Volunteer Travel Guide India

From the snow-capped Himalayas in the north to the sun drenched coastal villages of the south, India unfolds like an ancient tapestry. At times threadbare and fading, the land stretches from desert dunes and scattered slums to the rich embroidery of ancient, jewelled palaces, and the majestic domes of forgotten empires.

Since the first civilisations rose on the banks of the Indus River almost 5,000 years ago, India has given birth to Buddhism and Hinduism, been touched by the Empire of Alexander the Great, seen the ancient empires of the Mauryas and Guptas rise and fall, and has traded with Pharaohs and Caesars.

An invasion by the white Huns scattered its people until the sweeping hand of Islam saw new kingdoms rise, heralding the era of the Sultans. Defeat came again as the Mogul Emperors marched over the mountains and into the Punjab. The decline of the Mogul Empire gave way to the Marathas, who consolidated control of India just in time for the arrival of the British. The sun finally set on the British Empire as India reclaimed independence in 1947, heralding a new age of democracy.

India is a feast for the senses; where the air is heavy with the scent of jasmine and dancers trail frenetic melodies in colourful silk saris. Its cooks compose dishes from a palette of exotic spices that may leave a lingering taste of saffron or aniseed. In India's cities, the stench of slum living competes with the cacophony of seemingly endless traffic and a myriad of other textures, colours and movements all jostling for your attention.

The Basics

Time:

Local time is GMT +5.5.

Electricity:

240 volts, 50Hz. A variety of power outlets are used in India, but most plugs have two or three round pins.

Language:

Although English is generally used for official and business purposes, Hindi is the official language and is spoken by about 30 percent of the population. Urdu is the language common with the Muslim demographic. There are 16 other languages also spoken.

Health:

There are a number of health risks associated with travel to India, including malaria and dengue fever, and travellers should take medical advice on vaccinations at least three weeks before departure. Outbreaks of dengue fever and Chikungunya virus occur, both being transmitted by mosquitoes. Malaria outbreaks are common in areas above 6,562 feet (2,000m), particularly in the northeastern state of Assam. Outbreaks of cholera also occur frequently. Those travelling from an infected area should hold a yellow fever certificate. Food poisoning is a major risk in India; all water and ice should be regarded as contaminated and visitors should drink only bottled water and ensure that the seal on the bottle is intact. Meat and fish should be regarded as suspect in all but the best restaurants and should always be well cooked and served hot. Salads and unpeeled fruit should be avoided. Health facilities are adequate in the larger cities but limited in rural areas. Travellers are advised to take out medical insurance. Bird flu was first discovered in domestic poultry in February 2006, but no human infections have been reported. The risk for travellers is low, but as a precaution close contact with wild, domestic and caged birds should be avoided, and all poultry and egg dishes should be well cooked.

Tipping:

Taxi drivers do not expect to be tipped, however all other services expect small tips, including porters, guides, hotel staff and waiters in small establishments. In tourist restaurants or hotels a 10% service charge is often added to bills. Baksheesh is common in India, it is more a bribe than a tip and will ensure better service; it is given before rather than after the service.

Customs:

India is generally a fairly tolerant society however visitors should be aware of religious and social customs. When visiting temples visitors will be required to remove their footwear and cover their heads. In general women should dress conservatively both to respect local sensibilities and to avoid unwanted attention. Topless bathing is illegal. Indians do not like to disappoint and instead of saying 'no' will come up with something positive, even if incorrect. Social order and status are very important in Indian culture. Avoid using the left hand, particularly when eating.

Business:

Business in India is conducted formally, with punctuality an important aspect. Suits and ties are appropriate, and women in particular should dress modestly. If it is very hot, jackets are usually not required and short sleeve shirts are deemed appropriate. It is customary to engage in small talk before getting down to business and topics can range from anything from cricket to politics. Business cards are usually exchanged on initial introduction, using the right hand only. Handshakes are fairly common, though one should wait to see if greeted with a hand, or a 'namaste' - a traditional Indian greeting of a small bow accompanied by hands clasped as if in prayer. Visitors should return the greeting. It is common for women to participate in business meetings, and hold high positions in companies, and foreign businesswomen are readily accepted. Business hours are usually from 9.30 to 5.30pm (weekdays) with a lunch break from 1pm to 2pm, and Saturdays from 9.30am to 1pm.

Communications:

The international access code for India is +91. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). City/area codes are in use, e.g. (0)11 for Delhi. International calls can be quite expensive and there are often high surcharges on calls made from hotels; it is cheaper to use a calling card. Alternatively, there are telephone agencies in most towns which are identifiable by the letters STD for long distance internal calls and ISD for the international service. The local mobile phone operators use GSM networks and have roaming agreements with most international operators. Internet cafes are available in the main cities and resorts.

Duty Free:

Travellers to India over 17 years do not have to pay duty on 200 cigarettes or 50 cigars or 250g tobacco; one bottle of alcohol; medicine in reasonable amounts; 59ml of perfume and 250ml eau de toilette; and goods for personal use. Prohibited items include livestock, bird and pig meat products.

Health

There are a number of health risks associated with travel to India, including malaria and dengue fever, and travellers should take medical advice on vaccinations at least three weeks before departure. Outbreaks of dengue fever and Chikungunya virus occur, both being transmitted by mosquitoes. Malaria outbreaks are common in areas above 6,562 feet (2,000m), particularly in the northeastern state of Assam. Outbreaks of cholera also occur frequently. Those travelling from an infected area should hold a yellow fever certificate. Food poisoning is a major risk in India; all water and ice should be regarded as contaminated and visitors should drink only bottled water and ensure that the seal on the bottle is intact. Meat and fish should be regarded as suspect in all but the best restaurants and should always be well cooked and served hot. Salads and unpeeled fruit should be avoided. Health facilities are adequate in the larger cities but limited in rural areas. Travellers are advised to take out medical insurance. Bird flu was first discovered in domestic poultry in February 2006, but no human infections have been reported. The risk for travellers is low, but as a precaution close contact with wild, domestic and caged birds should be avoided, and all poultry and egg dishes should be well cooked.

View information on diseases: Malaria, Dengue Fever, Cholera

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:

Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:

Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

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Dengue Fever

Cause:

The dengue virus - a flavivirus of which there are four serotypes.

Transmission:

Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease:

Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution:

Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet).

Risk for travellers:

There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.
Prophylaxis (protective treatment):
None.

Precautions:

Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:

An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:

As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Indian Tourist Office, New Delhi: +91 (0)11 2332 0342 or www.incredibleindia.org

India Embassies

Indian Embassy, Washington DC, United States: +1 202 939 7000.

Indian High Commission, London, United Kingdom: +44 (0)20 7836 8484.
Indian High Commission, Ottawa, Canada: +1 613 744 3751.
Indian High Commission, Canberra, Australia: + 61 (0)2 6273 3999.
Indian High Commission, Pretoria, South Africa: +27 (0)12 342 5392.
Indian Embassy, Dublin, Ireland: +353 (0)1 496 6792.
Indian High Commission, Wellington, New Zealand: +64 (0)4 473 6390/1.

Foreign Embassies in India

United States Embassy, New Delhi: +91 (0)11 2419 8000.

British High Commission, New Delhi: +91 (0)11 2687 2161.
Canadian High Commission, New Delhi: +91 (0)11 4178 2000.
Australian High Commission, New Delhi: +91 (0)11 4139 9900.
South African High Commission, New Delhi: +91 (0)11 2614 9411.
Irish Embassy, New Delhi: +91 (0)11 2462 6733.
New Zealand High Commission, New Delhi: +91 (0)11 2688 3170.

India Emergency Numbers

Emergencies: 100 (Police); 102 (Ambulance).

Airports

Indira Gandhi International Airport (DEL)

Location: The airport is located 12 miles (20km) south of Delhi.
Time: GMT +5.5.

Contacts: Terminal 1 (Domestic): +91 11 2567 5126 or 2569 6351. Terminal 2 (International): +91 11 2565 2021 or 2565 2011. 24-hour operator: +91 11 2569 6107.

Transfer between terminals: The International Terminal is three miles (5km) from the Domestic Terminal; a free bus connects the two, leaving every 30 minutes.

Transfer to the city: Taxis are the easiest way to get to central Delhi, especially for those not familiar with the city. Metered taxis are available but it is best to use pre-paid taxis (via the taxi counter in Arrivals), to eliminate any uncertainty over fares. Airport buses also leave for central Delhi 24 hours a day. Travel time to the city is around 30 minutes by taxi and 45 minutes by bus.

Car rental: Car hire (with driver) can be arranged in the Arrivals hall. Avis and Hertz operate from the airport, however self-drive cars are not advised due to the erratic nature of Indian driving.

Facilities: ATMs are available at Terminal 1A (Domestic) and in the Arrival Visitors Area of the International Terminal. Banks and bureaux de change are also available. Passengers should be prepared for a certain amount of chaos at the airport; customs are slow, the queues for the x-ray machines are long and the staff at the endless security checks are rude. There are no shops or restaurants of note. The only modicum of comfort is the Raj Lounge, where friendly staff are on hand to serve welcome drinks. Travellers with special needs should contact their airline in advance.

Departure Tax: Rs.300.

Website: www.delhiairport.com

Chhatrapati Shivaji International Airport (BOM)

Location: The airport is located 18 miles (29km) north of Mumbai.
Time: GMT +5.5.

Contacts: Tel: + 91 (0)22 836 6700.

Transfer between terminals: The two terminals are five miles (3km) apart, and are connected by a free bus service.
Transfer to the city: Pre-paid taxis are available outside Arrivals (journey time approx 60 min).

Car rental: Car hire, with or without a driver, can be arranged in Arrivals, however due to the erratic nature of Indian driving self-drive cars are not advised.

Facilities: ATMs and bureaux de change are available in both terminals along with a number of bars, restaurants and shops. There are limited disabled facilities and travellers with special needs should advise their airline in advance. As with all Indian airports, travellers should be prepared for a certain amount of chaos; queues are long for immigration and the many security checks and endless uniformed staff stand around with no obvious purpose. The restaurants are best avoided and passengers are advised to take their own snacks.

Parking: Parking is available at both terminals.
Departure Tax: Rs. 200.

Website: www.mumbaiairport.com

Climate

The best time to visit Delhi is in October-November and in February-March, when the nights are cool and the days filled with mellow sunshine. December and January can be a little gloomy in Delhi while mid-summer (May, June and July) is very hot with temperatures over 45C; it is a dry heat and is sometimes accompanied by dusty desert winds. Most of the rain falls between July and September but they are not the tropical rains you'll experience in India's coastal cities.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: United States citizens must have a valid passport and a visa.

Entry requirements for UK nationals: British citizens must have a valid passport and a visa.

Entry requirements for Canadians: Canadians require a valid passport and a visa.

Entry requirements for Australians: Australians require a valid passport and a visa.

Entry requirements for South Africans: South Africans require a valid passport and a visa.

Entry requirements for New Zealanders: New Zealand citizens require a valid passport and a visa.

Entry requirements for Irish nationals: Irish citizens require a valid passport and a visa.

Passport/Visa Note: Some parts of the country are restricted areas and require a special permit. Travellers planning to go to the far northwest of the country or to the islands should check with India Tourism for the latest information.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Nepal

Nepal's acronym of Never Ending Peace And Love, does well to characterise this nation of good natured and accommodating people; a land of majestic Himalayan scenery comprising eight of the world's ten highest mountains, including Mt Everest: the uppermost place on earth at 29,029ft (8,848m).

Situated between India and Tibet, the Kingdom of Nepal is filled with as many different ethnic groups, customs and traditions as it is diverse in geography. From the hot Indian plains and steamy southern Tarai lowlands, the terrain crosses the Kathmandu Valley and rises to the frozen heights of the Himalayan peaks towards the Tibetan plateau known as the 'roof of the world'. Spread across these varied altitudes are communities of colourful cultures and people (many untouched by modern development), animated cities and towns, and far-flung mountain villages. Life here revolves around an intricate intermingling of ancient Hindu and Buddhist religious rituals. Numerous festivals are celebrated throughout the year coloured by a diversity of religious and tribal traditions. The capital of Kathmandu brings an assortment of these different societies together into a vibrant collection of brilliant sights and exotic smells, with modern shops co-existing with street sellers, while pyramidal Buddhist temples, holy Sadhus of the Hindu faith and medieval palace squares fill the urban landscape.

Nepal is well endowed with glorious scenery - verdant terraced valleys, rushing rivers and ice-blue lakes that originate in the 'abode of snows', or Himalayas. The uplifting sight of soaring mountains is a magnet for mountaineers and trekkers, offering some of the greatest challenges and most scenic walking opportunities on earth. Its diverse terrain offers tremendous opportunities for adventurous activities, and although mountain climbing and trekking are the most popular, there is also superb white-water rafting on steep mountain rivers, as well as elephant-back safaris or tiger tracking in the Royal Chitwan and Royal Bardia National Parks situated within the jungles of the southern Tarai belt.

Nepal has many attractions, but the essence of the country is its smiling, friendly people with their heartfelt palm-pressed greetings, and together with its inspiring scenery, this beguiling kingdom is a place where one visit is usually not enough to satisfy the captivated traveller.

The Basics

Time:

Local time is GMT +5.5.

Electricity:

Electrical current is 220 volts, 50Hz. Round two- and three-pin plugs are used.

Language:

Nepali is the official language. English is spoken in all major tourist areas.

Health:

There is a risk of malaria between June and September in the low-lying areas including Chitwan National Park, but not in the common trekking areas. Outbreaks of Japanese encephalitis occur annually, particularly between July and December; vaccination is advised. Cholera outbreaks occur and food and water precautions should be followed. Untreated water should be avoided; visitors can buy bottled water or purify their own. When trekking it is preferable to treat river water rather than leaving a trail of plastic bottles behind. Purifying water with iodine is the cheapest and easiest way to treat water. Altitude sickness is a real risk for trekkers. Many trekkers may suffer from altitude sickness above 8,202ft (2,500m); if symptoms persist it is wise to descend as quickly as possible. Standard of care in hospitals varies, but there are traveller's clinics in Kathmandu and numerous pharmacies in the major towns. Medical insurance is essential, which should include air evacuation. Travellers arriving from infected areas require a yellow fever vaccination certificate.

Tipping:

Restaurants and hotels may add 10% to bills in which case no further tip is required; otherwise a 10% tip is customary in places that cater to tourists. It is customary to tip guides and porters on treks. Elsewhere it is not customary to tip, but gratuities are always appreciated.

Customs:

Nepal has numerous cultural practices that are unusual to foreigners. In the tourist areas there is a high degree of tolerance towards visitors, but away from these places foreigners should be sensitive to local customs. Never accept or offer anything, or eat with the left hand. Do not eat from someone else's plate or offer food from one's own. Women should dress conservatively and cover as much as possible. Permission should be sought before taking photographs, particularly at religious sites. Public displays of affection between men and women are frowned upon.

Business:

The Nepalese are warm and friendly, and business tends to be conducted with a combination of formality and sincerity. Much time is given to small talk and socialising. Handshakes are fairly common, though one should wait to see if greeted with a hand, or a namaste - a traditional greeting of a small bow accompanied by hands clasped as if in prayer. Visitors should return the greeting. Dress tends to be formal and conservative, with suits and ties the norm. Titles and surnames are usually used; the elderly in particular are treated with great respect and the word 'gi' is added after the name as a polite form. Punctuality is important, although it may take some time to get down to business, and negotiation can be a long process. English is widely spoken and understood, though discussions in Nepali may occur between Nepalese themselves within a meeting. Business hours are usually 9.30am or 10am to 5pm Sunday to Thursday (closing at 4pm in winter). Saturday is a holiday.

Communications:

The country code for Nepal is +977, and the outgoing code is 00, followed by the relevant country code (e.g. 0044 for the UK). City/area codes are in use, e.g. (0)1 for Kathmandu and (0)41 for Pokhara. Two mobile phone operators provide GSM 900 network coverage in the main cities and towns, but this does not extend to the summit of Mount Everest! In the main tourist centres of Kathmandu and Pokhara there are Internet cafes on every corner.

Duty Free:

Travellers to Nepal do not have to pay duty on 200 cigarettes, 50 cigars or the equivalent in other tobacco products; 1 litre of alcohol and perfume for personal use. It is illegal to export goods that are over 100 years old.

Health

There is a risk of malaria between June and September in the low-lying areas including Chitwan National Park, but not in the common trekking areas. Outbreaks of Japanese encephalitis occur annually, particularly between July and December; vaccination is advised. Cholera outbreaks occur and food and water precautions should be followed. Untreated water should be avoided; visitors can buy bottled water or purify their own. When trekking it is preferable to treat river water rather than leaving a trail of plastic bottles behind. Purifying water with iodine is the cheapest and easiest way to treat water. Altitude sickness is a real risk for trekkers. Many trekkers may suffer from altitude sickness above 8,202ft (2,500m); if symptoms persist it is wise to descend as quickly as possible. Standard of care in hospitals varies, but there are traveller's clinics in Kathmandu and numerous pharmacies in the major towns. Medical insurance is essential, which should include air evacuation. Travellers arriving from infected areas require a yellow fever vaccination certificate.

View information on diseases: Malaria, Japanese encephalitis, Cholera

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:

Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:

Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

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Japanese encephalitis

Cause:

Japanese encephalitis (JE) virus, which is a flavivirus.

Transmission:

The Japanese encephalitis virus is transmitted by various mosquitoes of the genus Culex. It infects pigs and various wild birds as well as humans. Mosquitoes become infective after feeding on viraemic pigs or birds.

Nature of the disease:

Most infections are asymptomatic (e.g. cause no symptoms). In symptomatic cases, severity varies; mild infections are characterized by febrile headache or aseptic meningitis. Severe cases have a rapid onset and progression, with headache, high fever and meningeal signs. Permanent neurological sequelae are common among survivors. Approximately 50% of severe clinical cases have a fatal outcome. Geographical distribution: Japanese encephalitis occurs in a number of countries in Asia and occasionally in northern Queensland, Australia.

Risk for travellers:

Low for most travellers. Visitors to rural and agricultural areas in endemic countries may be at risk, particularly during epidemics of JE. Prophylaxis (protective treatment): Vaccination, if justified by likelihood of exposure.

Precautions:

Avoid mosquito bites.

Source:

WHO.

Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:

An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:

As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Nepal Tourist Office, Kathmandu: +977 (0)1 4256909 or www.welcomenepal.com

Nepal Embassies

Royal Nepalese Embassy, Washington DC, United States (also responsible for Canada): +1 202 667 4550.

Royal Nepalese Embassy, London, United Kingdom (also responsible for Ireland): +44 (0)20 7229 1594/6231.

Royal Nepalese Embassy, Canberra, Australia: +61 (0)2 6162 1554.
Royal Nepalese Embassy, Cairo, Egypt (also responsible for South Africa): +20 (0)2 361 6590.
Royal Nepalese Consulate-General, Auckland: +64 9 520 3169.

Foreign Embassies in Nepal

United States Embassy, Kathmandu: +977 (0)1 400 7200.

British Embassy, Kathmandu: +977 (0)1 441 0583.
Canadian High Commission, New Delhi, India (also responsible for Nepal): +91 (11) 4178 2000.
Australian Embassy, Kathmandu: +977 (0)1 4371 678.
South African High Commission, Colombo, Sri Lanka (also responsible for Nepal): + 94 11 5635 966.
Irish Embassy, New Delhi, India (also responsible for Nepal): +91 (0)11 2462 6733.
New Zealand Consulate, New Delhi, India (also responsible for Nepal): +91 11 2688 3170.

Nepal Emergency Numbers

Emergencies:100 (Police); 228094 (Ambulance)

Airports

Tribhuvan International Airport (KTM)

Location: The airport is situated four miles (6km) east of Kathmandu.
Time: GMT +5.45.
Contacts: Tel: +977 (0)1 470 274.
Transfer to the city: A pre-paid taxi service operates from immediately outside the arrival gate. Rates are exhibited on a board and the fare must be paid in advance. Local buses also serve the airport, the journey is 35 minutes and costs Rs40.
Car rental: Car rental companies are represented.
Facilities: Facilities include banks and bureau de change, shops, duty-free, snacks, Internet, post office and tourist information. The airport is well equipped with facilities for those with disabilities.
Departure Tax: Rs. 1,130 (international), Rs. 169.50 (domestic).
Website: www.tiairport.com

Climate

The Kathmandu Valley has a mild climate most of the year, situated at an altitude of 4,297ft (1,310m). Summer temperatures range from 67-81°F (19-27°C), and in winter temperatures are between 36 and 68°F (2-20°C). During the rainy monsoon season between June and August, there is an average rainfall of between 7.8-14.7 inches (200-375mm) in Kathmandu. May and June can be very hot and humid until the monsoon rains bring relief. In spring (March to April) and autumn (October to November) the temperatures are pleasant with occasional short bursts of rain, while November to February are dry, but can be very cold, especially at night.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: United States citizens must have a passport and visa.

Entry requirements for UK nationals: British citizens must have a passport and visa.

Entry requirements for Canadians: Canadians must have a passport and visa.

Entry requirements for Australians: Australians must have a passport and visa.

Entry requirements for South Africans: South Africans must have a passport and visa.

Entry requirements for New Zealanders: New Zealand citizens must have a passport and visa.

Entry requirements for Irish nationals: Irish citizens must have a passport and visa.

Passport/Visa Note: Tourist visas can be issued on arrival to most nationalities. A 60-day visa costs US$30 and a 150-day/multiple-entry visa costs US$80. Tourist visas are valid for Kathmandu Valley, Pokhara Valley and Tiger Tops in Chitwan. Visitors intending to trek or visit other areas should obtain a permit from the Central Immigration Office.

Volunteer Travel Guide Vietnam

Verdant patchworks of rice paddies, pointed lampshade-style hats, a country ravaged by war, and economic repression - these are the international images of Vietnam, seen on worldwide television and read about in the newspapers. But there are other scenes to be found, ones of natural beauty, ethnic culture, and imperial history, of timeless traditional villages, idyllic sea resorts and dynamic cities.

Shaped like an elongated 'S', Vietnam stretches along the east coast of the Indochinese Peninsula and is likened by its people to a long bamboo pole hung with two baskets of rice, represented by the two fertile regions at either end of the country. Between the lush Red River Delta and the highlands in the north, known for their magnificent scenery and colourful hill tribes, and the agricultural plains and floating markets of the Mekong Delta in the south, lie miles of white sandy beaches, towering mountains, rivers and dense forests, and the thousands of bizarre rock and cave formations on the islands of Halong Bay.

The impact of Japanese and Chinese trade, French occupation and American intervention has left its stain on Vietnam, smeared over a period of more than two thousand years of recorded history. However, the country has also been left with a vivid legacy from different cultures evident in the character of its towns, as well as in the architecture and food.

The quaint town of Hoi An, once a major trading port, boasts the perfectly preserved architectural influences of the Asian merchants from the north, while the broad leafy boulevards of the capital Hanoi and Ho Chi Minh City are reminiscent of France. Menus offer Chinese variations of spring rolls, steamed dumplings and noodles. Hué is the old imperial capital of Vietnam with its royal palaces and palatial mausoleums, and nearby the battle sites of the Demilitarised Zone (DMZ) are reminders of the brutality of war.

Ancient temples and colourful pagodas are scattered throughout the urban centres, while among them stand hotels of modern luxury, and the development of tourism infrastructure is a booming business. Vietnam is a perfect balance between ancient times and the here and now, a country that reveres its past heroes, a nation that has collectively put the woes of war behind it, and people who welcome visitors to their country with open arms and friendly smiles.

The Basics

Time:

GMT +7.

Electricity:

220 volts, 50Hz. Plugs are either the two flat-pin or the two round-pin type. Three rectangular blade plugs can be found in some of the newer hotels.

Language:

The official language is Vietnamese. Some Chinese, English and French are spoken. Tour guides can also speak Russian and Japanese. Numerous ethnic languages are also spoken in parts.

Health:

An outbreak of bird flu in 2004 claimed numerous human lives; recent outbreaks have also resulted in human fatalities. Avian flu in poultry has now spread to numerous provinces and cities across Vietnam. All care should be taken to avoid contact with live poultry and visitors are advised to exercise caution when eating poultry dishes, particularly raw or undercooked poultry products. Other health risks in the country include Hepatitis A and E, typhoid, Japanese encephalitis, bilharzia, plague, cholera, diarrhoea and HIV/AIDS. Malaria prophylaxis is recommended for travel outside the main cities and towns, the Red River delta and north of Nha Trang. There has been an increase in the amount of deaths relating to dengue fever over the past year, and visitors should take care to protect themselves from mosquito bites during the day, especially just after dawn and just before dusk, particularly in the southern Mekong Delta region. Travellers should seek medical advice about vaccinations at least three weeks before leaving for Vietnam and ensure they have adequate insect protection. Typhoid can be a problem in the Mekong Delta. Those arriving from an infected area require a yellow fever vaccination certificate. Water is potable, but visitors usually prefer to drink bottled water. Decent health care is available in Hanoi and Ho Chi Minh City (Saigon) with English-speaking doctors, and there is a surgical clinic in Da Nang, but more complicated treatment may require medical evacuation. Pharmacies throughout the country are adequate, but check expiry dates of medicines carefully. Health insurance is essential.

Tipping:

Most restaurants and hotels now add a 5 to 10% service charge to their bills. In top hotels porters expect a small tip. Hired drivers and guides are usually tipped, and it is customary to round up the bill for taxi drivers in the cities. Tipping is not generally expected, but some small change for most services is appreciated.

Customs:

Shorts should be avoided away from the beaches if possible. Shoes must be removed on entering religious sites and a donation is expected when visiting a temple or pagoda. Photography is restricted at ports, harbours and airports, and it is polite to ask permission before taking photographs of people, especially of ethnic minorities. Never leave chopsticks sticking upright in a bowl of rice as it has strong death connotations.

Business:

Business practices in Vietnam are conducted in a similar fashion to those of China, Japan and Korea rather than their Southeast Asian counterparts. Pride and tact are important to bear in mind, as practices tend to be formalised more so than in Western countries. Often it is best to be introduced rather than approach the person with whom business is intended for fear of suspicion. Negotiations and settlements may take longer as the Vietnamese like to examine contracts thoroughly. Formal dress is common but in summer months the dress tends to be more casual. It is important to be on time for business appointments as the Vietnamese consider lateness rude. The person is always addressed as Mr., Mrs., and Ms., followed by their personal name (not family name), unless otherwise referred. It is worth finding out in advance. Shaking hands with both hands is the most respectful greeting although bowing is still popular among the older population, and meetings always begin with the exchange of business cards, which should be given and received with both hands; each person expects to receive one, so be sure to bring a vast supply. Business hours are typically 8am to 5pm Monday to Friday with an hour taken at lunch, and 8am to 11.30am on Saturdays.

Communications:

The international country code is +84. The outgoing code is 00, followed by the relevant country code (e.g. 001 for the United States or Canada). City/area codes are in use, e.g. Hanoi is (0)4 and Ho Chi Minh City is (0)8. GSM 900 mobile networks cover the major urban areas. Internet cafes are available in Hanoi, Ho Chi Minh City and Internet access is often available at post offices in rural areas.

Duty Free:

Travellers to Vietnam over 18 years do not have to pay duty on the following items: 400 cigarettes, 100 cigars or 500g tobacco; 1.5 litres alcohol with alcohol content higher than 22% and 2 litres below 22%; up to 5kg tea and 3kg coffee; perfume and items for personal consumption within reasonable amounts; other goods to the value of five million Vietnamese dong.

Health

An outbreak of bird flu in 2004 claimed numerous human lives; recent outbreaks have also resulted in human fatalities. Avian flu in poultry has now spread to numerous provinces and cities across Vietnam. All care should be taken to avoid contact with live poultry and visitors are advised to exercise caution when eating poultry dishes, particularly raw or undercooked poultry products. Other health risks in the country include Hepatitis A and E, typhoid, Japanese encephalitis, bilharzia, plague, cholera, diarrhoea and HIV/AIDS. Malaria prophylaxis is recommended for travel outside the main cities and towns, the Red River delta and north of Nha Trang. There has been an increase in the amount of deaths relating to dengue fever over the past year, and visitors should take care to protect themselves from mosquito bites during the day, especially just after dawn and just before dusk, particularly in the southern Mekong Delta region. Travellers should seek medical advice about vaccinations at least three weeks before leaving for Vietnam and ensure they have adequate insect protection. Typhoid can be a problem in the Mekong Delta. Those arriving from an infected area require a yellow fever vaccination certificate. Water is potable, but visitors usually prefer to drink bottled water. Decent health care is available in Hanoi and Ho Chi Minh City (Saigon) with English-speaking doctors, and there is a surgical clinic in Da Nang, but more complicated treatment may require medical evacuation. Pharmacies throughout the country are adequate, but check expiry dates of medicines carefully. Health insurance is essential.

View information on diseases: Typhoid fever, Schistosomiasis (bilharzia), Plague, Malaria, Japanese encephalitis, HIV/AIDS and Sexually Transmitted Diseases, Hepatitis E, Hepatitis A, Dengue Fever, Cholera

Typhoid fever

Cause:
Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:
Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:
Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:
Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:
Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

Schistosomiasis (bilharzia)

Cause:
Several species of parasitic blood flukes (trematodes), of which the most important are Schistosoma mansoni, S. japonicum and S. haematobium.

Transmission:
Infection with bilharzia occurs in fresh water containing larval forms (cercariae) of schistosomes, which develop in snails. The free-swimming larvae penetrate the skin of individuals swimming or wading in water. Snails become infected as a result of excretion of eggs in human urine or faeces.

