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Afghanistan

Afghanistal US Consular Information Sheet March 03, 2009


COUNTRY DESCRIPTION:


Afghanistan has made significant progress since the Taliban were deposed in 2001, but still faces daunting challenges, including de

eating terrorists and insurgents, recovering from over three decades of civil strife, dealing with years of severe drought and rebuilding a shattered physical, economic and political infrastructure. Coalition and NATO forces under ISAF work in partnership with Afghan security forces to combat Taliban and al-Qa’ida elements who seek to terrorize the population and challenge the government. Violence in 2008 reached unprecedented levels, as both ISAF/Afghan forces and the Taliban initiated more battles than ever before. President Hamid Karzai was sworn in as President of the Islamic Republic of Afghanistan on December 7, 2004 and the Afghan Parliament was subsequently convened in late 2005. The government is working to develop a more effective police force, a more robust legal system, and sub-national institutions that work in partnership with traditional and local leaders to meet the needs of the population. The U.S. works closely with the international community to provide coordinated support for these efforts. An Afghanistan-hosted Peace Jirga with Pakistan resulted in a commitment to cooperate in combating terrorism, facilitate the return of Afghan refugees, and support regional economic activity. Read the Department of State Background Notes on Afghanistan for additional information.


ENTRY/EXIT REQUIREMENTS:


 A passport and valid visa are required to enter and exit Afghanistan. Afghan entry visas are not available at Kabul International Airport or any other ports of entry in Afghanistan. American citizens who arrive without a visa are subject to confiscation of their passport and face heavy fines and difficulties in retrieving their passport and obtaining a visa, as well as possible deportation from the country. Americans arriving in the country via military air usually have considerable difficulties if they choose to depart Afghanistan on commercial air, because their passports are not stamped to show that they entered the country legally. Those coming on military air should move quickly after arrival to legalize their status if there is any chance they will depart the country on anything other than military air. Visit the Embassy of Afghanistan web site at http://www.embassyofafghanistan.org for the most current visa information. The Consular office of the Embassy of Afghanistan is located at 2233 Wisconsin Avenue NW, Suite 216, Washington, DC 20007, phone number 202-298-9125. Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.


SAFETY AND SECURITY:


The latest Travel Warning for Afghanistan emphasizes that the security situation remains critical for American citizens. The Taliban and associated insurgent groups, al-Qaida network terrorist organizations, and narco-traffickers oppose the strengthening of a democratic government. These groups aim to weaken or bring down the Government of Afghanistan and to drive Westerners out of the country. They do not hesitate to use violence, including targeting civilians. Terrorist activities may include, but are not limited to bombings -- including improvised explosive devices and car bombs -- assassinations, carjackings, rocket attacks, assaults and kidnappings. There were over 120 suicide attacks in 2008. There is an ongoing threat to attack and kidnap U.S. citizens and Non-Governmental Organization (NGO) workers throughout the country. In 2008,, more than 30 NGO workers were killed (six foreigners) and at least 78 NGO staff members (seven foreigners) were abducted. Over 25 other foreign civilians, including journalists, were kidnapped. Kabul continues to experience suicide bombings against Afghan government personnel and installations, Afghan and coalition military assets, and international civilians. Riots -- sometimes violent -- have occurred in response to various political or other issues. Crime, including violent crime, remains a significant problem. Official Americans' use of the Kabul-Jalalabad, Kabul-Kandahar highways and other roads throughout the country is often restricted or completely curtailed because of security concerns. Insurgents continue to use roadside and car bombs to conduct attacks and abductions along major highways. Millions of unexploded land mines and other ordinance present a constant danger. The country faces a difficult period in the near term, and American citizens could be targeted or placed at risk by unpredictable local events. Americans should not come to Afghanistan unless they have made arrangements in advance to address security concerns. The absence of records for ownership of property, differing laws from various regimes and the chaos that comes from decades of civil strife have left property issues in great disorder. Afghan-Americans returning to Afghanistan to recover property, or Americans coming to the country to engage in business, have become involved in complicated real estate disputes and have faced threats of retaliatory action, including kidnapping for ransom and death. Large parts of Afghanistan are extremely isolated, with few roads, mostly in poor condition, irregular cell phone signals, and none of the basic physical infrastructure found in Kabul or the larger cities. Americans traveling in these areas who find themselves in trouble may not even have a way to communicate their difficulties to the outside world. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.


CRIME:


 A large portion of the Afghan population is unemployed, and many among the unemployed have moved to urban areas. Basic services are rudimentary or non-existent. These factors may directly contribute to crime and lawlessness. Diplomats and international relief workers have reported incidents of robberies and household burglaries as well as kidnappings and assault. Any American citizen who enters Afghanistan should remain vigilant for possible banditry, including violent attacks.


INFORMATION FOR VICTIMS OF CRIME:


The loss or theft abroad of a U.S. passport should be reported immediately to the local police and to the U.S. Embassy in Kabul. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy in Kabul for assistance. The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to provide a list of attorneys if needed. The local equivalent to the "911" emergency line in Afghanistan is: 119 Please see our information on Victims of Crime, including possible victim compensation programs in the United States.


CRIMINAL PENALTIES:


While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Afghanistan’s laws, even unknowingly, may be expelled, arrested or imprisoned. During the last several years, there have been incidents involving the arrest and/or detention of U.S. citizens. Arrested Americans have faced periods of detention—sometimes in difficult conditions—while awaiting trial. Penalties for possession or use of, or trafficking in illegal drugs in Afghanistan are severe, and convicted offenders can expect long jail sentences and heavy fines. Another sensitive activity is proselytizing. Although the Afghan Constitution allows the free exercise of religion, proselytizing is often viewed as contrary to the beliefs of Islam and considered harmful to society. Proselytizing may lead to arrest and/or deportation. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.


SPECIAL CIRCUMSTANCES:


Because of the poor infrastructure in Afghanistan, access to banking facilities is limited and unreliable. Afghanistan's economy operates on a "cash-only" basis for most transactions. Credit card transactions are not available. International bank transfers are limited. Some ATM machines exist at Standard Charter Bank and Afghan International Bank (AIB) in the Wazir Akbar Khan neighborhood of Kabul, but some travelers have complained of difficulties using them. International communications are difficult. Local telephone networks do not operate reliably. Most people rely on satellite or cellular telephone communications even to make local calls. Cellular phone service is available locally in Kabul and some other cities, but can be unreliable. Injured or distressed foreigners could face long delays before being able to communicate their needs to family or colleagues outside of Afghanistan. Internet access through local service providers is limited. In addition to being subject to all Afghan laws, U.S. citizens who are also citizens of Afghanistan may also be subject to other laws that impose special obligations on Afghan citizens. U.S. citizens who are also Afghan nationals do not require visas for entry into Afghanistan. The Embassy of Afghanistan issues a letter confirming your nationality for entry into Afghanistan. However, you may wish to obtain a visa as some Afghan-Americans have experienced difficulties at land border crossings because they do not have a visa in their passport. For additional information on dual nationality in general, see the Consular Affairs home page for our dual nationality flyer. U.S. citizens are encouraged to carry a copy of their U.S. passport with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available. As stated in the Travel Warning, consular assistance for American citizens in Afghanistan is limited. Islam provides the foundation of Afghanistan's customs, laws and practices. Foreign visitors -- men and women -- are expected to remain sensitive to the Islamic culture and not dress in a revealing or provocative manner, including the wearing of sleeveless shirts and blouses, halter-tops and shorts. Women in particular, especially when traveling outside of Kabul, may want to ensure that their tops have long sleeves and cover their collarbone and waistband, and that their pants/skirts cover their ankles. Almost all women in Afghanistan cover their hair in public; American women visitors should carry scarves for this purpose. Afghan customs authorities may enforce strict regulations concerning temporary importation into or export from Afghanistan of items such as firearms, alcoholic beverages, religious materials, antiquities, medications, and printed materials. American travelers have faced fines and/or confiscation of items considered antiquities upon exiting Afghanistan. It is advisable to contact the Embassy of Afghanistan in Washington for specific information regarding customs requirements. Travelers en route to Afghanistan may transit countries that have restrictions on firearms, including antique or display models. If you plan to take firearms or ammunition to another country, you should contact officials at that country's embassy and those that you will be transiting to learn about their regulations and fully comply with those regulations before traveling. Please consult http://www.customs.gov for information on importing firearms into the United States. Please see our Customs Information sheet.


