I have now spent what I consider to be a significant amount of time in West Africa. My first taste of the region came in 2005 when I studied abroad in Accra, Ghana. During that semester, I was also able to visit Togo, Benin, and Burkina Faso. Last year, I took my time traveling through Ghana, Cote d’Ivoire and Mali. As I write this now, I am back in Mali, having come here overland from Senegal.
As much as I love West Africa, I have experienced a lot of illness here: amoebic dysentery, malaria (twice), a leg infection that caused me to be immobile for 3 weeks, and countless bacterial infections that have led to various incarnations of traveler’s diarrhea. Many of these illnesses were a result of my own carelessness. Here are a few things I’ve learned.
Anything can get infected
At home, a tiny cut is nothing to worry about. Stop the bleeding and let it be. I rarely apply neosporin or even put on a band-aid. In Africa, this strategy is problematic. In northwest Benin, I got a small cut (maybe 2cm) on my leg. I did nothing to treat the cut, thinking it was too small to be worrisome. After two days, my leg had become severely infected. In fact, from my knee to my foot, it was like touching a piece of jello. By the time I got back to Accra, I needed an IV of antibiotics. Shortly thereafter I was taking oral antibiotics and receiving shots in my ass twice a day (part of the reason I had a complicated regimen was because I am allergic to penicillin). I was in bed for three weeks – putting my leg in any position other than horizontal was extremely painful. All of this because I didn’t clean a cut.
Coartem is your best friend
I’ve had malaria twice. At best, it is a more violent version of the flu. At worst, it is fatal. So much depends on the strain and how quickly you treat it. In both instances, I was fortunate to have access to Coartem, a powerful combination of artemether and lumefantrine that is widely used as an emergency standby for malaria treatment. I am very thankful for its existence. Each time, it brought relief within 8-10 hours. I now carry it with me whenever I am in a place where malaria is endemic. For more on malaria, check out these articles: Which Malaria Prophylactic Should you Take? and Should you Take Malaria Prophylactics?.
A solitary mosquito can ruin your night
The tendency for mosquitos to gravitate toward the ear canal is almost as annoying as the bites themselves. One single mosquito can harass you for hours. Use a net. Always. Insect repellant is also a good idea, as is permethrin, which you can put on the net and your clothes and it will actually kill mosquitos on contact.
Cipro is your second best friend
Ciprofloxacin is one of the most destructive antibiotics on the market. It treats a variety of bacterial infections in addition to decimating the beneficial flora in your gut. Every now and then, you may need to drop a neutron bomb on your intestinal track. Cipro is that neutron bomb. For lingering traveler’s diarrhea, Cipro will typically provide relief within 6-8 hours. Related reading: Ciprofloxacin: the Traveler’s Panacea (lots of important info there including concerns about cipro’s overuse).
Sometimes you just feel lousy
While traveling in West Africa, there are moments when you are just going to feel lousy. Maybe you are dehydrated. Maybe there is a minor bacterial infection in your gut. In any case, there will be times when you are not seriously ill, but you need to take it easy. Take care of yourself. Rest and hydrate.
Drink water. Lots of it.
Speaking of hydration… Dehydration can cause headaches and fatigue, among other things. At a minimum I drink 4 liters of water a day, sometimes more if I have been sweating a lot. If I am feeling exceptionally dehydrated, I’ll buy a packet of oral rehydration salts, about 20 cents, and mix it with a liter of water. See our post 4 Ways to Treat Water when Traveling.
Don’t sit on lingering symptoms
A lingering sickness, perhaps something that is not completely debilitating, but merely annoying, can be a cause for concern. Some intestinal infections can produce intermittent symptoms that are not severe enough to force action. For example, some people who have giardia will go weeks without taking action because the symptoms aren’t severe enough (some people, it should be noted, do have severe symptoms with giardia). While there is no need to panic, you should visit a clinic and have some tests done if you are experiencing ongoing symptoms.
How about you? Have you traveled in West Africa or Africa in general? What tips do you have when it comes to travel health?