Tuesday, 14 July 2009

I self medicate, do you?

Getting malaria is never pleasant, especially when you contract it the first night you stay in a country. What are the chances of that happening? No really! What would it be statistically? Now that would be a worth-while statistical analysis, even perhaps worthy of a Ph.D.

I always wondered, in all those classic missionary stories how people died so quickly, sometimes only weeks after arriving. Now, however, I think that it is amazing that they lasted so long, especially since they had no idea what was killing them.

Generally with malaria, it is possible to count back 10 days from when you get your first symptoms to know exactly where you contracted it. This knowledge is more aesthetic than helpful for diagnosis. Unfortunately, I can’t even say that I contracted it while at some exotic location or event. It is much more interesting to say, “Ah yes, it was while I was trekking through Elephant Marsh that I was bitten” or “it was while I was at the all-night initiation dance. Having to tell people that I was bitten while sitting around a dodgy in-ground swimming pool at a cheap hotel in Lilongwe doesn’t really have the same ring to it.

Unfortunately, contracting malaria is easy. Determining that you really have it is another matter altogether, especially where we live in Malawi. After 13 years of living here I believe that determining one’s malaria state is more of an interpretive art than hard science. It is a bit like divining water with a willow branch. This is partly due to malaria affecting people differently. I often don’t get a fever, which is usually the classic symptom. I do take anti-malarial drugs, which do give some protection. But, they also mask some of the symptoms.

Another factor, which inhibits one knowing their malaria state, is the system and in this arena I am at an immediate disadvantage. Many locals just treat themselves. Every thing is malaria - flu, common cold, you name it. They buy the drugs at the local store and off they go. But because of my background, (western, middle class and tertiary educated) I have had drummed into me my whole life that I should follow correct procedures and that I should defer to proper authorities. Therefore, to ‘treat’ myself without a proper medical examination is one step from being a casual drug user. So it was with this burden that I took myself off to the local clinic to get my blood checked for parasites.

The malaria test is really not a difficult test. All that is needed is some blood, a glass plate, a few drops of special fluid, some heat and a microscope. The day I went, I was fortunate enough to meet the medical assistant, which is not always the case. This however, was where my fortune ran out. After listening to me ramble on in my stupor about the possibility of having malaria he told me that he was unable to give me the malaria test because, “the microscope was a little bit broken”. To the untrained ear this might still offer some hope that you will eventually get a test done and that the machine is being fixed as you speak. But for me, with finely tuned ears, I knew that there would be no test. The microscope had been completely obliterated in some freak accident or by some force of nature and that the chances of ever seeing it again in that hospital were about as slim as meeting Elvis in his blue suede shoes on the streets of Namwera. In an attempt to encourage me, he suggested that I just take the drugs. “If it is malaria it will treat it and if not, well then, it will be something else and you can come back again”, he said. Defeated in my quest for the definitive test, I decided to buy the drugs and dose myself up hoping that my doctor back home wouldn’t get wind that I was a self medicator.