Using the brains of people on anti-malarial drugs

The ecstatic measures for reliving trauma

I was reading in the bumper Christmas edition of the Economist [1] that Ecstasy [2] (methylenedioxymethamphetamine or MDMA) is being used to treat Posttraumatic Stress Disorder [3] (PTSD).

Generally, the idea is that people suffering from the disorder under therapy probably have to recollect and go over the causative issues; Ecstasy supposedly suppresses the effects of going over the experiences, hence helping in the amelioration of the disorder towards recovery.

Anti-malarial woes

In conversation with my dad yesterday, I learnt that he had just recovered from a bout of malaria which seemed to have knocked him out for days.

However, in our shared experiences with malaria, the chat moved to the use of anti-malarial drugs the most common type being Chloroquine [4] -based compounds. Nivaquine [5], a trademark drug was probably the bitterest thing I had ever tasted on earth but until I was 10 years old, I did not have any contra-indications to the drug.

My father never had side-effects to the drug but my mother was a classic case of where the doctor should sometimes listen to the patient – she did say she could not tolerate Chloroquine but in his bedside manner prescribed the drug with some other palliative drug to deal with the preconceived side-effects.

Within hours, my mum was in a critical allergic state, all swollen and bloated, the doctor had to call on some reserves of deep knowledge to sort the problem out.

Brain affects from side effects

By the time I was 11, each time I took Nivaquine, my soles and palms itched relentlessly, I could have sworn it was better to suffer pain than to be sentenced to the itch, with time this was treated with an antihistamine until an alternative drug was available for prescription.

This was Fansidar [6] but it came with its own side effects that when I did self-medicate in Nigeria, I took my anti-malarials with an analgesic to manage the headaches, an anti-histamine to manage the itch and a sedative to get some sleep.

The common side-effect experience I shared with my dad was that these drugs increase brain activity to the extent that one is unable to sleep.

My brain began the complex geometric analysis of lines and their relationships in 3-dimensional space; the capacity for the management of that information was just phenomenal. My dad found that he was managing sectors of circles usually up to 30 sectors and rearranging these sectors whilst fitting polygons in the available spaces.

We both wished the brain activity were devoted to some activity aligned to the work we do which might then be of some serious benefit.

Meanwhile, another good friend I spoke to yesterday had just returned home from Nigeria and was also knocked out by malaria but it seemed what it did the most was realign his body-clock such that he became a diurnal sleeper rather than the normal nocturnal sleeper.

Using a hyper-active brain for research

Just like in the use of Ecstasy, there should be some benefit to harnessing the brain activity in these side effects. Just as computers are linked up in tandem to solve problems or discover patterns for protein analysis or extraterrestrial intelligence, maybe, just maybe when the brain is enduring this high capacity information manipulation it could be inspired or injected with some intractable problem and all that processing offers amazing and ingenious solutions that sober minds cannot begin to fathom.

Obviously, this is one area of testing that would definitely not work with conventional animal testing and so beyond the ethical issues of the administration of these drugs and the modalities for finding suitable guinea-pigs for this experiment which can be conducted along the lines and strictures of semen or egg donors, there might just be some benefit for mankind.

Bizarre research

The question then becomes whether this area of research should be based in malaria ridden countries where we harness the brain power of recuperating sufferers or it be based in established research centres where people are administered the drug to create the side effects in better managed conditions.

Bizarre as it sounds, I think this is one area of research worth looking at, through the pain and discomfort there might well be a yet undiscovered treasure trove of human ability behind the veil of the therapeutic or the prophylactic management of malaria.

Sources

[1] Agony and ecstasy | Agony and ecstasy | The Economist

[2] Methylenedioxymethamphetamine - Wikipedia, the free encyclopedia

[3] Posttraumatic stress disorder - Wikipedia, the free encyclopedia

[4] Chloroquine - Wikipedia, the free encyclopedia

[5] Nivaquine – netdoctor.co.uk

[6] Fansidar (discontinued in the UK - January 2008)

Yar'Adua - Catching his breath in Germany

He is only human

The developments now indicate that Alhaji Umaru Musa Yar'Adua is quite alive and able to chat by phone to a BBC correspondent.

