Health and safety- eSwatini


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

First-timers to Africa often worry about tropical diseases, venomous snakes and other hazards popularly associated with the ‘dark continent’. In fact, eSwatini is generally a safe and healthy place in which to travel. Much of the country lies at high enough altitudes to enjoy a temperate climate and none of it is tropical (eSwatini lies south of the Tropic of Capricorn), so many ailments associated with tropical Africa are either rare or absent entirely. Those that do occur are generally confined to the lowveld. A much greater risk than any disease to the average traveller is road accidents, which can be minimised by a few sensible precautions.


Visit your doctor or a specialist travel clinic to discuss your requirements, if possible at least eight weeks before you plan to travel. Check 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) and hepatitis A. Immunisations against rabies may also be recommended for some travellers. Proof of vaccination against yellow fever is needed if you are coming from a yellow-fever endemic area, though a yellow-fever vaccine is not needed for eSwatini alone. Immunisation against cholera is no longer required for eSwatini.

Hepatitis A vaccine (Havrix Monodose or Avaxim) comprises two injections given about a year apart. The course may be available on the NHS. It protects for 25 years and can be administered close to the time of departure. Hepatitis B vaccination should be considered for longer trips (two months or more) or for those working with children or in situations where contact with blood is likely. Three injections are needed for the best protection; for those aged 16 or over, they can be given over a three-week period if time is short. Longer schedules give more sustained protection and have to be used for those under 16. Hepatitis A vaccine can also be given as a combination with hepatitis B as ‘Twinrix’, though two doses are needed at least seven days apart to be effective for the hepatitis A component, and three doses are needed for the hepatitis B. Again this schedule applies to those over 16.

The newer, injectable typhoid vaccines (eg: Typhim Vi) last for three years and are about 85% effective. Oral capsules (Vivotif) may also be available for those aged six and over. Vaccinations for rabies are recommended for travellers visiting more remote areas, especially if working with animals.

Experts differ over whether a BCG vaccination against tuberculosis (TB) is useful in adults: discuss this with your travel clinic. In addition to these various vaccinations, you must give proper consideration to protection against malaria.

Travel clinics and health information

A full list of current travel clinic websites worldwide is available on For other journey preparation information, consult (UK) or (US). Information about various medications may be found on All advice found online should be used in conjunction with expert advice received prior to or during travel.


eSwatini is, by-and-large, a safe country in which to travel. It does not have South Africa’s alarming crime rate, and tourists are seldom targeted. Equally, it does not have South Africa’s history of racial tension, which means that visitors are unlikely to encounter any antagonism on that basis. Indeed, hospitality is a cornerstone of Swazi culture and the average visitor’s experience is overwhelmingly a friendly and relaxed one. The most serious hazards for the independent traveller are on the roads (see opposite).

That said, some South African crime does sometimes creep over the border. This includes occasional ‘car-jacking’ – the hijacking of drivers, often at gunpoint, for the theft of their car. Armed robberies of wealthier urban residences are not uncommon, and inevitably street crime such as pick-pocketing occurs in busy parts of town. Manzini has a worse reputation in this respect than Mbabane.

In general, the basic guidelines for safe travel are the same in eSwatini as anywhere else. Be alert, avoid obviously compromising situations, and don’t play the tourist too conspicuously. It’s common sense, really. The UK Foreign Office, which errs on the side of caution, offers the following specific advice:

  • Avoid travelling into or out of eSwatini by road after dark, as carjacking has occurred on major routes from South Africa and Mozambique.
  • Avoid walking in downtown Mbabane and Manzini after dark.
  • Be wary of picnicking in remote areas unless in a large group.
  • Keep valuables in a safe place and avoid carrying large amounts of money or wearing conspicuous jewellery.
  • Drivers who break down or need to change a tyre should be wary of anyone who offers help. Do not stop to assist apparently distressed motorists, as this is a technique sometimes used by hijackers. Instead, report the incident to the police.
  • Always park in well-lit areas of town.
  • Keep car doors locked and valuables such as mobile phones, cameras and handbags out of sight.

