What
precautions should be taken against malaria?
This
is the first question asked when travelling to southern
Africa. Malaria is a serious health risk in the region
and visitors should take the necessary precautions.
The Department of Health in collaboration with the
National Malaria Advisory Group recently published
up-to-date guidelines for the prevention and treatment
of malaria.
The
most important step is to prevent mosquito bites.
An anti-mosquito spray or lotion should be applied
to exposed areas of the body after dark, and protective
clothing such as long-sleeved shirts and pants worn.
Visitors
should also sleep under mosquito nets and burn mosquito
coils or spray the sleeping area with an anti-mosquito
spray.
Taking
a prophylactic anti-malarial drug is essential, and
certain factors influence selection. Malaria-risk
areas can be divided into chloroquine-sensitive and
chloroquine-resistant areas, according to the susceptibility
of the malaria parasites in the area to the antimalarial
drug chloroquine.
Be
sure to determine what type of area you will be visiting
and obtain drugs accordingly. Chloroquine (chloroquine-sensitive
areas) or chloroquine plus proguanil or mefloquine
(chloroquine-resistant areas) is recommended.
There
are a few areas where resistance to both chloroquine
and mefloquine occurs and for these doxycycline is
recommended.
Bear
in mind that some brands have side effects, particularly
mefloquine, and it is extremely important to finish
the prophylactic course which involves taking the
anti-malarial drug for at least six weeks after leaving
a malarial area.
Don't
be tempted to travel without anti-malaria drugs and
don't believe rumours that they make things worse
if you do contract malaria - that is simply not true.
Visiting the region of KwaZulu
Natal province known as Zululand
On
most maps Zululand is the region North of the Tugela
River bordering the coast, stretching as far as the
Swazi Kingdom and Mozambican borders. In actual fact
the area just below Swaziland and Mozambique stretching
down to the St. Lucia Wetland game park is Tongaland,
home grounds of the Matonga tribe. For all intensive
purposes this entire region will be referred to as
Zululand by most South Africans and is also labelled
as the Malaria area of the country together with Swaziland
and the Kruger National game park.
In
reality the risk of contracting malaria is not as
widespread as this. Malaria carrying mosquitoes only
occur in the low lying (plains & valleys) parts
of these areas, which excludes much of Zululand as
well as most of Swaziland. Certainly the places most
often visited by tourists are malaria free, despite
a huge expansion in the range of this decease in the
last 18 months. Tongaland however is certainly a high
risk area, as is any low lying place with an established
human population within a one kilometer radius of
it. This does not included established urban settlements,
as they have the correct measures in place to avoid
malaria establishing itself.
What
this means is that, despite the fact that places like
St. Lucia town, Kwambonambi town, Mthubathuba town,
Eshowe town and Richardsbay city are slap bang in
the middle of Zululand, there is no risk of contracting
malaria while staying overnight there.
Many
other places are malaria free too, despite having
malaria infected places close by to them. Most of
the accommodation establishments inside the various
game parks, are quite definitely free of malaria.
The reason for this being that the people visiting
(tourists) these cordoned off areas and working in
them (KwaZulu Natal Nature Conservation Services staff)
are not infected with malaria and therefore the local
mosquito population are not infected with malaria.
Remember that mosquitoes are not able to fly the 1km
or more distance (often across a lake) to reach the
neighbouring human population.
Therefore
the brightly demarcated band of malaria area on maps
of the Eastern side of Southern Africa, should in
fact be pitted with pockets of malaria free places.
But to keep things simple and because malaria carrying
humans are settling closer and closer to these free
places, the general advice is to take malaria precautions
wherever you overnight in Zululand and any other low
lying area.
Here
are some points to be noted. The Anopheles Mosquito
generally only bites after dark, it has been said
only after 6pm at night for a few hours and again
early in the morning before dawn. This means you are
quite safe going on game drives or boat cruises during
day light hours in known malaria infected places.
Such as the lower lying tourist roads in the Zululand
game parks and the boat cruises up the St. Lucia Estuary
and even the main highway (the N2 ) up from Durban
to Swaziland. The main tourist camps "Hilltop"
and "Mphila", in the Hluhluwe Umfolozi Game
Park, are at too high an altitude for you to be bitten
by malaria carrying mosquitoes, so it is quite safe
to stay there too.
What
precautions should you take when visiting Zululand?
Well
the best precaution is common sense. Despite what
has been said in the above paragraph, there is really
no way of knowing for sure whether you will be sleeping
in a malaria free area or not. Getting malaria is
really not a very pleasant experience at all, and
from what I have seen it never really seems to go
away for good once you have been treated. The best
advice is to make sure you don’t get bitten.
As stupid as this may sound, it is technically quite
attainable.
Firstly
do take whatever prophylactic (fancy word for malaria
tablets) you and your doctor have decided on. For
Zululand which is now labelled as a chloroquine-resistant
area, all you need is Paludrine in conjunction with
Daramal. This is obtainable from any South African
chemist (far cheaper than at home). It is sold in
a single pack that will last you a two week period
in the infected area and the first tablet only needs
to be taken 2 days before entering the infected area.
