Eritrea - Health

Eritrea has a very healthy climate, especially in the Highland areas. Some would say that Asmara has an ideal climate, very similar to the Mediterranean or California. However, the Lowlands, especially along the coast, can be very hot and humid, particularly in the summer months of June - September. Visitors should take a good sun protection cream, a hat and sun-glasses with them.

Dehydration can hit very quickly, especially in the very hot lowland coastal areas (Massawa, Dahlak Islands, Assab). Drink plenty of water in a timely manner. It is essential to take a big bottle of mineral water on every trip outside Asmara. The water supply in major towns is treated and filtered; yet it should be boiled before drinking. Local and imported bottled mineral water is widely available. Ask for mai or mai gas (carbonated water).

Fruits, vegetables, meat, fish, bread, milk are widely available in Eritrea, cheap and of very good quality. But health experts advise: "Peel it, cook it, boil it, or forget it." Fruit you have washed and peeled yourself and hot food should be safe, but raw food, cold cooked food and salads and ice-cream are all risky.

Visitors should bring a supply of any necessary drugs (Paracetamol, anti-malaria tablets and Loperamide for acute diarrhoea) and prescriptions. It is wise to take some basic medical requirement with you (medical kit, containing sunscreen, insect repellent, antiseptic, dressings and several sachets of oral rehydration solution (ORS)).

Medical services are adequate throughout the country. However, modern facilities are not always available and supplies can be irregular. Chemists and drugstores can be found in larger towns. The Central Hospital Makane Hiwet in Asmara, is the most extensive and best equipped. Private doctors and clinics are also available. Sembel dental and polyclinics are housed in the Sembel Residential Complex.

Both AIDS and venereal diseases certainly exist in Eritrea. The country was not isolated from the outside world in the same way as it was in other respects. Ethiopian soldiers have been the main cause for the transmission of these diseases.

Your doctor or travel medicine specialist should be provided with details of your travel plans at least two months before departure to determine if any immunizations or preventive medications are required. It is important to inform the doctor if you are pregnant, have an existing medical condition, have undergone recent surgery, plan to travel with children or plan to be away for an extended period of time as these factors will influence your requirements.

Yellow fever vaccinations are required for all travelers entering Eritrea from infected area. It is also advisable to have vaccinations against diphtheria, tetanus, polio (DTP), hepatitis A, typhoid and meningitis. If your stay will be longer than a few weeks and/or in cases of sexual activity vaccination against hepatitis B is advised.

Malaria is endemic on the coastal plain, in the western lowlands and around Keren (anywhere less then 2000m above sea level), particularly during the rain season. Protection against mosquito bites should be taken if traveling in the lowlands. There is no malaria risk in Asmara.

Dengue

What is Dengue?

Dengue is a tropical illness that starts in one of your joints and is then followed by a fever and measles-like rash. The illness usually clears up after a few days. A person can only be infected if he's bitten by a mosquito infected with the dengue-virus. Dengue cannot be transmitted from person to person.

Where is dengue prevalent?

Dengue is prevalent in all tropical areas, particularly during and after monsoon periods. The likelihood of being infected is greater in heavily populated cities. There is no dengue risk at altitudes over 2000m (6500ft).

What are the symptoms?

There will usually be a period of three to eight days between the time you are infected via a mosquito bite and the first manifestation of the symptoms of the illness. These symptoms are:

A sudden and severe fever.
Acute frontal headache and pain behind the eyes (that becomes more pronounced as you move your eyes).
Muscle and joint aches.
Nausea and vomiting.
A measles-like rash on the chest and arms.

Treatment

The treatment is symptomatic, which means it is not the cause that is addressed, but the symptoms. S-called salicylic medications such as aspirin and ascal should be avoided because these will increase the likelihood of bleeding. Paracetamol, on the other hand, is suitable.

Is Dengue dangerous?

Dengue can be dangerous. An initial infection by the dengue-virus usually runs its course without complications, but the symptoms are more serious with a second infection. In addition to suffering from nosebleeds, small, local bleeding can occur under the skin and this will be recognizable as small red points on your feet, legs, armpits and the roof of the mouth. In the worst case, the patient can go into a shock and even die. However, the good news is that if it is treated early enough, the chances of a complete recovery are good.

Malaria

What is Malaria?

