Mefloquine Nights

Malaria, likely the number two killer in West Africa behind traffic accidents, affects my life in direct, omnipresent ways.

I sleep in a mosquito net and never spend an evening minute outside the net without first having slathered my exposed skin with insect repellent. The net, at least, serves other purposes. Undesirables (roaches, scorpions, spiders and the many other denizens of my hut) don't sneak into my bed at night. I'm reminded of how wonderful that is every time I find a potentially painful or shocking experience lurking on a wall.

The number one malaria countermeasure isn't the net or the repellent, it's a weekly prophylaxis, Mefloquine (Lariam). It has interesting side effects, though to avoid a closer acquaintance with malaria, I suffer them with joking complaints.

I have woken up a few times with my hut laid out before me in perfect clarity. The most striking thing of those moments was a large yellow bucket with the word Best written across it in bright red script. I own no such bucket. And one of the greatest parts of living in my hut is lying in bed in the morning until I am surrounded by the glowing halo of sunlight creeping through the gap between my brick wall and the straw roof. At night, it's as dark as a cave inside, and I can no more see my hand in front of my face than I can see the contents of my hut.

The first few times I could clearly see my hut at night were confusing. Yet I was able to puzzle it out thanks to an experience one night in January during training.

I had a room in a house there. I was blessed with a window and the town frequently had electricity at night. Sight at night was never a big problem. When I woke up one night to see a lumberjack's torso climbing through my window, I was forced to reconcile myself to the irritating reality of a Mefloquine-inspired hallucination. Vivid dreams are one thing, and often fun, but flat out seeing things can be bit irritating when you're trying to sleep.

Mefloquine has been the alleged cause of mental problems for many people. It causes anxiety and the usual vivid dreams and hallucinations. I've heard it shouldn't be taken for more than six months at a time and every ten days. I've been on it for almost ten months now and I have the privilege of taking it for at least 17 more, every Monday - read, every seventh day.

The real problem for me came the night I woke up in darkness with tiny things crawling all over me. I smacked them for about an hour, waiting for the hallucination to end. It was only when I woke the next morning I found I had had hundreds of baby spiders in bed with me - all tiny enough to crawl through the small holes Nyari had long-ago ripped in my net.

I don't consider myself to be susceptible to mental health problems and I have no intention of getting malaria. I have faith - everyone needs to have faith in something - in my individual biology to be strong against mefloquine's side effects for the long haul. In the mean time, I'm still waiting for my Kublai Kahn.