Thursday, August 2, 2012

If You Get Malaria, Stay in Africa

Author: Christopher Guess

I was walking through my old university campus a few years ago on assignment to cover a student group for a regional newspaper when I heard the standard call of a pedestrian: “Excuse me, do you have a few spare minutes?!” I turned around and a very nice undergraduate explained to me that they were raising money for World Malaria Day and asked if I was familiar with it.  I told her that I was and that I had, in fact, almost died from the disease a year earlier.  The students were stunned.  They began bombarding me with questions and, after answering as many as I could, I apologized and ran to meet up with the subjects of my story.

This encounter has always left me thinking.  Malaria, a disease which impacts more lives than almost any other disease in human history, is still shrouded in such a blackout of information.  Honestly, I cannot attest or speak conclusively to what most Westerners know or think of malaria.  I won’t rehash the fatality rates, the infections rates or the benefits of mosquito nets. Thanks to the likes of the Bill and Melinda Gate’s foundations those realities are becoming well known.  But it seems to me that most people don’t realize how utterly common malaria is in most of the developing world and how it isn’t the death sentence that it appears to be in the West.

Shortly after arriving in Nairobi for the first time, I was sitting outside a friend’s house with another journalist, an Italian who had been in Kenya for a number of years.  We had opened a few beers and had started talking.  I asked him if there was any advice he had for a first-timer like myself.  He thought for a few minutes and said one thing: “If you get sick with malaria, do not got back to Europe or America.” My mother is a nurse, and I had grown up with the idea of medical infallibility, so this puzzled me. Why, if I’m very sick with this disease I have heard my whole life killed millions, would I not want to go back to where the best hospitals are?  Because, he explained to me, they do not know how to treat the disease.  In what I presume was an attempt to scare me, the Italian told me a story of his friend who had recently become very ill. By the time his friend had managed to get to an emergency room in Rome he was too sick and, to make matters worse, was being treated by doctors with too little experience with the disease. He died soon after being admitted.

A Nairobi doctor examines a patient.
This story stuck with me and gave me pause. The West has the best hospitals, the best doctors and the best technology modern medicine has to offer. Why then, would doctors in Kenya be able to do any better?  Rome has the Internet for god’s sake! Couldn’t a doctor just look it up?

A few months later I was unfortunate enough to have to put this journalist’s advice to good use and realized the answer to my quest.  Lying on a beach during a much-needed vacation I became very, shall we say, gastronomically ill.  After regaining some composure I started shivering in the 40-degree heat.  I made it back to the mission where I was staying and the next morning a friend, who knew someone who knew someone, managed to get me into the police hospital to get looked at.

It was at this point I realized the intelligence in staying in-country when you contract a common tropical disease.

Upon arrival I was ushered into an examination room, which seemed to double as a laboratory and a break room for nurses.  Instead of drawing my blood, a doctor unwrapped a sterile razor blade, grabbed my right hand and proceeded to unceremoniously slit the tip of my finger.  He then picked up a glass slide, rubbed it against my cut and set it on a drying rack. Now you might imagine a clean, white, plastic rack with a steady stream of sterile air. It was indeed air-dried.  The rack, however, was a few pieces of wood nailed together with an air supply provided by a hair dryer.  After the blood dried, the doctor simply placed the glass slide underneath a microscope and counted the number of malaria parasites he could see. 

Inspector checks up stagnant water for Malaria
This, like much of the life I came to know, didn’t faze me. When I returned to the U.S. and decided to look up standard medical practices, I found out that the same test I had undergone in Africa runs for a five-figure price tag, involving a three-day overnight stay in the hospital.  Again, it was a great example of Africans doing what smart and ingenious people in less-than-perfect situations have done forever, taking an idea that works, and making it much cheaper and just as reliable.

I was very fortunate at this point.  I was not taking preventative medication but had managed to buy a dosage of the curative medicine Coartem for about $2 a few weeks before.  I only found out later that this medicine was not even approved for the U.S. market until a year later. When my previously mentioned mother attempted to find it in her hospital’s database it took her over an hour, something freely available in outdoor markets all over the world.

Christopher Guess is a journalist, photographer and tech entrepreneur based in Brooklyn, New York. Christopher writes about emerging innovations and individuals within Africa’s tech industry. Through his reporting, he seeks to highlight the successes and issues that emerging economies face when transitioning to knowledge based economies. He has reported extensively in the United States and internationally on humanitarian and economic issues. Eastern Africa became a specific point of interest for him while travelling and reporting in the area in 2008. In addition to his journalism, Christopher is the co-founder of two tech start-ups in New York City, giving him a distinct vantage point on developmental milestones and opportunities.

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