Malaria – Alan Holmes

I asked Alan Holmes author of Memories of Paradise – to write about his recent experience and rather sad journey with Malaria in Marloth Park. This is a real person’s own experience with Malaria …

In Alan’s own words:

My experience of Malaria in Marloth Park

• Alan Holmes

Ann-Jeanett and I had been living in Marloth Park since October 2005. We always slept under mosquito nets and used insecticide spray some hot summer nights. Other than that we took no precautions. Familiarity breeds contempt they say, and we were going to pay heavily for our carelessness.

In mid-August 2019 in what should have been winter when no malaria mosquitos should have been around, we both fell ill within a day of each other. The initial symptoms were like the start of a flu – headaches and muscle and joint aches, and a general feeling of lethargy. Within a couple of days we both felt weak and the headache got much worse. Ann-Jeanett’s symptoms never changed, she simply got weaker and weaker, to the point where I’d have to help her to the toilet and in the shower. She couldn’t lift her arms to wash herself. She had been battling Parkinson’s Disease for a couple of years, so this “flu” really hit her hard.

Another two days and I had classic malaria symptoms – uncontrollable shivering fever and terrible nausea, so we went to see our local doctors. They sent us for blood tests and malaria was confirmed in both of us. The parasite count in blood smear tests was concerning, so we were given medication and told to come back the next day for more blood tests. That night I began to have explosive diarrhoea on top of the shivering and vomiting.

Our parasite counts in the blood smear tests the next day showed much higher levels in my blood, but an improvement in Ann-Jeanett’s.  The doctor advised that I get to a hospital as soon as possible. We had no medical aid or hospital plan, so my only option was Tonga Hospital. We had both had very good treatment at this hospital in the past, so it wasn’t as scary a prospect for me as it might have been. After 3 days there on a constant saline drip to try and replace the fluids my body was losing due to the persistent diarrhoea, and blood tests every couple of hours, the hospital medical manager came to me. He told me that they had been unable to diagnose the strain of malaria I had and were transferring me to Temba Hospital, outside Nelspruit. I found out later that these were outright lies, as the truth was that the malaria strain I had was the “Xai-Xai” strain, which that hospital treated every single summer!

After admission at Temba, I was put into the “Hospice” ward. I have had nothing but excellent treatment from State Hospitals for the last 15 years, but my treatment in that hospital was shocking! The doctors were terrific, but the wards were run by the nursing staff. They ignored doctor’s orders; only updated charts once a day just before doctor’s ward rounds and dispensed medication when they felt like it. I spent 8 days there and most of the time my drip bags were empty. They would only be replaced five minutes before doctor’s ward rounds. One night I walked with my drip trolley to the nurse’s station at 10.30 pm to ask for my medications the doctor had specifically told them had to be dispensed every four hours and which I’d last had at 1 pm. I was chased back to the ward by a Sister, who LOCKED THE WARD DOOR! Needless to say, I got no medication until the doctor’s visit the next day.

After 8 miserable days in Temba Hospital I was discharged. I felt no better than when I had been admitted, but my discharge letter (which I still have a copy of) claims that all my vital signs were normal. I arrived back at home in Marloth Park feeling completely “out of it”, shivering with fever and with unrelenting diarrhoea. I found Ann-Jeanett in terrible condition – completely lethargic and claiming she didn’t have the strength to turn herself over in bed. My son Nick had taken her back to our doctors a couple of days before and after blood tests, they had told her that she had a bladder infection and sent her home with a course of antibiotics. This misdiagnosis was to prove fatal. I was being nursed in one room by my daughter-in-law Joan when Ann-Jeanett collapsed trying to get to the toilet in the room next door. I was semi-comatose and didn’t hear the paramedics arrive, or their hour-long attempt to revive her. She passed away a few meters from where I was lying delirious with fever.

