Before you go
Visitors to Namibia should always take out a comprehensive medical insurance policy to cover them for emergencies, including the cost of evacuation to another country within the region. Such policies come with an emergency number (often on a reverse-charge/call collect basis). You would be wise to memorise this, or indelibly tattoo it in as many places as possible on your baggage.
Personal effects insurance is also a sensible precaution, but check the policy's fine print before you leave home. Often, in even the best policies, you will find a limit per item, or per claim – which can be well below the cost of a replacement. If you need to list your valuables separately, then do so comprehensively. Check that receipts are not required for claims if you do not have them, also that the excess which you have to pay on a claim is reasonable.
Annual travel policies can be excellent value if you travel a lot, and some of the larger credit-card companies offer excellent policies. However, it can often be better to get your valuables named and insured for travel using your home contents insurance. These year-round policies will try harder to settle your claim fairly as they want your business in the long term.
Having a full set of immunisations takes time, normally at least six weeks, although some protection can be had by visiting your doctor as late as a few days before you travel. Ideally, see your doctor or travel clinic early on to establish an inoculation timetable. Legal requirements
No immunisations are required by law for entry into Namibia, unless you are coming from an area where yellow fever
is endemic. In that case, a vaccination certificate is mandatory. To be valid the vaccination must be obtained at least ten days before entering the country. Recommended precautions
Preparations to ensure a healthy trip to Namibia require checks on your immunisation status: it is wise to be up-to-date on tetanus
(ten-yearly) and diphtheria
(ten-yearly). Most travellers should have hepatitis A immunisation with Havrix Monodose or Avaxim. The course comprises two injections given about a year apart (total cost about £100) and lasts for ten years.
The newer typhoid
vaccines (eg: Typhim Vi) last for three years and are about 85% effective. They should be encouraged unless the traveller is leaving within a few days for a trip of a week or less when the vaccine would not be effective in time.
Immunisation against cholera is considered ineffective and is not required for trips to Namibia.
Vaccination against rabies
is unnecessary for most visitors, but would be wise for those who travel for extended periods (four weeks or longer), or stay in rural areas. Ideally three injections taken over a four-week period prior to travel are advised. But there is some benefit to be gained from even one injection if time is short.
Hepatitis B vaccination should be considered for longer trips (two months or more) or for those working with children or in situations where contact with blood is likely. Three injections are needed for the best protection and can be given over a four-week period if time is short. Longer schedules give more sustained protection and are therefore preferred if time allows.
A BCG vaccination against tuberculosis (TB) is also advised for trips of two months or more.
Malaria is the most dangerous disease in Africa, and the greatest risk to the traveller. It occurs in northern, and occasionally central, Namibia so it is essential that you take all possible precautions against it.
Prophylaxis regimes aim to infuse your bloodstream with drugs that inhibit and kill the malaria parasites which are injected into you by a biting mosquito. This is why you must start to take the drugs before you arrive in a malarial area – so that they are established in your bloodstream from day one. Unfortunately, malaria parasites continually adapt to the drugs used to combat them, so the recommended regimes must adapt and change in order to remain effective. None is 100% effective, and all require time to kill the parasites – so unless there is a medical indication for stopping, it is important to complete the course after leaving the area as directed (usually one to four weeks depending on the regime).
It is vital that you seek current advice on the best antimalarials to take. If mefloquine (Lariam) is suggested, start this two weeks before departure to check that it suits you; stop it immediately if it seems to cause depression or anxiety, visual or hearing disturbances, severe headaches, fits or changes in heart rhythm. Side effects such as nightmares or dizziness are not medical reasons for stopping unless they are sufficiently debilitating or annoying. Anyone who is pregnant, has been treated for psychiatric problems, is epileptic, has suffered fits in the past, or who has a close blood relative who is epileptic should avoid mefloquine. The usual alternative is chloroquine (Nivaquine) weekly plus proguanil (Paludrine) daily. The latter is the most likely regime to be offered for Namibia at the time of writing. However, if your trip includes visits to other African countries where there is a higher prevalence of more resistant falciparum malaria, then other prophylactic drugs may be suggested. These include mefloquine (as described above), doxycycline (a daily antibiotic) or Malarone (also taken once daily, but needing to be continued for only one week after leaving the area). Malarone has the advantage of having few side effects, but as it is expensive it tends to be reserved for shorter trips, although it is licensed for up to three months' use. Paediatric Malarone is now available for children under 40kg. The number of paediatric tablets required is calculated by weight. Malarone may not be suitable for everyone, so always seek advice from a doctor.
