Here’s how to minimize your risk of contracting this disease while on safari.

Because malaria is rare in the United States, we don’t hear a lot about it, save for periodic media sound bites that are largely negative and often unsettling. The news is usually bad news. For instance: More than 350 million people contract malaria each year, and about one million die from it. Meanwhile, drug-resistant strains of malarial parasites are said to be on the increase, making the disease harder to prevent and more difficult to cure. Every year, according to the CDC (Centers for Disease Control and Prevention), approximately 1,500 American travelers are diagnosed with malaria after their return to the States. And, the CDC claims, “Travelers to sub-Saharan Africa have the greatest risk of both getting malaria and dying from their infection.”

Yikes. That remark made me wonder: What, in fact, is the actual malaria risk for someone visiting Africa’s hunting countries? And what are the best ways to safeguard against the disease? Also, if one does contract malaria, what’s the likely prognosis? Is a full cure likely? In sum, how concerned or worried should we be about the risks and dangers of malaria?

To get the best possible answers to these questions I wanted to talk with someone who knows the subject in practice as well as in theory. Since few American doctors ever see, much less treat, an actual case of malaria, I opted to go to Africa–if only by phone this time–to interview a working authority on the subject. Dr. Phil Seidenberg has lived and practiced medicine in Zambia for five years. For the last 3 1/2 years he has been African Regional Medical Director for Global Rescue (see below) in the capital city of Lusaka, where he has encountered and treated many cases of malaria.

Unsurprisingly, Seidenberg confirms that malaria is endemic in most of the hunting countries, and agrees that the disease should be taken seriously by everyone visiting Africa. That’s the simple part. The specifics get a bit more complicated.

As most of us know, malaria is not a uniform threat even in Africa. The risk level varies region to region, and often is variable within a country or province.

“For instance, West Africa is generally high risk,” says Seidenberg, “as are parts of Ethiopia; while Botswana is low risk. I’ve never seen a malaria case from the border area [with Zambia and Zimbabwe] of Botswana. Another anomaly is South Africa; they don’t have much malaria.”

The CDC rates malaria risk in South Africa as “low,” but points out that the disease is present in Mpumalanga Province, Limpopo (Northern) Province, and northeastern KwaZulu-Natal as far south as the Tugela River. It also occurs in Kruger National Park. According to the CDC, all areas of Zambia, Zimbabwe, Tanzania, and Namibia have malaria present, at a “moderate” risk level for travelers. The CDC rates the risk in Botswana as “very low.” As Seidenberg points out, the threat of malaria also changes with the season, worsening during rainy periods, when abundant standing water helps mosquitoes breed and hatch prolifically.

More mosquitoes means more risk for the disease. Malaria is caused by a single-celled protozoan parasite of the Plasmodium genus. The parasite is carried and transmitted by infected female Anopheles mosquitoes. While probing for a “blood meal,” these mosquitoes inject malarial sporozoites into the human bloodstream. The parasites then incubate within the human host, reproducing at a rapid, exponential rate until they overwhelm the immune system, causing the overt symptoms of malaria: fever, chills, sweats, headache, and muscle pain; and sometimes nausea, vomiting, abdominal pain, backache, and dark urine. Untreated, the escalating disease can be fatal.

The best first step to avoiding this misery is to choose the right preventative (“prophylactic”) anti-malarial drug. According to Seidenberg, there are three basic choices for the hunting countries of Africa. Each has its own particular advantages and drawbacks.

Mefloquine (Lariam) has been around for quite a while and is preferred by some because it is taken on a weekly (rather than daily) basis, and is less expensive than some other options—an advantage on long-duration trips. Another plus is that Lariam can be safely used by pregnant women. On the downside, Lariam needs to be started at least two to three weeks prior to travel, and must be continued for three to four weeks post-trip. Worse, studies have shown that Lariam has more side effects than any other anti-malarial drug. These include gastric problems and, especially, dysphoria (the opposite of euphoria) including disturbing dreams, feelings of uneasiness, and psychological distress. However, many people use Lariam with no ill results. Those new to the drug should begin taking it at least a month before travel. Then if side effects occur, there’s still time to switch to a different medication before departure.