Nature of the disease:
Chronic conditions in which adult flukes live for many years in the veins (mesenteric or vesical) of the host where they produce eggs, which cause damage to the organs in which they are deposited. The symptoms of bilharzias depend on the main target organs affected by the different species, with S. mansoni and S. japonicum causing hepatic and intestinal signs and S. haematobium causing urinary dysfunction. The larvae of some schistosomes of birds and other animals may penetrate human skin and cause a self-limiting dermatitis, "swimmers itch". These larvae are unable to develop in humans.

Geographical distribution:
S. mansoni occurs in many countries of sub-Saharan Africa, in the Arabian peninsula, and in Brazil, Suriname and Venezuela. S. japonicum is found in China, in parts of Indonesia, and in the Philippines (but no longer in Japan). S. haematobium is present in sub-Saharan Africa and in eastern Mediterranean areas.
Risk for travellers:
In endemic areas, travellers are at risk to bilharzias while swimming or wading in fresh water.

Prophylaxis (protective treatment):
None.

Precautions:
Avoid direct contact (swimming or wading) with potentially contaminated fresh water in endemic areas. In case of accidental exposure, dry the skin vigorously to reduce penetration by cercariae. Avoid drinking, washing, or washing clothing in water that may contain cercariae. Water can be treated to remove or inactivate cercariae by paper filtering or use of iodine or chlorine. Source: WHO.

Plague

Cause:
The plague bacillus, Yersinia pestis.

Transmission:
Plague is a zoonotic disease affecting rodents and transmitted by fleas from rodents to other animals and to humans. Direct person-to-person transmission does not occur except in the case of pneumonic plague, when respiratory droplets may transfer the infection from the patient to others in close contact.

Nature of the disease:
Plague occurs in three main clinical forms: Bubonic plague is the form that usually results from the bite of infected fleas. Lymphadenitis develops in the drainage lymph nodes, with the regional lymph nodes most commonly affected. Swelling, pain and suppuration of the lymph nodes produces the characteristic plague buboes. Septicaemic plague may develop from bubonic plague or occur in the absence of lymphadenitis. Dissemination of the infection in the bloodstream results in meningitis, endotoxic shock and disseminated intravascular coagulation. Pneumonic plague may result from secondary infection of the lungs following dissemination of plague bacilli from other body sites. It produces severe pneumonia. Direct infection of others may result from transfer of infection by respiratory droplets, causing primary pulmonary plague in the recipients. Without prompt and effective treatment, 50-60% of cases of bubonic plague are fatal, while untreated septicaemic and pneumonic plague are invariably fatal.

Geographical distribution:
There are natural foci of plague infection of rodents in many parts of the world. Wild rodent plague is present in central, eastern and southern Africa, south America, the western part of north America and in large areas of Asia. In some areas, contact between wild and domestic rats is common, resulting in sporadic cases of human plague and occasional outbreaks.

Risk for travellers:
Generally low. However, travellers in rural areas of plague-endemic regions may be at risk, particularly if camping or hunting or if contact with rodents takes place.

Prophylaxis (protective treatment):
A vaccine effective against bubonic plague is available exclusively for persons with a high occupational exposure to plague; it is not commercially available in most countries.

Precautions:
Avoid any contact with live or dead rodents. Source: WHO.

Malaria

General considerations:
Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:
Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:
The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:
Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:
The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

Japanese encephalitis

Cause:
Japanese encephalitis (JE) virus, which is a flavivirus.

Transmission:
The Japanese encephalitis virus is transmitted by various mosquitoes of the genus Culex. It infects pigs and various wild birds as well as humans. Mosquitoes become infective after feeding on viraemic pigs or birds.

Nature of the disease:
Most infections are asymptomatic (e.g. cause no symptoms). In symptomatic cases, severity varies; mild infections are characterized by febrile headache or aseptic meningitis. Severe cases have a rapid onset and progression, with headache, high fever and meningeal signs. Permanent neurological sequelae are common among survivors. Approximately 50% of severe clinical cases have a fatal outcome.

Geographical distribution:
Japanese encephalitis occurs in a number of countries in Asia and occasionally in northern Queensland, Australia.

Risk for travellers:
Low for most travellers. Visitors to rural and agricultural areas in endemic countries may be at risk, particularly during epidemics of JE.

Prophylaxis (protective treatment):
Vaccination, if justified by likelihood of exposure.

Precautions:
Avoid mosquito bites. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission:
Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases:
Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution:
Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers:
For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis:
There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions:
Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment:
Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Hepatitis E

Cause:
Hepatitis E virus, which has not yet been definitively classified (formerly classified as Caliciviridae).

Transmission:
Hepatitis E is a waterborne disease usually acquired from contaminated drinking water. Direct faecal-oral transmission from person to person is also possible. There is no insect vector. It is suspected, but not proved, that hepatitis E may have a domestic animal reservoir host, such as pigs.

Nature of the disease:
The clinical features and course of the disease are generally similar to those of hepatitis A. As with hepatitis A, there is no chronic phase. Young adults are most commonly affected. In pregnant women there is an important difference between hepatitis E and hepatitis A: during the third trimester of pregnancy, hepatitis E takes a much more severe form with a case-fatality rate reaching 20%.

Geographical distribution:
Worldwide. Most cases, both sporadic and epidemic, occur in countries with poor standards of hygiene and sanitation.

Risk for travellers:
Travellers to developing countries may be at risk of hepatitis E when exposed to poor conditions of sanitation and drinking water control.

Prophylaxis (protective treatment):
None.

Precautions:
Travellers should follow the general conditions for avoiding potentially contaminated food and drinking-water. Source: WHO.

Hepatitis A

Cause:
Hepatitis A virus, a member of the picornavirus family.

Transmission:
The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected).

Nature of the disease:
An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60.

Geographical distribution:
Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled.

Risk for travellers:
Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.

Dengue Fever

Cause:
The dengue virus - a flavivirus of which there are four serotypes.

Transmission:
Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease:
Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution:
Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet).

Risk for travellers:
There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.

Prophylaxis (protective treatment):
None.

Precautions:
Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Cholera

Cause:
Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:
Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:
An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:
Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:
The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):
Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:
As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Tourism
Vietnam Tourist Office: +84 (0)4 942 3998 (Hanoi) or www.vietnamtourism.com

Vietnam Embassies
Embassy of Vietnam, Washington DC, United States: +1 202 861 0737.

Embassy of Vietnam, London, United Kingdom (also responsible for Ireland): +44 (0)20 7937 1912.
Embassy of Vietnam, Ottawa, Canada: +1 613 236 0772.
Embassy of Vietnam, Canberra, Australia: +61 (0)2 6290 1549.
Embassy of Vietnam, Pretoria, South Africa: +27 (0)12 362 8119.
Embassy of Vietnam, Wellington, New Zealand: +64 (0)4 473 5912.

Foreign Embassies in Vietnam
United States Embassy, Hanoi: +84 (0)4 831 4590.

British Embassy, Hanoi: +84 (0)4 936 0500.
Canadian Embassy, Hanoi: +84 (0)4 734 5000.
Australian Embassy, Hanoi: +84 (0)4 831 7755.
South African Embassy, Hanoi: +84 (0)4 936 2000.
Irish Embassy, Hanoi: +84 (0)4 974 3291.
New Zealand Embassy, Hanoi: +84 (0)4 824 1481.

Vietnam Emergency Numbers
Emergencies: 13 (Police); 15 (Ambulance)

Airports

Tan Son Nhat International Airport (SGN)

Location: The airport is situated four miles (7km) from Ho Chi Minh City (Saigon).
Time: GMT +7.
Contacts: Tel: +84 (0)8 845 6654.
Transfer to the city: Minibuses and metered taxis are available for transport to the city centre. Make sure the driver is wearing an official name badge and that the meter is on. Most hotels can arrange transport for arriving passengers, but visitors should organise this in advance.
Car rental: There are no car hire rentals at the airport.
Facilities: The airport is small and overcrowded and patience is often required, however the facilities are perfectly adequate. The tourist information desk at the international arrivals exit can help with hotel reservations. Foreign exchange kiosks are available outside both international arrivals and departures. A post office is outside the arrivals terminal.
Parking:
Departure Tax: US$14 for international flights.

Noi Bai International Airport (HAN)

Location: The airport is situated 28 miles (45km) north of Hanoi.
Time: GMT +7.
Contacts: Tel: +84 (0)4 827 1513, (0)4 826 8522, or (0)4 886 5060.
Transfer to the city: Airport minibuses and metered taxis are available outside arrivals for transport to the city centre. Use an official taxi, it should be indicated on the driver's name badge and check that the meter is on.
Facilities: The airport has a bureau de change and basic facilities.
Parking:
Departure Tax: US$14 for international flights.

Climate

Hanoi has a humid tropical climate, characterised by monsoons, like most of northern Vietnam. Summers, between May and September, are very hot with plenty of rain, while winters, from November to March, are cold and relatively dry. During the transition months of April and October anything is possible, and spring often brings light rain. The hottest month of the year is June. January is the coolest month, usually beset with a cold north-easterly wind.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US passport holders must have a valid passport and a visa is required.

Entry requirements for UK nationals: UK passport holders must have a valid passport and a visa is required.

Entry requirements for Canadians: Canadian passport holders must have a valid passport and a visa is required.

Entry requirements for Australians: Australian passport holders must have a valid passport and a visa is required.

Entry requirements for South Africans: South Africans require a valid passport and a visa.

Entry requirements for New Zealanders: New Zealand nationals require a visa and a valid passport.

Entry requirements for Irish nationals: Irish nationals require a valid passport and a visa.

Passport/Visa Note: Passport must be valid for at least one month after expiry date of visa. Otherwise passports should have six months validity for visa-free nationals, except for nationals of Denmark, Finland, Japan, Korea (Rep.), Norway and Sweden, who require three months validity. All visitors must have sufficient funds for the duration of their stay, onward or return tickets (if no visa is required) and all documents needed for next destination. Visitors should hold a spare passport photograph on arrival in Vietnam for use on the immigration form that must be filled out. You should retain the yellow portion of your immigration Arrival-Departure card on entry to Vietnam, as this is required for exit. Visitors coming from countries with no Vietnamese diplomatic representation will be issued a visa on arrival, provided the visitor is holding a letter from Vietnamese Immigration confirming this.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide China

China kept itself to itself for thousands of years, and foreigners still find it difficult to penetrate the inner depths of this fascinating and enigmatic country. There is a great deal to discover in this, the world's most populated country, with more than 1.3 billion citizens, and the third largest in the world territorially. What makes it attractive as a destination for Western tourists is its fascinating culture and valuable antiquities. Ruins and relics from Neolithic settlements and the dynastic reigns of the mighty emperors are there to behold, along with adventures along the legendary ancient trade routes, such as the Silk Road. The Forbidden Palace, Great Wall, and X'ian's Terracotta Army, are just some of the incredible attractions to be seen in this ancient Eastern empire.

The People's Republic of China has been under communist government since 1949, but is currently undergoing social and economic development. Emphasis is being placed on tourist facilities and infrastructure.

China is opening the doors to its wealth of historical and cultural treasures and visitors are flooding in to be amazed and awed.

Organised tours are still the favoured way to explore China, but independent travel is slowly becoming easier. The major cities, like Beijing and Shanghai, are modern metropolises offering fast food and glitzy stores alongside centuries-old historical buildings and traditional eating houses. Archaeological wonders vie with amazing architecture in the interior, while majestic mountains and remote monasteries crown the northern areas.

The Basics

Time:

Local time is GMT +8.

Electricity:

Electrical current is 220 volts, 50Hz. Plug types vary but the two-pin flat blade and oblique three-pin flat blade plugs are common. Adapters are generally required.

Language:

The official language is Mandarin Chinese, but there are hundreds of local dialects.

Health:

A yellow fever vaccination certificate is required from travellers coming from infected areas. There is a risk of malaria throughout the low-lying areas of the country, and it is recommended that travellers to China seek medical advice before departure. A total of 18 human cases of avian influenza ('bird flu') have been reported from China since November 2005. Twelve of the cases were fatal. Travellers are unlikely to be affected by bird flu, but live animal markets and places where contact with live poultry is possible should be avoided. All poultry and egg dishes should also be thoroughly cooked. Outbreaks of SARS (Severe Acute Respiratory Syndrome) are few and far between, although the last fatality was in 2008. Travellers are warned to remain vigilant against this viral disease. Japanese encephalitis has been responsible for the deaths of a number of people in the Shaanxi and Shanxi provinces in northern China, and rabies infects people every year, occasionally causing death. Outbreaks of dengue fever occur. A variant of hand, foot and mouth disease, an intestinal virus has also been prevalent in 2008, with children being at particular risk. Altitude sickness can occur in the mountainous regions of Tibet, Qinghai, parts of Xinjiang, and western Sichuan. Outside city centres, visitors should only drink bottled water. Western-style medical centres with international staff are available in the major cities and usually accept credit cards. Health insurance is recommended.

Tipping:

Tipping is not officially recognised, although the practice is becoming more common among travel guides, top-end restaurants, tour bus drivers and hotel staff. If wanting to tip leave a gratuity of 10%. Large hotels and restaurants often include a service charge in their bills, usually of about 10%.

Customs:

The Chinese have three names, the first of which is their surname, or family name. As a result visitors should be prepared for hotels mistakenly reserving rooms under their first names. For clarity surnames may be underlined. When addressing Chinese people the surname should come first and official titles should be used. Chinese handshakes last longer than those in western countries, and in conversation it is customary to stand close together. Politeness in Western terms is foreign to them, and they rarely bother with pleasantries. All foreigners should carry ID at all times as spot checks are common and failure to show evidence in ID will result in a fine or detention.

Business:

The Chinese are strict timekeepers and being late for a meeting is considered rude. When meeting people for the first time it is normal to shake hands and say 'ni hao', which means 'how are you'. Business cards are exchanged at the start of meetings in China and it is customary to have one side printed in Chinese and one in English. When giving or receiving business cards, or a gift, it is customary to hold it with both hands. Chinese consider gifts as an important show of courtesy. During a meal or reception your host is likely to offer a toast; you may be expected to offer him one in return. Business hours are 8am to 5pm, Monday to Saturday. A five-day week is more normal in larger cities. Workers take their lunch break between 12pm and 2pm and it is not unusual to find offices empty during this time.

Communications:

The international access code for China is +86. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). The city code for Beijing is (0)10. International Direct Dialling is available in most cities. Phone cards are widely available and calls can be made from post offices and hotels; phone booths on the streets are usually for local calls only. In hotels, local calls are generally free or will be charged only a nominal fee. Mobile phone networks are very advanced. Operators use GSM 900 networks and have roaming agreements with most non-North American international operators. Internet cafes are available in most main towns.

Duty Free:

Travellers to China do not need to pay customs duty on 400 cigarettes (600 cigarettes if stay exceeds six months), two bottles of alcoholic beverages (not more than 0,75 litres per bottle), or four bottles if staying longer than six months. Perfume for personal use is allowed. Prohibited goods include arms and ammunition or printed material that conflicts with the public order or moral standards of the country. Also prohibited are radio transmitters and receivers, exposed but undeveloped film and fresh produce. Strict regulations apply to the import or export of antiquities, banned publications, and religious literature. All valuables must be declared on the forms provided.

Health

A yellow fever vaccination certificate is required from travellers coming from infected areas. There is a risk of malaria throughout the low-lying areas of the country, and it is recommended that travellers to China seek medical advice before departure. A total of 18 human cases of avian influenza ('bird flu') have been reported from China since November 2005. Twelve of the cases were fatal. Travellers are unlikely to be affected by bird flu, but live animal markets and places where contact with live poultry is possible should be avoided. All poultry and egg dishes should also be thoroughly cooked. Outbreaks of SARS (Severe Acute Respiratory Syndrome) are few and far between, although the last fatality was in 2008. Travellers are warned to remain vigilant against this viral disease. Japanese encephalitis has been responsible for the deaths of a number of people in the Shaanxi and Shanxi provinces in northern China, and rabies infects people every year, occasionally causing death. Outbreaks of dengue fever occur. A variant of hand, foot and mouth disease, an intestinal virus has also been prevalent in 2008, with children being at particular risk. Altitude sickness can occur in the mountainous regions of Tibet, Qinghai, parts of Xinjiang, and western Sichuan. Outside city centres, visitors should only drink bottled water. Western-style medical centres with international staff are available in the major cities and usually accept credit cards. Health insurance is recommended.

View information on diseases: SARS, Rabies, Malaria, Japanese encephalitis, HIV/AIDS and Sexually Transmitted Diseases, Dengue Fever

SARS

Cause: SARS coronavirus (SARS-CoV) - Virus identified in 2003. SARS-CoV is thought to be an animal virus from an as yet unknown animal reservoir that first infected humans in the Guangdong province of southern China in 2002.

Transmission: An epidemic of SARS affected 26 countries and resulted in over 8,000 cases in 2003. Since then, a small number of cases have occurred as a result of laboratory accidents or through animal-to-human transmission (Guangdong, China). Transmission of SARS-CoV is primarily from person-to-person. SARS-CoV is usually spread when symptomatic cases of SARS cough or sneeze expelling infected respiratory secretions either directly onto the mucus membranes (eyes, nose or mouth) of other people or onto nearby surfaces on which the virus may persist for up to several days without cleaning. Transmission of SARS-CoV occurs mainly during the second week of illness which corresponds to the peak of virus excretion in respiratory secretions and stool and when cases with severe disease start to deteriorate clinically.

Nature of the disease: Initial symptoms are flu-like and include fever, malaise, muscle aches and pains (myalgia), headache, and shivering (rigors). No individual symptom or cluster of symptoms has proven specific for a diagnosis of SARS. Although fever is the most frequently reported symptom, it may be absent on initial measurement. Cough (initially dry), shortness of breath and diarrhoea may be present in the first week but more commonly reported in the second week of illness. Severe cases develop rapidly progressing to respiratory distress and requiring intensive care. Up to 70% of SARS cases develop diarrhoea which has been described as large volume and watery without blood or mucus.

Clinical definition of SARS: A person with a history of fever or a measured fever (≥ 38°C) AND one or more symptoms of lower respiratory tract illness (cough, difficulty breathing, shortness of breath) AND radiographic evidence of lung infiltrates consistent with pneumonia or Acute Respiratory Distress Syndrome (ARDS), OR autopsy findings consistent with the pathology of pneumonia or ARDS without an identifiable cause. No alternative diagnosis can fully explain the illness.

Geographical distribution: The distribution is based on the 2002-2003 epidemic. The disease appeared in November 2002 in the Guangdong province of southern China. This area is considered as a potential zone of re-emergence of SARS-CoV. Other countries/areas in which chains of human-to-human transmission occurred after early importation of cases were Hong Kong Special Administrative Region and Taiwan in China, Toronto in Canada, Singapore and Hanoï in Viet Nam. In other countries, imported cases did not lead to local outbreaks.

Risk for travellers: Currently, no areas of the world are reporting person-to-person transmission of SARS. Since the end of the global epidemic in July 2003, six cases of SARS have been reported globally - two from laboratory accidents (Singapore and Taiwan) and four in southern China in whom the source of infection remains undetermined although there is circumstantial evidence of animal-to-human transmission. Should SARS re-emerge in epidemic form, the World Health Organisation (WHO) will provide guidance on the risk of travel to affected areas. Travellers should stay informed about current travel recommendations. However, even during the height of the 2003 epidemic, the overall risk of SARS-CoV transmission to travellers was low.

Prophylaxis (protective treatment): None.

Precautions: Follow travel recommendations if any are issued by WHO. Frequent hand washing. Source: WHO.

Rabies

Cause: The rabies virus, a rhabdovirus of the genus Lyssavirus.

Transmission: Rabies is a zoonotic disease affecting a wide range of domestic and wild animals, including bats. Infection of humans usually occurs through the bite of an infected animal. The virus is present in the saliva. Any other contact involving penetration of the skin occurring in an area where rabies is present should be treated with caution. In developing countries transmission is usually from dogs. Person-to-person transmission has not been documented.

Nature of the disease: An acute viral encephalomyelitis, which is almost invariably fatal. The initial signs include a sense of apprehension, headache, fever, malaise and sensory changes around the site of the animal bite. Excitability, hallucinations and aerophobia are common, followed in some cases by fear of water (hydrophobia) due to spasms of the swallowing muscles, progressing to delirium, convulsions and death a few days after onset. A less common form, paralytic rabies, is characterized by loss of sensation, weakness, pain and paralysis.

Geographical distribution: Rabies is present in animals in many countries worldwide. Most cases of human infection occur in developing countries.

Risk for travellers: In rabies-endemic areas, travellers may be at risk if there is contact with both wild and domestic animals, including dogs and cats.

Prophylaxis (protective treatment): Vaccination for travellers with a foreseeable significant risk of exposure to rabies or travelling to a hyperendemic area where modern rabies vaccine may not be available.

Precautions: Avoid contact with wild animals and stray domestic animals, particularly dogs and cats, in rabies-endemic areas. If bitten by an animal that is potentially infected with rabies, or after other suspect contact, immediately clean the wound thoroughly with disinfectant or with soap or detergent and water. Medical assistance should be sought immediately. The vaccination status of the animal involved should not be a criterion for withholding post-exposure treatment, unless the vaccination has been thoroughly documented and vaccine of known potency has been used. In the case of domestic animals, the suspect animal should be kept under observation for a period of 10 days.

Rabies post-exposure treatment: In a rabies-endemic area, the circumstances of an animal bite, other contact with the animal, and the animal's behaviour and appearance may suggest that it is rabid. In such situations, medical advice should be obtained immediately. Post-exposure treatment to prevent the establishment of rabies infection involves first-aid treatment of the wound followed by administration of rabies vaccine and antirabies immunoglobulin in the case of a bite or exchange of saliva. The administration of vaccine, and immunoglobulin if required, must be carried out, or directly supervised, by a physician. Source: WHO.

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause: Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission: The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease: Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution: The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

Japanese encephalitis

Cause: Japanese encephalitis (JE) virus, which is a flavivirus.

Transmission: The Japanese encephalitis virus is transmitted by various mosquitoes of the genus Culex. It infects pigs and various wild birds as well as humans. Mosquitoes become infective after feeding on viraemic pigs or birds.

Nature of the disease: Most infections are asymptomatic (e.g. cause no symptoms). In symptomatic cases, severity varies; mild infections are characterized by febrile headache or aseptic meningitis. Severe cases have a rapid onset and progression, with headache, high fever and meningeal signs. Permanent neurological sequelae are common among survivors. Approximately 50% of severe clinical cases have a fatal outcome.

Geographical distribution: Japanese encephalitis occurs in a number of countries in Asia and occasionally in northern Queensland, Australia.

Risk for travellers: Low for most travellers. Visitors to rural and agricultural areas in endemic countries may be at risk, particularly during epidemics of JE.

Prophylaxis (protective treatment): Vaccination, if justified by likelihood of exposure.

Precautions: Avoid mosquito bites. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission: Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases: Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution: Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers: For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis: There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions: Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment: Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Dengue Fever

Cause: The dengue virus - a flavivirus of which there are four serotypes.

Transmission: Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease: Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution: Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet).

Risk for travellers: There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.

Prophylaxis (protective treatment): None.

Precautions: Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

China National Tourism Administration (CNTA), Beijing: +86 (0)10 6520 1114 or www.cnta.gov.cn/lyen/index.asp

China Embassies

Chinese Embassy, Washington DC, United States: +1 202 328 2500.

Chinese Embassy, London, United Kingdom: +44 (0)20 7299 4049.

Chinese Embassy, Ottawa, Canada: +1 613 789 3434.

Chinese Embassy, Canberra, Australia: +61 (0)2 6273 4780.

Chinese Embassy, Pretoria, South Africa: +27 (0)12 431 6500.

Chinese Embassy, Dublin, Ireland: +353 (0)1 260 1119.

Chinese Embassy, Wellington, New Zealand: +64 (0)4 472 1382.

Foreign Embassies in China

United States Embassy, Beijing: +86 (0)10 6532 3831.

British Embassy, Beijing: +86 (0)10 5192 4000.

Canadian Embassy, Beijing: +86 (0)10 6532 3536.

Australian Embassy, Beijing: +86 (0)10 5140 4111.

South African Embassy, Beijing: +86 (0)10 6532 0171.

Irish Embassy, Beijing: +86 (0)10 6532 2691.

New Zealand Embassy, Beijing: +86 (0)10 6532 2731.

China Emergency Numbers

Emergencies: 110 (police); 120 (ambulance - Beijing)

Airports

Tribhuvan International Airport (KTM)

Location: The airport is situated four miles (6km) east of Kathmandu.
Time: GMT +5.45.
Contacts: Tel: +977 (0)1 470 274.
Transfer to the city: A pre-paid taxi service operates from immediately outside the arrival gate. Rates are exhibited on a board and the fare must be paid in advance. Local buses also serve the airport, the journey is 35 minutes and costs Rs40.
Car rental: Car rental companies are represented.
Facilities: Facilities include banks and bureau de change, shops, duty-free, snacks, Internet, post office and tourist information. The airport is well equipped with facilities for those with disabilities.
Departure Tax: Rs. 1,130 (international), Rs. 169.50 (domestic).
Website: www.tiairport.com

Climate

The Kathmandu Valley has a mild climate most of the year, situated at an altitude of 4,297ft (1,310m). Summer temperatures range from 67-81°F (19-27°C), and in winter temperatures are between 36 and 68°F (2-20°C). During the rainy monsoon season between June and August, there is an average rainfall of between 7.8-14.7 inches (200-375mm) in Kathmandu. May and June can be very hot and humid until the monsoon rains bring relief. In spring (March to April) and autumn (October to November) the temperatures are pleasant with occasional short bursts of rain, while November to February are dry, but can be very cold, especially at night.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: United States citizens must have a passport and visa.

Entry requirements for UK nationals: British citizens must have a passport and visa.

Entry requirements for Canadians: Canadians must have a passport and visa.

Entry requirements for Australians: Australians must have a passport and visa.

Entry requirements for South Africans: South Africans must have a passport and visa.

Entry requirements for New Zealanders: New Zealand citizens must have a passport and visa.

Entry requirements for Irish nationals: Irish citizens must have a passport and visa.

Passport/Visa Note: Tourist visas can be issued on arrival to most nationalities. A 60-day visa costs US$30 and a 150-day/multiple-entry visa costs US$80. Tourist visas are valid for Kathmandu Valley, Pokhara Valley and Tiger Tops in Chitwan. Visitors intending to trek or visit other areas should obtain a permit from the Central Immigration Office.

Volunteer Travel Guide South Africa

Throughout the second half of the 20th century South Africa was regarded by most of the world as a pariah state where the ruling white minority passed a range of draconian laws to subdue and enslave the black majority. All this changed in 1994 with the release from prison of world-renowned freedom fighter and icon of the oppressed, Nelson Mandela. A new age of democracy was ushered in, and South Africa was suddenly revealed to the world in her beautiful true colours: a rainbow nation with a kaleidoscope of cultures and a host of attractions to enthral and entrance visitors.

A decade later tourists are flocking to sunny South Africa in droves, particularly to the Western Cape with its magnificent scenery, beautiful beaches, majestic mountains and green winelands.

The Republic, at the southern tip of Africa surrounded by ocean on three sides, offers a taste of the African experience with the chance to visit traditional tribal villages, game reserves and sprawling townships. At the same time it also offers the trappings of a first world holiday experience, with luxury hotels, sophisticated shopping, exciting theme parks and clean beaches. Have breakfast in a New York style deli; lunch in an African shebeen; cocktails on a sunset cruise; and dine in style in a fine British colonial restaurant. This is all possible in a South African city.

It is not only cultural diversity that makes South Africa magical. The country has a wealth of animal and plant life scattered across its varied climactic zones from desert to snow-covered mountains, forests to grasslands and mangrove swamps. Historically, too, there is plenty to discover, from the fossils of ancient hominids, to the pioneering spirit of the Dutch 'voortrekkers' and the settlement of the Eastern Cape frontier by the British colonialists.

South Africa has been billed as 'a world in one country', and any visitor who has experienced its delights, from the jumble of Johannesburg, the city built on gold mines in the north, to the sophistication of Cape Town in the south, is bound to agree.

The Basics

Time:

Local time is GMT +2.

Electricity:

Electrical current is 230 volts, 50Hz. Round, three-pin plugs are standard.

Language:

South Africa has 11 official languages, including Afrikaans, English, Xhosa, Zulu and Sotho. English is widely spoken.

Health:

Travellers arriving in South Africa from infected areas require a yellow fever vaccination certificate; otherwise no vaccination is required. There is a malaria risk in the low-lying areas of the Northern Province and Mpumalanga (including the Kruger National Park) and northeastern KwaZulu Natal, and precautions are advised when travelling to these areas. There is a high prevalence of HIV/AIDS. Tap water is safe in urban areas but sterilisation is advisable elsewhere, as there are periodic outbreaks of cholera in the poor communities of rural South Africa, particularly in Northern KwaZulu Natal, Mpumalanga, and Limpopo provinces. Drug-resistant TB has been reported throughout the country. Food poisoning is rare. Medical facilities in South Africa are good, but medical insurance is strongly advised as private hospitals expect cash upfront and public hospitals are best avoided.

Tipping:

Waitering is a livelihood and a tip of 10% is expected for good service, if a service charge is not included in the bill. Tipping for services rendered is widely anticipated by porters, taxi drivers and petrol attendants. Golf caddies should be tipped accordingly. 'Car guards' operate in the city centres and tourist spots and will offer to look after your parked car; they are usually immigrants from neighbouring countries looking for work and will expect anything from R2 upwards on your return.

