Sense About Science have very kindly given me the transcripts from their excellent Malaria and homeopathy sting from last month, and have let me stick it up here as a public archive for anyone who’s interested. Some amusing video from the sting here:

www.badscience.net/?p=260

news.bbc.co.uk/1/hi/programmes/newsnight/5178122.stm

Here’s a pretty funny Australian doing his own ad hoc survey of services.

web.archive.org/web/20000607043944/http://skeptics.com.au/features/qakatak/a-poxhouse.htm

And here is the SAS document on the sting. For me the funniest thing is the failure of homeopaths to give basic bite prevention advice: that’s what shows, to me, that the word “holistic” is product-branding, rather than anything more meaningful.

Investigation into prevention of Malaria through homeopathy

1.0 Summary

Homeopathic clinics appear to be offering substitutions for conventional anti-malarial prophylactics. Alice Tuff, 23, conducted 10 consultations with homeopathic clinics and pharmacies to find out what advice was being offered. The homeopathy clinics contacted were selected arbitrarily from the results of a web search in much the same way that someone seeking travel advice would find a clinic.

Scenario

In the consultations, Alice explained that she was planning to join a 10-week truck tour through Central and Southern Africa and that the anti-malarial drugs her doctor had prescribed made her feel queasy.

Background

Malaria kills over 3000 people a day mainly in Africa. According to the Health Protection Agency the risk of P. falciparum malaria is very high throughout sub-Saharan Africa except in the extreme south of Africa. In, the UK, there has been a recent increase in fatal cases of this strain of malaria. According to WHO P. falciparum is the most dangerous species of malaria and a patient may progress from minor symptoms to severe disease in a few hours. By this stage mortality is 15-20% and if untreated it is almost always fatal.

Standard malaria prevention recommended by the UK’s Advisory Committee on Malaria Prevention (part of the Health Protection Agency), which provides regular reviews of evidence for efficacy and anti-malarial resistance, involves:

§ Risk assessment

§ Anti-malarial drugs

§ Mosquito bite prevention advice

§ Symptom recognition advice.

The consultations with homeopathic clinics were measured against these criteria.

The phone and face-to-face consultations were recorded, summaries of transcripts are below. A consultation at a conventional travel clinic was also recorded to provide a point of comparison for the advice given.

Top line results from investigation

Out of the ten homeopaths consulted:

§ All the homeopaths were willing to provide homeopathic alternatives to conventional anti-malarial treatment. None of them recommended taking both conventional preventative treatments and homeopathic remedies.

§ Four of the homeopaths cited examples of people using homeopathic remedies to prevent malaria successfully.

§ None of the homeopaths referred Alice back to her doctor about the problems she had experienced with taking conventional anti-malarial drugs. If referred back to her GP Alice would have been prescribed alternative conventional anti-malaria drugs to gauge whether they also caused her to feel unwell.

§ Only two homeopaths enquired about Alice’s personal medical history.

§ Only one advised on how high the risk of catching malaria was in the client’s planned destination.

§ Only three homeopaths advised on mosquito bite prevention.

§ Only one advised on the symptoms of malaria and advised that if Alice did become symptomatic she should immediately seek professional help.

Summary of treatments

The remedies recommended by the ten consultations were homeopathic. This means they work on the principles of “like treats like”. This means an illness is treated by a medicine which could produce similar symptoms in a healthy person. The active ingredients are given in a highly diluted form. Homeopathic remedies are virtually 100% safe. Three main homeopathic treatments were recommended to protect against malaria but none of them have been proven to work.

1) Malaria Officinalis/ Malaria Nosode 30.

A nosode is a homeopathic preparation made from material from tissue samples from a sick person, mucus, pus or cultures of micro-organisms. From internet searches it was found the Malaria Nosode is made out of the rotting vegetation from marsh areas where the mosquito breeds.

2) China Sulph/China Officinalis

This is said to be made from the bark of Peruvian trees which contains quinine.

3) Natrum Mur.

Natrum Muriaticum is made of sodium chloride, more commonly known as salt.

To make the homeopathic remedies, the homeopaths create a series of dilutions. In the case of the Malaria Nosode 30C, 1ml of the original substance is diluted in 100ml of water or alcohol, 1ml of this solution is then taken and diluted in another 100ml of liquid. Thus a series of dilutions is created. In a 30c dilution the solution has been diluted in this way thirty times (100³⁰⁰ or1 x 10⁶⁰ ). This liquid solution is then absorbed into sucrose or lactose tablets.