A second prophylactic option is doxycycline, which Seidenberg says is gaining favor in the region. It is a good choice for last-minute travelers, because it can be started one to two days before arrival in a malarial area. Another plus is the price; it tends to be the least expensive anti-malarial. Doxycycline can also prevent several other infectious diseases that might be encountered, especially when hiking and camping, or when wading or swimming in fresh water. Negatives for doxy include the possibility of upset stomach or diarrhea, and most commonly, hypersensitivity to sunlight, leading to sunburn. The drug must be taken daily, and cannot be used by pregnant women or children under eight years old.

The third, and arguably the best drug of choice, is Malarone. This is actually a two-drug combo, consisting of Atovaquone and Proguanil. It is taken daily, and needs to be started only one to two days before travel. The drug is very well tolerated, and side effects are minimal and uncommon. Also and importantly, the two-drug punch greatly reduces the chance of contracting a resistant malarial strain. The only general drawback, aside from the fact that this medication cannot be used by pregnant women, could be the price. Malarone is more expensive than the other options, and since it is taken daily, cost could be a factor for some, especially on longer trips.

No matter which preventative you choose, it’s vital to understand that none of these drugs are 100 percent effective.

“If you’re bitten by an infected mosquito,” Seidenberg warns, “the drugs won’t keep the parasites from being introduced to your body. What the drugs can do is prevent the parasites from reproducing to the level where an acute infection develops. The prophylactic medicine keeps the parasite count low enough so that the body’s immune system can do its job.”

This brings us to the second important phase of malaria prevention: avoiding bites from infected mosquitoes.

“The two highest points of malaria transmission by the Anopheles mosquito occur around dusk and again in early morning, around sunrise,” says Seidenberg. “So you want to avoid bites at those times. The best way is to wear long clothing that reduces skin exposure, and to use DEET compounds to keep mosquitoes away. It’s also important to sleep under mosquito netting. The more bites you get during the night, the higher your chances of acquiring an infection. Permethrin-treated nets are most effective.”

Since DEET repellents can be hard to find in Africa, it’s best to bring your own copious supply. You might also want to pack your own pre-treated netting, especially if you plan to travel in the region before or after a safari. For additional protection, use permethrin on your hat and clothing (also on your boots and socks, which helps ward off ticks as well.)

But what if, in spite of all these precautions, you begin to have malarial symptoms? Since fever, chills, and headache can be caused by other diseases and viruses, you must first determine whether or not you actually have malaria. This is easy to do nowadays, thanks to an invention of the last decade called the Rapid Diagnostic Test (RDT), a take-along test card that’s simple to use. Simply prick a finger to spill a few drops of blood on the card’s sample pad; then wait fifteen minutes. If malarial parasites are present, colored bands in the test-card window will indicate the precise species. All travelers to Africa, Seidenberg believes, should carry a few RDTs.

“Results are available within fifteen minutes, there’s no lab required, and the sensitivity for detection is very, very high.”

RDTs have recently become available in the USA, but if you can’t find them near home, they are generally available without prescription in most African capital cities.

In the field, if your test results are positive for malaria, you can then proceed to the nearest treatment clinic. Or, if the proper curative drugs are available in camp, you can begin self-treatment (best if prescribed via mobile phone by a physician).

How worried should you be if you do have malaria?

“Malaria cases are usually divided into simple and complicated,” Seidenberg explains. “Most of the cases we see are simple, meaning they don’t involve the central nervous system, they aren’t severe enough to involve the kidneys or present other complex symptoms. These simple cases can be treated with oral medication in the setting of travel, as opposed to evacuation. With all malaria, the earlier the treatment starts, the better the outcome. But most cases can be cured without problems or complications.”

All in all, how concerned or worried should hunters be about malaria danger in Africa?

“The incidence of malaria in this country and this region has dropped considerably over the last five years,” says Seidenberg. “The risk for travelers is a lot less than it was five years ago. Hunters have generally done a good job readying themselves prophylactically, and they typically are in areas with smaller human populations. In some ways that decreases malaria risk, because human hosts are needed for transmission.”

In sum, then, the news is actually pretty good.

“Malaria is always going to be a concern,” Seidenberg concludes, “but with the proper drug prophylaxis and mosquito-bite avoidance, I think the risk is a lot lower now than it’s ever been. Hunters need to be aware of malaria, but they don’t need to be overly concerned or worried about it if they’re following the right precautions.”

