This is the first in a series of ‘Dogmeat Diaries’ by Ashley South that we shall be publishing. (Read below for an explanation about the title choice.) The Dogmeat Diaries recollect (not necessarily accurately) and reflect upon South’s experiences working in Burma/Myanmar over several decades.
CW: This post includes language around self-harming behaviour and suicide that might be triggering.
My first experience with malaria was the worst, although the second was pretty bad too. These were the only two times in my life I’ve been on an intravenous drip. The only other time I thought I was going to die was when I crashed my car (again) in 1996.
I’ve had malaria about 20 times – although I can’t be sure exactly because I learned how to self-diagnose, and medicate with Artesunate and Meflaquin. During the mid-to-late 1990s I was travelling regularly in Karen National Union (KNU) 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 and refugees we stayed with had none of these things. Of course, as a foreign aid worker, I had many more options than the refugees I was helping. These days, I make sure to slacken plenty of mosquito repellent, and wouldn’t dream of sleeping in the jungle without a bed-net.
Towards the end of my stint working with the refugees along the Thailand-Burma border (1994-97), I had built up some resistance and was throwing off a fever every six weeks or so, without thinking much of it. I would barely take the afternoon off work, and more than once made the five-to-six hour drive from Sangkhlaburi to Bangkok with a high fever, and veins full of quinine derivatives, Red Bull and paracetamol.
I decided that the best way to regain strength after a bout of malaria was eating dogmeat (good for boosting energy) fried in garlic. However, I had to explain to General Shwe Saing (commander of the 6 Brigade) 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 (plasmodium vivax) malaria produces a devastating hangover. I still shudder to recall my dark brown piss during bouts of PV, full of dead blood cells: thus ‘blackwater fever’.
The first time I picked up malaria was on the Tanintharyi River, way down south in Burma, in 1992. By the time I got back to home-base in 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 KNU headquarters at Mannerplaw, 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 told I had severe PF (plasmodium falciparum) malaria. 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 remember the utter exhaustion when I got back to my bare wooden bed, first time I managed to walk to the outhouse and back. I was pleased to piss unassisted; afterwards I slept deeply for several hours. It was several weeks before I was strong enough to return to teaching.
I was surprised and slightly hurt by how un-moved most local 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 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 needle out of my arm!” She just giggled – but looked worried. When the hallucination subsided, I found myself bursting into snippets of a half-remembered teenage punk anthem, which also rather alarmed E-. After a while (I don’t know how long; 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 and self-dramatisation, 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 an amazing 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.
The only other time I suffered real psychological impacts from malaria was as a result of medication, rather than the little parasites I had sort of got used to swimming in my blood. I’ve since learned that mefloquine is notorious for driving some people loopy.
I was back at work after another bout a few years later, although not really better. I had dosed myself with Artesunate (derived from tree-roots in China, and the last remaining cure for PF malaria in these parts, at that time), mefloquine (of which the malaria parasite was robustly tolerant, but which supposedly stopped the little rascals developing resistance to Artesunate), and paracetamol (to damp down my fever). Having spent a hot and sweaty afternoon in a refugee camp, where I was helping to make supplies, we were back at the Mon relief committee’s office in town, sitting round a table on their wide, hardwood veranda. This was a relatively important meeting with UNHCR (the UN refugee agency), which was always reluctant to become involved with the Mon refugees – despite the Thai authorities repeated campaigns to forcibly repatriate them to Burma.
I had kept it more-or-less together during the camp visit, but now exhaustion and illness were seeping from every pore, together with the hot season sweat I had been expelling all day. I wanted to crawl into a corner and sleep it off. My other great and inexplicable desire was to fling my arms around Nai K- and Nai D-, and tell them that I loved them, and respected them more than anyone else in the world. While this was a sincere sentiment, I don’t think my friends would have welcomed its expression, especially in this context. Still, in retrospect, it might have been worth it just to see the expression on the UN bureaucrats’ faces.
As it was, I restrained myself, playing little part in the conversation. Instead, I fiddled with the package I needed to deliver to the Mon refugee authorities, once the UN officials had departed. For legitimate (confidential) reasons, this contained about $20,000 cash in Thai Baht, for refugee supplies. This was before the days of the 1000 Baht note, and therefore constituted a fairly bulky package. Wrapped in brown paper and tied with string, it began to disintegrate as a result of my inattentive fidgeting, and profuse perspiration. I found myself scrabbling under the table, attempting to surreptitiously retrieve soggy, pink 500 Baht notes. No one said a word.
Dr Ashley South is an independent author, researcher and consultant, and a Research Fellow at Chiang Mai University in Thailand. Between 1992 and 1994, Ashley worked as an English teacher along the Thailand-Burma border. This was followed by three years coordinating relief supplies to ethnic Karen and Mon refugees and internally displaced people, who had fled armed conflict in Myanmar. Since then, he has mostly worked as a consultant for the aid industry and in academia, focusing on ethnic and humanitarian politics in Myanmar, and the southern Philippines.
Most of his publications are available at: www.AshleySouth.co.uk.