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Kazakhstan - Health and safety
With Dr Felicity Nicholson
It is recommended that you are up to date with all your primary courses and boosters including diphtheria, tetanus and polio – now given as the all-in-one vaccine (Revaxis) which lasts for ten years. Hepatitis A vaccine will be recommended for longer stay travellers, those living and visiting local people and those undertaking more adventurous travel. The vaccine can be given even close to the time of departure. One dose will protect for at least one year and a booster dose given at least six months later will extend coverage for 25 years. This vaccine may be available on the NHS. Vaccination against typhoid may also be advised for those travelling to more rural areas, particularly where there may be difficulty in ensuring safe food and water supplies.
Additional immunisations to be considered, depending on how long you will be staying in Kazakhstan and your intended activities and lifestyle, include hepatitis B, rabies and tick-borne encephalitis. Hepatitis B is recommended for those working in a medical setting or with children. The vaccine schedule comprises three doses that ideally should be given over a six-month period. If time is short then it can be given at zero, one and two months or for those aged 16 or over; using Engerix B, it can be given over a minimum of 21 days. Both of these more rapid courses need to be boosted after a year.
Rabies is present throughout the country, but is usually easy to avoid unless you are working with animals. A pre-exposure rabies vaccine is advised for those staying longer than a month and for those who are running and cycling as these activities put them at higher risk. It would also be recommended if you plan to be 24 hours or more from reliable sources of treatment. Like hepatitis B, the rabies vaccine comprises three doses and can be given over a minimum of 21 days. Having the pre-exposure vaccine changes what treatment you need and makes it easier to obtain.
Tick-borne encephalitis is a viral infection spread by infected ticks and is more common between April and September. If you intend to go trekking in forested areas during these months, then it would be wise to get immunised. The vaccine is readily available in private travel clinics and consists of two doses of vaccine at least two weeks apart with a third dose given five to 12 months later if at continued risk. Whether or not you have the vaccine, you should take all precautions to protect against tick bites and check and remove any ticks after walking in high-risk areas.
While pharmacies in Kazakhstan, especially in the main cities, are numerous and well equipped, it would be worth packing one or two basic medicines, such as oral rehydration salts. You should ensure too that your travel insurance covers you for medical expenses, including for possible medical evacuation.
Travel clinics and health information
A full list of current travel clinic websites worldwide is available on ISTM. For other journey preparation information, consult NaTHNac (UK) or CDC (US). Information about various medications may be found on NetDoctor. All advice found online should be used in conjunction with expert advice received prior to or during travel.
Kazakhstan is generally a safe country to travel around. Locals usually travel in groups and with families; single travellers should not be unnecessarily alarmed when asked if they are not afraid to travel in Kazakhstan on their own – this is not a reflection of the country’s safety situation. That said, exercising caution is always the best practice to adopt.
Pickpocketing, especially in crowded places such as markets and on busy public transport, can occur. Ensure that you keep your money and documents somewhere secure. If you are driving, don’t leave valuables visible in your parked vehicle: there have been reports of ‘smash and grab’ thefts.
While the informal taxi system in operation throughout the region provides a quick and cost-effective means of getting around town, it does carry with it certain risks, and you should be alert to these if you decide to hail a car, particularly at night. If a car stops for you that you do not particularly like the look of (because it appears to be in poor condition, or the driver seems drunk, or there are two or more men in it), simply wave it away again. The locals do this all the time. There have been serious incidents of violent robbery involving foreigners leaving bars and clubs late in the evening, sometimes somewhat incapacitated by drink, who have taken informal ‘taxis’ waiting outside the premises. If you are leaving a club or bar late, it is much safer to get the establishment to call an official taxi for you.
The taxi drivers waiting for arriving passengers at Almaty airport are a particularly frequent source of complaints. Often this is simply a matter of overcharging, but there have been more sinister incidents, including drivers taking arriving visitors into the middle of nowhere, and demanding money to return them to the centre of the city. If you need to take a taxi from the airport into the city, book an official one at the desk just before you leave the arrivals hall. There have also been reports of people posing at the airport as ‘meet and greet’ representatives, sent by the passenger’s inviting organisation to collect them. In some cases, they seem to have been able to get hold of passengers’ names, adding to the credibility of the story. They then drive you off somewhere remote and extort money to take you to your destination (similar to the taxi driver scam mentioned above). If you are being met at the airport, clearly establish the arrangements in advance with your inviting organisation, including how the person meeting you will be identified.
Although levels of violent crime in Kazakhstan are relatively low, muggings, especially at night, are a concern. The oil boom towns in the west of the country, especially Atyrau, are particularly problematic in this respect. You should avoid walking alone at night, and keep to well-illuminated areas.
The spiking of drinks has been reported in clubs and bars in Almaty, where the motive is generally robbery rather than sex, and the targets more often men than women. Keep a close eye on your drink. The effects of alcohol are at the root of many reported violent incidents in Kazakhstan. If a fight breaks out in the bar you are in, pay up quickly and leave.
Cases of extortion of money by police and other law enforcement officers are less common in Kazakhstan than they used to be (though petty corruption on the part of the traffic police remains a considerable problem). Police in Kazakhstan are allowed, perfectly legitimately, to request to see identification documents, and you should co-operate with this. There have, however, been concerns about extortion by people impersonating law enforcement officers: if you have any doubts about the bona fides of the person who has stopped you, you are entitled to ask to see their credentials before producing your passport. If you doubt the legitimacy of the ‘officer’, or are being asked for a bribe, try to take down their name and badge number, as well as the registration number of any vehicle. Do not get into the back of a police car or go anywhere else that you cannot be seen by passers-by. If in doubt, ask to accompany the officer to the closest police station to resolve any matters (invented or otherwise) there.
The usual personal safety precautions should be exercised for women travellers. You should dress modestly, especially in conservative southern and western Kazakhstan and in rural areas (although this is not a practice always followed by the locals). Particular caution should be taken when hailing taxis; phoning for a cab, or getting the establishment you are in to do this for you, is a safer option. Unaccompanied women may receive unwanted attention in bars and clubs but this is usually deflected with a few terse words. If the harassment continues, alert the management or leave the premises and find a more pleasant alternative. Try to avoid physical confrontation as alcohol-fuelled violence is not uncommon.
Homosexuality has been legal in Kazakhstan since 1997, but while a small gay scene has developed in Almaty, same-sex relationships are still often seen to be symptomatic of illness. Visitors are advised against showing open signs of affection in public, especially away from the larger cities.
Travellers with disabilities
Disabled visitors may experience difficulty travelling in Kazakhstan. Public transport is rarely able to carry wheelchairs, few buildings have disabled access, and streets are littered with trip hazards such as broken paving, uncovered manholes and utility pipes. Hotel rooms are often spread over multiple floors without lifts, and assistance from staff is not guaranteed. If you have a disability and are travelling to Kazakhstan, you would be advised to travel with a companion who can help you when the country’s infrastructure and customer service fall short.
Travelling with children
Travel with children is relatively easy given Kazakhstanis’ focus on family life. Children are welcomed in restaurants and shops but you may have difficulty manoeuvring pushchairs in and out of buildings and along broken pavements. Nappies, baby food and other similar items are widely available in supermarkets, but you are unlikely to find European brands outside of major cities. Journeys by car and public transport are often long and uncomfortable, which may deter families with younger children from travelling into the interior of the country.