Attitudes Towards Malaria (and other life-threatening diseases)

Before travelling to the Ivory Coast (and many other countries in Africa), you will probably frequent your local travel clinic to get a variety of vaccinations against diseases such as Yellow Fever, Meningitis, Typhoid and Cholera. You will also be prescribed malaria tablets to take regularly during your trip in order to avoid the country’s most pervasive illness.

What has surprised me since living here is the population’s relaxed approach to these scary diseases. About a month into my time here I was hospitalised for 72 hours due to a food infection and an abnormally high temperature. Though I still don’t believe I was ill enough to be in hospital that long, I was in a way grateful that after 3 days of a lot of drugs and drips, I was sure to be completely healthy. During my time in hospital I was so thankful for all the messages I received from local friends I had known for only a few weeks. Many asked what was wrong with me, asking if I’d caught a “petit palu”: just a little bit of malaria.

Malaria is so normalised here, it’s a fact of life. I once asked my buddy how many times he’d had malaria and his response was “this year?” I clarified that I meant how many times in his lifetime, and he laughed and said that it would be impossible to know, a bit like if someone asked me how many times I’ve had a cold in my life.

Initially I was terrified when I noticed new mosquito bites. I googled “how long after being bitten by a malaria-carrying mosquito will symptoms show?” and told myself that if I noticed any of these within the following week I would go straight to hospital. Three months later, I have been bitten far too many times to be scared, but I will still get myself checked out if I don’t feel on form. “I’m tired” can’t simply be excused by long days and late nights – it may well mean “I have malaria”. People always ask what I’m doing when I get out my anti-mosquito and spray my ankles. Preventative measures aren’t taken in the same way by locals: most beds are still lacking mosquito nets, and my roommate Sarah often leaves the windows open after dark (and no we don’t have nets that cover the windows…).

In most cases, the malaria is identified in the early stages and is easily treated with a course of medicine. A friend of mine however failed to go get a blood test when she was feeling slightly unwell. It didn’t seem serious so she took a day off work to rest. A few days later she was hallucinating about being a cake! Malaria develops very quickly and fortunately at that point she took herself to hospital and lived to tell the tale. A few days later and she might not have. Here if someone dies due to malaria though, it is blamed on witchcraft, on “les sorciers”, and not on a lack of prevention.

Sarah has been very tired recently, but we both thought it was probably related to the long hours she works, and the fact that in between her job she is trying to find time to write up her masters’ thesis. After a week of feeling worse than usual, she took herself to hospital and they told her to come back the following day for the blood test results, but she took two days to go back… oh African timing. When I got home two days later I asked her what the results were, and she very casually replied she had typhoid.

Due to her casual attitude, and the fact that I had been vaccinated against typhoid, I adopted a similarly relaxed manner for the rest of the week – until I mentioned it at the end of a Skype conversation to my parents and they freaked out. Within seconds they were googling typhoid and turns out that 1. the typhoid vaccine does not make you immune, it just reduces the risk considerably and 2. typhoid is very contagious, particularly if you are living in close quarters with someone infected. With this information, despite exhibiting none of the symptoms, I went for a blood test the following day to be sure: all clear!

What amused me the most though was the complete contrast in reactions between my parents and anyone who lives here (even I didn’t react half as much as they did, I think the Ivorian culture is rubbing off on me a bit). Following her diagnosis, Sarah was prescribed medicine to take twice daily. One evening she was too tired to cook and said she would go to sleep without medicine or food. My instant reaction was to go out and buy a loaf of bread so that she would take her tablets. It’s one thing to be relaxed about catching typhoid, but a whole other matter to not commit yourself to being well again.

Today Sarah submitted her thesis, so hopefully the reduced stress combined with the completion of her course of medicine should bring everything back to normal. To conclude: if you feel even slightly unwell in Africa, take yourself to hospital straight away! (Or even better, go to a clinic: you’ll pay slightly more for a consultation but you’ll avoid the queues and you’ll be looked after well).

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