Malaria: All the Things

Malaria is an interesting subject…

Me and my trusty Malaria-prevention pill

Me and my trusty Malaria-prevention pill

I wrote a post the a few months ago on Facebook about an interchange at my gym that struck me as funny about Malaria. Here’s the post:

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It struck me as funny because it very well encapsulates how even in a gym (a place that feels so western and familiar), Sierra Leone life is so permeated with discussions and consequences of this disease.

It also occurred to me, especially seeing my friends’ sometimes alarmed responses, how much my perspective has changed about Malaria since I’ve moved here. So I thought I’d write up a little something in the hopes of helping people at home understand what it’s like to live with the constant threat and reality of Malaria.

Disclaimer: These are the facts as I understand them. I’m not a medical professional and I’m sure a medical professional would give more nuanced information. But this is my blog, so here it is.

Everybody gets Malaria.

Seriously. Malaria is very common and it’s very hard to avoid. During the ten months that my first driver worked for me, he got Malaria twice. They talk about it like Americans talk about having a sinus infection. It’s a nuisance. An inconvenience. But just a fact of life.

Malaria kills, but not everyone and not equally.

Most adults I know who get Malaria don’t fear for their lives. If you survive Malaria as a child, your body develops some resistance to it (or immunity? Idk what’s the right word). So by the time you’re an adult, Malaria hits like a mild flu. Like the flu, it's children and older people that you really have to worry about. And this is the reason that Malaria is known as such a great enemy to Africa.

According to Unicef, Malaria is the largest killer of children in the world. It kills a child every 30 seconds. That’s 3000 children a day. "Over one million people die from Malaria each year, mostly children under five years of age, with 90 percent of Malaria cases occurring in Sub-Saharan Africa.” It’s bad. Real bad.

Also it’s very bad for pregnant women and can effect the development of the unborn child. My friend just yesterday told me that pregnant women are like a mosquito magnet because pregnancy raised the body temperature. So not only is it bad for the development of an unborn child, pregnancy makes Malaria almost impossible to avoid.

Malaria is VERY treatable.

Once Malaria is identified, there is a drug that you can take that will knock it out in like 24 hours. Where I buy it, it costs 60,000 Leones (about $7). That's about two day’s wages if you’re lucky enough to make $100 per month. I know that $100 per month sounds insanely low. But according the World Bank, per capita income in 2018 was an estimated $506. That's $50 per month. So a $7 malaria treatment is almost a week’s wages for most people.

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Malaria often goes untreated.

Now this is where my ignorance is at its highest. I don’t really understand why this is the case. Of course, one reason that this might happen is the family’s inability to afford the medicine. But even when they do have the money for the treatment, it often still goes untreated.

I have Sierra Leonean friends who have gone to the hospital with Malaria, paid upwards of 200,000 Leones (about $24), and not been given the medication that knocks it out. This means that they’re sick for another week minimum. I find this baffling. I fundamentally don’t understand. I’m not a medical professional, so I imagine there are reasons for this that are above my pay grade.

Malaria and Typhoid are often treated together.

The symptoms for Malaria and Typhoid are very similar. Often people are simply treated for both. I’ve many times asked what kind of sickness people had when they tell me they weren’t well and received the answer with a shrug, “Uh Malaria? Typhoid?” Or they’ll tell me they had Malaria and Typhoid. Maybe this is the reason that people aren’t given the Malaria drug? Since Typhoid is a common issue here too, maybe people just give them treatment that they know will work for both (mostly avoiding dehydration) and tell them to wait it out.

Malaria spreads through blood. You can’t get it by standing too close to someone who has it.

On the facebook post, someone made a joke that maybe I ought to move down a few treadmills to get away from the sick person. It was funny. Also it made me realize how accustomed we are to airborne and touch-based contagions. Our first instinct is to move away lest you get sick. But that’s not how malaria works. You can kiss someone with malaria and still not get it.

As I’m sure you know, a person gets malaria by being bit by a mosquito that has bitten an infected person. Blood mixes with blood and you get sick. So, stay away from mosquitoes and you won’t get sick.

HOWEVER, you can get malaria if you’re sleeping in the same room or house with someone who has it. And the way that works is that a mosquito bites an infected person and then bites other people in the room or house. Still from the mosquito.

There are LOTS of strategies for staying away from mosquitoes. LOTS.

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The most well-known strategy is to use a mosquito net while sleeping. I was all about the idea of a mosquito net. But the reality of them is different. Firstly, they are hot. They prevent a breeze from flowing freely so it starts to feel like you’re in a hotbox. Secondly, It’s super hard to keep them taut. So often they end up sinking in toward you while you sleep and landing on your legs and head. So it starts to feel pretty claustrophobic and itchy while you’re sleeping. Then when you’re done sleeping you’ve got this ridiculous net to deal with. There’s more I could say, but suffice it to say that mosquito nets are kinda the pits. I don’t know many people who actually use them.

Other strategies include bug zappers that you can buy in town, room spray that amounts to poison so you have to stay out of the room you just sprayed for 30-60 minutes and know that you’re hurting the earth while doing it, and incense you burn to drive the mosquitoes away, which only works as long as you burn it and for a small radius. One option is to just keep your windows screened and your doors shut, but that requires you to sweat all day or pay for expensive air conditioning and a generator for when the electricity goes. You can also take a prophylactic by mouth or shot that will prevent malaria.

As you can see, you have to stay on top of it. And there’s no easy/cheap/quick fix. I’ve used almost all of these options. Primarily I take a prophylactic and keep my windows screened and doors shut. That’s fine because my apartment has AC, I can afford a little higher electricity bill, and I’ve acclimated to the heat so it’s not so bad when the electricity goes out. Most people just accept that you’re going to get sick at some point. And they do.