Communications:

The international access code for South Africa is +27. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). As of 8 January 2007, South Africa has changed to 10-digit dialling (so city codes must be included, e.g. 021 for Cape Town) and international dialling has changed from 09 to 00. GSM mobile phone networks providing 900 and 1800 frequencies serve the country. Mobile service providers offer very cheap 'pay-as-you-go' Sim cards, which are a good option for visitors staying for some time. Internet cafes are widespread. Card and coin operated pay phones are also widespread.

Duty Free:

Travellers to South Africa do not have to pay duty on 200 cigarettes, 50 cigars and 250g of tobacco; 2 litres wine and 1 litre spirits; perfume up to 50ml and 250ml eau de toilette; and other goods to the value of R3,000. All other goods brought in from abroad by South African residents must be declared on arrival. These will be subject to import duties. For goods to be re-imported, travellers must complete a DA65 or NEP-form that is issued on departure. Prohibited items include meat and dairy products, all medication except for personal consumption, flick knives, ammunition, explosives and pornography containing minors and bestiality.

Health

Travellers arriving in South Africa from infected areas require a yellow fever vaccination certificate; otherwise no vaccination is required. There is a malaria risk in the low-lying areas of the Northern Province and Mpumalanga (including the Kruger National Park) and northeastern KwaZulu Natal, and precautions are advised when travelling to these areas. There is a high prevalence of HIV/AIDS. Tap water is safe in urban areas but sterilisation is advisable elsewhere, as there are periodic outbreaks of cholera in the poor communities of rural South Africa, particularly in Northern KwaZulu Natal, Mpumalanga, and Limpopo provinces. Drug-resistant TB has been reported throughout the country. Food poisoning is rare. Medical facilities in South Africa are good, but medical insurance is strongly advised as private hospitals expect cash upfront and public hospitals are best avoided.

View information on diseases: Tuberculosis, Malaria, HIV/AIDS and Sexually Transmitted Diseases, Cholera

Tuberculosis

Cause: Mycobacterium tuberculosis, the tubercle bacillus. Humans can also become infected by bovine tuberculosis, caused by Mycobacterium bovis.

Transmission: Infection with tuberculosisis usually by direct airborne transmission from person to person.

Nature of the disease: Exposure to Mycobacterium tuberculosis may lead to infection, but most infections do not lead to disease. The risk of developing disease following infection is generally 5-10% during the lifetime, but may be increased by various factors, notably immunosuppression (e.g. advanced HIV infection). Multidrug resistance refers to strains of M. tuberculosis that are resistant to at least isoniazid and rifampicin. The resistant strains do not differ from other strains in infectiousness, likelihood of causing disease, or general clinical effects; however, if they do cause disease, treatment is more difficult and the risk of death will be higher.

Geographical distribution: Worldwide.

Risk for travellers: Low for most travellers. Long-term travellers (over 3 months) to a country with a higher incidence of tuberculosis than their own may have a risk of infection comparable to that for local residents. As well as the duration of the visit, living conditions are important in determining the risk of infection: high-risk settings include health facilities, shelters for the homeless, and prisons.

Prophylaxis (protective treatment): BCG vaccine is of limited use for travellers but may be advised for infants and young children in some situations.

Precautions: Travellers should avoid close contact with known tuberculosis patients. For travellers from low-incidence countries who may be exposed to infection in relatively high-incidence countries (e.g. health professionals, humanitarian relief workers, missionaries), a baseline tuberculin skin test is advisable in order to compare with retesting after return. If the skin reaction to tuberculin suggests recent infection, the traveller should receive, or be referred for, treatment for latent infection. Patients under treatment for tuberculosis should not travel until the treating physician has documented, by laboratory examination of sputum, that the patient is not infectious and therefore of no risk to others. The importance of completing the prescribed course of treatment should be stressed. Source: WHO.

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause: Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission: The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease: Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution: The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission: Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases: Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution: Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers: For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis: There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions: Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment: Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Cholera

Cause: Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission: Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease: An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution: Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers: The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment): Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions: As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

South African Tourism, Johannesburg: +27 (0)11 895 3000 or www.southafrica.net

South Africa Embassies

South African Embassy, Washington, United States: +1 202 232 4400.

South African Embassy, London, United Kingdom: +44 (0)20 7451 7299.

South African High Commission, Ottawa, Canada: +1 613 744 0330.

South African High Commission, Canberra, Australia (also responsible for New Zealand): +61 (0)2 6272 7300.

South African Embassy, Dublin, Ireland: +353 (0)1 661 5553.

Foreign Embassies in South Africa

United States Embassy, Pretoria: +27 (0)12 431 4000.

British High Commission, Pretoria: +27 (0)12 421 7733.

Canadian High Commission, Pretoria: +27 (0)12 422 3000.

Australian High Commission, Pretoria: +27 (0)12 423 6000.

Irish Embassy, Pretoria: +27 (0)12 342 5062.

New Zealand High Commission, Pretoria: +27 (0)12 342 8656/7/8/9.

South Africa Emergency Numbers

Emergencies: 10111 (Police); 10177 (Ambulance)

Airports

Cape Town International Airport (CPT)

Location: The airport is situated 13 miles (20km) east of Cape Town.

Time: GMT +2.

Contacts: Tel: +27 (0)21 937 1200.

Transfer to the city: Door-to-door minibus services are available for the journey to the city, taking approximately half an hour (R150). Many hotels operate courtesy buses, and taxis are available, but only use Touch Down Taxis, the authorised airport taxi company.

Car rental: Car rental companies represented at the airport include Hertz, Avis, National Alamo, Budget, Imperial and Tempest.

Facilities: ATMs, bars, restaurants and currency exchange facilities are available throughout the airport. There are several shops, including duty-free in the International Departures' section. A VAT refund service is available by the International check in desk. Hotels reservations and tourist information are available in the International Terminal. There is a Vodacom shop in International Arrivals where visitors can buy local SIM cards for their mobile phones. A free magazine called The Other Guide is handed out in International Arrivals; it's packed with ideas on where to eat and what to do in Cape Town that month.

Parking: Short- and long-term parking, as well as valet parking, is available.

Departure Tax: None.

Website: www.airports.co.za

O R Tambo International Airport (ORTIA) (JNB)

Location: The airport is 14 miles (22km) east of Johannesburg.

Time: GMT +2.

Contacts: Tel: +27 (0)11 921 6262.

Transfer to the city: An airport bus departs regularly to the city centre. Authorised shuttle buses and taxis are available; these display the ACSA logo on their vehicles.

Car rental: Car rental companies represented at the airport include Sizwe, Avis, Budget, Imperial, Tempest, Europcar and Khaya.

Facilities: Facilties at the airport include bureaux de change, banks, a post office, shops, restaurants and bars, Internet access, mobile phone rental, viewing decks, a medical clinic and a prayer room.

Parking: Short- and long-term parking is available.

Departure Tax: None.

Website: www.airports.co.za

Durban International Airport (DUR)

Location: The airport is 10 miles (16km) southwest of Durban.

Time: GMT +2.

Contacts: Tel: +27 (0)31 451 6758.

Transfer to the city: An airport bus service is available to connect to the city, and a coastal town service carries passengers to the outlying resorts. Taxis are also available.

Car rental: Numerous car rental companies are represented at the airport, including Avis, Khaya, Budget, Europcar, Hertz, Imperial and National.

Facilities: Facilities at the airport include ATMS, a bank, lounges, a post office, restaurants and bars, and shops. Disabled facilities are good; those with special needs should contact their airline in advance.

Parking: Parking is available.

Departure Tax: None.

Website: www.airports.co.za

Kimberley Airport (KIM)

Location: The airport is situated five miles (8km) south of Kimberley.

Time: GMT +2.

Contacts: Tel: +27 (0)53 851 1032.

Transfer to the city: There is no bus service between the airport and the city, but a taxi service is available on request and car hire agencies are available at the airport.

Car rental: Car rental companies include Avis, Budget, Hertz, Imperial and National Alamo.

Facilities: Facilities include a pub in the arrivals terminal, public phones and an ATM.

Departure Tax: None.

Website: www.airports.co.za

East London Airport (ELS)

Location: The airport is located six miles (9km) west of the city centre.

Time: GMT +2.

Contacts: Tel: +27 (0)43 706 0306.

Transfer to the city: Gateway Shuttle (tel: 043 743 139) and Redshuttle Bus Services leave from in front of the arrivals terminal. Bookings should be made in advance. Their schedule follows flight schedules.

Car rental: Rental companies at the airport include Avis, Budget, Europcar, Hertz and Tempest.

Facilities: The airport has an ATM in the departures hall and information desk in the arrivals hall. A coffee shop, restaurant and bookshop are also available in the terminal building.

Departure Tax: None.

Website: www.airports.co.za

Bloemfontein Airport (BFN)

Location: The airport is located six miles (10km) from the city centre.

Time: GMT +2.

Contacts: Tel: +27 (0)51 407 2240.

Transfer to the city: Taxis and shuttles, which should be booked in advance, are available just outside the terminal building; schedules match the arrival of flights. Contact the Bloemfontein Airport helpdesk for more information.

Car rental: Avis, Budget, Hertz, National, Imperial and Tempest all have offices at the airport.

Facilities: The airport has a mobile phone rental shop, coffee bar, bookshop, restaurant and information desk. A VIP lounge and business lounge, conference room and ATM machine is also available.

Departure Tax: None.

Website: www.airports.co.za

Port Elizabeth International Airport (PLZ)

Location: The airport is situated about two miles (3km) south of PE.

Time: GMT +2.

Contacts: Tel: +27 (0)41 507 7319.

Transfer to the city: Taxis provide the only transport to the city centre.

Car rental: Car rental companies include Avis, Budget, Europcar, Imperial and National.

Facilities: Facilities include several shops as well as restaurants, cafes and pubs, and conference facilities. An ATM is available for cash withdrawal.

Parking: Long and short-term parking is available.

Departure Tax: None.

Website: www.airports.co.za

George Airport (GRJ)

Location: The airport is situated six miles (10km) from George.

Time: GMT +2.

Contacts: Tel: +27 (0)44 876 9310.

Transfer to the city: Taxis are the only form of transport between the city and the airport.

Car rental: Car rental companies include Avis, Budget, Hertz, Imperial and Europcar.

Facilities: Facilities include foreign exchange, an ATM, conference facilities, cafes, and a few snack shops. Cellphones are also available for rent.

Departure Tax: None.

Website: www.airports.co.za

Kruger Mpumalanga International Airport (MQP)

Location: The airport is situated 16 miles (25km) from Nelspruit at White River.

Time: GMT +2.

Contacts: Tel: +27 (0)13 753 7500.

Transfer to the city: Taxis are available.

Car rental: A number of car rental companies are located at the airport including Avis, Hertz, National/Alamo, Europcar and Budget.

Facilities: Facilities include an ATM and currency exchange facilities, a restaurant, café and curio shops.

Parking: Short and long-term parking is available.

Departure Tax: None.

Website: www.kmiairport.co.za

Eastgate Airport (HDS)

Location: The airport is situated five miles (8km) from Hoedspruit and is situated within the Hoedspruit Air Force Base Nature Reserve.

Time: GMT +2.

Contacts: Tel: +27 (0)15 793 3681.

Car rental: Avis has a rental office on site.

Facilities: Foreign exchange is available, and there is a small restaurant and curio shop.

Departure Tax: R110.

Website: www.eastgateairport.co.za

Richards Bay Airport (RCB)

Location: Richards Bay Airport is located four miles (7 km) north west of Richards Bay.

Time: GMT + 2.

Contacts: Tel: +27 (0)35 789 9630.

Transfer to the city: Taxis are available outside the arrivals hall.

Car rental: Car rental companies available are Sixt, Drive South Africa, Hertz, National, RIS Vehicle Hire, Avis, Budget, Afropulse, Europcar, Tempest and Imperial.

Facilities: The Runway Restaurant and Bar provides refreshment for travellers.

Parking: Short term parking is available.

Departure Tax: None.

Climate

Cape Town, on the Cape Peninsula, has a Mediterranean climate with dry summers and wet winters. Seasons are well defined, with winter, between May and August, being influenced by a series of cold fronts that cross the Peninsula from the Atlantic Ocean. Winters are characterised by heavy rain, particularly on the mountain slopes, strong north-westerly winds, and low temperatures. In summer the weather in Cape Town is warm and dry, but the idyllic sunny weather is often punctuated with strong south easterly winds.

Passport & Visa

Visa Agencies: Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: United States nationals need a valid passport, but no visa is needed for stays of up to 90 days.

Entry requirements for UK nationals: British nationals need a valid passport, but no visa is needed for stays of up to 90 days if passport is endorsed British Citizen including Guernsey, Jersey and Isle of Man, British Dependent Territories Citizen, or British Overseas Territories Citizen (Virgin Islands). Those whose passports state British National (Overseas) may stay up to 30 days without a visa. All others require a visa.

Entry requirements for Canadians: Canadian nationals need a valid passport, but no visa is needed for stays of up to 90 days.

Entry requirements for Australians: Australian nationals need a valid passport, but no visa is needed for stays of up to 90 days.

Entry requirements for New Zealanders: New Zealand nationals require a valid passport, but no visa is necessary for stays of up to 90 days.

Entry requirements for Irish nationals: Irish nationals require a valid passport, but no visa is necessary for a stay of up to 90 days.

Passport/Visa Note: Passports must be valid for at least 30 days beyond the period of intended stay. An onward or return ticket is required, as well as sufficient funds and documents needed for further travel. Note that visitors to South Africa must have at least one blank (unstamped) page in their passport, each time entry is sought; these pages are in addition to the endorsement/amendment pages at the back of the passport.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Malawi

Promoted as the ‘Warm Heart of Africa’, Malawi is a long, thin country renowned for the unequalled friendliness of its people, unspoilt national parks and wildlife reserves, and the beaches and tropical fish life of Lake Malawi, the third largest lake in Africa. It is dominated by the vast lake, as well as the Great Rift Valley that cuts through the country from north to south, creating fertile valleys, cool mountains and verdant plateaus.

Lake Malawi is an irresistible attraction for travellers, with its beaches, resorts, watersports and outstanding variety of fish life a magnet for divers and snorkellers. The lake is home to a bigger variety of fish species than any other freshwater lake on earth, most of them protected within the Lake Malawi National Park at its southern tip. Most visitors head for the small, restful village at Cape Maclear, which along with its offshore islands, is part of the park. Equally popular, Nkhata Bay to the north has bays, beaches and various water activities. Spread along the length of the lakeshore are numerous traditional fishing villages, and the fishermen in their dugout canoes form a quintessential postcard silhouette against the spectacular golden sunset.

Malawi is also blessed with numerous game reserves and national parks that are uncrowded, well stocked with animals and a renowned variety of birdlife, and offer a unique wilderness experience. The northern Nyika Plateau, at around 7,500ft (2,300m), is one of the world’s highest game reserves and is a remote area located in the most unspoilt and least visited part of the country, with beautiful grasslands and waterfalls, the highest concentration of leopard in Central Africa, and famous for its abundant orchid species. To the south the best-known park is Liwonde National Park with thousands of hippos and crocodiles on the banks of the Shire River, as well as large numbers of elephants, zebra and antelope.

The southern part of the country is the most developed and the most populated. Although Lilongwe is the capital, the region is home to Malawi’s largest city and main commercial centre, Blantyre, which is a good base for visiting two of the area’s attractions – the vast massif of Mt Mulunje, offering some of the finest hiking trails in the country, and Zomba Plateau.

Malawi has remained peaceful for over a century, unaffected by war and internal strife that has torn many other African countries apart, and although poor and densely populated, the country offers visitors a wealth of scenic highlights, culture and activities.

The Basics

Time:

Local time is GMT +2.

Electricity:

Electrical current is 220/240 volts, 50Hz. Three-pin, rectangular blade plugs are standard.

Language:

English is the official language, but Chichewa is more commonly spoken.

Health:

Malaria is a risk throughout the year and is highest on the coast. Cases of dengue fever and chikungunya fever were reported in February 2006 and are transmitted by mosquitoes; precautionary measures against being bitten should be taken at all times. In April 2008, an outbreak of Rift Valley fever was reported in five regions; contact with domestic animals and mosquitoes should be avoided. All travellers coming from a country with yellow fever require inoculation against the disease. Other risks include bilharzia, tuberculosis and rabies. Tap water should not be drunk unless it has been boiled or chemically treated. Medical facilities are limited, and outside of the capital medical care may be difficult to find. Limited French medications are available in Tana and it is advisable to bring along a medical kit for private use. Comprehensive medical insurance is advised.

Tipping:

Service charges are not included in hotel and restaurant bills, and tipping is at the client's discretion. It is common practice to tip guides in the national parks.

Customs:

It is courteous to ask permission before taking photographs of people. Homosexuality is illegal. Women, in particular, should cover their legs and upper arms when travelling outside of the main tourist areas.

Business in Malawi is quite formal; business cards are usually exchanged on meeting, accompanied by a firm handshake. Punctuality is important and dress should be formal; lightweight suits with a tie are acceptable. English is Malawi's official language and all business is conducted in English. Malawians tend to be very polite and thoughtful, and expect the same treatment in return. Business hours usually start fairly early; from 7.30am to 5pm Monday to Saturday.

Communications:

The international dialling code for Malawi is +265. The outgoing code is 101 followed by the relevant country code (e.g. 10127 for South Africa). There are no city/area codes required. The telephone system is not very reliable, but Internet, email and fax are available in most towns and tourist areas. The GSM 900 cell phone network gives coverage to most of the country and is compatible with most international operators.

Duty Free:

Travellers to Malawi do not have to pay customs duty on 200 cigarettes or 250g of tobacco. For travellers over 16 years 1 litre spirits, 1 litre beer and 1 litre wine can be brought into the country without incurring duty fees.

Health

Malaria is a risk throughout the year and is highest on the coast. Cases of dengue fever and chikungunya fever were reported in February 2006 and are transmitted by mosquitoes; precautionary measures against being bitten should be taken at all times. In April 2008, an outbreak of Rift Valley fever was reported in five regions; contact with domestic animals and mosquitoes should be avoided. All travellers coming from a country with yellow fever require inoculation against the disease. Other risks include bilharzia, tuberculosis and rabies. Tap water should not be drunk unless it has been boiled or chemically treated. Medical facilities are limited, and outside of the capital medical care may be difficult to find. Limited French medications are available in Tana and it is advisable to bring along a medical kit for private use. Comprehensive medical insurance is advised.

View information on diseases: African Sleeping Sickness, Schistosomiasis (bilharzia), Malaria

African Sleeping Sickness

Cause:
Protozoan parasites Trypanosoma brucei (T. b.) gambiense and T. b. rhodesiense.

Transmission:
Infection with African trypanosomiasis (sleeping sickness) occurs through the bite of infected tsetse flies. Humans are the main reservoir host for T. b. gambiense. Domestic cattle and wild animals, including antelopes, are the main animal reservoir of T. b. rhodesiense.

Nature of the disease:
T. b. gambiense causes a chronic illness with onset of symptoms after a prolonged incubation period of weeks or months. T. b. rhodesiense causes a more acute illness, with onset a few days or weeks after the infected bite; often, there is a striking inoculation chancre. Initial clinical signs include severe headache, insomnia, enlarged lymph nodes, anaemia and rash. In the late stage of the disease, there is progressive loss of weight and involvement of the central nervous system. Without treatment, the disease is invariably fatal.

Geographical distribution:
T. b. gambiense is present in foci in the tropical countries of western and central Africa. T. b. rhodesiense occurs in east Africa, extending south as far as Botswana.

Risk for travellers:
Travellers are at risk of African sleeping sickness in endemic regions if they visit rural areas for hunting, fishing, safari trips, sailing or other activities in remote areas.

Prophylaxis (protective treatment):
None.

Precautions:
Travellers should be aware of the risk in endemic areas and as far as possible avoid any contact with tsetse flies. However, bites are difficult to avoid because tsetse flies can bite through clothing. Travellers should be warned that tsetse flies bite during the day and are not repelled by available insect-repellent products. The bite is painful, which helps to identify its origin, and travellers should seek medical attention promptly if symptoms develop subsequently. Source: WHO.
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Schistosomiasis (bilharzia)

Cause:
Several species of parasitic blood flukes (trematodes), of which the most important are Schistosoma mansoni, S. japonicum and S. haematobium.

Transmission:
Infection with bilharzia occurs in fresh water containing larval forms (cercariae) of schistosomes, which develop in snails. The free-swimming larvae penetrate the skin of individuals swimming or wading in water. Snails become infected as a result of excretion of eggs in human urine or faeces.

Nature of the disease:
Chronic conditions in which adult flukes live for many years in the veins (mesenteric or vesical) of the host where they produce eggs, which cause damage to the organs in which they are deposited. The symptoms of bilharzias depend on the main target organs affected by the different species, with S. mansoni and S. japonicum causing hepatic and intestinal signs and S. haematobium causing urinary dysfunction. The larvae of some schistosomes of birds and other animals may penetrate human skin and cause a self-limiting dermatitis, "swimmers itch". These larvae are unable to develop in humans.

Geographical distribution:
S. mansoni occurs in many countries of sub-Saharan Africa, in the Arabian peninsula, and in Brazil, Suriname and Venezuela. S. japonicum is found in China, in parts of Indonesia, and in the Philippines (but no longer in Japan). S. haematobium is present in sub-Saharan Africa and in eastern Mediterranean areas.

Risk for travellers:
In endemic areas, travellers are at risk to bilharzias while swimming or wading in fresh water.
Prophylaxis (protective treatment):
None.

Precautions:
Avoid direct contact (swimming or wading) with potentially contaminated fresh water in endemic areas. In case of accidental exposure, dry the skin vigorously to reduce penetration by cercariae. Avoid drinking, washing, or washing clothing in water that may contain cercariae. Water can be treated to remove or inactivate cercariae by paper filtering or use of iodine or chlorine. Source: WHO.

Malaria

General considerations:
Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:
Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:
The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:
Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:
The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean.

Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Malawi Ministry of Tourism Parks and Wildlife, Lilongwe: +265 (0) 177 5499

Malawi Embassies
Malawi Embassy, Washington DC, United States: +1 202 797 1007.

Malawi High Commission, London, United Kingdom: +44 (0)20 8458 7714/ 8455 5624.
Malawi High Commission, Ottawa, Canada: +1 613 236 8931.
Malawi High Commission, Tokyo, Japan (also responsible for Australia): +81(0)3 3449 3010.
Malawi High Commission, Pretoria, South Africa: +27 (0)12 342 0146.

Foreign Embassies in Malawi
United States Embassy, Lilongwe: +265 1 773 166.

British High Commission, Lilongwe: +265 1 772 400.
Canadian High Commission, Lusaka, Zambia (also responsible for Malawi): +260 (0)1 250 833.
Australian Embassy, Harare, Zimbabwe (also responsible for Malawi): +263 (0)4 852 471.
South African High Commission, Lilongwe: +265 1 773 722/597.
Embassy of Ireland, Lilongwe: +265 1 706 405/408.

Malawi Emergency Numbers
Emergencies: 997 (Police); 998 (Ambulance)

Airports

Lilongwe International Airport (LLW)

Location: The airport is situated 12 miles (19km) from Lilongwe.

Time: Local time is GMT +2.

Contacts: Tel: +265 (0)176 0266.

Transfer to the city: Buses and taxis are available to the city centre.

Car rental: Most major car rental companies are represented at the airport.

Facilities: Facilities include a bank and bureaux de change, post office, restaurant, bar and duty-free shopping.

Departure Tax: US$30, payable in US Dollars.

Blantyre-Chileka International Airport (BLZ)

Location: The airport is situated nine miles (16km) from Blantyre.

Time: Local time is GMT +2.

Contacts: Tel: +265 (0)169 4322.

Transfer to the city: A bus service is available to the city centre.

Car rental: Car rental is available.

Facilities: A restaurant and bar are situated in the terminal building.

Departure Tax: US$30, payable in US Dollars.

Climate

Winter is the best time to visit Malawi, coinciding with the dry season, and lasting from May to October. The dry season is also the best time for game viewing and hiking. June and July are the coolest months with average daytime temperatures of 70ºF (21ºC), and colder nights especially in the highlands. November to April is the hot, humid rainy season with more rain falling on the higher plateaus than around the lake, with temperatures reaching up to 90ºF (mid-30ºCs). Some roads may become impassable during heavy rains.

Passport & Visa

Visa Agencies:
Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US passport holders require a passport, but no visa is required for stays of up to 90 days.

Entry requirements for UK nationals: UK passport holders require a passport, but no visa is required for stays of up to 90 days, irrespective of endorsement in passport.

Entry requirements for Canadians: Canadian nationals require a passport, but no visa is required for stays of up to 90 days.

Entry requirements for Australians: Australian nationals require a passport, but no visa is required for stays of up to 90 days.

Entry requirements for South Africans: South Africans require a passport, but no visa is required for stays of up to 90 days.

Entry requirements for New Zealanders: New Zealand nationals require a passport, but no visa is necessary for a stay of up to 90 days.

Entry requirements for Irish nationals: Irish nationals require a passport, but no visa is necessary for a stay of up to 90 days.

Passport/Visa Note: All visitors must have a return or onward tickets, all documents necessary for return or onward journeys and sufficient funds for their duration of stay. Extensions on visas are possible. Persons entering Malawi other than via a border immigration post must report to an Immigration Officer at any Immigration Office after arrival.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate

Volunteer Travel Guide Zambia

The big, beautiful country of Zambia is situated in the heart of the African sub-continent, untainted by commercial tourist development, but nevertheless well-equipped to allow visitors to experience the warmth, excitement, challenges and adventures of the real Africa.

Zambia beckons with an abundance of natural attractions and extreme sports, which has earned it the reputation of being the 'adventure centre' of the continent.

The country's prime attraction is the spectacular, breathtaking Victoria Falls on the Zambezi River between Zambia and Zimbabwe. Not only do the falls provide unmatched scenery as the water plunges into the depths of the gorge, but they are also the setting for a multitude of adrenaline pumping activities, like whitewater rafting, bungee jumping from the 364ft (111m) high bridge, canoeing, abseiling, micro-lighting over the falls, elephant-back safaris, jet-boating through the rapids and many more.

If dry land is more to your taste, Zambia offers dozens of superb game parks stocked with a profusion of birds and wildlife. Chief among the parks is South Luangwa National Park, centred on the most intact major river system in Africa, which hosts a huge concentration of game. The legendary 'Zambian walking safari' originated in this park and still offers one of the finest ways to experience the African wilderness.

Visitors to Zambia seldom linger in the towns, being bent on safaris or destined for game lodges and adventure camps, but those who choose to explore the somewhat dishevelled capital, Lusaka, will find it has an interesting charm. More than half of the inhabitants of this over-populated city are unemployed, yet the atmosphere is far from despondent as the people hustle and bustle, determined to survive. Thousands of stalls line the streets offering a fascinating array of services and goods.

Lovers of the outdoors cannot fail to find everything and more to satisfy them in the wetlands and wilderness of Zambia.

The Basics

Time:

GMT +2.

Electricity:

Electrical current is 220 volts, 50Hz. Square three-pin plugs, as well as two-and three pin round plugs are in use.

Language:

There are over 73 dialects spoken in Zambia, but the official language is English. All business is in English and most Zambians speak it fairly well.

Health:

Polio, typhoid, rabies and Hepatitis A vaccinations are recommended. Malaria is endemic in Zambia (prophylaxis is essential), and outbreaks of cholera and dysentery are common especially during the rainy season. Visitors to game parks are at risk of African trypanosomiasis (sleeping sickness), which is carried by tsetse flies; insect repellent is ineffective against tsetse flies. The country also has one of the highest rates of HIV/Aids infection worldwide. Avoid swimming or wading in bodies of fresh water, such as lakes, ponds, streams, or rivers due to the presence of bilharzia. Medical facilities in the country are under-developed and limited to the point that basic drugs and even clean needles are often not available. The small clinics in Lusaka are regarded as superior to the general hospitals, but clinics in rural areas are rarely stocked with anything more than aspirin or plasters. Full travel insurance, including cover for medical evacuation by air, is therefore essential and it is vital to bring a good first aid kit. Avoid food bought from local street vendors and ensure drinking water is filtered and boiled, or bought in sealed, branded bottles.

Tipping:

Tipping is discouraged, but still practised on occasion and is usually about 10%. A 10% service charge is included in bills, but tipping in hotels is against the law.

Communications:

The international dialling code for Zambia is +260. The outgoing code is 00 followed by the relevant country code (e.g. 0027 for South Africa). City/area codes are in use, e.g. 1 for Lusaka. Operator assisted calls can be booked by dialling 090 or 093. Public telephones are widely available, most requiring tokens, but card phones are now available from where international calls can be made. Connections tend to be bad, particularly outside of Lusaka. There are GSM 900 cell phone networks in operation, but coverage is limited mainly to urban areas. There are several Internet cafes in Livingstone and Lusaka, and secretarial services in Lusaka offer full telephone, fax, telex and email facilities. Postal services are fairly reliable.

Duty Free:

Travellers to Zambia over 18 years do not have to pay duty on the following items: 400 cigarettes or 500g tobacco, 1 bottle of alcohol and 2.5 litres of beer, and 1 ounce of perfume. Visitors may export the same items for free.

Health

Polio, typhoid, rabies and Hepatitis A vaccinations are recommended. Malaria is endemic in Zambia (prophylaxis is essential), and outbreaks of cholera and dysentery are common especially during the rainy season. Visitors to game parks are at risk of African trypanosomiasis (sleeping sickness), which is carried by tsetse flies; insect repellent is ineffective against tsetse flies. The country also has one of the highest rates of HIV/Aids infection worldwide. Avoid swimming or wading in bodies of fresh water, such as lakes, ponds, streams, or rivers due to the presence of bilharzia. Medical facilities in the country are under-developed and limited to the point that basic drugs and even clean needles are often not available. The small clinics in Lusaka are regarded as superior to the general hospitals, but clinics in rural areas are rarely stocked with anything more than aspirin or plasters. Full travel insurance, including cover for medical evacuation by air, is therefore essential and it is vital to bring a good first aid kit. Avoid food bought from local street vendors and ensure drinking water is filtered and boiled, or bought in sealed, branded bottles.

