Surviving Malaria in Africa

It’s amazing the impact that a tiny little mosquito can have…the sheer amount of pain and suffering it can cause. I learned this firsthand when I got malaria just a few days after landing in Africa. 

We were on day 3 of our overland tour when it hit me…

The night before we were treated to a delicious meal of Mexican tortillas, soup, bread pudding and ice cream – a rare night we didn’t cook our own meal at the campsite. So when I didn’t feel great the next morning I figured it was just the after effects of a rich meal. 

We headed out early for our first game drive. The 45-minute bumpy drive to the park was not exactly pleasant on an upset stomach but once we arrived I used the restroom and figured my stomach would settle down soon.

Entering the massive Lake Nakuru National Park, we saw all kinds of wildlife and beautiful landscapes. And just 20 minutes into it I was feeling so nauseous that I requested to sit up front with the driver. 

As each minute went by I felt more and more ill…

We stopped at a rustic squat toilet and that wasn’t the only unpleasant thing. Ugh, this was India all over again! “It must have been the ice cream,” I thought. Damn – I knew I shouldn’t have eaten that ice cream! 

There was just one problem with that theory though… no one else in our group was sick and everyone had eaten the same thing.

About an hour and a half into the game drive we stopped at a viewpoint with another squat toilet. Allow me to paint a rather grim picture. Something that looks like an outhouse with a jagged hole smashed into a concrete floor. Toilet paper? No. Sink? Ha! You must be joking. I won’t even describe the smell. And I was stuck there for way longer than I would have thought possible. It was downright scary. 

At this point, I started to feel a fever. But incredibly, I just figured I was hot because it was a hot day and I had been sitting in the sun in the safari car. It never occurred to me that what I was experiencing was my body reacting to malaria. 

We were riding around in a car like this on the game drive.

The car became absolutely unbearable. I felt every bump in the dirt road in my stomach and felt that at any moment I might throw up. It reminded me of the traveler’s sickness I had in India but man…this was far worse. I was mystified and couldn’t make sense of it. And here we were in the middle of this HUGE national park and there was no way out. The driver explained that we were nowhere near the park entrance. There was also the rest of the group to consider. This was hell.

By the time the safari ended and we re-joined the rest of the group on the overland truck, I knew I had to get out. I was in a dazed, feverish, horrible state and there was a six-hour drive to get us to Uganda that night. I didn’t know what was going on or what to do. I only knew one thing with 100% certainty – there was no way I was getting on that truck.

Was this the end? I had finally made it to Africa and was on my very first game drive. I was on a tour I had booked a year and a half earlier and centered our round-the-world trip around. This can’t be happening. 

And then it got worse – our tour leader (herself a malaria survivor) told me it could be malaria. She made arrangements to get us help and accommodations at a homestay in Nakuru and said we could arrange transportation to catch up with them in a day or two.

How Did I Get Malaria?

You’re probably wondering… was I taking anti-malaria pills? Was I using mosquito repellent? The answer is yes but neither one provides 100% protection against the disease. Anti-malaria pills are not full proof. Most of them are around 80-95% effective. I was on the best pill that money can buy (5x more expensive than the rest) – called Malarone – and I still got malaria. 

The incubation period was incredibly short. I had gotten a couple bites in the first few days and was in Africa for 5 days when it hit me. In most cases the incubation period is between 7 and 30 days, but certain types are shorter or longer.

I had been in Europe two months prior – so I didn’t pick it up there. It had to be one of those first few bites in Nairobi.

Powerful Pills

After settling into the homestay, we went to a clinic to get tested. They pricked my finger for a blood sample and confirmed it was malaria. This was frightening to say the least but the odd thing was, it was no big deal to the Kenyans. Everyone assured me, “You’re going to be OK.” They weren’t worried or in any way alarmed. Getting malaria is so common in Kenya, it’s akin to getting a bad cold. Our driver said nonchalantly, “Oh yeah – I had it just two months ago.”

Next, we saw a doctor who gave me two options: 

  • Get 1 injection, or
  • Take 4 pills over 2 days

I figured the pills were a safer bet and the doctor told me they would “knock it right out…really powerful pills.” 

