Congo - Health and safety


Health
Safety

Health

With Dr Felicity Nicholson. For up-to-date information on health issues across Africa, click here.

People new to exotic travel often worry about tropical diseases, but it is accidents that are most likely to carry you off. Road accidents are very common in many parts of the Congos so be aware and do what you can to reduce risks: try to travel during daylight hours, always wear a seatbelt and refuse to be driven by anyone who has been drinking. Listen to local advice about areas where violent crime is rife too.

Preparations

Preparations to ensure a healthy trip to either the DR Congo or Congo require checks on your immunisation status: it is wise to be up to date on tetanus, polio and diphtheria (now given as an all-in-one vaccine, Revaxis, that lasts for ten years), typhoid and hepatitis A. Immunisations against meningococcus and rabies are also likely to be recommended. Proof of vaccination against yellow fever is mandatory for entry into the Congos. The World Health Organization (WHO) recommends that this vaccine should be taken by everyone over nine months of age, although proof of entry is only officially required for those over one year of age. If the vaccine is not suitable for you then obtain an exemption certificate from your GP or a travel clinic although you would have to consider if it was wise to travel to a high-risk country for yellow fever without protection. In the last ten years there has been an almost 100% fatality in non-immune travellers going to yellow fever endemic areas who have contracted the disease. Immunisation against cholera may be advised for longer visits, especially if you are intending to stay in poorer areas. The oral cholera vaccine (Dukoral) gives about 75% protection and for adults and children over six years of age the course consists of two doses given between one and six weeks apart and at least one week before entering the area. Coverage is said to last for about two years. For those aged between two and six, three doses are needed, which requires a boost after six months.

Travel clinics and health information

A full list of current travel clinic websites worldwide is available on www.istm.org. For other journey preparation information, consult www.travelhealthpro.org.uk (UK) or http://wwwnc.cdc.gov/travel/ (US). Information about various medications may be found on www.netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.

Safety

Poverty is rampant, but outright begging is generally only seen in the capitals Kinshasa and Brazzaville; though once a foreign face is seen anywhere across the region other beggars can quickly appear. Citizens of both Congos are less likely to beg than in other countries and are more likely to try and extract cash and gifts through other means – such as overcharging. Set prices in taxis beforehand, and if possible have someone else negotiate prices for long-distance travel and tip them afterwards. When crossing frontiers, it is likely that your luggage will be searched by hand and things can easily go missing. Keep anything of value in your immediate possession, and be vigilant at all times with things you are carrying.

Corruption

The largest problem any visitor will encounter is corruption – it is endemic across the two countries, a veritable institution, and often the only way any officials receive money since when they do get paid it can be months behind schedule. Unfortunately when given a uniform and badge of some sort, people in the Congos will see this as licence to stop and harass anyone and everyone for money – and as a foreigner you can be guaranteed that you will be singled out. Remember that you are primarily seen as an opportunity by people you encounter, and friendliness can go a long way. However, I recommend against offering anything to anyone initially – I do not condone bribery and extortion and this habit can only make matters worse. This is a central problem with the Congos, and unless you want to depart empty-handed, limiting your generosity to those you meet is absolutely necessary.

Corruption is becoming less of a concern as international companies move into the DR Congo especially, and demand some semblance of professionalism from government officials that they deal with. Having genuine money problems can, sometimes, get you through tight situations and you might even find these people doing you a favour for free (but don’t count on it). However, knowing how to deal with these people is still critical to being able to move throughout the two countries without losing your sanity and every item of value in your possession.

Remain polite at all times – no-one in the Congos responds well to anger or threats and losing control will only make your situation worse. Realise that random arrests, being pulled aside, and constant poring over your various documents all comes down to a quest for cash. If you keep this in mind and aim to mitigate the amount you need to pay, your journey will be that much more enjoyable.

In fact, I recommend trying to have fun with these people – as much as possible. Being courteous, affable, but ultimately lacking as much money as they want to take from you will be your best approach. Carrying a wallet with a few dollars between checkpoints can get you through tough situations – bring small notes in American dollars, Central African francs (CFA), or Congolese francs (Fc) and hand them a wad of bills and quickly be on your way. They will not count them in front of you – they will be happy that you complied.

Besides this, it should be obvious that you should have your paperwork in order at all times when confronted with the possibility of running into various officials. Giving these people a valid reason to extort money from you is a bad situation to be in, as they will be trying their hardest to find anything wrong with your paperwork already. And as a general rule, unless an officer is standing right in front of your vehicle with his hands waving and blowing his whistle so hard a vein is going to pop – just drive around them. If they stop you later, simply apologise and say you didn’t see them. It’s like that in the Congos.

