My Story of Survival

Malaria kills 2,900* Liberians each year and it nearly killed me. If access to better malaria care existed, we could all be survivors.

View from the Ducor Palace Hotel in Monrovia, Liberia. / Jessica Benton Cooney, USAID

Each December, I mark my anniversary of triumphantly surviving cerebral malaria — a complication from the parasitic infection that can lead to brain injury or death.

I was infected with malaria in 2012 while living and working in Liberia on an international development project for USAID. About two weeks after a weekend trip to Robertsport, a small rural surfing village about two hours from Monrovia, I started to notice the tell-tale signs of malaria — dehydration, severe fever and chills.

When I was unable to walk or even lift my head, I went to a small public health clinic in Monrovia. There, I initially tested negative for malaria through a rapid diagnostic test — which normally detects antigens or proteins produced by malaria parasites in the blood.

At home, I retreated to my bed. After soaking several layers of bedsheets and suffering severe pain that felt like pins and needles coursing through my body, I went back to the clinic — assisted this time by hotel staff and my project driver down several flights of stairs.

Injected with fluids into a vein to counter dehydration, I was diagnosed with severe malaria. I was engulfed in pain, yet I was again sent home.

Nurses from Owensgrove Clinic in Grand Bassa County, Liberia who treat patients with malaria and other everyday infections and diseases. / Jessica Benton Cooney, USAID

That night I went to sleep, and I didn’t wake up. I had fallen into the unrousable coma that can accompany cerebral malaria as parasite-filled blood cells block small blood vessels and cause brain swelling.

Unable to reach me by phone, my worried colleague and close friend found me unconscious in my room the next morning. Assisted by others, she rushed me to emergency care.

Two days later, I awoke disoriented and confused by my inability to clearly form words. My arms had been marked and tracked by various tubes sticking out of my veins.

While I was out, an ad hoc team had come together to plot my medical care. This included a clinic doctor and nurse, two close friends, the Peace Corps program doctor, my project supervisor and his wife. Someone remained at my bedside around the clock.

At the doctor’s suggestion, they decided to medevac me to Paris as a precaution in case the Liberian clinic was not able to handle such a severe case of malaria.

When the time came, we drove for an hour to the airport in an old pre-Liberian civil war ambulance. I waited for several long hours on the tarmac in the searing west African heat, with severe head pain. Incredulously, we were informed that an eagle had been sucked into the plane while landing. A mechanic had to be sent overnight from Paris to fix the plane.

Children outside Voinjama, Liberia in March 2013 in a village the author visited during her time working on the USAID-funded Advancing Youth Project, which provides basic education, job training and leadership skills for young Liberians. / Jessica Benton Cooney, USAID

Finally flying over Liberia the next day with a team of paramedics, I reflected on all the other Liberians who don’t have access to medical treatment for malaria, the leading cause of death for the 4.2 million people in this country. One in 11 Liberians die of malaria before their fifth birthday.

Many people here — largely those in the poor, rural areas far from Monrovia — must walk for miles to seek treatment, especially during the rainy season when the roads are impassable by vehicle. For those that can reach a clinic, they still are unlikely to have access to quality, life-saving care.

Yet there is increasing hope of combating the disease, even in the poorest of settings where malaria flourishes, as USAID is arming women, children and families with cost-effective tools to prevent themselves from contracting malaria.

The President’s Malaria Initiative (PMI), led by USAID and implemented with the Centers for Disease Control and Prevention, has played a major role in reducing malaria transmission by distributing mosquito bed nets, spraying homes to eliminate mosquitoes, diagnosing and treating the disease, and administering preventative treatment for pregnant women — who are disproportionately at risk.

Launched in 2005, PMI today works in 19 focus countries in sub-Saharan Africa and the Greater Mekong sub-region in Asia.

Liberian midwives from villages in Grand Bassa County, Liberia. / Jessica Benton Cooney, USAID

After President Barack Obama’s call to end malaria worldwide in his final State of the Union address earlier this year, he requested an additional $200 million to fight malaria, citing malaria control as a central pillar of U.S. foreign policy and essential to building a more stable and prosperous world.

Although the number of children killed by malaria has been halved since 2000, and more than 6 millions lives have been saved, we still have a long way to go in this decades-long battle in Liberia and across the globe.

If Congress approves the request, ambitious new PMI programs are poised to provide nearly 70 million at-risk Africans with access to insecticide-treated nets, anti-malarial drugs, and other interventions.

In partnership with host governments, NGOs and other partners, the United States will also collaborate to eliminate malaria in Zambia and Cambodia through testing the drug resistant to malaria. And nearly 14 million bed nets will be replaced with new ones, ensuring that 27 million people in sub-Saharan Africa can sleep soundly at night.

Critically in Liberia, community-level public awareness campaigns via radio, posters and community mobilizers are also working to encourage early treatment — which is vital for survival.

A doctor from the Owensgrove Clinic in Grand Bassa Country, Liberia under a poster promoting sleeping under nets to prevent malaria. / Jessica Benton Cooney, USAID

Even for those who survive malaria, the fight is often not over. Until a vaccine is widely available, many remain susceptible to reinfection despite recent health victories in Liberia.

Similarly, despite all the care I received in Liberia, and later in Paris, my malaria recuperation was far from over after I left the hospital and returned home.

In addition to severe anemia, a series of ophthalmology exams and an MRI revealed that the brain swelling from the cerebral malaria had pushed up against my optic nerves and caused partial blindness in my left eye. Unfamiliar with such a case, my ophthalmologist was unable to offer comfort or hope of a full recovery.

Luckily, over the next several months my vision did slowly come back on its own. I also worked to regain my physical strength, ravaged by anemia.

Then, I returned to Liberia.

I celebrated my victorious arrival back to a country and to people I had come to love. With my ordeal freshly behind me, I was humbled to be in a place that taught me so much professionally and personally about resilience.

While the malaria war continues to rage on in Liberia, I remain hopeful that collective efforts will continue to reduce the fatality rates of this preventable disease.

This time, when I left in July 2013, I took a commercial flight home.

Self reflections in the Oslo Opera House in Norway: The author takes a self-portrait during a layover while traveling the long way home from Liberia. / Jessica Benton Cooney, USAID

*Figure was calculated as follows: 69 annual malaria deaths per 100,000 people; Liberia’s population estimated at 4.2 million.

About the Author

Jessica Benton Cooney is the Communications Specialist for USAID’s Center of Excellence on Democracy, Human Rights and Governance. Before joining USAID, she lived and worked in Liberia and Afghanistan, telling the story of several USAID partner organizations. She also covered elections, politics, and the House of Representatives as a staff writer and production editor for The Congressional Quarterly in Washington, D.C.

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