For the China X dilutions 1 ml of the substance is diluted in 10 ml of water or alcohol and this is serially diluted. In the X 6 dilution this has occurred six times so it is 1 x 10⁶. In the X8 this has occurred eight times or 1 x 10⁸_.

2.0 Summary of recorded consultations

Consultation 1: 10:17am, 29^th June 2006, face to face.

Description of consultation:

The consultation occurred in a small room within an alternative treatment practice centre. The homeopath asked what kind of tour I was doing and whether I needed anything else in addition to malaria tablets. I explained that I had already had the relevant vaccinations for Africa. The homeopath told me:

§ That there are homeopathic remedies that would not make me feel ill.

§ That when one of their friends had visited Africa the people they were with that took homeopathic remedies did not get malaria, whereas the people they were with took conventional medicine and did get malaria symptoms.

§ That the medicines would have to be posted to me nearer the time as they ‘do not keep well’. She explained that this was due to the fact that these remedies were machine made unlike the remedies you buy in homeopathic pharmacies where they dilute an actual substance. When pushed she explained that the remedies were made with a ‘resonance machine which is calibrated by dousing’.

Advice given:

§ The main remedy prescribed was Nat. Mur which, as the homeopath explained, is salt. There is another treatment based on quinine that I could also be given. She took this information from her homeopathic materia medica.

§ The homeopath also told me not to put the remedies through the airport X-ray machines as this would ‘damage the energies, as they are quite fragile in energy’.

Prescription (what, cost etc): Natrum Muriaticum (NaCl) (Dilution unknown)

Malaria 30C

China 6 C

Manganium 30C – for typhoid

Polio 30C

Arsenicum 30C – for yellow fever

£10 for consultation and remedies.

Asked about personal medical history? No

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarials? No

Referred back to Doctor who prescribed them? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

§ I also asked about homeopathic vaccinations and was told they do not exist but you ‘can give the vaccination in potency’. This means you can take remedies when you enter an area where a disease is endemic. I was told I could have remedies for Yellow fever, Dysentery and Typhoid.

§ I was also told I could buy a travel kits which would be able to help with most situations from Helios Homeopathic Pharmacy for £38

Quotes from consultation

1) Homeopath:” Okay, the good thing about the homeopathic version is it won’t make you ill like the malaria tablets. Also, once somebody told me she went to Africa to work and she said the people who took malaria tablets got malaria, although it was probably a different subversive type not the full blown, but the people who took homeopathics didn’t. They didn’t get ill at all.”

2) Homeopath: “For the acute clinic we make remedies on the machine which is fine and they work really well, but most people feel that they don’t have a shelf life. The remedies that are made up in a pharmacist are made from the original substances. The machine-made remedies, it’s a resonance machine and it works really well.”

AT:” What’s the difference between the machine and…”

Homeopath: “Well it’s calibrated by dousing. The machine is out there and it works almost brilliantly. The remedies work”.

3) AT: “What’s it called? [The malaria remedy]

Homeopath: Nat Mur. There are other possible ones but it is also a good treatment. The names of homeopathic remedies are in Latin. It’s actually salt. That’s salt. It’s a good remedy for treating people with malaria.

4) AT: ”Do you do vaccinations and stuff as well?”

Homeopath: “You can give something instead of vaccinations. You can give the vaccination in potency. ..

Now when you go somewhere there is an epidemic or where there is an endemic where there aren’t always outbreaks, the best thing to do is to be able to take a remedy if it is needed, if there is an outbreak.”

5) Homeopath: “What we worry about is the X-rays damaging the remedies as they are quite fragile in energy.”
Consultation 2: 10.14am and 17.04pm, 28^th June 2006, by phone.

Description of consultation:

Initial conversation

The homeopath told me:

§ There are remedies that you can take but homeopathy works by matching symptoms to disease (rather than as a preventative measure).

§ There was no guarantee I wouldn’t get malaria but no-one he knew who had taken homeopathic remedies had ever got ill.

§ That I should come for a consultation so he could specifically tailor the remedies to me and get a view of my ‘health picture’.

