Health and safety – Malawi



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

People new to Africa often worry about tropical diseases, but if you take the appropriate precautions, it is accidents that are more likely to carry you off. Road accidents are very common in many parts of Malawi, so be aware and do what you can to reduce risks: always travel during daylight hours and refuse to be driven by a drunk. Listen to local advice about areas where violent crime is rife, too.

Within Malawi, private clinics, hospitals and pharmacies can be found in most large towns, and doctors generally speak fluent English. Consultation fees and laboratory tests are remarkably inexpensive when compared with most Western countries, so if you do fall sick it would be absurd to let financial considerations dissuade you from seeking medical help.


Make sure all your immunisations are up to date. Proof of vaccination against yellow fever is needed for entry into Malawi if you are coming from a yellow fever endemic area. Please discuss with a travel health expert. It is also wise to be up to date on tetanus, polio and diphtheria (now given as an all-in-one vaccine, revaxis, which lasts for ten years), typhoid and hepatitis A. Other vaccines which could be recommended include hepatitis B and rabies.

The biggest health threat is malaria. There is no vaccine against this mosquitoborne disease, but a variety of preventative drugs is available, including mefloquine, malarone and the antibiotic doxycycline. The most suitable choice of drug varies depending on the individual and the country they are visiting, so visit your GP or a travel clinic for medical advice. If you will be spending a long time in Africa, and expect to visit remote areas, be aware that no preventative drug is 100% effective, so carry a cure in case you can’t get to medical help easily. It is also worth noting that no homeopathic prophylactic for malaria exists, nor can any traveller acquire effective resistance to malaria. Those who don’t make use of preventative drugs risk their life in a manner that is both foolish and unnecessary.



It is difficult to strike the right balance when discussing crime in a country such as Malawi. An analytical understanding of how and where you are most likely to become a victim of crime will not only help prevent such an experience, but it will also allow you to relax in situations where it isn’t a serious concern. African cultures are inherently honest, more so perhaps than ours, and to the average Malawian theft is unspeakably wrong, to the extent that petty thieves are regularly killed by mob justice. Because of this, small-town and rural Malawi remains very safe for travel, because Malawians in general wouldn’t think of robbing a tourist, or anybody else for that matter.

On the other hand, crime abounds in the cities, where petty thieves often work the markets and bus stations targeting any likely victim, and tourists are easily identified as such. Even so, there is no significant risk attached to walking around the city centres by day, though the market area of Lilongwe is very dodgy after dark. Elsewhere, don’t tempt fate by wandering alone along unlit streets at night, or going out with more money than you need. If you need to carry your money on your person, use a hidden money-belt. To avoid revealing its location in public, keep whatever spare cash you are likely to need elsewhere. Don’t wear jewellery of financial or sentimental value, and if you can, leave that give-away daypack in your hotel room. Finally, when in doubt, use a taxi – they are very cheap in the cities.

Many travellers routinely carry their money-belt on their person, even walking around a city at night. Anecdotal evidence gathered over years of African travel suggests this is not a good idea, as muggings, snatchings and pickpocketings are far more common occurrences than a locked room being broken into. Obviously, an element of judgement comes into this: if a room feels insecure or a hotel has a bad reputation, don’t leave anything of importance in it. And when you do leave stuff in a room, check that the windows are sealed and the door is properly locked. One factor to be considered is that some travellers’ cheque companies will not refund cheques stolen from a room.

In Malawi, crime against tourists occurs mostly in a few particular ‘trouble spots’ in the cities and along the lakeshore. The pattern appears to be a sudden outbreak of mugging and snatch thefts in one particular resort, followed by a quiet period, indicating that these robberies are largely the work of one particular gang which is eventually arrested or moves on. Lilongwe, Blantyre, Nkhata Bay, Cape Maclear and Salima have all experienced problems of this sort in the past, so your best course of action is to be cautious when you first arrive at one of these places, and to ask local advice once you are settled in. Camping wild on parts of the lakeshore is no longer advisable anywhere in Malawi, and we’ve heard of several instances of tents being broken into at ‘proper’ campsites.

Be cautious of people who befriend you on buses and offer you food or drink, because it appears that the practice of doping travellers in this manner has spread into Malawi. It’s worth noting that con tricks are most likely to be perpetrated by a smartly dressed, smooth-talking guy who can easily build up a rapport with a traveller.

For all the above, Malawi remains a remarkably friendly and honest country. What most often gets travellers into trouble is one moment of recklessness – walking around Nkhata Bay at night with a money-belt on, wandering around Lilongwe market with a daypack dangling off your shoulder, dithering in a city bus station with a map in your hand and puzzled expression on your face, arriving in a city at night and not using a taxi to get to a hotel. Focus your energy on recognising high-risk situations, and do all you can to avoid them. The rest of the time, so long as you conduct yourself sensibly, you have little to fear in terms of crime!

Women travellers

Sub-equatorial Africa is probably one of the safest places in the world for women to travel solo, and Malawi poses few risks specific to female travellers who apply the same common sense they would at home. Unwanted flirtation and the odd direct sexual proposition are a possibility, especially if you mingle with Malawians in bars, but a firm ‘no’ should defuse any potentially unpleasant situation. Men in Malawi probably constitute less of a sexual hassle than men in many Western countries, and for that matter than other male travellers.

Most Malawians have better things to worry about than how female tourists choose to dress, especially in established resort areas. That said, it would be insensitive to wear shorts or a revealing top in areas with a strong Islamic presence, or in villages where tourists are still relatively unusual. Unlike during the Banda era, however, it is no longer illegal or even unusual for women to wear trousers as opposed to a skirt.

Any female (or, for that matter, male) readers concerned about travelling alone in Malawi, but unable to find a travel companion, might be reassured by the thought that there are plenty of places in Malawi where it will be easy to meet with kindred spirits, and there’s a lot to be said for hooking up with people along the way – better, by far, than making an advance commitment to travelling with somebody who you don’t know well enough to be sure they’ll be a suitable travel companion.

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