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Don’t gamble in the Gambia

From rabies to sunburn, Dr Sneh Khemka offers some tips on staying healthy and safe when travelling in the Gambia.

A friend of mine is about to jet off for a couple of weeks’ holiday in the Gambia. Lucky thing! She came and asked me if I had any useful advice for travel health. I’ve travelled and worked in Africa several times, so was only too happy to oblige.

Malaria prevention

The first thing I checked was that she had plenty of mosquito repellent and a mosquito net packed in her luggage. Malaria is very common in the Gambia all year round, but the risk is highest from June to November. Taking anti-malarial medication is important, but the key is to avoid getting bitten in the first place.

Mosquitoes are at their worst after dusk so wear long-sleeved tops and trousers after the sun goes down, and ditch your flip-flops for socks and shoes that cover your feet. You may have heard stories that eating garlic or Marmite will keep mosquitoes away, but don’t believe them – there’s no evidence to show that this is true. The best repellent to use is one containing diethyltoluamide (DEET). Find one with a concentration of at least 20 percent, but 50 percent is better as this will protect you for up to 12 hours. That way you won’t have to keep re-applying it.

Although anti-malarial medication is available, I was quick to tell my friend that it doesn’t guarantee protection from malaria. There are several types – your doctor can give you more advice and prescribe something suitable. Don’t leave it until the last minute as you may need to start taking malaria tablets at least a week before you go away, as well as the whole time you’re in the Gambia and for a while after you get back.

Be aware of the symptoms of malaria – fever, aching muscles and a headache – and the fact that it can take up to a year after being bitten for them to appear. If you get these symptoms, remember to tell your doctor that you have travelled in a malaria zone.

Vaccinations

Luckily for my friend – who isn’t a big fan of needles – I was able to reassure her that she would probably only need one jab, unless she planned on venturing into remote areas. There’s a high risk of yellow fever throughout the Gambia – again, mosquitoes are the culprits for passing this on so follow the advice about covering up and using insect repellent. You should have the vaccine, although it isn’t essential unless you’re arriving in Gambia directly from another country where yellow fever can be transmitted.

Your doctor or travel centre can give you more guidance on the vaccinations you may need.

Food and water hygiene

Contaminated food and water are responsible for causing a host of diseases, not least the infamous ‘traveller’s diarrhoea’. You can reduce your chances of this by giving tap water a wide berth unless it’s been thoroughly boiled. Don’t make the mistake of eating salad that could have been washed in tap water or using it to brush your teeth. Similarly, a cold drink may seem appealing in a hot country but many a holiday has been ruined by a couple of contaminated ice cubes.

Watch out for food that hasn’t been kept properly chilled, and dairy products unless they have been pasteurised. Seafood is always a risk, especially raw, and although it may be tempting, give food from street vendors a miss unless it’s fresh, piping hot and served on a clean plate.

Rabies

Although I’ll take some convincing that being attacked by a rabid animal can be worse than the tribe of pygmies who tackled us on one memorable trip to Africa, it’s important to stay well away from animals that could have rabies. Don’t be fooled by domestic animals – they may look harmless but animals with rabies are unpredictable and could bite you without warning. This is how most people get rabies, although it can also be passed on if infected saliva gets into your body, for example through a scratch.

Sun care

You’re pretty much guaranteed warm sunshine throughout the year in the Gambia. Although great for sun-worshippers, it does mean you need to take some precautions and limit the time you spend in the sun, staying out of it completely during the middle of the day when it’s at its hottest. Sunburn and heat stroke can be serious, and long-term you may be putting yourself at risk of skin cancer. Use a ‘broad spectrum’ sunscreen of SPF 15 or higher that blocks out both UVA and UVB rays, and re-apply it at least every two hours. I always wear a hat and sunglasses – they accompanied me all the time when trekking to see gorillas in Uganda – and I recommend you do the same.

Gambia is a great holiday destination, and a few precautionary steps can make the difference between a health hazard and a great break away.

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