In hindsight and after a few emails from my last post on malaria, I think a little backstory will help to paint a more complete picture of the choices we’ve made. That last post really just focused on the ‘what’; this is the ‘why.’
Longer ago than I’d care to admit, I acquired malaria while living in Indonesia. I had been taking Lariam (and dealing with side effects from hallucinogenic dreams to hair loss), but it got me anyway, and was kind of awful. This has influenced the decision in a few ways.
First, the obvious: taking prophylactics don’t necessarily prevent you from contracting malaria. We received emails after last week’s post that told the same story, of friends and personal experiences with malaria despite taking meds.
Second: prophylactics can give you some wicked side effects. I don’t need to lose any hair; hallucinating and being responsible for a boat don’t go together. Again, input from a RN friend (thanks Linda!) via email, that Lariam can be associated with severe depression as well. Doxycycline causes photosensitivity. When we spent several weeks in Vanuatu in 2010, we did take prophylactics. Not inclined to repeat my Lariam experience, Jamie and I took Doxycycline. This drug is not recommended for children, so the kids took Malarone. The kids were fine. Jamie and I had nasty side effects with the Doxycycline- it gave us a kind of sun poisoning, regardless of sunscreen and protection. We may be more sensitive than most, I don’t know, but it was bad enough that we stopped taking the meds early. Jamie had residual problems for a year we attribute to just a couple of weeks on the drug.
In thinking about what to do, it’s hard to escape the fact that malaria is still endemic to a big swath of the globe. But people in these regions aren’t living on prophylactic medication. There are questions about long term use of the drugs, and the cost is prohibitive. Yet our path in the coming years is going to take us through a whole lot of this “red” zone. So we had to ask: does it really make sense to take the meds on an ongoing basis?
Even if we could afford it, I think the answer is no. I’m also pretty sure that without the (false) panacea of the medication, we’ll also be a whole lot more careful. And if we do happen to be unlucky and any of the Totem crew get sick, we have thought through our plan to address it.