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From Malaria with Love

I had been in Egypt a week, and it was my last night before boarding my flight to Paris on route to Abidjan. As always, it had been a highly productive week in Cairo. As usual, my sister made sure to spoil me with “macrona bashamel”, veal, and all of my favorites. The logic was that I needed to be properly fed before I boarded my plane, which was due to depart at 1:30 AM.

The driver had arrived close to 11:00 PM. It was now time to kiss everyone farewell for the nth time, something I always dread. As I got up from the couch I felt a chill run through my veins, and down my spine. It was a very familiar chill and I knew that my body was trying to tell me that something was off, way off. My sister saw me shake and immediately said “what’s up with that?”

I knew what was up with that. But, I kept hoping, oh please no. I’d know for sure in a few hours if the chills got worse; but for the moment, all I could do was put on a heavy sweater and drink something warm. My sister made me hot chocolate, and for all about 15 minutes I felt a warmth that quickly disappeared.

I got on the plane headed from Cairo to Paris and felt so exhausted I fell asleep almost immediately. Take off was at 1:30 AM as scheduled, and arrival in Paris was four hours later. The flight attendant woke me up to say that we were landing, and again, the damn chills hit every time I moved my body in any direction.

By 6:30 AM, I was in an Air France lounge shaking uncontrollably. No amount of clothing on top of clothing was making a difference. No amount of hot drinks was making a difference. I had no sore throat, clearly a very high fever, body aches down to my pinky, and the damn chills every time I moved.

The conclusion of what I had was clear. I didn’t need a doctor to tell me. Hello malaria my old friend, I’ve come to talk with you again. Because of a parasite softly creeping, that left its seeds in my blood stream while I was sleeping, you get the point (with my sincerest apologies to Simon and Garfunkel). It was really bad, and I knew it. But, I had seven hours of transit so what to do? Go into Paris and check myself into a hospital? No, I thought, this is a tropical disease and it’s likely best if I treat it where I got it, in Abidjan.

I started thinking “can I hold out, seven hours of transit and six more hours of flying time?” I wasn’t sure. After the chills would come nausea, and this had already started, followed by uncontrollable vomiting. This you don’t want on a plane. Four hours into my transit time the chills were now beyond manageable. The nice man sitting in front of me going to the Congo asked me if I needed help. I was shivering, but I was in a cold sweat. I told him no, that I thought I had malaria, and he said he was pretty sure I did. We talked about the pros and cons of staying in Paris and either he convinced me, or I convinced him, that it was probably best to treat the malaria in the Ivory Coast, if I could make it that far before the symptoms made it impossible for me to function.

A short while into our conversation I realized he was a contractor working on one of our energy projects in the Congo. He told me he had just gotten over malaria himself. When I introduced myself and he realized I was the Vice President of operations in the African Development Bank that was funding his project, he became more concerned. He kept bringing me hot coffee. I don’t drink coffee, but I was swallowing anything hot to try and manage the chills. You know it’s bad when the Ibuprofen your taking does nothing, and two blankets, a blazer, and a sweater also do nothing to control the chills.

Our flights were taking off around the same time. He went left, I went right. He wished me good luck. I thanked him for his kindness. We will likely never see each other again, but the generosity of this random stranger made me put it in my head that if and when I was in the Congo I would make it a point to look him up.

On the plane to Abidjan, I asked for an extra blanket. It made no difference, the chills were unstoppable. The flight attendant seemed concerned, ad she kept saying “you look like you have some kind of flu”. I didn’t, but failed to explain. Instead of being fearful of me as I was shaking with cold sweats, she went out of her way to give me extra pillows, anything I wanted to drink, and went into a motherly role. This too was very much appreciated, but I did over hear her say to her colleague that the platinum card holder in 1A seems very ill. I think she was referring to me.

I slept on the plane as much as I could, but when I woke up the nausea had started. Yes, that was the final sign that it was malaria. I kept hoping that the vomiting wouldn’t hit quickly so I stopped eating and drinking to keep my stomach as empty as possible. I tried to distract myself so I watched a re-run of an Egyptian movie I had seen before called “Ishtry Ragel”, or “buy a man” for you ignoramuses reading this who can’t interpret Arabic. The story was about a woman who wanted kids, but didn’t want to be married or have a man in her life. Her convoluted plot was to hire a man who had all the right qualifications and a good gene pool and use his sperm to be impregnated with the help of her uncle who just happened to be a fertility specialist. Anyway, like in every Egyptian movie she falls in love with the guy she hires and she ends up with a man regardless of here initial ambition. The movie made me even more nauseous; although I have to admit it got me thinking about how I could pull off a similar scheme to get a child minus the woman (aiwa metaad), and the kid would grow up really fast and take care of his baba (papa) with endemic malaria. Yup, I was starting to hallucinate, this happens with malaria because of a high fever and now I was getting really concerned.

We finally landed in Abidjan and the chills had stopped. In my confusion, I thought this was happening because the parasites were happy to be home. They were in their element, back with their other parasite brethren, in the blood of so many people right outside the airplane door. I kept thinking if someone made a movie about my two-decade’s worth of work in Africa a catchy title would be “From Malaria with Love”. Yup, I was losing it and I needed to see a doctor fast.

Protocol was waiting for me as they always do just outside the jetty. I had no bags so they put me in a car quickly and the driver instinctively drove me to my apartment at the Sofitel, where I’ve now lived for over a year. I felt better and started questioning whether I actually had malaria, or a bad cold. The main hospital, PISAM, was on the way to the hotel so I thought go home first sleep this off and see how you feel tomorrow.

Big mistake. I woke up the next morning more incoherent still stuck with the title of my movie “From Malaria with Love” in my head. When I woke up it took me about 5 minutes to figure out where I was and from there I knew I needed an ambulance to get me to PISAM fast.

Two colleagues from work came to my rescue immediately as did the ambulance that was called. The young Doctor looked into my eyes and in French declared to all in the room I had malaria and needed to be transported to the hospital immediately. Off I went malaria in tow, just me and my parasites.

At the hospital in the ER, a quick blood test was ordered. It came back positive. I had stage 3 malaria, with stage 4 being the highest level of parasites one can have in his/her blood stream. Three shots were ordered; one immediately, followed by two more every 24 hours. After that, it would be three days of three pills every day. But, I knew the medicine would make me sicker before I got better and after the first shot I started puking orange bile. The parasites make their home in the liver and go into the blood stream from there. If the parasites get to your brain it becomes pretty much life threatening. One of my colleagues had succumbed to that a few years back from what is known as cerebral malaria.

For six days, the medicine made me extremely sick and things only got better when the fever began to dissipate. In the first three days I had a fever of over 40 Celsius, or 104 Fahrenheit, and that’s where the hallucinations come from. Six days later the parasites were no longer detected in my blood stream, I had lost over 10 pounds, and I was so exhausted I could barely make it from my bed to the bathroom, 10 steps away. The following day, and against my Doctor’s advice, I was back in the office. This I thought would get my mind off any remaining symptoms.

So, for all of you that wish you had all these glorious third world adventures, and how amazing the development business is, think again. This life has its ups and downs and at least for me it’s been a life where I’ve learned to judge my success by what I had to give up to get what I wanted. You never want to sacrifice your health for any reason and you can take my word for that. “From Malaria with Love” would make for one grizzly movie.

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