Mosquito Bites…

I have over 89 of them – the reason I cannot count accurately is I am not in front of a mirror and cannot see how many I have on my back. I would say by the amount it itches there are quite a few.

The worst are the ones on my hands –clusters of three or four on my knuckles and between the fingers.

So with all these bites I thought this would be a great time to discuss malaria and other mosquito born diseases. Great segway? I think so – provided none of my mosquito bites happened between 11pm – 2am (which I am sure they nearly all did) I am at low malaria risk.

So here it is – a quick (and not necessarily medically accurate) Q & A to malaria in Uganda

Q: But Angela, don’t you sleep with a net?
A: The bad news is I got all of those bites when I was under a net. I would like to take this opportunity to point out the importance of not rolling against the net with bare skin when you are sleeping. The mosquitoes can still get you. Or worse every once and a while one gets caught in the net with you, they really like that, trust me. The high pitch whine as hovers looking for another place to bite will plague your dreams. Some people won’t use nets because it virtually turns your bed into a small oven. I have just gotten used to nightly sweating.

Q: Oh that sucks, but aren’t you taking anti-malarials?
A: I am. However an anti-malarial doesn’t prevent malaria, it just begins treating the parasite before it makes you really, really sick (in theory). An interesting side note – yesterday, I went to a local pharmacy to pick up more doxycycline (the anti-malaral I take) because I will be finished my Canadian tabs tomorrow. The original 4-month prescription that I came with was a grand $120 CAN (sh 204,000). The next two months worth cost me a mere sh 6,000 ($3.52 CAN), a pretty good deal.

Q: Wait you said in theory, so you can still get malaria on anti-malarial?
A: Unfortunately yes, you can still get malaria while on anti-malarial. To make matters worse if you use doxy, an antibiotic, for a long time you also run the risk of getting antibiotic resistance bacterial infections. Sweet, drug-resistant bacteria, and malaria, just through in some TB and Ebola and we have a party. I know that makes Africa seem like a dangerous place – but I have yet to get any of the above. *knocks on wood*

Q: What about using bug repellent?
A: Bug repellent works great and it effective most of the time. Last night (the night after I was eaten alive – clearly I didn’t use much the first time) I sprayed enough repellent to make me want to leave the room. Any self respecting mosquito cleared out, leaving only two with no self respect (or one really hungry one). I only had two new bites this morning. A fan is also nice, and I would use one if I had a place to plug it in. The moving air disrupts the mosquitoes’ ability to land.

Q: And what do you mean between 11 pm – 2 am?
A: The mosquito that transmits malaria is called an anopheles and according to the paper work I received on malaria (and according to the locals) they only bite in the middle of the night.

Q: Okay, so that’s how to avoid it. How do you know if you have it?
A: Short answer, you get really, really sick. Rumour has it you feel like you are going to die, and wish you were already dead. (This isn’t the best description because I felt like that after eating the raw mean in Ethiopia). You get a fever, followed by cycles of fever and chills – it means lots of sweating, hey kind of like sleeping under a net. Your stomach starts to feel bad, with lots of pain, and of course you can expect vomiting. The headache makes you wish the entire world would just shut up, and turn off the lights. Of course I have, fortunately, not experienced any of these, so don’t take my word for it.

Q: How do you treat it?
A: Tabs (prescription pills) called Coartem are the best bet. If women are pregnant they get Fansidar to protect the foetus. Saline IV to keep fluids up. In some cases, injections of quinine are given into the buttocks. But if you read my New Vision article on What could go wrong, I would recommend being too sick to take the tabs before you go that route.

Q: Well that seems not so bad, how badly are Ugandans affected?
A: Due to lack of treatment, money and access to treatment, a lot.

• 320 recorded deaths due to Malaria per day
• $658 million USD a year are lost to malaria
• Consumes 10% of the Ugandan Ministry of Health budget
• Consumes 60 million man hours
• 43% of school absenteeism is due to malaria (children under five and pregnant women are most effected by malaria)
• 25% of the average household income is spent on malaria treatment and control

I’m sure there is more I can tell you, but right now I have to go scratch.