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African Safari 2007
HEALTH AND SAFETY

INFORMATION ON HEALTH CONCERNS, SAFETY, AND PREVENTION OF ILLNESS
 
Most of this information is taken from internet forums.

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Water
To be really safe it is best to drink only bottled water unless told by our hosts that the water is safe.

ROY SAFARI provides 1 bottle of water per day while on safari drives. Bottled water is sold at the lodges and some stops along the way.

PROTECTING VALUABLES WHILE ON SAFARI

"During the day - camera, money, credit cards and tickets all come with me in my backpack. In the evenings, I usually leave the camera behind in a piece of locked luggage; the other - money, credit cards, tickets come with me. When staying at lodges, we've often used the safe deposit boxes at the Registration desk - rarely, if ever, leave anything in room safes."

We used money belts for our cash, and put anything else of significant value that we didn't want to take on a game drive in a suitcase which we locked. We didn't have any problems.

HEALTH AND SAFETY CONCERNS
Is it safe to visit Africa?
In general petty theft does occur in Africa's major cities and towns. Visitors should take the same care as they would normally take in any other destination worldwide. Keep a close watch on handbags, wallets, and cameras when walking in crowded places. Avoid walking at night and place valuables in safe deposit boxes at hotels.
While at safari lodges and tented camps you are typically far removed from human settlement and crime is virtually non existent. We advise that valuables be locked away or kept under the supervision of the camp or lodge manager while on safari.
Importantly, travel safety concerns arising from a negative event in one African country do not apply to Africa in total just as travel safety concerns in Florida do not apply to a trip to Lake Tahoe

 

Do not wear jewelry including ear rings in cities and towns. It's good to wear a money belt. A throw away camera to take pictures in the towns is a good idea

HEALTH

If you want to stay healthy, here is what you should do:

- Washing hands with soap, water and hot water.
- Drink bottled, boiled or filtered water.
- Eat cooked food, fruit and vegetables you have peeled. If your in a safari lodge, don’t worry.
- Don’t eat food purchased from food vendors.
- Don’t drink beverages with ice.
- Don’t eat dairy products that aren’t pasteurized.

Any food served at our lodges or camps is safe to eat.


Avoid mosquito bites at all costs, even though sometimes this is impossible. Here is the best advice on avoiding those buggers:

  • From dusk to dawn, be extra careful. This is when they feed.
    - Wear long-sleeved shirts, pants, and hats.
    - Use repellent with DEET. Make sure to apply all exposed areas and right before dusk.
    - Use bed nets, ideally with insecticide promethean or deltamethrin ---see insect link
  • All of the places on our safari have bed nets.

    You will need to make an appointment with your personal physician or travel clinic at 2 to 6 months prior to departure to review pertinent health precautions including necessary vaccinations and medications. Please discuss any other health-related questions with your health practitioner at this time.

    Malaria: A course of malaria prophylactics is advisable for all non-African visitors. Most brands need to be taken a few days/weeks before entering into a malaria area (depending on the brand), and for 4 weeks after you return home. Consult your doctor, nearest vaccination center or pharmacist for the most up-to-date requirements and brand recommended for the area to which you are traveling. Take your tablets regularly and ensure that you have a sufficient supply for the duration of your holiday and for the additional time once you return home. We recommend that you take your tablets in the evenings in order to avoid experiencing any potential side effects during the day. Mosquitoes usually bite between dusk and dawn. The best prevention is avoidance so we strongly advise that you cover up by wearing long sleeves and long pants and use mosquito repellent.

    Bilharzia: Bilharzia is a disease caused by tiny parasites (small snails) present in lakes, rivers and dams. There is no prophylactic available against Bilharzia, which is treated by drugs or an injection. The condition can be unpleasant so it's better not to swim in rivers or streams, particularly where the water is stagnant

    "As far as inoculations, Yellow Fever is not required of US citizens for entry into Kenya. For the other inoculations, it's a good idea to be current with Tetanus, Hep A, Polio booster and Thyphoid. But you should discuss these with your own physician based on your own medical history.
    Tetanus and Hep-A will be good for 10-years, while the Polio booster should last the rest of your life.
    Malaria meds are required and the current recommended one is Malarone with few if any side effects to most all who take this. If you have a drug plan these should be covered along with your co-pay; otherwise, espect to pay in the range of $90-$120/person."

    "It's always a good idea to get shots. I went to the public clinic in Sarasota, Florida. Most doctors don't want to bother with yellow fever because it's very seldom used. My doctor recommended the traveling nurse at the public county clinic. I had to call them for an appointment because they need to order the yellow fever shots. During the visit, the travel specialist nurse went over the shots /pills that are recommended. I did not get all of the recommended shots but I did get yellow fever, Hepatitis A and C and tetnus (always a good idea) shots. I had to go back to get a second hepatits booster shot about a month later. I also got a prescription for anti-malaria pills."

  • 3/11--New-- Just to clearify information on yellow fever shots here is more recent news on the topic.

