Malaria tropica

The most likely infection period for a malaria was before August 15th, while staying in Homabay and at Lake Victoria. On August 25th, I developed a high fever and was advised to approach The Centre of Inner Medicine, Department for Infections, HIV and Tropical Medicine of the Clinic of The Johann-Wolfsgang Goethe Universität in Frankfurt Main (Building 68, 1st floor for reception). The quick test immediately showed a positive result for malaria and the microscopy diagnosed a malaria tropica with a 0.6 % density of Plasmodium falciparum. From there is was only a short way, one floor down, where I spent 5 days in stationary treatment. I am not aware, I had more than three mosquito bites during the potential infection period, as I was extremely careful, using net and extra strong repellent at all time. And all of these three were during daytime (when the anopheles is not active). But I must have missed at least one. 

Treatment was with Riamet at 0, 8, 24, 36, 48 and 60 hours. Additionally, because the white blood cells shot up and there was a secondary infection suspected, I received 5 days of IV antibiotics. Malaria of this kind in a very draining experience. But I was surprised, how fast the symptoms faded and also the plasmodium count dropped. Be prepared for hot and cold sweat, fever way above 40 Celsius, attacks of trembling and hallucinations. To make it short: it's like in the movies. 

Well, I learned that in high risk regions it is better to take the malaria prophylaxis (even der side effects are strong). As my friend Erick said on the evening arriving in Kisumu: "Here you are just one bite away from a malaria". He was right.

Plasmodium falciparum (Copyright under Wikipedia Commons license).

"The gods must be crazy"

I was offline for a while and just returned from Kenya to Germany. We visited friends, drove from Nairobi to Homabay villages, then to Kisumu, and through Narok for a short visit to Massai Mara. Then returned to Nairobi for an appearance in Strathmore University. The main purpose of the visit was to support and get a closer impression of www.maklweta.org, which has been founded by Dr. Erick Komolo to support girl's education in rural Kenya, specifically in Homabay.

Students and parents engage together at a mentorship day in St. Mary's Kachar Secondary Girl's School.

This is a very extreme challenge. The region we have been to, has been also chosen by research centres to do field work on diseases and epidemiology. For that you cannot think of a "better" condition: highest HIV penetration in Kenya, very high malaria risk, cholera, diphtheria, typhoid, hepatitis of all kinds, rabies, tetanus. The list is much longer. Even very basic management of these, is rudimentary. Birth rate and teenage pregnancies remain high. So does the number of AIDS orphans. Antiviral medication is available, sometimes not applied properly and in other cases said to increase the spread of HIV, simply because the patients live longer and do not change sexual behaviour. Every village is full of children. Contraception is available, but not consistently applied. Domestic violence and alcohol go hand in hand, as everywhere, but on a presumably very high rates here. There are infrastructure challenges, like transportation and market access. But the lack of money seems more a constraint than a pure root of the problem. There are many things which could improve the situation with no funding at all, by just doing it. I was even joking: "What's a guy digging a well, while 5 drunk Africans are laughing that they found an idiot doing their work? It's a volunteer".

Classroom converted into a dormitory.

Erick has chosen to support girl's education first, because they are extremely vulnerabel. But also, they seem more reliable. Cash given into the hands of most guys on the street is likely to end up in a pub, brothel, or some self brewed spirits. If this vicious circle of Homabay can be broken at all, then it has to start from the girls and their education. It needs role models, mentoring and examples of what is possible. Erick himself is such a role model, making his way from a local school to the University of Nairobi and to his Law PhD at the University of Hong Kong, which is where we met first. Now he is practising law in Nairobi, is engaged with academic research and is committed to use his own example to improve his home province with www.maklweta.org. And I think, he has a very good strategy, how to crack this case by bringing a network of people and very targeted funding exactly to the point where it has to be applied. I would be happy if Erick finds soon a larger base of support. If you like to help, please take his organization's website (which is under construction just now) as first point of entry. It will be highly appreciated by the people of Homabay. This is not immediately a "feel good" or "baby hugging" exercise, though. Many of the faces you will see, might find their premature death within the next five years. This is a long haul project, not a low hanging fruit.

Dr. Erick Komolo revisiting the desk of his primary school classroom.

A left behind textbook in a classroom.