I Spoke Too Soon.. Malaria Part 2

I blogged two weeks ago about my desire for a problem-free last month of placement. I discussed some of the health problems I have experienced including having malaria 6 weeks ago and falling in a gutter. Personally, I don’t recommend doing either however both seem to be a right of passage of being in Ghana. 

As I wrote the post, malaria was brewing again in my liver and the day after I posted, I started feeling horrible at work and left work early to go home and rest. Just like last time, I had recently returned from a week field trip (this time in Western Region), and I noticed that I was sleeping more than usual and chalked it up to being exhausted. Unlike last time, I listened to my body and didn’t wait three weeks before seeking treatment. I decided against going back to the doctor and chose to buy the medication and rest. I didn’t have the time or feel the desire to go see a doctor again and spend money when I could treat it myself. 

Yet again, I appeared to be the healthiest person with malaria as I wasn’t throwing up or having difficulty moving around. I was suffering from muscle pain, muscle weakness, general discomfort, a headache and stomach pains. It’s hard to describe how malaria ‘feels’ but having gone through it once, I recognized the discomfort and crabby attitude. I knew as soon as I sat down at my desk that Friday that something wasn’t right with my body.

Because I have wonderful friends, a friend went to the pharmacy for me and picked up the malaria treatment and brought it to my room when I got back from work. She spoke with the pharmacist about my symptoms and that I had malaria within the last 6 weeks. Last time the doctor prescribed Coartem but it didn’t work very well for me. When I told my co-workers that I had been prescribed Coartem they all told me that it wasn’t an effective medication and that the parasite has developed a resistance to it and to try a different medication. The Coartem made my symptoms worse and it took me well over a week to bounce back and feel mostly back to normal after completing the three days of medication. All things considered, I’m not sure why I was prescribed Coartem however it seems like everyone is given Coartem the first time they have malaria.

This time I took Lonart which was half the price of Coartem and worked amazingly well. I wasn’t prepared for the nausea which was pretty bad during the first two days of treatment however eating soda crackers and drinking lots of water seemed to help. By the last day of Lonart I was feeling much better and I was able to move around and eat normally. I decided to take the Monday off work and work from home to allow my body to heal a bit more as I was still feeling mentally fuzzy and simple tasks were taking me longer than usual to complete. Tuesday morning I was back at work and feeling much better.

The weirdest part of malaria for me is the emotional chaos that seems to follow taking the treatment. Both times I’ve experienced emotional breakdowns and I struggle to control my emotions and mood swings for about a week after I finish the treatment. Someone told me that this isn’t uncommon in the recovery process however I couldn’t find any resources online about what to expect after completing malaria treatment.

I should point out that I have been taking my anti-malarial medication as directed by my doctor since I arrived in Ghana. I decided that after two rounds of malaria, that it wasn’t worth continuing the anti-malaria medication for the last few weeks. It is true that the anti-malaria medication doesn’t guarantee that you won’t contract malaria but it was a sound investment.

I found this video on youtube about malaria. It provides a general overview of malaria and the lifecycle of the parasite. 

FUN FACT: Did you know that malaria was common in North America? Malaria has since been eradicated.

It is true that malaria isn’t something to mess about with and seeking prompt treatment is key to a successful recovery. Most Ghanaians (and indeed, most Africans), have developed a resistance to the parasite and many adults don’t take the malaria medication and instead treat it the same way we in North America treat the common cold (lots of rest and fluids). It seems to affect small children and the elderly more than the average healthy adult because they have weaker immune systems. If you present with any of the usual symptoms (fever, headache, muscle pain), doctors assume that it is malaria and will treat for malaria before exploring other possible causes for the symptoms. Prevention is important and sleeping under a mosquito net is the first line of prevention. Avoiding mosquito bites altogether is virtually impossible if you are someone who tends to get bitten at home. 

Staying healthy is not so easy.

30 Days Left

It was odd to wake up this morning and realize that today was March 22nd which means 30 days remain of my field placement in Ghana. Looking back on when I first arrived in Ghana, I didn’t have any idea how much I would learn about myself, life and international development. I was also completely clueless about how to do everything from getting dinner to navigating Accra. There have been some pretty horrible lows and some incredible highs throughout this experience. On a personal level, I’ve learned how to cope in a foreign place without my friends and family (although I’ve made a new family here). I’ve mastered getting around on my own by tro tro and I know where I’m going in Accra now. I’m getting over my shyness and I will bargain for taxis to make sure I’m not getting “Obruni priced” (overcharged). I feel more independent than I ever have before and I know that I can function and establish a life in a foreign country. This gives me a sense of confidence I didn’t know I had.

