After five months in Australia and four months in New Zealand, malaria was the boogeyman that haunted me as I embarked on the South East Asia leg of my travels. I knew it was out there, and that it was serious. I knew that prophylactic medication was part of my rite of passage into Indonesia, but I wasn't happy about it. I had learned a thing or two about malaria, and it scared the daylights out of me, but the stories I heard about the drugs were equally as frightening. There was Lariam, one of the better medications, that was said to cause neuropsychiatric issues and insane, hallucinatory dreams that I dubbed "Lariam dreams." There was chloroquine, which seemed to be the drug of choice among backpackers, that could also cause stomach problems (which were a given in South East Asia anyway), mood disorders and hair loss. Good stuff.
As I understood the disease and the treatment, taking the pills didn't prevent you from contracting malaria; the only way to make that happen was to avoid being bitten. Once bitten by an infected mosquito, the virus makes its way to the liver, multiplies, and then spills out into your bloodstream. It is at this time that you first feel the effects of the disease, and the medicine begins to work its magic, helping to alleviate your symptoms and eradicate the virus. Because you are supposed to start your treatment one to two weeks before entering a malarious area, I found myself in a travelers clinic in Darwin, Australia, the week before jetting off to Timor, Indonesia.
I allowed myself a shot of gamma globulin to help boost my immune system, a prescription for choloroquine, which required me to begin my once-weekly regimen immediately, and a responsible overall checkup and gynecological exam, because it had been about a year since my last checkup. And just like that, I was on chloroquine for the next six months.
Within one-and-a-half weeks, I found myself on the island of Flores, Indonesia, in a place of astounding beauty. Rolling green rice terraces dotted the landscape, the hills and mountains were hidden amongst misty clouds, and I was preparing for a midnight trek up Mount Kelimutu for a view of its multi-colored crater lakes at dawn.
I was only about two or three pills into my regimen, and didn't seem to have any side effects at the time, but the night before my trek, I came face to face with a terrifying image. I sat on the front porch of my guest house watching a pale, gaunt, shaking man pick at his dinner. Unsettled but intrigued, I struck up a conversation with him, and asked him if he was OK. He explained that he had contracted malaria, and was on the back end of a terrible bout of illness. Fever, chills, shakiness, weakness, uable to eat, he had lost 10 pounds in a week. Horrified, I probed for more information.
"Were you taking medication before you became ill?"
I visibly winced when he answered, "Yes."
Nosier then ever, I asked, "Do you know where you picked it up?"
"Yes," he surmised, "it was probably on the island of Sumba."
I made a mental note to cross Sumba off my list of preferred destinations, and pledged my allegiance to the malaria prevention gods. One of my fellow trekkers, Brendan, a fly-by-the-seat-of-his-pants kind of guy, eschewed the visit to the travel clinic in Darwin. Flat broke, he opted to wait until he arrived in Indonesia to buy his pills, where he knew they would be cheaper. A hilarious episode ensued when Brendan attempted to communicate to the driver and sidekicks of our tricked out disco van from the airport that he needed to stop at a pharmacy.
The van stopped in front of a building, and an old man with no teeth wrapped in a batik sarong emerged from behind a counter peppered with large, unmarked glass jars full of different colored pills. He was so delighted to see foreigners that he came around the front of the counter and kissed me on the cheek. Minutes later, Brendan emerged from the shop with a plastic bag full of white pills, wondering what on earth he had just purchased. Hopeful that they were in fact malaria prophylactics, Brendan swallowed the first one, and we went on our way.
As far as I know, I stayed tropical-disease free during my six months in South East Asia. By the time I weaned myself off of the chloroquine, I was having some stomach distress and muscle cramps. Although I was unsure if the symptoms were from the chloroquine, or anxiety about my return to the United States after 16 months, I know I dodged a bullet. When I again returned to South East Asia for a trip to Borneo many years later, I indulged in some Lariam therapy. The hallucinogenic effects were lost on me, but I remained in a dream-like state in the gorgeous, monkey-clad jungles of Sabah, and once again skirted the tropical disease blues.
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