Malarial Muddle

Worldwide distribution of malaria: green is malaria-free, blue is eliminating malaria, red is controlling malaria. Image source: thelancet.com

 

 

If you’ve been following this blog for a while, you might be inspired to think about travelling to destinations like Thailand, Cambodia, Ecuador, or South Africa. All wonderful places to visit, but all home turf for malaria.

Malaria is nothing to take lightly; the World Health Organization estimates that in 2016 there were 216 million new cases of malaria worldwide resulting in 445,000 deaths. Thank you, Wikipedia, for those uplifting statistics. I got to witness the effects of this disease first-hand in 1972, when my mother was infected somewhere along the journey from Lebanon to Yemen. Luckily, she contracted a non-recurring form of malaria and recovered.

So when we travel to places where malaria hangs out, we always err on the side of caution. We get the best anti-malarial prophylactics we can buy and we take them religiously, even in zones where there is minimal risk. Any risk, I say, is too much.

In the early 1980s, Mark, my husband, travelled to South America. He planned to visit the Amazon and consulted a doctor here at home about malaria prevention. The doctor told him that the medication was much cheaper if you bought it in South America, and recommended he pick it up in one of the cities before he ventured into the jungle. When Mark arrived in Lima, Peru, he went to a number of pharmacies to buy the pills, but none of them had even heard of the drug, either by its common name or by its chemical name. He ended up cancelling the Amazon portion of his trip because he couldn’t get the necessary malarial protection.

Fast forward to a couple of months ago, when we went to a specialty travel medical clinic to get a prescription for Malarone, the current drug of choice for preventing malaria. We each needed 13 days of pills to cover the time we’d be in the Amazon region, plus a week afterward (as prescribed). When we arrived in Quito and prepared to take the first dose, we discovered that we had only 13 pills in total; either the doctor ordered the wrong amount or the pharmacy dispensed the wrong amount. In my busyness before departure, I hadn’t bothered to count the pills in the bottle. My mistake.

Well, we figure, no big deal, we can just go to a local pharmacy and buy more. Surely, people go in and out of the Amazon through Quito every day, so they must sell Malarone. Nope. Once again, the pharmacists looked completely baffled when we asked for Malarone. We tried the chemical name. Nada. We explained where we were going and that we needed something against malaria and they just shook their heads. We used the Web to try to find a source for Malarone in Quito and discovered to our dismay that the drug is not sold in many countries, particularly the countries where malaria is common. What the heck?? Apparently, the company that makes Malarone is restricting where they sell it in order to stave off drug-resistance and keep the medicine effective for as long as possible.

Whatever. The hard fact remained that we were in a pickle. Only enough pills to protect one person, no way to get any more. Options: travel unprotected or cancel our jungle excursion. After discussing it, we decided to proceed. The area we would be visiting wasn’t high risk and we both had waited a long time to visit the Amazon.

So who got the pills? Well, with half my internal organs either missing or severely diminished and a depressed immune system, I could not chance being infected, whereas, we reasoned, Mark’s more robust constitution should see him through in the unlikely event he did get malaria. Not a happy choice but one that seems to have worked out: a month after returning from our trip now, we are both feeling fine, and, in fact, we didn’t run into a lot of mosquitos in the Amazon.

Lesson learned: always buy your travel health prescriptions before you leave home and count your pills!

Afterword: Now I read that counterfeit antimalarial drugs are commonly sold in some Asian countries, including Thailand and Cambodia. Yet another reason to buy at home.

What would you have done in our shoes? Take the risk or cancel? Let me know in a comment.

Wild Animals I Have Annoyed

Elephants are majestic and beautiful. The babies can even be cute, with those little trunks and mischievous eyes, hiding between Big Mama’s massive legs. Awwww.

Elephants can also be very, very scary.

It was my second trip to Africa and I had already seen a lot of elephants. Elephants tearing up trees for lunch. Elephants bathing in rivers and rolling in the wet mud. Elephants playing or trundling across the horizon on elephant business. I had been extremely close to some of those pachyderms. Not that I approached them, but often when I stopped at roadside to watch, their meanderings would bring them near. They would continue doing whatever it was they were doing, clearly aware of my presence and about as concerned as if I were a small, harmless mammal, which is probably what I was from their towering point of view. They seemed like gargantuan but amusing vegetarians.

I had read all the safety tips for safaris and I never, ever left my car. So long as you’re in your car, the guidebooks say, the animals see you as a part of it and, since they have long since learned that cars don’t do much other than chug along well-worn tracks, they view you as neither prey nor predator and, consequently, of little interest.

As I drove slowly down one of the backroads of Kruger National Park, my car topped a hill. Below, about a hundred metres away, a herd of elephants was crossing the road. I stopped the car to enjoy the sight and to stay a non-threatening distance away. The group consisted of cows and their offspring of various ages.

As the parade wound down, the tiniest calf of all scuttled across, followed by the largest cow. I guessed that she was the matriarch of the group, bringing up the rear to make sure no one was left behind or nabbed by lions in her absence.

Maybe she was feeling especially protective of that newborn calf, or maybe she didn’t like the way my car was perched above them on the hill. Whatever it was, she turned in the road to face me.

Oh, crap, I thought.

All the signs of an elephant preparing to charge flashed through my mind. Direct stare: check.  Ears flapping: check. Trumpeting: check. Trunk swinging: check.

Double crap.

I threw the car in reverse and began backing up just as she charged. It is nearly impossible to drive rapidly backwards down a narrow, winding road while keeping terrified eyes on an elephant that is looming ever-larger in your windshield. Within moments, I missed the track and backed firmly into a thorn bush.

The elephant pounded up to the bumper of the car and stood there, swaying with menace. She stamped her feet so close that I was sure she was going to mash the hood. I wondered briefly if the damage waiver on the rental car covered crushing by angry elephant. She backed up and made repeated short charges at the car, trumpeting furiously all the while.

I remembered every detail of every photo and video I’d seen that demonstrated the destructive power of the great grey beasts—the tusk thrust through a window, the rolling of a VW Bug to the edge of a precipice, the flattening of a sedan when an ellie chose to make a joke out of reclining upon said vehicle.

I shouted to my companions: “Get down, and don’t look her in the eye!” as if the challenge of our puny gazes could incite this behemoth to any greater wrath.

The matriarch was shortly joined by a second, smaller cow, which ran around the melee, calling excitedly. I thought perhaps this was Big Mama’s teenage daughter, come to join in the fun of terrorizing tourists. Luckily, she provided a desperately needed distraction for the murderous matriarch. After what seemed like an eternity of close and hostile action, Big Mama turned away for a quick tete-a-tete with her daughter. Instantly, I slammed down the accelerator to send the car past the two elephants, and shot off down the road, in the opposite direction to the herd, needless to say.

Shaking with fear, I spent the next couple of hours reciting nonsensical expletives and repeatedly reminding my companions that we had actually just been charged by an elephant, like it would have somehow slipped their minds.

Do I still think elephants are majestic and beautiful and sometimes cute? Absolutely. Would I go to Africa again on safari? In a heartbeat. Do I want to see wild elephants up close and personal? Not on your life. But I wouldn’t trade this memory for a month of free nights in a calm, safe resort hotel.

Have you had a frightening encounter with wild animals while travelling? I’d love to hear about it.