Larium Is No Good
Peace Corps Medical switched my malaria meds to Doxycycline a couple weeks ago. It wasn’t just that the other medication, Larium (mefloquin), was making me depressed and irritable. I was in a constant state of seething anger, convinced I hated all Kenyans, and yet I was paranoid all the time that I had unknowingly offended someone and they would want to seek revenge on me some dark night as I was walking to the choo, or that I had expressed an opinion that violated some Peace Corps policy and I would be administratively separated from my service. I felt insecure, hypersensitive, and socially inept in a way I haven’t felt since seventh grade. I would wake up feeling inexplicably stressed out every morning, even though I had slept soundly. I had no firm grasp on reality, and no perspective. I believed I was perfectly capable of homicide.
And yet, the side effects were subtle enough that it didn’t occur to me that it was the Larium. The longer I’m off Larium the more I realize how profoundly it was affecting me. Living in Kenya is stressful with or without Larium, but after awhile I seemed to be devoid of any coping mechanisms, including a sense of humor. Instead of going outside or writing or finding some other outlet when I was stressed out, I just laid in bed staring at my mosquito net. Larium also seemed to exacerbate every emotion I experienced, so for months I thought I had discovered a new mental illness, called Peace Corps bipolar disorder (PCBD). Tiny things would send me into a flying rage or a deep, immobile depression, or make me maniacally happy, but there was never anything in between. In the moments when I felt good, it was giddy and precarious, like it could disappear suddenly. And afterwards I would feel exhausted. Emotional stability eluded me.
Over New Year’s I met a bunch of PCVs who had switched off Larium and reported amazing improvement. One PCV stopped hallucinating that her cat was a giant saw-toothed monster who was trying to eat her. Another PCV stopped bursting into tears for no reason. I am no longer paranoid all the time, and my sense of humor has returned.
Someone told me that Peace Corps is one of the few organizations that still prescribes Larium as the malaria prophylaxis of choice. The U.S. military stopped prescribing it because too many soldiers, uh, went crazy, or suffered long-term emotional problems, even after they returned home. Everyone reacts to Larium in different ways, but I can see how Larium would be particularly bad for people who are thrust into extremely stressful or traumatic situations, like soldiers and Peace Corps volunteers. It exacerbates emotional responses and strips you of your normal ability to deal with adversity. Some people have really bad nightmares, depression or anger, while the lucky ones get trippy dreams that they say keep them sane. I used Larium when I went to China for three weeks, and didn’t have any problems. I used it in Kenya for over seven months, and in retrospect I was probably starting to experience side effects after two months.
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Fellow PCV Eric gave an interesting analogy about Kenyans and HIV. He told a fable about a storm that came and flooded a man’s house. The water rose so high that he had to stand on a table to keep from getting wet. A neighbor came by and said, “Come with me. I have a car and we can escape together.” The man said, “No, I’ll be fine because the Lord will protect me from any harm.” The water kept rising until the man had to climb onto his roof to avoid being swept away and drowning. A neighbor came rowing by in a boat and said, “Come with me. I have this boat that will save us from drowning.” The man said, “No, I’ll be fine because the Lord will protect me from harm.” Well the water kept rising and swept the man to his death. When he saw God in heaven he said, “God, you said you’d always protect me from harm, yet you let me die in the flood. Where were you?” And God said, “I sent your neighbor with a car and another neighbor with a boat to help you, and both times you turned them down.”
In his community people know about HIV. They know how it’s spread and how to prevent it. But yet they have multiple partners and they don’t use condoms. They assume that the Lord will protect them, but they don’t see the information and free condoms that are available to them as God’s way of offering them help in fighting AIDS. Eric’s organization provides support to people living with AIDS (PLWAs), and 80 percent of the clients are women who got AIDS from their husbands. He asked one of the counselors at his organization why Kenyan men refuse to use condoms.
The counselor said, “They think they can’t feel any pleasure when they use a condom.”
“Maybe it’s more pleasurable for them to die of AIDS,” Eric said. God bless New York honesty.
My village is not as far along as Eric’s community, which is close to Kisumu. Today a kid around 20 years old came into the VCT for an HIV test. Afterwards he told me he wants to mobilize the high school and college-aged youths at his church to educate each other about AIDS. He said most youths are either getting false information or no information at all about HIV—what it is, how it’s transmitted and how to prevent it.
Before I came here I would have thought that was ludicrous. Everyone in the U.S. knows the basics about HIV and AIDS. But we have clients coming into the VCT freaking out because they’ve just attended a session about HIV conducted by Catholic priests. They have a wild, nervous look in their eyes and after hemming and hawing for a few minutes they say they want an HIV test because they just learned that condoms have holes in them. I never thought I’d see the day when the phrase “condoms have holes in them” would send me into a blind rage. Religious leaders – the people who are supposed to be role models in their communities – are willing to risk – no, not just risk – they are willing to be the cause of people’s deaths – by lying to further a political agenda of behavior control based on some arbitrary perversion of God’s message about sexuality.
The fight against AIDS is complex in Africa. There’s so much money pouring in from foreign governments, NGOs and private donors (think Bill and Melinda Gates Foundation) with noble intentions, and plenty of beneficiaries with genuine needs. But there are also opportunists who know that getting involved in the “noble fight” can be a very lucrative business. These opportunists are high-ranking politicians, 50-year-old village widows with an 8th grade education, and everyone in between. Many of them use the money and the cause to further their own agendas of keeping women disempowered, keeping congregations fearful of divine repercussions for “immoral” behavior define by themselves, keeping the rural poor dependent on leaders who are their only source of information about HIV, about resources, about money. Plenty of people lie about being HIV positive because they can get free food and they can secure microloans to start small income-generating projects, except that many people use the money to pay for school fees or medicine and then default on their loans. Anywhere there’s money in Kenya, there’s corruption at the expense of those who are already the most vulnerable populations. The corruption is in government, in churches, and now, in the fight against AIDS.