MEDICAL FACILITIES AND HEALTH INFORMATION:


Well-equipped medical facilities are few and far between throughout Afghanistan. European and American medicines are available in limited quantities and may be expensive or difficult to locate. There is a shortage of basic medical supplies. Basic medicines manufactured in Iran, Pakistan, and India are available, but their reliability can be questionable. Several western-style private clinics have opened in Kabul: the DK-German Medical Diagnostic Center (www.medical-kabul.com), Acomet Family Hospital (www.afghancomet.com), and CURE International Hospital (ph. 079-883-830) offer a variety of basic and routine-type care; Americans seeking treatment should request American or Western health practitioners. Afghan public hospitals should be avoided. Individuals without government licenses or even medical degrees often operate private clinics; there is no public agency that monitors their operations. Travelers will not be able to find Western-trained medical personnel in most parts of the country outside of Kabul, although there are some international aid groups temporarily providing basic medical assistance in various cities and villages. For any medical treatment, payment is required in advance. Commercial medical evacuation capability from Afghanistan is limited and could take days to arrange. Even medevac companies that claim to service the world may not agree to come to Afghanistan. Those with medevac insurance should confirm with the insurance provider that it will be able to provide medevac assistance to this country. There have been outbreaks of Avian Influenza in poultry in Afghanistan, to include the areas of Nangahar, Laghman, and Wardak provinces, and in the city of Kabul, however, there have been no reported cases of the H5N1 virus in humans. Updates on the Avian Influenza situation in Afghanistan are published on the Embassy’s web site at http://kabul.usembassy.gov/information_for_travelers.html. For additional information on Avian Influenza, please refer to the Department of State's Avian Influenza Fact Sheet available at http://travel.state.gov/travel/tips/health/health_1181.html Tuberculosis is an increasingly serious health concern in Afghanistan. For further information, please consult the CDC's Travel Notice on TB. http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx| The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Afghanistan. However, if one has questions, please inquire directly with the Embassy of Afghanistan at http://www.embassyofafghanistan.org before you travel. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site. For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site. Further health information for travelers is available from the WHO.


MEDICAL INSURANCE:


The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas. TRAFFIC


SAFETY AND ROAD CONDITIONS:


 While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Afghanistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance. All drivers face the potential danger of encountering improvised-explosive devices and land mines that may have been planted on or near roadways. An estimated 5-7 million landmines and large quantities of unexploded ordinance exist throughout the countryside and alongside roads, posing a danger to travelers. Robbery and kidnappings are also prevalent on highways outside of Kabul. The transportation system in Afghanistan is marginal, although the international community is constructing modern highways and provincial roads. Vehicles are poorly maintained, often overloaded, and traffic laws are not enforced. Vehicular traffic is chaotic and must contend with numerous pedestrians, bicyclists and animals. Many urban streets have large potholes and are not well lit. Rural roads are not paved. Please refer to our Road Safety page for more information.


AVIATION SAFETY OVERSIGHT:


As there is no direct commercial air service to the United States by carriers registered in Afghanistan, the U.S. Federal Aviation Administration (FAA) has not assessed Afghanistan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s internet website at http://www.faa.gov/safety/programs_initiatives/oversight/iasa. U.S. Government personnel are not authorized to travel on Ariana Afghan Airlines or any other airline falling under the oversight of the Government of Afghanistan’s Civil Aviation Authority, owing to safety concerns; however, U.S. Government personnel are permitted to travel on international flights operated by airlines from countries whose civil aviation authorities meet international aviation safety standards for the oversight of their air carrier operations under the FAA’s International Aviation Safety Assessment (IASA) program.


CHILDREN'S ISSUES:


 For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. R


EGISTRATION / EMBASSY LOCATION:


Americans living or traveling in Afghanistan are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site and to obtain updated information on travel and security within Afghanistan. Americans without internet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located in Kabul on Great Massoud (Airport) Road, local phone number 0700-108-001 or 0700-108-002, and for emergencies after hours 0700-201-908. The web site is http://kabul.usembassy.gov/ * * * * * This replaces the Country Specific Information dated June 16, 2008 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties, Special Circumstances, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 29 May 2019 Source: Xinhua [edited] <http://www.xinhuanet.com/english/2019-05/29/c_138100250.htm>
A fresh positive polio case was detected in Afghanistan's eastern province of Kunar, bringing the number of confirmed cases of poliovirus to 8 since January this year [2019], a public health official said on Wednesday [29 May 2019]. "A new polio case has been reported from Watapur district of Kunar province which permanently paralyzed a 3-month-old boy," Wahidullah Mayar, spokesperson for the Ministry of Public Health, tweeted.
The latest case is the 1st case from the eastern Afghan region this year [2019], and the rest of 7 cases have been reported from southern provinces, he added. Poliovirus can be rapidly transferred, and the only way [to prevent the disease] is vaccination, according to the official.
The ongoing insurgency and conflicts have been hindering the efforts to stamp out the infectious disease in the mountainous country, as more than 1 million children from areas inaccessible to vaccination teams missed the latest vaccination drive.  [byline: Xuxin] ========================
[As this media report is based on a governmental announcement, I suspect this case will be in next week's global update, providing information on the date of onset of paralysis. It is noteworthy that this is the 1st case reported in Kunar province this year (2019). This represents the 8th case of WPV1-associated paralysis reported by Afghanistan with date of onset since 1 Jan 2019.
A map of Afghanistan showing provinces and districts can be found at <http://ontheworldmap.com/afghanistan/administrative-map-of-afghanistan-with-provinces-and-districts.jpg>.  Watapur district is located in the north central part of Kunar province. The southern and eastern districts of Kunar province border with Khyber Pakhtunkhwa and the tribal districts of Pakistan. The region is known for civil unrest. - ProMED Mod.MPP]
Date: Mon, 13 May 2019 18:12:22 +0200

Jalalabad, Afghanistan, May 13, 2019 (AFP) - At least three people were killed and another 20 wounded in a series of blasts in the eastern Afghan city of Jalalabad on Monday, an official said.   Nangarhar provincial spokesman Attaullah Khogyani said three blasts rocked the city centre, and had taken place near an armoured police vehicle.   "The nature of explosions is not clear, but it could be IEDs," Khogyani said, using the acronym for improvised explosive devices.   "So far we can confirm three people have been killed and 20 wounded."