Even so, it would appear that both the Times of Nigeria and ThisDay Online have been purveyors of falsehoods most despicable, the latter indicating that he had collapsed with something approaching multiple organ failure and that was then exacerbated by the non-scoop of the former announcing his death.

The Alhaji apparently began suffering from breathlessness and probably exhaustion most definitely due to the gruelling campaign trail, this is understandable.

The lament goes out that there could not be found in the length and breath of Great Nigeria a physician, a doctor or even a diviner who could treat this presumably benign condition that he had to be flown to Germany in what would have been a depressurised cabin at high altitude to get treatment.

This does not begin to illustrate the farce that this episode has become as I have time and again agonised over the fact that with all the resources and brains we have in that great country, nobody of any means would deign to visit a local doctor if they had opportunity to see a foreign one in Europe or America.

Usually, it is Europe which is closer that gets the most patronage.

Doctors in the know not

Except in cases where this foreign general practitioner has become a family doctor from afar, many expect the doctors or consultants versed in Western medicine, Caucasian ailments and highly sanitised conditions to divine or guess without empirical evidence from observation, the medical problems of wealthy Africans without the benefit of a professional record of medical history apart from a quick-fire question and answer round about whether you feel this or have experienced that.

Such is the folly of this debacle turning into a joke, where the comfort of being poked by strangers for a great price gives us the satisfaction that all is well. Considering anyone suffering from a strange fever would probably be quarantined as a significant health risk before someone cottons on the fact that it is everyday Malaria.

Many a time, some Malarial patients have had to abscond hospitals through bathroom windows to get treatment from traditional decoctions and herbs than be turned into an experimental chimera through the ignorance of arriving at the right prognosis sometimes late or even never.

Wherefore the health of the nation?

In the end, it is Nigerians that have been done a disservice; we launch people out of teaching hospitals, many of whom have never had the privilege of serious practical medicine because of the lack of proper training conditions and infrastructure.

They then become doctors whose appreciation of pain and distress is so deadened, it is a suicide wish to visit hospital - having professors of medicine run the Ministries of Health has simply been a political exercise than one of having technocrats really address this travesty.

Sub-standard and at times fake drugs get administered in teaching hospitals; it makes hell feel like a better place to visit and all the Health Minister could say was that the file had only been sent to his predecessor and not to him - at which point, even I was breathless with apoplectic rage.

But this is the reality of things in Nigeria; until the rich can trust our medical infrastructure enough, no matter the cost and then this trust along with market forces and demand begins to make this service affordable, no government in Nigeria should have the temerity to suggest that they have done anything in the service of their people.

Without the assurance of the health of a nation all other achievements are as dust and these sudden journeys to cure breathlessness in the West would just be signposts of the fact that Nigeria is probably just another large Bantustan - a Fourth-World country in stagnation and drawing backward.

What exactly is wrong with me?

The scramble on all fours

There was a time in West Africa as Europeans traverse the land exploring, charting and discovering land, people, rivers, resources and trade route that this area was know as the White Man’s Grave – the scourge of malaria and yellow fever decimated who dared visit.

However, the knowledge of the land did help in what eventually became known in history as the Scramble for the Partition of Africa. My vision of scramble makes those conquering tribes look more savage than the natives and the land they were scrambling for.

To paraphrase the Merriam-Webster Online Dictionary, it involves moving or climbing on all fours to struggle unceremoniously for a possession – Africa’s land, people and resources.

Dragons be there in the unknown

However, know the lay of the land is very useful, but that common knowledge is hardly available to the Chinese whose government considers topological maps classified and even edits out certain detail of maps ensuring they are too unreliable for motorists to consider using those directions for journeys to the hinterland.

Dragons be there, begins to make sense.

However, reading the travails of my friendly blogger in Nigeria on NaijaBlog as he tries to shake off the problems with malaria and other diagnosed issues, I do wonder about how health issues in Africa are properly addressed for the main populace.