Women travellers

Females travelling solo through the Congos are something of a rarity, but if you are obviously foreign, you should take the same precautions as males. However, women’s rights have a very long way to go in these regions and I cannot recommend travelling outside of the main towns and cities on your own – make some friends, go with a tour, have someone you trust come along. Going around alone at night is simply asking for trouble.

Some women can be seen in Kinshasa with Congolese boyfriends, and given the dichotomy between men and women it may be necessary to have some sort of male accompaniment to help a foreign woman in her travels around the country. Venture further afield and a solo female traveller will be quite the novelty, but like any traveller who is too far from the radar it could appear as an opportunity too good to pass up for local thieves. While a male might get away with fewer precautions when travelling around the countries alone, a female should make sure that her itinerary is known to someone inside the country. Make arrangements for people to meet you along the way, and involve others in the decision-making process of how to travel around. Hire motorbike and taxi drivers based on recommendations, not simply by flagging one down on the street.

Crime

Overall, crime is as much an issue in the two Congos as it is anywhere else in Africa – take care of your belongings, even in your hotel room, and be careful with your money as well as anything of value. Do not dress too extravagantly when in public and do not carry too much money while out on the town. Be careful at night and secure private transport when out in any town after dark, especially in Kinshasa. Avoid public transport altogether after dark in any of the big cities. Never walk around at night in any major towns, though Congo-Brazzaville is a far safer country than the DR Congo in this respect. Remember that you are more than likely being watched at all times, and wandering alone into a quiet neighbourhood can easily be seen as an opportunity to those less fortunate.

Riots

Various cities across both Congos have, in the past, had some rather nasty public uprisings that receive plenty of press coverage and plunge a city into more disarray than usual. I mention rioting because in large African cities where poverty is common, crowds can quickly accumulate from nowhere and large numbers of men in uniforms may be sent to disperse those crowds by any means necessary. It is helpful, then, to know how to handle oneself in these situations – and the best I can recommend is to seek shelter indoors at the nearest place with reasonable security such as a hotel, bank or restaurant. Foreigners in plain view during chaotic moments can be far too inviting a target for a few agitated locals, and observing these events from afar is the only way to observe them at all. It may be inviting to wait and see what may transpire, but you are truly playing with your life in these situations. Peaceful protest is something that does not really exist in the DR Congo on a spontaneous level, and it should be obvious if you are witnessing an organised march or an illegal manifestation from the general attitude of people in the streets – and the numbers of soldiers and police in the area. I would advise avoiding any large public gatherings unless a local is with you to provide some advice.

Eastern DR Congo

The fortunes of those in the DR Congo’s turbulent east have gone from bad to worse, to awful, back again to bad, and can now best be described as ‘getting better’. The entire region is still very much in flux, with continuing problems from numerous rebel groups and agitation from external forces such as foreign governments. Major towns are generally secure, but going out into the countryside requires preparation, planning, and above all local advice. Ask at every opportunity about the road ahead if you are taking private transport – things change faster than a guidebook can advise. If possible, hire a local to come with you and negotiate with people along the way. You may even need to hire security along certain roads in the east if you are overlanding – large trucks that ply these roads will sometimes have ubiquitous gunmen on their cabs and roofs, and one vehicle slowly trundling along dirt roads without any sort of protection is a great opportunity for people from all over the region to take their chances at relieving you of everything.

Things are improving, though, as the electoral results have given new hope to the region’s population. Fewer precautions are necessary and all-out combat and disarray is generally a thing of the past. It is far more likely that if there is a problem the region will be sealed off, and you will only have to deal with corrupt officials rather than open conflict.

Landmines

Large fields of mines left over from the days of UNITA litter the border between the DR Congo and Angola. Furthermore, there are reports of landmines in Cabinda, and the frontier regions of Congo-Brazzaville. All of these are decades old and, while usually not well marked, are well known by locals. Some farmers in Congo-Brazzaville have refused to work on certain fields because of the landmine risk. A more insidious and difficult aspect of the landmine problem across the Congos exists in the east: in the Kivus, new minefields were laid during the conflicts of 2003 and 2004. Some roads have been mined, and it was an active part of the conflict to plant mines around markets, hospitals, houses and footpaths, deliberately targeting civilians as they went about their daily lives.

The good news is that in conjunction with MONUC, mine-clearing firms have been working steadily around the country. Nonetheless, running off into the bush is a bad idea: if you are travelling deep into unknown territory, ask for a local’s advice at the very least, and preferably bring a guide. Make the guide walk in front, and follow his or her footsteps exactly if the area has a history of mines. Most major towns and their outlying areas have been cleared, but there is no way of totally confirming the safety of a region due to the ongoing conflict in some regions of eastern DR Congo. All of this means, again, that running far off the beaten track in the Congos can have serious consequences.

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