Health & insurance
Decent health care is quite easy to access in Addis Ababa, less so elsewhere. Ethiopia certainly has an impressive selection of tropical diseases on offer, but as long as you stay up to date with your vaccinations and take some basic preventive measures, you’re much more likely to get a bout of diarrhoea, a cold or an infected mosquito bite than an exotic disease such as sleeping sickness.
Before You Go
The World Health Organization (www.who.int) recommends that all travellers be covered for diphtheria, tetanus, measles, mumps, rubella and polio, as well as for hepatitis B, regardless of their destination. The consequences of these diseases can be severe, and outbreaks of them do occur.
According to the Centers for Disease Control & Prevention (www.cdc.gov), the following vaccinations are recommended for all parts of Africa: hepatitis A, hepatitis B, meningococcal meningitis, rabies and typhoid, and boosters for tetanus, diphtheria and measles. Proof of yellow-fever vaccination is mandatory for travel to Ethiopia. Depending on where you’ve travelled from, cholera vaccination may also be required.
Medical insurance is crucial, but policies differ. Check that the policy includes all the activities you want to do. Some specifically exclude ‘dangerous activities’ such as white-water rafting, rock climbing and motorcycling. Sometimes even trekking is excluded. Also find out whether your insurance will make payments directly to providers or will reimburse you later for overseas health expenditures (in Ethiopia many doctors expect payment in cash).
Ensure that your travel insurance will cover the emergency transport required to get you to a hospital in a major city, to better medical facilities elsewhere in Africa, or all the way home, by air and with a medical attendant if necessary. If you need medical help, your insurance company might be able to help locate the nearest hospital or clinic, or you can ask at your hotel. In an emergency, contact your embassy or consulate.
Membership of the African Medical & Research Foundation (www.amref.org) provides an air evacuation service in medical emergencies in many African countries, including Ethiopia. It also provides air-ambulance transfers between medical facilities. Money paid by members for this service goes into providing grassroots medical assistance for local people.
It’s a very good idea to carry a medical and first-aid kit with you, to help yourself in the case of minor illness or injury. Following is a list of items you should consider packing.
- Acetaminophen (paracetamol) or aspirin
- Acetazolamide (Diamox) for altitude sickness (prescription only)
- Adhesive or paper tape
- Antibacterial ointment (eg Bactroban) for cuts and abrasions (prescription only)
- Antibiotics (see your medical-health professional for the most useful ones to bring)
- Antidiarrhoeal drugs (eg loperamide)
- Antihistamines (for hayfever and allergic reactions)
- Anti-inflammatory drugs (eg ibuprofen)
- Antimalaria pills
- Bandages, gauze, gauze rolls
- DEET-containing insect repellent for the skin
- Iodine tablets (for water purification)
- Oral rehydration salts
- Permethrin-containing insect spray for clothing, tents, and bed nets
- Pocket knife
- Scissors, safety pins, tweezers
- Sterile needles, syringes and fluids if travelling to remote areas
- Steroid cream or hydrocortisone cream (for allergic rashes)
- Syringes and sterile needles
Since falciparum malaria predominates in Ethiopia, consider taking a self-diagnostic kit that can identify malaria in the blood from a finger prick.
There’s a wealth of travel-health advice on the internet. For further information, lonelyplanet.com is a good place to start. The World Health Organization publishes a superb book called International Travel and Health, which is revised annually and is available online at no cost at www.who.int/ith. It’s also a good idea to consult your government’s travel health website before departure, if one is available.
Other websites of general interest:
Centers for Disease Control and Prevention (www.cdc.gov)
Fit for Travel (www.fitfortravel.scot.nhs.uk) Up-to-date information about outbreaks and is very user-friendly for travellers on the road.
MD Travel Health (www.mdtravelhealth.com) Provides complete travel health recommendations for every country, updated daily, at no cost.
Availability & Cost of Health Care
Health care in Ethiopia is varied: Addis Ababa has good facilities with well-trained doctors and nurses, but outside the capital health care is patchy at best. Medicine and even sterile dressings and intravenous fluids might need to be purchased from a local pharmacy by patients or their relatives. The standard of dental care is equally variable, and there’s an increased risk of hepatitis B and HIV transmission via poorly sterilised equipment. By and large, public hospitals in the region offer the cheapest service, but will have the least up-to-date equipment and medications; mission hospitals (where donations are the usual form of payment) often have more reasonable facilities; and private hospitals and clinics are more expensive but tend to have more advanced drugs and equipment and better trained medical staff.
Most drugs can be purchased over the counter in the region, without a prescription. Try to visit a pharmacy rather than a ‘drug shop’ or ‘rural drug vendor’, as they’re the only ones with trained pharmacists who can offer educated advice. Many drugs for sale in Africa might be ineffective: they might be counterfeit or might not have been stored under the right conditions. The most common examples of counterfeit drugs are malaria tablets and expensive antibiotics, such as ciprofloxacin. Most drugs are available in larger towns, but remote villages will be lucky to have a couple of paracetamol tablets. It’s strongly recommended that all drugs for chronic diseases be brought from home.
Although condoms are readily available (sometimes boxes – yes boxes! – are in hotel rooms), their efficacy cannot be relied upon, so bring all the contraception you’ll need. Condoms bought in Africa might not be of the same quality as in Europe or Australia, and they might have been incorrectly stored.
There’s a high risk of contracting HIV from infected blood if you receive a blood transfusion in the region. The BloodCare 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.
The list of diseases that you could conceivably catch in Ethiopia is lengthy, but in truth you'd be extremely unlucky to catch any of them.
High temperatures mean that you should pay close attention to your fluid intake and make sure that you use some protection from the sun. Bites and stings from insects are common but relatively easy to prevent, while snake bites are extremely rare.
Never drink tap water unless it has been boiled, filtered or chemically disinfected (such as with iodine tablets). Never drink from streams, rivers and lakes. It’s also best to avoid drinking from pumps and wells: some do bring pure water to the surface, but the presence of animals can still contaminate supplies.
Bottled water is available everywhere, though it’s better for the environment if you treat/filter local water.