View information on diseases: Typhoid fever, African Sleeping Sickness, Schistosomiasis (bilharzia), Rabies, Malaria, HIV/AIDS and Sexually Transmitted Diseases, Hepatitis A, Cholera.

Typhoid fever

Cause: Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission: Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease: Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution: Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers: Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment): Vaccination.

Precautions: Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

African Sleeping Sickness

Cause: Protozoan parasites Trypanosoma brucei (T. b.) gambiense and T. b. rhodesiense.

Transmission: Infection with African trypanosomiasis (sleeping sickness) occurs through the bite of infected tsetse flies. Humans are the main reservoir host for T. b. gambiense. Domestic cattle and wild animals, including antelopes, are the main animal reservoir of T. b. rhodesiense.

Nature of the disease: T. b. gambiense causes a chronic illness with onset of symptoms after a prolonged incubation period of weeks or months. T. b. rhodesiense causes a more acute illness, with onset a few days or weeks after the infected bite; often, there is a striking inoculation chancre. Initial clinical signs include severe headache, insomnia, enlarged lymph nodes, anaemia and rash. In the late stage of the disease, there is progressive loss of weight and involvement of the central nervous system. Without treatment, the disease is invariably fatal.

Geographical distribution: T. b. gambiense is present in foci in the tropical countries of western and central Africa. T. b. rhodesiense occurs in east Africa, extending south as far as Botswana.

Risk for travellers: Travellers are at risk of African sleeping sickness in endemic regions if they visit rural areas for hunting, fishing, safari trips, sailing or other activities in remote areas.

Prophylaxis (protective treatment): None.

Precautions: Travellers should be aware of the risk in endemic areas and as far as possible avoid any contact with tsetse flies. However, bites are difficult to avoid because tsetse flies can bite through clothing. Travellers should be warned that tsetse flies bite during the day and are not repelled by available insect-repellent products. The bite is painful, which helps to identify its origin, and travellers should seek medical attention promptly if symptoms develop subsequently. Source: WHO.

Schistosomiasis (bilharzia)

Cause: Several species of parasitic blood flukes (trematodes), of which the most important are Schistosoma mansoni, S. japonicum and S. haematobium.

Transmission: Infection with bilharzia occurs in fresh water containing larval forms (cercariae) of schistosomes, which develop in snails. The free-swimming larvae penetrate the skin of individuals swimming or wading in water. Snails become infected as a result of excretion of eggs in human urine or faeces.

Nature of the disease: Chronic conditions in which adult flukes live for many years in the veins (mesenteric or vesical) of the host where they produce eggs, which cause damage to the organs in which they are deposited. The symptoms of bilharzias depend on the main target organs affected by the different species, with S. mansoni and S. japonicum causing hepatic and intestinal signs and S. haematobium causing urinary dysfunction. The larvae of some schistosomes of birds and other animals may penetrate human skin and cause a self-limiting dermatitis, "swimmers itch". These larvae are unable to develop in humans.

Geographical distribution: S. mansoni occurs in many countries of sub-Saharan Africa, in the Arabian peninsula, and in Brazil, Suriname and Venezuela. S. japonicum is found in China, in parts of Indonesia, and in the Philippines (but no longer in Japan). S. haematobium is present in sub-Saharan Africa and in eastern Mediterranean areas.

Risk for travellers: In endemic areas, travellers are at risk to bilharzias while swimming or wading in fresh water.

Prophylaxis (protective treatment): None.

Precautions: Avoid direct contact (swimming or wading) with potentially contaminated fresh water in endemic areas. In case of accidental exposure, dry the skin vigorously to reduce penetration by cercariae. Avoid drinking, washing, or washing clothing in water that may contain cercariae. Water can be treated to remove or inactivate cercariae by paper filtering or use of iodine or chlorine. Source: WHO.

Rabies

Cause: The rabies virus, a rhabdovirus of the genus Lyssavirus.

Transmission: Rabies is a zoonotic disease affecting a wide range of domestic and wild animals, including bats. Infection of humans usually occurs through the bite of an infected animal. The virus is present in the saliva. Any other contact involving penetration of the skin occurring in an area where rabies is present should be treated with caution. In developing countries transmission is usually from dogs. Person-to-person transmission has not been documented.

Nature of the disease: An acute viral encephalomyelitis, which is almost invariably fatal. The initial signs include a sense of apprehension, headache, fever, malaise and sensory changes around the site of the animal bite. Excitability, hallucinations and aerophobia are common, followed in some cases by fear of water (hydrophobia) due to spasms of the swallowing muscles, progressing to delirium, convulsions and death a few days after onset. A less common form, paralytic rabies, is characterized by loss of sensation, weakness, pain and paralysis.

Geographical distribution: Rabies is present in animals in many countries worldwide. Most cases of human infection occur in developing countries.

Risk for travellers: In rabies-endemic areas, travellers may be at risk if there is contact with both wild and domestic animals, including dogs and cats.

Prophylaxis (protective treatment): Vaccination for travellers with a foreseeable significant risk of exposure to rabies or travelling to a hyperendemic area where modern rabies vaccine may not be available.

Precautions: Avoid contact with wild animals and stray domestic animals, particularly dogs and cats, in rabies-endemic areas. If bitten by an animal that is potentially infected with rabies, or after other suspect contact, immediately clean the wound thoroughly with disinfectant or with soap or detergent and water. Medical assistance should be sought immediately. The vaccination status of the animal involved should not be a criterion for withholding post-exposure treatment, unless the vaccination has been thoroughly documented and vaccine of known potency has been used. In the case of domestic animals, the suspect animal should be kept under observation for a period of 10 days.

Rabies post-exposure treatment: In a rabies-endemic area, the circumstances of an animal bite, other contact with the animal, and the animal's behaviour and appearance may suggest that it is rabid. In such situations, medical advice should be obtained immediately. Post-exposure treatment to prevent the establishment of rabies infection involves first-aid treatment of the wound followed by administration of rabies vaccine and antirabies immunoglobulin in the case of a bite or exchange of saliva. The administration of vaccine, and immunoglobulin if required, must be carried out, or directly supervised, by a physician. Source: WHO.

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause: Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission: The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease: Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution: The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission: Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases: Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution: Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers: For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis: There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions: Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment: Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Hepatitis A

Cause: Hepatitis A virus, a member of the picornavirus family.

Transmission: The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected).

Nature of the disease: An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60.

Geographical distribution: Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled.

Risk for travellers: Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control.

Prophylaxis (protective treatment): Vaccination.

Precautions: Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.

Cholera

Cause: Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission: Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease: An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution: Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers: The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment): Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions: As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Zambia National Tourist Board, Lusaka: +260 (0)1 229 087 or www.zambiatourism.com

Zambia Embassies

Zambian Embassy, Washington DC, United States: +1 202 265 9717.

Zambian High Commission, London, United Kingdom: +44 (0)20 7589 6655.

Zambian High Commission, Ottawa, Canada: +1 613 232 440.

Zambian High Commission, Tokyo, Japan (also responsible for Australia and New Zealand): +81 (0)3 3491 0121.

Zambian High Commission, Pretoria, South Africa: +27 (0)12 326 1854.

Foreign Embassies in Zambia

United States Embassy, Lusaka: +260 (0)1 250 955.

British High Commission, Lusaka: +260 (0)1 251 133.

Canadian High Commission, Lusaka: +260 (0)1 250 833.

Australian High Commission, Harare, Zimbabwe (also responsible for Zambia): +263 (0)4 852 471.

South African High Commission, Lusaka: +260 (0)1 260 999.

Irish Embassy, Lusaka: +260 (0)1 291 298.

New Zealand High Commission, Pretoria, South Africa (also responsible for Zambia): +27 (0)12 342 8656/7/8/9.

Zambia Emergency Numbers

Emergencies: 999

Airports

Lusaka International Airport (LUN)

Location: The airport is situated 16 miles (27km) east of Lusaka.

Time: GMT+2. Contacts: Tel: +260 (0)1 271 044, (0)1 271 313.

Transfer to the city: There is an airport bus service, and taxis are available.

Car rental: Most major car hire companies are represented at the airport terminal. Cars are usually hired with a chauffeur.

Facilities: The airport has a bank with bureau de change, a post office, restaurant, bar, duty-free shop, chemist, newsagent and a VIP lounge. A tourist help desk and travel agent can also be found in the airport terminal building, as well as a business centre.

Parking: Departure Tax: US$25 (may be included in ticket).

Climate

Zambia is warm all year round, but has three distinct seasons. Between December and April the weather is hot and wet; from May to August it is cooler and dry; between September and November conditions are hot and dry. Average summer temperatures range between 77°F to 95°F (25°C to 35°C), while in winter the variation increases ranging from 43°F to 75°F (6°C to 24°C).

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: United States citizens must obtain a visa to visit Zambia. It can be issued on arrival and is valid for the period of stay. A valid passport is also required for entry to Zambia.

Entry requirements for UK nationals: British citizens require a valid passport and a visa to visit Zambia. Visas may be purchased at the port of entry, and will be valid for the period of stay, although it is often best to organise one in advance.

Entry requirements for Canadians: Canadians require a valid passport and a visa to enter Zambia. Visas may be obtained on arrival and are valid for the period of stay.

Entry requirements for Australians: Australians require a valid passport and a visa to enter Zambia. Visas can be obtained on arrival and are valid for the period of intended stay.

Entry requirements for South Africans: South Africans do not need a visa to visit Zambia for 90 days within a 12-month period, whether taken together or in sections. A valid passport is required.

Entry requirements for New Zealanders: New Zealand nationals require a valid passport and a visa, which can be issued on arrival. Visas are valid for length of stay.

Entry requirements for Irish nationals: Irish nationals require a valid passport, but a visa is not necessary for a period of 90 days in a 12-month period, whether taken at once or in sections.

Passport/Visa Note: A return ticket or proof of onward travel, all documents for next destination and proof of sufficient funds is required for all travellers. Visas issued on arrival vary in fee according to amount of entries and nationality. There is a special provision for day visitors coming across the border from Zimbabwe into Livingstone. For those nationalities requiring a visa for Zambia, a fee of US$10 is paid on arrival for a 'Day Tripper Visa' and is valid for a maximum stay of 24 hours.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Cameroon

Situated on the Gulf of Guinea, on the west coast of Africa, Cameroon is sandwiched between its powerful neighbour Nigeria to the north and Equatorial Guinea to the south.

The area was a German protectorate until after World War I when it was divided between the British and the French, with the French receiving the larger share and Britain controlling the northernmost strip along the Nigerian border. French Cameroon achieved independence in 1960 and the largely Christian southern third of British Cameroon voted to join the Republic of Cameroon the following year. The northern two-thirds of British Cameroon, mainly Muslim, eventually joined Nigeria.

Tourism is limited, but those who venture to Cameroon will find a nation of remarkable diversity, from its varying landscapes of tropical rainforests and beaches, mountains and desert, to its assortment of people and cultures. National parks and reserves lay claim to some of the richest flora and fauna in Africa. Southwest Cameroon is a mountainous region dominated by the highest mountain in West Africa, and Africa's highest active volcano, Mt Cameroon, which sits on the edge of the Gulf of Guinea and is a popular mountaineering destination.

On the coast there are beautiful beaches around Limbé and at Kribi while the north of the country boasts Cameroon's most famous national park, Waza National Park, with its huge numbers of elephant, giraffe, lion, antelope and birdlife (open from mid-November to mid-June). Yaoundé, the capital city situated on seven hills, has modern hotels, shops and markets, but it is Douala that is the biggest city and Cameroon's economic capital, positioned on the Wouri River a few miles from the coast.

Whether going to the cities, the beaches or exploring its natural resources, visitors to this land they call 'Africa in One Country' can be sure that they will be pleasantly welcomed by a people whose custom is to receive strangers as if they were friends, a country where hospitality is the golden rule.

The Basics

Time:

Local time is GMT +1.

Electricity:

Electrical current is 220 volts, 50Hz. Round two-pin attachment plugs are in use.

Language:

French and English are the official languages, although French is more commonly spoken and is the language of business. There are also numerous other African dialects.

Health:

A yellow fever vaccination certificate is required for all travellers older than one year of age to Cameroon. There is a risk of malaria throughout the country and prophylaxis is recommended for all travellers. Cholera outbreaks do occur in Cameroon, particularly between the months of December and June. Travellers should drink only boiled or bottled water. Medical facilities are very limited with frequent shortages of medication and outdated equipment; visitors should ensure they have comprehensive medical insurance, which includes emergency air evacuation. Doctors and hospitals generally expect immediate cash payment.

Tipping:

If service charges are not included then 10% is customary.

Customs:

Law requires that everyone carry identification at all times. It is forbidden to take photographs of ports, airports, government buildings and military sites. Homosexuality is illegal.

Communications:

The international dialling code for Cameroon is +237. The outgoing code is 00 followed by the relevant country code (e.g. 0027 for South Africa). City codes are not required. International phone calls can be made from CAMTEL offices. A GSM 900 network provides cellphone coverage mainly in Yaoundé, Malabo and the southwest of the country. Internet cafes are available in the main towns.

Duty Free:

Travellers to Cameroon do not have to pay duty on 400 cigarettes or 50 cigars or 5 packs tobacco; 1 bottle of alcohol; and 5 bottles perfume. Entry to the country with sporting guns has to be accompanied by a license

Health

A yellow fever vaccination certificate is required for all travellers older than one year of age to Cameroon. There is a risk of malaria throughout the country and prophylaxis is recommended for all travellers. Cholera outbreaks do occur in Cameroon, particularly between the months of December and June. Travellers should drink only boiled or bottled water. Medical facilities are very limited with frequent shortages of medication and outdated equipment; visitors should ensure they have comprehensive medical insurance, which includes emergency air evacuation. Doctors and hospitals generally expect immediate cash payment.

View information on diseases: Yellow fever, Typhoid fever, Schistosomiasis (bilharzia), Rabies, Meningococcal disease, Malaria, HIV/AIDS and Sexually Transmitted Diseases, Hepatitis B, Hepatitis A, Cholera

Yellow fever

Cause:

The yellow fever virus, an arbovirus of the Flavivirus genus.

Transmission:

Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours. Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes.

The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks.

Nature of the disease:

Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution:

The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported).

Risk for travellers:

Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas.
Prophylaxis (protective treatment):
Vaccination. In some countries, yellow fever vaccination is mandatory for visitors.

Precautions:

Avoid mosquito bites during the day as well as at night.

Endemic Countries:

The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

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Typhoid fever

Cause:

Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:

Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:

Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:

Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:

Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment):

Vaccination.

Precautions:

Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

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Schistosomiasis (bilharzia)

Cause:

Several species of parasitic blood flukes (trematodes), of which the most important are Schistosoma mansoni, S. japonicum and S. haematobium.

Transmission:

Infection with bilharzia occurs in fresh water containing larval forms (cercariae) of schistosomes, which develop in snails. The free-swimming larvae penetrate the skin of individuals swimming or wading in water. Snails become infected as a result of excretion of eggs in human urine or faeces.

Nature of the disease:

Chronic conditions in which adult flukes live for many years in the veins (mesenteric or vesical) of the host where they produce eggs, which cause damage to the organs in which they are deposited. The symptoms of bilharzias depend on the main target organs affected by the different species, with S. mansoni and S. japonicum causing hepatic and intestinal signs and S. haematobium causing urinary dysfunction. The larvae of some schistosomes of birds and other animals may penetrate human skin and cause a self-limiting dermatitis, "swimmers itch". These larvae are unable to develop in humans.

Geographical distribution:

S. mansoni occurs in many countries of sub-Saharan Africa, in the Arabian peninsula, and in Brazil, Suriname and Venezuela. S. japonicum is found in China, in parts of Indonesia, and in the Philippines (but no longer in Japan). S. haematobium is present in sub-Saharan Africa and in eastern Mediterranean areas.

Risk for travellers:

In endemic areas, travellers are at risk to bilharzias while swimming or wading in fresh water.
Prophylaxis (protective treatment):
None.

Precautions:

Avoid direct contact (swimming or wading) with potentially contaminated fresh water in endemic areas. In case of accidental exposure, dry the skin vigorously to reduce penetration by cercariae. Avoid drinking, washing, or washing clothing in water that may contain cercariae. Water can be treated to remove or inactivate cercariae by paper filtering or use of iodine or chlorine. Source: WHO.

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Rabies

Cause:

The rabies virus, a rhabdovirus of the genus Lyssavirus.

Transmission:

Rabies is a zoonotic disease affecting a wide range of domestic and wild animals, including bats. Infection of humans usually occurs through the bite of an infected animal. The virus is present in the saliva. Any other contact involving penetration of the skin occurring in an area where rabies is present should be treated with caution. In developing countries transmission is usually from dogs. Person-to-person transmission has not been documented.

Nature of the disease:

An acute viral encephalomyelitis, which is almost invariably fatal. The initial signs include a sense of apprehension, headache, fever, malaise and sensory changes around the site of the animal bite. Excitability, hallucinations and aerophobia are common, followed in some cases by fear of water (hydrophobia) due to spasms of the swallowing muscles, progressing to delirium, convulsions and death a few days after onset. A less common form, paralytic rabies, is characterized by loss of sensation, weakness, pain and paralysis.

Geographical distribution:

Rabies is present in animals in many countries worldwide. Most cases of human infection occur in developing countries.
Risk for travellers:
In rabies-endemic areas, travellers may be at risk if there is contact with both wild and domestic animals, including dogs and cats.

Prophylaxis (protective treatment):

Vaccination for travellers with a foreseeable significant risk of exposure to rabies or travelling to a hyperendemic area where modern rabies vaccine may not be available.

Precautions:

Avoid contact with wild animals and stray domestic animals, particularly dogs and cats, in rabies-endemic areas. If bitten by an animal that is potentially infected with rabies, or after other suspect contact, immediately clean the wound thoroughly with disinfectant or with soap or detergent and water. Medical assistance should be sought immediately. The vaccination status of the animal involved should not be a criterion for withholding post-exposure treatment, unless the vaccination has been thoroughly documented and vaccine of known potency has been used. In the case of domestic animals, the suspect animal should be kept under observation for a period of 10 days.

Rabies post-exposure treatment:

In a rabies-endemic area, the circumstances of an animal bite, other contact with the animal, and the animal's behaviour and appearance may suggest that it is rabid. In such situations, medical advice should be obtained immediately. Post-exposure treatment to prevent the establishment of rabies infection involves first-aid treatment of the wound followed by administration of rabies vaccine and antirabies immunoglobulin in the case of a bite or exchange of saliva. The administration of vaccine, and immunoglobulin if required, must be carried out, or directly supervised, by a physician. Source: WHO.

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Meningococcal disease

Cause:

The bacterium Neisseria meningitidis, of which 12 serogroups are known. Most cases of meningococcal disease are caused by serogroups A, B and C; less commonly, infection is caused by serogroups Y and W-135. Epidemics in Africa are usually caused by N. meningitidis type A.

Transmission:

occurs by direct person-to-person contact, including aerosol transmission and respiratory droplets from the nose and pharynx of infected persons, patients or carriers. There is no animal reservoir or insect vector.

Nature of the disease:

Most infections do not cause clinical disease. Many infected people become asymptomatic (i.e. cause no symptoms) carriers of the bacteria and serve as a reservoir and source of infection for others. In general, susceptibility to meningococcal disease decreases with age, although there is a small increase in risk in adolescents and young adults. Meningococcal meningitis has a sudden onset of intense headache, fever, nausea, vomiting, photophobia and stiff neck, plus various neurological signs. The disease is fatal in 5-10% of cases even with prompt antimicrobial treatment in good health care facilities; among individuals who survive, up to 20% have permanent neurological sequelae. Meningococcal septicaemia, in which there is rapid dissemination of bacteria in the bloodstream, is a less common form of meningococcal disease, characterized by circulatory collapse, haemorrhagic skin rash and high fatality rate.

Geographical distribution:

Sporadic cases are found worldwide. In temperate zones, most cases occur in the winter months. Localized outbreaks occur in enclosed crowded spaces (e.g. dormitories, military barracks). In sub-Saharan Africa, in a zone stretching across the continent from Senegal to Ethiopia (the African "meningitis belt"), large outbreaks and epidemics take place during the dry season (November-June).

Risk for travellers:

Generally low. However, the risk is considerable if travellers are in crowded conditions or take part in large population movements such as pilgrimages in the Sahel meningitis belt. Localized outbreaks occasionally occur among travellers (usually young adults) in camps or dormitories.

Prophylaxis (protective treatment):

Vaccination is available for N. meningitidis types A, C, Y and W-135.

Precautions:

Avoid overcrowding in confined spaces. Following close contact with a person suffering from meningococcal disease, medical advice should be sought regarding chemoprophylaxis. Source: WHO.

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Malaria

General considerations:

Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home.Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:

Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:

Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

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HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission:

Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases:

Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution:

Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers:

For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis:

There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions:

Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment:

Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

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Hepatitis B

Cause:

Hepatitis B virus (HBV), belonging to the Hepadnaviridae.

Transmission:

Hepatitis B is transmitted from person to person by contact with infected body fluids. Sexual contact is an important mode of transmission, but infection is also transmitted by transfusion of contaminated blood or blood products, or by use of contaminated needles or syringes for injections. There is also a potential risk of Hepatitis B transmission through other skin-penetrating procedures including acupuncture, piercing and tattooing. Perinatal transmission may occur from mother to baby. There is no insect vector or animal reservoir.

Nature of the disease:

Many HBV infections are asymptomatic (e.g. causes no symptoms) or cause mild symptoms, which are often unrecognised in adults. When clinical hepatitis results from infection, it has a gradual onset, with anorexia, abdominal discomfort, nausea, vomiting, arthralgia and rash, followed by the development of jaundice in some cases. In adults, about 1% of cases are fatal. Chronic HBV infection persists in a proportion of adults, some of whom later develop cirrhosis and/or liver cancer.

Geographical distribution:

Worldwide, but with differing levels of endemicity. In north America, Australia, northern and western Europe and New Zealand, prevalence of chronic HBV infection is relatively low (less than 2% of the general population).

Risk for travellers:

Negligible for those vaccinated against hepatitis B. Unvaccinated travellers are at risk if they have unprotected sex or use contaminated needles or syringes for injection, acupuncture, piercing or tattooing. An accident or medical emergency requiring blood transfusion may result in infection if the blood has not been screened for HBV. Travellers engaged in humanitarian relief activities may be exposed to infected blood or other body fluids in health care settings.

Prophylaxis (protective treatment):

Vaccination.

Precautions:

Adopt safe sexual practices and avoid the use of any potentially contaminated instruments for injection or other skin-piercing activity. Source: WHO.

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Hepatitis A

Cause:

Hepatitis A virus, a member of the picornavirus family.

Transmission:

The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected).

Nature of the disease:

An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60.

Geographical distribution:

Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled.

Risk for travellers:

Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control.

Prophylaxis (protective treatment):

Vaccination.

Precautions:

Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.

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Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:

An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:

As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

SOCATOUR Tourist Board, Yaoundé: +237 223 3219.

Cameroon Embassies

Cameroon Embassy, Washington DC, United States: +1 202 265 8790.

Cameroon High Commission, London, United Kingdom: +44 (0)20 7727 0771.
Cameroon High Commission, Ottawa, Canada: +1 613 236 1522.
Cameroon Consulate, Sydney, Australia: +61 (0)2 9989 8414.
Cameroon High Commission, Pretoria, South Africa: +27 (0)12 362 4731.

Foreign Embassies in Cameroon

United States Embassy, Yaoundé: +237 2220 1500.

British High Commission, Yaoundé: +237 2222 0545.
Canadian High Commission, Yaoundé (also responsible for Australia): +237 2223 2311.
South African High Commission, Yaoundé: +237 2220 0438.

Airports

Yaounde Nsimalen International Airport (NSI)

Location: The airport is situated 12 miles (20km) from Yaoundé.
Time: Local time is GMT +1.
Contacts: Tel: +237 223 3602.
Transfer to the city: There taxi services available to the city.
Car rental: Car rental is available at the airport.
Facilities: Facilities include a bank and currency exchange, restaurants, bars, post office, various shops and duty-free, a tourist help desk and a business centre.
Parking: Short and long-term parking is available.
Departure Tax: CFA 10,000 (international), CFA 500 (domestic).

Douala International Airport (DLA)

Location: The airport is situated six miles (10km) from Douala.
Time: Local time is GMT +1.
Contacts: Tel: +237 342 3630.
Transfer to the city: There taxi services available to the city.
Car rental: Car rental is available at the airport.
Facilities: Facilities include a bank, post office, shops, a restaurant and bar, and duty-free shopping. Warning: there is currently a scam with fraudsters claiming to operate from Douala airport selling puppies.
Departure Tax: CFA 10,000 (international), CFA 500 (domestic).

Climate

The climate varies according to the region. In the south, the dry season runs from November to February, the little rainy season from March to June and the big rains come between August and September. The average temperature is 79°F (26°C). The tropical coastal areas receive a lot of rain that can reach in excess of 30ft (9m). In the north the rainy season is spread out from May to the end of September, but receives very little over the year and drought is a way of life in the far north.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US nationals require a passport and a visa to enter Cameroon.

Entry requirements for UK nationals: UK nationals require a passport and a visa to enter Cameroon.

Entry requirements for Canadians: Canadians require a passport and a visa to enter Cameroon.

Entry requirements for Australians: Australians require a passport and a visa to enter Cameroon.

Entry requirements for South Africans: South Africans require a passport and a visa to enter Cameroon.

Entry requirements for New Zealanders: New Zealand nationals require a passport and a visa to enter Cameroon.

Entry requirements for Irish nationals: Irish nationals require a passport and a visa to enter Cameroon.

Passport/Visa Note: All travellers require confirmed onward or return tickets and all necessary documents for next destination. Visas on arrival can only be issued to those holding a prior approval from Le Delegue General de L'Immigration. All other visas must be acquired before travel to Cameroon.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Tanzania

The largest country in East Africa, Tanzania boasts the highest mountain on the continent, the exotic spice islands of historical Zanzibar, and the famous Serengeti National Park whose seemingly endless plains stage one of the greatest spectacles of animal behaviour, the annual migration of millions of wildebeest and zebra followed by their predators.

The Great Rift Valley gives rise to the unique geological formations found in the magnificent Ngorongoro Crater and Mt Kilimanjaro. It is also home to the world's largest game reserve, the Selous, covering an area larger than Switzerland.

Tanzania is richly endowed with many animal and bird species and offers some of the finest game viewing on the continent. Dar-es-Salaam is the largest city, a hustling, bustling and surprisingly scenic tropical seaport that is a common starting point for trips into the country.

A dusty safari into the vast wilderness is superbly complemented by time spent on the refreshing Zanzibar islands, with white palm-fringed beaches, beautiful coral gardens, and historic Stone Town - an exotic reminder of its days as a major spice and slave trade centre.

Tanzania is home to hundreds of different ethnic groups and cultures, from the red-clad herders of the Masai tribes on the Serengeti plains to the modestly veiled women of Zanzibar's Islamic Stone Town.

The warmth and smiling faces of its friendly people will touch the heart of every traveller.

The Basics

Time:

GMT +3.

Electricity:

230 volts AC, 50Hz. Rectangular or round three-pin plugs are used.

Language:

Swahili and English are the official languages. Several indigenous languages are also spoken.

Health:

Travellers are advised to take medical advice at least three weeks before leaving for Tanzania. Most visitors will need vaccinations for hepatitis A, typhoid, yellow fever and polio. Those arriving from an infected country are required to hold a yellow fever vaccination certificate. There is a risk of malaria all year and outbreaks of Rift Valley Fever occur; travellers should take precautions to avoid mosquito bites. Food prepared by unlicensed vendors should also be avoided, as meat and milk products from infected animals may not have been cooked thoroughly. Sleeping sickness is a risk in the game parks, including the Serengeti, and visitors should avoid bites by tsetse flies. There is a high prevalence of HIV/Aids. Cholera outbreaks are common throughout the country and visitors are advised to drink bottled or sterilised water only. Medical services are available in Dar-es-Salaam and other main towns, but facilities and supplies are limited; visitors with particular requirements should take their own medicines. Comprehensive medical insurance is advised.

Tipping:

Waiters in the better restaurants should be tipped around 10%. Guides, porters and cooks in the wildlife parks and on safari trips expect tips. The amount is discretionary according to standard of service and the number in your party.

Safety:

As in other East African countries, the threat from terrorism is high and visitors should be cautious in public places and tourist sites and hotels, particularly in Zanzibar's Stone Town. The area bordering Burundi should be avoided. Street crime is a problem in Tanzania, especially in Dar-es-Salaam where tourists should be alert and cautious. Lonely beaches and footpaths are often targeted; women are particularly vulnerable to attacks. Visitors should leave valuables in their hotel safe and not carry too much cash on them at any time. Armed crime is on the increase and there have been serious attacks on foreigners in Arusha and on Pemba Island. In February 2007 a party of tourists were also robbed by armed men near Ngorongoro Crater. Road accidents are common in Tanzania due to poor road and vehicle conditions, violation of traffic regulations and exhaustion among long-distance drivers. In the most recent accident, a bus travelling to the popular tourist town Arusha plunged off a bridge into the river after the driver lost control of the vehicle, killing at least 47 passengers.

Customs:

Visitors to Zanzibar should be aware that it is a predominantly Muslim area and a modest dress code, especially for women, should be respected when away from the beach and in public places. Topless sunbathing is a criminal offence. Smoking in public places is illegal.

