That Time I Caught Malaria In Africa
The following is an excerpt from the new travel compilation released by TheExpeditioner.com, The Expeditioner’s Guide to the World: Intrepid Tales of Awesomeness from the Open Road, available for sale now at Amazon.com.
I awoke the next morning to find a foot dangling from the bunk above mine. Apparently someone had come in and claimed it at some point between two and eight in the morning. I untangled myself from the web of blue mosquito netting that I had wrapped around my body the night before, and I attempted to get up. When I stood I felt a sudden pain in my body; it felt like my stomach was attempting to continue the journey forward from the motion of standing, oblivious to the pesky body cavity that was keeping it in place. The cavernous, thatched room around me began to spin, with small pinpricks of light dancing around my eyes. I gripped the bed post and sat back down on the bed.
What exactly did I drink last night? I wondered to myself. Or, perhaps the better question was, “How much?” Surprisingly little, I reminded myself. Perhaps only a couple of beers. Actually, I remember being more concerned about downing bottles of water once I got back from scuba class — an attempt to rehydrate from all the ocean water I had swallowed the previous morning.
I stood up again, ambled out into the blaring sunlight outside, and made my way to the hostel’s outdoor bar/restaurant for breakfast. Probably just a little hungover, I thought as I shuffled through the sand in my new Mozambique flag-emblazoned sandals. Maybe even a tad dehydrated?
“I’ll have a liter bottle of water,” I said to the bartender, counting out a couple hundred meticales. “Actually, better make that two.”
The barkeep handed over two towering jugs of water and I immediately unscrewed the top of one and began gulping. “Can I also have a yogurt with cereal,” I added between gulps, choosing what sounded like the least threatening of early-morning meals from the menu. The thought of eggs, oatmeal, or anything else not having the consistency of a dry piece of bread made my stomach flip.
“Where’d you make out to last night?” came a female voice behind me.
“Or rather, who were you making out with?” another voice, this time male, chirped in.
“Oh, just thought I’d go for a little late-night swim,” I said, turning around.
Laura and Chris were two Brits who went to university in Bristol. Technically, Chris and Laura were in the seventh week of an eight-week trek through southern Africa that had begun at Laura’s Aunt’s house in Gaborne, Botwana, and was to end back there after a full counter-clockwise circle through Namibia, South Africa, Zimbabwe and Mozambique.
They’d been at the hostel in Maputo, the country’s capital, the night I arrived, and they were with me on the next day’s ten-hour bus ride north that brought us here. The first night we arrived, Laura had bought a bottle of cheap rum from a street vendor and all of us who had ridden up that day sat on the beach taking slugs followed by shots of coke. Several drinks later, Chris, her travel mate for the past month-and-a-half, had stripped down to his swim trunks and was lying on the sand, talking to himself.
“This is truly paradise. Truly, truly paradise,” he kept repeating in a strong Bristol accent to no one in particular. “And I want to eat prawns. Lots and lots of prawns.” We called him “prawn” for the rest of the week. He never knew why.
Somewhere around when I said the word “swim,” a gulp of water made it back up my esophagus and dribbled out my mouth as I coughed — the actions of a mental patient or someone who had experienced a face-debilitating syndrome.
“Oh, hey, you don’t look too good mate,” Chris said, suddenly looking worried. “You look a little beat too.”
“Had a little too much to drink last night?” Laura asked.
“No, funny thing is, I barely had anything to drink. I’m probably just a little dehydrated. What with all that sea water and the sun. I think I need to just rest up and rehydrate for the morning.”
They both stood up to leave. “Yeah, I think that’s probably a good thing. Well, when you’re feeling better, head down to the beach. We’re gonna get a wicked game of beach cricket going this morning. Yesterday, we taught those two kids we met on the first day who sell bracelets on the beach how to play. Man those kids know their way around a wicket, they may just go pro.”
Not knowing what exactly a wicket was, or whether that was a good thing for one to know their way around, I simply nodded and reassured them I’d be down soon. “Yeah I can’t wait. Maybe I’ll get in a little mid-morning snooze before I actually start the day though.”