My other two sons drove down from Johannesburg early the next morning. I don’t remember anything about that day. The next morning my sons tried to get me into a car to take me to the doctor, but I collapsed in the driveway. An ambulance was called and I was taken back to Tonga Hospital. After being admitted to Casualty, I was left to lie in my own filth for the entire day. My sons tried desperately to get a doctor to attend to me, but were fobbed off with excuses like “I’m going off shift now” and “he’s not my patient”.

My eldest son Tom is a media personality and he put out a desperate call on social media for help. Tens of thousands of people all over the world joined the effort and some Good Samaritans came forward to rescue me. A medivac helicopter flew from Johannesburg to Tonga Hospital (which is almost on the Mozambique border) with some top paramedics on board. Local private ambulances arrived to assist and to light up a landing area for the helicopter.

When the paramedics got to me, I had blood pressure of 60/30 and a barely detectable heartbeat. They stabilised me and loaded me into the helicopter, which took off and flew to Nelspruit to refuel. I had to be removed from the helicopter for the refuelling so once again there were private ambulances waiting, so that the paramedics could continue to work on me. At about 1 am, the helicopter landed on the roof of a private hospital in Sandton, where a specialist physician was waiting to treat me.

I only became aware of what was going on around me two days later in the ICU. I was hooked up to a multitude of machines and was on constant dialysis. In all I received more than 20 units of blood in the 12 days I spent in Hospital, 8 of which were in ICU. 

Two of the worst effects of the malaria were the complete lack of control of the muscles in my legs and arms,  and the loss of the lining in my mouth due to the extreme dehydration caused by the vomiting and diarrhoea. Physiotherapy gave me back the ability to walk, initially with the aid of a Zimmer frame. The lining of my mouth and the skin on my lips took another two weeks to recover. During this time, I slept for about 20 hours each day.

The cerebral strain of malaria I had attacks mainly the brain and the heart. I can no longer do strenuous exercise and I have problems with short-term memory. By far the worst effect of the disease was on my vision. I had already lost most of the vision in one eye after a stroke some years before. Now the vision in my good eye has deteriorated to the extent where I can only dare drive a car in bright sunlight and certainly never again in traffic.

My advice to anyone visiting or living in Marloth Park? Take every possible precaution to avoid being bitten by mosquitos! If you suspect that you may have malaria, get blood tests done as soon as possible. And no matter what the cost, avoid State Hospitals! They do not have the facilities or the staff to deal with the disease, especially now that they’re having to cope with the Covid pandemic. Despite the Good Samaritans and the crowd funding assistance I received, my entire family’s bank accounts were cleaned out to pay for my treatment. I am still paying off some of the outstanding bills for blood tests and blood transfusions, but I am alive and able to enjoy each day.

I asked Alan to write for us about his experience with Malaria. Lots of people in our group constantly ask about the danger of this contracting this disease when visiting the Lowveld, Kruger Park and Marloth Park. The most important thing is to detect the disease as early as possible and get the right treatment.

Precaution: Try not to get bitten. Mosquitoes love biting around the ankles, so wear trousers and socks around sunset. Use ample of insect repellent on uncovered areas of your body. Bath or shower with citronella soap. Burn Doom and Raid coils and citronella candles inside the house and close doors and windows before sunset to keep the little buggers out. Sleep under mosquito nets.

People ask about malaria pills. I never took pills in all the years that I worked for Sanparks or visited Kruger and Marloth Park. The Darachlor (spell?) made me sick and nausea. I have a lot of friends and colleagues who also live in the Lowveld, Skukuza and Marloth Park. Some contracted Malaria. Some never got sick. But all of them agree on one thing: If you don’t feel well, get tested for Malaria as well. The first symptoms of Malaria are the same as a bad flu, as Alan also stated. The sooner the right diagnoses is made and you receive the right treatment, the faster you will recover.

Alan Holmes is the author of a wonderful book – Memories of Paradise – The book is available in shops in Marloth Park. You can also order it straight from him on WA 0729238923 It is such a nice book. And it is beautifully written.