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.

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.