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This beautiful desert in southern Africa is home to huge gemsbok, springbok, and a variety of other game.

Quick. Name a famous desert.
If you said Sahara, join the crowd. Everyone knows the world’s largest desert. If you said Kalahari, though, you’re probably a hunter.

Northern Africa’s Sahara, 3.6 million square miles, grows world-record sand dunes. Southern Africa’s Kalahari, 350,000 square miles, grows world-record gemsbok. And more. A lot more. The Kalahari is a veritable Noah’s ark of wildlife, so many species that one can’t resist listing them to emphasize the point: In addition to gemsbok, this famous sand supports lions, leopards, cheetahs, caracals, African wild cats, wild dogs, brown and spotted hyenas, and jackals. There are ant-eating aardwolves and bat-eared foxes, Cape foxes, Chacma baboons, scrub hares, springhares, meerkats, polecats, genets, honey badgers, the weird pangolins and aardvarks, and three species of mongoose.

Feeding the predators, large and small, are migrating herds of springbok, blue wildebeest, eland, kudu, red hartebeest, steenbok, common duiker, warthogs, zebra, giraffe, and even elephant. Black wildebeest historically roamed the southeast edge of the Kalahari, but today they have been introduced on many large cattle ranches throughout the region, along with blesbok, impala, waterbuck, sable, and even a few rhinos. Birds and reptiles? Other than ostrich, we won’t even try to list them, but rest assured you can enjoy upland hunting for francolin, guinea fowl, doves, and sand grouse.

And they call the Kalahari a desert?

Technically it really isn’t; it’s a semi-desert. Although dry and extremely hot in summer, it greens up with the three to eight inches of rain that falls each summer from November to March, irrigating grass and thorn scrub amid its long, low, red sand ridges interspersed with valleys locally called streets. Umbrella-shaped camelthorn trees are a common sight in many districts. The Kalahari, “the great thirst” in the local Tswana tongue, is most desiccated in the southwest where it spills out of Botswana into South Africa and the eastern reaches of Namibia.

Its edges are not precisely defined. Rather, they blend into a wetter, 2,500,000 square mile Greater Kalahari Basin that includes the southeast corner of Angola, southern fringe of Zambia, most of Botswana and a sizeable swath of South Africa north of the Orange River, which was not named for its color nor any citrus fruit, but in honor of William of Orange. Some claim the Kalahari sand basin extends as far north as the Congo and as far south as the Cape, but we’ll confine our attentions to the classic, dry central core known famously as Bushman country.

Bushmen, the San people, evolved both culturally and physiologically to survive where no other people could. Archeological evidence places them in most of southern Africa 30,000 years ago. Tens of thousands of their rock art images adorn caves, cliffs and boulders, depicting them hunting eland, giraffe, and other animals with bows. Apparently the Kalahari has long been a hunter’s paradise, and formerly a much wetter one. After the sixteenth century, pressure from new immigrants, black and white, forced the San deeper and deeper into the central core of the Kalahari basin where only they could survive. Bushmen, when living their traditional lifestyle as hunter/gatherers, were widely regarded as the best game trackers in the world. They had to be, not only to find game, but to follow it while waiting for the slow poison on their arrows to take effect. Under the influence of modern cultures, few retain these skills, but many who do are hired by professional hunters to track leopard and other game for clients.

The Kalahari basin rests on a plateau 3,000 feet above sea level. Seasonal streams, omuramba, drain some of it, leaving shrinking pools where game drinks, but most sheet water ends up in isolated, shallow lakes. The most famous, Makgadikgadi Pans in northeast Botswana, is a remnant of ancient Lake Makgadikgadi that once covered 106,000 square miles. The Okavango River cuts across the Caprivi Strip of Namibia after draining central Angola, then disappears into the sands of the Kalahari in the famous wetlands of Okavango Delta on the northeast edge of the desert.

Smaller pans scattered across the region provide seasonal sustenance for grazing animals as well as humans. In 1849, the famous Dr. David Livingstone, with the aid of William Cotton Oswell, crossed the Kalahari from the southeast to “discover” Lake Ngami. He reported bird flocks darkening the sky, sitatunga by the thousands, and lions preying on them. In extremely wet years, overflow from Okavango still swells Lake Ngami, but it is a mere shadow of its former glory, often completely dry. The sitatunga and lion are long gone, but the remnant water makes this a bird mecca.