I have also gained a greater appreciation for the comforts of home. Things like knowing that when I turn on a faucet, water will come out of it (cold and hot water), and that I can find a flushing toilet when I need it are small things I appreciate a lot more. Unreliable power and unreliable or slow internet make life all the more interesting (and at times extremely frustrating when you are trying to get something done). I will point out that even within Ghana, things at Legon are much better than elsewhere in Accra and indeed much of the country. I’ve learned that getting upset about such matters is not good and although sometimes it might be hard, laughing about it is always the best way to deal with it. Education is another thing that I am more appreciative of in Canada. So many kids can’t afford to go to school in Ghana and many of them sell water and other items on the road. Kids in Ghana (generally speaking) are required to buy a school uniform and pay school fees to attend school. It is not uncommon to meet children who have never gone to school which is really heartbreaking, especially when they tell you that their dream is to be a doctor, teacher, nurse etc.

Ghana hasn’t been all good though. ‘Ghana tummy’ as it is affectionately known has plagued me on and off this entire trip and at times it gets really painful. Thankfully my wonderful parents brought me some Pro-biotics and that seems to help. I have also contracted malaria (thankfully only once), and I have fallen in a gutter. These sorts of things are a badge of honour and make you feel like you’ve had the real Ghana experience. I’ve also broken electronics (laptop and cellphone) but was amazed at how easy it was to resolve these issues. Ghana does get really overwhelming sometimes but I try to focus on the good days and forget the not so good days.

As the end grows near, I can now appreciate the beauty of Ghana. It is hardly a secret that I truly can’t stand Accra because it is busy, noisy 24 hours a day, crowded, smelly etc. I feel more justified in my feelings when I travel outside and talk with other Ghanaians who echo my dislike for Accra! Living in Accra does have major perks like having access to a wide range of restaurants and it is really convenient to travel to many parts of Ghana from Accra. As much as I think I would love to live in other cities like Tamale, Cape Coast or Takoradi, I’m content with where I am. I have loved spending time in Tamale, Kumasi, Cape Coast - Elmina, and Takoradi where people are really friendly and kind - especially when you look lost. I really like that people take a moment to greet me when I’m walking around, it is such a small and simple gesture but it can make my day.  Ghana itself is naturally beautiful. The lush and green Volta Region is stunning, as is the savannah-like Northern Region. 

Veronika, me and Lisa at Nzulezu - village on stilts

I reflect on some of the crazy yet hilarious adventures I have had over the last 7 months. Some of the more memorable ones include the trip to Nzulezo where the driver was driving extremely dangerously. On the plus side, I made new friends (Lisa and Veronika) who were wonderful to have around. 

At the top of Mount Afadjato

Another entertaining trip was to Volta Region to visit the Tafi Atome Monkey Sanctuary and climb Mount Afadjato - the highest peak in Ghana. Despite the crazy rainstorm that turned descending the mountain into a muddy water slide, we had a fantastic day and had another story to tell. 

Busia Beach

A more peaceful weekend was Western Region where Sarah and I went to Butre and Busia and got to visit a Fort and hang out on a beautiful beach. In hindsight, this was probably our most simple overnight trip, despite planning it in an hour on Friday morning. 

Kevin and I in Kokrobite

I have been really lucky to have had visitors over Christmas break. Having my boyfriend planning a trip to Ghana while writing exams and then getting on a plane within 36 hours of finishing his exam meant the world to me. What a fantastic Christmas present. I know he really enjoyed his time in Ghana.

With the parents at Mole

Vanesa, my Mom, me and Peter in Aburi

My parents also came for a visit and it was so nice to have my Mom and Dad around since I’ve never gone that long without seeing them before. It felt really strange being the ‘parent’ in that situation because they had no idea where they were going but I did. What a change from all previous family vacations where my parents were firmly in charge of the plans and the money. I was so excited to go to Mole National Park and we got to see elephants up close in their natural habitat which was an incredible moment. 

I’ve met some really cool people along the way as well, probably my most favourite people are Peter and his wife Vanessa who own and operate Peter’s Pizza in Aburi. I have eaten lunch several times at Peter’s and each time is yummier than the last! They are such wonderful people and I love talking with them and learning more about their life experiences and how they ended up in Aburi. I really hope I can visit them once more before I leave.

