Just an hour ago, I found our Cameroonian caregiver, Nadine, sitting on a stool in the corner of the kitchen, hunched over.
“Excuse me, I’m sorry,” she said. “I am not well. I am hurting and I think I need to go home.”
Instinctively, I knew she had malaria. Her stiff body movements, glazed facial expression, sluggish steps, and lightly folded arms (holding her elbows) indicated malaria. I asked her a series of questions to make sure:
1. How did you sleep last night…were you in feverish pain, alternating from sweating to freezing? (Yes)
2. Did these symptoms appear suddenly, after the sun went down? (Yes)
3. Do you have an appetite? (No)
I went upstairs to get emergency malaria drugs and fever-reducers. She took the pills and laid down on a couch, so weak she could hardly move. This is a very typical scenario for malaria, one that I’ve witnessed too many times to count while living in Cameroon.
Malaria has been a regular part of my life in Cameroon. I first suffered the sickness in 2005. That first time, I had malaria that caused horrific stomach problems. It was misery. Feel free to skip the next few sentences, as this may be a little too much information. At the time when I first had malaria, I was in a place with no indoor toilet facilities. At night, it was unsafe to go outside of my locked room to the latrine. I was so sick, and so desperate, that I had to turn a used coffee can into a toilet multiple times throughout the night.
That’s what it’s like to have malaria.
Since then, I’ve had malaria about once a year. There are a few explanations for this. Because malaria is caused only and only by malaria-infected mosquitoes (I emphasize the word only because when I travel to the states people are always afraid that I am going to infect them with malaria!), I may have been bitten by the “bad” mosquitoes about once a year. Or I may have been bitten only a few times, and the sickness (parasite) has remained in my liver and flares up when I am ill or my immune system is compromised.
I see a French doctor in Cameroon who told me that it’s best to treat malaria even if symptoms are weak, and if the medication for malaria doesn’t make things better, it’s not malaria (it could be the flu or something simpler). He also said that although getting tested for malaria can be helpful, all too often the malaria test shows up negative when in fact the person has the illness. Malaria can also be difficult to diagnose due to the variety of symptoms it can cause. Everything from diarrhea to coughing to vomiting can be attributed to malaria. It really is a beast of a sickness that takes many forms.
Treating malaria, when it’s caught as soon as it begins, is usually very simple and within a day or two it starts to dissipate. It’s all about recognizing the symptoms and taking immediate action.
In the fall of 2010, in spite of my understanding of malaria’s symptoms and treatment, I was foolish to have believed that I had a bad case of the flu. I didn’t immediately treat malaria and stayed in bed in agony for about four days. The pain became more and more intense, especially at night. I developed a cough (a symptom of malaria at times).
Because I neglected to go to a doctor, the malaria began to attack my body in a severe way and soon I was coughing up brown chunks of infected blood. I let a few more days pass, because during the day I felt as if I were getting slightly better. But, unknown to me, I had pneumonia and malaria-pneumonia is a recipe for physical misery. The oxygen in my body was not being properly distributed due to the constant coughing spasms, and my legs carried almost all of my pain.
My knees hurt so bad one night that I actually started screaming for help. Our night guard helped me heat enough water on the stove so that I could immerse my legs. It helped momentarily, but for the next day I rolled back in forth in terrible pain. I don’t know why I didn’t go to a doctor sooner (I’ve a terrible aversion to going to see the doctor, primarily for financial reasons). One Sunday morning, my Taiwanese friend, Yiewen, called me. She heard through the phone that I was in a critical condition and immediately drove me around town, looking for a doctor. In her passenger seat, I hunched over, holding onto my legs, trying to soften the sensation of knives being driven into my flesh.
We found a Belgian doctor who took one look at me and said, “You’ve got advanced pneumonia.” He took out three white horse pills, gave them to me, and examined me. I was given a treatment for malaria and pneumonia. He said that due to the fevers and sweating, and lying on my back in a bed for too long, I developed pneumonia. I followed his course of treatment and two weeks later, I was okay.
