Monday, September 14, 2015

Better Safe Than Sorry

So two plus years into my five year travel project, I was beginning to feel pretty good about what I'd been doing and the progress I'd been making against the goals I set for myself. I'd been to Europe a handful of times, wandered a little bit over the United States and even made it to northern Africa when I went to Morocco last year. Not bad.

But then last month came the first of what I hope will be a number of big trips. I'm not talking about a six or seven hour flight to get over the Atlantic Ocean or anything like that. I mean a really huge deal.  Like 15 hours in the air on a single flight. Something I couldn't even conceive of two years ago before I actually did it myself. I'm talking Victoria Falls. Safari. Elephants. Lions. Hippos. All sorts of other animals I'd grown up loving as a kid. The first big one. And it was. It was absolutely amazing.

But before I could fly to South Africa or see Victoria Falls or spend a morning seeing absolutely nothing in Zambia or fear hippos on a tiny boat in Namibia or never want to leave northern Botswana, I had one more stop to make: the doctor's office.

That's right. For the first time in my life, I was traveling to a place where the diseases I might catch could possibly be life threatening. Now I usually consider myself a pretty hardy sort of guy. I never get a flu shot (I mean how difficult is the flu?) and I scoff at MMR (measles-mumps-rubella) vaccinations because I had all three as a kid in England and I'm still here. My attitude toward bacteria and viruses is pretty much bring it on. I can withstand it. But malaria? Typhoid fever? Well, I don't know about those. So a couple of weeks before we hopped on a 15 hour flight from New York to Johannesburg, I spent an hour or so after work at Capitol Travel Medicine about a half mile from my home in Arlington, VA getting whatever I needed to fend off disease in Africa. Here's the menu and the bill.

  • Hepatitis A Immunization: $90 for a shot now and a booster shot later.
  • Tetanis / Diphtheria / Pertussis Immunization: $65 for a shot now.
  • Typhoid Fever Vaccine: $85 for four pills.
  • Malaria Medication: $5 for 16 pills. Thank you to my company's prescription drug program for that low low cost.
  • Ciprofloxacin (for travelers' diarrhea): $9 for ten pills. Didn't need it. Woo hoo!!

Sometimes travel just isn't cheap. And if the list above for something you might never need doesn't prove that to you, I don't know what would. And despite my bravado about diseases I can catch over here in the United States, I wanted no part of any of this stuff and I was all in. Give me everything. No way am I messing around with these kinds of diseases.

Now, if you are reading this post and heading over to southern Africa and thinking you just don't want to pony up the dough to take care of this nonsense, it's not required. The only real requirement over there is that you prove you've had a Yellow Fever inoculation if you are coming from a country where Yellow Fever is prevalent. And if it's not obvious, the U.S. isn't on the list. So you can really take your chances if you want. And we were told while getting our pre-shot debrief that people actually decide they don't want to do this. Are you kidding me? I know $254 seems like a lot to pay, but the taking a chance on the alternative is way worse in my opinion. 

I hate getting shots. Yes, I realize I'm a big baby and no, it really doesn't hurt. I just don't like them.
In case you don't know, the three primary diseases we got ourselves protected against have some pretty nasty effects. Typhoid, which is bacterial, causes high fever, abdominal pains, diarrhea and headaches.  Hepatitis A is viral and has the same effects as Typhoid with some vomiting and jaundice thrown in for good measure. Both are spread by drinking liquids or eating food contaminated with infected feces. Both the cause and the effects sound nasty enough here. If I'm drinking feces contaminated water, I want whatever protection I can get.

Malaria on the other hand is transmitted between people through a particular type of mosquito (the Anopheles mosquito). Symptoms of malaria are similar to some of those of Hepatitis A (vomiting, high fever and headaches) but in some cases can cause yellowing of the skin, coma or death! According to wikipedia, the disease is caused by parasitic protozoans which sounds like something I never want anywhere near me let alone inside me.

So if it's not obvious from the picture above, I got my shots. All two of them. Although I could have opted for a third shot which would have taken care of Typhoid Fever but I didn't. You can inoculate yourself against Typhoid by taking pills or getting the needle. Give me the pills over the shot any time! The picture of me grimacing in anticipated pain should be enough to convince you of my preference.

Our attitude towards this stuff was really if you are going to protect yourself, protect yourself! Even though we felt absolutely well protected medically, we had pre-trip imaginings of jungles and other sorts of terrain teeming with mosquitoes. David Livingstone's diaries of his time in Africa describe his children with mosquito bites over every square inch of their bodies which sounds like no fun at all. So to make doubly or triply sure we didn't get malaria we stocked up well and each took an extra small backpack with us on the plane stocked full of an unconscionable amount of Deep Woods Off! in both spray (less than 3 oz. there) and wipe (non-liquid and therefore TSA-compliant) form in addition to each buying an insect repellant jacket or hoodie from a company called ExOfficio.

It sounded like we were good to go but we still had to make sure. With all this stuff in the forefront of our minds, we had to talk to some locals about it when we were on the ground, right? And it started as soon as we landed and hopped in the van taking us to our hotel in Victoria Falls. The story from our guides was one that would become familiar by the end of the week. Everyone we talked to from day one to day six denied that there was ever any malaria (diseases caused by infected feces weren't really discussed) where they lived and noted they had never had the disease despite living their entire lives in Africa.

Furthermore, we were told by people in Victoria Falls that you only need to worry about malaria in rural areas. And when we got to the Elephant Valley Lodge in rural Botswana on the last couple of days they told us there was no worry of catching anything out in the bush but it is the city near already infected people where you need to be protected against mosquito-borne diseases. If there was one thing people unanimously agreed upon, it was that in winter, there are no mosquitoes in their country.

It's been about two and a half weeks since I've been back from Africa and I have had no headaches, diarrhea, high fever or abdominal pains and certainly no jaundice or yellowing of the skin or comas. I'm done with my malaria pills (you have to take them for seven days after you return) and I haven't yet gone back for my Hepatitis A booster but I'm feeling pretty confident.

I also feel like the Deep Woods Off! and the insect repellant jacket I wore almost everywhere after dark or before light helped me out. I don't recall getting bitten by anything anywhere I wiped myself or while I was covered up. But I do know one thing we were told just isn't true: there ARE mosquitos in winter in Victoria Falls. The first day we got to Africa I changed out of long pants and put on shorts and headed down for dinner at our hotel in Victoria Falls. Sure enough, I forgot to use the Off! and I paid a price. A couple of bites on my ankles but no malaria. Not yet anyway. And I don't think there will be. When it comes to stuff like this, better safe than sorry is my motto. You should be too if you plan a trip like this. The alternative is way worse. And I don't want to know how much worse it is.

Want to know how my Typhoid Fever pills worked? Read the pamphlet above.

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