I am one of 500 million people to become seriously ill from malaria this year.

Chances are you do not spend the better part of your day worrying about malaria. To you, a mosquito is a nuisance, not a killer. Malaria is all but extinct in the first world, a blessing the extent of which you will probably (and hopefully) never truly comprehend. In those countries too poor to eradicate or even properly combat the disease, however, malaria is responsible for more deaths than anything else. Three thousand children in Africa die EVERY DAY on account of the disease - one child every thirty seconds.

Its confinement to the underdeveloped world, however, comes as a result of extensive anti-malarial programs in the West during the first half of the 20th century. Malaria is very much a part of our history. Three U.S. presidents (Washington, Lincoln, and Grant) suffered from the disease. During the Civil War, one million soldiers in the Union Army died from it; during WWII, malaria killed more people (in the Pacific arena) than combat. Even more shocking, according to a recent article in The National Geographic, “one out of every two people who have ever lived have died of malaria.”

I did not know any of that when I fell victim to the disease while living in northern Uganda. All I knew was that my overpriced anti-malarial medication hadn’t worked. I felt like I was going to die. The night I became sick was the longest and loneliest night of my life. I spent the first ten hours lying on my back unable to move or to speak. Every time I opened my eyes I saw nothing but the walls spinning and swirling around me. I felt nauseous and dizzy. I felt excruciating pain in my head. I felt cold. It was probably 95 degrees and I was shivering so badly my muscles ached. I put my towel over my sheet for warmth. Then all of a sudden I became unbelievably hot. I felt like my body was cooking itself to death (the fever associated with malaria, which often proves fatal, is the body’s futile attempt to cook the parasites to death. I was terrified. I knew it would be days before I could see a doctor and even longer before I could reach an actual hospital.

Even then, in between the explosions in my head, I could see the irony of my pre-departure anxiety over not having health coverage. All the medical insurance in the world would not have changed the fact that I was hundreds of kilometers of virtually impassable road from the nearest hospital. In Pader, there are only two options for the sick - health clinic or spiritual healer - and from what I had gathered there was little difference between the two in terms of actual treatment. A woman who worked at the so-called guesthouse where I stayed was tested for malaria at the clinic; the needle used to draw blood left her arm with a gaping and infected wound. Unable to treat it, the wound opened up into a hole the size of a quarter. She showed it to me and I could see all the way through to her bone. At night I could hear her sobbing from the pain. I gave her my small bottle of Ibuprofen. It barely made a difference.

There are no doctors in Pader. The health clinic is staffed by one woman who does not have the resources or the expertise (or the inclination) to treat the multitude of patients who sit quietly outside the building, waiting, praying, and dying. For them, malaria is more often than not a death sentence. Even those lucky enough to survive it are often left with severe neurological damage. People in this part of the world cannot access or afford treatment. It took me four days to receive medication; a day or two longer and I would have been beyond help, as is the case with nearly everyone else. The United States was able to completely eradicate malaria in just four years; in most of Africa it remains the number one killer precisely because people infected with it are forced to wait outside health clinics for days only to discover that these clinics do not have the drugs needed to combat the disease. They are simply sent home to die.

The small hospital I went to four days after my blood became infected was founded by missionaries. There are no government hospitals, and the few hospitals that exist rely entirely on donations. I remember feeling humbled and ashamed by what I saw there. People walked unbelievable distances to reach this hospital. They walked so far their feet bled (very few people could afford shoes, and the ones that could would not have needed to walk). During the height of the war in 2002 and 2003, the hospital had been a sanctuary. Children would arrive at its gates every night just before dark in order to sleep safely. Called ‘night commuters’, they made the journey (which was often 10-15 kilometers) night after night in order to avoid being abducted or killed by rebels. One night a nurse pointed out to me a group of about twenty sleeping children; despite nearly a year of peace, some still made the journey every night, a testament to the terror of this war. The walls of a tiny hospital made them feel safer than all the government soldiers in Uganda.

I was dumbfounded to learn how much a round of Coartem (an anti-malarial drug) at this hospital costs: 1,500 Ugandan shillings, which is roughly $0.85. Eighty-five cents! Can you imagine? If a drug with the power to cure malaria costs $0.85, why does it take four days and an American passport to get it? Pader is home to offices of the World Food Programme, the UN High Commissioner for Refugees, the UN High Commission for Human Rights, UNICEF, Save the Children, International Committee of the Red Cross, to name a few. So why are people still dying by the thousands from this treatable disease? Despite the UN programs to fight malaria, the infection rate is actually on the rise. And it is easy to see why: the hospital had stocks and stocks of anti-malarial medications but people had no way of getting there to receive them. There are only two ambulances in all of Pader district to bring people to the hospital. Two! And they only operate during business hours on weekdays, when it hasn’t rained. It’s unbelievable.

I can never donate blood again, and my malaria could flare up once, twice, three times a year for the rest of my life. Every time I feel a twinge in my head or experience a slight fever I have flashbacks, and I am loathe to admit that I have become a bit of a hypochondriac. But I consider myself to be incommunicably fortunate. I have an appointment with a doctor at Dartmouth Hitchcock’s Center for Infectious Diseases in a few days and I will always have access to the medicine that I need. I am one of 500 million people to become seriously ill from malaria this year, but I will not be one of the roughly three million who will die from it.

The 2006 ICSAA Participants recommended that immediate attention and action be taken to increase prevention efforts against diseases such as malaria and HIV/AIDS in ways that do not only focus on curing the diseases but also on providing awareness education to prevent the forms of discrimination and the cultural stigma the sick confront within their societies.