Travel Reference
In-Depth Information
breastfeeding. It can be spread through 'blood to blood' contacts, such as with contamin-
ated instruments during medical, dental, acupuncture and other body-piercing procedures,
and through sharing used intravenous needles.
At present there is no cure; but medication that might keep the disease under control is
available. In 2002 the Botswana government elected to make antiretroviral drugs available
to all citizens free of charge, becoming the first country in the world to offer this treatment
for free. Still, for people living in remote areas of the country access to such treatment is a
problem, as is the continuing stigma attached to 'owning up' to having the infection. In
Namibia, antiretroviral drugs are still largely unavailable, or too expensive for the major-
ity of Namibians.
If you think you might have been infected with HIV, a blood test is necessary; a three-
month gap after exposure and before testing is required to allow antibodies to appear in
the blood. Self-treatment: none.
Malaria
Apart from road accidents, malaria is probably the only major health risk that you face
while travelling in this area, and precautions should be taken. The disease is caused by a
parasite in the bloodstream spread via the bite of the female
Anopheles
mosquito. There
are several types of malaria; falciparum malaria is the most dangerous type and the pre-
dominant form in Botswana and Namibia. Infection rates vary with season and climate, so
check out the situation before departure. Several different drugs are used to prevent mal-
aria and new ones are in the pipeline. Up-to-date advice from a travel health clinic is es-
sential as some medication is more suitable for some travellers than others (eg people with
epilepsy should avoid mefloquine, and doxycycline should not be taken by pregnant wo-
men or children aged under 12).
The early stages of malaria include headaches, fevers, generalised aches and pains, and
malaise, which could be mistaken for flu. Other symptoms can include abdominal pain,
diarrhoea and a cough. Anyone who develops a fever in a malarial area should assume
malarial infection until a blood test proves negative, even if you have been taking antimal-
arial medication. If not treated, the next stage could develop within 24 hours, particularly
if falciparum malaria is the parasite: jaundice, then reduced consciousness and coma (also
known as cerebral malaria) followed by death. Treatment in hospital is essential, and the
death rate might still be as high as 10% even in the best intensive-care facilities.
Many travellers think that malaria is a mild illness, and that taking antimalarial drugs
causes more illness through side effects than actually getting malaria. This is unfortu-
nately not true. If you decide against antimalarial drugs, you must understand the risks,
and be obsessive about avoiding mosquito bites. Use nets and insect repellent, and report
