Rural Zambia is often not a healthy place to be. However, visitors using the better hotels, lodges and camps are unlikely to encounter any serious problems. The standards of hygiene in even the most remote bushcamps are generally at least as good as you will find at home.
Major dangers in Zambia are car accidents (especially likely if you drive at night) and sunburn. Both can also be very serious, yet both are within the power of the visitor to avoid.
The following is general advice, applicable to travelling anywhere, including Zambia:
Food and storage
Throughout the world, most health problems encountered by travellers are contracted by eating contaminated food or drinking unclean water. If you are staying in safari camps or lodges that rely on overseas visitors, then you are very unlikely to have problems. However, if you are backpacking and cooking for yourself, or relying on local food, then you need to take more care.
Tins, packets, and fresh green vegetables (when you can find them) are least likely to cause problems – provided that clean water has been used for washing the vegetables and preparing the meal. In zambia's warm climate, keeping meat or animal products unrefrigerated for more than a few hours is asking for trouble.
Water and purification
Whilst piped water in the major towns is unlikely to harbour any serious pathogens, it will almost certainly cause upset stomachs for overseas visitors. In more rural areas, the water will generally have had less treatment, and therefore will be even more likely to cause problems. Hence, as a general rule, ensure that all water used for drinking or washing food in Zambia is purified.
To purify water yourself, first filter out any suspended solids – perhaps passing the water through a piece of closely woven cloth, or something similar. Then either vigorously boil it for a minimum of two minutes, or sterilise it chemically. Boiling is much more effective, provided that you have the fuel available.
Tablets sold for purification are based on either chlorine, iodine or silver, and normally adequate. Just follow the manufacturer's instructions carefully. Iodine is most effective, especially against the resilient amoebic cysts that cause amoebic dysentery and other prolonged forms of diarrhoea.
A cheaper alternative to tablets sold over the counter is to travel with a small bottle of medical-quality tincture of iodine (2% solution) and an eye dropper. Add four drops to one litre of water, shake well, and leave to stand for ten minutes. If the water is very cloudy – even after filtering – or very cold, then either double the iodine dose, or leave to stand for twice as long.
Note that this tincture of iodine can also be used as a general external antiseptic, but it will stain things deep purple if spilt – so seal and pack its container exceedingly well.
Heat and sun
Heat stroke, heat exhaustion and sunburn are often problems for travellers to Africa, despite being easy to prevent. To avoid them, you need to remember that your body is under stress and make allowances for it. First, take things gently – you are on holiday after all. Next, keep your fluid and salt levels high: lots of water and soft drinks but go easy on the caffeine and alcohol. Thirdly, dress to keep cool with loose-fitting, thin garments, preferably of cotton, linen or silk. Finally, beware of the sun. Hats and long-sleeved shirts are essential. If you must expose your skin to the sun, then use sun-blocks and high factor sun-screens (the sun is so strong that you will still get a tan).
Avoiding insect bites
The most dangerous biting insects in Africa are mosquitoes, because they can transmit malaria, yellow fever, and a host of other diseases. Research has shown that using a mosquito net over your bed, and covering up exposed skin (by wearing long-sleeved shirts, and tucking trousers into socks) in the evening, are the most effective steps towards preventing bites. Bed-net treatment kits are available from travel clinics; these prevent mosquitoes biting through a net if you roll against it in your sleep, and also make old and holy nets protective. Mosquito coils and chemical insect repellents will help, and sleeping in a stream of moving air, such as under a fan, or in an air-conditioned room, will help to reduce your chances of being bitten.
Visitors on safari are also exposed to bites during the day from tsetse flies. These large dark flies (bigger than house flies) bite during the day and are especially attracted both to the scent of cattle and to dark colours. Dark blue seems to be their favourite, so avoid wearing that and don't forget your insect repellents even during the day. (See Sleeping sickness, page 78.)
DEET (diethyltoluamide) is the active ingredient in almost all repellents, so the greater the percentage of DEET, the stronger the effect. However, DEET is a strong chemical. Repellents containing around 50% DEETare regarded as an effective, non-toxic concentration. It will dissolve some plastics and synthetic materials, and may irritate sensitive skin. Because of this, many people use concentrated DEET to impregnate materials, rather than applying it to themselves. Mosquito nets, socks, and even cravats can be impregnated and used to deter insects from biting although permethrin is the treatment of choice for mosquito nets. Eating large quantities of garlic, or cream of tartar, or taking yeast tablets, are said to deter some biting insects, although the evidence is anecdotal – and the garlic may affect your social life.
Snakes, spiders and scorpions...
Encounters with aggressive snakes, angry spiders or vindictive scorpions are more common in horror films than in Africa. Most snakes will flee at the mere vibrations of a human footstep whilst spiders are far more interested in flies than people. You will have to seek out scorpions if you wish to see one. If you are careful about where you place your hands and feet, especially after dark, then there should be no problems. You are less likely to get bitten or stung if you wear stout shoes and long trousers. Simple precautions include not putting on boots without shaking them empty first, and always checking the back of your backpack before putting it on.
Snakes do bite occasionally, and you ought to know the standard first-aid treatment. First, and most importantly, don't panic
. Most snakes are harmless and even venomous species will only dispense venom in about half of their bites. If bitten, you are unlikely to have received venom; keeping this fact in mind may help you to stay calm.
Even in the worst of these cases, the victim has hours or days to get to help, and not a matter of minutes. He/she should be kept calm, with no exertions to pump venom around the blood system, whilst being taken rapidly to the nearest medical help. The area of the bite should be washed to remove any venom from the skin, and the bitten limb should be immobilised. Paracetamol may be used as a painkiller, but never use aspirin because it may cause internal bleeding.
Most first-aid techniques do more harm than good; cutting into the wound is harmful and tourniquets are dangerous; suction and electrical inactivation devices do not work; the only treatment is antivenom. In case of a bite which you fear may be both serious and venomous then:
• Try to keep calm. It is likely that no venom has been dispensed
• Stop movement of the bitten limb by applying a splint
• If you have a crepe bandage, firmly bind up as much of the bitten limb as you can. Release the bandage for a few minutes every half-hour
• Keep the bitten limb below
heart height to slow spread of any venom
• Evacuate the victim to a hospital that has antivenom
give aspirin. You may offer paracetamol, which is safe
• Do not
apply ice packs
• Do not
apply potassium permanganate
If the offending snake can be captured without any risk of someone else being bitten, take it to show the doctor. But beware, since even a decapitated head is able to dispense venom in a reflex bite.
When deep in the bush, heading for the nearest large farm or camp may be quicker than going to a town: someone there may know how to get a supply of antivenom, and probably will have the facilities to radio for help by plane.