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HEALTH |
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Disease is an ever-present threat to people in Kenya, most of whom
have no access to clean water, and not enough money to afford a doctor
if they do fall ill. As a visitor it's wise to take precautions - wash
and dress all cuts, and avoid food that has been left lying around after
cooking.
Malaria is endemic to the country, as are other diseases such as
bilharzia, and rates of HIV infection are high. If you're going to be on
the road for a long time, it may be worth considering taking some
vitamin tablets with you, though these are no substitute for a balanced
diet with plenty of fresh fruit and vegetables. One of the biggest
hazards though, is the fierce heat of the tropical sun, against which
you would be wise to take protection.
For a comprehensive, and extremely useful, account of the health
problems which travellers encounter worldwide, consult the pocket-format
Rough Guide to Travel Health by Dr Nick Jones.
If you're interested in homeopathy, look at the very impressive Abha
Light Health Centre's website . The centre is in Kariobangi, east
Nairobi and has ambitious aims.
Medical resources for travellers
Your first source of advice and probable supplier of jabs and
prescriptions is your general practitioner. Family doctors are often
well informed and are likely to charge you a (relatively low) flat fee
for routine injections. For yellow fever and other exotic shots you'll
normally have to visit a specialist clinic, often in the next large town
if you live in the country, although city-dwellers should have no
difficulty finding a vaccination centre that has supplies
Inoculations
For arrivals by air from Europe, Australia and New Zealand, or North
America, Kenya has no required inoculations. Entering overland, though,
you may well be required to show International Vaccination Certificates
for both yellow fever and cholera.
If you fly on an airline that stops en route in Africa, you should have
the yellow fever shot before you leave and preferably get a cholera
vaccination exemption stamp in case some border official thinks that you
need a cholera vaccination stamp to enter the country (the cholera shot
is widely considered completely ineffective, and not officially required
for entry into Kenya or any other East African country, although border
officials may not be aware of this). You may otherwise be subjected to
them at the airport. Plan ahead and start organizing your jabs at least
six weeks before departure. Remember that a yellow fever certificate
only becomes valid ten days after you've had the jab. You should also
start taking malaria tablets before departure and don't forget to
continue taking them for the prescribed time after you return.
Tetanus and polio boosters are necessary and doctors usually recommend
typhoid jabs (beware that these can take you out of action for a couple
of days). For hepatitis A , Havrix is now commonly prescribed, and needs
a booster after six months to knock up your immunity to ten years. The
much cheaper gamma-globulin (or immunoglobulin) shots are only effective
for a few months.
To reduce the risk of contracting hepatitis, be extra careful about
cleanliness and in particular about contamination of water - a problem
wherever a single cistern holds the whole water supply in a cockroach-infested
toilet/bathroom, as often happens in Lamu
Malaria
Though in Nairobi and the highlands, the malaria risk is low, on the
coast, mosquito bites are assured and protection against the disease is
absolutely essential.
Caused by a parasite carried in the saliva of female Anopheles
mosquitoes, malaria is endemic in tropical Africa and has a variable
incubation period of a few days to several weeks meaning you can get it
long after being bitten. Though not infectious, the disease can be very
dangerous and sometimes fatal if not treated quickly. The destruction of
red blood cells by the falciparum type of malaria parasite can lead to
cerebral malaria (blocking of the brain capillaries) and is the cause of
a nasty complication called blackwater fever in which the urine is
stained by excreted blood cells.
Other diseases
Bilharzia (medical name schistosomiasis) is a dangerous disease. It
comes from tiny flukes (the schistosomes) that live in freshwater snails
and which burrow into animal (or human) skin to multiply in the
bloodstream. The snails only favour stagnant water and the chances of
picking up bilharzia are small. The usual recommendation is never to
swim in, wash with, or even touch, lake water that can't be vouched for.
Most lakes and rivers harbour bilharzia, to some extent, but the
possible danger of crocodile attack means you are unlikely to want any
close contact with inland waters. If you feel major fatigue and pass
blood - the first symptoms of bilharzia - see a doctor: it's curable.
