You probably have less chance of getting sick in French Polynesia than in any major international city. There’s no malaria, land snakes, poisonous spiders or crocodiles, and cold and flu bugs are brought in from elsewhere. Mosquitoes do exist in quantity, however, and dengue fever as well as chikungunya will be a concern when there is an outbreak. Your biggest worry will be sunburn and avoiding infection in minor cuts and scrapes.
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The overall risk of illness for a normally healthy person is low. The most common problems are diarrhoeal upsets, viral sore throats, and ear and skin infections. The two following ailments are the only relatively common things you should know about, although the chances of contracting them are unlikely.
Dengue fever is a viral disease spread by the bite of a daytime-biting mosquito. It causes a feverish illness with headache and severe muscle pains similar to those experienced with a bad, prolonged attack of influenza. Danger signs include any sort of bruising or bleeding, vomiting or a blotchy rash – if you experience any of these alongside the fever get medical attention quickly. There is no preventive vaccine. Self-treatment involves paracetamol, fluids and rest. Do not use aspirin.
Also known as Weil’s disease, leptospirosis produces fever, headache, jaundice and, later, kidney failure. It is caused by a spirochaete organism found in water contaminated by rat and pig urine. The organism penetrates skin, so swimming in flooded areas or in rivers near pig farms is a risky practice. If diagnosed early it is cured with penicillin. This disease is often confused with dengue fever; if you have blood in your urine consider leptospirosis, which is considerably more serious.
This viral infection transmitted by certain mosquito bites was traditionally rare in French Polynesia until late 2014 when an epidemic hit the five archipelagos. Chikungunya (the unusual name means 'that which bends up' in the East African language of Makonde, a reference to the joint pain and physical distortions it creates in sufferers) is rarely fatal, but it can be, and it's always unpleasant. Symptoms are often flu-like, with joint pain, high fever and body rashes being the most common. It's important not to confuse it with dengue fever, but if diagnosed with chikungunya then expect to be down for at least a week, possibly longer. The joint pain can be horrendous and there is no treatment; those infected need simply to rest inside (preferably under a mosquito net to prevent reinfection), taking gentle exercise to avoid joints stiffening unbearably. At the time of writing the epidemic was over and should not be considered a major threat. Still, the best way to avoid it is to avoid mosquito bites, so bring plenty of repellent, use the anti-mosquito plug-ins wherever you can and bring a mosquito net if you're really thorough.
The municipal water supply in Pape’ete and other large towns can be trusted, but elsewhere avoid untreated tap water. In some areas the only fresh water available may be rainwater collected in tanks, and this should be boiled or otherwise treated. Water at restaurants, particularly resort restaurants, is safe.
Threats to health from animals and insects are rare, but you need to be aware of them.
Bites & Stings
Poisonous jellyfish and sea snakes are virtually unheard of in French Polynesia. More of a worry are extremely well-camouflaged stonefish, prolific on coral reefs and rocky areas – they are nearly impossible to see and have poison-injecting spines along their backs. If you do get stung, apply heat immediately and head for the hospital. Wearing plastic, waterproof sandals provides the best protection.
Poisonous cone shells abound along shallow coral reefs. Stings can be avoided by handling the shell at its blunt end only and preferably using gloves. Stings mainly cause local reactions; nausea, faintness, palpitations or difficulty in breathing flag the need for medical attention. Also watch out for sea urchins, as the spines are long and sharp, break off easily and once embedded in your flesh are very difficult to remove.
On land, mosquitoes and noseums will be your biggest concern. Although there is no malaria in French Polynesia, there are occasional dengue-fever and chikungunya outbreaks spread by mosquitoes. Noseums (nonos in French Polynesia) aren’t disease carriers but be careful not to over-scratch the bites or you’ll risk severe infection.
Skin & Ears
Coral ear is a fungal infection caused by water entering the canal. Apparently trivial, it can be very, very painful and can spoil a holiday. Apart from diarrhoea it is the most common reason for tourists to consult a doctor. Self-treatment with an antibiotic-plus-steroid eardrop preparation is very effective. Stay out of the water until the pain and itch have gone.
