With Dr Felicity Nicholson. For up-to-date information on health issues across Africa, click here.
Rwanda itself isn’t a particularly unhealthy country for tourists and you’ll never be far from some kind of medical help. The main towns have hospitals (for anything serious you’ll be more comfortable in Kigali) and all towns of any size have a pharmacy, although the range of medicines on sale may be limited. In Kigali, the pharmacy in Boulevard de la Révolution is open 24 hours.
Away from Kigali, district hospitals and health centres are spread countrywide. A health centre generally has around five nurses, supported by a doctor and community health workers. In rural areas traditional medicine is also widely used. The growing private sector has more than 310 clinics and dispensaries. The incidence of HIV/AIDS is hard to estimate accurately but seems at last to be falling, thanks to preventive measures and the wider availability of antiretroviral drugs.
The most serious health threat to travellers in Rwanda is malaria. Akagera National Park and other low-lying parts of the east qualify as high risk malarial areas, especially in the rainy season. The risk exists but is far lower in highland areas such as Kigali, Butare, Nyungwe National Park, the Virunga Mountains and foothills, and the Lake Kivu region. Nevertheless, all visitors to Rwanda should take preventative measures against malaria, and be alert to potential symptoms both during their trip and after they return home.
Other less common but genuine health threats include the usual array of sanitation-related diseases – cholera, giardia, dysentery, typhoid etc – associated with the tropics (though these seem to affect visitors to Africa less than they do travellers in Asia), and bilharzia, which can only be caught by swimming in freshwater habitats inhabited by the snail that carries the disease.
Preparations to ensure a healthy trip to Rwanda 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), and hepatitis A. Immunisations against meningococcus and rabies may also be recommended. Proof of vaccination against yellow fever is needed for entry into Rwanda for all travellers over one year of age, regardless of where you are coming from. Immunisation against cholera may also be recommended for Rwanda.
If you do get ill in Rwanda, bear in mind that the most likely culprit – as in most parts of the world – will be the common cold, flu or travellers’ diarrhoea, none of which normally constitute a serious health threat. However, travellers with overt cold- or flu-like symptoms might not be allowed to track gorillas or chimpanzees, both of which are susceptible to infectious airborne human diseases and may lack our resistance.
So far as tourists need be concerned, Rwanda is among the most crime-free of African countries. Kigali is a very safe city, even at night, though it would probably be courting trouble to stumble around dark alleys with all your valuables on your person. Be aware, too, that this sort of thing can change very quickly: all too often, as tourism volumes increase, so too does opportunistic and petty crime.
The following security hints are applicable anywhere in Africa:
- Most casual thieves operate in busy markets and bus stations. Keep a close watch on your possessions in such places, and avoid having valuables or large amounts of money loose in your daypack or pocket.
- Keep all your valuables and the bulk of your money in a hidden money belt. Never show this money belt in public. Keep any spare cash you need elsewhere on your person – a button-up pocket on the front of the shirt is a good place as money cannot be snatched from it without the thief coming into your view. It is also advisable to keep a small amount of hard currency (ideally cash) hidden in your luggage in case you lose your money belt.
- Where the choice exists between carrying valuables on your person or leaving them in a locked room I would favour the latter option (thefts from locked hotel rooms are relatively rare in Africa). Obviously you should use your judgement on this and be sure the room is absolutely secure. Bear in mind that some travellers’ cheque companies will not refund cheques which were stolen from a room.
- Leave any jewellery of financial or sentimental value at home.