Before you even think of setting foot in (most of) Africa you need to start
thinking about Immunisation. Even with the right precautions protection is
not guaranteed - your level of protection depends on too many variables for
the vaccinations to be 100 % successful in protecting you. As an example of
the risks, every single French
traveller we met beyond Mali seemed to have had Malaria; they don't
approve the use of Larium in France. I still picked up malaria in tyanzania
even with Larium... so minimise the risks by checking out
http://www.mara.org.za/mapsdownload_bmp.htm where you have the
definitive malaria risk resource.
If you can live with that the you should consider getting the following
shots (Info from Trailfinders -
remember that I am not a doctor!):
Yellow Fever -
Obligatory in most of sub-Saharan Africa. Check your certificate is
correctly filled in, stamped, and up to date. Good for 10 years
Cholera - Not
generally given nowadays, but it's a good idea to have the certificate to
avoid money-grabbing officials - ask your GP for info. Good for 6 months.
Hepatitis A protection for 10 years if you get a second injkection
6-12 months after the first.
Tetanus - Good
for 5-10 years
Polio - Good for
Typhoid - Good
for 3 years
Meningitis - I
believe you need the C strain for Africa, not the standard European shot -
don't assume your nurse will know the difference. Good for 3 years
Also to be considered if you want
to go down the travel-in-an-all-over-condom route:
Trailfinders, among others, can
give you a vaccination card with the appropriate certificates included for
you to stamp yourself if you fancy a bit of cholera certificate forgery -
remember to record you blood group, though you probably want to be avoiding
What you carry should reflect your personal skills and
needs. If you carry first aid equipment that you don't know how to use yourself the
chances are that it is a waste of space - unless you first aid kit takes up
half the car it will not contain anything that, generally speaking,
virtually every doctor in Africa already has at hand; don't be fooled by
out-of-date stories of lack of drugs or resources.
I work with two medical and first aid kits;
the big ones stay with the vehicle, and the little ones stay in my day pack
- they are covered in the personal equipment
Before the trip I took a refresher course with a doctor-friend in IV
procedures which involved an evening of poking needles into things and
people - Intravenous fluids are very useful in stabilising casualties in the
event of an accident - and vehicle accidents are the most prevalent danger
to travellers on this type of trip, so there is a definite value in learning
how to set up an IV drip.
I've also had extensive training in lots of different types of first aid as
a soldier and diving instructor over the years, so what I take may be a
little more comprehensive than most people would want to carry. Also, I
choose what I know and am familiar with - I'm no doctor and others may have
better advice to offer. But in summary the first aid kit consists of:
Emergency Dental Kit - From
Boots, and get a bottle of Clove Oil too
2 x Resusci Face Shields - these
include gloves and HIV barriers. Lots of gloves too.
Assorted burn sheets and saline
(also useful for irrigating eye injuries).
Assorted Bandages, flexible
splint (flexisplint) , tape, safety pins.
Assorted basic procedure or wound
care packs (contain everything for dressing a wound).
Shears (for cutting through
clothing), various disposable scalpels, forceps and clamps.
A big pot (100) of Mediwipes or
similar - great for cleaning
6 x 500ml Haemaccel or Gelofusine
- for replacing lost blood - the soft bags pack more easily.
Giving sets and assorted needles
for the above
Good sterile needle/syringe set
for all eventualities, though not as essential as it used to be now that HIV
education is getting through
Medium sized Stifneck extrication
collar - the kind that you see on TV wherever there's a car accident -
medium fits me...
Assorted Plasters, steristrips,
Melolin and Primapore, and sutures
Savlon, Iodine, a space blanket
and a thermometer
Apart from wound cleaning I like
to keep everything that could be classified as a drug in a separate pack.
Again this list is what I personally like to have around - check what your
GP thinks would suit you:
Avomin 25mg - stops nausea
Arsumax 50mg* - Also locally
recommended as the best (new) way of treating Malaria with zero reported
side effects. A tenth of the price of Malarone.
Augmentin 375mg - wide spectrum
Ear drops - ask your chemist
what is best for swimmers ear
Eye drops - dust in eyes is a
real problem - a good anitbiotic drop is worth taking.
Ibuprofen 400mg* - generic
painkiller, like Neurophen only twice the strength and a tenth of the price
Imodium 2mg - block you up when
you need to travel - I avoid it if I can and let nature take it's course
(but I also haven't had any more than minor tummy problems)
Larium 250mg - malaria
protection, also taste great and make your dreams a whole lot more
interesting - there are issues with this drug but it is by and large
effective and my body tolerates it well - get informed before you decide as
it costs a fortune.
Malarone 250mg - suggested by
Trailfinders as the best malaria cure - very expensive
Piriton 4mg - cheap, safe and
simple antihistamine - for itches, mossie rash.
Sudocrem - From the baby
section in Boots - Nappy rash cream - seriously.
Bactiflox 500mg* - Antibiotic for
bacteria in your gut.
Fasigyne 500mg* - Treatment for
Vermox 500mg* - For worms.
(Note: the three above are on
recommendation from a missionary doctor working in Mali - you will need to
find out how to identify the individual symptoms to use them effectively)
*I've starred the drugs that I
bought en-route (Dakar) - drugs are much cheaper in Africa where they are
Next time I'll take along a CD
that helps with diagnosis - there are a lot of resources out there and I'd
welcome suggestions; it would beat the very short diarrhoea section in
You should also consider putting
together a personal medical and first aid kit (see below)
At some point in your journey you
are almost certain to witness a serious accident or the aftermath of one
(almost always involving vehicles). Before you begin your journey give some
thought about how you intend to react when this happens.
Also consider whether there is a
difference in a request for assistance for an injured Mandinka, a white
expat, or another white traveller, because these are issues that are better
addressed before you experience the shock of a real accident scene.
Remember that if you do choose to
offer assistance, and blood is present, there is a very real risk if HIV
infection, and protection should always be used.
A further issue for consideration
is the unfortunate fact that if you are white and the victim is not, when
the authorities arrive you may be held responsible for the accident -
whether you were involved or not - you are simply seen as an easy target for
compensation for the victim.
Likewise, you will constantly be
asked by the locals to give them medicine - it's a common form of begging
however genuine the need. Consider carefully the issues of responsibility if
drugs you give are misused (especially antibiotics), or if they provoke an
I've given cloves to a woman
complaining about toothache -an effective remedy actually, and also good for
cooking), but personally prefer to keep my limited medical supplies for my
These seem to be very negative
approaches, but it is better to be aware of the risks and informed about the
issues than to wade in without thinking. I know of many stories on this
theme and personally think that the sight of a white person in an expensive
4x4 studiously ignoring a injured human in need is one of the cruellest
images of Africa.