No group immediately claimed responsibility for the attack, but the area around Jalalabad is home to fighters from both the Taliban and the Islamic State group's Afghan affiliate.   On March 6, at least 16 people were killed in a suicide attack on a construction company in Jalalabad, which is near the Pakistan border.   Violence in Afghanistan has continued apace even during the holy month of Ramadan, and despite government calls for a ceasefire.
Date: Sat, 11 May 2019 14:59:03 +0200

Ghazni, Afghanistan, May 11, 2019 (AFP) - A landmine explosion killed seven children and wounded two others in southern Afghanistan on Saturday, officials said, as war ordnance again claimed civilian lives.   The blast occurred in Ghazni province, south of the capital Kabul, when the children stepped on a landmine while playing near a main road, provincial spokesman Aref Noori told AFP.   "The mine was planted by the Taliban on a main road to inflict casualties on security forces," he said.   The Taliban did not immediately respond to a request for comment.   The insurgents often use roadside bombs and landmines to target Afghan security forces, but the lethal weapons also inflict casualties on civilians.   Amanullah Kamrani, a member of Ghazni provincial council, said the children were aged between seven and nine and at least four of them belonged to one family. 

Years of conflict have left Afghanistan strewn with landmines, unexploded mortars, rockets and homemade bombs -- and many are picked up by curious children.   Last month, seven children were killed and 10 more wounded in the eastern province of Laghman when a mortar shell exploded while they were playing with it.    According to the United Nations, 3,804 civilians -- including more than 900 children-- were killed in Afghanistan in 2018, with another 7,000 wounded. It was the deadliest year to date for civilians in Afghanistan's conflict.
Date: Tue, 16 Apr 2019 14:52:10 +0200

Kabul, April 16, 2019 (AFP) - Torrential rainstorms have lashed drought-stricken Afghanistan in recent days, bringing widespread flooding that has killed at least five people and washed away homes including in the capital Kabul, officials said Tuesday.   While some welcomed the wet weather after the punishing dry spell of recent years, residents complained about the lack of infrastructure and government assistance to help them clear up from the deluge.

Sixteen of Afghanistan's 34 provinces were hit in the past 24 hours, destroying or damaging hundreds of houses and sweeping away livestock, said Hashmat Bahaduri, a spokesman for Afghanistan's National Disaster Management Authority (ANDMA).   Hardest hit was Herat province in western Afghanistan, where at least five people were killed when their houses collapsed, Jilani Farhad, a spokesman for the local governor said.   Officials were also searching for 17 people whose minivan was swept away by flooding in the province's Obey district late Monday, Farhad added.    "There were women and children in the vehicle, we are searching but haven't found any sign of them yet," he said.

Extraordinary scenes played out in the capital, where the usually parched Kabul River swelled suddenly, bursting its banks in places and swamping surrounding streets and neighbourhoods with about one metre (three feet) of water in places.   Drug addicts who normally spend their time in the riverbed or hiding under bridges could be seen openly smoking opium at street level as water swirled around them.   By Tuesday, authorities were warning locals living along the river to be prepared to evacuate their homes as water levels surged.   Bahaduri said 113 houses had already been partially or completely destroyed in Kabul.

In the capital, a university student named Mujtaba bemoaned a lack of drainage canals, but others welcomed the rain.   "It is a bliss to have all this water and rain, we are thankful to God to have rain and get rid of the drought problems," Kabul resident Mansoor Majab told AFP.   Years of dry weather, combined with a booming population and wasteful consumption, have drained Kabul's water basin, forcing residents to drill ever-deeper wells.   This winter saw heavy snowfall across parts of Afghanistan, which had led to flash floods in the spring melt.   Over one hundred people had been killed as of March 28 due to flooding in Afghanistan so far this year, according to ANDMA.
Date: Mon 1 Apr 2019, 4:39 PM
Source: Xinhua Net [edited]

A 2-year-old child was reported to have been affected by poliovirus despite receiving anti-polio vaccination in Afghanistan's southern province of Uruzgan [Oruzgan], a local official said on [Mon 1 Apr 2019].

The case was found affecting a baby-boy in Charchino district of the restive province, where he received 5 times anti-polio immunization, Khan Agha Miakhil, director of provincial public health department, told Xinhua.

The ongoing insurgency and conflicts have been hindering the efforts to stamp the infectious disease out in the mountainous country, he said.

The latest confirmed polio cases have risen to 2 so far this year [2019] while 20 polio cases were registered in the country last year [2018], according to health officials.
=======================
[With the addition of this case, it will bring the number of confirmed cases of polio reported from Afghanistan this year (2019) to 3; 2 prior cases were reported from Kandahar province. The total number of cases reported by Afghanistan during 2018 was 21, including 2 cases from Uruzgan (Oruzgan) province.

The history of 5 doses of polio vaccine is an unfortunate occurrence, but well observed in many countries due to competing infections for receptor sites. One wonders if this child had received the recommended 1 dose of IPV as part of the vaccinations. Below are a collection of references that can give an overview of the observations and studies done to address the issue of observed OPV "vaccine failure" and possible causes.

Uruzgan province shares it's southern border with Kandahar province where the prior cases of polio were reported this year (2019) (see

The HealthMap/ProMED map of Afghanistan can be found at:

References discussing challenges in vaccine efficacy with OPV.
1. Nasir UN, Bandyopadhyay AS, Montagnani F, et al. Polio elimination in Nigeria: A review. Hum Vaccin Immunother. 2016 Mar 3;12(3):658-63. doi: 10.1080/http://promedmail.org/post/21645515.2015.1088617.
Full article available at:
2. Paul Y and Priya. Polio eradication in India: some observations. Vaccine. 2004 Oct 22;22(31-32):4144-8.
Abstract available at:
3. John TJ and Vashishtha VM. Eradicating poliomyelitis: India's journey from hyperendemic to polio-free status. Indian J Med Res. 2013 May;137(5):881-94.
Full article available at:
4. Taniuchi M, Platts-Mills JA, Begum S, et al. Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants. Vaccine. 2016 Jun 8;34(27):3068-3075. doi: 10.1016/j.vaccine.2016.04.080. Epub 2016 May 3.
Full article available at:
5. Saleem AF, Mach O, Quadri F, et al. Immunogenicity of poliovirus vaccines in chronically malnourished infants: a randomized controlled trial in Pakistan. Vaccine. 2015 Jun 4;33(24):2757-63. doi: 10.1016/j.vaccine.2015.04.055. Epub 2015 Apr 24.
Full article available at:
6. Patriarca PA. Poliomyelitis in selected African and Asian countries. Public Health Rev. 1993-1994;21(1-2):91-8.
Abstract available at:
7. John TJ. Experience with poliovaccines in the control of poliomyelitis in India. Public Health Rev. 1993-1994;21(1-2):83-90.
Abstract available at:
8. Balraj V, John TJ and Thomas M. Efficacy of oral poliovirus vaccine in rural communities of North Arcot District, India. Int J Epidemiol. 1990 Sep;19(3):711-4.
Abstract available at:
9. Sutter RW, Patriarca PA, Brogan S, et al. Outbreak of paralytic poliomyelitis in Oman: evidence for widespread transmission among fully vaccinated children. Lancet. 1991 Sep 21;338(8769):715-20.
Abstract available at:
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Belarus

Belarus - US Consular Information Sheet
November 25, 2008
COUNTRY DESCRIPTION:
Belarus became an independent republic in 1991, after the breakup of the Soviet Union.
In 1996, a constitutional referendum, not recognized by the internat
onal community, centralized power in the executive branch (president), headed by Alyaksandr Lukashenka.
Economic and political reform in Belarus has stalled or is being reversed under his authoritarian government.
The Belarusian Government’s human rights record remains very poor.
President Lukashenka gained a third five-year term as president in March 2006, in an election that international observers judged to be seriously flawed.
Democratic nations, including the United States and the members of the European Union, condemned the subsequent governmental crackdown on peaceful protests in Minsk, and imposed visa restrictions and other sanctions on senior Belarusian officials. As a result of the release of political prisoners in August 2008, the EU lifted its visa restrictions, but those of the United States remain in effect.
Both Belarusian and Russian are official languages, and Russian is widely spoken throughout the country, particularly in the cities.
Tourist facilities are not highly developed, but food and lodging in the capital and some regional centers are adequate.
Read the Department of State Background Notes on Belarus for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required.
Travelers must obtain a visa in advance to visit or transit through Belarus.
Travelers who do not have a visa cannot register at hotels.
U.S. citizens visiting or residing in Belarus are required to register with the local office of the Citizenship and Migration Department of the Ministry of Interior (formerly OVIR) within three business days after arrival.
The registration fee is one National Minimum Tariff Unit (currently about $17).
Failure to register can result in fines and difficulties when departing.
U.S. citizens staying in hotels are automatically registered at check-in.
Visa validity dates are strictly enforced; travelers should request visas of sufficient length to allow for changes in arrival and departure plans, and should carefully review the beginning and ending dates of their visas before traveling.
A valid exit visa is necessary to depart Belarus.
Generally, the visa issued by a Belarusian Embassy or Consulate is valid for both entry and exit.
Photocopies of visas may be helpful in the event of loss, but note that a copy of a visa will not be sufficient for entry or departure, as Belarusian border officials always require original travel documents.

