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"...a threefold cord is not quickly broken."
Ecclesiastes 4:12

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Health Tips

Pre-Trip Health Preparations

Make sure you're healthy before you start traveling. That includes being well rested and in shape. A typical day in Malawi will start at 6AM and end at 11PM. You will do a great deal of walking. Don’t wait until you get to Malawi to exercise those “out-of-shape” muscles. Start getting in shape now.

Make sure your teeth are OK. If you wear glasses or contact lenses take a spare pair and your prescription.

If you require a particular medication take an adequate supply, as it may not be available locally. Take the prescription or, better still, part of the packaging showing the generic rather than the brand name (which may not be locally available), as it will make getting replacements easier. It's wise to have a legible prescription or a letter from your doctor with you to prove that you legally use the medication to avoid any problems.

Recommended Vaccinations for Preventable Diseases

Below are the current recommendations for vaccine-preventable diseases in Malawi. Since this information changes so frequently, visit the CDC website for the most up-to-date information. Schedule an appointment with your health care provider at least 4 – 6 weeks before your trip to allow time for the vaccines to take effect.

You can also contact the Allegheny County Health Department to request the recommended immunizations specifically tailored for you and your trip. You can also get your immunizations at the ACHD office in Oakland, as an alternative to going to your doctor. Costs for each vaccine is available on their website.

  • Routine – if you are not up-to-date with measles mumps rubella (MMR), diphtheria pertussis tetanus (DPT) or polio vaccines.
  • Hepatitis A or immune globulin (IG) – to prevent exposure that might occur through food or water.
  • Hepatitis B - if you might be exposed to blood or bodily fluids or be exposed through medical treatment.
  • Typhoid – to prevent exposure that might occur through food or water.
  • Rabies - if you might be exposed to wild animals.

Recommended Malaria Prevention Medication

Malaria is a preventable infection that can be fatal if left untreated. Prevent infection by taking prescription anti-malarial drugs and protecting yourself against mosquito bites. In addition to taking medication as prescribed, it is important that you sleep under treated bed nets whenever possible. Using insect repellent can also prevent against mosquito bites.

Anti-malarial drugs to prevent malaria are only available by prescription through a health care provider. Atovaquone-Proguanil (Malarone), Doxycycline or Mefloquine (Lariam) are all good choices for Malawi. Note: Chloroquine is NOT an effective anti-malarial drug in Malawi and should not be taken to prevent malaria in this region. Visit the CDC website for more information to help you and your doctor to decide the best antimalarial drug for you based on your medical condition and the noted side effects.

When taking anti-malarial drugs it is important that you take the medication exactly as prescribed, on time and without missing doses. Over dosage of anti-malarial drugs can be fatal. Each medication has different instructions as to how long to take it before and after your trip. Therefore, based on the drug chosen by you and your doctor, it is imperative that you carefully calculate the number of doses you will need, based on the length of the trip and the prescribed dosage before and after. Your health insurance may not cover the cost of these drugs, so you may wish to shop around for the best price.

Basic Hygiene

You can go a long way towards avoiding illness by following these basic but important guidelines:

  • Wash your hands before eating. Use plenty of soap or hand sanitizer.
  • Wash your hands after using the toilet. Once again, use plenty of soap or hand sanitizer. Pack a roll of toilet paper for emergencies. Also pack a dozen sandwich size zip-lock bags. Garbage cans are few and far between in Malawi. Use these zip-lock bags until you find a garbage can.
  • Keep hands and objects out of your mouth.
  • Drink plenty of bottled water or carbonated beverages to avoid dehydration.
  • Eat clean fruits and vegetables and don’t be afraid to try new things when they are offered to you. Malawian passion fruit, beans, mangoes, tomatoes, tiny bananas, etc. are delicious!
  • Avoid sunburn! Bring at least a #15 sunscreen and a hat. Malawi is close to the equator and you will burn much faster there. A bad sunburn will incapacitate you for a few days.
  • Never antagonize animals or insects. Treat every creature with respect.
  • Never walk around with bare feet and if you have to dig a lot in the soil with your bare hands, ask about gloves. Hookworm enters the body through bare skin.
  • Get adequate rest and pray against sickness.

Other Diseases Found in Malawi

Food and waterborne diseases are the number one cause of illness in travelers. Travelers’ diarrhea can be caused by viruses, bacteria, or parasites, which are found throughout Central Africa and can contaminate food or water. Infections may cause diarrhea and vomiting (E. coli, Salmonella, Cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe.

