The Real Malaria

Last night I was watching a clip of the documentary about the book Guns, Germs, and Steel, which follows the author, Jared Diamond, around the world in his quest to discover how such huge inequalities emerged between the developing and the developed world. In other words, why are some countries so rich and others so poor?  While in Zambia, one of the poorest countries in the world, with an average life expectancy of 35, he visited a hospital and talked to a health worker about the burden of malaria there.  Dozens of children were lying in beds in one ward, one of which barely had her eyes open, unblinking.  Then, the camera panned to Mr. Diamond, who had to cover his face because he started crying.  He said, “There’s a difference between understanding something intellectually and experiencing it firsthand.” I immediately teared up, not just from seeing this older, world-renowned author becoming so upset about a problem that is so far removed from most of us, but also because I had an almost identical experience about six weeks ago. 

In late February, I spent a few days in neighboring Amuria district to help out with Integrated Support Supervision (ISS).  During ISS, we visit a range of health facilities to get data related to malaria.  On our second day, we visited St. Clare Health Center III.  In Uganda, there are four levels of health facilities, with one being the lowest, according to size and services offered.  Although St. Clare was a level III health center, it operated like a level IV, according to Ann, a local nurse, who was helping us with ISS.  St. Clare is a private hospital funded by the Catholic Church, and has a few mzungus or foreigners working there. Amuria is less developed than Soroti, and here “in the middle of nowhere” (not my words, but those of our driver, Ronald) on a small hill was a pretty impressive facility on a beautiful campus.  Besides the hospital, church, and school, there weren’t even huts around this area.  It was nothing but trees and scrubby bushes as far as the eye could see.  

My part of the ISS was to get data from the Antenatal Clinic (ANC).  To get to the ANC, I had to pass through the children’s ward.  As I was waiting in the hall outside the ANC office, Ann came in telling one of the nurses that a child had a very high fever and needed immediate attention.  I could see several people huddled around one of the beds.  Curiosity got the better of me, and I went over to see what was happening.   

It was a four year-old girl who was naked, with her eyes closed, arms bent and fists clenched near her face. She kept making an involuntary whimpering sound over and over.  This sound still haunts me.  Ann said that her malaria test result was a 3+, which means she had an extremely high density of malaria parasites in her blood.  This, combined with a fever of 104 and convulsions, led to a diagnosis of severe malaria.  Ann instructed the nurses to give her an I.V. (of what I can’t remember, but should know) to bring the down fever.  They also kept crushing up some pills and gently sprinkling it in her mouth.  Besides the fact that a little girl was in so much pain from a completely preventable disease in such an efficient hospital, so much seemed wrong; the colorful, cheerful paintings of biblical scenes on the walls, nets on every bed (which is rare in most health facilities), and the fact that I felt helpless and ashamed that I wasn’t doing enough.  All of this was just too much for me, and I had to leave the ward with tears in my eyes.  

It’s like Jared Diamond said, intellectual understanding can’t make you ready for first-hand experience. No matter how many case studies I read in grad school, days of training and workshops I’ve completed here, none of it could have emotionally prepared me for seeing malaria up close and personal.  When I came back later, Ann was still with the little girl.  Her fever had come down, and her body looked a little more relaxed.  I’m not very religious, but I believe in prayer.  So, I said a prayer for the girl and her family.  She was still alive when we left St. Clare later that afternoon and I can only hope and pray she is still alive today.     

To be honest, I can barely get through writing this without crying.  Look, I know there are countless sad stories out there about sick kids in Africa, but I still feel compelled to share mine.  We’ve all seen the stereotypical images on TV commercials or the news.  I’m not trying to be trite, pull at your heart strings or make you feel guilty.  But this problem is real.  It doesn’t go away when the commercial ends or after I leave Uganda.  It won’t go away without a lot of sacrifices of our time, efforts, and yes, money.   I know that my one year service here isn’t enough to make a huge impact and at times I should have taken a lot more initiative.   But, if by reading this story, you start paying more attention to malaria and hopefully help raise awareness about it (or development or global health) then at least I’ve made a small dent in this gargantuan epidemic.  You can start by sharing this blog entry with your friends, family, colleagues, or students.  Changing your cover or profile photo on facebook to one of our Stomping Out Malaria images (found on my facebook page) for the month of April is also a simple, easy step to help our movement gain momentum leading up to World Malaria Day on April 25th.  Thank you.

When I was a history major at Western Kentucky University, Jared Diamond’s book was discussed and lauded by several of my professors.  He actually came to speak at WKU, but for some reason, I didn’t go to his lecture and I’ve always regretted it.  Now that I’ve seen how emotionally invested he is in development, Guns, Germs, and Steel will quickly move up my reading list.  After all, he inspired me to finally share this experience.