As I looked at the now still form of what used to be a 7-month old baby, I tried not to hear the hair-splitting wails of the woman who had just ceased to be a mother. I tried to mentally lock out the drama that was playing out around me as she thrashed about on the floor, asking God why He would be so wicked as to take from her 28-year old self her 7-month old only child; I tried not to notice how determinedly her husband was standing by the corner trying to “be a man”, to show full composure; perhaps even to show no emotion, his pain suggested only by the furious twitching of his lower lip and the mist that clouded the tiny slits that occupied the place on his face where people would normally have eyes. I tried not to notice all this because, as I looked down at the little innocent who had so needlessly died, all I felt was rage. Rage at the parents, rage at her grandmother, rage that acknowledgement of their grief would only worsen – not temper. Rage because the child that had just died, the 7-month old child that had just walked away from a 28-year old mother and a 33-year old father, had been taken on that walk by no less a phenomenon than malaria.
Strange as it sounds, malaria still kills thousands of people the world over, and hundreds of children in your own locality in the time it takes a woman to have two menstrual cycles. In the time it takes the English Premier League to complete one season, about 300,000 people in Nigeria die from malaria. And this, not because the disease itself is untreatable, but because of the continued supremacy of the ignorance of the people, by the people, against the people.
Ignorance of the disease and how to go about its treatment is no excuse. That is why this 28-year old woman will never get her daughter back. That she did not know that she should not have kept in her house a 7-month old child with fever who was vomiting and passing watery stools is not enough; that she did not know that her generous aliquots of pastor’s prayers and grandma’s concoctions may be more potent in exorcising evil spirits than in curing malaria does not matter.
But I already resolved to be kind. So instead of giving the couple the verbal bashing I think they deserve for killing their own child, I resolved there and then to try to save another couple from killing theirs. Hence this piece, which has been written in as informal and as simple a manner as I can handle.
Malaria has long been blamed on the mosquitoes that thoroughly infest our environment, and with good reason. It is mosquitoes, the females among them no less, that transfer the malaria parasite from one infected person to another uninfected person. The malaria parasite itself can cause malaria in human beings but does not cause malaria in mosquitoes. Like I hinted at earlier, a patient who is down with malaria has excellent chances of full recovery if appropriate treatment is commenced on time and fully carried out. But for appropriate treatment to be initiated, one must recognize that malaria is afoot, and for one to recognize the presence of malaria, one must be familiar with its – common – symptoms.
Now, while I will not presume to tell you what your own malaria symptoms could be (perhaps because I am sure you know them already), I will make bold to tell you what you may notice in a child around you, or what a child around you may complain of when he or she has malaria. Someone with malaria infection may have all (or some of) these symptoms listed. In some cases, the malaria sufferer may not even have any of these symptoms, or may have just one of the symptoms listed. The paucity of the symptoms exhibited by the person doesn’t make the sickness any less dangerous.
- The child may refuse foods or be uninterested in food and drink.
- Fever with chills – the person may be noted to have very hot body temperatures, while at the same time shivering from cold. Caring for the person may be challenging because, one minute, the person may complain of being cold and needing a blanket. The next minute, once the blanket is applied, the person throws it off, complaining of heat. And all the while, their body temperature remains burning hot. The episodes of fever are sometimes followed by excessive sweating, following which the body temperature may drop to normal.
- Cough
- Nausea
- Vomiting
- Diarrhea
- There may be yellowing of the eyes
- Fatigue – the person may notice that they become too easily or too frequently tired after little or no physical activity.
- Malaise – the person maybe uneasy, without being able to say precisely what it is that is responsible for their unease.
- Joint pains
- Muscle pains
- That telltale bitterness that fills the mouth
OK. So when your usually active child who always fights with you for your mobile phone or for the remote controller of the television suddenly begins to prefer the company of his pillow, when the child who previously could not get enough of breast milk (to the scarce-expressed chagrin of his father who has had to wait in a never-moving queue for his turn at the breast) suddenly loses interest in all things round and beautiful, that is not the time to quote the scriptures with the local pastor; that is not the time for “trying” the herbal remedies Mama brought with her from the village when she came for the customary omugwo. Mbanu. It is time to dress the child up and take him to a hospital so he can be properly diagnosed. His fever may not be spiritual. It may be malarial.
In fact, in recognition of how big the problem posed by malaria is, Community health experts now advise us to commence antimalarial treatment within 72 hours of onset of the aforementioned symptoms if we cannot get the patient to hospital and symptoms fail to abate within that timeframe. The consequences of treating for malaria when it is not present are far more tolerable than are the consequences of NOT treating for malaria when it is present.