Business:

Although Tanzanians come across as relaxed and friendly, it is important to observe certain formalities, especially with greetings. It is advisable to learn a few Swahili catch phrases when greeting, followed by a handshake. Women and men rarely shake hands in Swahili culture, however if the woman extends her hand, the man is obliged. Tanzanians are to be addressed as Mr., Mrs., and Ms, followed by the family name. Business dress is seldom very formal, however lightweight suits are recommended for formal occasions. Business hours are similar to Western countries, but a longer lunch break is taken during the hotter months, and business continues later in the evening from Monday to Friday.

Communications:

The international country dialling code for Tanzania, as well as Zanzibar, is +255. The outgoing code is 000, followed by the relevant country code (e.g. 00027 for South Africa). City/area codes are in use, e.g. (0)24 for Zanzibar and (0)22 for Dar-es-Salaam. International calls made from rural areas may have to go through the operator. Mobile phones work in the main urban areas and Zanzibar; the network operators use GSM 900 and 1800 networks. Travellers should contact their service provider to ensure they have international roaming. Avoid making telephone calls from hotels; they can charge as much as $10 per minute. Internet cafes are available in the main towns and resorts.

Duty Free:

Travellers to Tanzania do not have to pay duty on 250g tobacco or 200 cigarettes or 50 cigars; alcoholic beverages up to 1 bottle; and 473ml perfume. Restrictions apply to firearms, plants, plant products and fruits.

Health

Travellers are advised to take medical advice at least three weeks before leaving for Tanzania. Most visitors will need vaccinations for hepatitis A, typhoid, yellow fever and polio. Those arriving from an infected country are required to hold a yellow fever vaccination certificate. There is a risk of malaria all year and outbreaks of Rift Valley Fever occur; travellers should take precautions to avoid mosquito bites. Food prepared by unlicensed vendors should also be avoided, as meat and milk products from infected animals may not have been cooked thoroughly. Sleeping sickness is a risk in the game parks, including the Serengeti, and visitors should avoid bites by tsetse flies. There is a high prevalence of HIV/Aids. Cholera outbreaks are common throughout the country and visitors are advised to drink bottled or sterilised water only. Medical services are available in Dar-es-Salaam and other main towns, but facilities and supplies are limited; visitors with particular requirements should take their own medicines. Comprehensive medical insurance is advised.

View information on diseases: Yellow fever, Typhoid fever, African Sleeping Sickness, Malaria, HIV/AIDS and Sexually Transmitted Diseases, Hepatitis A, Cholera.

Yellow fever

Cause:

The yellow fever virus, an arbovirus of the Flavivirus genus. Transmission: Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours.

Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes.

The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks.

Nature of the disease:

Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution:

The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported). Risk for travellers: Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas. Prophylaxis (protective treatment): Vaccination. In some countries, yellow fever vaccination is mandatory for visitors. Precautions: Avoid mosquito bites during the day as well as at night.

Endemic Countries:

The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

Typhoid fever

Cause:

Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:

Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:

Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:

Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:

Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.
Prophylaxis (protective treatment):
Vaccination.

Precautions:

Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

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African Sleeping Sickness

Cause:

Protozoan parasites Trypanosoma brucei (T. b.) gambiense and T. b. rhodesiense.

Transmission:

Infection with African trypanosomiasis (sleeping sickness) occurs through the bite of infected tsetse flies. Humans are the main reservoir host for T. b. gambiense. Domestic cattle and wild animals, including antelopes, are the main animal reservoir of T. b. rhodesiense.

Nature of the disease:

T. b. gambiense causes a chronic illness with onset of symptoms after a prolonged incubation period of weeks or months. T. b. rhodesiense causes a more acute illness, with onset a few days or weeks after the infected bite; often, there is a striking inoculation chancre. Initial clinical signs include severe headache, insomnia, enlarged lymph nodes, anaemia and rash. In the late stage of the disease, there is progressive loss of weight and involvement of the central nervous system. Without treatment, the disease is invariably fatal.

Geographical distribution:

T. b. gambiense is present in foci in the tropical countries of western and central Africa. T. b. rhodesiense occurs in east Africa, extending south as far as Botswana.

Risk for travellers:

Travellers are at risk of African sleeping sickness in endemic regions if they visit rural areas for hunting, fishing, safari trips, sailing or other activities in remote areas.

Prophylaxis (protective treatment):

None.

Precautions:

Travellers should be aware of the risk in endemic areas and as far as possible avoid any contact with tsetse flies. However, bites are difficult to avoid because tsetse flies can bite through clothing. Travellers should be warned that tsetse flies bite during the day and are not repelled by available insect-repellent products. The bite is painful, which helps to identify its origin, and travellers should seek medical attention promptly if symptoms develop subsequently. Source: WHO.

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Malaria

General considerations:

Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:

Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:

Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

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HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission:

Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases:

Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution:

Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers:

For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis:

There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions:

Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment:

Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

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Hepatitis A

Cause:

Hepatitis A virus, a member of the picornavirus family.

Transmission:

The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected).

Nature of the disease:

An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60.

Geographical distribution:

Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled.

Risk for travellers:

Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control.

Prophylaxis (protective treatment):

Vaccination.

Precautions:

Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.

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Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:

An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:

As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Tanzanian Tourist Office: +255 (0)22 512 7671 (Dar es Salaam) or www.tanzaniatouristboard.com

Tanzania Embassies

Embassy of Tanzania, Washington DC, United States: +1 202 939 6125.

High Commission of Tanzania, London, United Kingdom (also responsible for Ireland): +44 (0)20 7569 1470.
High Commission of Tanzania, Ottawa, Canada: +1 613 232 1500.
High Commission for the United Republic of Tanzania, Tokyo, Japan (also responsible for Australia and New Zealand): +81 (0)3 3425 4531.
High Commission of Tanzania, Pretoria, South Africa: +27 (0)12 342 4371/93.

Foreign Embassies in Tanzania

United States Embassy, Dar-es-Salaam: +255 (0)22 266 8001.

British High Commission, Dar-es-Salaam: +255 (0)22 211 0101.
Canadian High Commission, Dar-es-Salaam (also responsible for Madagascar, Comoros and Seychelles): +255 (0)22 216 3300.
South African High Commission, Dar-es-Salaam: +255 (0)22 260 1800.
Irish Embassy, Dar-es-Salaam: +255 (0)22 260 2355.
The New Zealand High Commission, Pretoria, South Africa (also responsible for Tanzania): +27 (0)12 342 8656.

Tanzania Emergency Numbers

Emergencies: 112/999

Airports

Julius Nyerere International Airport (DAR)

Location: The airport is situated eight miles (13km) southwest of Dar-es-Salaam.
Time: Local time is GMT +3.
Contacts: Tel: +255 (0)22 284 4562/3/4/5.
Transfer to the city: Taxis, usually unmetered, are available and take between 20 minutes and an hour to reach the city centre depending on traffic. The price must be negotiated before leaving. Many hotels provide transport on request. A shuttle bus service meets all flights and can take travellers to the city centre for TZS 150.
Car rental: Local car hire companies operate at the airport.
Facilities: The airport has a post office, banks, a bureau de change, restaurants, cafeterias, bars, wireless Internet connection, Business Lounge, duty free shop, newsagent/tobacconist, pharmacy, gift shop, travel agent, and tourist help desk. Facilities are available for disabled travellers.
Parking: Departure Tax: US$ 30 for international flights and US$ 5 for domestic flights.

Climate

Ghana is a tropical country lying just north of the equator. The rainy season lasts from April to October in northern Ghana and from April to June and again from September to October in the south. Temperatures range from about 70°F to 90°F (21°C to 32°C) and the humidity is relatively high. The rest of the year is hot and dry with temperatures reaching up to 100°F (38°C). In most areas the temperatures are highest in March and lowest in August, after the rains. Variations between day and night temperatures are small.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: A visa is issued on arrival, and a passport valid for six months from date of entry is required.

Entry requirements for UK nationals: A visa is issued on arrival, and a passport valid for six months from date of entry is required.

Entry requirements for Canadians: A visa is issued on arrival, and a passport valid for six months from date of entry is required.

Entry requirements for Australians: A visa is issued on arrival, and a passport valid for six months from date of entry is required.

Entry requirements for South Africans: A visa is issued on arrival, and a passport valid for six months from date of entry is required.

Entry requirements for New Zealanders: A visa is issued on arrival, and a passport valid for six months from date of entry is required.

Entry requirements for Irish nationals: A Visitor's Pass is issued on arrival, and a passport valid for six months from date of entry is required.

Passport/Visa Note: All visitors entering Tanzania require a visa. Visitors may obtain a visa on arrival at Dar-es-Salaam or Zanzibar airports for US$50, payable in cash. All visitors also require proof of sufficient funds and should hold documentation for their return or onward journey. Passports should be valid for at least six months from date of entry. Those arriving from an infected country must hold a yellow fever vaccination certificate.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate

Volunteer Travel Guide Kenya

enya is the 'Land of the Lion King' and sits at the centre of the African safari experience, with an outstanding variety of wild animals and Big Five viewing opportunities. Although safaris are its greatest attraction, it is a country of great diversity with much more to offer than splendid wildlife. Essentially it is a place for outdoor living - the coast offers beaches and water-based activities, the mountains present a challenge to hikers and climbers, and the rolling savannahs are a game-viewers paradise.

The country sits astride the equator and offers fabulous scenery and a variety of tribal cultures. From its central location, the sacred peaks of Mt Kenya reign over a landscape primarily covered by grasslands and thorn trees, much of it enclosed within its many parks and reserves. To the west the spectacular Great Rift Valley is sprinkled with lakes teeming with a variety of birdlife, whose shores and surrounds are traversed by agricultural farmlands. To the east lies the promise of an idyllic beach holiday with the requisite white palm-fringed beaches and pristine coral reefs. Inhabiting the highlands and Rift Valley are two of the most well known of the numerous tribal cultures, the Kikuyu farmers and the tall, red-clad Masai cattle herders. The coast is home to ancient Swahili civilisations and old port towns that are rich in a history of exotic spice trading and fighting.

Kenya has a sophisticated tourism infrastructure, with two major cities controlling the majority of the tourism trade. Nairobi, the capital, is the safari and hiking hub, situated in the cool Central Highlands, while on the east coast the hot and humid trading port of Mombasa functions as the gateway to the resorts and pristine beaches of the area. Sadly the heavy influence of tourism has meant excessive prices for safaris, souvenirs and most activities of interest to foreigners, as well as the constant hassle by touts, guides and sellers to part with as much money as they can dupe the guilty traveller into spending.

Despite this, the people are friendly and visitors can choose to do as little or as much as they like, and the combination of wildlife, together with its beaches and mountains, make Kenya a fantastic holiday destination.

The Basics

Time:

Local time is GMT +3.

Electricity:

240 volts, 50Hz. UK-style square three-pin plugs are used.

Language:

English is the official language but Swahili is the national language, with 42 ethnic languages spoken.

Health:

Travellers should get the latest medical advice on inoculations and malaria prevention at least three weeks prior to departure. A malaria risk exists all year round, but more around Mombasa and the lower coastal areas than in Nairobi and on the high central plateau. Immunisation against yellow fever, polio and typhoid are usually recommended. A yellow fever certificate is required by anyone arriving from an infected area. Other risks include diarrhoeal diseases. Protection against bites from sandflies, mosquitoes and tsetse flies is the best prevention against malaria and dengue fever, as well as other insect-borne diseases, including Rift Valley fever, sleeping sickness, leishmaniasis and Chikungunya fever. AIDS is a serious problem in Kenya and the necessary precautions should be taken. Water is of variable quality and visitors are advised to drink bottled water. Cholera outbreaks occur frequently, and travellers should take care not to drink contaminated water and be cautious of food prepared by unlicensed roadside vendors. There are good medical facilities in Nairobi and Mombasa but health insurance is essential.

Tipping:

Tipping is not customary in Kenya, however a 10% service charge may be added to bill in more upmarket restaurants. Otherwise small change in local currency may be offered to taxi drivers, porters and waiters. On safari, however, drivers, guides and cooks often rely heavily on tips to get by, but these are discretionary.

Customs:

The taking of photographs of official buildings and embassies is not advised and could lead to detention. It is illegal to destroy Kenyan currency. The coastal towns are predominantly Muslim and religious customs and sensitivities should be respected, particularly during Ramadan; dress should be conservative away from the beaches and resorts, particularly for women. Homosexuality is against the law. Smoking in public places is illegal, other than in designated smoking areas, and violators will be fined or imprisoned.

Business:

Business in Kenya tends to be conducted formally and conservatively, with the appropriate formal attire of a jacket and tie. Punctuality is important. Business cards are exchanged and handshakes are standard. English is the principal language of business. Business hours are usually from 9am to 1pm and 2pm to 5pm Monday to Friday.

Communications:

The international access code for Kenya is +254. The outgoing code is 000 followed by the relevant country code (e.g. 00027 for South Africa), unless dialling Tanzania or Uganda when the outgoing codes are 007 or 006 respectively. City/area codes are in use, e.g. (0)41 for Mombasa and (0)20 for Nairobi. International Direct Dial is available throughout most of the country, but the service is expensive and inefficient. Hotels usually add a hefty surcharge to their telephone bills; it is less expensive to either call from one of the international phone services, which are available in larger towns or buy a pre-paid calling card for use in the public telephone booths. For international operator-assisted calls call 0196. All major urban areas are covered by the mobile network; the local mobile phone operators use GSM networks that have roaming agreements with most international mobile phone operators. Internet cafes are widely available in most towns and tourist areas.

Duty Free:

Travellers to Kenya over 16 years do not have to pay duty on 227g tobacco or 200 cigarettes or 50 cigars; 1 bottle of alcohol; and 473ml perfume. Prohibited items include fruit, imitation firearms, and children's toys pistols. No plants may be brought into the country without a Plant Import Permit (PIP).

Health

Travellers should get the latest medical advice on inoculations and malaria prevention at least three weeks prior to departure. A malaria risk exists all year round, but more around Mombasa and the lower coastal areas than in Nairobi and on the high central plateau. Immunisation against yellow fever, polio and typhoid are usually recommended. A yellow fever certificate is required by anyone arriving from an infected area. Other risks include diarrhoeal diseases. Protection against bites from sandflies, mosquitoes and tsetse flies is the best prevention against malaria and dengue fever, as well as other insect-borne diseases, including Rift Valley fever, sleeping sickness, leishmaniasis and Chikungunya fever. AIDS is a serious problem in Kenya and the necessary precautions should be taken. Water is of variable quality and visitors are advised to drink bottled water. Cholera outbreaks occur frequently, and travellers should take care not to drink contaminated water and be cautious of food prepared by unlicensed roadside vendors. There are good medical facilities in Nairobi and Mombasa but health insurance is essential.

View information on diseases: Yellow fever, Typhoid fever, African Sleeping Sickness, Malaria, Leishmaniasis, HIV/AIDS and Sexually Transmitted Diseases, Dengue Fever, Cholera

Yellow fever

Cause:

The yellow fever virus, an arbovirus of the Flavivirus genus.

Transmission:

Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours. Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes. The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks.

Nature of the disease:

Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution:

The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported).

Risk for travellers:

Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas.

Prophylaxis (protective treatment):

Vaccination. In some countries, yellow fever vaccination is mandatory for visitors.

Precautions:

Avoid mosquito bites during the day as well as at night.

Endemic Countries:

The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

Typhoid fever

Cause:

Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:

Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:

Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:

Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:

Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

African Sleeping Sickness

Cause:

Protozoan parasites Trypanosoma brucei (T. b.) gambiense and T. b. rhodesiense.

Transmission:

Infection with African trypanosomiasis (sleeping sickness) occurs through the bite of infected tsetse flies. Humans are the main reservoir host for T. b. gambiense. Domestic cattle and wild animals, including antelopes, are the main animal reservoir of T. b. rhodesiense.

Nature of the disease:

T. b. gambiense causes a chronic illness with onset of symptoms after a prolonged incubation period of weeks or months. T. b. rhodesiense causes a more acute illness, with onset a few days or weeks after the infected bite; often, there is a striking inoculation chancre. Initial clinical signs include severe headache, insomnia, enlarged lymph nodes, anaemia and rash. In the late stage of the disease, there is progressive loss of weight and involvement of the central nervous system. Without treatment, the disease is invariably fatal.

Geographical distribution:

T. b. gambiense is present in foci in the tropical countries of western and central Africa. T. b. rhodesiense occurs in east Africa, extending south as far as Botswana.

Risk for travellers:

Travellers are at risk of African sleeping sickness in endemic regions if they visit rural areas for hunting, fishing, safari trips, sailing or other activities in remote areas.

Prophylaxis (protective treatment):

None.

Precautions:

Travellers should be aware of the risk in endemic areas and as far as possible avoid any contact with tsetse flies. However, bites are difficult to avoid because tsetse flies can bite through clothing. Travellers should be warned that tsetse flies bite during the day and are not repelled by available insect-repellent products. The bite is painful, which helps to identify its origin, and travellers should seek medical attention promptly if symptoms develop subsequently. Source: WHO.

Malaria

General considerations:

Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year.

Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:

Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:

Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

Leishmaniasis

Cause:

There are several species of the protozoan parasite Leishmania, including espundia or oriental sore, and kala-azar.

Transmission:

Infection is transmitted by the bite of female phlebotomine sandflies. Dogs, rodents and other mammals are reservoir hosts for leishmaniasis. Sandflies acquire the parasites by biting infected humans or animals.Transmission is also possible from person to person by injected blood or contaminated syringes and needles is also possible.

Nature of the disease:

Leishmaniasis occurs in two main forms: Cutaneous and mucosal leishmaniasis (espundia) cause skin sores and chronic ulcers of the mucosae. Cutaneous leishmaniasis is a chronic, progressive, disabling and often mutilating disease. Visceral leishmaniasis (kala-azar) affects the bone marrow, liver, spleen, lymph nodes and other internal organs. It is usually fatal if untreated.

Geographical distribution:

Many countries in tropical and subtropical regions, including Africa, parts of central and south America, Asia, southern Europe and the eastern Mediterranean. Over 90% of all cases of visceral leishmaniasis occur in Bangladesh, Brazil, India, Nepal and Sudan. More than 90% of all cases of cutaneous leishmaniasis occur in Afghanistan, Algeria, Brazil, the Islamic Republic of Iran, Saudi Arabia and the Syrian Arab Republic.

Risk for travellers:

Generally low. Visitors to rural and forested areas in endemic countries are at risk.

Prophylaxis (protective treatment):

None.

Precautions:

Avoid sandfly bites, particularly after sunset, by using repellents and insecticide-impregnated bednets. The bite leaves a non-swollen red ring, which can alert the traveller to its origin. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission:

Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases:

Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution:

Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers:

For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis:

There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions:

Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment:

Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Dengue Fever

Cause:

The dengue virus - a flavivirus of which there are four serotypes.

Transmission:

Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease:

Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution:

Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet).

Risk for travellers:

There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.

Prophylaxis (protective treatment):

None.

Precautions:

Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:

An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:

As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Kenyan Tourist Board: +254 (0)20 271 1262 or www.magicalkenya.com

Kenya Embassies

Kenyan Embassy, Washington DC, United States: +1 202 387 6101.

Kenyan High Commission, London, United Kingdom (also responsible for Ireland): +44 (0)20 7636 2371.
Kenyan High Commission, Ottawa, Canada: +1 613 563 1773.
Kenyan High Commission, Canberra, Australia (also responsible for New Zealand): +61 (0)2 6247 4788.
Kenyan High Commission, Pretoria, South Africa: +27 (0)12 362 2249/50/51.

Foreign Embassies in Kenya

United States Embassy, Nairobi: +254 (0)20 363 6000.

British High Commission, Nairobi: +254 (0)20 284 4000.
Canadian High Commission, Nairobi: +254 (0)20 366 3000.
Australian High Commission, Nairobi: +254 (0)20 444 5034/9.
South African High Commission, Nairobi: +254 (0)20 282 7100.
Honorary Consul of Ireland, Nairobi: +254 (0)20 556 647.
New Zealand Consulate, Nairobi: +254 (0)20 271 2466.

Kenya Emergency Numbers

Emergencies: 999.

Airports

Moi International Airport (MBA)

Location: The airport is situated six miles (10km) north west of Mombasa.

Time: GMT +3.

Contacts: Tel: +254 (0)41 433 211.

Transfer to the city: Public buses go regularly to the city centre, but most travellers take a taxi or arrange to be picked up by their hotel or tour operator.

Car rental: Avis, Europcar and Hertz are represented at the airport.

Facilities: Facilities at the airport are fairly limited by international standards but include left luggage, disabled facilities, first aid, banks, a bureau de change, bars, a restaurant, duty-free, a post office, curio shops, tourist information and hotel reservations.

Parking: Short- and long-term parking is available.

Departure Tax: US$20, but this is usually included in the ticket price.

Website: www.kenyaairports.co.ke

Jomo Kenyatta International Airport (NBO)

Location: The airport is situated 10 miles (16km) south east of Nairobi.

Time: GMT +3.

Contacts: Tel: +254 (0)20 822 111

Transfer to the city: The KBS bus service 34 leaves fairly regularly for the city centre; most travellers however take a taxi or arrange to be picked up by their hotel or tour operator. The Mercedes taxis take passengers to the central city hotels for a fixed fare.

Car rental: Avis, Europcar and Hertz, among others, are represented at the airport.

Facilities: The facilities at the airport are fairly limited, but include a bank and bureau de change, left luggage, telephones and fax, medical aid, a bar and restaurant, duty-free shops selling curios, a post office, tourist information and hotel reservations. There are disabled facilities, but passengers should advise their airline in advance of any special needs.

Parking: Short- and long-term parking is available.

Departure Tax: US$20, but this is usually included in the ticket price.

Website: www.kenyaairports.co.ke

Climate

Situated at a high altitude, Nairobi has a moderate climate. The summer months are sunny and warm without blistering temperatures, while winters are mild to cool, with very chilly evenings. Rainfall is also moderate, the wettest part of the year being late summer to autumn, when cloudy, drizzly days are common.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: United States citizens require a valid passport and a visa.

Entry requirements for UK nationals: British citizens require a valid passport and a visa.

Entry requirements for Canadians: Canadians require a valid passport and a visa.

Entry requirements for Australians: Australians require a valid passport and a visa.

Entry requirements for South Africans: South Africans must have a valid passport. No visa is required for a stay of up to three months.

Entry requirements for New Zealanders: New Zealand citizens require a valid passport and a visa.

Entry requirements for Irish nationals: Irish nationals require a valid passport and a visa.

Passport/Visa Note: Visas can be obtained by most nationalities on arrival for a fee of US$50, which is valid for a period of three months and must be paid in a convertible currency. This may result in passenger delays and it is preferable to arrange a visa in the country of origin. Required by all passengers are onward or return tickets, documents needed for next destination and sufficient funds for length of intended stay (at least US$500). Passports must be valid for at least the period of stay.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Uganda

A small, landlocked country straddling the equator between Kenya and the DRC in Eastern Africa, Uganda is one of the continent's most beautiful countries, boasting a wide variety of scenery, culture and wildlife despite its modest size.

Its reputation as 'Africa's friendliest country' is not only accredited to its likeable people, but also to its redevelopment as an eco-friendly environment, with the enlightened management of 10 national parks, and its introduction of eco-tourism projects, adventure sports and unique gorilla-trekking opportunities that have put the country back on the tourist circuit.

Not only is Uganda progressive in its development as an environment-friendly destination, but its approach towards HIV/AIDS has been hailed as the most effective in sub-Saharan Africa. After years of misrule, hardship and war under Idi Amin, Uganda is once again receiving positive global interest due to its forward-thinking policies and wealth of tourist attractions. The hardship and war have not been forgotten by the people, but they are memories confined to the past.

Uganda's variety of landscapes is as astounding as its biodiversity. Forested crater lakes on the floor of the Rift Valley give way to typical East African savannah as well as tropical rainforest. The glacial peaks of the highest mountain range in Africa, the 'Mountains of the Moon' or Rwenzori Mountains that mark the country's western border, as well as a number of extinct volcanoes make for world-class hiking and mountaineering.

There are several large bodies of water, including the massive Lake Victoria, which it shares with Tanzania and Kenya, and the myriad islands dotting Lake Victoria and Lake Bunyoni are ideal birdwatching destinations. Lake Victoria is also the source of the Nile, the longest river in the world, which passes through the impressive Murchison's Falls and creates some of the most exciting white water rafting on earth.

What also makes Uganda a unique safari destination is its remarkable concentration of primates, which is the highest on earth, and people are drawn from around the world to track chimpanzees and to experience the face to face encounter of a lifetime: that with a massive mountain gorilla.

The Basics

Time:

Local time is GMT +3.

Electricity:

Electrical current is 220 volts, 50Hz. Three-pin, rectangular blade plugs are in use.

Language:

English is the official national language. Luganda is also widely spoken and is the most common of the numerous indigenous languages.

Getting around:

Buses connect all major towns daily. Minibuses and shared taxis are a good way of getting around and are the most commonly used by Ugandans - they are frequent, have fixed fares and leave when full. A few airlines offer scheduled and charter flights within the country; some places can only safely be reached by air. Cars can be rented from Entebbe Airport, Kampala and other major towns.

Health:

Travellers' diarrhoea is the most common complaint for visitors to Uganda. Recommended vaccinations include hepatitis A and typhoid; a Hepatitis E outbreak in northern Uganda since the end of 2007 has killed over 60 people so far and infected thousands more, and visitors are advised to take precautions if visiting the area. All visitors require vaccination against yellow fever. Cholera outbreaks occur occasionally, but most travellers are at low risk for infection; bottled water is widely available. Malaria and HIV/AIDS are widespread. Outbreaks of the plague and meningitis occur and visitors should insure that vaccinations are up to date. A recent outbreak of Ebola has killed 37 people in western Uganda; it is spread through direct contact with blood or secretions of an infected person. Incidents of sleeping sickness are on the rise, carried by tsetse flies. Limited health facilities are available outside of Kampala. Comprehensive medical insurance is advised.

Tipping:

At local hotels and restaurants, tipping is not common, but tips of 5-10% are expected at tourist-orientated establishments. It is customary to tip guides and drivers.

Customs:

Visitors are advised not to take photographs of military or official sites, including Owen Falls Dam.Homosexual practices are frowned upon.

Business:

Uganda has one of the fastest growing economies and is one of the most liberal countries in Africa. Agriculture is the largest sector of the economy and coffee the chief export. Uganda is most welcoming for foreign investment and business is steadily on the increase. Appointments should always be made prior to business meetings. Formal dress attire is to be observed, and the shaking of hands is expected on introduction. Business is usually conducted in English. Business hours are generally 8am to 5pm Monday to Friday with an hour taken over lunch.

Communications:

The international dialling code for Uganda is +256. The outgoing code is 000 followed by the relevant country code (e.g. 00027 for South Africa). City/area codes are in use, e.g. (0)41 for Kampala.There is extensive cellular telephone network coverage over most of the country with GSM 900, and Internet facilities are available in most large towns.

Duty Free:

Travellers to Uganda over 17 years of age do not have to pay duty on 200 cigarettes or 227g tobacco, or a combination of 227g tobacco products; 1 bottle of wine or spirits; and 500ml of perfume or eau de toilette.

Health

Travellers' diarrhoea is the most common complaint for visitors to Uganda. Recommended vaccinations include hepatitis A and typhoid; a Hepatitis E outbreak in northern Uganda since the end of 2007 has killed over 60 people so far and infected thousands more, and visitors are advised to take precautions if visiting the area. All visitors require vaccination against yellow fever. Cholera outbreaks occur occasionally, but most travellers are at low risk for infection; bottled water is widely available. Malaria and HIV/AIDS are widespread. Outbreaks of the plague and meningitis occur and visitors should insure that vaccinations are up to date. A recent outbreak of Ebola has killed 37 people in western Uganda; it is spread through direct contact with blood or secretions of an infected person. Incidents of sleeping sickness are on the rise, carried by tsetse flies. Limited health facilities are available outside of Kampala. Comprehensive medical insurance is advised.

View information on diseases:Typhoid fever, Plague, Meningococcal disease, Malaria, HIV/AIDS and Sexually Transmitted Diseases, Hepatitis E, Hepatitis A, Cholera, Yellow fever

Typhoid fever

Cause:

Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:

Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:

Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:

Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:

Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

Plague

Cause:

The plague bacillus, Yersinia pestis.

Transmission:

Plague is a zoonotic disease affecting rodents and transmitted by fleas from rodents to other animals and to humans. Direct person-to-person transmission does not occur except in the case of pneumonic plague, when respiratory droplets may transfer the infection from the patient to others in close contact.

Nature of the disease:

Plague occurs in three main clinical forms: Bubonic plague is the form that usually results from the bite of infected fleas. Lymphadenitis develops in the drainage lymph nodes, with the regional lymph nodes most commonly affected. Swelling, pain and suppuration of the lymph nodes produces the characteristic plague buboes. Septicaemic plague may develop from bubonic plague or occur in the absence of lymphadenitis. Dissemination of the infection in the bloodstream results in meningitis, endotoxic shock and disseminated intravascular coagulation. Pneumonic plague may result from secondary infection of the lungs following dissemination of plague bacilli from other body sites. It produces severe pneumonia. Direct infection of others may result from transfer of infection by respiratory droplets, causing primary pulmonary plague in the recipients. Without prompt and effective treatment, 50-60% of cases of bubonic plague are fatal, while untreated septicaemic and pneumonic plague are invariably fatal.

