer is the main road through the city. This is where you will find most of the government buildings, hotels, larger shops, supermarkets, major businesses, etc. It’s easy enough to imagine as you drive through Libreville via the the Bord de Mer, that you are in what was once a fairly metropolitan city circa 1980. And while not like any U.S. I’ve ever been to, it far exceeds the standards of it’s counterparts in developing countries.

But, turn off the Bord de Mer and within a block you will find a very different world. The streets become narrow, the buildings more dilapidated and the pavement questionable. Here, the real life of Libreville is lived. Houses of cinder block and corrugated tin line the streets. Stray dogs wander through dirt yards and trash-lined alleys. Rusted and faded signs advertise local bars, restaurants, tailors, shops and markets. Everywhere there are people standing, sitting, walking, talking, half-heartedly selling vegetables or energetically peddling household items. And then suddenly, there will be a break in the scenery, occupied by a large office building, a church or mosque.

It was on these winding streets off the Bord de Mer that we found ourselves. For the record, if I were dying and my only hope of survival was to relocate this clinic, I would have to trust Chris to retrieve my lifeless body and remember that I want at least one Bob Dylan played at my funeral, preferably “Sweetheart Like You.”

After approximately 112 left turns, we ended up on a narrow, unpaved, red dirt road full of potholes deeper than most swimming pools. I am going to work under the assumption that the majority of medical cases seen at this particular clinic involve head trauma received by one’s head being repeatedly smashed into the window of their car while on this road.

Add to this the fact that we were away from businesses of any sort, surrounded by trees and vegetation camouflaging small houses and sheds, and it’s only natural that I asked Chris if we were by any chance visiting a witch doctor before going to the actual clinic. But then, all of sudden, there was a paved parking lot surrounding a clean, modern-looking medical building.

All I have to say of the experience is thank God Roger was there. He is fluent in French so he first got us checked in then went with me to meet the doctor. We went through the basics of her symptoms a little medical history. She was weighed and her temperature was taken. Then we got a little surprise. The doctor said she would need a shot to bring the fever down. After pulling out a needle roughly the size of the space shuttle, it became clear, without translation, that the shot would NOT be administered in Ava’s arm. At this point, poor Roger was the only person who wanted to be in the room less than Ava. He ran madly for the door, prompted no doubt by Ava screaming, “Get Roger out of here!” Poor guy.

After a shot, 2 blood tests and an hour wait, we got a negative reading for malaria, “paludisme” or “palu” as it is called here. However, they recommended treating for malaria, a 3 day cycle of meds and antibiotics, because of the nature of her symptoms.

We went home but had to wait until the next morning to get the meds because our local pharmacy did not have the right kind. By then, her fever had not gone down, even with Advil, her chills continued and were now being followed by sweating…and she simply looked pitiful. We found out about another pharmacy that administers blood tests without a long wait and for about $100 less than the clinic. An hour after the test, Chris returned to the car where I was waiting with the girls. As soon as I saw his face, I knew the results.

Now, I know enough not to panic. I know that this was not so very serious, but forgive me, I couldn’t help a few tears. It’s not like she was in any danger at this point, but malaria. It just sounds so bad, right? No sooner had the first tear dropped and our poor driver went into a panic. “Pas grave, madame! Pas grave!” he repeated, nearly running off the road in an effort the comfort me.

Apparently, malaria is the rest of the world’s flu. Nearly one hundred years ago, my great-grandfather died of the flu (or was it pneumonia?) But now, we have a shot for it. That’s not to say that people don’t get sick and even die, but those people are the unfortunate exception. Think of how much money has been spent on research and medications to reduce the flu from epidemic to seasonal annoyance. And so what about malaria?

In so many places, it is endemic – a continuous killer for those without education on prevention or access to both preventive measures and treatment. If the flu was causing hundreds of thousands of deaths in America, would we segregate the acceptability of the disease by class? I don’t think so. But before I go too far down the path of angry diatribe, let me just say that my tears were, in one part, selfish. They were of self-pity, for both me and Ava. But they were also tears of gratefulness that I had access to medicine and care for my daughter. Gratefulness that she had been exposed to the highest level of healthcare in the world from the time of her birth – and before. She had always had healthy food and clean water in abundance.

Yet, they were also tears of sadness that a disease, so manageable in the right setting, could kill. They were for other mothers who, at that moment, were crying tears of grief and loss.

In the last week I have talked to a number of people who have had malaria. It does seem to be “pas grave.” But I have also talked to people who have known children and adults who have died right here in Libreville. One woman was allergic to the medication and threw up the treatments. Instead of getting a new medication, she grew increasingly ill and died. It’s hard to make sense of it.

It was a long week for my little one. Continuous fever and recurring chills followed by intense sweating and extreme fatigue. We spent 5 solid days lying in my bed with the curtains drawn. By the time we emerged, we were a bit weary, a bit worn, but none the worse for it.

As I finish this post, we are one week out. Ava is back to her old self, mostly. She tires easily, but for a kid that was doing handsprings on the trampoline the same day she got a cast on her arm, she seems to be doing just fine. It takes a lot to keep her down.

I know I have spent the last seven years asking people for one thing after another – for money or activism or involvement. And I know I have probably made everyone crazy with my constant soapboxing. But I have been both humbled and honored by the way so many of you have reached out and rallied behind my ever-growing “causes.” I was not going to use this blog as a tool for social activism – and I promise not to turn it into that. But I will close by asking you to consider visiting the following site: www.nothingbutnets.net For a small, one-time or ongoing donation, you can provide life-saving mosquito nets to families. And maybe, somewhere there is an 8-year old who will grow up to make a difference in her world because of it.