Travelers who overstay their visa’s validity -- even for one day -- will be prevented from leaving until they have been granted an extension by the Department of Citizenship and Migration.
United States citizens without valid visas face delays in leaving Belarus and may have trouble finding adequate accommodation.
By Belarusian law, travelers with an expired visa may not check in at any hotel or other lodging establishment.

U.S. citizens traveling through Belarus to other countries are strongly advised that there is a transit visa requirement for entering and leaving Belarus.
Transit visas are required even for travelers transiting on direct overnight trains with no stops or transfers on Belarusian territory. Transit visas should be obtained prior to any journey that requires travel through Belarus.
Commonwealth of Independent States (CIS) and Russian visas are no substitute for this transit visa.
Most travel agencies, including those in Russia and CIS countries, as well as train ticket sales personnel, are often not aware of this visa requirement and may not seek a transit visa for a traveler unless instructed by the traveler to do so.

U.S. citizens attempting to transit Belarus without a valid Belarusian transit visa have been denied entry into the country and forcibly removed from trains.
In some instances, local border and railway authorities have threatened passengers who did not possess a valid transit visa with jail or extorted “fines.”
American citizens are advised not to pay any border or railway officials for transit visas or “transit visa fines,” as these officials are not authorized to issue such visas.
Americans finding themselves in Belarus without transit visas, if confronted by border or train personnel, should request to be put in contact with consular officials at the U.S. Embassy in Minsk.
U.S. citizens traveling to Belarus via Russia are reminded that they must possess a Russian transit visa in addition to their Belarusian visa. Russian Embassies outside of the United States, including the Russian Embassy in Belarus, generally do not issue transit or tourist visas to Americans.
Russian transit visas are not normally obtainable at Russian airports.

The Law on the Legal Status of Foreign Citizens and Stateless Persons in the Republic of Belarus states that all foreign citizens may be granted permission for a temporary stay (up to 90 days within a chronological year), temporary residence (up to one year), or permanent residence.
Belarusian Embassies and Consulates will issue visas for temporary stays.
A temporary stay visa will allow the bearer to be present physically in Belarus for a maximum of 90 days within the 365-day period for which the visa is issued.
Once an individual has spent 90 days in Belarus, at one time or through a combination of visits, he or she will not be eligible to receive another visa until the original 365-day period has passed.

Individuals who receive visas for a temporary stay, but wish to remain in Belarus for longer than 90 days, must apply for temporary or permanent residence with the Ministry of Interior.
Individuals must make the application in Belarus within the 90 days allotted for a temporary stay.
Permission for temporary residence can be granted to students, spouses, or close relatives of Belarusian citizens, or for “work, business, or other activities.”
Travelers may contact the Consular Section at the U.S. Embassy in Minsk for information about application procedures for temporary or permanent residence.
Every foreigner entering Belarus is required to fill out a migration card.
This card should be retained for the whole period of stay and should be presented to the border authorities when exiting Belarus.

Foreign citizens without a valid Belarusian visa, migration card, or proper registration with the Department of Citizenship and Migration as a temporary visitor or resident can be subject to sanctions up to and including deportation under the provisions of the Code of Administrative Violations.
Depending on the circumstances, deportees also can be banned from returning to Belarus for a period from one to ten years.

Foreign citizens visiting and transiting Belarus also should be prepared to demonstrate sufficient financial means to support their stay.
For individuals staying in Belarus for less than one month, this amount is equal to approximately $15/day/person.
For those staying for longer than one month, the requirements call for $375/month/person.
Belarusian officials may request this proof of funds at the time of visa application, at the border, or during registration.
According to the Ministry of Interior, cash, credit cards, paid hotel reservations, or a letter from an inviting party pledging full financial support are sufficient means to demonstrate financial wherewithal.

Belarus requires all foreign nationals (other than accredited diplomats) entering the country to purchase medical insurance at the port-of-entry, regardless of any other insurance they might have.
Costs for this insurance will vary according to the length of stay.
(Subject to change, current information puts costs at approximately $1 for a one or two day stay, $15 for a stay of up to 31 days, and $85 for a stay of one year.)

Travelers entering Belarus by air with more than 35 kilograms of luggage (77 pounds) will be charged 2 Euros per kilogram in excess of that limit.
The fee must be paid in dollars or Euros.
In accordance with current customs regulations, foreigners may enter Belarus with up to $10,000 and exit the country with up to $3,000 without submitting a written declaration.
For additional information on customs rules for Belarus please see the Belarusian State Customs Committee official web site.
The Belarusian Government enforces a requirement for special permits to travel in “protected border zones.”
The Government of Belarus has not provided information defining the parameters of those zones.
Travelers should be alert for warning signs, road barriers, and/or border guard posts, and are advised not to cross into such areas without permission.

Foreign missionaries may not engage in religious activities outside the institutions that invited them unless they have a religious worker visa.
One-year validity, multiple-entry, "spiritual activities" visas, which are required of foreign missionaries, can be difficult to get, even for faiths that are registered with the government and have a long history in the country.
Approval often involves a difficult bureaucratic process.

A law enacted in 2002 required all religious groups and organizations, including recognized “traditional” religions such as Russian Orthodoxy, Roman Catholicism, Orthodox Judaism, Sunni Islam, and Lutheranism, to re-register; most organizations have done so.
Unregistered religious groups may not legally gather for religious purposes.
Many unregistered groups continue to meet, however, leaving them vulnerable to selective implementation of the law by authorities.
The law also stipulates that only Belarusian citizens can head religious organizations in Belarus.
In recent years, authorities have harassed, warned, fined, and briefly detained members of some unregistered and so-called "non-traditional" faiths for engaging in unsanctioned worship or proselytism. The U.S. Embassy strongly recommends that any U.S. citizen who chooses to attend a religious service of an unregistered religious group do so only after consulting with members of the group about the risk of harassment or possible arrest by local law enforcement authorities.
U.S. citizens are also urged to contact the U.S. Embassy should they encounter any problems with authorities due to their participation in such services or events.

Naturalized U.S. citizens originally from Belarus do not automatically lose Belarusian citizenship upon naturalization.
Such individuals retain Belarusian citizenship unless they take specific steps to renounce it.
The Belarusian authorities will allow naturalized U.S. citizens from Belarus to enter the country without a valid Belarusian passport on a “certificate of return” issued by Belarusian Embassies and Consulates, but please note that a valid Belarusian passport will be required to leave the country.
It can take two to four weeks to receive a new Belarusian passport.
For additional information please consult with the Embassy of Belarus at http://www.belarusembassy.org.
Belarusian citizens, including dual nationals, are subject to Belarusian laws requiring service in Belarus’ armed forces, as well as other laws pertaining to passports and nationality.
American-Belarusian dual nationals of military age who do not wish to serve in the Belarusian armed forces should contact the Embassy of Belarus in Washington, D.C. to learn more about an exemption or deferment from Belarusian military service before going to Belarus.
Without this exemption or deferment document, they may not be able to leave Belarus without completing military service, or may be subject to criminal penalties for failure to serve.

