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Travel Health


One of the topics we receive the largest number of questions about is travel health in Africa. What jabs do I need? Which anti-malarial should I take? Do I need that 10-kg medical kit which includes syringes, sutures, and a portable defibrillator?

The first and most important advice we can give is to have a one-on-one consultation with a travel medicine specialist at least 8 weeks before you depart for Africa. You need to go over your itinerary with someone who is familiar with your full medical history and the medications you're currently taking, as well as the latest developments in the field.

Please remember that nothing on the Internet, no matter how authoritative the source, can substitute for a personal consultation with a travel medicine specialist! We have seen people soliciting medical advice from fellow travellers on online forums, which is a bit worrying - not only is it impossible to verify the quality of the information, but the person providing it knows nothing about your medical history, which is the single most important factor in determining what is right for you.

If you don't know of a travel medicine specialist or travel clinic nearby, a full list of current travel clinic websites worldwide is available from the International Society of Travel Medicine.

The second piece of advice we can give is to remember that the vast majority of people who travel to Africa enjoy their trips with no health problems whatsoever. While it's wise to be concerned about staying healthy, there's no need to become paranoid or to let worrying about your health interfere with your enjoyment of your safari.

Here are answers to some of the most frequently asked questions:

Which jabs (shots) do I need?
This depends entirely on your itinerary and your personal medical history. Bring a copy of your itinerary to your consultation to make sure that all countries are taken into account - this is particularly important for determining whether you will need a yellow fever vaccination.

You should also check with your GP / primary care physician to make sure that your basic immunizations are up-to-date. Many adults have a tendency to fall behind on boosters for their standard immunizations such as diphtheria, polio, and tetanus. These are just as important as the more exotic immunizations.

What do I need to do to avoid getting malaria?
The most deadly animal in Africa is not, as you may have heard, the hippo - it's the Anopheles mosquito. In this case the female of the species is indeed more deadly than the male, as she is the one whose bite spreads malaria.

The first line of defence is to avoid being bitten in the first place. This means covering up with light-coloured clothing at dusk (when Anopheles mosquitoes become active) and using repellent containing DEET on exposed skin. Remember to re-apply the repellent after washing your hands or if you've been sweating.

The second is to take anti-malarial medication (prophylaxis). The choice of anti-malarial depends on your itinerary and your personal medical history, as some of the drugs are contraindicated for people with particular medical problems. Regardless of which drug you take, you must complete the full course (including the part which takes place after you have left the malarial region) in order to benefit from its protective properties.

While some people prefer not to take the medication, we strongly recommend taking it if your safari includes time in malarial regions. The drugs may have side effects, but malaria is not a trivial illness. If you would prefer a malaria-free safari, we're happy to recommend places where you can go on safari without the risk of malaria.

One final note about malaria: if you develop a feverish illness when you come back from your trip, make sure that your doctor knows that you have recently returned from Africa and that you spent time in malarial regions. Most doctors see very few (if any) cases of malaria and it won't be the first thing that comes to mind. Rapid diagnosis is key to successful treatment, so make sure your doctor knows that malaria is a possibility. Symptoms related to the most serious form of malaria usually occur within three months following infection, though symptoms related to the less serious forms can occur more than a year following infection.

For more information about malaria and malaria prevention, visit Malaria Hotspots.

What should I put in my travel medical kit?
Your lodge or camp will have a first-aid kit on hand, and one or more staff members will be trained in first aid. Remember, the staff live in the bush full-time, and accidents do happen so they need to be prepared. That being said, the kit may not contain the brands of medication you are familiar with, so you may prefer to bring your own. The following list is an example and is not necessarily right for everyone, but it may give you some ideas on where to start. Note that this is in addition to any prescription medication.
  • Hand sanitising gel
  • Alcohol or Betadine swabs for disinfecting cuts, scrapes, etc
  • Triple antibiotic ointment (Polysporin)
  • An assortment of plasters (bandages)
  • Sterile gauze pads and tape
  • Ibuprofen
  • Aspirin
  • Digital travel thermometer (make sure the battery is charged!)
  • Antihistamine (Benadryl)
  • Insect bite cream
  • Oral antiseptic / analgesic
  • A few throat lozenges (cough drops)
  • A course of antibiotics (Cipro)
  • A course of cold medicine (Sudafed)
  • A course of anti-diarrhoeal medication (Immodium)
  • Salt and sugar packets to create oral rehydration solution (you can also buy commercial rehydration solution)
  • Tweezers (on Swiss army knife)
NOTES:
  • This basic kit is customized depending on trip length, planned activities, and the remoteness of the destination.
    • If you have a tendency to sprain your ankles, you may want to bring an ACE bandage if you plan to do a lot of walking / hiking, as well as some Nu-Skin or Moleskin for blisters.
  • You don't need huge amounts of any one item. 4 of each for things like plasters, gauze pads, alcohol swabs, salt packets etc is normally plenty. Store them in a Ziploc bag so they don't get lost in your luggage.
  • In case you're curious, so far we've used everything except the Cipro, Benadryl, and Immodium (touch wood) on my trips. We went several trips before needing the Betadine, plasters, gauze, and tape.
Do I need to bring syringes?
There are good arguments both in favour of bringing syringes and in favour of leaving them out. Here is Julian's take on them:
  • If I'm going somewhere extremely remote, I'll take a separate emergency sterile kit (syringes, a blood draw / IV transfusion kit, and sutures). There is a high incidence of HIV in Africa and equipment does get re-used without being properly sterilised - I don't want to make anyone paranoid, but it's something to consider. I've made up my own but you can buy them commercially as well. If you go to the trouble of bringing one of these, keep it in your daypack - it doesn't do you much good sitting in your tent if you really need it!

Is it safe to eat the food at the safari lodges / camps, or do I need to bring an extra suitcase full of protein bars and granola?
Safari lodges and camps depend on their reputation among visitors like you for their survival. The safari community is very small, and the last thing any camp wants is to get a reputation for causing people to come down with food poisoning! So they will take every possible precaution to ensure that the food is safe. We have never encountered a case of anyone becoming ill from something they had eaten at a safari camp. In many cases, the food is not only perfectly safe but extremely good!

Even the fruit and vegetables?
Yes, even the fruit and veg! The wonderful fresh fruits and vegetables are one of the things we look forward to most on our safaris.

Resources
If you'd like to do some research on these or other questions prior to your appointment with your travel medicine specialist, we recommend consulting the following websites: These are the best travel medicine resources available on the Internet, assembled by specialists in the field. But please remember that not even they can substitute for a one-on-one consultation with a travel medicine specialist.