Why we aren’t taking anti-malarial drugs

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.’

Malaria deaths
World malaria fatality rates, via Global Health Equity

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.

7 Responses

  1. I lived in Tanzania for 3 years and never took an anti-malarial. Aside from all the nastiness you mentioned – they are VERY hard on the liver and not intended for long use…also, if you do get malaria (as miserable as it is) – a test and treatment is super cheap and super easy (at least it was in TZ) and in 2-3 days, all better. Smart decision if you ask me.

  2. We just opened a log on sailblogs, our tag is “lost our marbles” I would appreciate any advise you have, we are looking for a boat to go cruising. I have read all your blogs and am inspired.

  3. Windtraveler, that is great to know. We are definitely on the same page! Our pack of 20 individual test kits (e.g., no shared equipment, so we can give some away) was about $50. The meds have generally been cheaper in-country as well (plus, they know which kind you NEED vis. resistant strains in the area!).

    Anonymous, So glad you enjoy the blog and are inspired! Congrats to you, it’s heady days when you decide to pursue the dream. Not sure how to give open-ended advice other than to say GO FOR IT! Yeah! I found Beth Leonard’s guide on voyaging to be the most helpful during our prep years. Meanwhile I’d be happy to help with more specific questions any time.

  4. that takes me back… my wife and i were on lariam during a year long trip through s.e. asia 15 years ago. i went off it after waking from a dream in which my brother died in my arms – a dream so real that i couldn’t relax until i’d phoned home and confirmed he was ok. nasty stuff!

    anyhow, i’m hoping that my family and i can do what you guys are doing in about 5 years, so looking forward to following your blog in the meantime…

    – mike

  5. Behan, would you be able to recommend a good kit? Did your nurse friend recommend one in particular? My past experiences with anti-malaria drugs have left me unenthusiastic, and my research has led me to feel the same way you do about them.

    1. Hey guys! We got our kit at http://buzz-off.org/shop/malaria-testing-kits/ . But that’s an Australian distributor (we were in Oz at the time), and the test kits are from a pharmaceutical company in… New Jersey. There is surely a better way for you to get them in North America- maybe Google around a bit? We’ve had to use a test kit already, and it was a snap (and, thankfully, a negative result!).

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