Malaria

Each year malaria kills more than two and a half million people. It is a deadly disease and a leading killer in Mali. However it is treatable. Since also quite likely you will be infected while in Mali, it is best to be prepared and know what to do.

Prevention: There are 400 types of mosquitoes, 60 of which can carry and transmit the malaria parasite. Most of these like to feast at dusk and during the night, so do what you can to protect yourself: long sleeves or shawls, bug spray and mosquito nets. But since it is impossible to completely avoid being bitten, it is strongly recommended that you take anti-malarials for the duration of your internship.

The three most common anti-malarials are Lariam, Malarone and Doxycycline. Mefloquine or Lariam is reputed as the most effective, but it is not for everyone. Several people are subject to vivid dreams or nightmares, insomnia, nausea, anxiety or depression. If you have any history of mental illness and depression, it is best to avoid this drug. Malarone is also quite effective, but you pay a steep price for it: roughly $6 per day. And there are still no guarantees. Doxycycline is a common antibiotic which offers moderate protection against malaria. Secondary effects include increased photosensitivity (make sure to take sunscreen) and yeast infections in women (take a couple of treatments just in case). Yet while Doxycycline is not the most effective anti-malarial, it can aid your immune system in fighting other infections and minor diseases.

It is also possible to buy Savarine in Mali, another effective antimalarial, for roughly $20/month. So you may want to purchase Malarone for the first few days - enough time to find a doctor in Mali who can prescribe Savarine for you.

None of these or other medications can give you 100% protection, but don't let that discourage you from taking them. They offer an extra boost in fighting the disease should you be infected and you will likely not get as sick as you would were you to take nothing.

Symptoms: Signs that you may have malaria include: fever, severe headache, general ache in body and bones, stiff neck. If you feel these symptoms it is best to get a blood test as soon as possible. Most clinics will be able to do a blood test (called 'goutte épaisse')or tell you where to go. Price varies and private clinics are more expensive but often quicker (2,000 - 3,000 Fcfa). When you get the test, make sure you explain that even in the parasite count is very low, you need to know. If the result is positive find a clinic where you can buy a treatment. The most recommended is Coartem. A box costs roughly 5,500 Fcfa and contains 16 pills. Follow the instructions inside and while you will may still feel like death warmed up for a couple days, you should get better. If the treatment does not work, it is important to see a doctor immediately.

Medical Insurance: Depending on your insurance company, you may need to notify them that you have become ill and have purchased medication. The company may insist you call them, but as you cannot make collect calls from Mali (and may be put on hold when you call!) try to arrange before hand another way of contacting them if need be. For example, you may be able to contact a family member back home and have that person make the call. Keep all receipts, especially the slip from the test showing the presence of malaria parasites.

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General Ills

It will be difficult, if not impossible, to avoid getting sick at least once while in Mali. Best be prepared.

Diarrhea : Common malaise to new arrivals. Drink lots of (safe) fluids and avoid dairy products and fruit - although bananas can help. Troubles should ease up within a week but if blood appears in your stool or fever develops, consider antibiotics and/or a visit to a clinic.

The greatest danger during a bout of diarrhea is dehydration and the loss of essential nutrients. The best remedy is to drink lots of fluids and take an oral rehydration solution, easily made and very effective in preventing dehydration. To a litre of safe, drinking water add four heaping teaspoons of sugar and half a tablespoon of salt. These proportion are important - too much salt is harmful and too much sugar can prolong the diarrhea. It does not matter so much if there is too much water.

Constipation : This is an equally common yet less expected problem. A diet heavy in starch and lack of fresh fruit and vegetables can block up the system and cause discomfort. You may want to plan ahead and bring laxatives. If you don't have any, try dates, fresh fruit, coffee and lots of liquid. Avoid bananas. If situation persists, laxatives can be obtained from a local clinic.

Colds : It may seem illogical to catch a cold when it is 40°, but colds are spread by virus and as a new arrival, you will be especially susceptible. Keep up your fluids and try some local herbal teas like quinqueliba.

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Basic Hygiene

Every foreigner in Mali must find his or her own balance between absolute paranoia about germs and total lassitude. While you may want to eat as locals do, remember that you do not have the same resistance and immunity. Special diligence about what you consume is most important in your first month, but even after a few months try to remain diligent. Here are some tips to keep in mind.

•  Washing your hands is the best way to prevent the spread of germs and bacteria.
•  Treat the water you drink - either with purifying tablets or by boiling
•  Opt for fruit that can be peeled
•  When buying food from vendors, select what has just been cooked and is still hot
•  Avoid drinks with ice - the water used may be unsafe
•  Crack open dried dates before eating to check for bugs!

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