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.
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, our bias was consistent with the advice she gave us.
What are we doing, then? Lots of preventative measures.
Screen to keep mosquitoes out
- 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.
Use mosquito repellent
- Use sound! 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. Plug-in devices that can be tuned to a range of insects and even mice/rats could be useful!
- Good ol’ repellent lotion. First line of defence is based on essential oils; there are a number of these on the market.
- 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.
- Burn mosquito coils. Hate em…. but have them, just hope not to use.
Choices to lower risk of bites
- 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 electricity, I don’t think it will be hard.
If we suspect 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 has a positive test. 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 by avoiding anti-malarial drugs. Feel free to disagree.
* 2013 update: no malaria, but a few test kits were used during our time in PNG.