All about malaria

If you'll allow me to take a public-service-announcement turn with this blog entry, I thought I'd talk a little about malaria since tomorrow is World Malaria day. Malaria is a huge concern in Africa and it's not something that just affects tribespeople in the middle of the jungle. Off the top of my head, I can think of six people I knew in Kinshasa who have had malaria (three of whom came down with it during the eight months we were there). Even here in Bamako, where I've only met a handful of people, someone I know came down with it a few weeks ago.

Bear in mind that the people I know who are getting it are not taking anti-malarial medication for whatever reason. I guess the one saving grace is that people here are on the lookout for it, so it's not dismissed as the flu. Doctors here know how to treat it since they see it so often.

Yes, mom, I sleep under a mosquito net every night and take my malaria medicine regularly.

This article is copied from http://www.cnn.com/2009/HEALTH/04/22/atoz.malaria/

LONDON, England -- Malaria is one of the world's worst health problems and one of its biggest killers, with half a billion people affected every year, according to the Roll Back Malaria partnership.

Around half a billion people are infected with malaria every year. Ninety percent of those cases are in Africa.

Saturday marks World Malaria Day, when the world commemorates global efforts to eradicate the disease.

Below CNN's Vital Signs has produced a complete A - Z guide to how malaria spreads, the symptoms to look out for and how to protect yourself.



A is for Anti-malarial drugs

The history of anti-malarial medicine has been marked by a constant struggle between evolving drug-resistant parasites and the search for new drugs. Currently, anti-malaria experts are focusing on therapies that combine several drugs for better effects.


B is for Blood stream

Once a mosquito has bitten and the malaria parasites reach the liver, the parasites divide and create thousands of mature parasites. These are released into the blood and infect red blood cells. At that point, typical malaria symptoms such as fever and anemia develop.


C is for Chloroquine

Until recently, Chloroquine, an anti-malarial drug, was the first option for many people because of its relatively low price and effectiveness. However, resistance to Chloroquine in many parts of the world has rendered the drug ineffective.


D is for Diagnosis

After noting your symptoms and travel history, your doctor will likely obtain a sample of your blood for observation. Two blood samples, taken at six- and 12-hour intervals, can usually confirm the presence of the malaria parasite and its type. It is possible to be infected by more than one parasite at the same time.


E is for Epidemic

According to the World Health Organization (WHO), large and devastating epidemics can occur when the mosquito-borne parasite is introduced into areas where people have had little prior contact with the infecting parasite. These epidemics can be triggered by wet weather conditions and further aggravated by floods or mass population movements driven by conflict.


F is for Fever

The most common symptom of all types of malarias is high fever, which is why doctors often misdiagnose malaria for flu. The fever is a reaction to toxins in the blood. It is therefore advised to tell your doctor you have been to a malaria affected zone, even if symptoms arise months after the trip.


G is for Genome

In 2002, -- hundred years after it was discovered that mosquitoes transmit the malaria parasite -- the complete genetic codes of both the human malaria parasite and the mosquito that spreads it was cracked. This development brought scientists a step closer to developing drugs and vaccines to fight the disease, Nature magazine reported.


H is for Hotspots

Most cases and deaths are in sub-Saharan Africa, many of them occurring among children. However, Asia, Latin America, the Middle East and parts of Europe are also affected. In 2006, malaria was present in 109 countries and territories.

I is for Immunity

Travelers from malaria-free regions such as Europe and the United States, with little or no immunity, who go to areas with high disease rates, are particularly vulnerable. It is essential to take precautions by taking anti-malarial drugs prescribed by your doctor.


J is for Julius Wagner-Jauregg

Julius Wagner-Jauregg, a Viennese doctor, was the first to intentionally infect syphilis patients with malaria parasites. By controlling the subsequent malaria-related fever with an anti-malaria drug, the effects of both syphilis and malaria could be minimized. Jauregg received the Nobel Prize in Medicine in 1927.


K is for Killer

Malaria is a life-threatening disease but it is preventable and curable if the right steps are taken. Education in recognizing the symptoms has reduced the number of cases in some areas by 20 percent. Recognizing the disease in the early stages can stop the disease from becoming a killer.


L is for Laser gun

U.S. scientists say they are developing a laser gun that could kill millions of mosquitoes in minutes. The laser fires at mosquitoes once it detects the audio frequency created by the beating of wings, the lead scientist on the project told CNN. The project is being funded by the Bill & Melinda Gates Foundation.


M is for Mosquitoes

Malaria is caused by the bite of the female Anopheles mosquitoes. The mosquitoes bite between sunset and sunrise and parasites from the mosquito are then injected into the person's skin and transported to the liver. About 170 species of such parasites exist, but only four cause malaria in humans.