Sexually transmitted diseases (STDs), including the HIV virus, are rife
in Kenya. Four out of five deaths among 25 to 35 year olds are AIDS-related.
It goes without saying that casual sex without a condom is a deadly
gamble and you should assume any sexual contact to be HIV positive.
Using a condom will also protect you from other sexually transmitted
diseases, including Hepatitis B (HBV), which is quite widespread in
Kenya and if anything even more contagious, though rarely fatal if
treated. Both HIV and HepB are very easily passed between sexual
partners suffering from relatively minor, ulcerous STDs, and the very
high prevalence of these is thought to account for the high incidence of
heterosexually transmitted HIV. These diseases are also quite easily
transmitted by shared syringe or body-piercing or tattooing equipment.
Medicine bag
Various items worth taking on a trip include:
Alcohol swabs Invaluable for cleaning minor wounds or insect bites.
Antihistamine cream Apply immediately after insect bites to reduce
itchiness.
Anti-malaria tablets Enough for prevention, plus extra for a cure if
necessary.
Antibiotics If you are likely to be far from medical help for any length
of time, your doctor should be able to prescribe you suitable
antibiotics in case you need to treat a serious lower bowel crisis or
dysentery.
Antiseptic cream Avoid metal tubes, which tend to puncture.
Aspirin or paracetamol for pain or fever relief.
Iodine tincture, with dropper, or water purifying tablets If you can't
get clean water, these will do the trick.
Lens solution/eye drops If you wear contacts, take a good supply.
Lip-salve/chapstick
Thermometer Get a plastic one that sticks on your forehead. Ideally
you'll be 37 ° C or 98.4°F
Zinc oxide powder Useful anti- fungal powder for sweaty crevices.
Water and bugs
Kenya's once fairly safe tap water is increasingly unfit to drink and
the supply can be particularly suspect during periods of drought or
heavy flooding. If your stay is brief, you might as well stick to the
widely available bottled water (buy in bulk from supermarkets, not from
your hotel). Be very cautious of rain-or well-water where there is no
mains supply and always purify it first if in any doubt.
In truth, serious stomach upsets don't afflict a large proportion of
travellers. If you're only staying a short time, it makes sense to be
very scrupulous: if bottled water isn't available, then purifying
tablets or, better, iodine (six drops per litre of water, then wait for
half an hour), or boiling it for thirty minutes kills most things. For
longer stays, think of re-educating your stomach rather than fortifying
it; it's virtually impossible to travel around the country without
exposing yourself to strange bugs from time to time. Take it easy at
first, don't overdo the fruit (and wash it in clean water), don't keep
food too long, and be very wary of salads served in cheap restaurants.
It is also wise to eat food that is freshly cooked and piping hot,
rather than things that have been lying around for hours hatching germs.
Should you go down with diarrhoea , it will probably pass of its own
accord in 24-48 hours without treatment. In the meantime, and especially
with children, for whom it may be more serious, it's essential to
replace the fluids and salts you are losing, so drink lots of water with
oral rehydration salts (if you can't get them - usually in sachets from
pharmacies - use half a teaspoon of salt plus eight of sugar in a litre
of water). It's a good idea to avoid greasy food, heavy spices, caffeine
and most fruit and dairy products, though some say bananas and pawpaws
are good. Plain rice or ugali with boiled vegetables is the best diet if
you can stick to it, with maybe weak black tea if you can't survive
without it. Yoghurt or a soup made with Marmite or Vegemite (the former
available in Kenya) are forms of protein that can be easily absorbed by
your body while you have the runs. Drugs like Lomotil and Immodium
simply plug you up - undermining the body's efforts to rid itself of
infection - though they can be useful if you have to travel. Stay right
away from the popular Kaomycin, which isn't particularly safe to use and
can even encourage diarrhoea. Avoid jumping for antibiotics at the first
sign of trouble: they annihilate what's nicely known as your "gut flora"
and will not work on viruses. If you continue to feel bad, seek medical
help. Also note that having diarrhoea can make drugs less effective if
taken orally, as they can pass straight through your system without
being absorbed - this can apply to malaria pills for example, and women
using the pill should note that diarrhoea can make it less reliable.