§ When asked how effective the remedies were, he could not answer the question directly but said that if you have the right remedy it is effective but if you have the wrong one it may miss the target.

Follow up conversation

I rang the homeopath back later the same day and said that I was confused about the advice he had given me as I had subsequently found advice on the Health Protection Agency’s (HPA) website, which said that the HPA and the Faculty of Homeopathy advised against using homeopathy for malaria prevention.

In response, the homeopath told me:

§ (Initial laughter) ‘Of course they did’ and if you are influenced by that statement follow the conventional route.

§ In response to my comment about the Faculty of Homeopaths the homeopath said ‘they are all medics’ so ‘they must more or less toe the medical line.’

§ That no-one who followed his advice and took homeopathic remedies had ever got malaria but that this was not statistically supported by the medics.

§ That it was possible to find arguments for both conventional and homeopathic treatment but that conventional antimalaria tablets were ‘a bad idea’.

§ In response to the fact I was looking for an alternative, he said to me there were alternatives available but ‘not approved by orthodoxy.’

Advice given:

No specific remedies were prescribed as a full consultation was required first.

Prescription (what, cost etc): No prescription given

£75 for consultation

Asked about personal medical history? I was asked if I was generally fit or had any medical problems.

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarial? No

Recommended back to Dr? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

I was advised it was a personal choice between whether I took conventional or homeopathic antimalarial treatment, but it felt that the homeopath was putting them on a par with each other in terms of effectiveness whilst being dismissive of conventional anti-malarial treatment.

Quotes from consultation

1) AT:”I was wondering if there was a homeopathic alternative I could take instead of them [my anti-malarial tablets]”

Homeopath: “Yes, I say yes there is but that isn’t exactly how homeopathy works. It might work but our system is geared towards matching the remedy to the actual symptoms. I just need to tell you that as an overriding caution. We can do it, but there is no guarantee. Having said that nobody I have ever given these has ever had the illness. “

2) AT: “Right, so will these be pretty effective then, the remedies?”

Homeopath: “I cannot answer that question. The answer I can give you is that if you have the right remedy, yes it’s effective.”

3) AT:” I think I have decided not to take the appointment because I did some research and I came up with a warning from the Health Protection Agency website saying you shouldn’t use homeopathy for malaria so I think it might be better if I use the drugs.”

Homeopath:” [Laughter] Of course they did. Right, if you are influenced by that go with whatever will make you comfortable.”

AT:” Well, I’m just a little bit confused because it said it was supported by the Faculty of Homeopathy as well. I assume they are someone important? I don’t know.”

Homeopath: “Right, yes well, the faculty are all medics so they must more or less toe the medical line. In the end it’s what you feel comfortable with. There isn’t going to be a consensus. If you absolutely don’t want to take drugs or have injections there are always ways of avoiding it… You have to be comfortable with whatever you do. That is the point. If you feel more comfortable following the orthodox advice then go with it. “

4) Homeopath: ”I did say to you no I cannot provide a guarantee …nobody who I have given these things have ever had this disease but that will not statistically support what I am doing in the minds of medics. “

5) Homeopath: “We will find arguments to support our case, each of us. I am quite clear that these things [conventional tablets] are a bad idea and therefore I will see them as undesirable. Those who are medical will be quite clear it is a good idea and will say that the side effects or the risk are minimal so one shouldn’t hesitate.”

6) AT: “It’s just because I had a bad experience last time with malaria tablets which is why I decided to see if there was something else I could take”.

Homeopath:” The answer to that is yes, but not approved by orthodoxy. Plain and simply yes.”

Consultation 3: 11.53am, 9^th June 2006, face to face.

Description of consultation

The consultation took place over the counter of a smart homeopathic shop.

The homeopath told me:

§ That there was something I could take to prevent malaria.

§ That the remedy was called ‘malaria’ and I could definitely take it instead of my conventional tablets.

§ That there were no side effects to taking the homeopathic remedy.

§ The homeopath asked if I was going to continue with my conventional medication, when I asked if I could take the homeopathic remedy instead, I was told that I should stop taking my malaria tablets because it is was bad that they were giving me side effects.

§ The homeopath asked if I knew how to protect myself from bites. I replied that I had been to India before but not Africa and no further comments were made about bite protection.