N is for Nets

The distribution of mosquito nets with insecticide is a very effective method of malaria prevention, and it is also one of the most cost-effective methods. These nets can often be obtained for around $3. Earlier this month, actor Ashton Kutcher won a Twitter race against CNN to reach 1 million followers. Kutcher had pledged 10,000 mosquito nets to charity if he beat CNN, and 1,000 if he lost. CNN agreed to do the same.


O is for Obstacles

In many endemic areas, access to health facilities, as well as drug costs, still present major obstacles. Humanitarian agency Medecins Sans Frontieres estimates that the cost of treating a malaria-infected person in an endemic country was between $0.25 and $2.40 per dose in 2002.


P is for Pandemic

For malaria to become a pandemic (plague) in an area, several factors have to be present: high human population density; high mosquito population density; high rates of transmission from humans to mosquitoes and from mosquitoes to humans.


Q is for Quinine

Quinine was the first effective treatment for malaria in the 17th century. Since the 1940's, many other anti-malarial drugs have appeared on the market and have taken precedent over quinine. But quinine is still being used to treat malaria in some cases.


R is for Repellent

The Centers for Disease Control and Prevention says inspect repellents with DEET (most common active ingredient in strong insecticides) in them should be used on exposed skin and flying-insect spray can be used to kill mosquitoes in the sleeping area. DEET may be toxic, however and should be used with care.


S is for Symptoms

Fever is not the only symptom of malaria. Other symptoms can include shivers, headaches and nausea. Sweating and exhaustion is also common and in some cases, it can affect the brain or kidneys.


T is for Tablets

Malarone is a common anti-malaria drug among many travelers. It is said to have a 97 percent efficacy with relatively few side-effects. It can be given just one day before arrival in a malaria endemic country and only needs to be taken for another week after leaving.


U is for Unborn child

According to the WHO, pregnant women are at high risk of contracting malaria. The illness can result in high rates of miscarriages and cause more than 10 percent of maternal deaths annually. This figure can rise to 50 percent in cases of severe disease.


V is for Vaccine

Despite intensive research, no effective malaria vaccine has been developed to date. But according to a report in April's New Scientist journal, a unique vaccine taken from the saliva of infected mosquitoes has received approval from the U.S. Food and Drug Administration to be tested in people.


W is for World Malaria Day

April 25 has become World Malaria Day to provide a global effort to control malaria around the world. The international malaria community only has two years left to meet the 2010 targets of delivering effective protection and treatment to all people at risk of malaria, as called for by the UN Secretary-General, Ban Ki-Moon.


X is for X-ray

X-ray microscopes are used to find the presence of malaria in red blood cells and see how they interact with healthy cells. One of the advantages of this type of microscope is that it produces very-high-resolution images of the cell structure.


Y is for Yellow fever

Yellow fever is another disease transmitted by mosquitoes. Some countries, such as Peru, require a certificate showing yellow-fever vaccination before you can travel there.


Z is for Zanzibar

Zanzibar, part of the African republic of Tanzania, has had relative successes in combating malaria; Africa's biggest killer according to the New Scientist journal. The achievements are due to the widespread use of treated bed nets, along with the switch to new anti-malarial drugs instead of Chloroquine in 2004.

A place to hang my hat

After almost four weeks in Bamako, I'm finally beginning to feel a little more at home here. The people here have been fantastic and I'm getting used to the notion that the power will not go out several times a day, nor does someone expect a bribe from me just because they're sitting in a chair near where I've parked the car.

We moved into our house which is really nice. It's in a newer section of town and the house itself can't be more than ten or fifteen years old. It has two bedrooms, three bathrooms, a living/dining room, and a kitchen. The second level has a nice terrace overlooking the street, and there's even a small guest house attached to the back of the house that has a bedroom and bathroom.

There are tile floors, AC units, and ceiling fans throughout the house. The house is furnished which worked out great for us since we don't really own any furniture and weren't thrilled about the prospect of shopping for it in Bamako. Most of the furniture in the house is really nice with the exception of the couches in the living room. They look nice but have got to be some of the most uncomfortable things I've ever sat on in my life. The back is at a 90-degree angle to the seat so you have to sit perfectly upright, and the seat is very shallow so you can't lay back and relax either. Honestly, when I want to sit down and read I look at those couches and shake my head in disgust and then head to another room in the house.