Trivialising malaria

I do remember in when I lived in Nigeria, every fever was classified as malaria and we almost all self-medicated especially where there was no health insurance with a family doctor service attached.

Fortunately, in my early years, we always had the luxury of a family doctor and treatments that dealt with most ailments that afflicted us.

The treatment for malaria then involved the ingestion of a component of quinine normally as chloroquine sulphate and marketed as nivaquine. My father was always able to use that medication without problems; my mother however could not tolerate that drug.

At that time doctors were aware of the intolerance and contra-indications usually manifesting as itching palms and soles that it was sometimes administered intramuscularly with an antihistamine.

None of which worked for my mother despite the fact that she did tell the doctor who thought he knew better that the drug should be off limits – he eventually learnt as my mother bloated up in reaction to the drug – an emergency ensued and eventually she was fine.

Banking on the inefficient

Then, I never knew malaria was that much of a scourge as we all considered it to be, so it is sad that as we marked the Africa Malaria Day, the World Bank was found wanting in the way they publish results, offer financial assistance and provide effective drugs for the treatment of malaria.

This accusation appeared in the Lancet a very reputation science journal and is corroborated in the flimsy defence that the World bank gives as to the projected spends rather than what they have done.

I would hate to question the competence and vision of the president of the World Bank Paul Wolfowitz (neo-con proponent of the Iraq War as US Deputy of Defense under Donald Rumsfeld) in ensuring that the goals of the World Bank are met effectively, efficiently, fully and accountably most especially in public health issues all around the world.

This topic is not one of those where governments have to meet the political, moral or economic pre-requisites of the American sense of good governance but one of urgency in preventing catastrophe in desperately affected areas.

Diagnosing the Brief Illness

The more serious issue pertains to a disease called Brief Illness because a majority of published obituaries in the Nigerian newspapers seems to have people who have succumbed to Brief Illness.

Maybe for reasons of circumspection the real causes of death cannot be published most especially if it is related to AIDS, there is another problem of proper diagnosis on the one hand and the other of useable medical histories.

From the tale of my NaijaBog friend, arriving at a proper diagnosis has been fraught with convention and opinion; the former on the assumption that he has malaria and the latter that it might be typhoid or something else.

It is a shame that there is no proper codification or analysis to pin this issue down, that he has therapeutic amelioration for malaria only to end up with another diagnosis related to some bacterial infection.

Many Nigerians do not have the benefit of a good diagnosis of their ailments for effective treatment to be administered for a guaranteed recovery for diseases and ailments that would not last days in better-equipped and knowledgeable settings.

You are now because of history

Where we have Nigerians of means who can avail themselves of international medical expertise; the lack of a medical history or poor knowledge of genetic issues leave doctors in the West having to deduce problems, which may not be common to their demographic.

For instance, cosmetic surgery works well for Caucasians, but those activities require a different approach with black skin for the fact that scarring is more obvious.

The lack of knowledge of pre-disposed, pre-existing, congenital or even tropical conditions when consulting Western medical personnel means paying for care will not result in an equivalent cure.

Personal miracles lacking verifiable proof

Beyond medicine we have the hold of herbal or traditional medicine where medicine men, witch doctors or even religious soothsayers offer all sorts of cures for every kind of ailment.

There is a possibility and many do get cured from their testimonies, but not many can provide medical proof of a pre-existing condition that has received a touch of the miraculous.

Part of the society is also entranced by superstition that it is possible for some to believe that a serious or chronic medical condition is as a result of some voodoo activity of enemies or detractors.

The witch doctors feed into this mentality milking the victims of all resources, comforting the hapless customer with fear in the hope that some remote coercion can lift the hex off the person leading to a cure.

It makes you wonder which century we are in.

Tackling the bottlenecks

The approach to medicine in Africa needs to change; we have not been able to grapple with healthcare enough to address health properly.

The governments and ministers who thwart every attempt to objectively address health issues with religious and ignorant pronouncements need to be brought to book first then condemned for trying to turn that challenge to their rotten opinions into a race or religious argument.

We cannot continue to sacrifice Africans to ideology and politics when there is much to be done to deal with issues that decimate some of our most productive talent and resources.