Malaria: Arguably the only African natural resource unwanted by the rest of the world

After almost two decades in and around regions endemic with the parasitic disease, I finally contracted malaria. Had it only been malaria it probably wouldn’t have been such a big deal, but tests revealed that I was carrying two additional parasites: Schistosomiasis and Giardia lamblia. All three combined, had systematically compromised my immune system and I was rushed to hospital.

It started like any simple Flu

A day or two before I started to show acute malarial symptoms I had a runny nose, a small fever, a bit of a chill, mild diarrhoea, aching joints, back pain and a general malaise reminiscent of regular flu. There was nothing out of the ordinary to suggest malaria, in fact, I was convinced that it was flu and thought nothing of it. I took some flu medication and went to bed hoping that it would all be over by sunrise.

The following morning I woke up in a pool of sweat, shivering and with the exception of my fingers and small hand gestures, I was unable to move — immobile in a Zambian hotel room. The sunlight coming through the tiny window was hurting my eyes but I didn’t have the strength to get up and shut the blinds. I just lay there on the wet, cold sheets unable to turn my head away from the sunlight. I managed to pulled up the blanket all the way past my eyeballs and there I stayed until the sun had shifted.

My body wasn’t just shivering, not like a chill, it was shaking like some violent form of Parkinson’s and there was nothing I could do about it.

My whole body felt like it was being stabbed by a million frozen needles, as if I’d been tossed into the freezer and left there on the cold ice without a shred of clothing for protection. I was cold and exhausted. My body wasn’t just shivering, not like a chill, it was shaking like some violent form of Parkinson’s and there was nothing I could do about it.

Doctor to the Rescue

I’m not sure whether I was delirious or that I was still half asleep and dreaming, but I distinctly remember someone telling me to call a doctor. Something was seriously wrong with me.

With great difficulty, and begrudgingly, I reached for the phone to call a doctor. I know, typical man, won’t call a doctor till he’s dying. Barely twenty minutes later an American doctor was standing over me surrounded by a full entourage of hotel security personnel. I must have looked pretty pathetic because their faces were quire grim. The doctor didn’t waste any time. After a basic examination he proclaimed: “it looks like malaria but we’ll need to run some tests to confirm.” They loaded me into his car and drove me to the clinic.

Within fifteen minutes the results were in. Malaria. The nurse didn’t waste a moment and administered an injection (quinine I presumed at the time) followed by some oral medication. The pills were the size of a good size gobstopper and they were difficult to swallow. I remember wondering whether death by malaria would be less painful than death by gobstopper? Why can’t they crush them to a powder or make smaller pills but let you take more?

I was weak and really didn’t enjoy lying in that claustrophobic examination room. By the time the injection’s stinging sensation subsided, so did most of the shakes and I was finally able to sit upright to have a proper conversation with the doctor.

Malaria but not Zambian

To be honest, I was puzzled as to where I could have gotten infected. Based on the test results, at least that’s what the doctor told me, it would suggest that my type of malaria exists mostly in coastal Tanzania and Kenya. I’ve always assumed that any symptoms would have shown up within 7 to 14 days of infection, like the textbooks suggest.

In my case, however, it would appear that I’ve been infected with malaria for at least 5 months (since my time in Mombasa) without showing any severe symptoms. Which would indicate that it’s been either dormant in my liver or the symptoms have been so mild that my immune system was strong enough to cope with the virus without me noticing — until now.

The doctors didn’t want to take any chances because my immune system had been severely compromised. Within the hour I was screened for anything and everything. Eleven tests later, and all for under $100, they had discovered the cause of my fatigue, fever and intestinal discomfort? In addition to the malaria, they found Schistosomiasis (sometimes known as bilharzia) and Giardia lamblia, two parasites that may have persisted in my body for a very long time.

Treatment and Recovery

Over the course of the next two days, I was given additional injections and handed detailed instructions that outlined which drugs and in which doses need to be taken. Some of the medication could only be taken individually as either the side effects would be exacerbated or that the chemicals would neutralize one another.

The malaria and giardia medication gave me pretty bad headaches and I was experiencing bouts of vertigo and nausea, but overall it was a hell of a lot better than going through another malarial fever. The doctors seemed to think that I would make a full recovery provided enough rest and adherence to the treatment schedule. Further tests will confirm if I’m completely cured.

Apparently I’m one of those fortunate few, or unfortunate depending on how you look at it, who are able to carry malaria without suffering acute symptoms. The downside is that my body may have been subjected to multiple lifecycles, each iteration taking a sizeable bite out of my immune system and possibly damaging my liver.

A few months earlier

About four months back I approached my regular doctor in Dubai stating that I was feeling run down, lethargic and without my usual spark. I had said that I work in and out of Africa but he quickly dismissed malaria (or any other parasites) as a possible cause as I wasn’t exhibiting acute symptoms. I was disappointed by the lack of diagnosis but didn’t have anything else to support my case.

They ran some basic tests but couldn’t find anything out of the ordinary. They tested my hormone levels and organ function but all came back within normal ranges. I felt that the Dubai doctors were generally disinterested in solving the mystery and were dismissive of my mild symptoms. At the far end of the spectrum, a stab in the dark, I thought that maybe I was intolerant to certain foods and asked to be screened — these too, were inconclusive.

I put it down to getting older, poor hotel diet, too much travel, not enough exercise or stress at work. I was beginning to think that I was going crazy.

After a month of dealing with incompetent doctors and inconclusive tests I pretty much gave up on finding a medical cause for my fatigue. I put it down to getting older, poor hotel diet, too much travel, not enough exercise or too much stress at work. I was beginning to think that I was going crazy. It was like I was stuck in some episode of the body snatchers. Someone had stolen my vitality, replaced it with a dilapidated clone but only I was able to spot the impostor.

I started taking vitamin supplements to try and get my energy up to normal levels, but it wasn’t helping much. I’d see a small boost in the morning but by noon I was back to ground zero. It’s only now that I realise my malaise was caused by the parasites. They were hindering my body’s ability to absorb nutrients and were slowly stripping me of important vitamins and minerals.

Conclusion

I’m glad I got sick in Zambia rather than some ‘western’ country where diagnosis could have dragged on for weeks and cost me (or my insurance company) thousands of dollars. Within just a few hours the local doctors made sense of the symptoms and pinpointed the cause.

Looking back, despite the dismissive nature of the Dubai doctors, I should have insisted on being tested for parasites, malaria and various tropical diseases. It was silly of me to go along with a doctor who maintained that it was ‘unlikely’ to be malaria without ordering a test to reinforce his suspicions or put mine at ease.

Malaria is preventable if the right precautions are taken. Clearly, though, despite my best efforts I wasn’t cautious enough and not one but three parasites got through when I wasn’t paying attention.

I’ll put this down to a learning experience which demonstrates that we’re never as vigilant as we think we are. It could have been worse.

[Title image: Red blood cells infected with Malaria — unknown source]

Bibliography

Africa, Doctor, Dubai, Giardia lamblia, Health, Lusaka, Malaria, Medicine, Schistosomiasis, Symptoms, Zambia Africa, Travel