I hope that this last month doesn’t fly by but I know it will. It’s still rather strange to actually be planning to return home in 30 days and return to my regular life in Canada. It took me a long time to be comfortable and happy in all aspects of my life in Ghana but I’ve finally succeeded in doing so and I’m sad to see this experience come to an end. I've made incredible friends throughout this experience and I am going to miss them all terribly. Part of me wishes I could extend to continue working but I know that this isn’t possible. I must admit, I’m excited about seeing my family and my fellow classmates who I haven’t seen since September. I’m also REALLY excited for some homemade macaroni and cheese and tacos! I’ve promised myself to make more time to write on my blog once I return to Canada because I have lots of stories to tell but due to being busy at work, I haven’t had the time to dedicate to my blog as I would have liked. 

Here’s to hoping Ghana will be kind and there will be no catastrophes for the last month. 

(How hard can it be?)

Malaria

As most people already know, I contracted malaria during the last couple weeks. Based on my symptoms, I have been exhibiting symptoms of malaria for the last three weeks without seeking treatment. In keeping with my uncanny ability to contract illnesses in a very unconventional way, I did not have a fever or vomiting, two of the most common symptoms of malaria. I was however, very exhausted and had a constant headache. Neither of these symptoms were alarming for me because I had been traveling for a month for my Christmas holidays. So I thought I had a cold and rested as much as possible and didn’t think much of it. 

My second week back at work after my holidays I really struggled to get out of bed in the mornings. Instead of arriving at work shortly after 9am, I was now arriving after 10am and truly failing at accomplishing anything because I couldn’t keep a thought in my head for more than a few seconds. My doctor in Canada gave me a course of antibiotics to take in case I suspected I had an infection or something so I decided to take them and see if it improved my symptoms. I also resumed taking my iron supplements as I suspected that I was once again anemic because I know I am not getting enough iron from diet alone. The antibiotics seemed to help somewhat and I felt a bit more energetic for a few days.

Last Wednesday night, I was once again feeling worse and my wonderful American friends convinced me that it was time to go see a doctor. From a suggestion from a fellow Canadian volunteer, I went to the small clinic at the A&C Mall in East Legon. I was surprised at how clean and quiet the clinic was. It was comparable to any other clinic I’ve been to in Canada. The biggest difference was that I didn’t have to provide any identification or health insurance. I simply filled out a small form and waited to see the doctor. The doctor recommended a blood test for malaria which was done in the clinic by a nurse. It did freak me out that the nurse didn’t wear gloves while pricking my finger. Apparently this isn’t uncommon in Ghana but it was certainly uncommon for me! The results came back that I did have malaria so I was prescribed a three day course of anti-malarials and told to go home and rest. In total, the doctor and blood test cost me 26 cedi ($17), and the pills cost me 10 cedi ($6.60). 

It freaked me out that the pills made all my symptoms worse instead of better. By Sunday, when I had completed the medication, I was feeling pretty awful. I knew beforehand that taking my daily doxycycline would suppress my symptoms if I contracted malaria but I wasn’t expecting to be as uncomfortable as I was while taking the medication. I was unable to regulate my body temperature so I would be freezing cold but sweating profusely. My appetite wasn’t great and I felt weak and sore. I finally got the fever however I wasn't vomiting as I was expecting. I am grateful to have good friends who checked in on me to make sure I was alright. 

I decided to go back to the doctor on Tuesday because I was still feeling unwell and wasn’t convinced that the malaria was gone. To me, a three day course of antibiotics isn’t enough to cure the ailment however that seems to be the magic number here. I had another malaria test which came back negative (yay!) and my iron levels were only slightly low. Basically I just needed to rest and start trying to resume a normal schedule. I am still having pretty low energy levels however I am hopeful that I will be feeling my normal self by next week. The heat is absolutely contributing to my slow recovery. 

For the record, the common symptoms of malaria are:

• fever
• headache
• nausea
• vomiting diarea 
• sweating/chills
• muscle aches and pains

The best ways to prevent malaria are to take prophylaxis medication, sleep with a bed net, wearing bus spray and most importantly wearing long pants when the mosquitos are out (dusk-early evening). If in doubt, go see a doctor. I hate going to doctors as a general rule however having a friend take me for moral support was helpful.

Finally, take the advice available on the internet with a grain of salt, I found some useful information but mostly I got increasingly freaked out by the horror stories of people with severe malaria.