Sunday, 26 May 2019

Malawi – Managing Malaria


May 14-20

Hello everyone!

Most of my blogs are normally about amazing locations in interesting destinations. This one is a bit different. It’s set in my house. Why? Well I haven’t really been able to leave it for the past week…

Guess which one has malaria?

I woke up on Wednesday (May 15th) feeling OK, if a little cold. I taught my regular day at school, though was raising some eyebrows that I was walking around in glorious sunshine and 25°C in a hoodie. Man flu, I told them. I got through a meeting, forced a bit of food down me (I didn’t seem hungry for some reason) and went home shaking in the car. Still in a hoodie. Feeling increasingly frail and making some strange noises which some would equate with breathing, I hopped into bed. The time had just passed 2:30 pm.

My sanctuary for a few days

Aside from a couple of staggers to the toilet and sending messages to say there was no way I was working on Thursday (May 16th), I was asleep until gone 4am. I woke up, feeling blindingly hot. Understandable as I was fully clothed under a duvet, I thought. Going to the toilet confirmed I was severely dehydrated.

The dark amber colour of my urine makes me think
I was like the character on the right of this picture

I spent the day in bed, counting myself lucky that our power situation is quite good at the moment (either owing to the torrent of rain in 2019 or the upcoming election, not sure which). My head was pounding and sweltering, being soothed by a fan on full blast; my body was shaking under a duvet. Half a piece of toast and lots of water was all I was interested in.

I was drinking over 5 litres of water a day

When Hannah returned from school, I asked if she could take me to the doctor. We have a clinic quite close but everything felt like a struggle, with Hannah even deciding to drop me at the entrance instead of parking. I leant on the desk the whole time I was signing in, unable to independently hold myself up for long.

The clinic at ABC in Area 47

I was shown into a ward a little bit larger than my bedroom. There were 3 beds, each with a mother and young child. Curtains were there but weren’t being used for privacy purposes. Some of the children were incredibly brave; others were screaming murder, particularly when one nurse couldn’t get the needle in properly.

I was given pain relief pills - a few days later, Mini decided that
she wanted to try them too...luckily, she only ate one!

My nurse pulled out a thermometer and stuck it pistol-style next to my sweating head. Oh, your temperature is too high. Too high.” Always reassuring to hear, and I thoroughly enjoyed her repeating it many times. I had my blood taken and was told to wait for the doctor to analyse it. “I hope it’s not malaria,” I whispered at full voice. Weakness had spread to my mouth as well (some would say every cloud has a silver lining). Doctor Brian returned about 20 minutes later and started speaking in a quiet, matter-of-fact tone.

“We have looked at your blood sample. The malaria is stage 3…”

He didn’t really mention the word again for a while, so I had to double check with him. Yes, I did have malaria. Many thoughts crossed my mind, ranging from the downright ridiculous (excellent, something to blog about) to the rational (people get this here all the time, they know what to do) to the concerned (stage 4 is the danger zone and I’m at stage 3?).

4 plus signs is the most severe, though I'm not sure of the details

I was given some pills – paracetamol for the firework display happening in my head, D-ARTEPP for the plasmodium parasite (of course I Googled it, and of course I have no idea what that really means). A few messages – mainly to parents in my class, who were expecting an all-singing, all-dancing assembly the following morning – and then bed.

The number of pills you take is based on weight - I took 1.5 a day

Malaria is an incredibly frustrating disease for someone like me who can’t sit still for two TV episodes, let alone lay prone in a bad for days as you don’t have the energy to do anything else. I’m sure my time could have been served more productively, instead of watching Netflix and napping. But the main advice is drink lots of fluids and rest. Reading made me fall asleep. There was no desire to cook when I didn’t want to eat (my weekend food was almost exclusively little bits of KFC). As for half-marathon training…

One solitary drumstick kept me going for a long time

I improved each day – by Saturday (May 18th) I was able to go to watch a bit of TV next door and stay awake for most of the day. Sunday (May 19th) I could move a lot more freely. By Monday afternoon (May 20th), I felt just about back to normal with limited meds needed as the headaches had died down. Normal enough to write this, anyway. I can’t watch any more TV.

My class made me a card, very sweet! Also showed that
quite a few of them can't spell my name...

Some people may suggest that I wouldn’t have gotten malaria if I was on pills such as Malarone or Doxycycline to prevent the disease from spreading. My common answer is that I’m not here on holiday – I live here, and have done for almost 3 years now. 1000 days. Is it feasible to take preventative medicine for 1000 days? When there’s not much idea about the long-term damage it could do? I’ve also read that I’ve slightly built up some immunity to malaria now, not that this was the nicest way of doing that.

Taking these every day may give me other negative health effects

I’ve always told people that Africa is the best place to get malaria. I have no evidence to back up that bold statement; however, millions of people get it every year. Most survive, even though the number of deaths is frankly terrifying. They know how to treat it. The testing is easily done, either in a hospital or independently from a pack bought at a pharmacy. The treatment pills are accessible, whereas they may not be in an area where malaria isn’t a threat.

Malaria is Latin(ish) for 'bad air', as people used to think the
disease was linked to the air they were breathing

Malawi is one of three African nations trialling a vaccine which, if successful, could be transformative to the continent.

Apparently almost 90% of cases and deaths attributed to malaria happen in Africa

Nasty and frustrating, malaria has a bad reputation for a reason. It kills hundreds of thousands of people every year. Mosquitoes are one of the biggest natural killers of our species through passing on this parasite. If it’s caught early enough, like mine was, then people make a relatively swift recovery – it doesn’t feel swift at the time, but it was just over a week for me.

The podcast I listen to said that malaria has probably killed 50% of
the humans who have ever lived - (very) approximately 54 billion

I feel lucky – lucky that I didn’t play macho man and wanted to go to the doctor; lucky that it was caught early enough to be treated; lucky to get lots of messages of support even from people who I hadn’t told about it. Malaria is a horrible thing and anyone else who gets it in the future has my deepest sympathy and hope that they recover quickly.

Feeling much better - yes, I'm wearing a lemur onesie

Love you all,

Matt

Update – I went back to work on Wednesday. Some of the symptoms (dehydration, headache) were still there but I was able to handle the day comfortably enough.

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