What he gave me was ARTEQUICK – containing artemisinin, as well as some antibiotics and pills to bring the fever down. Certain types of malaria have been found to be resistant to artemisinin, but lucky for me, it worked. Just 24 hours after taking my first 2 pills I was feeling better. I had thrown up, I had no appetite and no energy, my stomach was still in a bad state, but it seemed I might survive. It seemed the pills were working.

These pills saved me...

This was by far the worst sickness I have ever experienced, but the worst of it lasted only two days. Over the next couple of weeks I had trouble eating and dealt with various side effects, but gradually I got back to normal. It wasn’t easy, but not willing to let go of the dream, and with Root by my side, I made it through. There had already been more than 5 months-worth of travel challenges and frustrations but getting malaria was a new low. There were moments when I said to Root, “I think I might really be done now,” and was contemplating a flight back to New York.

Taken For a Ride

We caught up with our group in Uganda but it was a grueling and expensive journey. The people that took care of us were the employees and wife of a man named Peter. They were so caring and so kind. But Peter only saw dollar signs at the opportunity to help us. As the owner of the homestay and local tour company he offered us transportation back to our group for $1,239. 

Yes, you read that right.

Tragically – we misunderstood Peter and thought he was going to charge us half of this. When we realized it, he insisted our travel insurance would cover all costs (and by the way it didn’t cover a dime.) I was too weak to argue and it was obvious we were stuck. The alternative would have been to catch a bus to the border, manage through the chaos of the border crossing in Uganda, find another bus on the other side and somehow make it to our campsite – safely. I’m sure this would have made for some great travel stories but I was in no condition to deal with it.

Our overland truck

Our tour group on the truck

So we got there. We paid the money and the main thing is – we got there. We had such a great group and tour leader and I’m so grateful for that. Everyone was so nice and so concerned for me. I’m grateful I got immediate treatment and the treatment worked. And I can’t tell you how much more grateful I am for first-world, quality medical care.

How To Avoid Getting Malaria and Other Mosquito-Transmitted Diseases

{Disclaimer: I’m not a doctor or an expert, but here’s what I’ve learned from my own experience.}

DEET: It’s toxic and smells bad but you need to use it as soon as you get off the plane and don’t get complacent. The repellent you use should have at least 25% DEET but does not need to contain more than 30%, since there is no increase in effectiveness above that. Lotions work better for me than sprays or aerosols – probably because they just provide better coverage. Buy your repellent at home and bring it with you. I found it difficult to find products with DEET in Africa and Asia, but we did have luck in finding them at major airports at pharmacies like Boots – a UK chain.

MOSQUITO NET: If I were to go back in time and do the trip over, I would definitely pack a mosquito net. I would use it everywhere in Africa and Asia that did not provide one. I didn’t want to carry the extra weight and I worried about how I would rig up the net in hotel rooms. But looking at the different types of nets you can buy in this guide, I would have chosen the ridge-style net and brought a ton of string with me… safety pins, hooks, etc. I can’t tell you how many nights I woke up to mosquitoes biting me. In countless hotel rooms in Southeast Asia, we really tried to stay on top of killing whatever mosquitoes were in the room so they wouldn’t get us at night but if we missed just one, it would get me. 

True story: One night we stayed in a beach hut in Dar Es Salaam. The beds had mosquito nets. After settling in, I shined my headlamp up and saw at least 8 mosquitoes swarming an inch above my net. Scary!!

DUCK TAPE: One of the most useful things you can pack. Use it to patch any holes in your net or the nets provided to you. Also make sure to tuck in the bottom of your net under your mattress and keep your hands and feet away from the edges.

VACCINATIONS AND MALARIA PILLS: Don’t leave home without ‘em. Don’t get lazy about taking your pills. Most people in our group were on Doxycycline. Malarone has the least side effects and we just got the occasional mouth sores from it. I know they say to take it 1-2 days prior to traveling to an area with malaria but I would take it 7 days before.

LONG-SLEEVED PANTS AND SHIRTS: Covering up certainly helps and especially at dawn and dusk when mosquitoes are out in full force, but the reality is – it’s hot in these places and you won’t be covered up all the time. Just make sure to use your DEET!

LUCK: Honestly, there’s a certain amount of luck involved. All 24 people on our tour got bit at one time or another but never got malaria.

