Namibia is probably the healthiest country in sub-Saharan Africa for visitors. It has a generally low population density and a very dry climate, which means there are comparatively few problems likely to affect visitors. The risks are further minimised if you are staying in good hotels, lodges, camps and guest farms, where standards of hygiene are generally at least as good as you will find at home.
The major dangers in Namibia are car accidents caused by driving too fast on gravel roads, and sunburn. Both can also be very serious, yet both are within the power of the visitor to avoid.
The following is general advice, applicable to travelling anywhere, including Namibia:
Food and storage
Throughout the world, most health problems encountered by travellers are contracted by eating contaminated food or drinking unclean water. If you are staying in safari camps or lodges, or eating in restaurants, then you are unlikely to have problems in Namibia.
However, if you are backpacking and cooking for yourself, or relying on local food, then you need to take more care. Tins, packets, and fresh green vegetables (when you can find them) are least likely to cause problems – provided that clean water has been used in preparing the meal. In Namibia's hot climate, keeping meat or animal products unrefrigerated for more than a few hours is asking for trouble.
Water and purification
Tap water in Namibia's major towns and borehole water used in many more remote locations is perfectly safe to drink. However, even the mildest of the local microbes may cause slight upset stomachs for an overseas visitor. Two-litre bottles of mineral water are available from most supermarkets; these are perfect if you're in a car.
If you need to purify water for yourself in the bush, then first filter out any suspended solids, perhaps by passing the water through a piece of closely woven cloth or something similar. Then bring it to the boil, or sterilise it chemically. Boiling is much more effective, provided that you have the fuel available.
Tablets sold for purification are based on either chlorine, iodine or silver, and normally adequate. Just follow the manufacturer's instructions carefully. Iodine is the most effective, especially against the resilient amoebic cysts which cause amoebic dysentery and other prolonged forms of diarrhoea.
A cheaper alternative to tablets sold over the counter is to travel with a small bottle of medical-quality tincture of iodine (2% solution) and an eye dropper. Add four drops to one litre of water, shake well, and leave to stand for ten minutes. If the water is very cloudy (even after filtering) or very cold, then either double the iodine dose, or leave to stand for twice as long.
This tincture of iodine can also be used as a general external antiseptic, but it will stain things deep brown if spilt – so seal and pack its container exceedingly well.
Heat and sun
Heatstroke, heat exhaustion and sunburn are often problems for travellers to Namibia, despite being easy to prevent. To avoid them, you need to remember that your body is under stress and make allowances for it. First, take things gently; you are on holiday, after all. Next, keep your fluid and salt levels high: lots of water and soft drinks, but go easy on the caffeine and alcohol. Thirdly, dress to keep cool with loose-fitting, thin garments – preferably of cotton, linen or silk. Finally, beware of the sun. Hats and long-sleeved shirts are essential. If you must expose your skin to the sun, then use sun blocks and high factor sun screens (the sun is so strong that you will still get a tan).
Avoiding insect bites
The most dangerous biting insects in parts of Namibia are mosquitoes, because they can transmit malaria, yellow fever, and a host of other diseases.
Research has shown that using a mosquito net over your bed, and covering up exposed skin (by wearing long-sleeved shirts, and tucking trousers into socks) in the evening, are the most effective steps towards preventing bites. Bed-net treatment kits are available from travel clinics; these prevent mosquitoes biting through a net if you roll against it in your sleep, and also make old and holy nets protective. Mosquito coils and chemical insect repellents will help, and sleeping in a stream of moving air, such as under a fan, or in an air conditioned room, will help to reduce your chances of being bitten.
DEET (diethyltoluamide) is the active ingredient in many repellents (Repel have an excellent range), so the greater the percentage of DEET, the stronger the effect. However, DEET is a strong chemical. Just 30% is regarded as an effective, non-toxic concentration. It will dissolve some plastics and synthetic materials, and may irritate sensitive skin. Because of this, many people use concentrated DEET to impregnate materials, rather than applying it to themselves. An alternative to this is to use Bug Guards – wrist and ankle bands containing 100% DEET in capsule form. The capsules break on movement, but the chemical never touches the skin. One pack contains four bands, which when used, last for two weeks. Mosquito nets, socks, and even cravats can be impregnated and used to deter insects from biting. Eating large quantities of garlic, or cream of tartar, or taking yeast tablets, are said to deter some biting insects, although the evidence is anecdotal – and the garlic may affect your social life.
This mosquito-borne disease may mimic malaria but there is no prophylactic medication available to deal with it. The mosquitoes that carry this virus bite during the daytime, so it is worth applying repellent if you see any mosquitoes around. Symptoms include strong headaches, rashes and excruciating joint and muscle pains and high fever. Dengue fever only lasts for a week or so and is not usually fatal. Complete rest and paracetamol are the usual treatment. Plenty of fluids also help. Some patients are given an intravenous drip to keep them from dehydrating. It is especially important to protect yourself if you have had dengue fever before. A second infection with a different strain can result in the potentially fatal dengue haemorrhagic fever.
Snakes, spiders and scorpions...
Encounters with aggressive snakes, angry spiders or vindictive scorpions are more common in horror films than in Namibia. Most snakes will flee at the mere vibrations of a human footstep whilst spiders are far more interested in flies than people. You will have to seek out scorpions if you wish to see one. If you are careful about where you place your hands and feet, especially after dark, then there should be no problems. You are less likely to get bitten or stung if you wear stout shoes and long trousers. Simple precautions include not putting on boots without shaking them empty first, and always checking the back of your backpack before putting it on.
Snakes do bite occasionally, and you ought to know the standard first-aid treatment. First, and most importantly, don't panic
. Most snakes are harmless and even venomous species will only dispense venom in about half of their bites. If bitten, you are unlikely to have received venom; keeping this fact in mind may help you to stay calm.
Even in the worst of these cases, the victim has hours or days to get to help, and not a matter of minutes. He/she should be kept calm, with no exertions to pump venom around the blood system, whilst being taken rapidly to the nearest medical help. The area of the bite should be washed to remove any venom from the skin, and the bitten limb should be immobilised. Paracetamol may be used as a painkiller, but never use aspirin because it may cause internal bleeding.
Most first-aid techniques do more harm than good: cutting into the wound is harmful and tourniquets are dangerous; suction and electrical inactivation devices do not work. The only effective treatment is antivenom. In case of a bite, which you fear may be both serious and venomous then:
• Try to keep calm. It is likely that no venom has been dispensed.
• Stop movement of the bitten limb by applying a splint.
• If you have a crepe bandage, firmly bind up as much of the bitten limb as you can. Release the bandage for a few minutes every half-hour.
• Keep the bitten limb below heart height
to slow spread of any venom
• Evacuate the victim to a hospital that has antivenom
• Never give aspirin. You may offer paracetamol, which is safe.
• Do not apply ice packs.
• Do not apply potassium permanganate.
If the offending snake can be captured without any risk of someone else being bitten, take it to show the doctor. But beware, since even a decapitated head is able to dispense venom in a reflex bite.
When deep in the bush, heading for the nearest large farm or camp may be quicker than going to a town: it may have a supply of antivenom, or facilities to radio for help by plane.