STORY FROM INDONESIA
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Malaria, Insights on The Traveler's Plague

Copyright 2000 story by Jean-Philippe Soule

Within ten minutes, my light headache had increased significantly. All the muscles around my spine, from my lower back to the top of my neck cramped with excruciating pain. Wrapped under blankets and warm sleeping bags in a room with the temperature of a sauna, I was so cold my teeth were clattering. The pain was unbearable and all I could do was shiver and cry. In a desperate effort, I called for help.

. . .

Years ago when I read about malaria to prepare for my first jungle travels, it struck me as an exotic disease which is easily warded off by taking preventative medicine. I took my prophylactic medicine religiously and never worried much. Much to my surprise, I was later hospitalized in a comatose state. I was put under intra-venous fluid treatment in addition to a high dosage of Larium and Primaquine. Other tropical diseases and the preventive medicine had hidden the symptoms of a rare and vicious strain of malaria until the last moment. Doctors said I was lucky to be alive. It was a Vivax strain I caught in Irian Jaya, Indonesia and was resistant to most known medicines. I was told that relapses would occur and that I would have to be treated with a dosage of 5 pills of Larium each time I suffered an attack. My body would be in constant struggle against the drugís terrible toxic side effects. Primaquine, which is supposed to kill the malaria in the liver to prevent relapses, was ineffective and I was told by numerous specialists that I would probably have to live with malaria all my life. The good news was that I survived the first attack, so I probably wouldnít die during relapses.

. . .

I did much research on the disease and eventually decided that my next step would be to go to China to seek treatment using a plant called Artemesinin. Chinese have used the plant for over a thousand years to treat migraines, fevers, heart problems, and malaria. By some minor miracle, my relapses faded and I didnít need to go. It had taken nearly three years, a radical change in diet, continuous physical training, and a staunch belief that I would someday experience a full recovery for the attacks to cease. I kept researching though, knowing that one day I would return to tropical rainforests and would be exposed to malaria again.To my great surprise I have since learned that malaria is the disease affecting the largest number of people worldwide and one of the leading causes of death. The World Health Organization estimates that 270 million new malaria infections occur worldwide annually. 25% of childhood deaths in Africa are attributed to malaria. It is a mosquito-borne protozoal disease that is endemic throughout most of the tropical and semi-tropical regions of the world. The transmission occurs in an estimated 100 countries where 2 billion people are at risk of malaria infection. These numbers are staggering and today new strains of malaria are spreading and could even re-appear in countries that have been free from the disease for decades. Some scientists even believe that breakouts could happen in the United States.

. . .

 During our three-year sea kayak expedition in the jungles of Central America, neither Luke nor I take any preventative medicines. Other travelers we meet are often shocked about our decision. When they ask why, I tell them that it puts local people at risk, the side effects over long periods of time are bad, and there is no guarantee that it will protect us entirely. People often reply that they never knew. They just followed the advice of their medical doctor back home. Educating the medical community and people traveling to countries at risk isnít on top of the priority list of the modern countriesí Health departments. Education is important, but the decision is up to each of us. Malaria is a painful disease. If taken in time, medicines are effective to treat most cases. Responsible and knowledgeable travelers deciding to visit infected areas should either accept the risk and be ready to treat the disease, or change their travel plans and visit countries where they will not be putting themselves at risk. 

The conscientious traveler is the one who goes further than merely listening to and trusting his or her general practitioner. I learned that lesson the hard way. For most, malaria remains mysterious. The media often publish breaking news on cancer, diabetes, or aids research, but malaria is often ignored as it only occurs in the developing world. There is little research and few breakthroughs worth noting. 

. . .

People often ask us if we arenít afraid of wild animals like sharks and crocodiles, or storms when we are far from the coast, or people. During our 3 years and 5000 mile paddle odyssey in Central America what we fear most are the diseases. Malaria is on top of the list, and it reminds us that we are just vulnerable humans. To continue our journey, we hope to find a way to obtain more Artenam. We will continue to paddle through the rainforests to meet indigenous people, and accept the risk of not using preventative medicine so as not to expose the ones we come to visit.

Jean-Philippe Soule

 

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