Malaria is a serious threat to many citizens of tropical countries around the globe. When visiting such a country, you might get into the situation where people advise you to take a Malaria test because you have had fever and nausea. Even though you took Malarone or any other prophylaxis, you might have been infected by a single mosquito bite. This article elaborates on my experience with Malaria and the Ugandan health care system.

Beautiful country, with danger around

Have you been to Africa before? – I had not. For the first time ever I left Europe to experience a completely different continent and culture, the destination was Uganda. The first week over there was amazing. Friendly people, tasty food and looots of sun. However, the point where I started feeling really sick came on Friday, exactly one week after arrival. Symptoms: stomach ache, nausea, fever.

So what do you do then, sitting in an African village and feeling sick? – If you have temperature, you go and take a Malaria test, because there are roughly 2 Million cases of Malaria and  up to 1 Million deaths from Malaria a year  (WHO) and it is important to ensure yours is not one of them.

If the result of the test is positive, the next step is to take Malaria medication, two pills a day, three days in a row. If the doctor means it well, you will get additional Vitamin B supplements to strengthen the immune system and to help the body fight the parasite. After three days you are cured, so the idea . But let’s see how this works in reality.

My Malaria Diary

Day 1: “Dear diary, this morning I still felt sick and after realizing that the fever didn’t drop in the past two days, I decided to see a doctor to make sure my Malaria prophylaxis works and the illness is harmless. Together with a fellow student I went to a small Health container on the Sssese Islands and took the test. After ten minutes of waiting the doctor approached me with a serious face: “You have Malaria”. I couldn’t believe what he just said, but had to accept it, I mean he is the doctor. Back in the hotel I had to stay in bed all day in order to cope with the side effects of the medication such as head ache, tiredness, and anorexia. Three days of heavy treatment should resolve the issue, so the plan.”

Day 3: “Today we drove to a clinic in the city Massaka to test whether or not the treatment applied. 15 minutes after taking the test the answer was: “You have Malaria”. I was taken to hospital to try a different kind of medicine after having explained that I should have been cured already. Arrived, I was connected to a drip for two days and one night. The injections were intended to kill the parasite and to keep my body hydrated, as I wasn’t able to eat and drink properly since the start of the tablet treatment.”

Day 4, evening: “Today I had to take a third Malaria test, result: Negative. The treatment in hospital was successful and the parasite was dead, I fought Malaria. However, I had to take some pills for three more days, ensuring that the parasite would be completely cleared and banned forever.”

Finally cured, we thought

Day 7: The final treatment was over, time to take my very last test and enjoy Africa. Result: Positive. Again, I couldn’t believe it. How can a parasite be so immune against three different ways of Malaria treatment? Why me? – The time had come to take a decision, stay sick or go home. I chose for option number two.

Day 9: The backpack was packed and I travelled to Kampala, the capital of Uganda. Before taking a flight back to Germany, I visited a British clinic there (the best one present) to get some medication for the way back. When entering the doctor’s room I was convinced of being seriously sick. I told the doctor my whole story and she looked at me like I was crazy, but said with a smile: “Those Africans will never make it, I bet you never had Malaria”. I didn’t agree after having taken medication for one week and we made a deal. “If you really had it, you’ll get your money back”. I was totally in for that one. We made a blood test again, this time not only checking for parasites but antibodies to diagnose a past infection. Result: Negative. Both negative. The doctor was laughing and told me that I wasn’t the first case who got misdiagnosed.

Let’s face it

There were actually two other tourists who died, because it wasn’t possible for the local doctors to see the parasites in their blood.

I went back to our village that day to enjoy the beautiful country, healthy and happy, but imagine what could have happened without the British doctor.

A simple gastroenteritis mistaken for Malaria. A serious Malaria not recognized.

This article is not meant to share my personal suffering, it is more to open your eyes for the things that go terribly wrong in countries such as Uganda. There are plenty of cases like mine and now I am wondering: how can we accept such drawbacks? I had the luck to be able to pay for a great doctor, but what about the ones who don’t? And lastly, are there really so many deaths from Malaria?

Solutions?

This issue is an important one and it is hard to tell what has to be done to cope with it. There are easy tests to check for parasites, but somehow that does not resolve the problem. I believe a starting point is to improve the education of nurses and to train them for Malaria diagnosis specifically.

Lastly we have to keep on thinking critically in every situation we face. Just because someone is wearing a white coat his/her diagnosis is not necessarily correct.