On Safari in East Africa: Hippos

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Hippos

One of the scariest moments all year was the night we heard a hippo munching grass right outside our tent. Mind you – camping in Africa was a great adventure and it was awesome to hear wildlife at night. Unique bird, insect and animal noises we’d never heard before – and totally different in each new place we went. But this was not a noise I wanted to hear. Hippos are one of the most dangerous animals in Africa! That night we were camping near a river with tons of hippos, and given that they feed nocturnally, we could expect them to be grazing on the grass around us.

In these situations, you really don’t want to have to get up to go to the bathroom in the dark. If we did have to go and we saw a hippo we were told to not make a sound, don’t panic, keep the light of your headlamp on the animal and move slowly – backwards – back to your tent. It’s noise that will really upset them, so when I awoke to hearing a huge munching sound right outside our tent I was so panicked I froze, barely breathing so as to not make a sound. I also heard the distinct sounds that hippos make so I was convinced that the animal was indeed a hippo. I heard it munching on the right of the tent, then to the left…this continued for a couple of very long hours until it finally walked away.

Hippos are violent! One day, while on a river cruise in Uganda, we saw two hippos fighting right in front of us. You could see the power of these massive animals splashing and biting each other in the water. The photo on the right shows blood where one was bitten.

Hippos spend most of their days in water to keep cool under the hot African sun. Their eyes and nostrils are high on their heads, allowing them to see and breathe while mostly submerged.

This cute little hippo by the shore with its mother is around three months old. Baby hippos are born underwater and have to swim to the surface to take their first breaths.

FACT

Hippos are quite agile. They can easily climb steep riverbanks at night and travel several miles to graze before returning to the water. They prefer to eat alone and can eat around 150 pounds of grass each night.  

On Safari in East Africa: Buffalo

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Buffalo

In the dictionary, next to the word grumpy, there should be a picture of an African Buffalo – the grumpiest, surliest animals we saw on safari. Whenever we saw them, they would turn and look at us like we had rudely interrupted their morning coffee. We weren't interrupting much since usually they would be lounging by the river, or near a mud hole. When actually bothered or attacked, a buffalo herd forms a protective circle around their young. They will even attack and kill lions and their cubs. 

Despite their placid cow-like appearance, their nicknames include "The Widowmaker" and "The Black Death." Buffalo gore and kill more than 200 people each year. They are known to ambush and attack hunters that wound them.

Male-only groups of buffalo, so-called "loser" groups, are formed by older males. When they have grown too old to defeat the younger males for breeding rights, they leave the herd and set out on their own. These "losers" will often find one another and form groups for protection.

Like many animals, buffalo are plagued by insects. You can often spot them wallowing in the mud or bathing near rivers to rid themselves of the biting bugs.

FACT

The horns of adult males have fused bases which form a bone shield. The shield, called a "boss", can even deflect bullets.

On Safari in East Africa: Leopards and Cheetah

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Leopards

Leopards are extremely difficult to spot in the African bush. They’re shy, secretive and nocturnal. So it was incredibly lucky when we saw one on a game drive in Lake Nakuru, Kenya. In fact, it was Root who spotted it, nestled in a bush near the road and he shouted to our driver “Stop! Leopard!” and he slowly backed up the car. I was in the front seat with the window down and when the car stopped I was looking directly into the eyes of the leopard about 8 feet in front of me. As you can see from the photos below, its eyes were amazing. Such a beautiful creature. After a few seconds it turned its attention to some antelope nearby and started to slink its way through the grass towards them.

FACT

Leopards are incredibly strong and known for their climbing ability. They can carry carcasses weighing more than 110 pounds up into the trees and this is how they protect their food.

Cheetah

One of the very first animals we saw in the Serengeti was the cheetah. Built for speed, they are sleeker and lighter than leopards. They are so fast they don’t have to stalk their prey as much as the leopard. Their eyes are very exotic looking, with black "tear stripes" running from the corners of their eyes. These help block out sunlight, which aids them in spotting prey.

FACT

The cheetah is the fastest land animal in the world, reaching speeds of up to 70 miles per hour. They can accelerate from 0 to 60 miles per hour in just 3 seconds.