Children born to Belarusian parent(s) before August 15, 2002, even if born in the United States and in possession of a U.S. passport, may not be issued a Belarusian visa for travel to Belarus.
The Belarusian government considers these children to be Belarusian citizens until age 16, when they may choose to accept or reject that claim to citizenship.
Instead of a visa, a "certificate of return" is issued that will allow the child to enter Belarus.
It is imperative that parents of such children understand that, in order to leave the country, the child will be required to have a Belarusian passport if he/she does not already have one.
It can take anywhere from two to four weeks to complete the application procedures and receive a new Belarusian passport.
(Note: if the parent left Belarus on a series PP passport, given to Belarusians who reside abroad and have cancelled their local registration, then Belarus would not require the child to reject his/her claim to citizenship).
For children born to one Belarusian parent and one foreign parent after 2002, the parents must by mutual consent agree to Belarusian citizenship for the child, regardless of the place of birth.
If the parents cannot reach consensus, Belarus would only force Belarusian citizenship on a child in cases where the child would be left stateless.
Visit the Embassy of Belarus web site at http://www.belarusembassy.org/ for the most current visa information, or contact the Embassy of Belarus at 1619 New Hampshire Avenue, NW, Washington, DC 20009, tel: 202-986-1606, fax: 202-986-1805, consul@belarusembassy.org.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Both organized and spontaneous demonstrations occur in Belarus.
Localized street disturbances relating to political events occur most frequently in Minsk or larger cities.
In some instances, authorities may use force to disperse protesters; bystanders, including foreign nationals, may face the possibility of arrest, beating, or detention.
Even demonstrations intended to be peaceful can sometimes become confrontational and escalate into violence.
For this reason, it is recommended that American citizens avoid all demonstrations and protest gatherings.

Security personnel may at times place foreign visitors under surveillance.
Hotel rooms, telephones, and fax machines may be monitored, and personal possessions in hotel rooms may be searched.
Taking photographs of anything that could be perceived as being of military or security interest may result in problems with authorities.
These sites are not always clearly marked and application of these restrictions is subject to interpretation.

For the latest security information, Americans living or traveling abroad should regularly monitor the Department of State’s Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
CRIME:
Belarus has a moderate incidence of street crime. Though violent crime against foreigners is rare, criminals have been known to use force if met with resistance from victims.
Common street crime, such as mugging and pocket picking, occurs most frequently near public transportation venues, near hotels frequented by foreigners, and/or at night in poorly lit areas.

American citizens and other foreigners in Belarus have also been the victims of car theft, car vandalism, and hotel and residential break-ins.
Foreigners visiting nightclubs should pay particular attention to their surroundings, as criminal elements may rob unsuspecting patrons after surreptitiously drugging their drinks.
Travelers should keep a copy of their passport in a separate location from their original passport.

As in many countries around the world, counterfeit and pirated goods are widely available in Belarus. Transactions involving such products may be illegal under local law. In addition, bringing them back to the United States may result in forfeitures and/or fines. More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you in finding appropriate medical care, contacting family members or friends and explaining how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
To see if you can be compensated in the U.S. as a victim of violent crime overseas, see our information on Victims of Crime.

The local equivalents to the “911” emergency line in Belarus are: 111 Fire and Rescue Squad, 102 Police, 103 Ambulance (Medical Emergency)
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care in Belarus is limited.
There is a severe shortage of basic medical supplies, including anesthetics, vaccines and antibiotics.
Elderly travelers and those with existing health problems may be at risk due to inadequate medical facilities. Travelers are encouraged to ensure that they bring an adequate supply of prescription medications in the event that there are delays in departing Belarus.
Tuberculosis is an increasingly serious health concern in Belarus.
For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to Belarus on a 30 day visit.
Long-term residents or students must obtain an HIV/AIDS test in Belarus and submit the results to the Department of Citizenship and Migration.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control (CDC) and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
MEDICAL INSURANCE:
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning Belarus is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
American citizens on short-term visits to Belarus (up to 90 days) are permitted to drive with a valid U.S. state driver’s license.
U.S. citizens should, therefore, always carry their passports with them to prove date of entry into the country in the event that police stop them.
If residing in Belarus for more than 90 days, one should apply for a Belarusian driver’s license.
Drivers will be required to successfully complete a two-part test in Russian; the first part is a computer-based multiple-choice test on local driving rules, and the second part is a driving test.
To receive a local driver’s license, drivers will also need to complete a medical exam at a special medical clinic, which will include a general physical, a chest x-ray, and an eye exam.

Radar traps and road construction sites, often unlit at night, are widespread.
Except for a stretch of the main east-west highway, where the speed limit is 100 km/h (60 mph), the maximum speed limit on divided highways or main roads outside village, town or city limits is 90 km/h (55 mph).
Speed limits in cities are 60 km/h unless marked and will usually range between 40 km/h and 70 km/h, with frequent radar traps.
Visible and hidden dangers exist, including potholes, unlit or poorly lit streets, inattentive and dark-clothed pedestrians walking on unlit roads, drivers and pedestrians under the influence of alcohol, and disregard for traffic rules.
Driving in winter is especially dangerous because of ice and snow.
Driving with caution is urged at all times.

Radio-dispatched taxi services are generally reliable, arrive promptly once called and usually offer the lowest fare.
Most radio-dispatched taxis are metered, although fares can vary greatly and are considerably higher in the late evening and overnight hours.
The use of informal taxis or "gypsy cabs" is not recommended.

Minsk has a clean, safe, and efficient subway system that easily reaches most of the city center. Service is stopped briefly during the early morning hours, but otherwise runs regularly throughout the day.
Ticket prices are extremely low by western standards.
Though their routes are extensive, buses and trolleys lack heating or cooling capabilities and are usually crowded.

Travelers on all public transportation should be wary of pickpockets and other petty crime.
For travelers interested in car rental, only one major western rental agency currently operates in Minsk.
In general, rental car networks in Belarus are not well developed.

Travelers may experience significant delays (of several hours) in crossing the border by road into neighboring countries.

Please refer to our Road Safety page for more information.
Also visit the website of the country’s national tourist office and national authority responsible for road safety at: http://siteks.com/sites/touragency/.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Belarus, the U.S. Federal Aviation Administration (FAA) has not assessed Belarus’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES:
Traveler's checks are normally not accepted in Belarus as a means of payment, but can be freely exchanged for cash at any bank.
Most hotels, restaurants, and stores accept major credit cards.
All Belarusian banks provide cash from major credit cards.
All payments in Belarus are made in Belarusian rubles.
Authorized currency exchange centers are widely available throughout major cities.


