Malaria in Zambia

I never understood how difficult village life was like until I got malaria. I never missed a dose of prophylaxis and always sleep under a mosquito net. I'm also a terrible hypochondriac here. In the past year I have convinced myself that I have had ebola and the black plague (having internet can be a curse in the village sometimes). In my defense, it was completely possible that I had been exposed to both illnesses (or at least that is what my internet searches told me). Regardless of these quick forays into madness, malaria has always been what I should have been most worried about.

It happened 4 months ago. I started feeling like body hotness (that is what they describe as a fever here and is coincidentally what I think my stripper name would be as well) around the evening. The malaria parasite is cyclical and so in the day you feel OK and at night you have chills and a killer headache. I immediately took my anti malaria medication and tried to get to sleep as best I could. In the morning my sheets were soaked with sweat and I had a groggy feeling. I got on my bike and went to the road to get a ride to the provincial capital. I wanted to be close to medical care in case things got worse.

I left my bike at my friend Courtney’s house and hitched a ride to Chipata. When I told my drivers that I had malaria they chuckled a bit. This wasn't the sad response that I was expecting. It was like the chuckle you would give after someone told you about how drunk they got on their 21^st birthday. I was passing through a rite of passage. They had experienced it so many times before that it lost much of the danger that it held in my thoughts.

The next two days were definitely a trial. I had a migraine and the shakes. I lost my appetite and took as many ibuprofen as I could get my hands on to keep the pain away. Because I was taking my prophylaxis, the reaction wasn't as bad as it could have been. Villagers will often get malaria two or three times a year and have very little of the comforts that I was able to enjoy from my bed in the Peace Corps house in Chipata. Not to mention that most of the worst cases of malaria are seen in children who don't have the immunity and are often malnourished.

For the last two weeks I have been working on a medical project with Dr. Alan Baumgarten, R.N. Carol Mctigue, and other medical professionals from Asheville and all over the US. In conversations with our Zambian counterparts, there was mention that at times 80% of the patients visiting the hospital are stricken with malaria. We saw a child admitted with a high fever and who was so dehydrated that her veins had collapsed. This made putting in an IV impossible and a needle of fluid had to be put into her bone to reflate her veins. The doctors there tried valiantly to rehydrate her and save her life, but there was too much fluid in here lungs, her fever was too high and she didn't make it through the night. This was only one of the children that we saw on the trip who was near death due to malaria.

For the last day of the medical project, Alan and I put together a celebration for World Malaria day at my local clinic. There were around 500 people who showed up to see the dramas, speeches, a quiz, and a performance of a song about malaria in Chinyanja to the tune of the Kenny Rogers' the gambler (sung by myself and my neighbor Courtney). The people were entertained even if they didn't get everything about the message. There was also a donation of a Zambulance (bicycle ambulance that can carry a patient to the clinic). It was a wonderful day. As we were leaving, Alan was pulled into the clinic by the nurse there. A child with malaria was seizing with a high fever and her eyes rolled back in her head. Alan dove in to help. It has been inspiring to see him work in such difficult circumstances for the last two weeks. He did as much as he could to help re-hydrate her and stop the seizing. With a forlorn look on his face we took the taxi back to the hotel. In the ride back he said that he was pretty sure that she was lost.

It was a difficult end to such a meaningful day, but that is just how up and down things are here. I know how difficult it is to be sick with malaria and it is horrible to watch a child suffer through it, especially because there are so many ways to prevent it. Later in the evening we were having a few celebratory drinks with the District Health Officer who was at the event. He called the clinic to check on the girl. When he got off the phone he said that her fever had dropped and it looked like she would make it. Alan and I both let out a sigh of relief.

It was odd to think that while we were in the yard around the clinic celebrating there was a child in the clinic who was suffering so much. I remembered that while we were talking to her father who sat by her bed, he chuckled a bit when the nurse asked if his kids were sleeping under a net. It would be unthinkable to even smile while your child was near death in America, but that's how things go here. Life can at times be incredibly sad and tragic, but people still joke and keep on living. This can at times be a strength and other times feel terribly frustrating. Tragedy and everyday life are blended and life continues all the same. Let's hope that the future holds less of the sadness and more of the joy for the people here.


*Stomping Out Malaria in Africa is a Peace Corps initiative that uses strategic partnerships, targeted training Volunteers and intelligent use of information technology to support the local malaria prevention efforts ofer 3,000 Volunteers in sub-Saharan Africa. For more information go to stompoutmalaria.org and follow Stomp activities at http://www.facebook.com/StompOutMalaria*<http://www.facebook.com/StompOutMalaria

**Many thanks to Dylan Trivette for this amazing picture of Beauty, one of the girls in my village.