Before Livingstone reached Lake Ngami, rumors of it had inspired William Cornwallis Harris, whose 1836 hunt had taken him near the south end of the Kalahari, to propose an expedition to find the lake. The Royal Geographical Society declined to fund it. From 1943 to 1948, R. Gordon Cumming hunted the southeast corner of the Kalahari and wrote about it in A Hunter’s Life in South Africa, but he never pushed deep into the desert. His accounts of migrating springbok by the hundreds of thousands is classic African natural history.

The Kalahari still holds good populations of lions in some areas.

Pans played essential roles in more modern immigrations into the Kalahari. As recently as the 1950s, white settlers were pioneering into the area to establish sheep and cattle ranches, building homesteads near the shores of wet pans where they sank wells. The flows from these bore holes now sustain wildlife across the region. A first-generation descendent of one such pioneer, Hannes Steyn, recently guided a client to the new world’s record gemsbok, a cow with one horn reaching 50 inches and both adding up to 109 1/8 inches under the SCI scoring system. This was no fluke. Steyn regularly leads clients to huge gemsbok. In just three days he guided my wife and me to 41- and 40-inch bulls on his Namibian farm.

The Kalahari gemsbok, a subspecies of rapier-horned oryx, is a classic desert survivalist with specialized physiology that enables it withstand severe heat and go for days without water, extracting moisture from leaves, desert melons, and cucumbers. Special nasal blood vessels shunt air-cooled blood to the brain while body temperature soars as high as 113 degrees F. Some say the long horns are also used as heat radiators. They are certainly used as defense against lions.

Ranches have been both curse and blessing to Kalahari wildlife. Not surprisingly, the early cattlemen, Boers, contributed to the destruction of native wildlife to protect grazing lands and crops. Market hunters later devastated wild game populations, nearly wiping out the black wildebeest, or white-tailed gnu. In the 1960s, governments began erecting “veterinary” fences to prevent wild game, potential carriers of the dreaded foot-and-mouth disease, from migrating into cattle regions. Wildebeest, hartebeest, springbok, and others piled against fences and died by the thousands. As recently as the 1980s, some herds during drought years declined by 90 percent. On the upside, ranchers, to meet hunting demand, reintroduced many species formerly extirpated. Boreholes provide year-round water, negating the need for migrations.

Dozens of professional hunters and hundreds of farms and ranches offer mixed-bag plains game hunting across the Kalahari. Some enclose 50,000 acres or more behind high fences. Many form conservancies in which the free-roaming wildlife resource is shared rather than fenced. Such private lands are spared the upheavals and uncertainties of governments that open and close hunting on government concessions for purely political reasons.

Ranch hunts in the Kalahari are currently some of the easiest, safest, and most affordable in Africa. While not exactly wilderness, the land–vast, isolated, and undeveloped–feels as if it is. You can hunt for weeks and never hear traffic, never see a highway or powerline, never detect the glimmer of a city light. You will see a sky aglow with stars and hear the yapping of jackals, the barking of kudu, perhaps the cough of a leopard. The Kalahari remains quintessential Africa.

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It took him most of a lifetime to get to Africa… but it was worth the wait!

It was 4:00 a.m. when I pulled on my boots and walked out into the cool night air. Last evening’s campfire had been reduced to embers but I welcomed its lingering warmth as I settled into a dew-dampened canvas chair. The unfamiliar calls of unseen birds overhead caught my attention, and when I looked up, I saw that the Southern Cross was right where I had left it just a few short hours before.

“You’re not in Texas any more,” I said to myself. “And you’re not in Kansas, either.” I was in the Karoo of South Africa, and I was so stoked by the excitement of a grueling but successful kudu hunt and the taking of a monster steenbok, I could not sleep.

I have offered up my most fervent prayers in the hours before dawn while sitting quietly and alone in a deer stand or in the dark timber of elk country, and I could do no less with a new African day on its final approach. I had a long list of blessings to count, among them the opportunity to share Africa with my youngest son, Larry. Mauve-tinged fingers of light were tickling along the horizon’s rocky backbone before my thoughts turned to the events which had brought me to this place.