The Foreign Office also advises against giving strangers a ride. Offering a lift, however, is part of life in rural eSwatini and can be an interesting opportunity to meet local people. Common sense and experience will enable you to judge when it is safe to do so: a single driver picking up a group of young men after dark on the edge of town is asking for trouble; a car full of tourists picking up an elderly woman with a heavy load in a rural area is a nice gesture. If in any doubt, of course, don’t do it.

International terrorism has not yet reared its ugly head in eSwatini, although the Foreign Office urges you to exercise the same vigilance as you would anywhere else in the world. Recent years have seen an increasing number of political demonstrations. You are best advised to avoid these, especially if the police regard them as unauthorised and so decide to disperse them forcefully.

Women travellers

Women travellers are unlikely to encounter any problems when travelling around eSwatini – at least, none that is not already familiar from back home – and sexual harassment is less prevalent than in many Western countries. Traditional Swazi culture is strongly patriarchal, but Swazis are used to female visitors travelling independently. In rural areas, it is best to dress with due sensitivity to local culture by not baring too much flesh. Wearing a wrap or sarong over shorts or a short skirt is a good idea – you are unlikely to encounter overt disapproval for failing to do so but it shows respect. In urban and tourist areas people are more cosmopolitan. Be aware, though, that single women in bars may attract unwelcome attention, especially given the local history of prostitution. Don’t be put out by questions about your marital status: locals are often curious about single women – especially if unmarried or without children, which is unusual in eSwatini. This is simply a matter of cultural difference. Women should not accept lifts from strangers or walk around town alone after dark. Women’s sanitary products are widely available.

Travelling with children

eSwatini is a great place to take your kids, and local children will enjoy any opportunity to interact with your own. In traditional society, children are expected to be respectful of their elders – which, in rural communities, may extend to not addressing them directly or making eye contact. Again, it is accepted that visitors do things differently, but I for one found no harm in encouraging my own young daughter to respect local culture. There are countless exciting things for kids to do. A few, such as whitewater rafting and guided bush walks, have a lower age limit, typically of 12 years, although exceptions can often be made on request. Half-price discounts for children are the norm with many operators. Children are more vulnerable to some health risks, so ensure that you take all medical precautions.

Gay travellers

Male homosexuality in eSwatini, as in many African countries, remains a strong social taboo. There are, of course, gay Swazis, but there is no ‘out’ gay culture in the country and thus no gay clubs or meeting places for travellers. By way of illustration, in 2011 the Minister of Justice and Constitutional Affairs, Magwagwa Gamedze, dismissed a recommendation by a United Nations working group on human rights that eSwatini enact a law to protect gay members of society. ‘It was difficult for government to formulate a policy on homosexuals or enact a law to recognise them,’ said Gamedze. ‘Their numbers do not permit us to start processing a policy.’

Very little information is available on same-sex couples in eSwatini. The constitution does not safeguard the rights of gay people, and ‘sodomy’ laws dating from the early 20th century that outlaw consensual homosexual acts between adults are still on the books. Human rights groups have criticised eSwatini for its anti-gay legislation.

Travelling with a disability

eSwatini lags far behind South Africa in promoting travel for people with disabilities, and visitors will not find the same range of facilities that they might expect in developed countries. In town, for instance, you should not expect level-entry public buildings and curb cuts, while few hotels offer adapted rooms and no disability-specialist operators currently run dedicated trips to eSwatini. That said, with advance notice many hotels and tour operators can meet the needs of disabled travellers and will ensure that accommodation, facilities and itineraries are chosen and/or adapted accordingly. Disabled travellers will find friendly and enthusiastic help wherever they go, though they should remember that helpers may not be trained so will need clear instructions. The Mountain Inn in Mbabane comes recommended by the accessible travel resource, while the Ngwenya Glass Complex is wheelchair accessible. You can find general information and advice about disabled travel in Africa at Gordon Rattray’s excellent website. Also try Access Africa: Safaris for people with Limited Mobility (Bradt Travel Guides).