[Nairobi, Kenya 28°C] It’s now one week before my arrival in Juba and according to the prescription of apo-mefloquine that sits on my desk, I should be starting my antimalarial treatment today by taking my first 250-gram tablet. One tablet to be taken one week before arriving in a malarial area (some areas of Kenya qualify, but not in large urban areas like Nairobi). One tablet should be taken once a week after supper while in the malarial area, which should be continued for four weeks after leaving the area. A total of 13 weeks.
I’ve been hesitant to take mefloquine from the beginning because of the potential side effects (see previous post), which—according to the prescription—include but are not limited to “a sudden onset of unexplained anxiety, depression, restlessness or irritability, or confusion (probably signs of more serious mental problems).” Like most people, I’ve never been treated for depression, but I have felt ‘depressed’ before, lacking in confidence and motivation. A concern of mine is, would a drug like Larium (the brand name for m) instigate the “more serious mental problems” that the manufacturer delegates as the responsibility of the consumer? Besides, I don’t want to feel more anxious or depressed than what naturally occurs during episodes of cultural shock and adaptation, particularly not in situations that may already have their own normal levels of stress and misunderstanding that comes when being in unfamiliar cultural surroundings.
The warnings continue on the box with, “you may develop other serious side effects, including persistently abnormal heartbeat or palpitations,” but this time without the disclaimer blaming the person taking the medication. I’m not sure if I’ve had palpitations before but I may have. Are they warning that a heart attack may follow while taking these pills? Not something I want to contemplate from Southern Sudan or anywhere else for that matter!
Last night while chatting with Carla (the guesthouse owner) and another guest at Miti Mingi , we decided to make some tea. The only choice in the house was a herbal tea made of crushed leaves from the neem tree (Azadirachta indica). On the back of the box is written, “… Neem has remarkable healing properties…” Then it continues by listing them: boosts body’s immune system, stimulates the production of T-cells, purifies the blood, and prevents or cures during treatment of sore throats, colds, fevers, food poisoning, lowering blood pressure and cholesterol, irregular heartbeat… and the list finally mentioned malaria. Finally, an alternative and natural treatment against malaria. This tea was produced from trees in Kenya, and in the Kaswahili language the tree is called Muarubaini, which can be translated as the tree with forty cures.
According to Vandana Shiva, physicist, environmental activist, intellectual, author and future Nobel Prize winner(!?), the medicinal and chemical uses of the neem tree’s bark, leaves fruit and seed oil have been known and used in India for more than 4000 years.
I noticed the mention of neem on a back page of a pamphlet given to me at the Santé Voyage clinic where I received my vaccinations and consulted about malaria prevention. None of the medical staff mentioned any natural products as a possible alternative for the common prophylactics like mefloquine, aralen, chloroquine, etc.
In Senegal, there is a movement to bring neem to the masses to decrease the numbers of unnecessary deaths from malaria. Below is a video from the Al Jazeera show ‘People & Power’, dating from December 8, 2008:
The Forestry Department at the Food and Agricultural Organization (FAO) of the United Nations have coordinated since 1994 the International Neem Network whose activities are documented in their recent, The Activities of the International Neem Network. Other online documentation can be read from the website.
So, I’ve decided to forgo the mefloquine prescription by leaving it in my bag. I will now drink neem herbal tea and will look for neem soap to wash with as an added repellent. Or course this will be done in tandem with my other preventative measures, like sleeping under a Permethrin-impregnated mosquito net, and using mosquito repellent on uncovered skin areas between dusk and dawn when mosquitoes are most active.