There are furniture stores to be found in Bamako, but unless you want to spend upwards of $1000 for a couch of dubious craftsmanship, you're better off patronizing one of the many roadside furniture salesmen. There are lots of people making couches, desks, beds, tables, and other assorted furniture right on the side of the road. I wouldn't expect this stuff to last more than a couple years, but to get an entire living room set for a few hundred bucks, why not? My wife and I are debating whether to get some couches and chairs from a roadside shop, or else try our luck at the embassy rummage sale this weekend. If you think some Americans are asking crazy prices for the junk they're selling at garage sales, wait till you shop at an embassy rummage sale. Most merchandise is old, ugly, and you have to compete with various Middle-Eastern businessmen who are prepared to overpay for that pleather ottoman so they can resell it for twice what they paid for it.

Anyway, I got a lead on a good local guy who will be making a desk for me for about $100. In the meantime, I'm using a spare nightstand to perch my laptop on while I type. We bought a new clothes washer, refrigerator, and stove from the local appliance store. Our stove is gas and runs off a propane tank that we keep in the kitchen. We have to light the burners ourselves but I like having a gas stove again. After contending with the sketchy power situation in Kinshasa for eight months, this is a dream. No more burners that barely get past warm, or ovens that scorch the top and bottom of our food while leaving the middle uncooked. And there's the added excitement of using a match to light everything.

We have a guard as well. He's not really needed, but ACME pays for security services so whatever. During the day, our guard is Mamadou. He's a pretty cool guy. He speaks some English and likes to practice with me, and I practice French with him. He's pretty big on making tea and has it several times a day. It's kind of strange to see him sitting in the 100 degree-plus heat, sipping a piping-hot glass of tea, but different strokes for different folks, I guess. At night our guard is a guy named Adama, and he's a soccer player as well. He invited us to one of his games - they charge admission and he plays in the big stadium in town, so I wonder if he's playing for some kind of semi-pro team.

My wife took the camera with her on her trip upcountry this week, so I'll try to get some pictures of our place soon.

Hello from Bamako, Mali

Dodgy internet connections and a number of other events have kept me from my blogging duties, but I’m back online. Yes, my wife and I have moved to Mali. We made the decision about a month ago. She was offered a position from ACME out of the blue – literally, within hours of finding out that the position was open, ACME made the offer – so after a few days of prayer and deliberation we felt that it was the best thing for us to do. The next few weeks were full of work as we had to finish up work in Kinshasa, get rid of the few possessions we’ve accumulated over the past seven months, and get ready to move to Bamako.

We got just about everything taken care of although, as previously noted in this blog, not having an internet connection for those last few weeks threw a spanner in the works for me. I was able to successfully get most of my work done before we left, and I can work remotely from Mali to polish off the last few tasks I need to wrap up before I can effectively hand off my work to whoever will be taking care of it next.

Getting out of Kinshasa was a headache. First, we weren’t able to get a flight on Saturday as we had originally planned so we took a flight on Sunday instead. Arrangements had to be made to take care of that, but having an extra day to prepare for our departure wasn’t the worst thing in the world. The bigger problem was that my visa for DRC had expired in early March and without a valid visa, I wouldn’t be able to leave the country. You’d think that for a country as tough to get into as DRC, they’d be anxious to kick you out. Nope. We initially thought they’d just let me leave and not let me back in, but after talking with a few other expats in the days leading up to our flight out, we learned that there was no way I was getting out of the country, at least not without greasing the palm of an official. The travel company that took care of getting us to the airport and handling our bags worked out an “arrangement” with an official to the tune of $80. I sat in the airport waiting area and sweated it out for a couple hours while that was all taken care of. The official waved me past the immigration officials when it was time to board the plane, and that was that. I was leaving Kinshasa after almost eight months.

The flight to Addis Ababa, Ethiopia was uneventful and we spent a low-key evening in a hotel before we boarded a plane to Bamako the next morning. It was a six hour flight from Addis to Bamako – not much to speak of besides another rather poor selection of in-flight films.

How is Bamako? Hot. Hot, hot, hot. Everyone I talked to in Kinshasa who had been to Bamako said it was going to be hot. Indeed, it sure is. I started to get a sense of what I was in for as the plane descended into Bamako. You know how they display the plane’s altitude, time of arrival, and outside temperature on the monitors in the cabin as you’re flying? When the plane was about 3000 feet above ground, the temperature was at 75 degrees and it just kept climbing as we descended until it was nearing 100 as we touched down. The terrain was on the barren side with lots of dust, a few scrubby-looking trees and bushes, and not much else.

I will say that the Bamako airport is much nicer than Kinshasa – no hassles from security, no problems in immigration, and local men looking to make money assisting you with your baggage were helpful and yet not overbearing or pushy.