Geographical distribution:

There are natural foci of plague infection of rodents in many parts of the world. Wild rodent plague is present in central, eastern and southern Africa, south America, the western part of north America and in large areas of Asia. In some areas, contact between wild and domestic rats is common, resulting in sporadic cases of human plague and occasional outbreaks.

Risk for travellers:

Generally low. However, travellers in rural areas of plague-endemic regions may be at risk, particularly if camping or hunting or if contact with rodents takes place.

Prophylaxis (protective treatment):

A vaccine effective against bubonic plague is available exclusively for persons with a high occupational exposure to plague; it is not commercially available in most countries.

Precautions:

Avoid any contact with live or dead rodents. Source: WHO.

Meningococcal disease

Cause:

The bacterium Neisseria meningitidis, of which 12 serogroups are known. Most cases of meningococcal disease are caused by serogroups A, B and C; less commonly, infection is caused by serogroups Y and W-135. Epidemics in Africa are usually caused by N. meningitidis type A.

Transmission:

occurs by direct person-to-person contact, including aerosol transmission and respiratory droplets from the nose and pharynx of infected persons, patients or carriers. There is no animal reservoir or insect vector.

Nature of the disease:

Most infections do not cause clinical disease. Many infected people become asymptomatic (i.e. cause no symptoms) carriers of the bacteria and serve as a reservoir and source of infection for others. In general, susceptibility to meningococcal disease decreases with age, although there is a small increase in risk in adolescents and young adults. Meningococcal meningitis has a sudden onset of intense headache, fever, nausea, vomiting, photophobia and stiff neck, plus various neurological signs. The disease is fatal in 5-10% of cases even with prompt antimicrobial treatment in good health care facilities; among individuals who survive, up to 20% have permanent neurological sequelae. Meningococcal septicaemia, in which there is rapid dissemination of bacteria in the bloodstream, is a less common form of meningococcal disease, characterized by circulatory collapse, haemorrhagic skin rash and high fatality rate.

Geographical distribution:

Sporadic cases are found worldwide. In temperate zones, most cases occur in the winter months. Localized outbreaks occur in enclosed crowded spaces (e.g. dormitories, military barracks). In sub-Saharan Africa, in a zone stretching across the continent from Senegal to Ethiopia (the African "meningitis belt"), large outbreaks and epidemics take place during the dry season (November-June).

Risk for travellers:

Generally low. However, the risk is considerable if travellers are in crowded conditions or take part in large population movements such as pilgrimages in the Sahel meningitis belt. Localized outbreaks occasionally occur among travellers (usually young adults) in camps or dormitories.

Prophylaxis (protective treatment):

Vaccination is available for N. meningitidis types A, C, Y and W-135.

Precautions:

Avoid overcrowding in confined spaces. Following close contact with a person suffering from meningococcal disease, medical advice should be sought regarding chemoprophylaxis. Source: WHO.

Malaria

General considerations:

Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:

Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:

Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission:

Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases:

Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution:

Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers:

For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis:

There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions:

Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment:

Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Hepatitis E

Cause:

Hepatitis E virus, which has not yet been definitively classified (formerly classified as Caliciviridae).

Transmission:

Hepatitis E is a waterborne disease usually acquired from contaminated drinking water. Direct faecal-oral transmission from person to person is also possible. There is no insect vector. It is suspected, but not proved, that hepatitis E may have a domestic animal reservoir host, such as pigs.

Nature of the disease:

The clinical features and course of the disease are generally similar to those of hepatitis A. As with hepatitis A, there is no chronic phase. Young adults are most commonly affected. In pregnant women there is an important difference between hepatitis E and hepatitis A: during the third trimester of pregnancy, hepatitis E takes a much more severe form with a case-fatality rate reaching 20%.

Geographical distribution:

Worldwide. Most cases, both sporadic and epidemic, occur in countries with poor standards of hygiene and sanitation.

Risk for travellers:

Travellers to developing countries may be at risk of hepatitis E when exposed to poor conditions of sanitation and drinking water control.

Prophylaxis (protective treatment):

None.

Precautions:

Travellers should follow the general conditions for avoiding potentially contaminated food and drinking-water. Source: WHO.

Hepatitis A

Cause:

Hepatitis A virus, a member of the picornavirus family.

Transmission:

The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected).

Nature of the disease:

An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60.

Geographical distribution:

Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled.

Risk for travellers:

Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control.

Prophylaxis (protective treatment):

Vaccination.

Precautions:

Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.

Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:

Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:

An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:

As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Yellow fever

Cause:

The yellow fever virus, an arbovirus of the Flavivirus genus.

Transmission:

Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours. Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes. The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks.

Nature of the disease:

Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution:

The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported).

Risk for travellers:

Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas.

Prophylaxis (protective treatment):

Vaccination. In some countries, yellow fever vaccination is mandatory for visitors.

Precautions:

Avoid mosquito bites during the day as well as at night.

Endemic Countries:

The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Uganda Tourist Board, Kampala: +256 (0)41 342 196 or www.visituganda.com

Uganda Embassies

Uganda Embassy, Washington DC, United States: +1 202 726 7100.

Uganda High Commission, London, United Kingdom (also responsible for Ireland): +44 (0)20 7839 5783.
Uganda High Commission, Ottawa, Canada: +1 613 789 7797.
Uganda High Commission, ACT, Australia (also responsible for New Zealand): +61 (0)2 6286 1234.
Uganda High Commission, Pretoria, South Africa: +27 (0)12 342 6031/3.

Foreign Embassies in Uganda

United States Embassy, Kampala: +256 (0)41 259 791/2/3.

British High Commission, Kampala: +256 (0)31 231 2000.
Canadian High Commission, Nairobi, Kenya (also responsible for Uganda): +254 (0)20 366 3000.
Australian High Commission, Nairobi, Kenya (also responsible for Uganda): +254 (20) 444 5034-9.
South African High Commission, Kampala: +256 (0)41 434 3543.
Ireland Embassy, Kampala: +256 (0)41 434 0400.

Uganda Emergency Numbers

Emergencies: 999

Airports

Entebbe International Airport (EBB)

Location: The airport is situated 25 miles (40km) southwest of Kampala.

Time: Local time is GMT +3.

Contacts: Tel: +256 (0)41 353000 or 3323.

Transfer to the city: Airport taxis provide a direct, fixed-rate service to Kampala for US$25. Shuttle buses operate a service to Kampala Sheraton and other major hotels. Small commuter buses identified by a blue square or band, are cheap and run between the airport and Entebbe (2 miles/4km), and Entebbe and Kampala (journey time: one hour).

Car rental: Hertz and other local car rental companies operate at the airport. Chauffeur-driven cars can also be hired at the airport.

Facilities: Facilities include bars and restaurants, duty-free shopping, craft and gift shops, a business communication centre, and tourist information desk. Public payphones are located in departures and arrivals, and cellular telephone services are also available. There are 24-hour banks and bureaux de change at both departure and arrivals halls.

Parking:
Departure Tax: None.
Website: www.caa.co.ug

Climate

Uganda has a typically tropical climate with little variation in temperature throughout the year. Distinctive wet and dry seasons characterise the climate of most of the country, except in the semi-arid north east. The dry season, generally from December to February and mid-June to mid-August, is the best time to visit. The two rainy seasons are from March to May, and September to November. In the south the rainiest month is April. The mountainous areas in western and eastern Uganda can be cold at night.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US nationals require a valid passport and a visa, which can be obtained on arrival.

Entry requirements for UK nationals: UK nationals require a valid passport and a visa, which can be obtained on arrival.

Entry requirements for Canadians: Canadians require a valid passport and a visa, which can be obtained on arrival.

Entry requirements for Australians: Australians require a valid passport and a visa, which can be obtained on arrival.

Entry requirements for South Africans: South Africans require a valid passport and a visa, which can be obtained on arrival.

Entry requirements for New Zealanders: New Zealand nationals require a valid passport and a visa, which can be obtained on arrival.

Entry requirements for Irish nationals: Irish nationals require a valid passport, but no visa is necessary for a stay of up to six months.

Passport/Visa Note: All visitors require a passport that is valid for at least six months on entry. Visitors must hold return or onward tickets, and sufficient funds. All nationals can obtain a visa on arrival at a cost of US$50 (single entry), US$100 (multiple entry with six months validity) or US$200 (multiple entry with 1 year validity).

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Ghana

Formerly a British colony known as the Gold Coast, Ghana was the first black African nation to achieve independence in 1957. It is a relatively small country on the West coast of Africa situated between Togo and Côte d'Ivoire and remains a somewhat unexplored tropical gem, an untapped destination that abounds in history, culture, wildlife and scenery with a wide variety of tourist attractions. And throughout its 10 regions visitors will be greeted with the warm-hearted smiles of its welcoming people.

Nature has been extremely generous to Ghana with its national parks and reserves providing a sanctuary for the native flora and fauna; the grasslands of Mole National Park in the north are home to a variety of large animals, while birds and butterflies are particularly numerous in Ghana's forests.

Rainforests such as that of Kakum National Park in the southern central region, with its canopy walkway and nature trails, provide a haven for eco-tourists. Miles of unspoilt beaches, waterfalls, rolling forested hills, rivers and lakes complete the portrait of a country that is a nature lover's delight.

The diverse ethnic groups of Ghana and the ancient traditions of its people have shaped one of the richest cultural environments in Africa that boasts festivals, dance and music as well as a colourful dress and a wide variety of arts and crafts.

The traditional and cultural heartland of the country is the Ashanti region, home to the nation's dominant tribe, the Ashanti, who are most famous today for their craftwork and ancient artistry in fabrics, particularly the colourful kente cloth.

Ghana's vibrant capital city, Accra, is the gateway to the country and is located in the smallest, yet most populated region on the Gulf of Guinea. The modern city has excellent accommodation, restaurants and nightlife, colourful markets, and is a good base from which to explore the Atlantic coast west of Accra, which boasts many fine palm-fringed beaches, resorts, ancient forts, castles, and fascinating fishing villages.

The forts and castles along the coastline date back to the 15th century and have an intriguing history of European occupation, fierce battles and slavery. The Cape Coast Castle, Fort St Jago and Elim Castle are recognised as UNESCO World Heritage Monuments.

The Basics

Time:

Local time is GMT.

Electricity:

Electrical current is 220 volts, 50 Hz. Both round and flat three-pronged plugs are most commonly used.

Language:

English is the official language, but many other African languages are spoken including Twi, Fante, Ga, Ewe, Hausa and Dagbani.

Health:

Visitors must be in possession of a current medical vaccination certificate for yellow fever. Prophylactics against malaria are recommended and waterborne diseases are prevalent, including outbreaks of cholera during the rainy season. Visitors are advised to buy bottled drinking water, which is widely available. Bird flu has been confirmed in Ghana, but the risk to visitors is considered to be very low; as a precaution it is advisable to avoid close contact with live birds and ensure all poultry products are well cooked. Good medical facilities are found in all the cities and major towns, but facilities outside urban areas are poor and emergency services are limited. Medical insurance is advised and should cover medical evacuation.

Tipping:

Service charge is rarely added to restaurant bills and tipping for quality service is only expected in restaurants (usually about 10%). For other services tipping is discretionary.

Safety:

Most visits to Ghana are trouble-free, but it is wise to be vigilant in public areas particularly in and around Accra and to avoid travelling in taxis alone after dark if possible. Visitors should avoid carrying large sums of cash or valuables on them and to be vigilant when drawing money from ATMs in central Accra. Theft of luggage and travel documents has occurred at Kotoka International Airport. Visitors should also be vigilant in and around Tamale and Kumasi where there has been an increase in crime including muggings and attacks on foreigners. There is a potential for outbreaks of violence between rival political factions, fighting between inter-ethnic groups and civil unrest; travellers are advised to stay up to date with daily developments. Visitors to the Northern Region should be alert to the possibility of renewed outbreaks of inter-ethnic fighting.

Customs:

Ghanaians are generally a conservative people and visitors should respect local customs, traditional courtesies and dress codes, particularly in the villages. Ghanaians do most things with their right hand; eating, touching food, taking and receiving things, waving, shaking hands etc.

The left hand is used for 'dirty things' and it is regarded as rude to use the left hand for the aforementioned things. If in doubt, use the right hand. Homosexuality is illegal. Greeting is an important social function and handshakes are common. No civilian may wear camouflage clothing as it is reserved for the military. Visitors to remote villages, shrines or palaces should visit the local elder or priest and take a small gift such as a bottle of local schnapps, gin or money. Always seek permission before taking photographs of people; it is not permitted to take photographs of military institutions or the airport.

Business:

Ghana is a very relaxed and friendly country, however in business, a formal dress code is expected, and punctuality is essential at all meetings. The exchange of business cards is common. It is important in all meetings to greet and shake hands with each person and acknowledge their presence. The person is to be addressed as Mr. Mrs., or Ms., followed by their surnames, unless otherwise specified. Gifts are unnecessary though greatly appreciated. Business hours are generally 8am to 5pm Monday to Friday with an hour taken over lunch.

Communications:

The international dialling code for Ghana is +233. The outgoing code is 00 followed by the relevant country code (e.g. 0027 for South Africa). Accra's city code is 21. The telephone system is relatively reliable, but most people use mobile phones. Telephone, fax and telex services are available in all main towns, and hotels. Most major hotels also have business centres, which provide secretarial and courier services. Internet cafes are on the increase throughout the country, but connection speeds are usually slow. There are several GSM cell phone operations across Ghana that have roaming agreements with most international networks, and phones can be rented in Accra.

Duty Free:

Travellers to Ghana over 16 years do not have to pay customs duty on 400 cigarettes, or 100 cigars, or 454g of tobacco, or a proportionate mix of these items; 1 litre of wine and 1 litre of spirits; and 237ml of perfume and eau de toilette. Gift items are dutiable.

Health

Visitors must be in possession of a current medical vaccination certificate for yellow fever. Prophylactics against malaria are recommended and waterborne diseases are prevalent, including outbreaks of cholera during the rainy season. Visitors are advised to buy bottled drinking water, which is widely available. Bird flu has been confirmed in Ghana, but the risk to visitors is considered to be very low; as a precaution it is advisable to avoid close contact with live birds and ensure all poultry products are well cooked. Good medical facilities are found in all the cities and major towns, but facilities outside urban areas are poor and emergency services are limited. Medical insurance is advised and should cover medical evacuation.

View information on diseases: Yellow fever, Malaria, Cholera

Yellow fever

Cause:

The yellow fever virus, an arbovirus of the Flavivirus genus. Transmission: Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours.

Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes.

The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks.

Nature of the disease:

Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution:

The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported). Risk for travellers: Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas. Prophylaxis (protective treatment): Vaccination. In some countries, yellow fever vaccination is mandatory for visitors. Precautions: Avoid mosquito bites during the day as well as at night.

Endemic Countries:

The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

Malaria

General considerations:

Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently. Cause: Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:

The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise. Nature of the disease: Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease.

The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:

The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

Cholera

Cause:

Vibrio cholerae bacteria, serogroups O1 and O139. Transmission: Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host. Nature of the disease: An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:

Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:

The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):

Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries. Precautions: As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Ghana Tourist Board, Accra: +233 21 222 153 or www.ghanatourism.gov.gh

Ghana Embassies

Embassy of Ghana, Washington DC, United States: +1 202 686 4520.
Ghana High Commissioner, London, United Kingdom (also responsible for Ireland): +44 (0)20 7201 5900.
Ghana High Commissioner, Ottawa, Canada: +1 613 236 0871.
Ghana High Commission, ACT, Australia: +61 (0)2 6290 2110.
Ghana High Commission, Pretoria, South Africa: +27 (0)12 342 5847.

Foreign Embassies in Ghana

United States Embassy, Accra: +233 21 741 000.
British High Commission, Accra: +233 21 221 665.
Canadian High Commission, Accra: +233 21 211 521.
Australian High Commission, Accra: +233 21 701 2961.
South African High Commission, Accra: +233 21 762 380.
Honorary Consul of Ireland, Accra: +233 21 518 112.

Ghana Emergency Numbers

Emergencies: 999.

Airports

Kotoka International Airport (ACC)

Location:

The airport is situated seven miles (12km) from Accra city centre.

Time:

Local time is GMT.

Contacts:

Tel: +233 21 776 171.

Transfer to the city:

Metered taxis as well as shared taxis are available.

Car rental:

Car rental companies have booths outside the arrivals hall.

Facilities:

Facilities include shops and duty-free shopping, snack bars, restaurant and bar, a business centre, post office and information desk. A bureau de change and 24-hour ATM are located in the arrivals hall. There are also 24-hour medical care and immunisation services available.

Departure Tax:

US$50 (international), 1,000 cedis (domestic).

Website:

www.gcaa.com.gh

Climate

Ghana is a tropical country lying just north of the equator. The rainy season lasts from April to October in northern Ghana and from April to June and again from September to October in the south. Temperatures range from about 70°F to 90°F (21°C to 32°C) and the humidity is relatively high. The rest of the year is hot and dry with temperatures reaching up to 100°F (38°C). In most areas the temperatures are highest in March and lowest in August, after the rains. Variations between day and night temperatures are small.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US citizens must have a passport and visa.

Entry requirements for UK nationals: UK nationals must have a passport and visa.

Entry requirements for Canadians: Canadians must have a passport and visa.

Entry requirements for Australians: Australians must have a passport and visa.

Entry requirements for South Africans: South Africans must have a passport and visa.

Entry requirements for New Zealanders: New Zealand nationals must have a passport and visa.

Entry requirements for Irish nationals: Irish citizens must have a passport and visa.

Passport/Visa Note: Visitors must hold a return or onward ticket as well as all documents needed for their next destination. Visas can be obtained on arrival provided prior consent has been obtained with the Director of Immigration a minimum of 48 hours before arrival. A copy of the bio data and photo page of the visitor's passport should accompany this application. Applications can be made by the visitor's host, business or sponsor; or directly by fax (+233 21 258249) or email (director@myzipnet.com). The host or applicant will require copy of the fax or email in order to pay for the visa.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Honduras

Exuding an air of paradise with its exotic palm-fringed beaches, clear turquoise waters, majestic mountains, verdant jungles and beguiling Mayan ruins, the laid back way of life and relative obscurity to the tourist market makes Honduras an ideal getaway for those who enjoy getting off the beaten track.

It has all the right ingredients for a tourist hotspot; pristine beaches, great hotels and a rich cultural history. Despite this, Honduras has scarcely registered on the Western radar in the past, other than its 15 minutes of fame in 1998 when it was ravaged by Hurricane Mitch. These days it is enjoying a boom in popularity as a relatively unknown, unspoilt and undeveloped destination, recognised for its Ecotourism opportunities, affordable scuba diving, mountain treks and river rafting, as well as its appeal to the rich and famous eager to escape the prying eye of the paparazzi.

Toucans pose alongside orchids in the humid cloud forests and mountains, while banana plantations cover the rest of the aptly named 'Banana Republic', famous for its banana cake, banana pancakes, fried plantain and banana chips. Many ancient Mayan and Lenca ruins can be found hidden away from civilisation in lush jungle landscapes, ready to enchant the most seasoned of travellers. One of the country's most breathtaking Mayan archaeological sites is the Copan Ruins, a World Heritage Site set in a verdant valley in the far western region of Honduras, reminiscent of something out of an Indiana Jones movie.

The once thriving port of Trujillo has an intriguing pirate history and exquisite tropical beaches, while the region known as the Mosquito Coast, which extends towards the Nicaraguan border, is the largest tract of tropical rainforest north of the Amazon and is one of the most popular spots in the world for ecotourism. The country also boasts 373 miles (600km) of Caribbean white sand beaches, and the offshore Bay Islands such as Utila, Roatan and Guanaja are an extremely popular destination, particularly for divers and snorkellers. There is plenty more to discover in this exciting country, however, and the warmth and hospitality of the Honduran locals is bound to lure first time visitors back time and time again.

The Basics

Time:

Local time is GMT –6.

Electricity:

Electrical current is 110 volts, 60Hz. Flat blade attachment plugs and flat blades with round grounding pin are in use.

Language:

Spanish is the official language although English is often spoken in the Bay Islands.

Health:

Mosquito-borne illnesses are an ongoing problem in Honduras. All travellers are advised to take mosquito repellent to prevent illnesses such as malaria and dengue fever, as well as to protect from annoying mosquito and sand fly bites. It is strongly recommended that routine vaccinations are up to date. Tap water is not safe to drink but bottles or bags of purified water a readily available. Honduras regularly suffers from severe air pollution, which can aggravate or lead to respiratory problems. For divers, there is a hyperbaric decompression chamber on Roatan. State hospitals are under-funded and travellers should use private hospitals where possible. Health insurance is recommended.

Tipping:

A service charge of 10 percent is usually added to bills at restaurants, but anything extra is for good service. It is customary to tip hotel bellboys and cleaning staff for good service.

Customs:

There is a strong Spanish influence in Honduras. Beachwear and shorts should not be worn away from the beach or poolside. Men are required to wear dinner jackets for formal social occasions. A common and appropriate greeting for men and women is a handshake.

Business:

Appointments are necessary and should be made two weeks in advance. Visitors are expected to be punctual, though meetings may not start on time. Business travellers should allow plenty of time for socialising and should not rush getting straight down to business, as Hondurans place importance on establishing personal contact. Business is male dominated but since 2005 women now make up 47 percent of the labour force. Business suits or jackets for men and dresses and skirts for women are customary. Though some businesspeople speak English, correspondence should be in Spanish. Business hours are Monday to Friday from 8am to 5pm with an hour or two taken over lunch.

Communications:

The international access code for Honduras is +504. The outgoing code is 00, followed by the relevant country code (e.g. 0044 for the United Kingdom). City/area codes are not in use. Roaming agreements exist with international mobile phone companies and coverage is generally good along the coast and around major towns. Internet cafes are common and can be found in major towns.

Duty Free:

Travellers over 18 years do not have to pay customs duty on 200 cigarettes or 100 cigars or 450g of tobacco, two bottles of alcoholic beverages, a reasonable amount of perfume for personal use and gifts up to a total value of US$1,000.

Health

Mosquito-borne illnesses are an ongoing problem in Honduras. All travellers are advised to take mosquito repellent to prevent illnesses such as malaria and dengue fever, as well as to protect from annoying mosquito and sand fly bites. It is strongly recommended that routine vaccinations are up to date. Tap water is not safe to drink but bottles or bags of purified water a readily available. Honduras regularly suffers from severe air pollution, which can aggravate or lead to respiratory problems. For divers, there is a hyperbaric decompression chamber on Roatan. State hospitals are under-funded and travellers should use private hospitals where possible. Health insurance is recommended.

View information on diseases: Malaria, Dengue Fever

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently. Cause: Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission: The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise. Nature of the disease: Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death.

The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution: The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

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Dengue Fever

Cause: The dengue virus - a flavivirus of which there are four serotypes. Transmission: Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease: Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution: Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet). Risk for travellers: There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.

Prophylaxis (protective treatment): None.

Precautions: Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Honduras Tourist Board, Tegucigalpa: +504 222 2124 or www.visitehonduras.com

Honduras Embassies

Embassy of Honduras, Washington DC, United States: +1 202 966 7702.

Embassy of Honduras, London, United Kingdom: +44 (0)20 7486 4880.
Embassy of Honduras, Ottawa, Canada: +1 613 233 8900.
Embassy of Honduras, Sydney, Australia: +61 (0)2 9247 1730.

Foreign Embassies in Honduras

American Embassy, Tegucigalpa: +504 236 9320.

British Honorary Consulate, Tegucigalpa: +504 237 6577.
Canadian Embassy, San José, Costa Rica (also responsible for Honduras): +506 2242 4400.
Australian Embassy, Mexico City, Mexico (also responsible for Honduras): +52 (0)55 110 12200.
South African Embassy, San Pedro Sula: +504 552 4702.

Honduras Emergency Numbers

Emergencies: 119 (Police); 195 (Ambulance).

Airports

Toncontin International Airport (TGU)

Location:

The airport is located three miles (6km) southwest of Tegucigalpa's centre.

Time:

Local time is GMT – 6.

Contacts:

Tel: +504 233 1115.

Transfer to the city:

The Airport Taxi Company has a set price of L140 (US$7.50) to anywhere in the city. The journey takes around 15-25 minutes. More affordable taxis pass by in front of the airport on the main road, but since they have no taxi meters, visitors have to haggle the price in Spanish.

Car rental:

Car rental companies include Avis, Budget, Hertz, Maya and Thrifty.

Facilities:

The airport features a post office, bank, bureau de change, many restaurants, several airline lounges, a duty free shop and a first aid room.

Parking:

There are 150 short-term parking spaces available.

DepartureTax:

US$30, or US$27 for Honduran nationals.

Climate

Honduras's climate is hot and humid almost all year round. The coast is hot and tropical while the mountainous area is slightly cooler. The north coast is prone to a very hot climate and experiences rain throughout the year.

The dry season runs from November to April and the wet season from May to October. The Caribbean coast experiences heavy rain from September to February. Average annual temperatures hover around 90°F (32°C). Hurricane season runs from June to November and landslides, mudslides and flooding may occur.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans:United States citizens do not require a visa if visiting for a stay of up to three months. A valid passport is required.

Entry requirements for UK nationals: British citizens do not require a visa for a stay of up to three months. A valid passport is required.

Entry requirements for Canadians: Canadian citizens do not require a visa for a stay of up to three months. A valid passport is required.

Entry requirements for Australians: Australian citizens do not require a visa for a stay of up to three months. A valid passport is required.

Entry requirements for South Africans: South African citizens do not require a visa for a stay of up to three months. A valid passport is required.

Entry requirements for New Zealanders: New Zealand citizens do not require a visa for a stay of up to three months. A valid passport is required.

Entry requirements for Irish nationals: Irish citizens do not require a visa for a stay of up to three months. A valid passport is required.

Passport/Visa Note: Travellers require a passport valid for at least three months on arrival and must hold proof of onward/return ticket and all documents required for next destination. Extensions are possible for a fee of US$10 to US$50 at the Immigration Department.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Costa Rica

Known for its spectacular natural beauty and biodiversity, Costa Rica boasts over 15 different ecosystems with dramatic changes in landscapes, climate and nature. Magnificent beaches stretch for miles along an unspoilt coastline. High on the mountains, cool and pristine cloud forests are alive with mysterious sounds and below splendid tropical rain forests are packed with life.

The country is famous for its progressive approach to conservation and is the prime eco-tourism destination in Central America due to its wealth of protected areas. Over 25 percent of the country is protected, spread between 75 different national parks, wildlife refuges and biological reserves.

In such a small geographical area it is surprising how much there is to see and do. There are activities to suit all travellers and any mood, from action to relaxation. These include surfing, snorkelling and sunbathing, horse riding, hiking and wildlife-spotting, deep sea fishing or river cruises. One can also simply enjoy a soak in the hot springs.

Travellers are also drawn to the country because of the endearing Tico hospitality. Costa Ricans are known for their incredible gregariousness and delightful ability to pamper guests - whether pointing out the right direction or cooking a typical authentic meal, they will be full of smiles and warmth. All this together with easy accessibility and an efficient infrastructure makes Costa Rica the jewel of Central America and a gem of a vacation destination.

The Basics

Time:

Local time is GMT -6.

Electricity:

Electrical current is 120 volts, 60Hz. Flat two-pin plugs and three-pin (two flat blades with round grounding pin) plugs are in use.

Language:

Spanish is the official language, but English is widely spoken.

Health:

There are no vaccination requirements for Costa Rica. There is a risk of malaria in some areas all year round and advice should be taken on precautions. Water in cities is generally safe but it is advisable to buy bottled water, especially outside the main towns where there is a risk of contamination. Dengue fever is one of a number of diseases carried by insects that also occur in this region, especially during the rainy season; protection against insect bites is the best prevention. Medical services are reliable in cities and the standard of hygiene and treatment is very high.

Tipping:

Hotels add a 10% service charge plus a 3% tourist tax to their bills by law. In tourist and upmarket restaurants a tip of 10% is usual, however some establishments already include a 17% sales and service tax in the bill. Taxi drivers are not normally tipped, but tour guides are. In general if service has been particularly good service staff appreciate a 5 to 10% tip.

Customs:

'Machismo' is the main characteristic of Costa Rica culture, although women are quickly becoming more significant. Costa Ricans are conservative when it comes to family values, and roles between male and female are expected to be traditional.

Business:

Costa Rica has a formal business environment, where men and women wear conservative suits, appointments are made and meetings begin on time. Business projects can be slow, however, as Costa Ricans are conservative in their approach to new ideas and keen to avoid risk. Spanish is the main language, but most business people speak English; however it is polite to have business cards as well as other promotional material printed in both English and Spanish. Alot of women have high profile jobs, alto Machismo exists. Visiting businesswomen will be treated with respect once their ability and authority is clearly established. Hours of business are generally 8am to 4pm Monday to Friday with a two-hour lunch break from 12pm.

Communications:

The international access code for Costa Rica is +506. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). City codes are not required. Costa Rica has one of the most advanced telecommunications systems in Latin America. The cheapest way to phone internationally is a direct call using a phone card. Mobile phone operators use GSM 1800 networks. Internet cafes are available in the main towns.

Duty Free:

Travellers to Costa Rica over 18 years do not have to pay duty on 3 litres of alcohol; 500g of tobacco or 400 cigarettes or 50 cigars. Perfume for personal use is allowed provided it is a reasonable quantity.

Health

There are no vaccination requirements for Costa Rica. There is a risk of malaria in some areas all year round and advice should be taken on precautions. Water in cities is generally safe but it is advisable to buy bottled water, especially outside the main towns where there is a risk of contamination. Dengue fever is one of a number of diseases carried by insects that also occur in this region, especially during the rainy season; protection against insect bites is the best prevention. Medical services are reliable in cities and the standard of hygiene and treatment is very high.

