Health

Tanzania has a tropical climate and different bacteria, flora and fauna than most visitors are accustomed to , so it is advisable to take a few health precautions when travelling to make sure your trip goes as comfortably and smooth as possible. Malaria is usually top on the list of visitors’ worries, and prevention goes a long way towards keeping you protected. Make sure to visit your doctor to get a prescription for the anti-malarial drug the best suit you. The yellow-fever vaccination is no longer official required when entering Tanzania; however this is still a requirement if you wish to visit Zanzibar. Other vaccination should be considered.

Immunisation
The best choice of vaccines for your trip depends on many individual factors, including your precise travel plans. Vaccines commonly recommended for travellers to Africa include those against Tetanus, Diphtheria, Polio, Typhoid, Hepatitis A, Hepatitis B, Yellow fever, Rabies and Meningitis.

Certificate required for entry into, or travel between, some African countries. Several of these vaccines require more than one dose, or take time to become effective. It is always best to seek advice on immunisation well in advance, if possible around 6 weeks before departure.

What to pack
It is advisable to travel with a small medical kit that includes any basic remedies you may need, such as antacids, painkillers, anti-histamines and cold remedies. You will also need anti-diarrhoeal medication such as Imodium (adults only); and oral rehydration sachets such as Electrolade, especially if travelling with children. Also include first aid items such as Band-Aids, antiseptic and dressings. It may be worth asking your doctor to prescribe a broad spectrum antibiotic, suitable for treating dysentery or severe infections.

Take along scissors, tweezers, and thermometer, lip salve, sun block, water purification tablets or drops, as well as your preferred brands of toiletries and cosmetics. If you wear spectacles or contact lenses, take spares. Also take a torch and a pocket knife.

Food & Hygiene
If you eat every meal you are offered, anywhere in the tropics, you will undoubtedly become ill. Be selective. Possible disease hazards range from minor bouts of travellers’ diarrhea to dysentery and more serious parasitic diseases that may ruin your trip, so precautions are worthwhile. Always choose food that has been freshly and thoroughly cooked, and is served hot.

Avoid buffet food, or anything that has been re-heated or left exposed to flies. Avoid seafood. Raw fruit and vegetables tend to be very difficult to sterilise: don’t eat them unless they have been carefully and thoroughly washed in clean water, or are easy to cut open or peel without contaminating the flesh. In the tropics, the easiest and safest fruits are bananas and papayas.

Do not be afraid to reject food you consider unsafe, to ask for something to be prepared specially, or to skip a meal.

Water Purification
Only drink water that you know is safe. Don’t drink tap water or brush your teeth with it, stick to bottled or canned drinks – well known brands are safe. Have bottled mineral waters opened in your presence, and regard all ice as unsafe. Alcohol does not sterilise a drink!

If in doubt, purify water by boiling or with chlorine or iodine, or using a water purifier. (One of the safest methods is to use 2 percent tincture of iodine: add 1 drop of iodine to each cup of water, and wait 20 minutes before drinking.)

Accidents and Injuries
Accidents and injuries kill many more travellers than exotic infectious diseases: be constantly alert! Risks arise not just from the accidents themselves but also from the scarcity of skilled medical care. Don’t drive on unfamiliar, unlit roads at night. Don’t ride a moped, motorcycle or bicycle. Don’t drink and drive, and don’t drive too fast. Insist that taxi-drivers drive carefully when you are a passenger. Use seat belts, and for children, take your own child seats. Take special care at swimming pools: never drink and swim, and always check the depth. Carry a small first aid / medical kit. Minor wounds may easily become infected: look after them carefully and seek prompt attention if necessary.

Tropical Diseases
Malaria:Malaria is a disease spread by mosquitoes that bite mainly at dusk and at night: every traveller to Africa needs reliable, up to date advice on the risks at his or her own destination. Prevention consists of using effective protection against bites (see below), plus taking anti-malarial medication. The most suitable choice of medication depends on many individual factors, and travellers need careful, professional advice about the advantages and disadvantages of each option. The most effective preventive drugs for travel to Africa are:

Lariam: widely-used; side-effects have received much media attention (ranging from vivid dreams to more serious neurological reactions); those who should not take this drug include travellers with a previous history of neurological and psychological problems.

Doxycycline: possible side-effects include a skin reaction that can be triggered by bright sunlight, as well as an increased risk in women of vaginal thrush.
Malarone: highly effective, well-tolerated, and with an extremely low rate of side-effects, but more expensive and currently only available on an unlicensed basis from specialist centres. Chloroquine and Paludrine have little risk of side effects and were previously widely used, but are now only about 50-60 per cent effective in many parts of East, West, and Central Africa, and must be used with caution, if at all. Commercial import to Tanzania has even been stopped.

Whatever your choice, you must take an anti malarial drug if you are visiting a malarial region, and you must continue taking the drug for the necessary period after your return; you must also take precautions to reduce the number of insect bites (see below).

Visitors to malarial areas are at much greater risk than local people and long term expatriates – from malaria as from several other diseases: do not change or discontinue your malaria medication other than on skilled professional advice. Travellers to very remote places should also consider taking stand-by malaria treatment, for use in an emergency.

Other Tropical Diseases Tropical diseases are relatively uncommon in travellers. Most of them tend to be food-borne or insect-borne, so the precautions listed above will prevent the majority of cases.

Schistosomiasis, also known as Bilharzia, is a parasitic disease spread by contact with water from lakes, rivers and streams. Regardless of any advice you may receive to the contrary by local people, and even tour guides, no lake, river, or stream in Africa is free of risk. Contact should be avoided or kept to a minimum. Chlorinated swimming pools are safe.

Rabies: In Africa, dogs are not pets: avoid handling any animal. Rabies is transmitted by bites, but also by licks and scratches: wounds need thorough scrubbing and cleansing with antiseptic, followed by prompt, skilled medical attention including immunisation. Seek advice about pre-travel rabies immunisation, especially if your trip will be a long one.

Coming Home
Most cases of traveller malaria occur when travellers stop taking antimalaria drugs as soon as they get home. This is dangerous – tablets should be continued as instructed (at least 4 weeks after leaving a malarial area, except for Malarone, which can be stopped after 1 week).

Symptoms of malaria – and other tropical diseases – may not appear until long after your return home – you may not necessarily associate them with your trip. Always report any symptoms to your doctor, and make sure that he or she knows that you have been to Africa, even up to 12 months after your visit. DEMAND a blood test for malaria. If you have been exposed to schistosomiasis, a blood test at least six weeks after returning home should be considered.

No responsibility can be accepted by AMREF or contributors for actions taken as a result of information contained here. Everyone is advised to seek proper medical advice where necessary before, during and after travel.

The Flying Doctor Service
In many parts of Africa access to adequate health care can mean long, tortuous journeys by road. The Flying Doctor Service operated by AMREF not only provides outreach and emergency care to local communities in remote regions, it also provides a medical air evacuation service to tourists. By joining the Flying Doctors’ Society you can help the service reach the people who need it most and also ensure a free emergency evacuation flight for yourself should the worst happen on your travels. Visit the Flying Doctors page to find out more, and to become a member of the society, click here.

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