    For visitors from western countries, the US and most European, Yellow Fever inoculation is no longer a requirement in Kenya or Tanzania.

    As long as when leaving these two countries you are returning to the US, you'll be fine. If, you would be going onto some other countries, the YF might be required having earlier been in Kenya and/or Tanzania at minimum 60-days, or 6-weeks or 6-months... can be different depending on the country.
    So, - if US/Kenya/Tanzania/US - no Yellow Fever required. London also will not require Yellow Fever.




     

    "As for the travelers revenge...I always have a perscription for Cypro filled and take it with me. Only once did I use it (and that was for an infection I had been treating before I left home.)
    On a few occasions I've used Pepto Bismal for the slight stomach problems I have encountered. It has been a lifesaver for nausea from bumpy flights, jet lag, etc.
    I also carry something like Imodium, which just halts the revenge, that I would try before resorting to the more potent Cypro, which fights the underlying cause of the revenge."


    ADVICE FROM A TRAVEL AGENT:

    Lariam (mefloquine) costs about $9-$10/pill which you commence taking 1 or 2 weeks prior departure (same day weekly), weekly while in Africa and then for 4 weeks upon your return. Assuming a 2-week safari, you'd need about 8 tabs costing about $90.

    Malarone which has less side-effects, is taken daily, commencing 2-days prior arriving in infected area, then daily (preferrably in the morning with food - dairy such as milk, yougurt, cheese is recommended). And for 7-days upon returning from the area. If you have a drug plan these pills may cost about $35+/-; without a plan, figure between $90-$120, so check around.

    Doxycycline, is an antibiotic (and a generic med) and not specific for malaria but often recommended for those who for some reason can't take the other two. These tend to make one sensitive to sun and woman may get thrush (yeast infections). Though less costly than those above, have to be taken for 30-days after leaving/returning from infected area.

    Though some people have no reaction to the Lariam, the possible side-effects can be restless or interrupted sleep, wierd dreams, even psychotic episodes. Fewer people have reactions to Malarone, if any. With doxy you have to consider the side effects as above.

    Here's a good article published by the Center for Disease Control about the drugs, their side effects, who should not take each one, etc.

    http://www.cdc.gov/travel/malariadrugs.htm

7/4 This is a good site to check for updated warnings:

http://www.osac.gov/Reports/report.cfm?contentID=40708

 7/26--CIPRO--This person seems to know a lot about this drug so I'm adding this to this site. As with any medical information, it's best to talk to your doctor.

First let me explain about Cipro ,Imodium or anything else you might be wanting to use .

I am assuming that you are concerned about getting and abdominal infection and diarrhea and cramps.

The most common bacterial infection that you will/could get that willcause you problems is from E. Coli.

Now the "E" stand for Entertoxigenic.
Enter means gut and you all know what toxic means !!

Now if you get sick and Imean sick and not just some uncomfortable cramps and a few loose stools...then

you WILL have to use Cipro... a ton of Imodium is not going to help.

Here is what happens:

If you get E.Coli not only does it produce a toxin BUT it also sheds the linning of your gut... so you lose much of your food absorbing mechanism.

Now you eat something and the food is NOT absorbed in the first 2-3 feet of your small bowel, as it normally would.

So this food passes into your colon.
But this bulk of food should not be in your Colon.....so the colon has to attempt to neutralize this, and it does so by "sucking" in water from your system.
Well too much water in the colon and too much cramps ...so you pass a watery bowel motion. ( maybe even with some blood) Becareful if you start passing blood..go to the hospital.

Meanwhile the Toxin is working on your upper gastrointestinal tract (stomach and first part of small bowel)
This will cause you cramps and acute nausea...you may vomit...if you do vomit...you now have it coming out of both ends.... you know what happens now......

that's right dehydration.

So you better sip on fluids in small amounts all day long even though you may not want to and just the mention of food makes you more ill than you already are.

At this time Imodium will help ... a better drug is Lomotil.
But Imodium is over the counter.

Don't for a minute think that you are going to kill the bacteria by taking Imodium or Pepto Bismol.

You are sick and you WILL have to use Cipro.
Don't forget if you take Cipro on a trip with you and do not use it ...it is good for 4-5 year...so keep it around in case you need it on another venture.

Now the gut linning that the E.Coli caaused you to shed ...will regenerate in 2-4 days...... so do not start eating heavy food until about the 3rd day.

A simple comparison to the shedding your your gut lining ...is the endometrial shedding of a lady's uterine lining during her menstrual period.
The lining DOES regenerate ...if it did not ...you all would not be reading this right now.!!!!!

Okay about Cipro:

Lucia78 you mentioned could you take something else in place of Cipro.... yes maybe you could...but what!!! don't you want something that is very good IF you should get sick.?!!

Cipro may cost more but it is better in its spectrum against many bacteria.

You see Penicillin works against E. Coli, but not against very many of them.... all you know is that right now you are sick and you want to get better.