Advice given:

Take one malaria tablet once on one day of the week

Take China Sulph. the rest of the week twice a day

Take one Vitamin B tablet daily

Prescription (what, cost etc): China Sulph 8x

Malaria 30

Vitamin B1

£18.69

Asked about personal medical history? No

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarials? Advised against it

Recommended back to Dr? No

Advice on bite prevention? Enquired about my knowledge but did not check what I knew.

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

§ In a follow up call to the shop I spoke to another homeopath, who gave me the same advice and said that I should follow Dr Lothell’s advice from ‘The World Travellers Guide to homeopathy’. This is to take the Malaria Nosode and the China Sulph as I was told previously. I was told in this instance that homeopathy had a couple of hundred years behind it and that the logic behind it was sound.

§ I was also told the remedies would prevent ‘a malaria shaped hole’ in my energy.

§ I was also told there were homeopathic alternatives to vaccinations; the example given was for yellow fever.

§ I was told in this instance to protect against bites.

Quotes from consultation:

1) AT:” Will it have any side effects.”

Homeopath: “No, no side effects. Are you carrying on with your medication?”

AT: “Well can I take these instead?”

Homeopath: “Yes I think you should take these instead because if you are having side effects that’s not good. “

Follow up call quotes

2) Homeopath: “Okay, no problems at all. What we do is rather than individualising the case we follow Dr Lothells advice for malarial medicine in the world travellers’ guide of homeopathy.”

3) AT:” Can I take these instead of the tablets and they will okay?”

P1: “Yes. Homeopathy has got a couple of hundred years behind it and the logical bit is quite sound. If a thousand furious malarial mosquitoes all came towards you, I wouldn’t hold my breath and say to them I’ve taken a homeopathic remedy. What it should do is the remedies should lower your susceptibility because what they do is they make it so you energy, your living energy doesn’t have a kind of malaria shaped hole in it. The malarial mosquitoes won’t come along and fill that in. The remedies sort it out.”

Consultation 4: 10.24am, 28^th June 2006, by phone.

Description of consultation

The homeopath told me:

§ That there is a popular homeopathic remedy for malaria made from the malarious tree that people normally take.

§ When asked if I could take this remedy instead of my tablets, the homeopath said that was fine as long as I started to take them a week before I went.

Advice given:

None

Prescription (what, cost etc): Malaria nosode

£6

Asked about personal medical history? No

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

On a follow up call I was told:

§ That there were no statistics available but thousands of people use homeopathic remedies successfully.

§ That it was my decision whether or not I took the homeopathic remedy.

§ I was also told that there was a travel combination of ‘vaccines’ that I can take for Hepatitis A, Diphtheria, Polio, Meningitis, Yellow Fever and Typhoid.

§ I was told that I could prevent mosquitoes from biting by using citronella and lavender oil.

Quotes from consultation

1) Homeopath: “We have already made combination that is very popular called malaria comp and it’s a homeopathic preparation made from the malarious tree. That’s what people usually take”.
Consultation 5: 9.39am, 30^th June 2006, face to face.

Description of consultation:

The consultation was over the counter of a homeopathic pharmacy.

The homeopath told me:

§ That there was a combination of homeopathic remedies I should take.

§ When I asked what was in them, they responded that one was made from quinine and the other was made from different types of malaria. They said: ‘It works on the same principles as vaccination but …very, very dilute’.

§ That there will be no side effects.

Advice given:

Take Malaria Nosode weekly and start two weeks before I travel and continue for four weeks after I return.

Take China daily only in affected areas.

Take garlic as it changes the taste of your blood so it is bitter and the mosquitoes don’t like to bite you

Make sure the remedies are not x-rayed by the airport machines.

.

Prescription (what, cost etc): Malaria Co. Nosode 30

China Officinalis 6x

£8.25

Asked about personal medical history? No

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

§ I asked about their travel kits and I was told that they would help with illnesses such as dengue fever and dysentery. They work by the individual looking through the booklet and looking up their symptoms and matching them to the remedy.

Quotes from consultation

1) AT: “What actually are in these? I’ve never been to a homeopath before.”