View information on diseases: Malaria, Dengue Fever

Malaria

General considerations:
Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:
Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:
The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:
Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:
The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.
Back to Top

Dengue Fever

Cause:
The dengue virus - a flavivirus of which there are four serotypes.

Transmission:
Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease:
Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution:
Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet).

Risk for travellers:
There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.

Prophylaxis (protective treatment):
None.

Precautions:
Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Contacts

Visa Agencies
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism
Costa Rica Tourism Board, San Jose: +506 223 1733 or www.visitcostarica.com

Costa Rica Embassies
Embassy of Costa Rica, Washington DC, United States: +1 202 234 2945/6.

Embassy of Costa Rica, London, United Kingdom: +44 (0)20 7706 8844.
Embassy of Costa Rica, Ottawa, Canada: +1 613 562 2855.
Consulate General of Costa Rica, Sydney, Australia: +61 (0)2 9969 4050.
Honorary Consulate of Costa Rica, Johannesburg, South Africa: +27 (0)11 486 4716.

Foreign Embassies in Costa Rica
United States Embassy, San Jose: +506 519 2000.

British Embassy, San Jose: +506 258 2025.
Canadian Embassy, San Jose (also responsible for Australia): +506 242 4400.
South African Consulate-General, San Jose: +506 222 1470.
Mission of Ireland to the UN, New York, United States: +1 212 421 6934.

Costa Rica Emergency Numbers
Emergencies: 911

Airports

Juan Santamaria International Airport (SJO)

Location: The airport is situated 14 miles (23km) west of San José, and two miles (3km) south of Alajuela.

Time: Local time is GMT -6.

Contacts: Tel: +506 443 0840.

Transfer to the city: There are frequent public buses and airport taxis are also available.

Car rental: Car rental is available.

Facilities: There is a currency exchange booth and ATMs in the airport terminal, as well as a souvenir store, duty-free, a food court and coffee bar.

Departure Tax: US$26, or the Colon equivalent.

Climate

Being tropical, there is little difference in temperature throughout the year, but there is a lot of rainfall, particularly from May to November. Temperatures along the coast are hotter, averaging 89ºF (32ºC), although they are tempered down by sea breezes. The highland areas are warm during the day and can be quite cool at night.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US nationals do not require a visa for stays of up to 90 days. A passport valid for 30 days after the date of entry is required. An extension can be organised on arrival.

Entry requirements for UK nationals: UK nationals must have a passport that is valid at least 30 days after the date of entry. A visa is not required for a stay of up to 90 days provided the passport is endorsed with British Citizen, British National (Overseas) or British Overseas Territories Citizen. Extensions can be arranged on arrival. In all other cases, a passport must be valid beyond six months and a visa is required.

Entry requirements for Canadians: Canadians must have a passport that is valid at least 30 days after date of entry. A visa is not required for stays of up to 90 days. Extensions can be organised on arrival.

Entry requirements for Australians: Australians must have a passport that is valid at least 30 days after the date of entry. A visa is not required for stays of up to 90 days. An extension can be organised on arrival.

Entry requirements for South Africans: South African nationals must have a passport that is valid at least 30 days after the date of entry. A visa is not required for stays of up to 90 days. An extension can be organised on arrival.

Entry requirements for New Zealanders: New Zealand citizens must have a passport that is valid at least 30 days after the date of entry. A visa is not required for a stay of 90 days. Extensions can be organised on arrival.

Entry requirements for Irish nationals: Irish nationals must have a passport that is valid at least 30 days after date of entry. A visa is not required for a stay of 90 days. Extensions can be organised on arrival.

Passport/Visa Note: All visitors must hold an onward or return ticket and sufficient funds. An exit visa must be obtained from the Immigration Department for all passengers staying in the country for longer than 30 days. Passports must be valid for at least 30 days after date of entry for visa exempt nationals and for six months for those requiring a visa. Admission to Costa Rica is refused to gypsies of any country and anyone with insufficient funds. Indecent clothing and long, unkempt beards and hair is prohibited.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Ecuador

Situated on the equator, Ecuador is the smallest country in the Andean Highlands. Despite its size it is probably the world's most bio-diverse country, crammed with an astounding variety of wildlife, birds and vegetation existing in the contrasts of climatic zones. Within a short time the traveller can experience dramatic changes in scenery, temperature and altitude, journeying between Pacific Coast beaches and the sweltering, mosquito-ridden rainforest; to the charming capital city of Quito surrounded by ice-covered volcanoes; and to colourful highland markets that add character and warmth to the windswept highlands of the Andes Mountains.

The people, their cultures and traditions have also been formed, and are influenced by, their geographical environment. The backbone of the country is the Andean highlands, made up of two mountainous chains and over 30 volcanoes. Between them lies the central highland valley or sierra, the Avenue of the Volcanoes, at about 8,960 feet (2,800m) above sea level.

This is the heartland of agricultural activity, punctuated by dozens of remote communities, and is where the bulk of the population live. Larger towns like Saquisilí and Otavalo swell on market days when villagers come to sell their produce and handiwork in a vibrant and colourful atmosphere of festivity. The sierra is also home to most of the old and historically important cities, including Quito.

With its beautiful colonial architecture, magnificent panoramic scenery, vibrant indigenous groups and welcoming people it is one of the most enticing and rewarding countries to visit in South America.

And, as if it needed anything further, one of the world's greatest treasures of natural history lies in the bewitching Galapagos Islands, famed for its fearless and unique wildlife, and is the highlight of most trips to Ecuador.

The Basics

Time:

Local time is GMT -5 (Galapagos Islands are GMT -6).

Electricity:

Electrical current is 120 volts, 60Hz. Two-pin plugs are standard.

Language:

Spanish is the official language, but Quechua is the main language spoken among the indigenous people.

Health:

A yellow fever certificate is required from those arriving from infected areas, and is recommended for everyone entering Ecuador, particularly for those travelling to the regions of the Amazon basin. There is high risk of malaria and dengue fever in areas below 5,000ft (1,500m). There has been a dramatic increase in the number of reported cases of dengue fever primarily in coastal and Amazon regions.

The best prevention is to cover up and use mosquito repellent liberally throughout the day. High altitude can affect some people's health so visitors to Quito (6,500ft/2,800m), for example, are advised to take it easy for the first few days. It is advisable to take seasickness tablets on a Galapagos boat cruise. Tap water should not be consumed; bottled water is available. Milk is unpasteurised so it is best to avoid dairy products. Medical facilities are inadequate and medical insurance is highly recommended.

Tipping:

A 10% service charge is usually added to good quality hotel and restaurant bills, but often the waitron does not receive this fee, so it is discretionary to add another 5-10%. Taxi drivers do not expect to be tipped and tour guides usually receive a $4-$8 tip.

Customs:

Always ask permission to take photos of the local people. A tip is often requested. It is a legal requirement to carry identification at all times. Dress is more conservative and modest in the highlands compared to the coast. Politeness and good manners are essential for communication and a light handshake is the practiced form of greeting.

Business:

An essential aspect of conducting business in Ecuador is having a tie with a reputable local partner. Business dealings are somewhat formal; dress is usually smart and conservative, punctuality is important and greetings are made with a handshake. Dress can be more casual in hotter regions such as Guayaquil.

Business cards are usually exchanged and it is recommended to have some business cards, company brochures and presentations translated into Spanish. Note that business disputes that would in countries such as the United States be dealt with by civil litigation are often, under Ecuadorian law, viewed as criminal, and can lead to arrest and imprisonment. Although the official language is Spanish, English is widely spoken and understood in the business sector. Business hours are usually 8.30am to 4.30pm Monday to Friday, with some businesses closing during lunch.

Communications:

The international access code for Ecuador is +593. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). The city code for Quito is (0)2. Calls made from hotel rooms can be very expensive, but public telephones can be found in most public buildings in the main cities; the most cost-effective way to telephone internationally is from call centres, which are located in most towns and cities.

They also offers fax services and sometimes Internet connections, but Internet cafes are available in the main towns. The local GSM cell phone network does not have roaming agreements with international operators; European, Australian and other phones from non-GSM cell phone networks will not work, but cell phones can be rented at the international airports or at cellular phone shops.

Duty Free:

Travellers entering Ecuador do not have to pay customs duty on 300 cigarettes or 50 cigars or 200g tobacco; 1 litre of alcoholic beverages; perfume for personal use; and gifts and personal effects to the value of US$200 for a stay of up to seven days, US$300 for eight days to six months, and US$400 for stays of six months to two years.

Health

A yellow fever certificate is required from those arriving from infected areas, and is recommended for everyone entering Ecuador, particularly for those travelling to the regions of the Amazon basin. There is high risk of malaria and dengue fever in areas below 5,000ft (1,500m). There has been a dramatic increase in the number of reported cases of dengue fever primarily in coastal and Amazon regions. The best prevention is to cover up and use mosquito repellent liberally throughout the day. High altitude can affect some people's health so visitors to Quito (6,500ft/2,800m), for example, are advised to take it easy for the first few days. It is advisable to take seasickness tablets on a Galapagos boat cruise. Tap water should not be consumed; bottled water is available. Milk is unpasteurised so it is best to avoid dairy products. Medical facilities are inadequate and medical insurance is highly recommended.

View information on diseases: Yellow fever, Malaria, Dengue Fever

Yellow fever

Cause: The yellow fever virus, an arbovirus of the Flavivirus genus.

Transmission: Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours. Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes. The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks. Nature of the disease: Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution: The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported).

Risk for travellers: Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas. Prophylaxis (protective treatment): Vaccination. In some countries, yellow fever vaccination is mandatory for visitors. Precautions: Avoid mosquito bites during the day as well as at night.

Endemic Countries: The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.
Back to Top

Malaria

General considerations: Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home.

Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently. Cause: Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission: The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease: Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution: The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

Back to Top

Dengue Fever

Cause: The dengue virus - a flavivirus of which there are four serotypes. Transmission: Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa. Nature of the disease: Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less. Geographical distribution: Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet). Risk for travellers: There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue. Prophylaxis (protective treatment): None. Precautions: Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Ministry of Tourism, Quito: +593 (0)2 250 7559 or www.vivecuador.com

Ecuador Embassies

Embassy of Ecuador, Washington DC, United States: +1 202 234 7200.
Embassy of Ecuador, London, United Kingdom: +44 (0)20 7584 2648.
Embassy of Ecuador, Ottawa, Canada: +1 613 563 8206.
Embassy of Ecuador, Canberra, Australia: +61 (0)2 6286 4021.
Consulate of Ecuador, Auckland, New Zealand: +64 (0)9 303 0590.

Foreign Embassies in Ecuador

United States Embassy, Quito: +593 (0)2 256 2890.
British Embassy, Quito: +593 (0)2 297 0800.
Canadian/Australian Embassy, Quito: +593 (0)2 245 5499.
South African Embassy, Lima, Peru (also responsible for Ecuador): +511 440 9996.
Irish Honorary Consul, Quito: +593 (0)2 357 0156.

Ecuador Emergency Numbers
Emergencies: 101 (Police); 131 (Ambulance).

Airports

Mariscal Sucre International Airport (UIO)

Location: The airport is situated three miles (5km) from Quito city centre.
Time: Local time is GMT -5.
Contacts: Tel: +593 (0)2 2944 900 ext 2608.
Transfer to the city: Taxis are available outside the terminal, and there are bus services available.
Car rental: Avis, Budget and Hertz are represented at the airport along with some local companies.
Facilities: Facilities include shops, restaurants, cafes and duty-free shopping and tourist information desks. Banks, ATMs and currency exchange are available. There is also telephone and Internet access. Passengers with special needs are catered for and a wheelchair service is available on request.
Departure Tax: Airport tax: $2 (Domestic), $40.80 (International).
Website: www.quitoairport.com

Jose Joaquin de Olmedo International Airport (GYE)

Location: The airport is situated three miles (5km) north of Guayaquil city centre on Avenue de las Américas.
Time: Local time is GMT -5.
Contacts: Tel: +593 (0)4 228 2100.
Transfer to the city: Buses and taxis offer services to the city.
Car rental: Car rental is available at the airport.
Facilities: The airport has Information desks, restaurants, currency exchange, bank, ATMs and post office.
Departure Tax: Airport tax: $2 (Domestic), $26 (International).

Climate

Ecuador's geography has endowed the country with a variety of microclimates.The coast is hot all year, with a humid rainy season between December and May. In the mountains climate depends on altitude, becoming cooler the higher you go. The Amazon region is hot, humid and wet while the Galapagos Islands are dry with a steady year-round average temperature of 77ºF (25ºC).

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US nationals must hold a valid passport. No visa is necessary for stays of up to 90 days per year.

Entry requirements for UK nationals: UK nationals must hold a valid passport. No visa is necessary for stays of up to 90 days per year.

Entry requirements for Canadians: Canadians must hold a valid passport. No visa is necessary for stays of up to 90 days per year.

Entry requirements for Australians: Australians must hold a valid passport. No visa is necessary for stays of up to 90 days per year.

Entry requirements for South Africans: South African nationals must hold a valid passport. A visa is not required for stays of up to 90 days per year.

Entry requirements for New Zealanders: New Zealanders require a valid passport. No visa is required for stays of up to 90 days per year, though this is not applicable to holders of passports issued in Cook Islands or Niue.

Entry requirements for Irish nationals: Irish nationals must hold a valid passport. No visa is necessary for stays of up to 90 days per year.

Passport/Visa Note: Passports should be valid for at least six months on arrival. All visitors should hold an onward or return ticket and sufficient funds for their stay.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Peru

Peru is a large country on the Pacific coast of South America, encompassing a desert coastline, tropical rainforest and soaring mountains, each with distinct environments. These offer an exceptional opportunity for travellers to experience a variety of landscapes, an abundance of wildlife, a rich history and archaeological heritage, and the vivacious character of durable native cultures, all within one nation.

Fishing villages, fine beaches, agricultural lands, and Peru's major towns and cities, including the capital of Lima, are interspersed along the narrow belt of desert coastline that stretches the length of the country. The lush Amazon Basin takes up half of Peru and is an ecologically rich area of tropical rainforest that encompasses some of the world's most remote and least explored areas, sparsely populated and for the most part, inaccessible. Separating the coastal desert from the jungle is the splendid Andes mountain range, an endless chain of soaring peaks over 22,000ft (7,000m), and home to millions of indigenous highland people, speaking the ancient Inca language of Quechua, and living in traditional villages with steeply terraced agricultural fields, with their wandering herds of llamas and alpacas.

An interesting history of ancient civilisations, tales of lost cities, undiscovered treasures, and unsolved mysteries make Peru one of the most exciting countries to visit. Travellers can marvel at the sophistication of pre-Colombian cultures and explore the many legacies left by the imperial Inca Empire, particularly the ancient Inca capital of Cuzco. Hiking along the legendary ancient royal Inca highway brings visitors to the awesome, majestic 'Lost City of the Incas', Machu Picchu. Boats transport tourists to the unique floating islands and the traditional world of the island people on Lake Titicaca. Travellers can wander around splendid colonial cities that have preserved their Spanish architecture, look into the depths of the world's deepest canyon, and contemplate the intriguing mystery of the Nazca Lines.

Peru, 'Land of the Incas', offers a stimulating and rewarding travel experience and is one of the most diverse and exhilarating of the South American destinations.

The Basics

Time:

Local time is GMT -5.

Electricity:

Electrical current is 220 volts, 60Hz (Arequipa 50Hz). Two-pin, flat blade and round plugs are standard.

Language:

Spanish and Quechua are the official languages, but many other dialects are spoken. English is spoken only in major tourist centres and hotels.

Health:

Those entering the country from an infected area require a yellow fever certificate, and outbreaks of yellow fever do occur; vaccination is recommended for those intending to travel to the low-lying jungle areas in particular, but is not necessary for Lima, Cuzco or Machu Picchu. Although no other vaccinations are officially required, visitors are advised to take precautions especially if planning to travel to jungle regions. Immunisation against typhoid is sensible. Malaria is a risk all year round in the lowland areas, except for Lima and the coastal regions to the south, and dengue fever is on the increase. Protection against mosquito bites is essential as a number of other mosquito-transmitted diseases occur. There have been a number of recent incidents of rabies transmitted by bites from vampire bats in the Madre de Dios and Puno provinces, as well as in the north near the border with Ecuador; visitors to these areas are advised to have a course of rabies injections prior to travel, and not to sleep in the open without a mosquito net. Cholera and cases of the plague occur, but visitors are unlikely to be affected. Other risks include Chagas' disease. The most common ailments for travellers, however, are diarrhoea and altitude sickness. Drink only bottled water, avoid drinks with ice, and be wary of food bought from street vendors. Health care is good in the major cities, better at private clinics than at the public hospitals, but is expensive, and health insurance is essential. Pharmacies in Lima are well supplied. Screening for HIV is inadequate and visitors are advised to avoid blood transfusions if possible.

Tipping:

Some restaurants add a service charge of between 5% and 10%, which will be indicated by the words 'propina' or 'servicio' near the bottom of the bill. Even if service charge has been added the waiter can be offered an additional 10% for exceptional service; this is also the going rate for tipping where service charge has not been added. In hotels porters expect about US$0.50 per bag. Taxi drivers are not tipped (the fare should be set before departure). Tour guides are customarily tipped.

Customs:

Do not take photographs of anything to do with the military. Homosexuality, although legal, is frowned upon. Visitors should avoid wearing any native Indian clothing as this will be seen as insulting, regardless of intention.

Business:

Business in Peru centres on the capital, Lima. Business is usually conducted in a formal and somewhat conservative manner, and it is worth noting that a business visa is needed from a local Peruvian Consulate. Dress should be formal, with suits and ties the norm. Titles and surnames are usually used upon greeting, and handshakes are standard for men and women. Business cards are usually exchanged and it is useful to have them printed in Spanish on one side. Although English is fairly common, it will be an advantage to have business materials translated into Spanish; an effort to speak Spanish will be well received. Women may encounter some sexism. Punctuality is important, although meetings are not likely to begin on time. Business hours can vary but are usually from 9am to 6pm Monday to Friday. Some businesses can close for siesta from 1pm to 3pm.

Communications:

The international access code for Peru is +51, and the outgoing code is 00, followed by the relevant country code (e.g. 0044 for the UK). City/area codes are in use, e.g. (0)1) for Lima. A mobile phone operator provides a GSM 1900 network with coverage limited to major towns and cities. Peru is well connected to the Internet with a proliferation of inexpensive Internet kiosks, called cabinas pública, available on street corners in most towns and cities.

Duty Free:

Travellers to Peru over 15 years old do not have to pay duty on 400 cigarettes or 50 cigars or 50g of tobacco; 2kg of food maximum; 3 bottles of alcoholic beverages not exceeding 2.5 litres; and gifts to the value of US$300. Items such as sausages, salami, ham and cheese may only be brought in if accompanied by an original sanitary certificate. The import of ham from Italy and Portugal is prohibited. The export of cultural or artistic items from the country is not permitted.

Health

Those entering the country from an infected area require a yellow fever certificate, and outbreaks of yellow fever do occur; vaccination is recommended for those intending to travel to the low-lying jungle areas in particular, but is not necessary for Lima, Cuzco or Machu Picchu. Although no other vaccinations are officially required, visitors are advised to take precautions especially if planning to travel to jungle regions. Immunisation against typhoid is sensible. Malaria is a risk all year round in the lowland areas, except for Lima and the coastal regions to the south, and dengue fever is on the increase. Protection against mosquito bites is essential as a number of other mosquito-transmitted diseases occur. There have been a number of recent incidents of rabies transmitted by bites from vampire bats in the Madre de Dios and Puno provinces, as well as in the north near the border with Ecuador; visitors to these areas are advised to have a course of rabies injections prior to travel, and not to sleep in the open without a mosquito net. Cholera and cases of the plague occur, but visitors are unlikely to be affected. Other risks include Chagas' disease. The most common ailments for travellers, however, are diarrhoea and altitude sickness. Drink only bottled water, avoid drinks with ice, and be wary of food bought from street vendors. Health care is good in the major cities, better at private clinics than at the public hospitals, but is expensive, and health insurance is essential. Pharmacies in Lima are well supplied. Screening for HIV is inadequate and visitors are advised to avoid blood transfusions if possible.

View information on diseases: Yellow fever, Cholera

Yellow fever

Cause: The yellow fever virus, an arbovirus of the Flavivirus genus. Transmission: Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours. Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes. The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks. Nature of the disease: Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution: The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported). Risk for travellers: Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas. Prophylaxis (protective treatment): Vaccination. In some countries, yellow fever vaccination is mandatory for visitors. Precautions: Avoid mosquito bites during the day as well as at night.

Endemic Countries: The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

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Cholera

Cause: Vibrio cholerae bacteria, serogroups O1 and O139. Transmission: Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons.

Cholera affects only humans; there is no insect vector or animal reservoir host. Nature of the disease: An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution: Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America. Risk for travellers: The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment): Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries. Precautions: As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Tourism
PROMPERU (Commission for the Promotion of Peru), Lima: +51 (0)1 224 3279 or www.peru.info

Peru Embassies

Peruvian Embassy, Washington DC, United States: +1 202 833 9860.
Peruvian Embassy, London, United Kingdom (also responsible for Ireland): +44 (0)20 7235 1917/2545.
Peruvian Embassy, Ottawa, Canada: +1 613 238 1777.
Peruvian Embassy, Canberra, Australia: +61 (0)2 6273 7351.
Peruvian Embassy, Pretoria, South Africa: +27 (0)12 346 8744.
Peruvian Embassy, Wellington, New Zealand: +64 (0)4 499 8087.

Foreign Embassies in Peru

United States Embassy, Lima: +51 (0)1 434 3000.
British Embassy, Lima: +51 (0)1 617 3000.
Canadian Embassy, Lima: +51 (0)1 444 4015.
Australian Consulate-General, Lima: +51 (0)1 222 8281.
South African Embassy, Lima: +51 (0)1 440 9996.
Honorary Consul of Ireland, Lima: +51 (0)1 273 2903.
New Zealand Consulate, Lima: +51 (0)1 422 7491.

Peru Emergency Numbers

Emergencies: 011/5114

Airports

Jorge Chávez International Airport (LIM)

Location: The airport is situated 10 miles (16km) north west of Lima.
Time: Local time is GMT –5.
Contacts: Switchboard: +51 (1) 517 3100. Flight Information: +51 (1) 595 0666.
Transfer to the city: Taxis can be found outside the international flights terminal. Buses and minibuses also service the city centre, but their stops are outside the airport gates on Avenida Faucett. They travel to the city, stopping along the main avenues.
Car rental: Car rental companies include Hertz, Budget and National.
Facilities: Facilities at the airport include banks, bureaux de change, ATMs, a post office, public telephones, a couple of restaurants, shops, left luggage and a tourist information desk. There are disabled facilities; those with special needs should contact their airline in advance.
Parking:
Departure Tax: US$30.25 or the equivalent in soles (international).
Website: www.lap.com.pe

Climate

Lima has a mild climate, although it is situated in the tropics, and rain in the city is almost unheard of. The weather in Lima is influenced by the cold offshore Humboldt Current, which ensures that summer temperatures hover in the low to mid 60's Fahrenheit (16-18ºC), and only a few degrees lower in June and July. Humidity in the city is very high, and as a result fog is often present, especially between May and November.

Forecast | Maps | Radar

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US nationals do not require a visa for touristic stays of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Entry requirements for UK nationals: British nationals do not require a visa for touristic stays of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Entry requirements for Canadians: Canadian nationals do not require a visa for touristic stays of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Entry requirements for Australians: Australian nationals do not require a visa for touristic stays of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Entry requirements for South Africans: South African nationals do not require a visa for touristic stays of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Entry requirements for New Zealanders: New Zealand nationals do not require a visa for touristic stays of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Entry requirements for Irish nationals: Irish nationals do not require a visa for a touristic stay of up to 90 days. Extensions up to 30 days are possible. A valid passport is needed.

Passport/Visa Note: All travellers require return or onward tickets, all documents required for onward travel and proof of funds. It is recommended that all foreign passports are valid for at least six months after arrival. If travelling for business purposes, a visa is required. Visas cannot be obtained on arrival.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Argentina

Argentina is a country of immense beauty and proportions. Its geographic diversity spans the most breathtaking terrain from Antarctica, through the wild, glacier-filled mountains of Patagonia and massive open plains of La Pampas to the deserts and tropical jungles in the north.

The country can be enjoyed for its natural wonders alone, but no visit here could be called complete without stepping into its soul, its capital city. The elegant Buenos Aires is home to 40 percent of the population, and is a buzzing metropolis with a rich, passionate and tortured history that is integral to its character. It is Europe and South America contained in one geographical location, with elements of the unknown around each corner. It is familiar and strange at the same time, but at its very core, wonderfully welcoming.

Along the elegant avenues of the fashionable districts, sophisticated diners observe passers-by while they sip strong coffee or enjoy smooth cervezas. There is a constant smell of meat grilling from every corner and sidewalk that reveals the Argentine passion for 'asado'. Neither glamour nor passion is in short supply in this cosmopolitan hub where Porteños are equally versed in football, politics and fashion.

There are disparities between the rich and poor, with many people living in near slum conditions in the outskirts of Buenos Aires. Since 1992 the economy has teetered near collapse due to corruption and government mismanagement, prompting regular and sometimes violent demonstrations. However it is business-as-usual as far as tourism is concerned; in fact, the resultant devaluation of the peso has made the country much more affordable for travellers.

The Basics

Time:

Local time is GMT -3.

Electricity:

Electrical current is 220 volts, 50Hz. Most hotels and offices use the three-pin flat type plug, however most older buildings use the two-pin round type plug.

Language:

Spanish is the official language, but English is understood in the tourist areas.

Health:

There is a low risk of yellow fever, cholera and malaria in some northern provinces, so it is wise to seek your doctor's advice when travelling to these areas. However since the outbreak of yellow fever in neighbouring Brazil and Paraguay in January/February 2008, it is recommended that all visitors to regions bordering these countries, including Iguazu Falls, be inoculated against yellow fever. Outbreaks of dengue fever are on the increase, and visitors are advised to avoid getting mosquito bites as there is no effective treatment for it. A hepatitis A vaccination is recommended before travel to Argentina as well as a typhoid vaccination for those who might eat or drink outside major restaurants and hotels. Water is safe to drink in major towns and cities. Medical facilities are good in the major cities. Treatment is expensive, however, and medical insurance is advised. Asthma, sinus and bronchial ailments can be aggravated by pollution in Buenos Aires. Those with specific conditions should bring a sufficient quantity of medical supplies and medicines for the trip.

Tipping:

A 10% tip is expected at restaurants. Porters expect some small change per bag.

Customs:

Argentineans are warm and unreserved people.

Business:

Business people dress well in Argentina and visitors are expected to wear a smart suit. Handshaking is normal. Argentineans are great conversationalists and are interested and knowledgeable about world events, politics and sporting. Meetings usually begin with small talk. Use titles when addressing people: Señor (Mr), Señora (Mrs) and Señorita (Miss) followed by their surname. Business culture in Argentina can be bureaucratic and as with most South American countries negotiation and decision making can take a long time and is best done face to face. Make sure you see the right people, as only those in high positions are likely to be able to make a final decision. Business hours are 9am to 5pm in Buenos Aires, with an hour for lunch. Outside the capital it is normal to take a siesta between 1pm and 4pm. Many business people are away on holiday during January and February.

Communications:

he international access code for Argentina is +54. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). The area code for Buenos Aires is (0)11. Calls are usually made from public call centres, but there are also public telephones that take coins or phone cards, although one usually pays more than the unit value of the card. Mobile phones are increasingly popular; the area code must always be used when phoning a mobile in Argentina. Internet cafes are widely available in Buenos Aires and other popular tourist destinations. Many hotels also offer Internet access.

Duty Free:

Travellers to Argentina over the age of 18 years can bring in the following items to the value of US$300 without incurring customs duty: 2 litres of alcohol, 400 cigarettes or 50 cigars, and 5kg of food items. Restrictions apply to fresh foodstuffs such as meat and dairy products. Prohibited items include explosives, inflammable items, narcotics and pornographic material. Firearms and ammunition for sporting purposes are allowed if accompanied by a license/certificate.

Health

There is a low risk of yellow fever, cholera and malaria in some northern provinces, so it is wise to seek your doctor's advice when travelling to these areas. However since the outbreak of yellow fever in neighbouring Brazil and Paraguay in January/February 2008, it is recommended that all visitors to regions bordering these countries, including Iguazu Falls, be inoculated against yellow fever. Outbreaks of dengue fever are on the increase, and visitors are advised to avoid getting mosquito bites as there is no effective treatment for it. A hepatitis A vaccination is recommended before travel to Argentina as well as a typhoid vaccination for those who might eat or drink outside major restaurants and hotels. Water is safe to drink in major towns and cities. Medical facilities are good in the major cities. Treatment is expensive, however, and medical insurance is advised. Asthma, sinus and bronchial ailments can be aggravated by pollution in Buenos Aires. Those with specific conditions should bring a sufficient quantity of medical supplies and medicines for the trip.

View information on diseases: Yellow fever.

Yellow fever

Cause:
The yellow fever virus, an arbovirus of the Flavivirus genus.

Transmission:
Yellow fever in urban and some rural areas is transmitted by the bite of infective Aedes aegypti mosquitoes and by other mosquitoes in the forests of south America. The mosquitoes bite during daylight hours. Transmission occurs at altitudes up to 2,500 metres. Yellow fever virus infects humans and monkeys. In jungle and forest areas, monkeys are the main reservoir of infection, with transmission from monkey to monkey carried out by mosquitoes. The infective mosquitoes may bite humans who enter the forest area, usually causing sporadic cases or small outbreaks. In urban areas, monkeys are not involved and infection is transmitted among humans by mosquitoes. Introduction of infection into densely populated urban areas can lead to large epidemics of yellow fever. In Africa, an intermediate pattern of transmission is common in humid savannah regions. Mosquitoes infect both monkeys and humans, causing localized outbreaks.