Setting aside the first bottle, I began chugging down the second, feeling bloated and a little more nauseous than when I began the first bottle. I started having doubts as to my whole dehydration self-diagnosis. Barely able to make it through a third of my cereal, I grabbed what was left of the second bottle and headed back to my bunk, eager to sleep off whatever the hell was bugging me that morning.
“Hiya,” a girl in her late twenties said as I pushed open the room’s door. “You must be the bloke whose face I nearly squashed trying to climb into my bunk last night. You must’ve really been sauced up, you barely moved when I slipped and kicked you in the stomach.”
“That was you?” I replied. “I just thought I was having a bad dream.” Looking behind her, I was eyeing the comfortable confines of my bed that lay just feet away from my quickly failing body.
“Just arrived last night,” the girl said, taking my hand and shaking it. “I’m Kris. Bus was a little late coming up from Maputo. How long you been here?” she asked.
“About a week now. I just wrapped up my scuba course, and now I’ve got a couple days to finally enjoy the beach. Nice change of pace from just watching it from a boat as I sail away.” I was trying not to be rude, but I knew if I didn’t get to bed soon my manners were going to be the least of my worries. “Sorry, don’t mean to be short, but I gotta lay down for a bit, I’m feeling a little under the weather.”
“Hmmm, you haven’t been drinking the water have you? I heard there’s this parasite that lives in the water and it begins to grow and multiply the minute it gets into you,” she said, oblivious to my clues. “Takes weeks for it to work its way through your system. And that’s after you spend days trying to puke it out.”
Hoping not to hear the word “puke” or “parasite” again, especially not in close proximity, I politely tried to get her to leave. “No, I think I’m just a little dehydrated. Just need to get a little more sleep and I’ll be fine.” Stepping out of her way in an effort to make my intentions clear, I said goodbye. “Have a good breakfast, and try to stick to the bottled stuff if you know what I mean.”
Minutes later I was laying on the thin, sweat-ridden mattress, clutching its sides as waves of nausea rolled through my body. Having not been able to fall back asleep, instead I lay prostrate, unable to gather the energy to lift any part of my body from the bed. For some reason now, the very thought of food or water seemed to send my body into fits of squeamishness. If this was dehydration, I thought, then I vow to carry a bottle of water with me the rest of the trip. And I promise to drink from it like a sailor at every chance I got.
This went on for the next half-hour, the inductions of sickness coming and going at an ever-quickening pace, as if I was entering into the advanced stages of labor. I thought of the scene in Alien when the spawn emerges from that guy’s body as the other scientists look on in terror. I can’t spend the rest of the day here, I thought, lying alone in a bunk-filled dorm while beach cricket was being had, and perfectly good stretches of sand were laying there exposed with me not on them.
In a burst of manufactured energy I hoisted my body up from the bed. Instantly, I felt a rush of heat pulse though my body and a thin layer of sweat materialize on my forehead. My stomach jolted out of place. Oh God, I thought, I think I’m going to be sick.
I shuffled outside, onto the sand, and directed my body toward the bathrooms. A thatched-roof, concrete structure with a wall down the middle separating the sexes, the bathrooms offered little privacy from the outside world. But, as a consolation, they did offer great salamander viewing while you showered, the wily creatures emerging at night on a regular basis to watch over you from high above.
Stumbling into the first stall, I stood above the toilet. Suddenly feeling better, and oddly enough, slightly euphoric, I wondered if, perhaps, it was all just a false alarm. That was the last thought I had for several minutes.
When I regained consciousness I felt a pain on the side of my forehead. I reached up and felt the harsh, concrete surface of the wall rubbing against my head. As my vision came into focus, my eyes fixated on the outer workings of the back of a toilet. I realized that I was laying sideways, my head askew in the corner of the stall, my left arm hugging the toilet seat, vomit strewn around me and the rest of the small enclosure. I should have been scared. I should have wondered what was happening to me. Instead I thought to myself, Well, this is a first.
Interestingly, whatever just happened made me feel a whole lot better. Minutes ago it felt like a fully-loaded semi-truck had just run over my body. Now I felt like a load of bricks had been lifted off my chest, my stomach regaining its normal composure.