Heat and altitude
It's important not to underestimate the power of the equatorial sun at
the equator and overdose on rays in the first week or two. A hat and
sunglasses are strongly recommended at all times to combat the heat and
bright light.
The sun can quickly burn , or even cause sunstroke , and a high-factor
sunblock is vital on exposed skin, especially when you first arrive.
Finally, be aware that overheating can also cause heatstroke , which is
potentially fatal. Signs are a very high body temperature, without a
feeling of fever but accompanied by headaches and disorientation.
Lowering body temperature (by taking a tepid shower for example) and
resting in a cool place is the first step in treatment.
The sun's radiation is stronger at higher altitudes, but the biggest
risk if you climb to over 2500m above sea level can be altitude sickness
, which may affect climbers on Mount Kenya, and even walkers in the
Cherangani Hills.
Many people get occasional heat rashes , especially at first on the
coast. A warm shower, to open the pores, and loose cotton clothes should
help, as can zinc oxide powder. Dehydration is another possible problem,
so make sure you are drinking enough fluids (but not alcohol or caffeine),
especially when hot or tired. The main danger sign is irregular
urination (only once a day for example). Dark urine definitely means you
should drink more. Excessive sweating can also lead to the body losing a
lot of salt . If this applies to you, sprinkle extra on your food.
Cuts and bites
Take more care than usual over minor cuts and scrapes . In the tropics,
the most trivial scratch can quickly become a throbbing infection if you
ignore it. Take a small tube of antiseptic with you, or apply alcohol or
iodine.
Dogs are usually sad and skulking, posing little threat, but rabies does
exist in Kenya, and can be transmitted by a bite or even a lick, so it's
best to avoid playing with pets unless you know the owner and are sure
they are safe. Scorpions and spiders abound, but are hardly ever seen
unless you deliberately turn over rocks or logs: scorpion stings are
painful but almost never fatal, while spiders are mostly quite harmless,
even the really big ones. Snakes are common but, again, the vast
majority are harmless. To see one at all, you'd need to search
stealthily; walk heavily and they obligingly disappear.
Hospitals
For serious treatment there's a frightening lack of well-equipped
hospitals and drugs, and in most you're routinely expected to pay for
treatment, syringes, plastic gloves, cotton wool, drugs and other
medical equipment. The Consolata Sisters' hospitals - the Nazareth
Hospital on Riara Ridge, outside Nairobi (tel 02/335684), and another in
Nyeri (tel 020/772032) - are well-run and modestly priced. Nairobi
itself is fairly well provided: the Nairobi Hospital in Argwings Kodhek
Road is reasonably good (tel 02/722160). We've mentioned the best local
hospitals throughout the text in the "Listings" sections
Teeth
Get a thorough dental check-up before leaving home and take extra care
of your teeth while in Kenya. Stringy meat, acid fruit and sugary tea
are some of the hazards. A freshly cut "toothbrush twig" ( msuake ) is a
useful supplement - some varieties contain a plaque-destroying enzyme;
you can buy them at markets.
Flying doctors
Kenya's flying doctor Air Ambulance service (which also operates in
Tanzania) offers free evacuation by air to a medical centre - very
reassuring if you'll be spending time out in the wilds. Annual tourist
membership costs $50 per person. The income goes back into the service
and the African Medical Research Foundation (AMREF) behind it. You can
contact them in advance (PO Box 30125 Nairobi; membership/information on
02/501301-3, fax 609518, ) or buy their insurance on arrival; they have
an office at Wilson Airport, from where most of their rescue missions
set out. Similar services are offered by AAR Health Services (tel
02/715318-26) and Mediplus (tel 02/714060 or 712502), both in Nairobi.
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