Malaria

This post will blend our two writers, Daktari and his wife.  One is more scientific, the other more theological
 (the lecture and the sermon).

I like to hunt mosquitoes at night around our house.  I think it’s a part of my service as an infectious disease doctor; I call it “vector reduction.”  And it’s something of a sport, and it’s part of living in Africa.  Sometimes we live in a FarSide cartoon where I can imagine that it’s a big  coup de tat for the mosquito if it can get an ID doc to hit himself in the forehead.  Or the wife of the doc to smack him and say “Mosquito!”

That’s the light part.  You can stop here. Or proceed with caution into the harsher realities.

In terms of malaria transmission, we live in a “hypoendemic” area.  That means there is some around, but not a lot.  We historically would have a case come to my attention once every couple of months.  For those of you who might wonder why, it’s a matter of temperature.  Our weather at Tenwek is too cold for the parasite that dwells within the mosquito to go through its lifecycle.  It’s as though there are zillions of mosquitos buzzing around here that just can’t complete sporogenesis which activates the parasite.

Anyhow, then these past few weeks it’s been unseasonably warm and there has been some more standing water around after the rains, and all of the sudden there’s an epidemic of malaria going on around us.  We’ve had an epidemic of epidemics the last few months: cholera and typhoid for the most part.   

And the richest targets in the world for malaria infection are pregnant women and children under 5 years-old.  86% of malaria mortality is in these two groups, and I’ve seen a few bad cases in the past two weeks.  Women with kids that are just a few days old have been coming into our ICU because a mother’s immune system changes late in pregnancy, to protect the baby from TH2 helper cells.  That is, the security guard of the immune system that tells the body what is self and what is other.  This makes the mom’s health vulnerable so that the baby, who is other than self, will be sustained.  And unfortunately, these are the same defenders that are needed to respond to the malaria parasite.  It is an act of perfect coordination with the Fall of Creation.  The serpent still acts to kill steal and destroy the children of Eve. 

We had a lady who was hanging on by a thread last week in the ICU.  7 days post-partum with a bad case of malaria.  So in the middle of the night last week when the pager went off, I went up to the hospital in the dark and ran the code for resuscitation.  Pounding and pounding and pounding 10 rounds of chest compressions on her- more than any regular patient would ever get in a code.  But her baby needed her to live.  We tried.  And we tried.  And I did not want to let go. But she died.  7 days after giving birth.  And the blood of Abel would cry out again from the ground-

But the blood of Christ speaks a better word than the blood of Abel (Hebrews 12:24).  I do believe that the One Child of Eve has already come to crush the head of that serpent and his parasitical sin-death relationship. The One Child of Eve came that we might have Life.  

The child of the woman in the hospital survived.  He faces tremendous odds in life, but he has a heart beating own it’s own in his chest to praise God.

A few days later, a local gardener, who also had a 7 day-old baby and a post-partum wife, came to our door asking for help because his wife was having terrible headaches.  We brought her in for a malaria smear.  She was unwittingly hosting that parasite that would destroy her if given free reign. But thank God, there is a cure! And she will be fine.   

We may not exude a happy happy happy kind of hopefulness in writing the truth about this work running a hospital’s medical ward and ICU in Sub-Saharan Africa where little to no preventative care is routinely given for patients.  The suffering of humanity is intensely heavy and overwhelming numbers of deaths are encountered weekly. Seven patients died in one day last week.  Seven.  Mind numbing.

How can this be remotely connected to hope?

Then today in church I heard the pastor say, “Hope is the great grandchild of suffering.” 

(Suffering produces perseverance and perseverance produces character and character- hope. Romans 5:3,4). 

Herein lies the Gospel. It must be that the suffering of Christ will do these things, not me, because if it were up to me, the end result of my suffering would be-hardness- bitterness- despair and we’ve been pretty close to it.   Only when we remember the suffering of our Savior will we persevere, and when we recall His perseverance of three days in Hell that broke the power of death then character is formed, and when we see His character in doing all this for love, then only will true deep hope in our hearts amount to anything.  The Gospel encounters suffering with open arms of love. Hope can only live if it’s connected to the Resurrection.  That hope will not disappoint.

The Lord is close to the broken hearted and saves those who are crushed in spirit. Psalm 34:18