And yet, the side effects were subtle enough that it didn’t occur to me that it was the Larium. The longer I’m off Larium the more I realize how profoundly it was affecting me. Living in Kenya is stressful with or without Larium, but after awhile I seemed to be devoid of any coping mechanisms, including a sense of humor. Instead of going outside or writing or finding some other outlet when I was stressed out, I just laid in bed staring at my mosquito net. Larium also seemed to exacerbate every emotion I experienced, so for months I thought I had discovered a new mental illness, called Peace Corps bipolar disorder (PCBD). Tiny things would send me into a flying rage or a deep, immobile depression, or make me maniacally happy, but there was never anything in between. In the moments when I felt good, it was giddy and precarious, like it could disappear suddenly. And afterwards I would feel exhausted. Emotional stability eluded me.
Over New Year’s I met a bunch of PCVs who had switched off Larium and reported amazing improvement. One PCV stopped hallucinating that her cat was a giant saw-toothed monster who was trying to eat her. Another PCV stopped bursting into tears for no reason. I am no longer paranoid all the time, and my sense of humor has returned.
Someone told me that Peace Corps is one of the few organizations that still prescribes Larium as the malaria prophylaxis of choice. The U.S. military stopped prescribing it because too many soldiers, uh, went crazy, or suffered long-term emotional problems, even after they returned home. Everyone reacts to Larium in different ways, but I can see how Larium would be particularly bad for people who are thrust into extremely stressful or traumatic situations, like soldiers and Peace Corps volunteers. It exacerbates emotional responses and strips you of your normal ability to deal with adversity. Some people have really bad nightmares, depression or anger, while the lucky ones get trippy dreams that they say keep them sane. I used Larium when I went to China for three weeks, and didn’t have any problems. I used it in Kenya for over seven months, and in retrospect I was probably starting to experience side effects after two months.
------------
Fellow PCV Eric gave an interesting analogy about Kenyans and HIV. He told a fable about a storm that came and flooded a man’s house. The water rose so high that he had to stand on a table to keep from getting wet. A neighbor came by and said, “Come with me. I have a car and we can escape together.” The man said, “No, I’ll be fine because the Lord will protect me from any harm.” The water kept rising until the man had to climb onto his roof to avoid being swept away and drowning. A neighbor came rowing by in a boat and said, “Come with me. I have this boat that will save us from drowning.” The man said, “No, I’ll be fine because the Lord will protect me from harm.” Well the water kept rising and swept the man to his death. When he saw God in heaven he said, “God, you said you’d always protect me from harm, yet you let me die in the flood. Where were you?” And God said, “I sent your neighbor with a car and another neighbor with a boat to help you, and both times you turned them down.”
In his community people know about HIV. They know how it’s spread and how to prevent it. But yet they have multiple partners and they don’t use condoms. They assume that the Lord will protect them, but they don’t see the information and free condoms that are available to them as God’s way of offering them help in fighting AIDS. Eric’s organization provides support to people living with AIDS (PLWAs), and 80 percent of the clients are women who got AIDS from their husbands. He asked one of the counselors at his organization why Kenyan men refuse to use condoms.
The counselor said, “They think they can’t feel any pleasure when they use a condom.”
“Maybe it’s more pleasurable for them to die of AIDS,” Eric said. God bless New York honesty.
My village is not as far along as Eric’s community, which is close to Kisumu. Today a kid around 20 years old came into the VCT for an HIV test. Afterwards he told me he wants to mobilize the high school and college-aged youths at his church to educate each other about AIDS. He said most youths are either getting false information or no information at all about HIV—what it is, how it’s transmitted and how to prevent it.
Before I came here I would have thought that was ludicrous. Everyone in the U.S. knows the basics about HIV and AIDS. But we have clients coming into the VCT freaking out because they’ve just attended a session about HIV conducted by Catholic priests. They have a wild, nervous look in their eyes and after hemming and hawing for a few minutes they say they want an HIV test because they just learned that condoms have holes in them. I never thought I’d see the day when the phrase “condoms have holes in them” would send me into a blind rage. Religious leaders – the people who are supposed to be role models in their communities – are willing to risk – no, not just risk – they are willing to be the cause of people’s deaths – by lying to further a political agenda of behavior control based on some arbitrary perversion of God’s message about sexuality.
The fight against AIDS is complex in Africa. There’s so much money pouring in from foreign governments, NGOs and private donors (think Bill and Melinda Gates Foundation) with noble intentions, and plenty of beneficiaries with genuine needs. But there are also opportunists who know that getting involved in the “noble fight” can be a very lucrative business. These opportunists are high-ranking politicians, 50-year-old village widows with an 8th grade education, and everyone in between. Many of them use the money and the cause to further their own agendas of keeping women disempowered, keeping congregations fearful of divine repercussions for “immoral” behavior define by themselves, keeping the rural poor dependent on leaders who are their only source of information about HIV, about resources, about money. Plenty of people lie about being HIV positive because they can get free food and they can secure microloans to start small income-generating projects, except that many people use the money to pay for school fees or medicine and then default on their loans. Anywhere there’s money in Kenya, there’s corruption at the expense of those who are already the most vulnerable populations. The corruption is in government, in churches, and now, in the fight against AIDS.
posted by Justina at 9:05 PM
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