Heading into malaria country

Papua New Guinea has sobering malaria statistics. It has the highest incidence of malaria in the Western Pacific. Internal problems with infrastructure, resources and funding give malaria victims an unnecessarily high mortality rate. We’ll travel from PNG to Indonesia, and continued endemic malaria: it’s not like anything we’ve experienced to date.

So it might seem strange that we’re not going to take any anti-malarial drugs in PNG and Indonesia during our journeys in the coming year.

Bay of Islands with Oso
Mosquito tip #432: avoid dark clothing, which attracts the critters. Oh, and don’t breathe, because so does carbon dioxide. 

If you know us, you know we’re not big risk takers. We recently visited a travel doctor as part of our preparations. We brought our bias to avoid prophalyctics and were expecting to have to “discuss” it. To our relief, was consistent the advice she gave us.

What are we doing, then? Lots of preventative measures.

There’s screening:

  • Repellent-treated nets and screens (we got ours in Australia from Buzz Off) on our hatches and ports. We have the screens and nets, and will soak them in a solution of permethrin. The treatment is supposed to be good for about a year, and we have enough to re-treat if it seems necessary.
  • We have additional nets, also treated, to drape our bunks at night. The romantic Out of Africa look is a bonus.

There’s repellents:

  • Chemical free is best. We have little ultrasonic devices that are the size of a thumb. Battery powered, they emit a high pitch sound which mosquitoes don’t like. They don’t have a big range- just 8 or 10 feet- but that’s enough most of the time. 
  • Good ol’ repellent lotion. First line of defence is based on essential oils; we have several to use.
  • As much as I hate using chemicals, especially directly on our skin, it’s a risk trade off with malaria that we have to weigh. If we aren’t finding success with the natural repellents, DEET based lotion is stashed too.
  • Coils. Hate em…. but have them, just hope not to use.

There’s basic behavior and smarts:

  • Avoid areas with lots of bugs  (anchor awaaaaayyyy from the mangroves!)
  • Choose light colored clothing, not dark. 
  • No perfume/fragrances. Easy, since we mostly think they literally stink.
  • Stay put from dusk to dawn. This is when malarial mosquitoes are primarily active; we’ll plan our activity to try and ensure being inside the well screened boat during those times. Since we’ll be in islands without power, I don’t think it will be hard.

And if we think anyone even MIGHT have malaria:

  • TEST. We have 20 test kits (these are from Buzz Off, too): if anyone shows a sign of fever, they get tested. It’s a simple finger prick that you measure on a card. Pleasantly dummy proof.
  • TREAT. If malaria is indicated, we begin treatment. There’s enough Malarone on Totem for multiple courses. In fact, it’s probably an overkill quantity. I’m OK with that. 
  • Take off! We’d head for a clinic the second anyone is diagnosed. Just because we can handle starting treatment doesn’t mean we think we should play doctor. Our medical kit is oversupplied if anything; the bigger problem then is the distance to a clinic that will have trained staff.

I can’t help worst-case-scenarioing on this. What if Jamie and I are both infected? I know from experience it can make you completely non-functional. It’s one of the reasons we’re hoping to find buddy boats who are also headed on this route, which is a big stretch from the beaten path.

In the grand scheme of things, we don’t think we’re taking a risk here. Feel free to disagree.

* 2013 update: no malaria, but a few test kits were used during our time in PNG.

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8 Responses to Heading into malaria country

  1. Anonymous August 24, 2012 at 10:42 pm #

    No disagreement here.

    Risk mitigation is just a game of “what if” and probability estimation. There is no such thing as 100% risk free in anything (as you clearly know).

    You seem to have done a thorough and thoughtful analysis and come up with reasonable and appropriate primary and backup solutions…and that’s pretty much all you can do (short of never leaving the house…which presents it’s own risks of course).

  2. Andy August 25, 2012 at 10:45 am #

    I didn’t know there was an easy at home test for malaria. Pretty neat. I see there is also a rapid test for dengue fever, are you carrying that as well?
    I really enjoy your blog. Best of luck.
    andy

  3. Catherine VK4GH August 26, 2012 at 5:26 am #

    No disagreement here either. We cruised Vanuatu for 4 months with 3 kids, and we were glad we didn’t use prophylatics.
    Other than the Louisiades, PNG can be very dangerous with violent intrusions and robbery.
    Would be interested to read your planning for this eventuality.
    Catherine

  4. Behan Gifford August 26, 2012 at 6:29 am #

    Hey Andy, I didn’t know about dengue but did realize there are a startling number of things you can test yourself for at home!

    Catherine, that’s good to know re: your Vanuatu experience. Re dangers in PNG, you can read about our initial planning there in my post from last week, http://sv-totem.blogspot.com.au/2012/08/mapping-route-through-papua-new-guinea.html. There are dangerous places to be sure, but “safe” is definitely not limited to the Louisiades.

  5. The Ceol Mors August 28, 2012 at 10:40 am #

    Here’s hoping you never have to bust out a test kit. I don’t think I would be comfortable taking the prophylactic meds either. I’d much rather deal with the after effects of bathing in DEET.

  6. The Crew of Savannah September 13, 2012 at 2:12 am #

    Hi there. We’re going through this thought process right now as well since we may be heading that way soon too. I just read an article about a natural substance, Artemisia. Have you heard of that? just wondering if you had come across that in your research.

    Safe sailing!

  7. Behan Gifford September 13, 2012 at 4:13 am #

    I haven’t heard of Artemisia- sounds interesting, I’ll check it out! Meanwhile, putting finishing touches on our mozzie netting- ports, hatches, and bunk drapes…

  8. medicated mosquito net manufacturer in India October 8, 2012 at 6:25 pm #

    Thanks for sharing the post here. Keep up the good work. All the best.

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