Mosquitoes and Malaria

16/12/2007

I have no doubt that several litres of my blood are now flying around Timor in the bellies of contented mosquitoes.
A confluence of factors - the rain, the temperature, the seasonal cycle - has brought us a sudden invasion of bugs, of every imaginable shape and size. But it's the mosquitoes that I most sincerely hate.
Timorese mosquitoes are not particularly large, swift or intelligent. But they descend upon you in massive waves, with a Zen-like disregard for DEET and slapping. No matter how many you squish, there always seem to be a hundred more ready to die for their cause.
Resistance is futile.

But Yudha resists anyway. Passionately.
Every night, Amandi and I respectfully evacuate the house as Yudha, canister of Baygon in hand, marches through in a murderous rage. Anything that doesn't have the grace to die quickly from the first shot is promptly drowned in insecticide.
I was initially amazed by how the fight against mosquitoes aroused such savagery in Yudha's otherwise tender soul. But it turns out that in the two years he's been in Timor, he's had malaria six times.

Not everyone has the capacity to launch such a robust counter-attack, however.
Planting season means, for the mosquitoes, many more bare-bodied, distracted men out in the fields for longer hours. And unattended children left at home to fend for themselves.
Already, I see a discernible upswing in the number of patients with malaria at our twice-a-week clinic. Most young people recover with antimalarial medicines after a week or two, with little long-term consequence except for the lost productivity on the farms. But it's the vulnerable ones - infants, pregnant women, grandparents - who suffer the more prolonged, severe, and sometimes fatal variants.

The cornerstone of malaria control in developed countries is mosquito avoidance - simply laughable here, given the overwhelming numbers. Economic factors also come into play: One well-meaning initiative to give a free mosquito net to every newborn flopped, when some enterprising Timorese figured out that sewn together, the nets make for great fishing.

How is the prevalence and impact of malaria in Vatunau solvable? I don't know. But for now, the antimalarials and I hold the line.

-raj