Homeopath: “Ok well this is China Officinalis and it is made from the bark of a tree. Its quinine and quinine is one of the main ingredients of anti-malaria. With homeopathy it’s very dilute so you are just giving a little bit to your body to remind it so it can build up some immunity. With this one [Malaria Nosode] it is actually made from Malaria so it works on the same principles as vaccinations but it’s homeopathic so it’s very, very dilute. Your body is just going to respond to it lightly, you’ll have no chance; it’s such a dilute potency that there is no chance you will catch malaria or anything like that. It’s made from all different types of malaria.”

2) AT: “I also saw on the web site that you do travel kits”

Homeopath:” It’s more geared towards travelling to places like Africa and SE Asia…It covers things like jelly fish stings, dengue fever.”

AT: “What about things like stomach upsets or dysentery?”

Homeopath: “That is one of the main thing it covers, like diahorrea. “

Consultation 6: 12.35pm, 28^th June 2006, by phone.

Description of consultation

The homeopath asked me what region of Africa I was going to and whether it was high risk. They then told me:

§ That the remedies were ‘homoeopathically the same as taking doctors stuff’ and ‘ no remedies doctors (provide) can guarantee prevention.’

§ That the remedies will lessen the risk and severity of the attack.

§ That they are not 100% effective but that other remedies, conventional antimalarial, won’t either.

Advice given;

Take Malaria Officinalis once a day one day a week and start two weeks before go

Take China Officinalis twice a day on other days and carry on for couple weeks when get back

Take Vitamin B and eat lots of garlic

Take Echinacea for the immune system

Prescription (what, cost etc): Malaria Officinalis

China Officinalis

No cost given

Asked about personal medical history? No

Asked about destination/advised on destination? Asked which part of Africa and if I knew if high risk area.

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? Yes

Advised if got bitten to use lavender oil and homeopathic remedies called Apis and Ladun

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

I was told that Echinacea was a prophylactic. The homeopath again said that it was my choice about whether I took homeopathic remedies or not but that both options (conventional and alternative) are feasible.

Quotes from consultation:

1) Homeopath: “Ok basically homeopathically it is also the same as taking doctors stuff. No remedies…all the time can guarantee prevention, however the risk and the severity of the attack can be lessened so there are things that you can take.”

2) AT: “So can I take these instead of my tablets?”

Homeopath:” Well nobody can say absolutely they are 100%. Nothing can guarantee it nor can the other remedies. I wouldn’t like to say they would do that, but certainly they can cut down the risk and severity of the attack.”

Consultation 7: 10.04am, 28^th June 2006, by phone

Description of consultation

The homeopath told me:

§ That conventional malaria tablets are a homeopathic remedy in a way.

§ That there is no replacement but you can consult a homeopath and ‘get something different’

§ That I should come in for a consultation so that they could advise me properly.

§ When asked whether she could definitely give me an alternative to my tablets she replied that she could and that it would be a ‘precautionary ethogen’.

Advice given:

None

Prescription (what, cost etc): £40 for consultation

£4 for any prescriptions but in follow up call stated £15 per prescription

Asked about personal medical history? No

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

§ The homeopath rang to cancel the appointment I had made and said she had already ordered the remedies in, without me having a consultation, and referred to them as ‘some malaria vaccines’.

§ In a follow up call the homeopath checked my destination and referred to the remedies as “vaccines”

§ I was told they ‘were alternative to the ones [conventional treatment] you get’

§ I was also told that the vaccines were £15 each in contrast to the original conversation where I was told they were £4 each.

Quotes from consultation

1) AT: “And you would definitely recommend something I can take instead of my tablets because that’s what I want really.”

Homeopath: “Yes. Some precautionary ethogen and you would continue to take it.”

2) AT: “Can I take these instead of my malaria tablets?”

Homeopath: “Yes. They are homeopathic. You know how to take homeopathic vaccines?”

3) AT: “Are they quite effective these remedies? They’re quite good?”

Homeopath: “They are alternative to the ones you get. I’ll put the information with them so you can make your own decision.”

Consultation 8: 3.04pm, 28^th June 2006, by phone.

Description of consultation:

The telephone consultation was in response to an email I had sent, which said that there was a homeopathic remedy for malaria but that I had to ring to speak to the homeopath. On ringing I was told:

§ That there was something I could take and, when I enquired as to what it was, that it was a remedy they make up in the shop.

