It’s me. I’m the weakest link.
Like most other expats that we’ve met here, we’re not taking any malaria prophylaxis. We decided not to for two reasons. First, and foremost, no one knows what taking that stuff for long periods of time does to your body (especially for the kids). Second, Malarone is the only effective anti-malarial drug that doesn’t have bad side effects, and it’s really expensive. It would be several thousand dollars per person per year.
So I have been designated family worrier about malaria. I had the bed nets made; I remember to spray the mosquito repellant in the evening; I go on nightly killing sprees to keep mosquitos out of the house. No one else in the family really thinks much about it. Nor do many of our expat friends, most of whom have been here two, three, four plus years and have never had it.
So I feel pretty unlucky catching it in my first five months.
Then again, the small sampling Tanzanians that I talked to all reported having malaria. (You have to take that with a large grain of salt, though. It is pretty common that anytime a Tanzanian goes to a doctor with any headache, fever or stomach ache, the doctor diagnoses them with “malaria”.)
I got the common African variety, malaria falciparum, which is kind of a good news/bad news situation. The bad news is that falciparum it kills 90% of the people who die from malaria. The good news is that it doesn’t hide out in your liver, so when you treat it successfully you get rid of it and don’t have relapses later. And really, most of the people it kills don’t have access to care. If you have money and live in a city like Dar, your risk is pretty small.
Fortunately we identified it early and treated it immediately so I didn’t have a bad case. The initial count of parasites in my blood sample was 17; the IST Clinic that treated me often sees counts around 100 and has seen bad cases of 800 or 1,000. For me, it felt like a bad flu that lasted about four days: fever, headaches and a complete inability to get out of bed for hours at a time. So along with the good looks and star power, I guess it just one more spooky similarity between George Clooney and me.
The thing is, it seems like Malaria would be tough to catch. First, it’s transmitted by just one type of mosquito that mostly feeds at night. Second, the mosquito that transmits the parasite has to bite someone else who has malaria first and then bite you within 15 minutes or so. So if you’re not around a lot of other people who have it, your chances of getting it go down significantly. No one in our house had it and we don’t go out that much, so most nights our risk is pretty low.
It’s not clear how I got it. I suspect it may have been at the ambassador’s Fourth of July party, which seems ironic since the major risk at the time was having a George Bush moment with a bowl of pretzels. But that was 10 days before I came down with malaria and I was around a large number of people, some of whom might have had it.
(As an interesting historical side note, I didn’t realize that the US South had endemic malaria into the 1950s. There was even a National Malaria Eradication Program to eliminate it. It’s also how DDT got its start before farmers started using it more widely for pest control.)
So my lesson learned here is that despite all the counter measures, you never know when there is a mosquito out there with your name on it.
So given that all my other activities weren’t sufficient, I have decided to copy the British colonialists. Tonic has quinine, which used to be effective against malaria. Maybe if I increase my gin and tonic consumption, I will add another barrier to transmission.
Or even if it doesn’t work, at least I’ll enjoy it. And that’s more than I can say for the bug spray, mosquito nets and wearing long clothing in hot weather.