The first time was the worst, although the second was pretty bad too. The only two times in my life I’ve been on an intravenous drip.
I’ve had malaria about 20 times — although I can’t be sure exactly, because towards the end I was self-diagnosing, and medicating with Artesunate and Mefloquine. During this period in the mid-to-late 1990s I was travelling regularly in KNU (Karen National Liberation Army) Fourth and Six Brigades, and the Mon ceasefire zones, home to some of the most drug-resistant strains of malaria in the world. In the rainy seasons I would walk into places which during the dry season were more or less accessible by 4-Wheel Drive. Looking back, I can’t properly explain why I didn’t use mosquito repellent or nets. Jungle macho, I suppose — plus the fact that the villagers we stayed with had none of these things. Towards the end, I had built up some resistance, and was throwing off a fever every four-to-six weeks, without thinking much of it. I would barely take the afternoon off work, and more than once made the five-six hour drive from Sangkhlaburi to Bangkok with a 40┬░ fever, and veins full of quinine derivatives, Red Bull and paracetamol. I discovered that the best way to regain strength after a bout of malaria was eating dogmeat taut gratiam (fried in garlic). However, I had to explain to General Shwe Saing that dog wasn’t the only meat I liked to eat. (The sound of yelping, followed by gunfire, followed by silence, followed an hour or so later by an invitation to dinner became too regular a routine.) I also discovered that a bottle of Singha beer processed through a liver only recently recovered from PV malaria produces a devastating hangover. (I still shudder to recall my dark brown piss during bouts of PV, full of dead blood cells, if I understand correctly: thus ‘blackwater fever’.)
Anyway, the first time I picked up malaria was on the Tenasserim River, way down south, in 1992. By the time I got back to Chiang Mai, I was feeling pretty rough. I took several malaria tests, but each came out negative. (I hadn’t realised that the paracetamol I was taking to control the fever was also masking the evidence of parasites in my blood.) The small NGO I was working for thought I was malingering, and packed me off to the border. By the time I got to Mannerplaw (KNU headquarters, until 1994) I had the classic symptoms: high fever spikes, aching bones, tingling skin, terrible teeth-chattering chills, searing headache, and a strange light-heartedness, followed by drenching sweats and sleepless exhaustion. I had my blood tested again at a KNU clinic, and was gratified to be told I had PF malaria (+ three). I spent the next two weeks in Too Wa Lu hospital (which I later learned had been assessed by a French medical agency, which recommended that it should be de-commissioned, and encased within concrete, as a public health risk). Towards the end of my stay, a young Karen soldier in the next bed died of his battle wounds in the night, without as far as I could tell having regained consciousness since arriving in hospital the afternoon before. A few days later, I was back in my small house in neighbouring Pwe Ba Lu village. It took me at least a week to re-gain enough strength to walk a few hundred yards into the main village. I was struck by how un-moved most people were by accounts of my ordeal. Everyone on the border had malaria, time and again. It was just something you put up with. My incredibly friendly and gracious Karen hosts were far more concerned that I had no access to regular electricity or Western food.
However, on that first awful night, even the lovely and imperturbable Thramu E- was taken aback. I was thrashing about on a bamboo bed, hooked up to quinine and saline drips, which had yet to kick in. A huge, round, black, cartoon-like pig burst through the door, and started charging in circles around my sick-bed. I called out to Thramu: “Get rid of that pig – before it rips the needles out of my arm!” She just giggled – but looked really quite frightened. When the hallucination subsided, I found myself bursting into snippets of half-remembered teenage punk anthem, which also rather alarmed E-. After a while (I don’t know how long, as I was later told that I had slipped in and out of a coma, and was in danger of collapsing into a full-blown cerebral malaria), I decided to kill myself. I had got into a spot of romantic bother, which combined with the malaria, the drugs, and my natural disposition to paranoia, had formed in me a sudden conviction that all my problems could be easily solved, by ending my life. Immediately, I was able to view my troubles in perspective: after all, these were trivial concerns, in the context of my own death. In that moment, I felt a surge of life-affirming well-being, which came with the realisation that I didn’t have to kill myself.
I spent another two weeks on that sweat-soaked bed, before I had the strength to walk out the door. In all that time though, as the quinine went drip, drip, drip — and my head went buzz, buzz, buzz — I knew that it was going to be okay.
Ashley South is an independent analyst, who specialises in politics and humanitarian issues in Burma and Southeast Asia. His most recent book is Ethnic Politics in Burma: States of Conflict.