Prophylaxis does not stop you catching malaria, but it significantly reduces your chances of fully developing the disease and will lessen its severity. Falciparum (cerebral) malaria is the most common in Africa, and usually fatal if untreated, so it is worth your while trying to avoid it.
It is unwise to travel in malarial parts of Africa whilst pregnant or with young children: the risk of malaria in many areas is considerable and such travellers are likely to succumb rapidly.
Because the strains of malaria, and the drugs used to combat them, change frequently, it is important to get the latest advice before you travel. Normally it is better to obtain this from a specialist travel clinic than from your local doctor, who may not be up-to-date with the latest drugs and developments. For details of relevant clinics, see below.
Travel clinics and health information
A full list of current travel clinic websites worldwide is available on www.istm.org/. For other journey preparation information, consult ftp://ftp.shoreland.com/pub/shorecg.rtf or www.tripprep.com. Information about various medications may be found on www.emedicine.com/wild/topiclist.htm.UKBritish Airways Travel Clinic and Immunisation Service
There are now just two BA clinics, both in London. At 156 Regent St, W1B 5LB, tel: 020 7439 9584, there is a walk-in service Mon–Sat; visits to 111 Cheapside, EC1V 6DT, tel: 020 7606 2977, are by appointment only. See also www.britishairways.com/travelclinics. Also sell a variety of health-related goods. Fleet Street Travel Clinic
29 Fleet St, London EC4Y 1AA; tel: 020 7353 5678Hospital for Tropical Diseases Travel Clinic
Mortimer Market Centre, 2nd Floor, Capper St (off Tottenham Court Rd), London WC1E 6AU; tel: 020 7388 9600; web: www.thhtd.org. Offers consultations and advice, and is able to provide all necessary drugs and vaccines for travellers. Runs a healthline (09061 337733) for country-specific information and health hazards. Also stocks nets, water purification equipment and personal protection meaures. MASTA (Medical Advisory Service for Travellers Abroad)
Keppel St, London WC1 7HT; tel: 09068 224100. This is a premium-line number, charged at 50p per minute.NHS
travel website, www.fitfortravel.scot.nhs.uk, provides country-by-country advice on immunisation and malaria, plus details of recent developments, and a list of relevant health organisations.Nomad Travel Pharmacy and Vaccination Centre
3–4 Wellington Terrace, Turnpike Lane, London N8 0PX; tel: 020 8889 7014; email: email@example.com; website: www.nomadtravel.co.uk. As well as dispensing health advice, Nomad stocks mosquito nets and other anti-bug devices, and an excellent range of adventure travel gear. Thames Medical
157 Waterloo Rd, London SE1 8US; tel: 020 7902 9000. Competitively priced, one-stop travel health service. All profits go to their affiliated company InterHealth which provides health care for overseas workers on Christian projects.Trailfinders Immunisation Centre
194 Kensington High St, London W8 7RG; tel: 020 7938 3999. Irish RepublicTropical Medical Bureau
Grafton Street Medical Centre, Grafton Buildings, 34 Grafton St, Dublin 2; tel: 1 671 9200. Has a useful website specific to tropical destinations: www.tmb.ieUSACenters for Disease Control
1600 Clifton Rd, Atlanta, GA 30333; tel: 877 FYI TRIP; 800 311 3435; web: www.cdc.gov/travel. The central source of travel information in the USA. Each summer they publish the invaluable Health Information for International Travel, available from the Division of Quarantine at the above address.Connaught Laboratories
PO Box 187, Swiftwater, PA 18370; tel: 800 822 2463. They will send a free list of specialist tropical-medicine physicians in your state.IAMAT (International Association for Medical Assistance to Travelers)
736 Center St, Lewiston, NY 14092. A non-profit organisation which provides lists of English-speaking doctors abroad.CanadaIAMAT (International Association for Medical Assistance to Travellers)
Suite 1, 1287 St Clair Av W, Toronto, Ontario M6E 1B8; tel: 416 652 0137; web: www.sentex.net/~iamat.TMVC (Travel Doctors Group)
Sulphur Springs Rd, Ancaster, Ontario; tel: 905 648 1112; web: www.tmvc.com.auAustralia, New Zealand, Thailand TMVC
