Togo - West Africa - page 1014

IN WEST AFRICA
Availability & Cost of Health Care
Health care in West Africa is varied: it can be excellent in the major cities, which generally have well-trained doctors and
nurses, but it is often patchy off the beaten track. 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
is an increased risk of hepatitis B and HIV transmission via poorly sterilised equipment. By and large, public hospitals in
Africa 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 West Africa, without a prescription. Many drugs for sale in West
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 capital cities, but remote villages will be lucky to have a couple of paracetamol tablets. It is recommended
that all drugs for chronic diseases be brought from home. Also, the availability and efficacy of condoms cannot be relied
on - bring contraception. Condoms bought in West Africa might not be of the same quality as in Europe or Australia,and
they might not have been correctly stored.
There is a high risk of contracting HIV from infected blood if you receive a blood transfusion in West Africa. To min-
imise this, seek out treatment in reputable clinics. If you have any doubts, 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 with-
in 24 hours.
The cost of health care might seem cheap compared with its cost in first-world countries, but good care and drugs
might not be available. Evacuation to good medical care (within West Africa or to your own country) can be very expens-
ive. Unfortunately, adequate health care is available to very few West Africans.
Infectious Diseases
It's a formidable list but, as we say, a few precautions go a long way…
Cholera
Although small outbreaks can occur, cholera is usually only a problem during natural or human-made disasters. Travellers
are rarely affected. It is caused by a bacteria and spread via contaminated drinking water. The main symptom is profuse,
watery diarrhoea, which causes debilitation if fluids are not replaced quickly. An oral cholera vaccine is available, but it is
not particularly effective. Most cases of cholera could be avoided by making sure you drink clean water and by avoiding
potentially contaminated food. Treatment is by fluid replacement (orally or via a drip), but sometimes antibiotics are
needed. Self-treatment is not advised.
Dengue Fever
Found in Senegal, Burkina Faso and Guinea, dengue fever (also called 'breakbone fever') is spread by mosquito bites. It
causes a feverish illness with headache and muscle pains similar to those experienced with a bad, prolonged attack of in-
fluenza. There might be a rash. Self-treatment: paracetamol and rest. In rare cases in Africa this becomes severe dengue