Medical Precautions and Requirements

Health Safety Policy

For information about our commitment to your safety in this age of contagions, please refer to our Health Safety Procedures. We allow you to specify the level of health precations that you wish for your tour with Easy Track Ghana.

Malaria and Avoiding Mosquitoes

The mosquito is the most dangerous animal in Africa by far! It is essential that casual visitors to Ghana take proper precautions against mosquitoes and the malaria that some may be carrying.

Taking a prophylaxis is no guarantee that you will not get malaria if bitten, but do not over-react and think that every mosquito bite is life-threatening.

While you may have heard that malaria-carring mosquitos come at dusk and dawn, there are many types of mosquitos traveling at all hours of day and night. These beasts can also transmit a number of other maladies, so it is best to avoid mosquitoes as best as possible.

For protection, stay in open, sunny, breezy areas and wear light colored, loose fitting long pants and long-sleeve shirts, shoes and socks. Mosquitoes can bite through T-shirts and other lightweight, tight-fitting clothing. Mosquitoes are attracted by motion, heat, the trail of carbon-dioxide (CO2) in your exhaled breath, the smell of Lactic Acid, found on your skin when exercising, and other elements of your skin biotics. Scientists estimate that genetics account for 85% of your appeal to mosquitos.

Mosquitoes do tend to prefer men over women, adults more than children, and larger people. Larger bodies produce more heat, more carbon dioxide and have more body mass to bite. They also can love the bacteria that grows at your ankles, so keep your feet washed well. Sleeping with a strong fan makes it difficult for mosquitoes to find you and also helps prevent the ability of these insects to fly.

Be sure you bring a DEET-based mosquito repellant, as these are difficult to find in Ghana. After extensive testing, the US military determined that a 35% time-release (micro-encapsulated) formulation offers best coverage with the least side effects. Anything in the range 20%-35% will be effective in most situations.

Use of DEET with sun-block lowers the efficacy of the sun-block. So, more frequent applications of sunscreen will be needed for adequate solar protection. Apply the sunscreen first, let it dry, then spray the DEET over the top of the sunscreen. DEET works by inhibiting signals from the mosquitoes' antennae and making it difficult for them to find you. It does not stun or kill mosquitos.

Treat your clothing before you arrive with a Permethrin spray. This is very effective as it does kill or stun insects that come in contact with the treated fabric. Permethrin will remain in fabric for 6 or more washings. Both DEET and Permethrin sprays may found at any camping goods dealer.

There are three choices for an anti-malarial prophylactic drugs:

• Mefloquine (Larium)
  This is a once a week tablet that is the least expensive malaria prophylaxis. As with any medication that staying in your body for a week, the potential for side effects is higher.
• Malarone (proguanil and atovaquone)
  This is a daily tablet that is much more expensive than Larium. It is not associated with the side effects that some people experience on Larium.
• Doxycycline
  This common antibiotic may also be used when taken daily at 100mg. It is less effective than the other medications.

While locals you talk to in Ghana may seem very casual about malaria, it is no joke to you and your virgin immune system. The first symptoms feel like the flu, with a general malaise. Quickly developing, it will give you a rapid fever and chills, make your head pound like a sledgehammer, make you vomit and give you diarrhea. If you do not get immediate treatment, you could die. Even with treatment, it is not a fun way to spend a week of your holiday recovering.

Without a test kit, malaria is not easy to diagnose, as there are many illnesses that have these same symptoms, including typhoid, meningitis and various viral fevers - some of which are also transmitted by mosquito bites. So you should always seek treatment when experiencing a rapid rise in temperature.

When in remote areas, you may wish to carry a test kit and a course of treatment. The best course is a short term (about 3 days) malarial treatment such as artesunate, available over the counter here. It wouldn’t hurt for you to purchase these inexpensive treatments before you leave to bring back with you in the event you begin to display malarial symptoms, your treatment is at hand.

Vaccinations

Only a Yellow Fever vaccination is required for entry into Ghana. You will be asked to show proof of immunization at the border.

Other vaccinations are at your discretion. If your doctor cannot obtain one for you (generally cheaper), these vaccinations are readily available at any travel clinic. There is at this time no commercially-available malaria vaccination.

