World Malaria Day

Question:  What do Alexander the Great, Genghis Khan, Amerigo Vespucci, Dante, and approximately 660,000 people in 2010 have in common?  Well Class, all of these people are reported victims of Malaria.

April is Malaria Month – in fact, today happens to be World Malaria Day.  Whereas this usually doesn’t mean much to the majority of people in the States, it has enormous implications to everyone living in the Developing World.  Malaria has become such a problem that it’s warranted the designation of an entire month to increasing awareness about the disease.  And it’s well earned.  Here’s why:  According to the World Health Organization, “there were about 219 million cases of malaria in 2010 (with an uncertainty range of 154 million to 289 million) and an estimated 660 000 deaths (with an uncertainty range of 490 000 to 836 000)…Most deaths occur among children living in Africa where a child dies every minute from malaria.”

I’ve made a number of off-hand references to this “doença” in some of my past posts, but I’ll summarize my observations again:  Malaria is to Mozambique what the common cold is to America.  It’s omnipresent, relentless, utterly annoying and it comes in seasonal waves.  Unfortunately, the similarities pretty much end at a superficial level.  Underneath the surface, Malaria is a cruel and elaborate monster, a blood parasite that’s transmitted through the bite of an infected female Anopheles mosquito.  Once it enters our immune system, it travels to through the circulatory system to the liver where it sets up shop.  Nice and cozy inside your liver, the parasite then reproduces and matures all the while planning a destructive campaign of biological warfare your body.  Depending on when Malaria can get its shit together and amass a sizable army of microorganisms, you start to feel symptoms 8 to 25 days after you first get bit.  First comes the flu-like symptoms:  headaches, fever, chills, joint pain, and hypersensitivity to light.  Then the contents of your bowels decide they no longer want to be contained, so they make for the exits.  Both ends.  Repeatedly.   And then, just when you’ve run out of toilet paper, you’re internal thermometer goes haywire.  Is it too hot?  No, it’s cold.  Wait…that’s not right, it’s hot. Wow, it’s really hot.  Wow, I’m sweating now.  But wait, my sweat feels like ice water.  More blankets!

But then things get even more serious.  If at this point you don’t get treated, Malaria, already in the middle of a crusade of terror, can up’s its game.  Seizures and even something called Conjugate Gaze Palsy (when your eyes don’t turn together in the same direction) can follow and eventually some people end up in a coma.  Or worse.

Although there is a cure for Malaria, there is no vaccination.  The disease has been eradicated in the US and Western Europe (thanks to painstaking and tedious efforts), but over 3 Billion people are still susceptible to infection.  Without a vaccine, these people will continue to be at risk. 

But there’s good news:  We’re working on it.  That same energy that was used to eliminate Malaria from certain parts of the world decades ago, is still being applied.  Bed nets are being distributed, insecticides are being used, and the correlation between standing water and mosquito breeding is being recognized.  And our work is working.   Mortality rates have fallen by more than 25% globally since 2000 (WHO).

As Peace Corps Volunteers, we are afforded a rare opportunity that host country nationals do not:  Prophylaxis.  Peace Corps requires its volunteers in Mozambique (and probably other countries as well) to take one of three medications that are designed to prevent contraction of the disease and to lessen the symptoms of Malaria if you do get it.   Sounds great, right?  Well, as with most things, there’s a tradeoff. 

Peace Corps Prophylaxis Option #1 is called Mefloquine (also known as Larium or Mefliam).  It’s a powdery, little white pill that I take once a week, every week, and I’ve been taking it since I got here 7 months ago. It’s infamous for its inherent ability to cause creepy lucid dreaming in those that are taking it.  It also makes you have to pee all the time and I believe it’s the reason I’ve been waking up with some pretty miserable back pain as of late.  What it’s not known for though are the rare, but serious neuropsychiatric problems associated with its use.  According to Wikipedia, which sourced an FDA report, “the FDA product guide states it can cause mental health problems, including anxiety, hallucinations, depression, unusual behavior, and suicidal ideations, among others.”  I can definitely attest to the validity of that statement.  Mood swings and a manic state of mind are pretty common these days.  They’re controllable, but it’s still stressful to deal with.  I’m sure some of my other PC colleagues could say the same thing.  Oh yeah, and then there’s this:  In 2009, the US Military stopped giving its troops Lariam after concluding that a number of military suicides, as well as the actions of four solider who murdered their wives at Ft. Bragg, were linked to the Lariam prophylaxis.  Instead, they switched to Peace Corps Prophylaxis Option #2:  Doxycycline.

Although Doxycycline doesn’t make you want to kill yourself, it doesn’t sound much better.  It’s an antibiotic that needs to be taken every single day.  In addition to whatever side effects come about from taking an antibiotic every day for an extended period of time, the medication can also cause you to become overly sensitive to sun-exposure.  When Peace Corps sends you doxy, apparently they also send you some extra-powerful sun screen.

The third Option on the list is Malarone, the high-priced wonder drug.  I don’t know very much about it, but what I do know is that it’s the last option for you as a Peace Corps Volunteer.  If all else fails, they put you on the magic pill.  Unfortunately it’s expensive, so PC can’t afford to just give it to everyone. 

Life on Malaria Prophylaxis is far from ideal.  But then again, so is the alternative.