Sooner or later, everyone who consciously wants to travel to Africa will have to consider this topic. Malaria, the infamous infectious disease transmitted by mosquito bites, is widely spread in (sub-)tropical areas and some of the worst types are likely to be found in the Forgotten Continent. As in severe cases an untreated infection can not only cause fever and headache but lead to coma and death, it is highly recommendable if not essential to try and prevent contamination, means reducing the risk of mosquito bites to the absolute minimum.

We thought we were well prepared. Cautiously, we always sleep under mosquito nets, we use a lot of repellent, we avoid exposure at dusk and we mainly wear light and long clothes. Furthermore, we take Malarone for prophylaxis, which is said to considerably reduce the probability of an onset in case of contagion. And the methods turned out to be successful. Since our arrival to Africa, Steffen and I hardly got more than 5 mosquito bites, and Eli – even more thoroughly applying the preventive measures  – just has been bitten once at the beginning in Dar Es Salaam. And anyway, malaria usually breaks out at least one week and up to three months after a bite, so we could go to our safari without worrying at all. An extremely unlikely case of malaria would definitely not occur during the rides through the national parks before reaching a rather developed civilization again.

Unfortunately, we soon had to realize that this feeling of security was not justified. Actually we were not well prepared at all. Or to be more precise: We knew how not to get malaria, but we had no idea how to behave and what to do if you do get it after all. On the last day at Katavi National Park, Eli began to feel very tired and later became sicker and sicker, with increasing fever and a painful feeling. First, we were convinced this would be due to the consequences of a sunstroke, but we decided to be on the safe side and drove back to Mpanda to have her make a malaria test. At least we knew that it is advisable to go and have malaria tested whenever you have fever in such areas. And then came the big shock: The most improbable explanation for Eli’s ill-being had become true. The diagnose was positive, with a level of 7 malaria parasites per 200 white blood cells.

Apart from the advice that if you have malaria you should go to some local doctors who know what to do, we had no idea of the correct behavior in such a situation. What did the concentration level mean? Was it really high or rather low? How can we treat the symptoms and eventually cure her from the disease? Especially for Eli, who had heard many horror stories about the course of malaria, this was a very tough time. Her panic was growing because literally she feared she could die in the following days. She truly had some terrible hours.

To make things even more complicated, we were at the most remote place of our whole safari. Obviously, the doctors had never had a white patient before and did not really seem to know what to do. They appeared to us rather surprised why Eli felt so bad, they recommended taking some painkillers to lower the body temperature (which indeed was a good idea and helped improving Eli’s state), but they were totally astonished that we would take Malarone for prevention. They told Eli now to take a higher dose, but we saw that this was simply a wild guess. Using a tediously slow internet connection, we managed after several hours to contact Steffen’s family and via them a doctor. He informed us that if you take Malarone as prophylaxis, it is important to change the medication for the therapy.

Later, our guide Hussein (who during all this period was an important support for translating, organizing and comforting) explained us that from birth on, each African normally has a steady concentration of about 10 parasites per 200 white blood cells and that for them, malaria starts being a real issue when the level increases to around 20 parasites. That was the reason for the doctors to be so confused about Eli’s state, they could hardly understand what was going on with this white person who did not have anything but a normal, not alarming result at a malaria test. So the next morning, we decided to take the 700 km looong and exhausting bus ride to Mbeya, where we would encounter the first hospital with much better educated doctors.

Thanks to painkillers, Eli could bear the main part of the ride without bigger problems, but the last hours became quite difficult for her. Nevertheless, we finally arrived to Mbeya after 19 hours in an uncomfortable bus, delayed but alive. We headed straight to the clinic and were attended directly by a friendly and competent doctor. For the first time, we felt ourselves to be in good hands. The doctor had had experiences with white patients before or at least perfectly knew how to treat and cure the infection. He prescribed 3 doses of quinine (the stuff Tintin already had given to some Congolese and which is also used in Tonic Water), which Eli had to get injected in 8 hours intervals. Afterwards, she was given other tablets, Artequick, which she took the next two days. For the whole investigation and all medicaments, we had to pay 16 €. And as promised, she completely recovered from the disease – the ultimate test resulted in negative. She had some tough side-effects, but it is wrong imagining her lying in a hospital bed. Already after the first injection, her state improved considerably and there was no necessity for taking painkillers. She relaxed one day in the hotel room, then we had a half-day long bus ride to Ruaha National Park and the last day of her treatment she spent on the safari, adoring lion babies.

What we have learnt: Understand that in Africa, malaria is part of the everyday life and that locals will be more tranquil about this issue. But for Europeans, malaria is serious and you should not take it easy and be casual about it. Protect yourself as much as possible from mosquito bites. Instantaneously go to a good doctor for further examination whenever you feel symptoms like headache or fever. But don’t freak out if despite the measures you should still get this infectious disease. Panic and horror stories are never helpful, keeping calm and serene is a lot more important in such a situation. Well treated, malaria is most likely to cure without lasting consequences. Yes, approximately one million persons die of malaria, many of them being African children. But we saw where they come from and where they live. In Ikola for instance (the village where we disembark the Liemba and where Eli took the cute picture with all the children), the next medical facility is at least perhaps 3 walking days away, people don’t have the time and the money to take their children there and in most cases a fever would not even be noticed.

Before we finish, we would like to thank all the persons who, near and far, helped us dealing with the situation. Thanks to our guide Hussein for always being present, missing his deserved meals and his night’s rests. Thanks to Damaris, Jochen and Dr. Hachmann for the assistance, guidance and all advices sent from Germany during a sleepless weekend and thanks to Karli for maintaining the remote communication online and for the mental support. A special thank you goes to Nadja who had given me a realistic and first-hand estimation on the actual course of the disease but also a valuable and reassuring opinion about prevention and treatment. And admittedly, we have to apologize for not having sufficiently informed ourselves about malaria and for simply having hoped not to get it.