Malaria?

Both Rebecca and one of the Americans we met, Albert from New Jersey, contracted malaria ... Though I worried I'd suffer a similar fate, having not had the option of sleeping under mosquito nets most nights, I seem to have dodged that particular bullet (knock on wood).

It seems I spoke too soon. Thursday night, I went to bed around 3 a.m., feeling good after a fairly productive night. By 4:30, I awoke with chills so severe I turned off my fan and donned my Willison Hall sweater. An hour later, I was making repeated visits to the washroom and by 6:30 I was retching into a bucket beside my bed. When Patrick and Bryna woke up, I walked from my room to the living room - about 15 feet - and almost collapsed from the effort.

Most attacks of malaria start suddenly. The patient feels unwell and feverish with headache (often severe), aches and pains (including backache and pain in the muscles), mild nausea, and loss of appetite. Symptoms often mimic those of 'flu' but without the running nose and sore throat of true influenza.

Severe teeth-rattling, bed-shaking chills, followed over the space of a few hours by high fever, profuse sweating, and exhaustion are classic features of the malarial paroxysm. Other symptoms include a dry cough, dizziness, or faintness (especially on attempting to stand up), nausea, vomitting, stomach ache, and diarrhoea. Most travellers will feel too ill, weak, and exhausted to get out of bed while the attack is on.

- "Traveller's Health: How To Stay Healthy Abroad" by Dr. Richard Dawood

Oh, did I mention that shortly after getting out of bed, I developed a fever and a pounding headache? Or that the only thing I ate all day yesterday was a piece of pita bread - which I left two-thirds unfinished? All signs pointed to a textbook case of malaria.

Though my roommate Patrick gave me his malaria treatment and suggested I start taking it immediately, I decided to venture downtown and have tests done at an expensive but allegedly reliable clinic. The doctor put me on symptomatic treatment and said we'd wait for the results before we did anything else.

But when the chills returned yesterday evening marking the seeming onset of another attack of this typically cyclical disease, I decided to start the malaria treatment anyway, knowing that there were little to no side effects even if I didn't have malaria.

When I got my lab results this morning, everything came back negative. But listening to my symptoms of the previous evening, the doctor informed me that false negatives for malaria are very common, and the doxycycline I'm taking could be obscuring the results. She suggested taking the malarial meds anyway, just to be safe.

Being on doxycycline also apparently makes the symptoms of malaria way less severe when you do contract the disease (doxy being only 90-95% effective). Assuming what I've been experiencing is malaria, I shudder to think what it would have been like without that anti-malarial buffer.

Overall, I've taken any threats to my health here very seriously, expending many hours on diagnoses and treatments over the last couple weeks alone. I'm still making daily visits to Solo B about the burn on my leg, and he says daily treatment will continue to be necessary for at least another week (the photo below shows progress as of Thursday, though I don't think the photos really show how deep the burn went). Turns out I really did some damage.


With both my leg and my recent illness, the medical practitioners I've been visiting seem to know what they're talking about, so I'm fairly confident all will end up okay. But I definitely have a growing appreciation for the Canadian health care system. Here, even when my diagnosis sounds utterly reasonable and is probably correct, I can't seem to push the country's abysmal health sector statistics from the back of my mind, leaving me mildly terrified.

Over the last two days, I've been thinking back to a discussion I had with my colleagues over a couple beers on one of our first evenings in Freetown about this potentially fatal illness, and how flabbergasted I was by their flippant attitudes towards it. Patrick confided that he'd had malaria three times, yet was still not bothering to take anti-malarials. Kari, who had more experience on the sub-continent than anyone else in our group, had also passed on meds.

Five months later, while I still think anti-malarials are worthwhile, I can understand their attitude a little more. I think being in Africa actually makes malaria significantly less scary, precisely because it's so commonplace. Most locals cannot even count the number of times they've had malaria, and are more likely to show sympathy or concern if you have a sprained ankle.

And because of the high prevalence, it's the first thing people look for when any of the symptoms appear. Where you get into trouble is when you're not looking for it and it's misdiagnosed.

In any case, I've now taken two-thirds of the malaria treatment and am feeling significantly better than I was 36 hours ago. I expect to be back to work on Monday.

And this whole process is serving as something of an edifier in how manageable even the diseases deemed most frightening by Westerners can be, provided you're educated enough to identify the symptoms and affluent enough to afford the $10 treatment, making it all the more tragic that two million people die of malaria every year.


Editor's note: This entry was written while monitoring the live scoreboard of the Villanova-Pittsburgh game, and I'd just like to go ahead and profess my undying love for Scottie Reynolds for hitting that final shot. Pathetic as it may sound, missing March Madness has been one of the toughest aspects of being in Sierra Leone. I may need to enlist someone to provide me updates for next weekend's Final Four game. Go 'Nova!