When I thought of Africa before my big journey, I was very worried about diseases. I think most of us associate this continent with malaria, polluted water, and poor hygiene.
But as soon as I landed in Uganda, I did not think much about all these "dangerous" things. Yes, sometimes I was even a bit careless, which caused me to get a parasite – presumably via drinking water.
I acted a bit on the principle of what the locals can eat or drink, I can too. Unfortunately, I was taught wrong. I used to have mild bowel problems, quite often. But this usually lasted only a few hours or days and was never so serious that I had to see a doctor. My body showed me now and then that I had eaten or drank something wrong.
For the past two months in Africa, I have had recurring nausea, stomach aches, and a bloated abdomen. It was not that bad, so I thought that it would be over soon. Unfortunately, it was not like that.
In South Africa, I visited a doctor for the first time. She said, that because of my symptoms, I would probably be pregnant or have gastritis. Since the former was pretty much impossible, she eventually prescribed the appropriate pills for the treatment of gastritis. Unfortunately, that did not help either. When I went home for a two-week visit, my family doctor diagnosed a parasite that I by then must have had in me for ages. Fortunately, after an antibiotic cure, everything was fine again.
In the end, of course, everything was half as bad, but still it was annoying to suffer from abdominal pain and nausea, again and again. What I mean by that is that, of course, you do not have to overdo it with hygiene. But especially with the drinking water, after this experience, I would only drink purchased, self-filtered, or boiled water. I even had a water filter with me, but was often too lazy to use it.
In Tanzania, after spending some days in a Maasai village near Lake Natron, I got peculiar vesicles in the area of my left cheek. It looked like herpes. But on the cheek, I found that somehow irritating. But good, I waited for it to go away again. After a few days, it had already reached enormous proportions and did not look like herpes anymore. After some research with the locals, they said that it would look like the bite of a "Nairobi fly". That was something completely new for me.
I started investigating on the internet. The symptoms listed there were really pretty much identical to mine. The Nairobi fly is a black and red beetle that contains a poisonous substance. In principle, it does not sting or bite, but it usually crawls over the skin at night. If you press it, as it can quickly happen unconsciously during sleep, the poison is released. This then causes the skin irritation. Usually this happens in the area of the face, the neck, or the arms.
The first 12 to 24 hours you notice nothing. Thereafter, the affected area of the skin turns red and blisters appear. I had them for about three weeks, which did not look very nice and hurt. Later, increased skin pigmentation persisted in this area for several months.
Regarding therapy, I did not find many clues on the internet. It seems to be something rather rare. The locals recommended me to put toothpaste on it to dry out the bubbles. That is what I tried then.
After my visit to the Maasai, I went to the Hadzabe, a very original hunter-gatherer tribe. I had the opportunity to hunt with them. When one of the Hadzabe saw my vesicles, he immediately led me to a tree, made a scratch in the bark with his knife and stroked the liquid that came out of it with his blood smeared fingers – he had just killed a dove with bow and arrow – on the bubbles. That gesture was really touching, though, I was not sure if it had made it any better or worse.
What should you do to stay healthy in Africa?
In my opinion, adequate vaccinations, a well-stocked first-aid kit, and the appropriate precautionary and hygienic measures are the most important things to keep in mind. It is the best to discuss all these issues in detail with a competent tropical medicine doctor.
What vaccinations do you need?
That depends very much on where the journey takes you. Since I had not set a precise route in advance, of course, I had to prepare for all countries.
You should already inform in advance about the recommended vaccinations of the respective countries. It is best to do this early enough in a tropical institute, since sometimes several partial vaccinations are needed. Some countries even require vaccinations to be allowed to enter the country.
I have got these vaccinations:
Cholera, diphtheria / tetanus, yellow fever, hepatitis A + B, meningococcus, rabies, and typhoid fever.
But please do not just simply imitate this. The best is to create a list of the countries that you plan to travel to. With this list you then go to a trustworthy and excellent doctor for tropical medicine to ask him or her for advice.
By the way, my health insurance in Austria did not pay any costs for vaccinations. It is also important to carry your vaccination passport while traveling. On one hand, one often forgets what vaccinations have already been received. On the other hand, certain vaccinations, such as yellow fever, are mandatory for some countries.
What belongs in your first-aid kit?
Although you can find the most medication locally, it is recommended to always have a first-aid kit with you. Especially in rural areas, there are often no pharmacies or they are very poorly equipped.
For example, when I was in a small village in Uganda for a few days, I curiously visited the doctor, and asked him what medicines he had in stock. He showed me a small shelf, and said he had two types of antibiotics, an analgesic, and an antimalarial drug. So the choice was relatively limited.
What I had in my first-aid kit:
Drug for diarrhea, malaria stand-by medication, disinfectant solution for wounds, plasters, bandages, disposable syringe, analgesics, antiallergic, broad spectrum antibiotics, after-sun, fever thermometer, sunscreen cream, water treatment pills, mosquito repellent, and an antifungal agent for the treatment of skin fungus diseases.
With regard to malaria, opinions often differ. Unfortunately, there is not (yet) a vaccine against this disease. However, you can take daily or weekly (depending on the preparation) special preventive medication, if you are in a risk area. Unfortunately, these have strong side effects in the long term, as I had to find out myself.
Even if you are only in a risky area for a short period of time, you should definitely consider this option so as not to spoil your stay with illness. Over a longer period of time, however, I would see it more critically. After all, the drugs are very strong.
I myself have been taking doxycycline for malaria prophylaxis on a daily basis for almost three months. At first, I did not notice any side effects, but over time I got stomach and bowel problems. Then I stopped the prophylaxis, and the symptoms disappeared rapidly. There are many different preparations that can be taken for prophylaxis, but all have serious side effects. Some travelers I met took a different medicine, which caused them bad nightmares and made them depressed.
When I stopped taking doxycycline, I then took Malarone tablets as so-called stand-by medication and always had a malaria quick test with me. Thus, when symptoms of malaria (such as fever) occur, one can start taking the medicine immediately.
Most important, however, is clearly a mosquito repellent. Using a mosquito net and spray or lotion to protect skin and clothing is something you should always do in risk areas. And, of course, discussing this topic with an experienced tropical medicine doctor. Although I realized that they are not all in agreement. But in any case, you can get some advice, and then base your own opinion on that.
Of course, it can be that you get sick on a longer journey. In this situation, it is important to allow yourself some rest and to look for a more comfortable accommodation. If it does not get better after a few days, you will probably have to go to a doctor.