What is the protocol for when one passes out and throws up all over a hostel toilet? I wondered. Call hotel management and ask for the cleaning services? Oh wait a second, this was not a hotel, this was a beachside hostel. It did not have management, nor did it have a phone for that matter. And cleaning services consisted of the woman from the nearby village whom I would see working a dilapidated looking mop late in the afternoon. No, this was a pull-yourself-up-by-the-bootstraps-and-take-care-of-things-by-yourself situation.
Thankful that no one else was in the bathroom at the time — this being late morning and all, most people were out enjoying the beach — I went to the sink and looked in the mirror. A large, red bump had formed on my forehead at the spot where the wall had met by head. My t-shirt was half-soaked by sweat and other substances I cared not to think about. I stripped it off and tossed it in the nearby garbage. Thankfully my swim trunks — basically the shorts I’d been wearing for the last five days straight — looked pretty clean, and were perfectly suited for an impromptu shower. I turned on the faucet and rinsed my mouth, then ran my hands under the water to clean them off. I then stepped into the nearest shower and turned it on, releasing a slow drip of cold water from the pipe above. Standing below, the frigid water jolted my senses into hyper-consciousness.
This is the point of the story, with obvious symbolic implications, when the protagonist usually arrives at some sort of epiphany as they “cleanse” themselves of the past and begin anew, washing away whatever past sins they’ve committed. Had I been an ex-hitman on the run in Africa, this would have been the point in the story where I would decide to head back to the village I had just abandoned and confront the evil gang leader who had been terrorizing the locals. Or, if I were a hardcore drug addict traveling to extreme parts of the world looking for a fix only to hit rock bottom from an overdose, this would have been the point in my tale when I would have decided to clean up my act and finally head home to face my demons.
But there were no major sins I needed redemption from, no large problems I was running away from, no bottom to hit that I could then claw my way back from. I was simply a traveler from America, away on vacation, looking for a little escape from the daily grind that was my everyday routine. A grind that did not normally include tropical diseases or battles against parasitic infestations. I was a protagonist with no arc to endure, an actor in a play with no third act. I was simply there, a Westerner, far from home, in the middle of Mozambique, scrubbing bits of puke from a pair of swim trunks with a piece of rock while standing in a cement shower.
Had I been adapting the day’s events into a screenplay I would have spiced things up a bit. I would have had the cleaning woman find my unconscious body later that day in the bathroom. Crowds would form as emergency preparations were made by the locals. I would have then been driven to the hospital in the back of an open-bed truck, while my newly-acquired love interest mopped sweat from my brow with a rag. You’ll be okay, I won’t let you die. Not after what we’ve been through. Tears would fill her eyes as she yelled to the heavens, Please God, let him live. Don’t let our newly-conceived son grow up without a father!
Awakening from my daydream, I filled a nearby bucket, splashed some water around the stall, and let all evidence of my presence wash down the drain. I fetched a toothbrush from the dorm and brushed my teeth, then picked out a clean shirt to put on. Feeling better, I thought to myself, I’m glad that’s finally over with. No more late-night beers for the rest of the trip, I vowed.
Minutes later, back in the dorm, I heard someone enter. “You okay? You still recovering from last night?” my British bunkmate asked as she came back in to see me huddled back on the bed, beads of sweat on my head.
“Ugghh,” I moaned. My mind was racing to try to remember how to communicate. “I think I just need a day off to recuperate. Plus this heat’s killing me today. When did it get so hot out anyway?”
“Hot? It’s much cooler than it was yesterday,” she replied, surprised. “In fact I came back here to grab a sweatshirt to bring down to the beach. You really okay? You may want to think about heading into Inhambane to get yourself checked out at the hospital.”
“Hospital?” I said, incredulously. “No, I’m fine. I don’t need to go into town. I just need a little rest. In fact I’ll meet you down at the beach in a little bit if you want.”
“Yeah, sure, sounds good. I’d still think about just getting yourself checked out. When I was in Tanzania last year I caught malaria, and it was not something fun to have.” With that she grabbed her sweatshirt and left, leaving me in the dark, staring up at the streams of light streaming through the thatch roof.
