With Dr Felicity Nicholson. For up-to-date information on health issues across Africa, click here.
Sensible preparation will go a long way to ensuring your trip goes smoothly. Particularly for first-time visitors to Africa, this includes a visit to a travel clinic to discuss matters such as vaccinations and malaria prevention.
To help travellers prepare for a trip, the Bradt website carries a section on health in Africa (see above). While this elaborates on the information below, the following summary points are worth emphasising:
Don’t travel without comprehensive medical travel insurance that will fly you home in an emergency.
Having a full set of immunisations takes time, normally at least six weeks, although some protection can be had by visiting your doctor as late as a few days before you travel. No immunisations are required by law for entry into Namibia, unless you are coming from an area where yellow fever is endemic. In that case, a vaccination certificate is mandatory. To be valid the vaccination must be obtained at least ten days before entering the country.
It is wise to be up to date on tetanus, polio and diphtheria, hepatitis A and typhoid. Immunisations against hepatitis B and rabies may also be recommended. Immunisation against cholera is not usually required for trips to Namibia. Vaccination against rabies is now recommended for all visitors as there is an international shortage of rabies immunoglobulin (RIG), which is essential if you have not had three doses of vaccine before you travel. Experts differ over whether a BCG vaccination against tuberculosis (TB) is useful in adults: discuss this with your travel clinic.
There is no vaccine against malaria, but preventative drugs are available, including mefloquine, atovaquone/proguanil (Malarone) and the antibiotic doxycycline. Malarone and doxycycline need only be started two days before entering Namibia, but mefloquine should be started two to three weeks before. Doxycycline and mefloquine need to be taken for four weeks after the trip and Malarone for seven days. It is as important to complete the course as it is to take it before and during the trip.
The most suitable drug varies depending on the individual and the country they are visiting, so visit your GP or a specialist travel clinic for medical advice. Be aware that no preventative drug is 100% effective, so carry a cure too.
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.
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.
Namibia is not a dangerous country, and is generally surprisingly crime free. Outside of the main cities, crime against visitors, however minor, is exceedingly rare. Even if you are travelling on local transport on a low budget, you are likely to experience numerous acts of random kindness, but not crime. It is certainly no more dangerous for visitors than most of the UK, USA or Europe.
That said, there are increasing reports of theft and muggings, in particular from visitors to Windhoek, so here as in any other city it is important not to flaunt your possessions, and to take common-sense precautions against crime. A large rucksack, for example, is a prime target for thieves who may be expecting to find cameras, cash and credit cards tucked away in the pockets.
Provided you are sensible, you are most unlikely to ever see any crime. Most towns in Namibia have townships, often home to many of the poorer sections of society. Generally they are perfectly safe to visit during the day, but tourists should avoid wandering around with valuables. If you have friends or contacts who are local and know the area well, then take the opportunity to explore with them a little. Wander around during the day, or go off to a nightclub together. You’ll find that they show you a very different facet of Namibian life from that seen in the more affluent areas.
For women travellers, especially those travelling alone, it is important to learn the local attitudes about how to behave acceptably. This takes some practice, and a certain confidence. You will often be the centre of attention, but by developing conversational techniques to avert overenthusiastic male attention, you should be perfectly safe. Making friends of the local women is one way to help avoid such problems.
Dangerous driving is probably the biggest threat to life and limb in most parts of Africa. On a self-drive visit, drive defensively, being especially wary of stray livestock, gaping pot-holes, and imbecilic or bullying overtaking manoeuvres.
Many vehicles lack headlights and most local drivers are reluctant headlight users, so avoid driving at night and pull over in heavy storms. On a chauffeured tour, don’t be afraid to tell the driver to slow or calm down if you think he is too fast or reckless.
Don’t confuse habituation with domestication. Most wildlife in Africa is genuinely wild, and widespread species such as hippo or hyena might attack a person given the right set of circumstances. Such attacks are rare, however, and they almost always stem from a combination of poor judgement and poorer luck. A few rules of thumb: never approach potentially dangerous wildlife on foot except in the company of a trustworthy guide; never swim in lakes or rivers without first seeking local advice about the presence of crocodiles or hippos; never get between a hippo and water; and never leave food (particularly meat or fruit) in the tent where you’ll sleep.
Snake and other bites
Snakes are secretive and bites are a real rarity, but certain spiders and scorpions can also deliver nasty bites. In all cases, the risk is minimised by wearing closed shoes and trousers when walking in the bush, and watching where you put your hands and feet, especially in rocky areas or when gathering firewood. Only a fraction of snakebites deliver enough venom to be lifethreatening, but it is important to keep the victim calm and inactive, and to seek urgent medical attention.