Malaria, or swamp fever, is a tropical disease transmitted by a mosquito that has been infected by biting someone that already has malaria. When the mosquito then bites other people, it injects parasites into the blood stream and these parasites multiply making the victim feel 'unwell'. There are different strains of malaria and these are transmitted by different types of parasites. Malaria, which is derived from the Italian word malaria, meaning 'bad air', is particularly prevalent in warm, swampy areas is

Where is malaria prevalent?

Malaria, which is derived from the Italian word malaria, meaning 'bad air', is particularly prevalent in warm, swampy areas. There is no malaria risk at altitudes over 2000m (6500ft f.e Asmara).

The symptoms

In spite of all possible preventive measures you can still be confronted with an attack of malaria for up to half a year after your stay in the tropics. It is therefore important you remain vigilant for the following symptoms after your return:

A flue-like feeling with muscle and joint aches followed by a high fever; and all without there being a clear reason for it. The fever, which might return with a certain regularity, need not always be spectacularly high.
Trembling, profuse sweating, headaches, and feeling 'poorly'. Other symptoms, which can divert attention from malaria, include vomiting, diarrhoea and/or stomach-ache. If you experience any of these complaints, consult a doctor and make it clear you have been to a tropical area.

How can you avoid infection?

If dengue or malaria are prevalent, you can reduce the likelihood of infection by taking a number of precautionary, anti-mosquito measures:

Take preventive medicines (Malaria only).
Keep (bed) rooms mosquito-free. Mosquitoes prefer dark areas and they don't like air-conditioning. If it is available than use it.
If possible, use mosquito netting. Tuck it in firmly under the mattress, and of course check for holes and make sure there is no mosquitoes already inside it.
If there are already mosquitoes inside the bedroom, spray with insect killer an hour before retiring.
Between sunrise and sunset - particularly during the early morning hours and late afternoon - wear clothes that cover most of your body: long trousers, shirts or t-shirts with long sleeves, gloves and socks.
Stay away from lakes, rivers and swamps after sunset.
Areas of skin that remain uncovered should be smeared with a mosquito repellent stick or lotion containing 'deet'.

When using 'deet' bear the following advice in mind:

Never use deet in a concentration higher than 30%. This is particularly important for children younger than two years old and pregnant women in the first 12 weeks of pregnancy.
Only apply it to the exposed areas of skin and avoid smearing too much in. Depending on personal factors such as heavy perspiration, deet will have a maximum working life of four hours.
Avoid contact with the eyes, lips, and irritated (f.e. sunburned) skin.
To ensure they do not rub it into their mouths or eyes, never apply deet to children's hands.

Travellers' diarrhoea

What is Travellers' diarrhoea?

An estimated 20-50 per cent of travellers suffer from stomach upsets caused by poor personal hygiene or by eating and drinking food and fluids contaminated with bacteria, viruses or worms. Travellers' diarrhoea is transmitted by risky foods like raw or undercooked meat, poultry, seafood, raw fruits and vegetables. Tap water, ice, and unpasteurized milk and dairy products are also associated with increased risk of travellers' diarrhoea.

What are the symptoms?

Travellers' diarrhoea is a condition characterized by a marked increase in the frequency of unformed bowel movements and is commonly accompanied by abdominal cramps, urgency, nausea, bloating, vomiting, fever, and malaise. and should therefore be taken seriously.

Treatment

Most cases of diarrhoea are self-limiting and require only simple replacement of fluids and salts lost in diarrhoeal stools.

Increase your intake of mineral water.

Use Oral Rehydration Salts (O.R.S.) if they are available.

Flat Coca Cola is usually helpful.

Take a light diet - weak tea, bilberry juice, boiled rice, bananas and rusk or plain biscuits. Avoid alcohol and coffee.

Try and change your itinerary so that you can stay close to adequate facilities.

Watch for any change in your health which might suggest that the diarrhoea is becoming more serious.

You can easily prepare O.R.S. yourself by dissolving 20 grams of sugar (four lumps) and two grams of kitchen salt (one teaspoon) in half a liter mineral water.

Antimotility agents like Loperamide come in convenient dosage forms and provide prompt symptomatic but temporary relief of uncomplicated travellers' diarrhoea by inhibiting intestinal movements. Avoid taking Loperamide if you have blood or mucus in your faeces.