I’ve been here for a week now and besides the searing heat (it was 104 at 5:00 in the afternoon yesterday), Bamako is a nice city. It has less of an international feel compared to Kinshasa. There’s a fairly large American presence here, but I don’t get the impression that the expat community here is made up of people from all over the globe. I think there’s more Americans and especially French here than anyone else in terms of foreigners. Could be wrong on that, though.

The roads here are way, way nicer than in Kinshasa and drivers are much more polite. However, I now have to contend with the swarms of moto riders infesting the roads. It appears to be the primary mode of transportation in Bamako. It’s common to see a pack of 20 motos in your rearview mirror, or six of them lined up at an intersection waiting for the light to turn green. What’s more maddening is that they drive all over the road and sidewalk and pass cars any which way they can.

At first, I was constantly watching every moto on the road, making sure they were watching what they were doing and not about to run into me. After a short time driving, though, I realized it’s best to take a more zen-like approach where I almost ignore them and just go with the flow. It’s almost like swimming in a school of fish – even though I’m surrounded a dozen motos, they always stay a foot or so away from my vehicle. I could be changing lanes, turning, speeding up or slowing down, and they successfully maintain that one-foot buffer.

Next week we should be moving into our permanent residence, a small house in the northeast corner of town. This week will involve shopping for appliances and housewares, getting an internet connection at our new place, and becoming more familiar with the city and streets.

Internet is back up

It's been a stressful couple of weeks for me due to a number of reasons, but one of the biggest was the internet being down at my house. We're supposed to leave soon to move to Mali (probably next week) and I've been scrambling to get some of the websites I've been working on up onto the internet before I leave Kinshasa. Kinda hard to do when you don't have internet access. Thankfully, I'm back in the game and have gotten the ball rolling on getting these sites live soon.

Big week here in the DRC - the national team won the African Nations Championship. Last Sunday afternoon I was at our usual game of ultimate frisbee at TASOK. Right after we finished the game, we heard a tremendous roar from the army base that's just on the other side of the wall from TASOK. Someone mentioned that the Congolese football team had a big game that day and we figured they must have won.

After the game, I hung out at TASOK for a while. As an hour or two went by, a few friends sent me text messages saying that there were crowds of people celebrating out in the streets and I should be careful driving home. As I started making my way home around 7:30, I came upon a mob of a couple hundred people filling the street. They were a little rowdy, but a happy kind of rowdy, at least as near as I could tell. Following the advice that was sent to me in the text messages from earlier that night, I drove extra slow as the crowd parted around my car. I honked the horn in a celebratory way, smiled a broad, congratulatory smile, and flashed victory signs to everyone. I guess that convinced them I was celebrating too, except I was just on my way to meet up with a different mob of joyful/rowdy people. They all pounded on my car and yelled "mundele" at me (the local term for white person) and walked on, cheering and smiling. I passed through without incident and made it home in one piece.

The next day, the president declared that Monday was a national holiday so the city effectively shut down. Nobody went to work, meetings were cancelled, stores were closed, etc. The streets were empty. And then Wednesday was declared a half-day in Kinshasa because the Congo team was returning from the tournament and they wanted to have a big parade to celebrate their return. I was at TASOK for some meetings that morning. Around 9am, I was informed that the school would be closing at 11:30 and everyone should get home as quickly as possible and stay out of the streets for the rest of the day in case things got rowdy. Whoa. I had to fight an incredible amount of traffic to get home and spent the afternoon and evening working and watching a few movies.

At any rate, congratulations to the DRC team and the people of the DRC for their victory. It's always good to have something to celebrate, especially in a place that can be as difficult to live as this, and it's great to see people so proud of their country.

Sorry...

Sorry for the lack of updates. The internet has been out of service at our place for almost two weeks now and I don't know when or if it will get back up before we leave. I'm still around, trying to finish up stuff for work and prep for a move, and I hope to be updating again at some point soon, either from Kinshasa or in Mali.

Onward and upward

Life is very busy for me at the moment so I can't write the lengthy blog entry that this news deserves, but my wife and I are moving to Bamako, Mali in a few weeks. She's accepted a position with ACME and they want her to start right away. This came up out of the blue and caught us off-guard. After some lengthy discussion and prayer, we decided to go for it, so we leave Kinshasa in a few weeks. Everyone we've talked to says that Bamako is a fantastic city with wonderful people, so that's encouraging to hear. Bamako is a very safe country and it seems like there's a lot to do there which is a change from Kinshasa.

When I have time I'll write more. Guess I'll have to change the title of my blog site to "Seven and a Half Months in Kinshasa."