I smiled to think how many times I had found comfort in the English saying, “Good things come to those who wait.” Extolling the virtue of patience, it gives soothing assurance that in life, conditions change with the passing of time, and the future is made bright by the collisions of dreams and opportunities. Curiously, it was different somehow when I said it aloud with only the Karoo to hear. Then I realized with great satisfaction that the difference wasn’t in the sound of it at all. This familiar phrase had changed because it wasn’t a promise any longer, it was an affirmation.

The author and his son share in the excitement of taking this nice impala.

My mind went back to the incredible things Larry and I had seen and done since our arrival in South Africa just three days earlier. Less than five hours after stepping off the airplane in Port Elizabeth, I had posed for photographs beside my first trophy, a magnificent impala. The celebratory back-pounding that Larry gave me that day was the sweetest pain I have ever suffered.

“I have waited fifty years for this sunrise!” I said to myself. My dream of Africa took its first breath in 1959 when I was a seventh-grade student in San Antonio, Texas. I was in the school library on a Friday afternoon when I stumbled across a copy of John A. Hunter’s first book, appropriately titled Hunter. Mesmerized, I read it cover-to-cover that weekend, not knowing that my self-made promise to see Africa one day would simmer for most of a lifetime before coming to a boil. I filled the intervening years collecting books by or about legendary professionals like Hunter–men like Selous, Taylor, and Bell–and their modern contemporaries.

For a working man like me, patience is essentially the product of prioritization, not by design but by necessity. Not to say that there aren’t many good things to enjoy along the path of daily living, but the time to enjoy even simple pleasures and the resources to cover the high cost of turning dreams into realities are easily siphoned away by the more immediate needs of family and career. I could only wait as my dream of Africa ebbed and flowed with tidal monotony.

After thirty-four years of service, my retirement from the BNSF Railway in 2007 liberated me from nagging worries and ringing telephones. My first adjustment to retirement was the easiest–I committed myself to the enjoyment of sunrises, a simple pleasure which millions of people take for granted every day. There is something in a sunrise that illuminates the mind and warms the soul, and I felt that I was much in need of both. I was sixty years old when I retired, and I had missed most of 22,000 opportunities to see a sunrise. I have seen most of a thousand in the three years since.

I owe the gift of Africa to four amazing people. Anyone who knows me can tell you that the center of my universe is my wife, Bilita. The daughter of a tough Texas Ranger (a lawman, not a ballplayer), she has been in my heart and at my side for over thirty-three years. It was she who convinced me that my life’s story would be incomplete without Africa among its chapters. I met the other three for the first time on the same day at the Dallas Safari Club convention in January 2009. They are Dr. Kevin “Doctari” Robertson, fellow DSC member Dale Butcher, and professional hunter JP Kleinhans. I am privileged to call them friends.

I have been reading Sports Afield for as long as I can remember, and I particularly enjoy Dr. Robertson’s writings, especially his Q&A column entitled “Ask Doctari.” In early 2008, I sent a question to him via e-mail through this website and in just a matter of days I was surprised to receive a detailed reply from Kevin himself. He not only answered my question as though he had no other demands on his time, he wrote as though we had been friends for years. It was Kevin who invited me to attend the convention in Dallas and meet him in person.

I heard the roar of the crowd long before I found the entrance to the DSC hall that day. I asked someone for directions to the Sports Afield booth, where Doctari would be signing books and meeting his many fans. As usual, Kevin had drawn quite a crowd, and when I finally worked my way to the front and identified myself, he greeted me with genuine affection. We talked about the role of organizations like the DSC in the global fight to preserve both the game and the right to hunt them, and with his encouragement, I found my way over to the membership booth and joined up for life.

This huge steenbok fell to a solid from the author’s .308.

I spent the rest of that morning watching and listening enviously as people booked African safaris on the spot. I talked to a few outfitters and collected a handful of colorful brochures, and it was well past noon when I headed upstairs to the food court. When I turned away from the cashier with lunch in hand, I discovered with dismay that every table was occupied. As I hopefully scanned the room for an empty chair, I saw a man sitting alone at a table and waving me over to join him. This simple act of courtesy was the turning point in the fulfillment of my dream to hunt in Africa.