Give yourself plenty of time, as not all vaccinations can be given at the same time and some are given in multiple doses. If you are going to be taking many vaccinations, it will require different appointments over a period of several weeks.

Required

• Yellow Fever
  The only required vaccination for entry into Ghana is for Yellow Fever. This vaccine provides lifelong protection.
  

Recommended

• Diphtheria, Polio and Tetanus
  A current DPT vaccination is a good idea. This is a common vaccination given to children, but you need a booster shot if it has been more than 10 years since your last DPT vaccination. Ghana lost its polio-free status in 2019, but cases are in remote areas of the north.
• Influenza
  A current flu vaccination is also a good idea. There will undoubtedly be people on your plane carrying this virus and you never know when a major flu season will occur.
• Hepatitis A
  This vaccine is strongly recommended. It is given in multiple doses to protect against this illness which is spread orally in conditions of poor sanitation.

At Your Discretion

• Hepatitis B
  This illness is carried in bodily fluids. This multi-dose vaccination is strongly recommended for visitors who may be volunteering or visiting clinics and may come into contact with blood or semen. Note that there is no vaccine for the other virulent strains of Hepatitis (C,D,E), which are spread in the same way as Hepatitis B.
• Typhus / Typhoid Fever
  While typhus is not a big problem in Ghana, this disease, spread by dirty food or water, can be fatal. This vaccination is recommended when traveling in remote or unsanitary areas or if you plan to be around animals.
• Meningitis (bacterial)
  Characterized by blinding headaches and fever, meningitis can be fatal. The vaccination against bacterial meningitis is especially recommended if you will be staying in close quarters with many people or children. Ideally get the vaccination containing strains A, C, W and Y, but if only the A+C is available, that is better than none at all. There is no vaccination against viral meningitis.

Not Available

• Malaria Vaccine
  Malaria vaccines are currently recommended for use in children living in moderate to high malaria transmission areas. This is a series of 4 injections starting at around the age of 5 months. These are not available to travelers to endemic areas at this time. Please use your preferred malaria prophylaxis mentioned in the previous section.

Medications

Be sure to bring your own medications, or obtain them at a much lower cost in Ghana. These would include your prescription medications, malaria prophylaxis, and these supplies, which can be inexpensively obtained in Ghana:

• Pain relief
• Hand sanitizer, spray or gel
• Band-aids and antiseptic spray
• Antibiotic for gastrointestinal (GI) infection
• Lip Balm
• Nasal decongestant
• Anti-fungal spray or cream

There are pharmacies in even mid-size towns and the medications they sell are incredibly inexpensive. Antibiotics are handed out quickly and do not require a prescription or doctor's consultation. Consultations and lab tests can be performed at a very low cost by clinics and hospitals in any large town.

Remember that a bout of diarrhea or vomiting will render any medication ineffective.

Sun, Heat and Humidity

Unless accustomed to intense equatorial sun or tropical climates, the sun, heat and humidity may tire you quickly. You will sweat a lot, so be sure to keep hydrated by drinking a lot of water and cutting down on salt, caffeine and alcohol. Take a relaxed pace and siesta during the hottest part of the day.

When in the sun, use a sunscreen and wear a hat. The mosquito repellant DEET lowers the effectiveness of any sunscreen, so more frequent applications of sun-block are necessary for adequate solar protection. Apply the sunscreen first, then the DEET on top of the sunscreen.

Heatstroke, caused when the body overheats, and skin cancer, caused by exposure to the sun, can both be very serious conditions. Less severe is a heat rash, a rash of tiny bumps, usually at a friction point, such as under the arms or along the waistband of your underclothes. Take frequent baths, use talc, baby powder or baby oil and retreat to air conditioning to treat heat rash.

Follow basic good health practices. Clean and cover all breaks in your skin. In a warm, humid climate any cut can easily become infected if not kept clean.

Tropical Illnesses

There are many ways to become sick in the tropics. Following some sound precautions can ensure that you enjoy your holiday in good health.

• Water and Food borne illnesses
  Be careful of what you eat and drink, as well as the conditions under which your food and beverage are prepared and served. Many illnesses are acquired by touching your eyes, nose or mouth with dirty hands, or by people with dirty hands touching the food you put in your mouth. Eating food prepared by dirty hands can, among many things, give you Typhoid fever or Hepatitis A.
  