Staph infection of cuts and scrapes is very common and cuts from live coral are particularly prone to infection.
There is one recompression chamber on Tahiti, at the Centre Hospitalier du Taaone. Even experienced divers should check in with organisations like DAN and check that their insurance covers costs both for local treatment and evacuation. Novice divers must be especially careful. If you have not taken out insurance before leaving home you may be able to do so online with DAN.
This is a very serious condition – usually, though not always, associated with diver error. The most common symptoms are unusual fatigue or weakness; skin itch; pain in the arms, legs or torso; dizziness and vertigo; local numbness, tingling or paralysis; and shortness of breath. Signs may also include a blotchy itchy rash, staggering, coughing spasms, collapse or unconsciousness.
The most common causes of decompression sickness (or 'the bends' as it is commonly known) are diving too deep, staying at depth for too long or ascending too quickly. This results in nitrogen coming out of solution in the blood and forming bubbles, most commonly in the bones and particularly in the joints or in weak spots such as healed fracture sites.
Avoid flying after diving, as it causes nitrogen to come out of the blood even faster than it would at sea level.
The only treatment for decompression sickness is to put the patient into a recompression chamber so nitrogen bubbles can be reabsorbed. There is one recompression chamber on Tahiti, at the Centre Hospitalier du Taaone.
In addition to normal travel insurance, it's a very good idea to take out specific diving cover, which will pay for evacuation to a recompression facility and the cost of hyperbaric treatment in a chamber. Divers Alert Network is a nonprofit diving-safety organisation that offers a DAN TravelAssist policy that provides evacuation and recompression coverage. If you have not taken out insurance before leaving home you may be able to do so online with DAN.
Ciguatera has been reported in many carnivorous reef fish, especially barracuda and very large jack, but also red snapper and napoleon fish; in French Polynesia it sometimes occurs in the smaller reef fish as well and this will vary from island to island. There is no safe test to determine whether a fish is poisonous or not. Although local knowledge is not entirely reliable, it is reasonable to eat what the locals are eating. Treatment consists of rehydration and, if the pulse is very slow, medication may be needed. Healthy adults will make a complete recovery, although disturbed sensation may persist for some weeks.
Sunburn is an obvious issue so use sunscreen liberally. It’s also important to stay hydrated; heat exhaustion is a state of dehydration associated to a greater or lesser extent with salt loss. Heat stroke is more dangerous and happens when the cooling effect of sweating fails. This condition is characterised by muscle weakness and mental confusion. Skin will be hot and dry. If this occurs, ‘put the fire out’ by cooling the body with water on the outside and cold drinks for the inside. Seek medical help.
Coral is sharp stuff and brushing up against it is likely to cause a cut or abrasion. Most corals contain poisons and you're likely to get some in any wound, along with tiny grains of broken coral. The result is that a small cut can take a long time to heal. As soon as you can, cleanse the wound thoroughly (getting out all the little bits of coral or dirt if needed), apply an antiseptic and cover with a dressing. You can get back in the water but healing time will be prolonged if you do. Change the dressing regularly, never let it sit wet and check often for signs of infection.
Availability & Cost of Health Care
Health facilities in the country are generally of a good standard but some less-populated islands will have little to no medical services.
French Polynesia has doctors and dentists in private practice, and standard hospital and laboratory facilities with consultants in the major specialities. The outer islands, of course, have more basic services. Private consultation costs from 3500 CFP to see a GP; specialists are more expensive and anywhere you go, the waiting times can be very long. Direct payment is required everywhere except where a specific arrangement is made, such as in the case of evacuation or where prolonged hospital stay is necessary; your insurer will need to be contacted by you.
Most commonly used medications are available, but private pharmacies are not allowed by law to dispense listed drugs without a prescription from a locally registered practitioner. It’s best to have a sufficient supply of any regularly taken medication as a particular brand may not be available and sometimes quantities can be limited.