Advice given:

That I take one dose three times on one day the week before I travelled and then that I should continue whilst I was away and continue for three weeks on my return.

Prescription (what, cost etc): Not specified

£5.20

Asked about personal medical history? No

Asked about destination/advised on destination? No

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

No other comments.

Quotes from consultation

1) AT: “I emailed the pharmacy about homeopathic alternatives to anti-malaria treatment. Basically I was told to ring you.”

Homeopath: “Yes, we have got it.”

AT:” I’m going away to Africa on a truck tour for 10 weeks but the anti-malaria tablets my doctor gave me made me feel sick last time. I wondered if there was a homeopathic remedy I could take instead?”

Homeopath: “Oh yes there is. When are you going?”

Consultation 9: 3.05pm, 4^th July 2006, face to face.

Description of consultation:

The initial contact was made by email through a referral by a company specialising in herbs. It was confirmed in the email that I could be given something instead of my tablets. The consultation was a room within a Pilates centre. The homeopath:

§ Asked me for details of my trip. The homeopath had lived in Africa and had suffered from malaria before.

§ Was very keen that people try to treat themselves naturally as a lot of the malaria strains had resistance to conventional treatments and most people suffered from side effects.

§ Asked me about my general health, digestion and so on. She asked me about what illnesses I had experience from childhood onwards. She said that this was so she could establish my underlying health. She also asked for the specific details of my childhood diseases.

§ Asked me about my emotional, physical and mental weaknesses. When I said that I got stressed easily she asked me to describe how this affects me physically.

§ She asked whether I got angry or irritable and how I dealt with it.

§ She said that there was no guarantee with either alternative or allopathic remedies but the alternative ones will make it unlikely to get malaria and will make the symptoms less severe.

Advice given:

§ I was told to eat fresh fruit and vegetables and to clear my digestive system using prune juice to make sure I emptied my bowels daily.

§ I was advised to drink water before 10am, fruit all day and a large bowl of salad followed by a normal evening meal.

§ Herbal tincture for my liver.

§ Take Malaria Nosode once a week

§ Tincture made with mean twice a day to keep my blood unattractive to mosquitoes

§ Remedies in case I contracted malaria

§ I was told that if I contracted malaria and I felt no better after 12 hours to see a professional doctor.

Prescription (what, cost etc): Malaria Co. 30C

Malaria Mix – for if you contract Malaria

Chelidonium+ Carduus herbal tincture

£50 for consultation and remedies.

Asked about personal medical history? Yes in great detail (see above)

Asked about destination/advised on destination? Yes – told chances of catching malaria 1% or 2% in Kenya

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? Yes

§ I was told to make sure that I had a mosquito net and that this was essential.

§ I was given a list of preventive remedies such as how to make a natural anti-mosquito remedy through geranium oil, lime juice or Avon Woodland Herb lotion.

§ I was told to eat the white part of grapefruits as it is a natural source of quinine and it would make my blood bitter.

Advice on symptom recognition? Yes – I was given specific list of symptoms.

Comments (e.g. other issues raised, or further follow-up)

I asked about vaccinations and I was told that homeopathic alternatives existed. She said that conventional vaccinations were ‘incredible things but they came at a cost’

Quotes from consultation

1) Homeopath: “I grew up in Africa and I have had malaria. So I’m very keen on people trying to treat themselves naturally. These days the malaria parasite is incredibly resistant to any kind of drug treatment. Anything you take, the side effects are just”

2) Homeopath: “What has your friend chosen to do?”

AT: “She is going the conventional route. Doxycycline I think.”

Homeopath: “It’s good that you are doing this. The thing about the drugs, they are just not good to take. Take, especially in the evenings when they come out, thin long cotton shirts or something. If they don’t provide a mosquito net, I think you can get them”

3) Homeopath: “What I need to say to you is that there is no guarantee with either allopathic or alternative malaria prophylaxis. I can’t guarantee you won’t get malaria. It will just make it unlikely. Because of the treatment I am giving you, the symptoms will be less severe and make it more manageable.”

4) AT: “In future if I wanted to, is there homeopathic alternatives [vaccinations] I could take instead?”

Homeopath: “Yes, there are.”

AT: “That would be something I would definitely be interested in.”