  Of these common illness that befall travelers, the most likely encounter will be with an unfamiliar e.Coli bacteria. People generally acclimate to local strains of e.Coli within 3 to 6 months. Simple diarrhea , with no mucus or blood, usually requires no treatment and will quickly resolve. Stay hydrated, keep out of the heat, and relax.
  
  Diarrhea is your body's way of getting rid of infection. Only take Lomotil or Imodium when absolutely necessary. These diarrhea-stopping drugs delay elimination of the offending organism, which increases the mucosal contact time with any invasive amoebas or toxins produced by bacteria. Diarrhea with a high fever, diarrhea with mucus and blood (dysentery), massive watery diarrhea (cholera), or prolonged diarrhea (more than 10 days), are indications to see a doctor.
  
  While you must be careful of the water you drink, you must also be wary of most bodies of fresh water in Africa because of the common parasite Bilharzia, or schistosomiasis. This microscopic parasite can bore through intact skin and is most common in shallow water, along weedy or reedy shores, or in places where infected people use the water or wash their clothes. "Tired all the time" is a common complain among expats, and the usual culprit is usually bilharzia or an intestinal yeast. A test at a clinic is the only way to confirm infection.
• Insect borne illnesses
  Malaria mosquitoes travel at dawn and dusk, but day-biting mosquitoes can spread viral fevers, including dengue fever (rare in Ghana) and yellow fever. These fevers feel like malaria, but are usually not fatal and are over in a week or so. Lots of water, rest and paracetamol (like Tylenol) is the recommended treatment.
  
  Besides mosquitoes, there are a number of other bad bugs in Ghana, such as biting flies and ticks. These too can carry disease, including tickbite fever, a flu-like illness, and sleeping sickness, a parasitic protozoa transmitted via bites from the large brown tsetse fly.
• Fungus
  Whether between the toes, under the arm, or between your legs, the tropical humidity can cause irritations. The best way to avoid these problems is to stay dry. A basic anti-fungal cream in your travel bag can help substantially, or you can pick some up at any pharmacy.

HIV and Sexually Transmitted Illnesses

Ghana has one of the lowest overall rates of HIV infection in sub-Saharan Africa. At around 1.7%, as last reported by UNAIDS in 2018, this is significantly higher than the 1% HIV prevalence rate of New York City, one of the most afflicted areas in the US.

Many men in Ghana do not know how to properly use a condom, nor can they afford them. So unfortunately the use of this preventative measure is not widespread. This also leads to the spread of other communicable diseases, for which few get treatment.

Everyone in Africa knows their HIV ABC's. It is a message seen everywhere:

• Abstain
• Be faithful
• Condomize

If you are having sexual relations with any person while you are visiting Ghana, it is your responsibility to ensure the good health of you and your partner. Please use appropriate precautions. Please help educate your partner. Any person will be grateful for any 'safer sex' or other health-related education that you provide. Just the basic health care knowledge you have makes you a very wise person compared to most people you will meet in Ghana.

"One Extra Bag" program

If possible, it would be a wonderful gift if you plan to leave behind any medicine, toiletries or other supplies that you bring to Ghana. Or better, participate in our 'One Extra Bag' program.

This program is designed to assist you to make a charitable donation to a reputable organization of your choice. We can take you and your donation to a school, clinic, orphanage, HIV prevention group, or any other such organization. You are encouraged to make the presentation yourself and see the workings of the organization that you are giving to. For many people, this event is the highlight of their visit.

To encourage your participation, Easy Track Ghana will give you a free airport pick-up for any full bag of supplies that you bring to donate. Thank you for your participation in this important program!

One Final Note

After reading this page, we frightened even ourselves! The words above are almost as frightening as this advertisement seen in Accra.

Just remember that the information written on this page is a sample of the worst in Ghana, or any tropical climate. While these things do exist here, the chances of your becoming sick with anything other than a heat rash or traveler's diarrhea is very small. You can almost guarantee a healthy trip if you remember to use your:

• Malaria prophylaxis
• DEET-based insect repellant
• Sunscreen
• Hand sanitizer
• Common sense