Just a thought…

Wouldn’t it be great if there was a vaccine? Seriously, would that be great?!

Ok, friends. That’s all the things I know about Malaria. I’m sure I’ll learn more as time goes…or some of you who read this blog may correct me or answer my questions. But as far as it goes, malaria has become just an everyday thing for me. And although I know its a big bad deal, it just seems like life. I guess in that way, I’m just another Sierra Leonean.

Sierra Leone Birding - Third Edition

Time for an update on my birding adventures.  I love that I started birding just in time to move to Africa.  That was not on purpose.  But it's really enriched my life here.  I find that every day is like a scavenger hunt and you never know what you're going to see.  It's such a part of my life that even my driver has normalized to it.  I got out of the car the other day to get a closer look at a bird while Navo was dealing with something.  He came back and motioned for us to go.  When I got back in the car he asked, "Looking at the birds?"  Yep.  Always looking.

Today's edition has some special birds from my recent trip to Kono district among others I've seen along the way.

Common Wattle-Eye ( Source )

Common Wattle-Eye (Source)

This one I saw out at the beach when I was there during the elections.  A few friends and I stayed out there while the elections were going on rather than staying closed in our houses.  On election day, nobody is allowed on the streets except voters.  Where we stay, the rooms have balconies looking out over a mountainous skyline.  And there is always the chance you might see some kind of special bird.  That morning two of these little guys were flitting around flirting with one another.  At first I thought they were just black and white.  And then I caught a glimpse of that red wattle-eye.  

It took me a VERY long time to find them in my book.  I even said they must not be in the book.  My birding friend replied, "I used to think that sometimes too.  But then I figured out I just didn't know the right place to look."  Amateur.  Finally I found them and everybody replied with an unimpressed "Oh, that one?" Lol.  I'm always a little disappointed when I find that their names have "common" in it.  But I'm learning that just because they're "common" doesn't mean their not magnificent or charming.  These little guys were very charming.

Common Kingfisher

Common Kingfisher

This one is another magnificent "common".  It can be seen around town perched on power lines.  The turquoise is almost translucent and it really is quite a thrill to catch a glimpse of it.  Doesn't matter how many times I see them, I get excited.  One time a few months ago I saw one while Navo and my house keeper, Magdaline, were in my truck.  I gasped and said, "Did you see that bird?!"  The two of them both broke out into laughter.  But they ARE magnificent and it IS exciting.  And you won't tell me different.

Senegal Coucal - AKA The Bird That Almost Got Me Arrested ( Source )

Senegal Coucal - AKA The Bird That Almost Got Me Arrested (Source)

So like I said, I'm always scanning the horizon to see what I can see.  Well, the other day I was in Kono and my driver decided to take us down the road that follows the fence to the diamond mines.  There is a human-made mountain that runs through Koidu Town where the mining takes place.  It's a centerpiece for conversation there.  I was interested in the mines, with fences that seem much more secure and well-kept than every other one I've seen in Sierra Leone.  But I was more interested to see if there were any birds to be encountered.

We were almost to the end of the road and I saw it.  My bird book describes the Senegal Coucal as a bird that "clambers in low vegetation, often in thick cover, runs and hops on ground, or flies clumsily for short distance."  I read that and it confirmed for me that this was the bird because I saw it's clumsy flight.  I even thought, What's going on with that bird?  Is it falling over? 

I quickly told Navo to stop, which startled him.  But he did and I opened my door, stood on the side rail, and started scanning the diamond mine to see if I could see it again.  I finally found it and started memorizing it's features - copper wings with a black tale and white on the breast - when my colleague in the back seat started in with, "Reverend...  Reverend...  Reverend... We need to go.  You need to sit down and we need to go."  At first I wondered why he was rushing me.  But finally I got back in and we started going.  And he said, "That's not allowed in the diamond mines.  They will come and bring you in.  You can't just stop and look in."  

So anyway, this funny vibrant bird almost got me in some real trouble.  Worth it.  

(Also you should google them.  The colors here don't do them justice.  And the one I saw was more white-breasted than tan.)

Common Fiscal ( Source )

Common Fiscal (Source)

We saw this one further down that same road along the diamond mines in Kono.  It was sitting on a power line facing the other direction.  I asked Navo to slow, but heeded the warning not to stop and stare.

The next day, I asked Navo to take the same route to see if there were any more birds to be seen.  We did see a large black bird, but Navo and I have a difference of opinion about what it was after looking it up.  So I'm not sharing that one.  It was otherwise slim pickin's except this guy...sitting in the exact same place as he was the day before, as if he was waiting for us to come and admire him.

Northern Grey-Headed Sparrow ( Source )

Northern Grey-Headed Sparrow (Source)

This guy you see everywhere, but I didn't really stop to notice it until I was in Kono.  I've been promised that in the provinces I'll see more birds.  So I studied this one hard thinking it must be special out here.  Then the day after I came back from Kono I saw a few outside my friend's apartment in Freetown.  This is a pretty straight forward bird.  For my Texan readers, I looks kinda like a house sparrow in coloring and behavior, but it's got a body more like a mockingbird.  It's like if a mockingbird and house sparrow had a baby.  I also love the coloring around the eye.  In some of them it looks like a superhero mask.

Village Weaver ( Source )

Village Weaver (Source)

These birds I first saw while touring Kroo Bay with my missionary (and birder) friend Cami.  She pointed them out.  They build very distinctive nests together in trees and essentially take over the neighborhood, so to speak.  There are several kinds, some with the black head and some that are more pure yellow.  This is what their nests look like.  

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Soon after I saw them in town, a family of them infiltrated a neighborhood tree.  The tree's foliage is much thicker than this one and there are like 30 nests up there from what I can see.  They're everywhere.

Ok, friends.  That's all for today.  Happy birding!