Malaria, like AIDS, can kill you because of its tendency to open doors to other illnesses, like pneumonia.
A few months before this episode, I had witnessed first-hand the devastation malaria can cause. A little boy named David was brought to me, dead. His malarial fevers cooked him to death. I held his cold little body, listened to his father as he cried out in agony, and realized that malaria wasn’t just an inconvenience to me anymore. It was a mortal enemy.
I now keep a good stock of malaria medications on hand at all times. I’ve had many encounters with malaria over the past year, and I’ve been able to stop the illness in its tracks. It’s really quite simple. Mosquito nets can prevent mosquito bites during the night (but only when very carefully, correctly, and regularly used), but I feel that having the emergency medication on hand is the best solution to preventing death from malaria.
Of all the deaths due to malaria that I’ve heard of over the years, most people died from waiting too long to get the malaria medication. In many cases, they could not afford it. Other times, sickness was attributed to witchcraft and “traditional” healing methods were used to save the sick person (where malaria is concerned, those do not work).
You would think that I would have had the good sense to take some malaria meds with me when I left for a visit to the U.S. this past November. But the idea didn’t even cross my mind. How in the world could I get malaria when I’m in the U.S.?
I was exercising one afternoon, and after I finished I felt extremely achy and weak. I had spent the past two days in the California sun, so I figured I was dehydrated and worn out from too much activity. I went home and crawled into bed (dealing with the exact symptoms I saw in Nadine this morning).
I stayed in bed for a couple of days, and as always, I felt a little better during the day. But the nights—OUCH—the pain was bad. The third day my Mother, who is a nurse, forced me to go to the ER. My sister drove me into the ER, and by this time, I was crumbling with pain, shivers, and malaria agony. But I still just could not believe that I had malaria in Sparks, Nevada.
I was put into a room, stuck with an I.V., and put on oxygen. As is predictable, I once again had pneumonia developing in my lungs from being in bed for too long and from malaria’s attack on my immune system. Perhaps I was bitten by a mosquito just before leaving Cameroon, or perhaps the malarial parasites flared up out of my liver, where they keep a nice little year-round condo.
I was in deep trouble. The second day, I am told that I was talking nonsense and appearing delirious—then before I knew it I was being wheeled to the intensive care unit. My oxygen levels were down to 51 percent. Malaria and pneumonia are perfect partners in crime.
What’s crazy is that some of the medications they wanted to use to fight malaria were not readily available in the U.S.! They would have had to special order them. I cursed myself for not bringing a box of my meds (Coartem) from Cameroon!
I had blood test after blood test, sleepless night after sleepless night. I slowly got better and was able to leave the hospital. This is where your typical “what it’s like to have malaria” story would end.
But the day I returned home, my left arm was hurting very badly, so we returned to find out what was causing the pain. I had a blood clot in my subclavian artery by my left collar bone. I was re-hospitalized for this and faced the fear that the blood clot could travel at any time to my brain, heart, or lungs. We theorize that my oxygen levels dropped so drastically because a piece of this clot entered my lungs.
I’ve since been on Coumadin. My arm is slowly healing. I may have permanent damage in my left arm/veins. Time will tell.
But I can’t help but wonder—if I had taken my malaria meds that night after I exercised, would any of this have happened? I believe the answer is no. I could have caught it early and saved myself the most awful experience I’ve ever been through.
Catching malaria as soon as it starts is the key!
This is why, over the course of 2012, Green Eyes in Africa has set the goal of getting emergency malaria medications into the hands of 500 families. We’re looking to distribute these medications in remote areas of the country where access to a pharmacy is limited. I’m excited for us to aggressively take on one of our worst enemies—malaria—with a brilliant and preventative battle plan.
In honor of the five year old little boy who was killed by this beast, we’re calling this The David Project.