There is no time for bacterial cultures and heaven forbid if you should wind up in the hospital.

I will try to make this simple:

Cipro has a BETTER mode of action.
It inhibits the DNA enzyme in the bacterial's cell wall that the bacterial needs to replicate its own DNA......no replication...the bacterial dies....simple as that .( not really but that is another story).

Penicillin will also act on the bacterial cell wall but in a much less potent mode of action( not on the DNA enzyme mechanism

Okay what do these antibiotics not damage OUR cell wall but only the bacteria's........simple....

we do NOT have a cell wall, we humans have a cell membrane.

So you see you cannot just inter change the antibiotics without thinking of the bacteria that you want to kill.

1. Get 3-6 Cipro from your doctor
2. If you get the Cipro with the XL after the name (eg, Cipro XL) then you only have to use this once a day.

3.Take the Cipor only of you are SICK and I mean sick... not little tummy aches and a little crampy loose bowle motion.

4.If you do not use the Cipro..save it ,it is good for 4-5 years.

5. Take Imodium with you ,get the "Quick Disslove " type , it is written quick dissolve right on the box.
6. If you have a few loose stools that are a bit aggravating to you ...then use the Imodium BUT not the Cipro.

7. You keep the Cipro for when/if you are SICK


 

Time will elapse after the drug leaves the pharmaceutical manufacturer, then is sent to a wholesaler, then goes to the pharmacy, then is dispensed to the patient. You just won't get 4-5 years from the time you pick up your prescription. Ask the pharmacist when you pick up the tablets what the expiration date is on the stock bottle on the shelf since, in this case, it's something you may not have to use -- let's hope that's the case -- and could save for a future trip.

Then, when you're home, keep the bottle in a cool, dry place, not the medicine cabinet in your bathroom. The warmth and humidity degrade the tablets over time. Room temperature is best.
I'm a pharamcist by training
 
I always carry Brewer's Yeast tablets (a herbal product) with me, as they are safe and excellent for regulating the acid-base balance in the stomach. We also use Brewer's Yeast in our hospital for resistant bacterial diarrhoea (Clostridium difficile) and it works very well. These patients would have tried every injectable antibacterial known to man (including cipro and much more potent drugs) without success - but yet the use of a simple health food supplement has worked wonders. Brewer's Yeast is cheap and safe. When in Afica, I take it on a daily basis to maintain a regular gut and it has not let me down on my last three trips.

 

I'm Kibokos's husband and I am a physician and Professor of Medicine at a medical school here on the East Coast of the U.S.. Normally I don't provide medical advice on this topic or on this sort of forum because it is not posssible to address all of the different diseases that might occur and present as diarreah. However, my wife (kiboko) has told me how wonderful this forum has been in helping her plan our safaris so I'll make a stab at clearing up some of your issues. First let me say that travelers diarreah (TD) is very common in travelers to certain parts of the world. According to our U.S. CDC, 30%-50% of travelers to East Africa will develop TD if they stay in country more than 10 days. Let me caution you that even if you think that number is high, it is still significant. Now how does one handle TD while on Safari. First, if the diarreah is uncomplicated (no blood in the stool and no fever) you can take imodium and an anibiotic. The antibiotic most used by physicians themselves is probably Cipro. However, a newer antibiotic Rifaximin (Xifaxan made by Salix Pharm.) is proving as effective and is not absorbed from the GI tract. Many U.S. physicians traveling to high risk areas take it on a daily basis to prevent getting TD. I know many who give it to their entire family because they feel it is so safe and better than risking a bad bout of TD. In all cases it is Better to take an antibiotic at the first sign of uncomplicated TD than to take an antimotility drug (imodium) alone and wait to see if it gets worse. If you do that, all your doing is giving the E. coli a chance to flourish and in nearly all cases this will mean you will have symptoms for at least 3 days. The combinded use of antibiotics plus an antimotility drug (i.e.imodium) is our recommended treatment for uncomplicated TD, here in the U.S.. I would encourage you to speak with your own physicians about Cipro and Xifaxan. Don't be surprised if your docs aren't aware of Xifaxan. It was only approved by the FDA last year but it has been widely used for several years in parts of Europe. Feel free to show them my post. In closing let me add that dehydration something you need to address. Take along some of the rehydration salt packets or just some salt and sugar packages. As for the other measures mentioned in many of the prior posts, all I can offer is that I have been on trips to remote places with travel mates that relied on them and they were NOT at all effective. I hope my post does not offend any of those who offered advice previously.



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PROTECTION FROM THIEFT
 

Beware of people bumping into you on the street or in busses. seems silly, because it's africa and it's crowded.. but they take advantage of it. I caught someone trying to pick me on a small bus while he was pretending to load a 50 pound bag of rice into the bus and practically sitting on me.

Watch your shoes at all times. They disappear often from tents, from rooms and from safari cars.

Beware of the hotel safe. Most people we talked to had their money stolen out of the hotel safe.