Friday, October 24, 2008

Whenever you see Chimpanzees, Donkeys follow

These were the wise words of Cleve as he gazed, hallucinating, into his white mosquito net.

The idea behind the thought had been that whatever animal you study will probably be the animal you’d hallucinate in a white mosquito net. But in his malarial state, anything he said probably would have made no sense.

It’s appropriate to say in the rainy season, but when it rains, it pours. Not only is Cleve terribly sick, but the generator fizzled out tonight. I think Adam and I ended up going to be at 7:30. It definitely left me with a feeling of well-restedness this morning (it’s Saturday at 8:35 am now) but it’s still a bit lame.

Malaria is a tough illness here -- it’s allegedly treated with a variety of over-the-counter medications, though calling them over-the-counter implies that there are any drugs here that are UNDER the counter.

All the malaria drugs have here some sort of “catchy” name that involves DOX (for Doxycycline) or QUINE (for the Quinine in most of the ingredients), but their efficacy is completely unknown. Additionally, they’re often stored in damp, hot warehouses, so basically, you never know what you’re going to get. At least Forrest Gump knew that anything he chose would be delicious and chocolatey.

Malaria is neither of the two.

Cleve had taken a drug recommended by the guys here by the name of MALADOX. It’s manufactured in India, and, we’ve determined through painful trial and obvious error, that it does nothing for us whiteys.

One wonders, when reading the label, how anyone ever subjected themselves to such a complete lack of knowledge about what they were putting in their bodies!?

These are exact excerpts from the instructions inside the box:

“What is MALADOX?

MALADOX is an antimalarial drug. Sulfadoxine is an ultra long acting sulfonamide. In combination with pyrimethamine the effect is supra-additive. It may be employed as a clinical curative. Another advantage of the drug combination is that the development of resistance is retarded.

How does MALADOX work?

MALADOX action is based on a differential requirement between host and parasite for nucleic acid precursors involved in growth as it selectively inhibits plasmodial dihydrofolate malaria.

For whom is MALADOX not suitable?

MALADOX is contra-indicated to patients with severe renal impairment, severe liver parenchymal damage, blood dyscrasias, hypersensitivity to components, megaloblastic anaemia due to folate deficiency.

What are the adverse reactions of MALADOX?

Impaired renal or hepatic function, folate deficiency, severe allergy or bronchial asthma, G6PD deficiency has been observed for long term / high dosage

How does MALADOX interact with other drugs?

Increased effect of warfarin and thiopentone. Pulmonary eosinophilia and agranulocytosis in combination with dapsone. Increased toxicity of methotrexate.”



Seriously? I worked in a lab and I don’t understand most of that.

And of course there’s also “Store in a dark place below 25ºC”. I don’t think such a place exists here.

The hardest part of it all, of course, is having to listen to Cleve suffer. I can imagine what he’s going through to some extent, despite never having had malaria, and am just trying to do everything I can to make his days easier.

There is also the knowledge that all of us have that there is really no easy solution to sickness here. American doctors would have no idea what to do with a real virulent case of malaria if Cleve got taken home, and doctors here may know their stuff but hospitals are far from hygienic and no place for someone with a weakened immune system.

So there’s really no other option than toughing it out.

I’m sure, statistically, that either Adam or I will get malaria while we’re here. I can only hope that this second medicine that Cleve is taking will prove to be more useful.


Robbie Honerkamp said...

I seem to remember that one of the malaria preventatives I used to take said something about "We don't really understand how it works, it just does". Which was more than a little disturbing. I think it might have been Lariam.

I eventually stopped taking it, and had excellent luck at avoiding malaria- until I stopped working in an office with easy access to tonic water. And that's when I got malaria for my birthday. :(

amazedlife said...

If you can find it, Coartem is the current best option for malaria. It's a bit expensive (haha, I crack myself up - it's about $10). It comes in a yellow and white box and it's good stuff. Except, like all anti-malarials, you'll feel like shit while you take it. Price you pay.