Malaria
Although I have not been to Angola I have spent many years in other African countries in which malaria is endemic, both as an expat brat and as a working adult with several children. We do not take any form of malaria prophylaxis. My children have never had malaria, I have not had it in over 20 years. The first thing to remember is that not every mosquito transmits malaria. You may have several mozzie bites, but this does not automatically mean that you will get malaria. Only a mosquito that carries the malaria parasite can transmit it. Details on the various species of malaria can be found on the websites of the WHO, CDC...
Based on many, many years of experience, my personal view on living in such countries is: Make sure you have mosquito screens an all windows and ideally on all patio doors. If you are going to use your patio/terrace after dark do try and have mosquito screens built around it. It may not look pretty, but it will keep most mosquitos away. Do try and set up mosquito nets around your bed as well. However, do not pick up just anything that calls itself a mosquito net. In malaria zones one needs a net with a mesh size small enough to keep mosquitos out. (see: www.safariquip.co.uk/all-categories/insect-protection/mosquito-nets/choosing-a-mosquito-net/). At www.kiwinet.co.za you can get beautiful custom-made nets.
Apparently those mosquitos that transmit malaria are active during the hours of darkness. Bearing that in mind make sure you have plenty of mosquito repellents (in your house, in your car, in your bag, everywhere basically) so that especially in the evening, even more so if you are in non airconditioned rooms, you can apply them to exposed areas of your body, i.e. those not covered by clothes. My impression is that the little beasts particularly love going for the legs, especially the ankles.
Some people have their compounds sprayed with insecticides on a regular basis, but this may create other problems, as it is not always clear which pesticides are used during the fumigation process and how they may affect humans in the short or long term.
The biggest problem anyone that fears malaria has to deal with is a fever. We, especially children, all get a fever now and again. In most cases it is due to a bacterial or viral infection that has nothing to do with malaria. So what does one do? If one cannot safely exclude malaria, i.e. the person with the fever does not have very clear symptoms of another illness, one needs to go for a blood test, which usually involves taking a drop of blood from the finger. There are three problems involved with this.
- One needs a really good lab with spot-on hygiene (lab glass slides have to be 100% clean!)
- The lab should be able to provide the result within an hour (it is no good receiving the result one day later)
- The lab should ideally operate 24/7 as sometimes, especially if one has malaria symptoms but the first blood test showed up negative, a second test needs to be done, say 6 hours later as by then - if indeed one has malaria - the parasites would have sufficiently multiplied to show up in a test.
You may come across what is known as a malaria quick test which can be carried out at home. Read www.malariasite.com/malaria/rdts.htm on the problems involving false positive or false negative results with this type of test.
Once the presence of the malaria parasite has been confirmed treatment is quite straightforward and usually involves taking the prescribed medication suitable to combat the particular malaria parasite involved over several days. Some people have problems retaining the tablets and may receive the medication via a drip. From what the two colleagues who have had malaria in the last 2 years have told me they all felt as if they were suffering from a flu: shivering in the early stages, fever, aching joints, generally feeling weak. However they were fine and back at work within a week. These may be the typical symptoms, but you also have the atypical ones like I had over 20 years ago:
A headache that seemed to creep up from the nape; stomach aches; however no fever, all over several days. One morning I could not lift myself out of bed but rather fell back/fainted and did not wake up until 3 hours later. Feeling very wobbly I managed to call the office for a driver, went to see a doctor with a perfectly equipped lab, he conducted the test there and then and even go me to have look at the slab under the microscope: 100% confirmed malaria tropicana. Had to take the first tablets there and then, went home, slept, woke up feeling a lot better, ate a bit, took the next tablets, feeling even better. Stayed at home for two days, thereafter felt as if nothing had ever been out of sorts with me.
I only vaguely remember having malaria as a child, but I do know that I had it a couple of times with no lingering/negative effects.
Having written all this you may think that I take a very lax view of malaria. I assure you that I do not. However, I do know that the majority of Western expatriates living in the main cities of countries in the malaria belt have a standard of living that reduces the exposure to malaria bearing mosquitos (airconditioned houses, offices; not surrounded by open sewers with stagnant water) and, not to be ignored, a much better level of health than the average national. With the help of the right medication an otherwise healthy body can cope with malaria so much better than one that is possibly weakened by other diseases, parasites, an unhealthy life and no access to good health care.
Then again, to me diseases/illnesses are part of life; I accept them and deal with them when and if they come along without panicking.
I have seen people leave countries in such zones because the fear of malaria controlled their lives. It is not their fault and I don't blame them because if one calls up any information on malaria the main thing one reads about is about the millions of deaths it causes every year. That probability that your average expat living on a fully loaded oil company compound does not contribute to those figures is not taken into consideration.
From what I know about Angola and supposing that the capital Luanda is your destination it is extremely expensive, if not the most expensive capital in the world. The number of cars compared to the road network is incredible, the congestion outrageous. There is a lot of construction going on which also extends to road works. Should you decide to go make sure the school of your choice is located on your compound or at least within a short driving distance, as should a clinic/lab. I just did a quick online search and came up with the following site which seems to offer good, balanced information. www.expatarrivals.com/angola/moving-to-angola
Sorry that this may have turned out into a bit of a sermon and a waffle.