While Africa has an impressive selection of tropical diseases, it’s more likely you’ll get a bout of diarrhoea or a cold than a more exotic malady. Stay up to date with your vaccinations and take basic preventive measures, and you’ll be unlikely to succumb to any of the serious health hazards.
The World Health Organization (www.who.int/ith/vaccines/en) recommends routine vaccinations including diphtheria, hepatitis B, measles, mumps, pertussis (whooping cough), polio, rubella, tetanus and varicella (chickenpox), regardless of your destination. Check you are up to date on these well in advance of leaving home.
The Centers for Disease Control and Prevention (www.cdc.gov) recommends hepatitis A and typhoid (as well as malaria prophylaxis) for all travellers to Malawi, plus hepatitis B and rabies in some cases.
While a yellow-fever-vaccination certificate is not officially required to enter Malawi, unless you are entering from a yellow-fever-infected area, carrying one is advised.
Find out in advance whether your travel insurance will make payments directly to providers or will reimburse you later for overseas health expenditures. Most doctors and clinics in the region expect up-front payment in cash.
It’s vital to ensure that your travel insurance will cover any emergency transport required to get you at least to Johannesburg (South Africa), or all the way home, by air and with a medical attendant if necessary.
If your policy requires you to pay first and claim later for medical treatment, be sure to keep all documentation. Some policies ask you to call back (reverse charges) to a centre in your home country, where an immediate assessment of your problem is made. Since reverse-charge calls aren’t possible in many parts of the region, contact the insurance company before setting off to confirm how best to contact it in an emergency.
Don’t drink tap water unless it has been boiled, filtered or chemically disinfected (such as with iodine tablets). Don’t drink from streams, rivers and lakes. It’s also best to avoid drinking from pumps, boreholes and wells; some bring pure water to the surface, but the presence of animals can contaminate supplies. Bottled water is widely available, except in very remote areas, where you should carry a filter or purification tablets.
If you become seriously ill, seek treatment in Lilongwe, Blantyre or South Africa or return home. If you fall ill in an unfamiliar area, ask staff at a top-end hotel or resident expatriates where the best nearby medical facilities are. In an emergency contact your embassy.
For routine complaints such as traveller's diarrohea, private clinics are widespread, even in villages along the lakeshore and in the bush. In smaller places, you can normally get treated by a competent, English-speaking doctor or nurse and leave with the necessary medication, all for a few thousand kwacha and within the space of half an hour.
Well-stocked pharmacies are found in Lilongwe and Blantyre. These invariably carry chloroquine and sometimes Fansidar (both for malaria) and other basics. It’s best to bring whatever you think you may need from home, including malaria pills and a malaria test kit. Always check the expiry date before buying medications, especially in smaller towns.
There is a high risk of contracting HIV from infected blood transfusions. The Blood Care Foundation (www.bloodcare.org.uk) is a useful source of safe, screened blood, which can be transported to any part of the world within 24 hours. A month's membership costs £12 (US$15).
For Western standards, expect to pay Western prices.