ATMs are also available for use, and it has become easier to use credit cards and debit cards in Belarus, especially in Minsk; however, this does not mean that it is safer to do so.
There have been reports of instances in which U.S. citizens have had their card numbers “skimmed” and the money in their debit accounts stolen or their credit cards fraudulently charged.
(“Skimming” is the theft of credit card information by an employee of a legitimate merchant or bank, manually copying down numbers or using a magnetic stripe reader.)
In addition to skimming, the risk of physical theft of credit or debit cards also exists.
To prevent such theft, the Embassy recommends that travelers keep close track of their personal belongings and only carry what is needed when out.
If travelers choose to use credit cards, they should regularly check their account status to ensure its integrity.
Persons seeking to marry in Belarus should consult the information located on the Embassy web site at http://minsk.usembassy.gov/marriage.html.
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Belarusian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Belarus are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Access for U.S. consular officers to U.S. citizens in detention is often limited and/or delayed.
Although U.S. citizens are able to obtain legal representation, there has been at least one case of delayed notification, hindered consular access, limited medical treatment, and trial behind closed doors. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Belarus are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Belarus.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located in Minsk at 46 Starovilenskaya Ulitsa; telephone (375 17) 210-1283 or after hours (375 29) 676-0134, fax (375 17) 334-7853 or (375 17) 17-217-7160 (consular section).
The Consular Section may also be reached by email at ConsularMinsk@state.gov
*

*

*
This replaces the Country Specific Information for Belarus dated December 7, 2007, and updates the sections on Exit/Entry Requirements, Safety and Security, Information for Victims of Crime, Medical Facilities and Health Information, and Criminal Penalties.

Travel News Headlines WORLD NEWS

Date: Thu, 2 Aug 2018 06:04:14 +0200
By Tatiana Kalinovskaya

Minsk, Aug 2, 2018 (AFP) - A massive corruption scandal has rocked the health service of ex-Soviet Belarus, leading even officials in the country dubbed "Europe's last dictatorship" to call for an overhaul of the system.   Authorities have arrested dozens of medics, drug company representatives and bureaucrats on suspicion of siphoning off millions of dollars in state funding.   Valery Vakulchik, head of the powerful KGB state security service, in televised comments last month denounced what he called a vast system of procurement of drugs and medical equipment at inflated prices.   Prices were habitually hiked by up to 60 percent and in some cases even doubled, he said.   Following his announcement, 37 top health officials were arrested and criminal investigations were opened involving 60 people including local representatives of international pharmaceutical companies.

The KGB chief acknowledged that the Soviet-style bureaucracy in the country bordering the European Union, ruled by strongman Alexander Lukashenko, helped promote corruption.   "The existing system of procuring medical equipment and drugs created the conditions for corrupt practices," he said.    "Bona fide suppliers could not rely on a positive outcome," he added, while procurements were made not directly from producers but "via numerous middlemen (and) finance companies."   Those detained in the scandal include deputy health minister Igor Lositsky, doctors at reputed clinics and leading business figures involved in producing and importing medicines.   One of the arrested businessmen is Sergei Shakutin, director of Iskamed group, who is the brother of one of Lukashenko's close associates.   Belta state news agency has published photos of searches at the home of a medical centre director that uncovered $500,000 in cash.   Officers also found $620,000 in the garage of the director of a public enterprise that imported medical equipment.

The KGB chief said bribes paid to corrupt officials amounted to millions of dollars.   "There will be further arrests since the people detained so far are just the perpetrators," Sergei Satsuk, editor of news site Yezhednevnik, who is familiar with the case, told AFP.   The chief beneficiaries in such schemes were retired law enforcement officials who set up companies to enter the lucrative medical equipment market, Satsuk said.   "In 10 years they drained all the juice out of the country's medical system," he said.   He said this involved supplying equipment that was not just over-priced but also often lacked the necessary certification or came with faked documentation.    Some equipment was imported as second-hand but re-sold as new.

- Powerful temptation -
This is one of the biggest corruption scandals in the history of Belarus, which is wedged between Russia and Poland and has been led by Lukashenko since 1994.   "Bureaucracy has privatised the state. We need to reform the whole system of state management, otherwise corruption schemes will spring up wherever budget funds are being spent," independent economist Yaroslav Romanchuk told AFP.

Other smaller corruption scandals have in recent years hit the sports, forestry and energy ministries as well as large companies, factories and banks.   Three ministers have been sacked and senior bureaucrats and regional officials have been arrested.   "Even if you clean out the state structures of bribe-takers, corruption won't die in Belarus for a single day," said Romanchuk.   "The very next day new people in old posts in the old system will relaunch the old corruption schemes."   The system "creates the most powerful temptation to set up schemes with kickbacks, bribes, swindling and abuses of office," Romanchuk said.
Date: Tue, 24 Jul 2018 18:11:12 +0200

Minsk, July 24, 2018 (AFP) - Belarus on Tuesday announced that it is extending visa-free travel for tourists from five days to 30 days in a move that could attract more visitors to the ex-Soviet state on the European Union's doorstep.

Strongman ruler Alexander Lukashenko signed a decree allowing visitors from 80 countries including 39 in Europe, as well as the United States, Australia and Japan to stay for 30 days.   The ruling will enter force when the decree is published in one or two days.   The decree says the move is aimed at "promoting further development of the Belarusian tourism sector" as well as making the country more attractive as a host for sports events and festivals and improving its connectedness to the global economy.

Belarus said it is keen to promote itself as a medical tourism venue and for people keen to recuperate and undergo spa procedures at its sanatoriums.   The visa-free rule requires visitors to fly in and out of Minsk's main airport.    As before, the visa exemption does not apply to foreigners arriving or leaving from Russia because of a lack of border controls betweeen the neighbours.

Minsk has close ties to former Soviet master Moscow, with Belarus part of an economic union with Russia.   Chinese people will also be covered by a separate visa agreement that comes into force in August.   Ties between Belarus and the European Union have improved since the 28-nation bloc began lifting most of its sanctions on the country in 2015 after Lukashenko released high-profile political prisoners.
Date: Tue, 17 May 2016 07:34:10 +0200

Belmopan, Belize, May 17, 2016 (AFP) - Belize has joined the growing number of Latin American nations grappling with the Zika virus, after the health ministry confirmed the country's first known case.    Authorities said Monday the infected person resides in Belize City, adding that efforts would be taken to prevent the virus from spreading.

"An immediate investigation was launched and several actions were simultaneously initiated to minimize and contain a potential outbreak," a health ministry statement said.   The mosquito-borne Zika virus can cause the birth defect microcephaly, which can cause babies to be born with unusually small heads and deformed brains.
Date: Fri 17 Jul 2015
Source: Rusnovosti [in Russian, trans. ProMED Mod.NP, edited]

The deceased patient was infected in Belarus
-----------------------------------------------
Rospotrebnadzor [Federal Service for Consumer Protection and Human Welfare] reported that the 1st death from tick-borne encephalitis has been registered in Moscow. The tick-borne disease was imported.

Rospotrebnadzor reports, "Infections in the capital are not registered this year [2015] and have never been registered previously. The patient was infected in Belarus."

According to Infectious clinical hospital No. 1 of the Department of Health of Moscow, 10 imported cases of viral encephalitis were identified in the 1st half of 2015; 2 cases of infection occurred in the Altai region and in the Republic of Karelia. One [imported] case was brought from the Kostroma region, the Yaroslavl region, the Volgograd region and the Republic of Udmurtia, as well as from Belarus and Mongolia.

Rospotrebnadzor also reports that the rise of the biological activity of _Ixodes_ ticks was noted. These ticks are considered the main vectors of infections such as tick-borne spring-summer encephalitis, tick-borne borreliosis (Lyme disease), granulocytic anaplasmosis, and monocytic ehrlichiosis.
=====================
[Nearly 10,000 people sought medical aid after tick bites in Moscow for the period April-June of this year (2015), among them there are more than 1900 children up to 17 years. Last year (2014) for the same period it was recorded that around 8000 people sought medical aid after tick bites. The ticks attacked people mainly in the territory of the Moscow region.

