Dying For The Cure
When travelling in Southern Africa, it is assumed malaria will be an issue, so a few weeks before leaving for our trip we made the dreaded doctor's appointment. After some consultation, we were given prescriptions for a malaria prophylactic and a typhoid vaccine. (It was too late for hepatitis vaccination.) We were also instructed not to drink the water, accept ice in our soft drinks, eat salad or digest any fruit we couldn't peel. Deciding not to open an uncertain debate about South African produce imports to the U.S., we nodded our heads obediently and left.
The next day I went to CVS to pick up the malaria pills (we decided to skip the typhoid stuff) and received quite a shock at the register. $350? Did I hear the price correctly? (Yes). Is there a generic option? (No.) Did our prescription drug card do any good? (A little). After weighing the odds of contracting the disease against my desire not to spend hundreds of dollars, I rationalized that not contracting malaria was worth the expense. It also helped that this economic dilemma came just a few days after Christmas. When I returned home clutching the golden pills, I promptly began thanking relatives for giving us enough cash over the holiday season to keep us malaria-free in the new year. Best present ever!
There are a few different types of antimalarial drugs. We were prescribed Malarone, a pill taken daily, starting two days before entering and continuing for one week after leaving the malaria zone. Since malaria-prone Kruger was our first stop, we started taking the pills on the plane ride over.
It wasn't until a week later in Cape Town that the discomfort started. At first it seemed like your average heartburn, so I chewed a few Tums from our first aid kit and tried to ignore it. But as soon as Cindy started complaining, we examined the Malarone package more thoroughly. Sure enough, intense prolonged heartburn was one of many side effects. In fact, the directions explicitly state that the pills should be taken with food in order to reduce the risk of upset tummy. And just the night before we had skipped dinner and cavalierly downed the pill with some water before bed!
This proved to be our undoing. For the next 10 days we were plagued with bouts of reoccurring indigestion, which, for example, made our sunset dinner atop Table Mountain as painful as it was beautiful. No wonder there's so many antacid commercials on T.V. and people mistake that sharp feeling just behind your breastbone for heart trouble. It certainly feels life threatening.
Our last week In S.A., we had plans to visit the Hluhluwe Umfilozi game reserve in Natal, an area where malaria is endemic. So we resolutely kept up our daily pill regimen despite our aching esophageuses, scarred by acid reflux. What could be worse than parasites, right?
But it was all for naught. We never made it to the park. Another nefarious side effect, nausea, kept us away. It reared its ugly head the night before our planned safari trip, rendering me pale, weak and unprepared for game gazing.
Since then we've had more than a few discussions with South Africans and at least one Peace Corps volunteer, all of whom were living close and sometimes in malaria zones. They never worry much about taking antimalarial drugs, all of which seem to have nasty side effects, including itching, dizziness, seizures, depression and paranoia to name just a few of the more memorable ones. The PC volunteer had to stop taking his weekly pills because of siriasis. The key, they said, is to avoid being bitten and head for a doctor at the first sign of flu-like symptoms.
My belly, my pocket and my wife tell me that next time I should follow their advice.
By Meredith Bragg |
February 8, 2006; 9:03 AM ET
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South Africa
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Tales From The Road/Skies
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Posted by: Debbie | February 9, 2006 12:27 PM
hey meredith-
i had a different experience, as i was a region where you couldnt avoid being bitten and it was high season. i took a once a week dose of meflaquine every friday nite and found i had incredibly vivid and realistic dreams, and then a foggy feeling for about half a day afterward. it was almost enjoyable. makes me think the experience varies a lot with the prophylaxis and individual.
Posted by: raj | February 14, 2006 01:17 PM
i have taken doxycyclyne for periods of up to four months on a number of occations.
it is taken daily, with a full glass of water and food. if the instructions are followed, the worst side affects are sunburn, sensitive eyes, and some of the craziest wet dreams you can imagine..
i was in hospital for a while with ross river virus, and the patient next to me had malaria, and even though i was as sick as i had ever been, i felt sorry for him. i would say that if you seek good advice, from doctors with tropical experience, and you follow that advice, even if you cop some of the side affects, you find you are a lot better of than someone who has malaria.
work it out for yourself..
Posted by: travis | February 21, 2006 10:09 PM
i've never taken any anti-malarial, and i've been criss-crossing africa for most of the past 15 years (i'm 33). that said, for south africa, unless you're going to be spending a LOT of time in northern natal or eastern mpumalanga or limpopo, you really don't need antimalarials in the first place.
however, part of the problem is that here in south africa, since there is so little malaria, most south africans don't have a clue about the effects of it (or the best ways to do a prophylaxis regimen).
for future reference, unless you go back to kruger or any of the other lowveld reserves, you won't need to take anything at all.
even when in a malarial area in south africa, there are so many animals around that the mosquitoes will go for them and not you -- humans are the meals of last resort for mosquitoes; places with high malarial rates generally have more people than animals in them.
Posted by: tinho | February 25, 2006 04:59 AM
i hate stereotypes, but your really are a typical ignorant american. Johannesburg's water system was recently tested and is considered one of the cleanest systems water systems in the world. It is one of the few major world cities where you can actually drink from the taps, unlike a city like London. Furthermore, you do not need antimalarials in South Africa. Why don't you take your prejudices and stay away from our country, you ignorant American. Thank you -- a proud South African.
Posted by: oh please | March 9, 2006 02:15 PM
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I lived in Tanzania in a place where everyone around me was getting malaria. I decided against taking anti-malarials due to the side effects. I was fortunate enough to be one of the only people who never got malaria but I saw enough people get malaria and get prompt and simple medication.... they felt bad for one day and were basically back to normal. I agree with this article!