Dengue, filariasis, leishmaniasis, and onchocerciasis are other diseases carried by insects that also occur in this region. Protecting yourself against insect bites will help to prevent these diseases.

Schistosomiasis, a parasitic infection, is found in fresh water in this region. Do not swim in fresh water (except in well-chlorinated swimming pools) in Central African countries.

Motion Sickness

Motion sickness (car sickness, sea sickness, air sickness) is not really an illness per se, but rather a collection of symptoms, which occur when your body, inner ear and eyes all send different signals to the brain. When riding in a car, for example, your inner ear will sense motion, but your body is sitting still and your eyes only see the inside of the vehicle. These mixed signals confuse your brain, and the result can be nausea, dizziness, lightheadedness and general malaise. Motion sickness can also be a problem for some people on cruise ships, and in airplanes, during turbulence, takeoffs, and landings.

For most of us, a trip to the drug store to purchase Dramamine, stocking up on ginger tea, or learning acupressure points, is preparation enough to be able to head off any symptoms of motion sickness. But for an unfortunate few, the symptoms refuse to be ameliorated by simple remedies, and can be severe enough to cause real misery. While motion sickness is only rarely life-endangering, the fear of spending several hours aboard a plane, bus or car suffering from nausea and vertigo, may be enough to deter even the most ambitious traveler from taking a prolonged trip.

A large number of prescription medications are available, and may be the only alternative-other than not traveling. Some commonly prescribed medications for motion sickness include antihistamines (including stronger variations of Dramamine) and scopolamine, which is sold under the trade name Transderm Scop, worn as a patch behind the ear. A word of caution-prescription drugs can be more powerful than herbs and over-the-counter medicines, and can cause significant side effects, but they are also more effective. (Additionally, herbal medicines are not regulated by any governmental agency, so quality, purity, and strength are not guaranteed.) While this will vary tremendously, depending on the type of drug and individual, it is something to consider and speak with your doctor about. Make sure that your doctor is also aware of any other medications that you are taking, both over-the-counter and prescription, as drugs can occasionally interact unfavorably with each other.

Traveler’s Diarrhea

Diseases that are transmitted by contaminated food and water pose the number one health risk to travelers. The most common consequence is traveler’s diarrhea. While it has some colorful pet names like “Montezuma’s Revenge” and “Delhi Belly”, persistent diarrhea can lead to serious complications.

There are no foolproof methods for avoiding traveler’s diarrhea, but you may reduce your chances of falling ill by following some common-sense guidelines. Peel all vegetables to make them safe to eat. Peel all fruits, too. High cooking temperatures destroy disease-causing organisms, so food that is served piping hot is generally safe, even if previously contaminated. Eating raw fish or meat in Malawi amounts to a willful act of self-destruction! Dry foods, such as breads and cakes, tend to be safe because they contain too little moisture to promote bacterial growth. As a general rule, remember this colonial slogan – “If you can cook it, boil it or peel it, you can eat it...otherwise forget it.”

Bottled water is your only choice for drinking and brushing your teeth. The Blantyre Partnership Team will have bottled water for each team member every day. Pasteurized dairy products and bottled carbonated beverages are usually safe to drink. Tea or coffee prepared with boiled water should also be OK to drink. By the way, if the water's not safe to drink, the ice made from the same water isn't safe either.

In hot climates like Malawi, make sure you drink enough - don't rely on feeling thirsty to indicate when you should drink. Not needing to urinate or the passing of very dark yellow urine is a danger sign. Always carry a water bottle with you on long trips. Excessive sweating can lead to loss of salt and therefore muscle cramping.

In Malawi, traveler's diarrhea affects as many as 20 to 30 percent of all travelers. In the event that you do become ill, Pepto-Bismol or Imodium are effective remedies to prevent and relieve diarrhea – two tablespoons (or tablets) are recommended. If vomiting accompanies the diarrhea, lay off food and drink for one hour. Then try a tablespoon of oral hydration serum (i.e. Gatorade) every 5 minutes for one hour. Professional care should be sought (notify the team leader) if the following occurs:

  1. Diarrhea or fever lasts for more than 48 hours

  2. Blood and/or mucus in your stool

  3. Persistent or severe abdominal cramps or pain

  4. Vomiting that lasts more that 6 hours

  5. Painful urination or discharge

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