This is the season of tickborne encephalitis virus (TBEV) transmission in Russia and neighboring countries. Russia, especially western Siberia, has the largest number of reported TBE cases. For additional details on TBE, see Mod.LL's extensive comments drawn from the US CDC (<http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/tickborne-encephalitis>). The CDC information notes that in Russia, 2 inactivated TBE vaccines are available: TBE-Moscow (Chumakov Institute, Russia) and EnceVir (Microgen, Russia). The European and Russian vaccines should provide cross-protection against all 3 TBEV subtypes. Vaccine failures have been reported, particularly in people aged over 50 years.

In the previous post on TBE, ProMED Corr.BA noted, "According to weekly monitoring, from 1 Apr-15 Jul [2015] in Russia, more than 412,000 cases of tick bites were registered, including 94,270 children. Compared with the same period of last year (2014), the number of people affected by the tick bites increased by 19 per cent. In 2015, 947 cases of tick-borne encephalitis have registered in Russia. The largest number of cases was reported in the Krasnoyarsk region, followed by Novosibirsk [Siberia], Irkutsk, Tyumen, Kirov, Sverdlovsk, Vologda, Leningrad, Kemerovo, Pskov, and Kostroma regions, the Republic of Khakassia, the Perm and Primorye regions, St Petersburg [city], Moscow (importations from Yaroslavl, Vologda, Karelia, Altai, and Mongolia, Belarus)." - ProMED Mod.TY]

[The locations mentioned in this posting can be seen on the map at

[A HealthMap/ProMED-mail map can be accessed at:
Date: 15 Jul 2015
Source: Evening Brest [machine translation & edited]

Belarus has 1 imported case of measles. The Ministry of Health of Belarus does not rule out the possibility of other imported cases of measles. This is especially true during the summer holidays and vacations.

According to the deputy chief doctor of the "National Center for Hygiene, Epidemiology and Public Health," Lyudmila Naroychik, other European countries often record measles. In 2014 Belarus recorded 5 imported cases of measles. So far in 2015, Belorus has already record 1 imported case. The infections have been from Russia, Israel, Spain, Turkey, according to BelTA  [unclear whether this refers just to 2014, or other years as well].

Measles is included in the national immunization schedule, and if vaccination is carried out, even in adulthood the person retains immunity. In this regard, it is important to get vaccinated before traveling abroad.
==================
[The HealthMap/ProMED map of Belarus can be found at:
More ...

Yemen

Yemen - US Consular Information Sheet
July 21, 2008
COUNTRY DESCRIPTION:
The Republic of Yemen was established in 1990 following unification of the former Yemen Arab Republic (North) and the People's Democratic Republic of Yemen (South). I
lamic and traditional ideals, beliefs, and practices provide the foundation of the country's customs and laws. Yemen is a developing country and modern tourist facilities are widely available only in major cities. Read the Department of State Background Notes on Yemen for additional information.

ENTRY/EXIT REQUIREMENTS: Passports and visas are required for travel to Yemen. Visas may be obtained at Yemeni Embassies abroad; all travelers to Yemen can also potentially obtain entry visas at ports of entry. Travelers to Yemen are no longer required to have an affiliation with and arrange their travel through a Yemeni-based individual or organization to enter Yemen. However, individuals may be asked for supporting evidence of their character, purpose of visit and length of stay. Upon arrival at ports of entry, travelers may be issued a visa valid for a maximum of three months.
Yemeni law requires that all foreigners traveling in Yemen obtain exit visas before leaving the country. In cases of travelers with valid tourist visas and without any special circumstances (like those listed below), this exit visa is obtained automatically at the port of exit as long as the traveler has not overstayed the terms of the visa.
In certain situations, however, foreigners are required to obtain exit visas from the Immigration and Passport Authority headquarters in Sanaa. These cases may include, but are not limited to, foreigners who have overstayed the validity date of their visa; U.S.-citizen children with Yemeni or Yemeni-American parents who are not exiting Yemen with them; foreigners who have lost the passport containing their entry visa; foreign residents whose residence visas are based on their employment or study in Yemen, marriage to a Yemeni citizen, or relationship to a Yemeni parent; or foreign residents who have pending legal action (including court-based "holds" on family members' travel). The loss of a passport can result in considerable delay to a traveler because Yemeni law requires that the traveler attempt to recover the passport by placing an advertisement in a newspaper and waiting a week for a response. All minor/underage U.S. citizens should be accompanied by their legal guardian(s) and/or provide a notarized letter in Arabic of parental consent when obtaining exit visas to depart Yemen. In all of these more complex cases, obtaining an exit visa requires the permission of the employing company, the sponsoring Yemeni family member, the sponsoring school or the court in which the legal action is pending. Without this permission, foreigners -- including U.S. Citizens -- may not be allowed to leave Yemen.
American women who also hold Yemeni nationality and/or are married to Yemeni or Yemeni-American men often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody (see Special Circumstances section below).
For more details, travelers can contact the Embassy of the Republic of Yemen, Suite 705, 2600 Virginia Avenue NW, Washington, DC 20037, telephone 202-965-4760; or the Yemeni (Mission to the U.N., 866 United Nations Plaza, Room 435, New York, NY 10017, telephone (212) 355-1730. Visit the Yemeni Embassy home page for more visa information at http://www.yemenembassy.org/.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY: The Department of State is concerned that al-Qa‘ida and its affiliates are actively engaged in extremist-related activities in Yemen and the Arabian Peninsula. The Department remains concerned about possible attacks by extremist individuals or groups against U.S. citizens, facilities, businesses and perceived interests.

