Malaria survivor living with effects four years on

EIGHT tiny bug bites, red spots that Kristine Silvestri knew she’d done everything she really could have to avoid.

She’d arrived in Ghana to pursue her studies and gain experience working alongside the country’s politicians, fully aware of the scourge of mosquito-borne malaria.

Now she was looking at these eight angry bumps and wondering if one of them was the reason she was suddenly feeling feverish and unsettled.

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“I woke up and knew right away something was wrong. I knew I had these bug bites, I knew it was suspicious,” she recalls. “I was so mad. I’d done everything I was supposed to do. It wasn’t fair.”

Bad enough that it seemed likely that, despite her best efforts, she might have contracted malaria.

Far worse that it would go on to threaten her life ...

Surprising that now, more than four years later, she is still battling the after-effects of the tropical
disease.

The full dramatic impact of how malaria can rip families apart will be told tonight in a television feature-length film starring award-winning actresses Brenda Blethyn and Hilary Swank.

They play two mothers who in other circumstances would never have met but find themselves thrown together after both lose a son to
malaria.

Written by Richard Curtis – who also penned Love Actually and Notting Hill – the fictional drama follows them through their grief and sets them on an epic journey to raise awareness of the disease.

The BBC1 film, which ties-in with this year’s Comic Relief, was written in an attempt to highlight the devastating yet often preventable human toll of malaria and to boost understanding of the work of charity Malaria No More UK, which campaigns to stamp out the disease.

For Edinburgh University student Kristine, the film is an emotional reminder of how close her own family came to losing her – and how a pinprick bite from a tiny bug could leave her battling for her life.

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“The moment I remember most is being terrified and thinking that I didn’t know if I would ever get to say ‘I love you’ to my mum and dad again,” recalls Kristine, 24. “That was truly terrifying.”

She added: “The whole experience changed me. Now I express my love to everyone close to me as often as I can.”

Kristine is studying for a masters degree at Edinburgh University. In 2008, she had just left Elon University in North Carolina for Ghana, where she intended to continue her studies into political science and public administration and work as an aide to African politicians during the presidential election.

She already had links with Ghana having helped raise money to fund a community health clinic in the Volta region, and her studies into healthcare provision had prepared her for the potential risks.

“It was ironic that there I was interested in healthcare and hoping to visit the clinic as a guest, only to end up elsewhere as a very sick patient.

“I knew how much of a serious threat malaria was, so I was religious about taking my prophylactics – preventative pills – every day at the same time. I got a net for my bed the first day I arrived and made sure I slept under it every night.

“I guess I was just unlucky.”

A bite from a mosquito infected with malaria parasites is all it takes. Anti-malarial drugs generally help prevent the disease but they are not 100 per cent effective, so people in affected countries are advised to dress in long sleeves and trousers and sleep under nets.

Once infected, rapid diagnosis and treatment is vital in the fight against the disease taking hold.

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Sadly, while Kristine sought medical help as soon as she felt unwell, the drugs used to treat her were not fully effective. “For some reason I wasn’t responding to the medication I was given,” she explains. “My uncomplicated malaria was given time to morph into a dangerous, drug-resistant strain,” she adds.

“The parasite attacked my brain and neurological system, leaving my upper body partially paralysed and my legs able to move just a few inches. I could hobble only a few feet before becoming unconscious due to uncontrollable dizziness.”

She had cerebral malaria – a deadly form of the disease which can rapidly lead to coma and death.

Kristine remembers lying in her hospital bed, her arms and legs rigid, paralysed from the neck down. “My arms were crunched up, I can only describe it as being like a T-rex, my arms were scrunched in on me and my hands were like claws. I couldn’t release my hands or arms and my legs were very stiff and scrunched up. It was hard to move.”

She remained like that for around two weeks before the medication finally did its job. It was a frightening fortnight in which she wondered if she’d ever see her family back home in New Jersey again.

Even once she started to improve, her recovery was painfully slow. Determined to continue her studies, she battled on even though her hands were stiff, making it hard to write and a 15-minutes walk to university took up to three hours.

When she contracted a water-borne parasite called giardia, her body could barely fight it. “At 5ft 8ins, I weighed little over 100 pounds,” she remembers. “When I looked in the mirror I saw a skeleton. My hair was brittle and grey, it lost all of its colour and my face was sunken in.

“I couldn’t remember what it was like to be healthy.”

Eventually, she was forced to return home, devastated to have failed to complete the tasks she had set herself.

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The lingering impact of her illnesses meant that 18 months on she was still undergoing intensive physiotherapy to help improve her mobility and brain training exercises to assist her memory and attention span. Even now, more than four years later and living in Edinburgh, she is still following a physical therapy plan to help build her strength.

Having battled through the nightmare of the illness at its worst, Kristine pledged to use her experience to raise awareness of malaria and to highlight the need for better care in the developing world.

She has since worked with Malaria No More in the US and is now supporting work by its UK arm. Her hope is that once she completes her Rotary International sponsored masters degree in health systems and public policy at Edinburgh University, she can return to Africa to help develop programmes aimed at tackling malaria.

“I’m conscious that millions of people have to live with the fear of malaria every day,” she adds. “I have lived through malaria, and now I feel responsible to do something about it, especially as I have had the privilege to recover thanks to wonderful health care.

“Others don’t have that opportunity. I can’t not try to do something about that.”

• Mary & Martha is on BBC1 tonight at 8.30pm. For details of Malaria No More UK’s work and to donate, go to www.malarianomore.org.uk

Four kinds of deadly

THERE are four kinds of malaria that directly affect humans. The most lethal is plasmodium falciparum – the type that can lead to cerebral malaria.

Other forms can return or lie dormant for years before emerging on a regular basis, bringing flu-like symptoms.

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There is no vaccine against malaria. However, it is preventable. Last week, it emerged that repellent DEET appears to be losing its effectiveness against mosquitoes.

Malaria causes more than 660,000 deaths per year, mainly among children in Africa.

The infection is caused by the malaria parasite entering the bloodstream – usually through the bite of an infected female mosquito.

Quinine was found to be an effective treatment for malaria in the 18th century by farmer’s son George Cleghorn from Balerno. The Edinburgh University medical graduate was working in Minorca when he found quinine bark acted as a cure for the disease.

Girls Aloud singer Cheryl Cole, pictured, was left battling malaria falciparum in 2010 after a holiday in Tanzania.