Any of you who may have travelled to a malarius country before will have experienced the frustrations and question marks around what to do to prevent malaria. For those of you who haven't here is a little information.
Unlike many 3rd world health problems such as yellow fever, typhoid, polio or hepatitus there is no vaccine for malaria. The disease, carried in mosquitos can only be prevented by not getting bitten or by taking one of several preventative drugs which are available to reduce the risk of aquiring the symptoms of the disease when you are infected. Unfortunately, with the list of preventative drugs also comes a long lineup of undesirable side effects. Many of which could be considered worse than actually getting malaria itself.
In Africa everyone gets malaria. Many of the locals will get it several times per year and it comes on like a strong cold or flu, some never get it, and some people die from it. Though the deaths tend to be in young children, or if no care is available. In Mauritania, where I am today, a large percentage of children (something like 20%) die from Malaria before age 5.
All travellers face this risk and must decide how they will tackle the problem. If you go to a health clinic in North America or Europe they will make the case sound pretty simple, select from one of these drugs and take it. In Canada before leaving for Asia I took a prescription of Doxycycline which is a strong antibiotic. This may be an ok solution for a 2 week trip but to take antibiotics for several months is attrocious to your body. I took my pills, one per day, for about a week and each day my stomach crunched up like I had swallowed a tin can and my mood swung into an unpleasant frustration much like if I haven't eaten in a long time. I quit the drug and though I spent 3 months in malarius zones and was bitten by many mosquitos I don't believe I had malaria. However, here in Africa the risk is much greater.
In Sweden I got a new drug, called Larium or Mefloquin. According to most countries this drug is the most effective against preventing malaria. It also has a reputation amoungst travellers which far exceeds its positive affects. This drug directly affects your psyche. Side effects listed on the package include mood swings, intense dreams, hallucinations etc. Basically it is described by travellers as a mild form of LSD, or perhaps not so mild. You take one pill per week and it builds up in your system. Last week I took my first pill to see how it would affect me, hoping that perhaps the affects would not be so strong. I took the pill on Tuesday, by Friday its effect was at its height, I was high on mefloquin and happy about it. During the previous few days I had begun to notice a few funny things, most notably that I was using my left hand for things I never use it for and that night I entered a place in my mind I have never been and woke to a dream which continued a few moments after my eyes had opened.
On Saturday I was as low as I can get, unable to lift my spirits and uncharacteristically swearing at everything. This affect lasted a few hours.
One week on Larium.
One last knock on Larium is that if you get malaria while on the drug (which can still happen) you must take a big overdose of Larium to treat the disease. From a first hand account I recieved last night this will put you on another world. Many of the other drugs have similiar treatments and effects.
So it is that each person must decide. Take a risk with the drug, or take a risk with malaria. Most long term travellers choose to carry with them some medications to take if they get malaria and forego the prevention drugs. Sticking to insect repellent as the main method of prevention. Today I should take my next Larium dose. What would you do?