Friday, November 26, 2010


Several weeks ago I went to a music concert on a Saturday night. I felt somewhat ill, with a splitting headache. The next day I felt largely the same, and rather tired. I wasn't sure if it was actual illness or exhaustion, since I'd been working long hours every day getting ready for a major meeting. But I spoke with a doctor friend after services Sunday morning who advised that I go to a local clinic and get tested for malaria as soon as possible. The next morning I went to the clinic where they drew a drop of blood (they make just a small prick on your finger to put a drop of blood on a glass slide. I assumed they'd take a vial and thus wore a short-sleeved shirt.) After reviewing the slide I was informed by the doctor that I indeed had malaria! I was expecting some sort of near death experience, but really malaria was rather disappointing as illnesses go, just a bad headache and a mild fever. Still, it's best not to take chances with a disease which kills millions every year, so I'm glad I got tested right away and got on medication. In Africa, in Sudan at least, you don't need a prescription to walk into any pharmacy and order whatever you like. "You want malaria medicine?, step right-up." "You'd like something with opium to soothe your nerves? Got just what you need." And the prices are so cheap. You can get a big box of pills for 10-pounds, the equivalent of $4.00. If there was any kind of postal system it would be quite lucrative buying medicines here and shipping them back to the US for resale. Anyway, after three days I felt better - not one hundred percent - but better. A friend gave me some of her SP pills, another standard malaria drug. After that I felt better, and when I returned to the clinic on Friday to be retested they said I was malaria-free.
Last week I spent five days in Aweil, up in Northern Bar-el Ghazal state. The area around Aweil is flat as a sheet of paper and prone to flooding, since the water doesn't have anywhere to go. The area was mosquito-ey (is that a word?) and the hotel we used lacked mosquito nets for the beds (however, they had monkeys running around - a fair trade-off I thought.) I know the first night that I heard mosquitoes buzzing around me and I awoke covered with bites. Conditions in the hotel improved and we were able to keep our room mosquito free the rest of the nights, but the damage was done. Shortly after we returned from Aweil I started feeling ill, and I recognized the symptoms. A quick trip to the clinic confirmed the presence of malaria - but "scanty" according to the technician who read the slide. Speaking of the technician, I had a fun time tormenting him as only I can. When he retrieved something from the mini-fridge in the lab room I asked him if he kept his lunch in there. He said "no," but did own-up to keeping waters and sodas in the fridge. Before reading the slide the technician dips the slide in four cups of different colored dyes, the process of which is supposed to make the malaria bugs stand out making them easier to see. I pointed out how in America at Easter we place eggs in cups of dye just like he had in order to dye eggs for children (I don't think he believed me.) By this point the technician, I could tell, was thinking that malaria was the least of my problems and mental illness was more likely present. But the best part was after he had looked at the slide through the microscope. I asked the technician if he'd ever looked at something through the microscope that scared him so much he'd wanted to run out of the room. I figured he'd just say, "no," but he excitedly said "YES!" then he went on to tell me how when he had first started how he had looked at a stool sample on a slide to check for worms and when he did the worms looked so large and they looked like they were coming right-up at him. By now I had practically fallen out of the chair I was laughing so hard. It was great. I knew this guy was happy too to have finally been able to share that event with someone who could appreciate it (for the comic moment it was, IMHO.)
After the test I saw the doctor who informed me I had a mild case of malaria. He prescribed a different medicine, although he was sure that this was a new infection rather than a relapse of the old case - whatever. The doctor explained that I would need to take the medicine with fatty foods. I just looked at him for a moment and then told him, "If you weren't a man I would kiss you." I told him he was the doctor I'd been looking for all of my life! The next morning I made sure to buy a bag of fresh lumps of dough fried in grease - Juba doughnuts - thinking to myself as I munched these greasy treats: Doctor's orders.
I have nearly finished my course of meds and I'm feeling better now. I think abother part of the problem is that I switched anti-malarial medications. I used to take Malarone, which worked great, but after running out switched to Doxycycline. There is evidently some resistence by malaria to Doxy, I've known several people that were taking it who got malaria anyway. But at least the treatment is easily available and cheap, and hopefully I won't need it again.