Some players deal cards and the player who gets the highest one, starts.

The player also must deal with different levels of malaria.

The player with the highest card deals the first hand.

That player then deals the first hand of cards for the round.

Many players deal the initial table cards in a 2x2 square.

Some players deal 12 cards each in the first three hands, rather than 9, 10 and 11.

After the first hand the players deal alternately, if only two play.

If more than two play, the players deal in rotation to the left.

If the player doesn't deal any card in a round, the final score will be double.

So the player can deal cards from the stock one at a time.