On Safari in East Africa: Rhino

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Rhino

Amazingly, we were less than 20 feet away from the largest, meanest looking animal ever – a rhinoceros and her cub. Since we had trekked out into a swamp from our campsite, and since rhinos can run much faster than people, we were very thankful to have the rangers with us. Here at the Ziwa Rhino Sanctuary, we got to see not only a mother and baby, but a group of 4 other rhinos as well. The sanctuary is the only place to see wild rhinos in Uganda due to poaching, prolonged human conflict and other issues.

Rhinos are the second largest land animal behind elephants. An adult white rhino can weight more than 7,000 pounds. We were surprised by the giant footprints we saw on our trek.

Birds, like the oxpecker, are often found on rhinos. Not only do they eat the ticks which feed off the rhino, but they also may alert the rhino to nearby predators. The birds help to make up for the rhino's poor eyesight. 

FACT

Despite their thick armor-like skin, rhinos are prone to sunburn. They often wallow in mud or dirt to protect themselves from the sun.

On Safari in East Africa: Elephants

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Elephants

Elephants are fascinating. They are not only the largest land animals on earth, they're also the most emotionally human. Seeing large herds in the wide open savanna was like peering back in time. After all, African and Asian elephants are the only two surviving species of what was a diverse group of large mammals in prehistoric times. On a boat ride in Queen Elizabeth National Park in Uganda, we saw two large elephants on the shore who appeared to be kissing :) Elephants are affectionate, social and compassionate, and have unique personalities like we do. 

While in Nairobi we visited a well-known orphan-elephant rescue and rehabilitation center. Sadly, many of these baby elephants' parents were killed by poachers. After a period of time at the center, they are carefully reintroduced back into the wild.

Our guide joked that this elephant had been trading with the Chinese. The Chinese are the world's biggest buyer of ivory (right behind the Americans). Far from a laughing matter, an estimated 36,000 elephants are being killed annually for their ivory. At this rate there will be no elephants in the wild by 2025!

Trees are elephant's back scratchers...we often saw them rubbing up against them.

FACT

An elephant's trunk contains over 40,000 muscles and can lift up to 770 pounds.

On Safari in East Africa: Zebra and Wildebeest

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Zebra and Wildebeest

Just minutes after landing in Africa on our taxi ride from the airport we saw our first animal, the zebra. Everywhere we went we saw their iconic black and white stripes. We even had some visit our campsite, which was great until we had to go to the bathroom and there were 4 or 5 zebra in the way. In the Masai Mara we saw massive herds of wildebeest and zebra on their great migration. They covered the plains, zig-zagging in jagged lines and clumps as far as the eye could see. The bearded faces of the wildebeest and stripped faces of the zebra will always remind us of the vast plains of the Masai Mara. A unique vision of two very unique animals.

Zebra and wildebeest are often found together because they have complimentary senses. Wildebeest have a great sense of smell that helps them find water, and zebra have keen eyesight to spot predators. Zebra mainly eat taller grasses while wildebeest eat the shorter ones. 

Baby zebra are born with brown instead of black stripes. As they mature the stripes become darker until they are their adult black color. No two zebra’s stripes are alike.

Millions of wildebeest migrate each year from their birthplace in the Serengeti to the Masai Mara. The 500 mile-long migration follows the rain cycle leaving the Serengeti in May, and returning in December.

FACT

Newborn wildebeest calves can stand after 2-3 minutes, and can run just 5 minutes after being born. (Can you imagine if human babies could run after 5 minutes?)

On Safari in East Africa: Giraffes

We had a spectacular month exploring East Africa – a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Giraffes

Giraffes are really tall, yet incredibly graceful. Seeing giraffes gently roam the savanna was like a vision of Africa in my head come to life. 

One day we witnessed the ritual known as “necking” amongst a group of males. They were swinging their necks wildly at each other – quite amazing to see! Males establish social hierarchies in this way. Whichever giraffe uses his neck and head most effectively and remains standing the longest is the winner and allowed to mate with the female.

Not only long necks…giraffes have really, really long tongues! So feeding them little food pellets was pretty funny. (And slimy.)

Their favorite food though is acacia leaves. I kept wondering how they manage to eat these thorny things. Apparently, this is where that massive tongue comes in handy  to scrape off the leaves. Plus they have very tough lips to guard against scratching.

