Fever = Malaria

Malaria is endemic in Zambia. To give you an idea how common it is here, whenever people have fever, they just say they have malaria; the two words are almost interchangeable. It’s so common, people get malaria like we get colds. Everyone knows the symptoms; self diagnosis is common, so are anti-malarial medications. Almost everyone here has had malaria at one point in their lives; it’s kind of like a rite of passage. The pharmacy at the hospital has a huge section reserved for different anti-malarials. I really didn’t have to spend the money and bring my own malaria treatment. The pharmacy here has better, and far cheaper, malaria treatment medication than hospitals in Brisbane. The latest malaria treatment, artemether plus lumefantrine, is difficult to get in Brisbane and not even available in the United States, is a dime a dozen here.

Malaria in this part of Africa is of the falciparum species, which, while causing the most number of malaria-related fatalities worldwide, is highly curable when treated early and aggressively. It doesn’t cause relapses like the other more benign varieties like ovale, malariae, and vivax. Whichever it is, I am trying my best not to get it. Between taking my malaria prophylaxis religiously, wearing long-sleeves in the evening, sleeping under a mosquito net, and spraying insect spray around my room regularly, I am hoping I can avoid joining the club.

In the hospital, treating patients for malaria is a daily chore. They may come with some other problems, but almost everyone gets a blood slide done for malaria. Quinine flows like the keg at a fraternity party and, because hypoglycemia is a common side effect, everyone on quinine eats sugar by the cupful. Good thing diabetes is not common here. I am sure that, by the end of these eight weeks, I will have seen more malaria cases than I will for the rest of my medical career, barring any future medical trips to malaria-endemic regions.