Tel: 1300 65 88 44; web: www.tmvc.com.au. 20 clinics in Australia, New Zealand and Thailand, including:Auckland
Canterbury Arcade, 170 Queen Street, Auckland City; tel: 373 3531Brisbane
Dr Deborah Mills, Qantas Domestic Building, 6th floor, 247Adelaide
St, Brisbane, QLD 4000; tel: 7 3221 9066; fax: 7 3321 7076Melbourne
Dr Sonny Lau, 393 Little Bourke St, 2nd floor, Melbourne, VIC 3000; tel: 3 9602 5788; fax: 3 9670 8394. Sydney
Dr Mandy Hu, Dymocks Building, 7th Floor, 428 George St, Sydney, NSW2000; tel: 2 221 7133; fax: 2 221 8401. South AfricaSAA-Netcare Travel Clinics
PO Box 786692, Sandton 2146; fax: 011 883 6152; web: www.travelclinic.co.za or www.malaria.co.za. Clinics throughout South AfricaTMVC (Travel Doctor Group)
113 DF Malan Drive, Roosevelt Park, Johannesburg; tel: 011 888 7488; web: www.tmvc.com.au. Consult the website for details of clinics in South Africa.SwitzerlandIAMAT (International Association for Medical Assistance to Travellers)
57 Voirets, 1212 Grand Lancy, Geneva; web: www.sentex.net/~iamat
Pharmacies in the main towns in Namibia generally have very good supplies of medicines, but away from these you will find very little. If you're venturing deep into the wilds, then you should take with you anything that you expect to need. If you are on an organised trip, an overlanding truck, or staying at hotels, lodges or safari camps, then you will not need much, as these establishments normally have comprehensive emergency kits. In that case, just a small personal medical kit might include:
• antihistamine tablets
• aspirins or paracetamol
• blister plasters (if you plan any serious walking)
• condoms and contraceptive pills
• insect repellent
• lipsalve (ideally containing a sunscreen)
• malaria prophylaxis
• Micropore tape (for closing small cuts – and invaluable for blisters)
• moisturising cream
• sticking plaster (a roll is more versatile than pre-shaped plasters)
However, if you are likely to end up in very remote situations, then you should also consider taking the following – and know how to use them:
• burn dressings (burns are a common problem for campers)
• injection swabs, sterile needles and syringes
• lint, sterile bandage and safety pins
• oral rehydration sachets
• steristrips or butterfly closures
• strong painkiller (eg: codeine phosphate – also use for bad diarrhoea)
• tweezers (perhaps those on a Swiss army knife)
• water purification equipment (2% tincture of iodine and dropper is ideal)
• several different malaria treatment courses and broad-spectrum antibiotics – plus a good medical manual.
If you wear glasses, bring a spare pair. Similarly those who wear contact lenses should bring spare ones, also a pair of glasses in case the dust proves too much for the lenses. If you take regular medication (including contraceptive pills) then bring a large supply with you – much easier than hunting for your usual brand in Namibia. Equally, it's worth having a dental check-up before you go, as you could be several painful days from the nearest dentist.
Hospitals, dentists and pharmacies in Namibia
Should you need one, Namibia's main hospitals are good and will treat you first and ask for money later. However, with comprehensive medical insurance as part of your travel cover, it is probably better go to one of the private clinics. The main ones are in Windhoek and Otjiwarongo, and these are capable of serious surgery and a good quality of care. Outside of these, there are private medical facilities in Karibib, Swakopmund, Tsumeb and Walvis Bay.
If you've a serious problem outside of Windhoek, then MediRescue (MRI)
organise medical evacuations from anywhere, and can be contacted on tel: 061 230505, radiopage: 252222, cell: 081 124 0012. They do insure individual travellers, but many lodges are members, covering you whilst you are staying there, and the best car-hire firms, like Avis, will automatically cover you with MediRescue if you have one of their cars. Finally, it may be that your insurers overseas would ultimately pick up the MediRescue bills if their services were needed.
Pharmacies in the main towns stock a good range of medicine, though often not in familiar brands. Bring with you a repeat prescription for anything you may lose or run out of.