Nature of the disease:
Although some infections are asymptomatic, most lead to an acute illness characterized by two phases. Initially, there is fever, muscular pain, headache, chills, anorexia, nausea and/or vomiting, often with bradycardia. About 15% of patients progress to a second phase after a few days, with resurgence of fever, development of jaundice, abdominal pain, vomiting and haemorrhagic manifestations; half of these patients die 10-14 days after onset of illness.

Geographical distribution:
The yellow fever virus is endemic in some tropical areas of Africa and central and south America. The number of epidemics has increased since the early 1980s. Other countries are considered to be at risk of introduction of yellow fever due to the presence of the vector and suitable primate hosts (including Asia, where yellow fever has never been reported).

Risk for travellers:
Travellers are at risk in all areas where yellow fever is endemic. The risk is greatest for visitors who enter forest and jungle areas.

Prophylaxis (protective treatment):
Vaccination. In some countries, yellow fever vaccination is mandatory for visitors.

Precautions:
Avoid mosquito bites during the day as well as at night.

Endemic Countries:
The World Health Organization considers the following countries to be endemic for yellow fever: Angola, Benin, Bolivia, Brazil, Burkino Faso, Burundi, Cameroon, Central African Republic, Chad, Colombia, Congo, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Ecuador, Equatorial Guinea, Ethiopia, French Guyana, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Guyana, Kenya, Liberia, Mali, Niger, Nigeria, Panama, Peru, Rwanda, Sao Tome and Principe, Senegal, Sierra Leone, Somalia, Sudan, Suriname, Togo, Trinidad and Tobago, Uganda, United Republic of Tanzania and Venezuela. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism
National Secretariat of Tourism, Buenos Aires: +54 (0)11 4312 2232 or www.turismo.gov.ar

Argentina Embassies
Embassy of Argentina, Washington DC, United States: +1 202 238 6400.

Embassy of Argentina, London, United Kingdom: +44 (0)20 7318 1300.
Embassy of Argentina, Ottawa, Canada: +1 613 236 2351.
Embassy of Argentina, Canberra, Australia: (02) 6273 9111.
Embassy of Argentina, Pretoria, South Africa: +27 (0)12 430 3524/7.
Embassy of Argentina, Dublin, Ireland: +353 (0)1 269 1546.
Embassy of Argentina, Wellington, New Zealand: +64 (0)4 472 8330.

Foreign Embassies in Argentina
United States Embassy, Buenos Aires: +54 (0)11 5777 4533.

British Embassy, Buenos Aires: +54 (0)11 4808 2200.
Canadian Embassy, Buenos Aires: +54 (0)11 4808 1000.
Australian Embassy, Buenos Aires: +54 (0)11 4779 3500.
Embassy of South Africa, Buenos Aires: +54 (0)11 4317 2900.
Embassy of Ireland, Buenos Aires: +54 (0)11 5787 0801.
New Zealand Embassy, Buenos Aires: +54 (0)11 4328 0747.

Argentina Emergency Numbers
Emergencies: 101.

Airports

Ministro Pistarini International Airport (EZE)

Location: The airport is situated 22 miles (35km) to the southwest of Buenos Aires.

Time: GMT -3.

Contacts: Tel: +54 (0)11 5480 6111.

Transfer between terminals: The two terminals are linked by a covered walkway.

Transfer to the city: Manuel Tienda Leon run a bus every 30 minutes to their terminal in the city centre (Madero Terminal), taking about 40 minutes. Public buses are cheaper but can take up to two hours to the city centre. Metered taxis are also available outside the terminal buildings, and chauffeured cars (remises) are available for hire on the lower level of both terminals.

Car rental: Car rental companies have desks in Terminal A.

Facilities: There are several shops, pharmacies, restaurants, cafes and bars, as well as duty-free shopping. Bureaux de change and ATMs are available as well as a 24-hour bank. There is a left-luggage facility and a tourist information desk in Terminal A. Other facilities include mobile phone hire, medical service, a VIP lounge and Internet access. Facilities for the disabled are good.

Parking: Long and short-term parking is available in both a multi-level covered parking garage (adjacent to Terminal A) and an open-air lot.

Departure Tax: Airport tax: US$18 (international flights), US$8 (regional and Uruguay), $6.05 (domestic). Security tax: US$2.50 (international), $1 (domestic). Immigration tax (international flights): US$10.
Website: www.aa2000.com.ar

Climate

Buenos Aires has a temperate climate with average temperatures ranging from 94°F (35°C) in January to 50°F (10°C) in July. The heaviest rain falls during autumn and spring, though rain can be expected at any time of the year. Many locals leave Buenos Aires during the hot summer months (December, January and February) and head for the coastal resorts.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US nationals require a passport for travel to Argentina, but no tourist or business visa is required for unlimited entries of up to three months each.

Entry requirements for UK nationals: UK nationals require a passport, but no tourist or business visa is required for a stay of up to three months for British Citizens. British Overseas Territories Citizens or British Overseas Citizens coming for tourism do not require a visa for stays of up to three months, while British Nationals (Overseas) do not require a tourist visa for a stay of up to one month.

Entry requirements for Canadians: Canadians require a passport, but no tourist visa is required for a stay of up to three months.

Entry requirements for Australians: Australians require a passport, but no tourist or business visa is required for unlimited entries of up to three months each.

Entry requirements for South Africans: South African nationals must hold a passport, but no tourist or business visa is required for unlimited entries of up to three months each.

Entry requirements for New Zealanders: New Zealand nationals require a passport, but no tourist or business visa is required for unlimited entries of up to three months each.

Entry requirements for Irish nationals: Irish nationals require a passport, but no tourist visa is required for a stay of up to three months.

Passport/Visa Note: Visas are valid for several entries within the period of validity stated in the visa. It is recommended that all visitors have sufficient funds (at least US$50 per day), as well as onward or return tickets and documents required for next destination. Extensions on visas are possible.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.

Volunteer Travel Guide Chile

A Chilean legend maintains that after God had created the wonders of the world he had many pieces leftover. He had raging rivers, sprawling glaciers, valleys and soaring mountains, snow-capped volcanoes, sparkling lakes, beautiful forests and deserts, icy fjords and sandy beaches. Rather than let all this beauty go to waste, he put them together in a remote part of the world, and so Chile was born.

Shaped like a long narrow strip and making up the western part of South America's tail, it is 2,610 miles (4,200km) in length and at most 115 miles (180km) wide. Travellers are drawn to this country because of its multitude of natural attractions, from the northern desert to the Lake District, and the mountains and fjords of Patagonia in the south. It has some superb National Parks, including Easter Island famous for its mysterious giant statues, and numerous activities for outdoor enthusiasts.

Chile's European heritage is evident throughout the country and travellers here are likely to feel more familiar with its culture than those of the neighbouring countries, with their strongly indigenous lifestyles. There are still local traditions persisting in parts of Chile however, and together with the European influence this makes for an interesting juxtaposition, providing a distinctive culture. The people are resilient, cordial and warm, from the fashionable capital city of Santiago to the isolated island of Chiloé, and Chilean hospitality is renowned.

Besides natural beauty and an interesting blend of cultures, Chile offers the visitor excellent wines and seafood, unique handicrafts and shopping, and a variety of characteristic architecture, making it a beautiful and memorable place to visit.

The Basics

Time:

Mainland is GMT -4 (GMT -3 from October to March). Easter Island is GMT -6 (GMT -5 from October to March).

Electricity:

Electrical current is 220 volts, 50Hz. Round two-pin plugs and round three-pin plugs (in-line) are used.

Language:

The official language is Spanish.

Health:

There are no vaccination requirements for entry to Chile, but a typhoid vaccine is recommended for travellers other than short term travellers who restrict their meals to major restaurants, hotels or cruise ships. Dengue fever is on the increase and visitors should take precautions against mosquito bites. Water is generally safe in the cities, but should be treated in the rural areas; bottled water is widely available for drinking. Santiago is severely polluted and this could cause respiratory problems or eye irritations, particularly from May to August. Travellers visiting the Andes Mountains should be aware of altitude sickness, and ascend slowly to allow the body to adjust. Health care in urban areas is adequate, but hospitals and clinics are extremely expensive and usually require payment in cash. Health insurance is strongly recommended.

Tipping:

Tips of 10% is expected in restaurants. It is not customary to tip taxi drivers but it is usual to round up the fare if they help with luggage. In general tipping small amounts is customary for all services.

Customs:

Bargaining is not practiced in street markets or stores. It is considered polite for smokers to offer cigarettes to travel companions before lighting up themselves.

Business:

Chilean business culture tends to be formal, and this includes dress, which should also be conservative. In business, Chileans should be addressed by their titles and surnames, unless otherwise stated. Businesses are often family-run. Third party introductions are indispensable when arranging a meeting, and developing a personal relationship is key. Chileans stand very close when conversing and it is impolite to pull away. Visitors are also expected to re-confirm appointments before arriving at a meeting. Foreigners should be on time for meetings, but it is not unusual for the host to be 15-30 minutes late. On introduction, a firm handshake and exchange of business cards is usual - cards should be printed in both English and Spanish and care should be taken to pay attention to the card before putting it away carefully. Business hours are generally 9am to 5pm Monday to Friday, with a two-hour siesta over lunch.

Communications:

The international access code for Chile is +56. The outgoing code is 00 followed by the relevant country code (e.g. 0044 for the United Kingdom). The area code for Santiago is (0)2. Internet cafes are available in the main towns. A number of telephone companies offer different rates for national and international calls, depending on the time of day. Public phones are widely available and international call centres are available in most shopping malls. Mobile phone companies have roaming agreements with most international cell phone companies; otherwise mobile phones can easily be rented. A GSM 1900 network is in operation. Internet cafes are widespread, particularly in the big cities.

Duty Free:

Travellers entering Chile do not need to pay customs duty on 400 cigarettes, 50 cigars (large or small) and 500g tobacco; 2.5 litres of alcohol; and perfume for personal use. Meat products, flowers, fruit and vegetables may only be imported if permission is given by the Department of Agriculture in advance.

Health

There are no vaccination requirements for entry to Chile, but a typhoid vaccine is recommended for travellers other than short term travellers who restrict their meals to major restaurants, hotels or cruise ships. Dengue fever is on the increase and visitors should take precautions against mosquito bites. Water is generally safe in the cities, but should be treated in the rural areas; bottled water is widely available for drinking. Santiago is severely polluted and this could cause respiratory problems or eye irritations, particularly from May to August. Travellers visiting the Andes Mountains should be aware of altitude sickness, and ascend slowly to allow the body to adjust. Health care in urban areas is adequate, but hospitals and clinics are extremely expensive and usually require payment in cash. Health insurance is strongly recommended.

View information on diseases: Typhoid fever

Typhoid fever

Cause:
Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:
Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:
Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:
Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:
Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

Contacts

Visa Agencies

Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com

Tourism

Chile National Tourism Board SERNATUR, Santiago: +56 (0)2 696 7141 or www.chile.travel

Chile Embassies

Embassy of Chile, Washington DC, United States: +1 202 785 1746.

Embassy of Chile, London, United Kingdom: +44 (0)20 7580 6392.
Embassy of Chile, Ottawa, Canada: +1 613 235 4402.
Embassy of Chile, Canberra, Australia: +61 (0)2 6286 2430.
Embassy of Chile, Pretoria, South Africa: +27 (0)12 460 8090.
Embassy of Chile, Dublin, Ireland: +353 (0)1 667 5094.
Embassy of Chile, Wellington, New Zealand: +64 (0)4 471 6270.

Foreign Embassies in Ecuador

United States Embassy, Santiago: +56 (0)2 232 2600.

British Embassy, Santiago: +56 (0)2 370 4100.
Canadian Embassy, Santiago: +56 (0)2 652 3800.
Australian Embassy, Santiago: +56 (0)2 550 3500.
South African Embassy, Santiago: +56 (0)2 231 2860-3.
Honorary Consul of Ireland, Santiago: +56 (0)2 245 6616.
New Zealand Embassy, Santiago: +56 (0)2 290 9800.

Chile Emergency Numbers

Emergencies: 133 (Police); 131 (Medical).

Airports

Santiago Arturo Merino Benitez International Airport (SCL)

Location: The airport is situated 13 miles (21km) north west of Santiago.

Time: Local time is GMT –5 (GMT –4 from the second Sunday in October to the second Saturday in March).

Contacts: Tel: +56 (0)2 690 1752/3.

Transfer to the city: Several bus services leave regularly for the city centre. Official airport taxis are also available from outside international and domestic arrivals.

Car rental: International companies such as Avis and Alamo are represented at the airport as well as several local companies.

Facilities: Facilities at this extremely well equipped airport include Business and Internet Centres, bureaux de change, banks and ATMs, duty-free shops as well as a variety of other retail stores, restaurants, cafes and bars, a post office, tourist information, travel agencies and hotel reservations. There are also plenty of children's play areas available.

Parking: Parking is available 24-hours a day.

Departure Tax: Passengers with a passport from Australia, Canada, United States or Mexico are required to pay a reciprocity tax on entering the airport. Australians: US$56, Canadians: US$132, US nationals: US$100, and Mexicans: US$15.

Website: www.aeropuertosantiago.cl

Climate

Ecuador's geography has endowed the country with a variety of microclimates.The coast is hot all year, with a humid rainy season between December and May. In the mountains climate depends on altitude, becoming cooler the higher you go. The Amazon region is hot, humid and wet while the Galapagos Islands are dry with a steady year-round average temperature of 77ºF (25ºC).

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: No visa is required by US nationals for visits of up to 90 days, but a US$131 reciprocity fee, payable in USD cash on arrival, will be charged for tourists. The receipt is regarded as a multiple entry visa and is valid until expiry of passport. A passport is required for travel to Chile.

Entry requirements for UK nationals: UK nationals do not require a visa for visits of up to 90 days. A passport is required.

Entry requirements for Canadians: No visa is required by Canadians for visits of up to 90 days, but a US$132 reciprocity fee, payable in USD cash on arrival, will be charged for tourists. The receipt is regarded as a multiple entry visa and is valid until expiry of passport. A passport is required for travel to Chile.

Entry requirements for Australians: No visa is required by Australians for visits of up to 90 days, but a US$61 reciprocity fee, payable in USD cash on arrival, will be charged for tourists. The receipt is regarded as a multiple entry visa and is valid for three months. A passport is required.

Entry requirements for South Africans: South African nationals must hold a passport. A visa is not required for stays of up to 90 days.

Entry requirements for New Zealanders: New Zealand nationals must hold a passport. A visa is not required for a stay of up to 90 days.

Entry requirements for Irish nationals: Irish nationals must hold a passport, but a visa for a stay of up to 90 days is not required.

Passport/Visa Note: Passengers must hold a Tourist Card (issued free of charge on arrival for 90 days) and sufficient funds to cover intended period of stay. A return or onward ticket is not required if holding a credit card or sufficient funds to purchase a ticket. Passengers with a passport from Australia, Canada, United States or Mexico are required to pay a reciprocity tax on entering Santiago airport before passing through Customs. Fees are US$61 for Australians, US$132 for Canadians, US$131 for US nationals and US$23 for Mexican passport holders. This tax must be paid in US dollars cash; it is paid once and remains valid until the passport expires (for Canadians and Americans) or for three months (for Mexicans and Australians).

Note: Passport and visa requirements are liable to change at short notice. Travelers are advised to check their entry requirements with their embassy or consulate.

You are offering your time, skills and enthusiasm for free – so why do you have to pay to volunteer?

It is a question many volunteer sending agencies in the US are asked time and time again. There is no hard and fast rule, and each potential volunteer should consider it their own responsibility to ask organisations questions such as: where their money goes, whether the organisation is profit or non-profit, whether the host organisation overseas is being charged and how much of the volunteer’s money is actually sent overseas. But in theory it is a relatively simple question to answer. If the volunteer themselves doesn’t pay, then who does?

Many volunteer-sending agencies are run as non-profit organisations, so volunteers can rest assured that money paid to these organisations is not lining anyone’s pocket. However the reality of the situation is this – it costs money to run any organisation and running costs must be covered by someone. Wages, office space, international phone calls, training courses, materials must all be paid for.

Although some organisations rely on external funding to cover such costs and therefore are able to charge a lower fee to an individual volunteer, increasingly organisations are recognising the sustainable benefit of running as a ‘social enterprise’. This means less reliance on funding and instead costs are covered by the organisation generating its own revenue.

So the US volunteer-sending agency charges individuals a fee prior to a volunteer departing the US. In return the agency provides volunteers with an organised and supported volunteering placement overseas. For any professional US agency the service they provide will most probably cover training prior to departure, support throughout the placement as well as (in some cases) the provision of insurance, food and accommodation whilst overseas.

So its not all give, give, give for the volunteer. Although paying for a volunteering experience by no means ‘guarantees’ a successful placement overseas, there are many benefits of working through a US volunteer-sending agency. You are given access to a wealth of advice, experience and support (both logistical and emotional) from those who work in and with the sending agency. Pre-departure preparation is generally an integral part of the service any professional volunteer-sending agency provides – covering important issues such as culture, language, your work environment, accommodation, what to pack, what to do if something goes wrong. Managing everyone’s expectations is also a key part of the service a good volunteer-sending agency provides.

Admittedly, there are a multitude of issues to consider when arranging an international volunteering experience and this article is by no means exhaustive; however do consider this before altogether disregarding a US volunteer-sending agency and trying to go it alone. If you sit and actually work out how much it would cost you in time and money (and peace of mind!) to find an organisation overseas, communicate with them to co-ordinate a role for yourself, phone and email them to develop a strong relationship, set up accommodation, arrange specialist volunteer insurance cover, organise transfers from the airport when you arrive…the list goes on…you might actually be surprised by how little the difference is between travelling to a country on your own and the cost of participating in a programme through a US volunteer-sending agency.

Useful Travel Links

• U.S. Customs & Border Protection
• US Centers for Disease Control & Prevention
• Transportation Security Administration
• Airport Security Checkpoint Wait Times
• World Time Server
• Worldwide Country Facts
• State Dept. Travel Warnings
• Passport Information
• List of state consumer affairs offices
• U.S. Embassies and Consulates
• Fly-Rights-A Consumer Guide to Air Travel: Guide to passenger’s rights from the Aviation Consumer Protection Division of the U.S. Department of Transportation
• International Health and Vaccination Requirements: A list of countries and their health requirements or warnings from the U.S. Centers for Disease Control. Also, find a list of cruise ship inspection scores.

Register Your Travel So We Can Contact You in an Emergency

• Why It’s Important
• How to Register (It’s Easy)
  

Planning Your Trip:  Know Before You Go!

• Information Resources
  • The Consular Information Program
  • How to Obtain Country Specific Information, Travel Warnings and Travel Alerts
  • Background Notes
  • Other Resources
• Customs and Import Restrictions
  • Customs Restrictions of Foreign Destinations – What You Cannot Take to Other Countries
  • U.S. Customs Restrictions – What You Cannot Bring Back With You
• Taking a Pet Overseas
• Places to Receive Mail
• Health:  What You Need to Know in Advance of Travel
  • Vaccination, Infectious Diseases, Pandemic Influenza, Foot & Mouth Disease, Chemical/Biological/Nuclear Incidents
  • Insurance, Medicare & Medicaid, Medical Evacuation
  • Bringing Medications or Filling Prescriptions Abroad
  • Doctors and Hospitals
• Special Planning Considerations
  • Student Travelers
  • Senior Travelers
  • Traveling With Disabilities

Required Travel Documents and Other Important Documentation

• Passport Requirements & How to Apply for a Passport
  • How to Apply for a U.S. Passport
• If You Need to Obtain a New Passport While Abroad
• Adoption Abroad
• Entry Requirements of Foreign Countries
• Work Authorization, Residence Permits
• Additional Fees

What to Take With You on the Trip, and What to Leave Behind

• Valuables
• Leave Copies of Documents and Itinerary With Relatives in the U.S.
• Plan for the Unexpected

Emergencies:  Consular Assistance and Crises Abroad

• Assistance from American Consuls
• How to Contact the Embassy or the State Department in an Emergency
• What You Should Know If You Are a Victim of Crime
• Passport Fraud
• Scams
• International Child Custody Disputes
• Arrests Abroad
• Special Warning About Drug Offenses Abroad
• Death of a U.S. Citizen Abroad
• Terrorism
• Hijacking/Hostage Situations
• How to Access Funds in the U.S.
• How to Get Your Passport Replaced

What You Should Know If You Are Residing Abroad or Are Planning to Reside Abroad

• Marriage, Birth, Divorce and Death Abroad
  • Marriage Abroad
  • Birth Abroad of a U.S. Citizen
  • Divorce Abroad
  • Death Abroad
• Federal Benefits Services Abroad
• Driver’s License
• Absentee Voting in U.S. Elections
• Selective Service Registration
• Be Prepared for Emergencies

If you have been offered a great bargain on a cruise or resort vacation, but you cannot seem to get all the details unless you pay the company first, you may be dealing with a travel scam.

PAY NOW, TRAVEL LATER … MAYBE
Typically, scam operators won’t give you full and complete information in writing until after you’ve given them a credit card number, certified check or money order. Once you do get further information, there will be restrictions and conditions which may make it more expensive, or even impossible, to take your trip.

While getting a refund is sometimes possible, it’s better to avoid paying anything in the first place. While there is the remote chance that you might miss a legitimate deal, chances are you will save yourself time and money in the long run.

To help avoid being a victim of a travel scam, the American Society of Travel Agents provides the following suggestions when evaluating travel offers:

• Retain a healthy dose of skepticism. Be extremely skeptical about unsolicited e-mail, postcard and phone solicitations saying you’ve been selected to receive a fabulous vacation or anything free. Be especially wary of firms requiring you to wait at least 60 days to take your trip.
• Do your homework. Some offers might sound great on the surface, but be sure to read the fine-print. Certain offers impose so many requirements and restrictions, such as black-out dates and companion fees, that you will either never have the chance to take the trip or you will end up paying more than had you made the arrangements on your own or used an ASTA travel agent
• Run a “background check.” Consumers should vet the companies from which they purchase travel services. They can do this by searching for the company on the Better Business Bureau’s Web site or by checking to see if they are members of ASTA. Other sites to check are www.complaintsboard.com and www.ripoffreport.com.
• Keep private information private. Never give out your credit card number unless you initiate the transaction and you are confident about the company with which you are doing business.
• Get the facts. You should receive complete details in writing about any trip prior to payment. These details should include the total price; cancellation and change penalties, if any; and specific information about all components of the package.
• Follow up. Once you have the complete details of your trip, contact the hotel and transportation companies on your own to make certain the reservations have been made.
• Know where you stand. If you insist on replying to an e-mail or calling a 900-number in response to a travel solicitation, understand the charges and know the risks.
• Know when to fold ‘em. Know when to walk away. High-pressure sales presentations that don’t allow you time to evaluate the offer, or which require that you disclose your income are red flags to be heeded.
• Protect yourself. Always pay with a credit card if possible. Even legitimate companies can go out of business. Under the Fair Credit Billing Act, credit card customers have the right to refuse paying for charges for services not rendered. Details of the Fair Credit Billing Act can be found at the Federal Trade Commission’s Web site.

SPORTS TRAVEL PACKAGES
Often you will find advertisements for travel packages to major sporting events, like the Super Bowl, the Daytona 500 or the World Series. Many of these offers are legitimate, but there have been instances in the past where consumers have been scammed by unscrupulous vendors who never had tickets to the event.

“Every year, we hear reports of sports fans whose travel plans were ruined by a questionable organization with an offer that sounded too good to be true,” said ASTA President and Chair, Chris Russo CTC. “A good travel agent knows which questions to ask and what to look for in a legitimate sports travel package. Many people aren’t aware, for instance, that under the U.S. government’s ‘Truth in Ticketing’ rules, a tour operator advertising a Super Bowl travel package that includes a flight and game tickets must have the game tickets in hand or have a written contract for the tickets before they can even advertise.”
Before you buy a sports travel package, be sure to carefully read the tour brochure and any other solicitation material and pay by credit card, where possible, so you can be protected under federal fair credit practice laws.

AGENT CREDENTIALS FROM ‘CARD MILLS’
Beware of offers from companies that sell questionable travel agent credentials. Consumers may be led to believe that such cards allow them to travel at free or reduced rates.

Organizations making these offers are known throughout the travel industry as “card mills” because they routinely offer credentials by the thousands in the form of an identification card that is sold for a significant fee. In turn, these cards would presumably be accepted by every segment of the travel industry. Many suppliers of travel, however, do not accept them.

Travelers have long needed various documents to travel. As security tightens in the United States, authorities are being strict about proper documentation. Whether you are visitng the U.S. or an American citizen traveling abroad, it is vital to have all your papers in order.

PASSPORTS AND VISAS
Depending on the country you plan to visit, you will probably need a passport, and perhaps a visa or tourist card. See Foreign Entry Requirements.

To obtain a passport application, contact the nearest Passport Agency, one of the many federal or state courts, or a U.S. Post Office that accepts passport applications. The State Department’s Passport Bureau has details on what you will need to apply for a passport.

Visas are available from the embassy or consulate of the country you will be visiting or from a “visa service” which will get your visa processed for a nominal fee.

In both cases, apply for your travel documents several months in advance of your scheduled departure to avoid peak season delays.

Update: Travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada will be required to have a passport or other secure, accepted document to enter or re-enter the United States. See More.

Beginning Jan. 31, 2008, U.S. and Canadian citizens have the option, in lieu of a passport or alternate document, to present a government-issued photo ID along with a birth certificate at land and sea borders. See More.

Also, The State Department will no longer amend valid passports. Passport holders will have to apply for a replacement passport.

Visiting the United States? If you are visiting from one of the 27 Visa Waiver Program countries, the US government is instituting new passport requirements in 2005 and 2006 that will affect you. Click here for more information on what is required and when.

MAKE COPIES OF EVERYTHING
Remember, your passport is your most valuable travel document when you are in a foreign country. Keep a copy of your passport number in a safe, separate place and immediately report the loss or theft of your passport or visa to the U.S. embassy or consulate and the local police authorities.

Make several copies of your passport, traveler’s checks, credit cards, itinerary, airline tickets and other travel documents. Leave one copy with a relative or friend back home and carry one copy with you.

Take most of your money in traveler’s checks and record the serial numbers, denominations and date and location of the issuing agency. Remove all unnecessary credit cards from your wallet. Be sure to carry your credit card company’s telephone number in case your card is lost or stolen. Always report losses immediately.

LET THE U.S. GOVERNMENT KNOW YOUR PLANS IN CASE OF EMERGENCY
Be sure to register your trip with the U.S. Department of State at https://travelregistration.state.gov/ibrs/. Travel registration is a free service to U.S. citizens who are traveling to, or living in, a foreign country. Registration allows you to record information about your upcoming trip abroad that the Department of State can use to assist you in case of an emergency.

U.S. embassies and consulates can assist American travelers who are victims of crime, accident, or illness, or whose family and friends need to contact them in an emergency. By registering your trip, you help the embassy or consulate locate you when you might need them the most.

VACCINATION CERTIFICATE
Certain countries may require an “International Certificate of Vaccinations” against cholera, yellow fever and other infectious diseases before you are allowed to enter. Specific information on entry requirements can be obtained from your ASTA travel agent, physician or the embassy of the country you will be visiting.

As an added precaution, make sure that your measles, mumps, rubella, polio, diphtheria and tetanus shots are up to date. You can also check with the Citizens Emergency Center at the U.S. Department of State in Washington, D.C. (202.647.5225), or the Centers for Disease Control at 404.639.3311 for up-to-date information on epidemics or unsafe conditions in your planned destination.

For detailed information about steps you can take to ensure a safe trip, see How to Have a Safe Trip.  Meanwhile, here are some quick tips to make your travel easier and safer:

• Register so the State Department can better assist you in an emergency: Register your travel plans  with the State Department through a free online service at https://travelregistration.state.gov.  This will help us contact you if there is a family emergency in the U.S., or if there is a crisis where you are traveling.  In accordance with the Privacy Act, information on your welfare and whereabouts will not be released to others without your express authorization.
• Sign passport, and fill in the emergency information:  Make sure you have a signed, valid passport, and a visa, if required, and fill in the emergency information page of your passport.
• Leave copies of itinerary and passport data page: Leave copies of your itinerary, passport data page and visas with family or friends, so you can be contacted in case of an emergency.
• Check your overseas medical insurance coverage: Ask your medical insurance company if your policy applies overseas, and if it covers emergency expenses such as medical evacuation.  If it does not, consider supplemental insurance.
• Familiarize yourself with local conditions and laws: While in a foreign country, you are subject to its laws.  The State Department web site at http://travel.state.gov/travel/cis_pa_tw/cis/cis_1765.html has useful safety and other information about the countries you will visit.
• Take precautions to avoid being a target of crime: To avoid being a target of crime, do not wear conspicuous clothing or jewelry and do not carry excessive amounts of money.  Also, do not leave unattended luggage in public areas and do not accept packages from strangers.
• Contact us in an emergency: Consular personnel at U.S. Embassies and Consulates abroad and in the U.S. are available 24 hours a day, 7 days a week, to provide emergency assistance to U.S. citizens.  Contact information for U.S. Embassies and Consulates appears on the Bureau of Consular Affairs website at http://travel.state.gov.  Also note that the Office of Overseas Citizen Services in the State Department’s Bureau of Consular Affairs may be reached for assistance with emergencies at 1-888-407-4747, if calling from the U.S. or Canada, or 202-501-4444, if calling from overseas.