FACT

The giraffe is the tallest mammal in the world. Even newborn giraffes are taller than most humans.

On Safari in East Africa: Lions

We had a spectacular month exploring East Africa -- a real dream come true and centerpiece of our trip. It was awe-inspiring to see first hand in the wild what we had only seen in zoos. Handpicking the best of the best of the thousands of photos we took, the On Safari in East Africa series showcases the animals we were privileged to see in Kenya, Rwanda, Tanzania and Uganda.

Lions

The first time we saw a lion, a big male came out of the brush and walked onto the road. Our guide yelled “Lion, lion, lion!” and stopped the car. Nonchalantly, the lion crossed, then disappeared into the brush. Seeing this wild lion, the king of Africa, made me think of the incredible daily struggles of all things under the harsh African sun. Here we were, in the middle of it, and there were lions in the bushes. One morning we witnessed a pride devouring a wildebeest. The males were eating while the females and younger lions played nearby on a tree. We could see parts of the carcass lifted up as they ate before the rest of the pride joined in on the meal. 

Surrounded by the hills of the Masai Mara near sunset, we came upon a small pride of lions. A young male got up and laid right in the middle of the road. It was so crazy to look him dead in the eye from just a few feet away.

Early in the morning in the Serengeti, we saw this lion pride resting and snuggling together. Ever watchful, they all got up and started to move toward some antelope. Watching them all walking on the road toward us is a sight we will not soon forget.

It’s amazing how well lions can be camouflaged. We barely saw this huge male lion napping in the grass of Ngorongoro Crater. Our guide told us that the only way to spot lions is by the dark spots in their tails and ears.

FACT

Masai Mara (in Kenya) is home to one of the highest concentrations of lions in the world. 
 

{ video: Lions hunting in East Africa }

Looking Forward To: AFRICA

When I think about Africa the words that come to mind are colorful, majestic, wild, and pure. It just seems to me there’s no other place on earth quite like it. I’ve imagined what it might feel like to stand and look out onto the savanna, breathe the air and hear the sounds of elephants, lions and more.

Photo by Kate Holt/Africa Practice

Two Special Visits

We start in Nairobi, where we’ll meet a young girl my parents have sponsored for the last six years through the Christian Foundation for Children and Aging. She’s 15 years old now. Through letters and photos they’ve gotten to know her and it will be really special to meet her and walk around the orphanage.

After our safari tour, we’ll go back to Rwanda to stay in a small mountain village with Jane, a family friend. Jane is currently working for the Clinton Health Access Initiative at the Rwamagana School of Nursing and Midwifery, and we’re hoping we might lend a hand too in some way while we are there.

One Epic Tour

In Nairobi, we’ll join a 34-day overland tour through East Africa. (Yes, that’s right. 34 days. HALP!) We’ll be with a group of about 20 people, driving through Kenya, Uganda, Rwanda and Tanzania, in a big bus/truck and staying at campsites along the way. It involves what’s called “participation camping” where you set up your own tent, help prepare the food, etc. Everyone pitches in and does something, so I imagine it won’t be long before we become our own little family. And I love this line from the tour notes:

“Your leader will outline the basic safety rules to be followed when camping in an unfenced location where wild animals are present.”

Highlights of the tour include:

  • Game drives in the Masai Mara National Reserve, Kenya
  • Camping in a small village on the lower slopes of Mount Kilimanjaro
  • Jeep safari in the Serengeti National Park, Tanzania
  • Mountain gorilla tracking in Volcanoes National Park, Rwanda
  • Game drives in the Ngorongoro Crater, the world’s largest caldera
  • Camping on the shores of Lake Mburo in Uganda
  • Spice plantation tour in Zanzibar

Courtesy of Jane, here is "Mrs. Chief posing"

And Cape Town

Finally, we’ll head down to Cape Town (where we’ll likely cash in some Starwood points to stay at the Westin). Over 10 days we hope to visit the nearby wine country and take in the area’s unique history, cosmopolitan culture and geography.

Oh, and did I mention I’ll be celebrating my 40th birthday…in Zanzibar?!?

Kinda nice how that worked out.