The Misery of Malaria

Samantha Madell becomes one of 500 million people to catch malaria in 2005

September 8, 2005

Three weeks after my return home from Vanuatu, it is apparent that the trip was life-altering in more ways than one.
The heart-rate monitor attached to my finger honks a warning: my pulse has shot up past 150 beats per minute. All I did to elicit this furious tachycardic response was to sit up and reach for my bucket. Sure enough, the mouthful of water that I've just swallowed comes straight back up.

At that point, if only my body had a drop of water to spare, I would have cried. As it happened, I was into my third day of vomiting and felt as dry as desert sand. My eyes wouldn't let go of a single tear.
I was reluctant to lie down again, but sitting up required more energy than I could muster. I dropped my thumping head into my hands, and waited.
Suffering malaria in a hospital bed:
A world away from the village with
no transport, no doctor, no medicine ...
The previous day I had, ironically, felt too ill to make the trip to hospital. Instead, I sent Lang out to buy me a thermometer, which told us my temperature had crept past 40ºC (104ºF). My body, meanwhile, was tricking me into believing that I was freezing to death. Every muscle between the base of my skull and my knees was screaming with the effort of shivering uncontrollably through yet another spike of fever.
Miraculously, by the morning of my trip to hospital, I had managed to hold down just enough water to warrant a trip to the toilet. Thus I discovered my latest symptom: hematuria (less scientifically - pissing blood).
In case this fact isn't obvious from my description, I will state it plainly: I have never been this ill before. Not even close. I could barely find the strength or even the will to walk a few steps, and during moments of fever-induced delirium, I honestly believed that this disease would kill me.
I was admitted to hospital for intravenous re-hydration, and a series of tests. Following a day of blood work, ECGs, chest x-rays, urinalysis, and several litres of IV saline, the expected diagnosis came back: malaria - a legacy of my recent cocoa adventure in Vanuatu.
Malaria is a disease caused by a single-celled parasite called Plasmodium. It is carried and spread between humans by certain species of mosquito. Upon injection into a human host, the parasite moves to the liver, where it reproduces rapidly. This incubation period typically takes 7 to 28 days. After this time, the parasites break out of the liver, entering the blood stream and invading red blood cells. The infected blood cells finally rupture, releasing more parasites, as well as waste products, into the bloodstream - it is this stage of the disease that produces the classic symptoms of fever and chills. It is estimated that malaria infects between 300 million and half-a-billion people every year.
The doctor quickly reassured me that I had only been infected with the relatively mild Plasmodium vivax - this was good luck, apparently. If I'd managed to contract Plasmodium falciparum (an aggressive strain of malaria that attacks the brain and has developed multiple drug resistance in some parts of the world), I would very likely be dead.
The miraculous
chloroquine.
A course of treatment
costs AUD$2.93 -
too expensive for
most malaria sufferers
Lang was dispatched to the nearest pharmacy that stocks chloroquine tablets (70 kilometres away, in our case), while I rested in my private, air-conditioned room, watching the aftermath of hurricane Katrina unfold on TV. Inevitably, my thoughts turned to the people of Olboe, who do not have cars, roads, doctors, hospitals, or pharmacies (let alone air-con and television). My determination to help people like those in Olboe through fair trade is stronger than ever following my three-night sojourn in hospital.
Now, after five uncomfortable days on chloroquine (which causes nausea and headache), and following another week or so of recuperation, I'm basically back to normal. The thing that haunts me is the dark knowledge that every thirty seconds, somewhere in the world, a child dies of malaria. That's over a million children who succumb to this horrible disease every year. For the most part, these children are caught up in a vicious cycle of poverty, malnutrition, and disease. Tragically, one of the few effective weapons currently being employed against this insidious disease is an equally insidious chemical that was banned in Australia twenty years ago: DDT.
There is no simple answer to malaria. There is no vaccine, and for some strains there is no cure. But while various factions rip into eachother over the rights and wrongs of using DDT for mosquito control in the Third World, the optimists (like Bill Gates, who has donated an extraordinary US$100 million to the cause) are applying their energies to the process of developing safe, affordable prophylaxis, while searching for the elusive silver bullet: a vaccine.

For the time being, all I can do is consider myself extremely lucky that I have access to world-class medical facilities, and live in a country where malaria is treatable, but generally unheard of. And, with my hydration levels back to normal, I can shed a tear for the 120 or so children who, somewhere in the world, have died from malaria during the time it took me to write this small article.

The Cocoa Communiqué

Lang & Sam meet some cocoa growers in a remote part of Vanuatu

Three reasons not to grow cocoa commercially in Australia

Sam becomes one of 500 million people to catch malaria in 2005