I am writing this recovering from my latest malaria…. Malaria has a pretty bad reputation worldwide and with enough reason: last year it killed around 438,000 people according to the WHO, so I don’t underestimate the illness. But what I want to write about is how the local culture weights into its perception and into its treatment as well.
You get malaria,(or paludisme), if you are bitten by a female infected mosquito. Those mosquitos wake up at night, so sleeping under a mosquito net is the best way to prevent it, and since it is treatable, anybody who has got it should start treatment as soon as possible. Failure to do so is what heightens the risk of death.
Malaria here in West Africa is almost like a cold in the West: everybody gets it a few times a year. The sympthoms include headaches, fever, weakness and nauseas. “I was down with palu” is a very commonly heard phrase, which means, the person was one week in bed recovering. Same if the treatment is 3 days long, it takes a full week to regain the full strength. It is incredible what a minuscule mosquito can do to us humans!
This is the campagin poster that you see around for
sleeping under mosquito nets
For the longest time the West thought that access to treatment and to mosquito nets were the key to decreasing malaria deaths. However, I have discovered that it has a lot to do with local beliefs and education (or lack of). For example, in villages and remote areas, if a baby is bitten and starts developing fever, the parents will assume that a bad spirit has possessed the kid and they will bring it to the local witch. The witch will do whatever he or she does, but most likely will not help.
Day 5-6 with fever of 40 C, the parents decide to organize themselves and go to the closest clinic to see if the “white people medicine” does something, but in most cases it is too late, the kid dies because small babies cannot resist fever of 40 Celsius for all those days. Several babies died in my arms in the rural Ivory Coast community where we were in this same story. So the access and the treatment are there, and the WHO provides it free to isolated communities, but it is up to the people to choose it. However, outside urban centers, there is still A LOT of mistrust of anything coming from “the white people” including the theory that malaria comes from a mosquito bite and has nothing to do with evil spirits.(What do we know about evil spirits?)
Little by little however (very slowly) the culture is changing and education is spreading about the scientific roots of malaria.
On the bright note, I was quickly diagnosed and sent to bed almost immediately (not that I had energies for anything else) with tablets, no perfusion. What an overwhelming surprise the amount of people who has brought me food! My little fridge is full as it has never been and I have the table and two chairs full of fruits and vegetables of all kinds. They don’t even knock on the door, they leave it by the door (as they know you are most likely sleeping) or if they come in they just to say: “Im leaving this in the kitchen”. One of my colleagues who has a washing machine came to take all my linens and the clothes that I soaked in sweat to wash them in the machine. Even my students would leave a couple of mangoes or a pineapple hanging from my door knob with little notes of: “get well soon madame”, “eat even if you are not hungy to recover your energies and come back to teach us” awwwwwwww.
This is my friend Edith. You can see the perfusion in her hand, so I would go to keep her company at the hospital. Clinics here are quite sober, but also quite permissive, I would lie down with her and we would watch videos in youtube together…
Being sick is different here. And speaking of malaria, I guess these people have endured it since their childhoods so they know perfectly that they need each other to overcome the illness. Or just to get by with it. It is something I would have expected maybe from my close family but never from outsiders. And this week it has brought a great joy to my heart. Solidarity with your neighbor (or your colleague or your friend or your teacher) when sick is something the world can learn from West Africa.