Those who travel in southern Africa with hygiene and skin care in mind are unlikely to encounter any health problems. Below are some issues that should be considered:
Food and drink: Mineral water is available most of the time, and in many places you will be able to drink from the tap. You should ideally take your meals in busy restaurants. People eat there for a reason and the turnover rate is high. Wash your hands thoroughly before eating.
Sunshine and heat: Sunburn is a frequent cause for health problems. Sunburn and sun/heat strokes are easier caught than you may think. You should therefore avoid the sun during the hottest hours of the day, always wear a hat and good sunglasses when you are walking, and use a good suntan lotion when sunbathing. The latter can best be brought along from home, where the choice of product is much larger and prices are lower. At high temperatures the body’s need for water increases very rapidly, as does its need for salt. Make sure you drink enough when the heat is extreme and you will simply have to take it very easy during the hottest hours of the day. Make it a habit to treat wounds, however small, with something like iodine. Infections can occur and spread rapidly in the tropics, so take as much care as possible with scratches and insect bites.
Malaria: The World Health Organization (WHO) advises all travellers to Africa to “to take all possible preventive measures to avoid malaria.” It is a dire necessity to prevent being stung (use a mosquito net and anti-mosquito lotion on the skin) and take malaria tablets. Malaria risk is very high during the rainy season. The prophylaxis recommended for most destinations in Africa by the WHO is mefloquine (Lariam). You have to start taking the tablets three weeks before departure. It is crucial to keep on taking the tablets until four weeks after your return. This is due to the long incubation period of the malaria parasite. These days Malerone is also recommended; it has fewer side effects, but is a bit more expensive. Consult your GP or some other healthcare authority.
Diarrhoea: Next to sunburn, the most common health problem is diarrhoea. Travellers in the tropics are often hit by it after a few days. In most cases, it is an innocuous phenomenon caused by the change of diet, the heat or harmless bacteria, against which the body will soon develop its defences. The main risk is dehydration. This occurs when the body loses more fluid, salt and glucose than it receives. The result is a feeling of listlessness and weakness. It can be prevented by drinking a solution of water and ORS. It is sold in bags at the pharmacies at home and contains all the minerals and sugars that are evacuated with diarrhoea. You can also take noncarbonated soft drinks or heavily salted broth. When diarrhoea is accompanied by high fever, bloody defecation or a strong urge to vomit, consult a physician. When the diarrhoea lasts for more than a few days without the above-mentioned symptoms or when you have to travel, you may take Imodium a couple of times. It is an opiate that stops the bowels completely for a number of hours.
Insect bites: osquitoes cannot be entirely avoided in this part of the world, but there are some measures that will considerably reduce the inconvenience. The “mosquito coil” will keep them at a distance for about eight hours. It helps to wear long trousers and a close fitting long sleeved roll-neck T-shirt in the evenings. Citronella and other repellents do have some effect, but do not expect miracles.
Bilharzia: Bilharzia does occur at some locations. Larvae that live in slow moving and stagnant fresh water cause it. One larva needs no more than a few minutes to enter the human body through the skin. The larva’s eggs mainly cause damage to the kidneys and bladder. The disease is very insidious and develops over a number of years. After diagnosis, full treatment is often possible. Cold and fast moving water will probably not put you at risk, but you should avoid all freshwater pools except swimming pools.
First-aid kit: A health kit for the tropics should contain adhesive bandages, bandages, cotton wool, scissors, thermometer, iodine, painkillers, malaria tablets, O.R.S.-packages (Oral Rehydration Solution), loperamide (against diarrhoea), sunscreen, pair of tweezers, insect-repellents such as DEET and a soothing ointment for persistent itching. If you are on medication, make sure to have a precise description available in English (no brand name, but composition and doses are important). Bring along a double quantity for the duration of travel and keep it separated from the other luggage.
Contact lenses: If you wear contact lenses, take a pair of spare glasses if you can. Contact lens users regularly suffer from irritation of the eyes caused by dust and drifting sand.
Medication: Ask your pharmacy to draw up a medical passport for you. This includes names of the substances and the exact composition of the medication that you use. Keep this document and your medication in your hand luggage. If you have a chronic illness, ask your GP for a written explanation of your disease and its treatment (in English). Likewise, make sure you carry a doctor’s statement when travelling with needles.
Vaccinations: The information below was given by the healthcare authorities at the time of writing. This information may change. Besides, your needs depend on whether you have had previous vaccinations, whether you are allergic to certain medicine, if you are pregnant, your age, and so on. This is why you should always contact your GP or some other healthcare authority for advice. We cannot give further information by telephone. In any case, we advise you to take malaria tablets and injections against DTP and Hepatitis A. Ask your health insurance if they refund vaccinations and malaria prophylaxes.
Some more advice for a pleasant stay: give your body and mind time to adapt to the new location. Avoid tension; do not plan to do a lot of things immediately. At least take it easy on the first day after arrival. Getting up early is a good habit; in hot countries, morning is often the most pleasant. Also, the people in the countries you are visiting are used to get up early themselves. If you adapt to their rhythm, you will see most of the country. If you are well rested, you will be able to absorb all the new impressions and have enough energy to make the most of your time.