He introduced himself as Dale Butcher from Amarillo, Texas. Dale has hunted Africa several times, and when I revealed my hope to book a plains-game hunt, he told me that his PH and longtime friend, JP Kleinhans, would soon be joining us. I instantly recognized the name and knew JP to be a professional hunter who I had seen on television in the company of Craig Boddington and Dave Fulson. I took an instant liking to JP when he arrived, and we agreed to meet at this table the next day and talk before the noisy lunch crowd arrived.

We met as planned, and I quickly learned that JP Kleinhans had the plains-game hunt I wanted at a price I could afford. We covered the basics and set my hunt for April 2010. I was babbling when I called to tell Bilita that it was a done deal, and she actually cried with happiness for me. Over the next few weeks, I talked to the several references JP provided, and after hearing their rave reviews, I knew that I had chosen well.

I stayed in touch with Doctari, Dale, and JP for a year before reconnecting with them at DSC’s 2010 convention. My son Jeffrey and his eight-year-old son, Cameron, were with me, and we were thrilled to see the many outdoor television personalities whose programs give us so much viewing pleasure. Cameron, my only grandson, is my faithful companion whenever Tracks Across Africa appears on the television screen, and his eyes lit up when he saw Craig Boddington.

As we stood in the crowd, hoping to have a word with him, Craig suddenly rose from his chair and announced with regret that he was late for an appointment. He was walking by me when I caught his eye and asked if he had time to meet my grandson, who is one of his biggest fans. He stopped and said with a honest grin, “No, but I will make the time!” and with that he extended his hand to each of us, autographed Cameron’s DSC cap, and posed for a photo that Cameron will cherish forever.

Tha author’s grandson, Cameron, is a huge fan of Craig Boddington and his TV show, Tracks Across Africa.

Later that day, Doctari introduced me to Monty Kalogeras who operates a safari shooting school near Mason, Texas. I considered myself to be a fair hand with a rifle, but two days of intensive coaching and training with Monty revealed that I had a lot to learn about setup, breath control, and trigger squeeze. When I turned my pickup through Monty’s gate and headed for Fort Worth and home, I was confident in my ability to quickly assess a shooting situation and then deliver a bullet on target. I was as ready for Africa as I would ever be.

The South African Air flight from Washington, D.C. to Johannesburg via Dakar, Senegal, was long and grueling but it was made tolerable by my considerable excitement to finally be on my way. I had no problems getting my rifle and ammunition through inspections at the DFW and Dulles airports, and the inspections by the South African police in Johannesburg and Port Elizabeth were facilitated by my courteous conduct and some judicious tipping.

That magnificent impala was just the beginning for me. Thanks to the expertise and keen eyes of JP and his head tracker, Boettie, I followed it up with an exceptional blesbok, a good Cape kudu, the monstrous steenbok mentioned earlier, a very nice springbok, a good duiker, and a hard-won zebra stallion. The gemsbok I took in New Mexico over a decade ago will be shifted from its place of honor over the mantle in my den in favor of the kudu.

PH JP Kleinhans used his skills to unite the author with this Karoo springbok.

It is not uncommon for hunters and their PHs to become friends for life, and so it is with JP and me. An expert in both the field and the taxidermy shop, JP Kleinhans is affable, charming, and enormously witty. I enjoyed his colorful stories and the laughs we shared almost as much as I did the hunting. Every moment was an adventure, whether we were defying the laws of physics as we drove up and down impossibly steep trails or enjoying an easy evening with wine and dinner. My time there was made even more enjoyable by the occasional company of JP’s lovely wife, Natia, and their two children. If Bilita had been there to share in the fun, those days would have been the best of my life.

Africa was a 20,000-mile journey that required most of a lifetime for me to complete. It is magical and intoxicating, and it easily overwhelms all of the senses. Although my dream of Africa has been realized, it has been replaced by its fraternal twin. In my mind, I can still see the Southern Cross as it was during those pre-dawn hours in the Karoo, and it beckons me to return. Bilita and I will see it together in 2011, and most of our time there will be in the company of JP, his family and staff, God willing.

If you are dreaming of Africa but also feeling the restraints of duties at home, be patient because good things really do come to those who wait. Talk to people who have been there, and by all means, enjoy the excitement of gathering your gear. Use your time to prepare, because when your African dream turns to reality, as mine did, it may be as unexpected as the crisp break of a custom trigger. And if you can, share Africa with someone you love.

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