So, how do you treat for malaria?
Before I talk about antimalarial medications, let me say a few things about handling the fever that is due to malaria. That fever usually responds well to paracetamol, although you may prefer to use ibuprofen. Your doctor will tell you how to administer the drug. But it is the tepid sponging that those busty nurses at teaching hospitals yap about that I want to highlight here. Tepid sponging refers to the use of tepid water – made from a mix of warm and cold water – to try to reduce the body temperature. This is done by dipping and wetting a towel in the tepid water and then dabbing different body parts of the feverish person with it. Dabbing, not scrubbing, not washing, not anointing. Dabbing. When next the child has a fever, take their clothes off them and do a tepid sponge. It works.
I would like to say that antimalarial combination therapy is the preferred mode of treatment. This means that you make simultaneous use of two different antimalarial medications in treating the condition. Happily, many of the antimalarials on pharmacists’ shelves today are pre-combined in just the right doses. This is to ensure that instead of taking two or more different antimalarial tablets each time, you take one tablet that contains the two different drugs. An example of these pre-combined medications is Lonart. Another is Amatem. Then there is Coartem. And Artecam, Artequin, and many others.
You or your child can take your antimalarials whether or not you have had your meal. Don’t prevent your child from taking their antimalarial because they have not had a meal or because they have refused to eat. The truth is that loss of appetite is one of the first symptoms that appears when you have malaria, and one of the last symptoms to completely disappear after you have successfully treated the condition.
If you are treating your child, maybe it is preferable you use tablets. I know there are these equally effective antimalarial powders that come in bottles to which you can add water to form suspensions which you can give the children to drink. But some people add too much water – to make the drug last longer –This excess water that they add to the powder just lessens the effective dose of drug that the child gets to drink at each administration. For this reason and for no other, I think tablets are better.
Do not give more than the recommended dose at any one time because you are in a hurry to make your child get well. An overdose does not make your child get well faster. It may actually make your child get sicker. With malaria and with at least one more thing else. Recommended doses are printed on the medication packs and on the leaflets that accompany them. Try to read those leaflets before you discard them. Reading does not kill.
Try not to skip any dose. Try not to forget. But if you do forget to take a dose, please take the next dose when you remember. Don’t come and go and be forming drug amebo, taking double dose, one for yesterday night and one for this morning, all at once. Haba! You want to go from malaria survivor to suicide survivor?
Let me hasten to say that if you live in Nigeria, and you use chloroquine or any of the variants of that “three-at-once” drug they call Fansidar (or Amalar, etc) to treat malaria, just know that every day is for the thief, and one day is for the owner of the house. And in this case, you are the thief, not the house owner. Those drugs are not effective in treating someone who already has malaria. They may have been effective when granny was a twelve-year old Girl Guide but that was many years ago, and I don’t even know whether the Girls’ Guide exists anymore. Many things have changed since then, and more particularly, the malaria parasites have become more stubborn. A la Donald Trump, chloroquine and “three-at-once” medicines are now ways of ensuring that your child who is suffering from malaria dies faster.
Speaking of dying, that is something malaria can bring about too. Something that it brought about in the patient whose death inspired this post. People with untreated malaria are liable to die young. And before they die, they may have convulsions. They may behave irrationally. They may experience kidney failure. They may see blood in their urine. Yes, malaria can be wicked like that, and in many other ways.
When you have treated your child and recovered him from the valley of the shadow of the darkness of malaria, you can take the following steps to keep him/her in the light of health, and out of easy reach of the next hungry, infected mosquito:
- Try to ensure that there are no stagnant water deposits around your house, whether clean or dirty. Although they can do dirty, the mosquitoes that spread malaria actually prefer to breed in clean water where they can find it. Their only requirement is that the water be stagnant.
- There is also that piece of advice about spreading a film of oil over surrounding stagnant water deposits in order to deprive whatever eggs are there of oxygen.
- When children are going out in the evenings, let them be fully clothed in long sleeved shirts, trousers, socks, and gloves. Let there be a minimum of skin which mosquitoes can bite.
- Let us all sleep under those insecticide treated bed nets. Doors and windows can also be protected with nets. Sometimes, we can use insecticides to fumigate our homes; although the producers of these insecticides nowadays claim that it is essentially harmless to humans in low doses, I think this fumigation is better done when there will be no one indoors, no one forced to stay and inhale the substance, no one to share the final moments of the mosquitoes with them as they embark on their one-way trip to insect-hellven.
May her soul rest in peace, and may God comfort her grieving parents. Amen.
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