Homeopath:” Again too many vaccinations, its tough on the immune system. They are incredible things but there is a cost as well. “

Consultation 10: 5.40pm, 4^th July 2006, by phone.

Description of consultation:

The homeopath:

§ Told me that there is a homeopathic remedy, hydrophobine, which is also known as malaria that comes in three different potencies.

§ Asked me whether I had you taken conventional anti-malarial tablets before and whether I had experienced any reactions.

§ When I explained that I’d had a bad reaction to my conventional tablets and that they made me feel ill, she said that ‘you are obviously not meant to take them’.

§ Asked me whether I was going into deepest Africa.

§ Told me that most people like the homeopathic remedies and prefer them to conventional treatments.

Advice given:

Take the homeopathic malaria remedy (hydrophobine) 3 weeks before I travel and while I am away.

Immune boosting tonic (made up by homeopath) daily

Vitamin C tablets daily.

Multi bio mineral daily

Prescription (what, cost etc): Homeopathic malaria remedy

Immune boosting tonic (£12)

Vitamin C

Multi bio mineral

Prices unknown

Asked about personal medical history? No

Asked about destination/advised on destination? Asked where going but no advice given

Advised to continue conventional anti-malarials? No

Recommended back to Dr? No

Advice on bite prevention? No

Advice on symptom recognition? No

Comments (e.g. other issues raised, or further follow-up)

No other comments.

Quotes from consultation

1) Homeopath :” No, have you used malaria tablets before?”

AT: “The conventional ones? “

Homeopath: “Yes.”

AT: “I took them a couple of years ago.”

Homeopath: “Any reactions?”

AT “Yes, I had a bad reaction then as well.”

Homeopath: “Right, so you are obviously not meant to take them. Are you going deep into Africa did you say?”

AT: “It’s sort of central Africa. It’s a truck tour so it’s though various countries, through central Africa and down to the South.”

Homeopath: “What I would do is boost your immune system for start off. Right you are going in four weeks. I would look at doing some vitamin C daily. I would look at taking a good daily multi bio mineral daily running up to it. There is a combination tonic I make up for people to take away. I could make that up for you for alongside the malaria, well for the trip actually. You can have, I can post you on the malaria tablets. Alternatively if you wanted to come into XX …in two weeks time. “

2) AT: “Are they pretty effective? Do they work quite well?”

Homeopath: “Well, most people do like them. They prefer to have them rather than the malaria. I can send you the immunity balance tonic if you would be interested in that?”

AT: I might be interested. I might pop in. When are you in?”

[

BA Travel Clinic 8^th June 2006, face to face

Description of consultation

The BA travel consultation was conducted with a nurse and took approximately half an hour. The nurse asked where I was going and for my vaccination and medical history.

Advice given:

§ The countries in central Africa where high risk but you will not need protection in certain parts of Southern Africa.

§ There are three possible malaria tablets for this type of trip; Malarone (atovquone-proguanil), Doxycycline and Lariam (mefloquine)

§ The pros and cons were discussed for each tablet

§ Lariam is linked to hallucinations and is not advised if history of depression. It is also particularly likely to affect women. However, the course of treatment is started 2-3 weeks prior to trip and the patient is monitored. This ensures if side effects occur it can be dealt with prior to leaving on trip.

§ Doxycyline is cheapest but can interfere with the contraceptive pill. It also can cause photosensitivity

§ Malarone is the newest and the most expensive but it has the least side effects.

§ I was given a choice of which I wanted to use but the nurse’s recommendation was Doxcycline due to the length of the trip and the fact I was not on the pill.

§ There is another anti-malarial treatment, a combination of Chloroquine and Proguanil, but this was not recommended for the regions I was visiting due to high levels of malaria resistance to these drugs.

Prescription (what, cost etc): Recommended Doxycycline.

Consultation cost £15 redeemable on purchase of tablets

Asked about personal medical history? Yes

Any medication

Contraceptives

History mental illness

Asked about destination/advised on destination? Yes

Advised to continue conventional anti-malarials? N/a

Recommended back to Dr? N/a

Advice on bite prevention? Yes

Advice on symptom recognition? Yes

Comments (e.g. other issues raised, or further follow-up)

§ To come back once decided what anti-malaria medication I would like to pursue.

§ Also advised on the other vaccinations I would need and my vaccination history taken.