One of the first things I noticed about Cameroon was how, often, I would see people at bars casually take tablets, what Cameroonians call medication. When I pressed to find out if someone was sick the answer would be, “C’est le petit palud” or it’s the small malaria. What? What does that even mean?
Malaria is a very serious disease that claims the lives of thousands of people a year in Cameroon alone. But to your local Market Mama malaria is an annoyance on the way to business as usual in a place where getting clear diagnosis and treatment is not always as easy as it seems. Still, le petit palud is often a describer for any number of things and could be simply a fever, typhoid or countless viruses. It’s so common here the seriousness becomes trivialized. Here are some of the caveats to malaria treatment and prevention in my corner of the rain forest:
- Prevention is lauded by NGO’s as a low cost reducer of malaria incidences worldwide. Personally, when I go into homes across the economic spectrum in Cameroon I rarely see nets. Why? They complain it reduces airflow in the bedroom. Many homes are already stagnant and swampy, why add an extra layer?
- Medication is not regulated very strictly here. You can buy Coartem (malaria treatment), Ciproflaxin (basic antibiotic), Amoxicillin (another antibiotic), and even Valium over the counter here. When a Cameroonian is pressed for cash and can afford only a doctor’s consultation OR medication, 9 times out of 10 they will deduce the problem and buy their tablets.
- The breadth of over the counter medications also compete with the widespread sale of counterfeit medications being sold among legitimate ones at roadside stands.
- Even getting malaria test results can be unreliable. Blood smears are not considered reliable by the Peace Corps in Cameroon and even the Rapid Tests can come up with false positives and false negatives.
As an American with no natural resistance, I’ve been reminded by my Medical Officer that cerebral malaria can kill in 24 hours, especially if prophylaxis isn’t being taken prior to infection. It’s those kinds of numbers that stress me out when my own rapid test comes back positive. There is a lot of passion when discussing the long term effects for Americans taking Mefloquine, Malerone and Doxycycline. Nobody wants to be on an antibiotic for two years or have vivid dreams, but when I’m projectile vomiting with a fever and body aches I know the odds are in my favor.