The
author is not a medical practitioner, but I have made
the following observations over the years in giving
foreigners travel advice. You do not need the often
prescribed stronger drugs, that are actually intended
for places with serious malaria problems such as Malawi
or Mozambique. In particular I am talking about Larium,
which makes 9 out of 10 users quite ill, and a lesser
proportion delirious, with rumoured lasting side effects,
besides it is very expensive anyway.
Something
else to consider is alternative forms of medicine.
For instance there are quite a number of Africans
who use Homeopathic anti malarial medicines when visiting
malarial areas. Even places like Mozambique which
is a high risk area. These homeopathic medicines do
not have the side effects that prophylactics have
as they are said to contain homoeopathically safe
amounts of Quinine. The distributors of these locally
made medicines are not aware of any of their patients
ever contracting malaria while using their medication.
So if you are interested in a alternative form of
medicinal protection, I suggest you contact the following
Homeopathic Doctor on the telephone numbers provided.
Dr.
Norina Standwich
115 Edmond’s road
Glenwood
Durban Metro
KwaZulu Natal
Rep. of South Africa
Tel: +27 (31) 2024166
Secondly
there is much you can do to create barriers between
you and the mosquito.
Use
insect repellent (Liberal amounts of the chemical
DEET are very effective).
Sleep under a mosquito net (provided for you by most
accommodation establishments)
Learn how to use a mosquito net correctly before using
it (not as easy as it would seem)
Wear long sleeve and long pants coverings after dark
and sit around the smoky camp fire at night.
If you really want to get clandestine:
Wear
only dark coloured clothing after sunset (mosquitoes
navigate on infra red)
Don’t wear sweet smelling perfume or deodorant
(all insects are attracted to those, when in Africa
smell like the African Summer)
Use citronella oil based soap when washing yourself
(it is biodegradable too)
Make sure there is a strong breeze blowing through
your room while sleeping (mosquitoes home in on the
water vapour as well as the Carbon Dioxide you breath
out while you sleep).
You can burn mosquito coils/candles in your room,
but these can irritate the throat especially if you
are asthmatic, and they scare away more interesting
visitors you might wish to see e.g.: bats, genets,
snakes etc.
Re apply insect repellent to exposed skin if you have
been sweating or have wiped it off accidentally (it
does not soak in).
Please note that eating garlic as a deterrent is an
absolute fallacy, and is likely to get you thrown
out of your tent / hut / bungalow by your fellow travellers,
which will certainly put you at the mercy of the mosquitoes.
What they don’t tell you.
Wearing
insect repellent, no matter how unpleasant it may
be, is a good idea all round. Any game viewing experience
in Southern Africa is likely to bring you into close
contact with another of Africa’s little pests.....
ticks.
By
my count ticks are far worse than mosquitoes.
Their
bites are more itchy than mosquito bites and can last
for weeks.
They can be extremely small (the famous pepper tick
is no larger than a pin prick), and therefore are
difficult to remove.
They can give you a, not life threatening but unpleasant,
infection know as tick bite fever. They are just are
crafty as mosquitoes at tracking you down, and can
crawl into your most sweaty crevices (don’t
ask) within seconds of clinging on to you.
They lurk about on not only clumps of tall grass but
even tree branches, waiting to jump onto any passing
mammal.
So common sense can certainly keep you safe from these
little nasties. The above information is designed
to give you a better understanding of the whole malaria
problem and not to make you blasé about the
reality of the risks involved.
Malaria
paranoia is no reason not to visit these amazing areas.
One must remember that the fact that these areas are
historically malaria zones, means that man has made
little impact on the natural state that exists even
to today. Tonga Land for example is a natural wonderland
of rivers, dunes, fresh and salt water lakes and Coastal
Forest as well as Mangrove and Sand Forests, all teaming
with indigenous plant and animal life. Myself and
my friends and the occasional lucky traveller have
spent many wonderful days here with the Tonga people,
despite the high malaria risk. It is certainly most
fortunate that malaria has aided such beauty in surviving
to be experienced by visitors in this present day.
If
you require more specific information on the risks
of malaria in areas you wish to visit, please do approach
us on the contact details provided in this web site.
What
about Tekweni Ecotours?
Note
that Tekweni Ecotour’s "Zululand Grassroots
Experience Safari" does enter the chloroquine-resistant
areas of Zululand, however our accommodation is situated
in a presently malaria free pocket and there is not
risk of contracting malaria while visiting the main
game viewing park during daylight hours. Tekweni Ecotours
has been visiting these places once a week every week
of the year for the last 6 years, and as of yet none
of our guides have contracted malaria and we are not
aware of any of our guests having contracted malaria.
As a matter of interest none of our staff have ever
used prophylactics while on tour.
Note:
Our safari that visits the Drakensberg Mountain Range,
"Rejuvenate Your Soul" does not enter any
malaria areas at all.
Malaria
Map