Working for Uncle Sugar

I thought I’d write a bit about the work that I’m doing here in Kinshasa. I was quite fortunate to be hired as a contractor at the US embassy, as I mentioned back in September. Since then, I’ve been working with a variety of organizations around Kinshasa that are affiliated with the US Embassy in some way and helping them create websites. I didn’t expect to come here and be a quote-unquote webmaster, but the work has been interesting and definitely more diverse than anything I’ve done prior to arriving here.

At present, I’m working on about seven different websites as well as working on the US Embassy-Kinshasa site. Only one has gone live – it’s a site for the Kinshasa Hash group. The other six are mired in the bogs of development and the work comes in fits and starts for a number of reasons:

The internet is slow and flaky here and the power goes out a lot. This means my productivity is way below what I would be able to achieve with a stable electrical supply and a non-flaky internet connection. It can take all day to upload content to a site if the connection doesn’t die on you in the midst of the data transfer. The electrical current varies from flickering to non-existent to normal, and there will be days where it’s fluctuating between flickering and non-existent for hours at a time.

Web sites are a new concept for a lot of people here. Well, they aren’t a *new* concept, per se, as much as they don’t really know what they’ll use a web site for once they’ve been given one. For example, I’m building a site for an alumni organization that’s made up of Congolese who have been to school in America in some capacity. A web site would offer them a great opportunity to network with other alumni, the universities they attended in the states, other Congolese, etc.

Initially they were most interested in what kind of logo they would have for their organization, and if it was possible to animate the words in the logo so they could spin around. They also gave me a lot of personal photos that, while nice, really don’t belong on a professional website.

Last week we had a workshop at the US Embassy and talked about what a website is for and what should be on it. We were able to scrap such requests as a live webchat option for members, a directory of all US Embassy locations and addresses worldwide, and a comprehensive list of US policy statements on any and all international matters. Now, we’ve narrowed it down so that we’re just looking to get news, calendar, history, donation, and contact sections on the site.

I guess what I’ve had to get used to is the way the internet is seen here. It’s not seen as a business tool as much as a bit of a novelty. It’s kind of like the way the internet was seen back in the late 90s, where people weren’t exactly sure what it could do for them. The web is here – people just don’t use it in their day-to-day lives like most of those in the West do. Here, most users have to go to internet cafes to access the web so they can read email, look at their Facebook pages, or check on football (soccer) news. Rather than use the web to communicate to Congolese here in the city of Kinshasa, it will be more helpful for these organizations to communicate with Congolese spread across the DRC via a website and, by extension, those who have left the country and are now living in North America or Europe. It’s a great way for them to reach the rest of the world.

Payment is not easy to come by. One of the conditions for me working on these websites is that these organizations will have to pay for the hosting of their sites themselves. I’ll create the site, but they’ll have to find a way to pay a web hosting service to host the site. Web hosting isn’t that expensive, maybe $100 a year, and the cost isn’t the hangup. The problem is that nobody around here has a credit card. Everything in Kinshasa is paid in cash, and web hosting services accept payment via credit card. When pressed, people around here can find a way to pay for something with a credit card, but it tends to take a while to scare up those connections.

Things just move slowly here. The tired old joke here is about how so-and-so is late because they’re on “Africa time” and while it’s tired and not funny any more, it’s true. People show up for meetings hours late or don’t show up at all, and despite countless emails and phone calls, I’ll go for weeks without hearing from someone I’m working with on a website or need content from. At first it was frustrating for me, but after a while I learned how to deal with it. It might be tricky for me to handle developing six different websites at once in a faster-paced environment, but when I’m only hearing from my collaborators twice a month (if that), it gives me a lot of downtime to switch between several projects.

Most days I start work around 8am. Working from home has its advantages as there’s no commute time, I can wear whatever I like, and lunch is whatever I feel like cooking up. Today I have a sort of Andrew WK getup on (white shorts with a white t-shirt and I’m a little unshaven – no long hair, sadly). I spend my days playing around with software to develop websites, meeting with people, making phone calls, emailing, and researching. Last week I spent a couple days taking pictures at a local school to add to a site I’m working on. Once a week I go to the US Embassy (not dressed like Andrew W.K., of course) to meet with my boss and spend the day there. I really like my boss a lot – she’s been a big help in connecting me with people around town, getting me supplies I need to do my job, and helping me with advice and problems I run into.

Since I’ve been here, I’ve actually come across a few other job opportunities but I’m pretty happy with what I’m doing now. The work is interesting and varied, I’m learning new skills and using my work experience, and I get to work with locals and help them help themselves. I’m sure that all sounds like it came out of a Peace Corps brochure, but it’s the truth.