The word “malaria” struck me like a shock of electricity. Malaria? Isn’t that something people die of in remote African villages? Matt, do you need a reminder as to where you are? Impossible, I’d been taking Malarone, the de facto anti-malarial drug on the market, the one that is 95% effective in preventing the parasitic disease, or so I had read online. That leaves 5% chance of infection, now doesn’t it? I would’ve had to have gotten it from a mosquito, right? And I’d been sleeping under a net and using repellent since I got here. Which all seemed fine, except for the fact that your first night was spent with a giant mosquito flying in and out of your ripped mosquito net, eating you alive and leaving bites on half your torso. Shit.
Lacking any reliable internet, medical staff or accessible libraries, I did what any good traveler does when in need of information: I reached for my guidebook. In this case it was Lonely Planet: Southern Africa. Surely there must be something of use in here, ignoring the fact that these guides are usually written by 23-year-old travelers on a whirlwind tour through a country. Not exactly the advice of a trained, medical professional.
I leafed through the book, and way back, on page 769, under “IN SOUTHERN AFRICA: Infectious Diseases,” was the “Malaria” section. I began to read:
Malaria is a widespread risk in Southern Africa. Apart from road accidents, it’s probably the only other major health risk that you face traveling in this area, and precautions should be taken. The disease is caused by a parasite in the bloodstream spread via the bite of a female Anopheles mosquito.
So far so good. At least I’d avoided the risk of “road accidents” that are apparently very widespread in this part of the continent. I continued on:
The early stages of malaria include headaches, fevers, generalized aches and pains, and malaise, which could be mistaken for flu. Other symptoms can include abdominal pain, diarrhea and a cough. . . . If not treated, the next stage could develop within 24 hours, particularly if falciparum malaria is the parasite: jaundice, then reduced consciousness and coma (also known as cerebral malaria) followed by death. Treatment in hospital is essential, and the death rate might still be as high as 10% even in the best intensive-care facilities.
Well, at least they weren’t beating around the bush.
Coincidentally, during my trip I had been reading “Into Africa,” the account of Henry Stanley’s epic search for Dr. Livingstone in the unknown interior of Africa in what is today considered southern Tanzania, just north of Mozambique. Stanley himself had thought he was impervious to Malaria, attributing his immunity to the boyhood cases of “Swamp Fever” that he had caught while living in the lowlands of Arkansas.
He thought this, until that is, he actually caught malaria. With no way to treat it other than quinine, the early precursor to today’s modern medication, he was to spend the next few weeks unable to do much searching for his elusive target. A team of porters had to carry his limp body on a stretcher through the bogs and swamps until he got better. (Of course he would eventually find Livingstone, reach international fame, then return to Africa to help form the Congo Free State, which, in turn, led to one of the world’s largest slave trade in history. Africa probably would have been well enough without him not recovering.)
At that time, Europeans, unaccustomed to the unfamiliar disease, assumed it was caused by the strange, bad air of the African interior, hence the name mal aria (bad air). In reality, malaria is a parasitic disease. There are about 56 strains of it, of which only four strains cause symptoms in humans (and one of which causes death), all carried by only one breed of mosquito out of thousands. Stanley himself after catching it, described the symptoms as “oppressive languor, excessive drowsiness” and an “incipient fever which shortly will rage through the system, laying the sufferer prostrate and quivering with agony.”
I would later learn that in 2008, there were 247 million cases of malaria and nearly one million deaths in the world — mostly among children living in Africa, where a child dies every 45 seconds from it, 3,000 of those are children under the age of five. Here in Mozambique, malaria is the main cause of death, accounting for 29% of the country’s deaths, followed closely behind by HIV/AIDS. For those under the age of five, the number are particulary grim, with 42% of deaths attributable to the disease. And, as expected, due to a lack of access to hospitals and proper medications, the majority of Mozambique’s malaria deaths occur in the rural parts of the nation.
By Matt Stabile
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Matt Stabile runs TheExpeditioner.com. You can read his writings, see his videos, purchase the book he co-edited or contact him via email at any time at TheExpeditioner.com.
Posted on May 16, 2011 by Matt Stabile