Sunday, January 23, 2011

Sunday, January 16, 2011

Malaria, Mosquitoes, ...

I recently read a really good series of articles online about malaria. They are quite detailed, a bit long and not dumbed down, but very readable for the layperson.

The articles were apparently written by a doctor who has lived in Uganda (a neighboring country of Tanzania) for many years and wanted to clear up the confusion around a disease that everyone knows about but with a lot of misunderstanding and misconceptions.

The articles are written as seven parts. I give a brief description of each part and provide a link to it.

Part 1. What happens when malaria gets into your blood stream and multiplies.

Part 2. Developing (partial) immunity. How the parasite actually reproduces and gets spread between people.

Part 3. Diagnosis, misdiagnosis, symptoms, and prophylaxis.

Part 4. Rapid tests for malaria and what can go wrong with them.

Part 5. Effective treatment, treatment options, risks.

Part 6. Prevention options, besides drugs.

Part 7. Prophylaxis drugs. Some thoughts about prevention.

For Diane and me, one thing I got from reading this series is that we are actually pretty unlikely to get sick with malaria, for several reasons.

First, it is only a certain kind of mosquito that can carry the malaria parasites. I have been looking carefully at the ones in our home that bite us. They are not the malaria kind. Also, we are rarely outside when it is dark, which is when the malarial mosquitoes are mostly out and about. My guess is that in our day to day life here in Mtwara our exposure to potentially infectious bites is really very low.

On the other hand, if we should go travel somewhere on a wildlife safari the exposure could shoot way up. As long as we are in Tanzania we should not become complacent.

Second, the fact that we are both taking a prophylaxis called mefloquine provides a lot of protection against the parasite should it be introduced into our bodies. According to the author, he has not seen a single case of a patient taking mefloquine properly who has had malaria. Other types of prophylaxis are also extremely effective.

Third, the symptoms that indicate possible malaria can all be caused by other diseases, of which there is a plethora in sub-Saharan Africa. Missing those others can be serious.

If we do get sick and suspect malaria we should be careful about the diagnostic process. Malaria seems to be greatly overdiagnosed.

In any case, besides the risk of malaria I get a fair number of mosquito bites that are just plain very itchy and annoying. So we use a mosquito net on our bed, I often wear long pants at home even when it's hot, and I keep insect repellant handy if we do go out at night. -Earl

Thursday, January 6, 2011

Sunshine, serenity and solitude by the sea...

A gently swaying hammock under the whispering pines. A lonely dhow anchored a hundred yards offshore. A vast sea-green sea that stretches to forever. Coconut palm fronds waving in the wind. A brisk salty sea breeze. Although we were surrounded by fragrant frangipani, flame trees, fiery red hibiscus & brilliant bougainvillea, there was not a soul around.

Sunshine, serenity & solitude by the sea! How delightful!

Taking advantage of our month long school break , Earl & I hopped on a tightly packed bus for a 9+ hour rough & tumble ride to Dar. After a couple of days at the less than luxurious & very cheap YMCA (shared bath, cold water & no towels), we boarded the Sea Bus ferry for a 2 hour sea voyage to the magical isle of Zanzibar aka Unguja Island.

Greeted by Father Damas at the hustling, bustling & extremely chaotic ferry terminal, we climbed into his old army jeep and circled around Zanzibar Town. On our way to the heart of the city, Stone Town, we caught glimpses of narrow streets & cobbled alleyways, women draped in black, overhanging verandas, colorful TingaTinga art, bustling bazaars, the Sultan's Palace, Beit El-Ajaib (House of Wonders), street-side vendors, and numerous Moslem minarets piercing the azure sky. The sun was sizzling hot & there was a spicy aroma in the air. Father Damas dropped us off at the Bishop's House, next door to St. Joseph's Cathedral. Also known as "Kanisa la Minara Miwili" (Church with Two Towers), the cathedral was built in 1898 by a French architect. At first glance, one might think one was in Paris!

Sister Laurent, our hostess, escorted us to our simply furnished room with bed & bath. Our window overlooked the narrow street below which was splashed with brightly colored paintings of everything African: dancers & drummers, zebras & giraffes, sun & seascapes, mud huts & mangroves. The highlight of our Stone Town stay was the House of Wonders, home to the Zanzibar National Museum of History & Culture. Besides viewing a life-sized mtepe, a traditional Swahili sailing vessel made without nails, the planks held together only with coconut fibers & wooden pegs, we learned about Princess Salame who secretly eloped with a German soldier & spent almost the rest of her life in Germany. A woman before her time, she was an advocate for healthcare & the education of women.

After our brief stay in the soul of Zanzibar Town, we bussed 60km to the northernmost tip of Zanzibar where we were perched on a small seaside outcrop with a spectacular view of the Indian Ocean. We stayed 3 days at the Mnarani Beach Cottages in Nungwi (private bath, hot water & BIG towels!), a real splurge for us - once every 16 years. The last splurge was on our honeymoon at the Keltic Lodge in Cape Breton, Nova Scotia. On Cape Breton we were 46+ degrees north of the equator and here we could practically touch it! Mnarani means "lighthouse" which was right next door. Built in 1888, the 70 foot tall lighthouse is still blinking!

Earl & I also ventured on a Spice Tour where we met other tourists from England, Holland, Liechtenstein, Canada & Tanzania. Nassor, our Zanzibari tour guide, led us on a leisurely stroll through the jungle-like plantation sprinkled with wild orchids. We nipped nutmeg from the tree, plucked lemon grass from the earth, scraped cinnamon bark off the tree, painted our faces with red Masai powder, whiffed vanilla beans on the vine, rolled peppercorns between our fingers, sniffed a bouquet of fresh cloves, and fingered smooth cones of cayenne peppers. We also sampled a medley of fresh picked fruit such as papaya, jackfruit, star fruit, mangoes, marmalade oranges, and pineapple. Our guides adorned us with woven jungle leaf jewelry - ties, necklaces, rings & bracelets. After a hot lunch of traditional foods such as coconut soup, pilau, & sauteed spinach (all seasoned with the spices we just sampled) in the shade of a thatched roof banda, we descended into the deep dark seaside Slave Cave. After Nassor shared a little Slave Cave history, we climbed out of the dark & into the light to take a refreshing dip in the Indian Ocean.

After an exceptionally crazy non-stop school year, we had a wonderfully relaxing holiday! Diane

Zanzibar Island Trip - Photos

In December we took the ferry from Dar es Salaam to Zanzibar, a beautiful two-hour ride on calm seas. While Diane slept, I went outside to enjoy the ocean and the warm winds. We stayed at guest quarters at the Catholic Cathedral in town and explored the streets a bit. It's a small historic city with a very Old World feel to it.

We did something very touristy -- we went on a "spice tour" to visit a farm where various kinds of spices are grown (along with fruits also). Zanzibar is known for this.

And we splurged on a stay at an idyllic beach cottage resort at Nungwi, which is at the very northern tip of the island. -Earl