On March 18, 2008, three mortar rounds landed in the vicinity of the U.S. Embassy in Sanaa. Yemeni students at a nearby school and Yemeni government security personnel posted outside the embassy were injured in the attack. On April 6, 2008, an expatriate residential compound in the Hadda neighborhood of southwestern Sanaa was attacked by mortar fire, and on April 30, 2008, suspected extremists fired two mortar rounds that exploded near the Yemen Customs Authority and the Italian Embassy. No injuries were reported in either incident. A group calling itself al-Qa'ida in Yemen may be responsible for all three attacks. Following the attacks against the Embassy and the residential compound, the Department of State ordered the departure of all American non-emergency embassy staff and family members on April 7, 2008.
On January 18, 2008, suspected al-Qa’ida operatives ambushed a tourist convoy in the eastern Hadramout Governorate, killing two Belgians. On July 2, 2007, suspected al-Qa’ida operatives carried out a vehicle-borne explosive device attack on tourists at the Belquis Temple in Marib, which resulted in the deaths of eight Spanish tourists and two Yemenis. The targeting of tourist sites by al-Qa’ida may represent an escalation in terror tactics in Yemen. On February 3, 2006, 23 convicts, including known affiliates of al-Qa’ida, escaped from a high-security prison in the capital city, Sanaa. Among the al-Qa’ida associates were individuals imprisoned for their roles in the 2000 bombing of the USS Cole and the 2002 attack on the French oil tanker Limburg. In the weeks following the escape, some prisoners voluntarily turned themselves in to authorities; to date, however, some escapees remain at large. Two of the escapees were killed in vehicle-based suicide attacks on oil facilities near Mukalla and Marib on September 15, 2006. Those attacks were followed by the arrest the next day in Sanaa of four suspected al-Qa’ida operatives, who had stockpiled explosives and weapons. On December 5, 2006, a lone gunman opened small arms fire outside of the Embassy compound during the early morning hours. The assailant, wounded by host-nation security personnel and subsequently arrested, was the sole casualty. It appears that, although the gunman was influenced by extremist ideology, he worked alone in planning and executing the attack.
Americans should avoid areas where demonstrations are taking place. A 2005 demonstration against an increase in the fuel price led to two days of widespread demonstrations and rioting throughout Sanaa and other cities. Those demonstrations resulted in a large amount of property damage, looting, and several roadblocks.
In late 2007 and throughout 2008, there has been an increase in anti-government demonstrations in southern Yemen, including the cities of Aden, Taizz, Ibb, and Mukalla, as well as surrounding regions. Some of these demonstrations have resulted in injuries and deaths. Americans should be aware of the potential for further demonstrations when traveling in these areas.
Throughout the country, U.S. citizens are urged to exercise particular caution at locations where large groups of expatriates have gathered. From time to time, the U.S. Embassy in Sanaa may temporarily close or suspend public services as necessary to review its security posture and ensure its adequacy.
In addition, U.S. citizens are urged to avoid contact with any suspicious, unfamiliar objects, and to report the presence of such objects to local authorities. Vehicles should not be left unattended and should be kept locked at all times. Americans in Yemen are urged to register and remain in contact with the American Embassy in Sanaa for updated security information (see section on Registration/Embassy location below).
Yemeni government security organizations have arrested and expelled foreign Muslims, including Americans, who have associated with local Muslim organizations considered to be extremist by security organs of the Yemeni government. Americans risk arrest if they engage in either political or other activities that violate the terms of their admission to Yemen.
Travel on roads between cities throughout Yemen can be dangerous. Armed carjacking, especially of four-wheel-drive vehicles, occurs in many parts of the country, including the capital. Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travel is particularly dangerous in the tribal areas north and east of Sanaa. Armed tribesmen in those areas have kidnapped a number of foreigners in attempts to resolve disputes with the Yemeni government. Hostilities between tribesmen and government security forces in the Sadah governorate north of Sanaa have flared up on several occasions since 2005. Serious fighting occurred in the city of Benni Hashish from late May through early June 2008. Americans are urged to avoid this region during periods of conflict.
Travel by boat through the Red Sea or near the Socotra Islands in the Gulf of Aden presents the risk of pirate attacks. If travel to any of these areas is necessary, travelers may reduce the risk to personal security if such travel is undertaken by air or with an armed escort provided by a local tour company.
Other potential hazards to travelers include land mines and unexploded ordnance from the 1994 civil war. This is of particular concern in areas where fighting took place in the six southern provinces. However, most minefields have been identified and cordoned off.
Americans are most vulnerable to terrorist attacks when they are in transit to and from their residences or workplaces, or visiting locations where large groups of expatriates have gathered. All Americans are reminded to vary their routes and times, remain vigilant, report suspicious incidents to the Embassy, avoid areas where large groups of expatriates have gathered, lock car windows and doors, and carry a cell phone.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information on travel by road in Yemen, see the Traffic Safety and Road Conditions section below.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, including the Travel Warning for Yemen, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME: The most serious crime problem affecting travelers to Yemen is carjacking. Travelers have rarely been victims of petty street crime.
INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends, and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the "911" emergency line in Yemen is 199, but operators do not speak English.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION: Lack of modern medical facilities outside of Sanaa and Aden and a shortage of emergency ambulance services throughout the country may cause concern to some visitors. Doctors and hospitals often expect immediate cash payment for health services. An adequate supply of prescription medications for the duration of the trip is important. While many prescription drugs are available in Yemen, a particular drug needed by a visitor may not be available.
The U.S. Embassy in Sanaa strongly advises all American citizens residing in or traveling to Yemen to ensure that they have received all recommended immunizations (see below).
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Yemen.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Yemen is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Based on previous abductions of foreigners in Iraq, Afghanistan and Kuwait, the Embassy recommends that Americans with doubts about the identity of security or police personnel on the roads remain in their vehicles, roll up their windows, and contact the Embassy. For additional information addressing security concerns for Americans in Yemen, please see the Safety and Security section above.
Travel by road in Yemen should be considered risky. Within cities, minivans and small buses ply somewhat regular routes, picking up and dropping off passengers with little notice or regard for other vehicles. Taxis and public transportation are widely available but the vehicles may lack safety standards and equipment. Embassy personnel are advised to avoid public buses for safety reasons. Despite the presence of traffic lights and traffic policemen, drivers are urged to exercise extreme caution, especially at intersections. While traffic laws exist, they are often not enforced, and/or not adhered to by motorists. Drivers sometimes drive on the left side of the road, although right-hand driving is specified by Yemeni law. No laws mandate the use of seat belts or car seats for children. The maximum speed for private cars is 100 kilometers per hour (62.5 miles per hour), but speed limits are rarely enforced. A large number of under-age drivers are on the roads. Many vehicles are in poor repair and lack basic parts such as functional turn signals, headlights and taillights. Pedestrians, especially children, and animals on the roads constitute a hazard in both rural and urban areas. Beyond the main inter-city roads, which are usually paved and in fair condition, the rural roads in general require four-wheel-drive vehicles or vehicles with high clearance.
Yemeni security officials advise against casual travel to rural areas. The U.S. Embassy sometimes restricts the travel of its own personnel to rural areas, while the Government of Yemen also sometimes places restrictions on Americans traveling outside Sanaa. Please check with the Embassy for the latest restrictions.
Travelers should take precautions to avoid minefields left over from Yemen's civil wars. Traveling off well-used tracks without an experienced guide could be extremely hazardous, particularly in parts of the south and the central highlands.
Penalties for driving under the influence of alcohol or drugs, and reckless driving which causes an accident resulting in injury, are a fine and/or prison sentence. If the accident results in death, the driver is subject to a maximum of three years in prison and/or a fine. Under traditional practice, victims' families negotiate a monetary compensation from the driver proportionate to the extent of the injuries -- higher if it is a fatality.
Please refer to our Road Safety page for more information and visit the web site of Yemen’s national tourism office at http//yementourism.com.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Yemen, the U.S. Federal Aviation Administration (FAA) has not assessed Yemen’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: Photography of military installations, including airports, equipment, or troops is forbidden. In the past, such photography has led to the arrest of U.S. citizens. Military sites are not always obvious. If in doubt, it is wise to ask specific permission from Yemeni authorities.
Travelers should be aware that automated teller machines (ATMs) are being introduced in major cities but are still not widely available in Yemen. Credit cards are not widely accepted. The Government of Yemen may not recognize the U.S. citizenship of persons who are citizens of both Yemen and the United States. This may hinder the ability of U.S. consular officials to assist persons who do not enter Yemen on a U.S. passport. Dual nationals may also be subject to national obligations, such as taxes or military service. For further information, travelers can contact the nearest embassy or consulate of Yemen.
American citizens who travel to Yemen are subject to the jurisdiction of Yemeni courts, as well as to the country's laws, customs, and regulations. This holds true for all legal matters including child custody. Women in custody disputes in Yemen may not enjoy the same rights that they do in the U.S., as Yemeni law often does not work in favor of the mother. Parents planning to travel to Yemen with their children should bear this in mind. Parents should also note that American custody orders might not be enforced in Yemen.
American women who also hold Yemeni nationality, and/or are married to Yemeni or Yemeni-American men, are advised that if they bring their children to Yemen they may not enjoy freedom of travel should they decide they want to leave Yemen. Such women often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody (See Entry/Exit Requirements section above).
American students and workers in Yemen sometimes report that the sponsors of their residence permits seize their U.S. passports as a means of controlling their domestic and international travel. While the sponsors say they seize the passports on behalf of local security services, there is no law or instruction from Yemeni passport or security offices requiring that passports be seized.
Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Yemeni laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possession or use, or trafficking in illegal drugs in Yemen are severe, and convicted offenders can expect long jail sentences and heavy fines. The use of the mild stimulant "qat” or “khat" is legal and common in Yemen, but it is considered an illegal substance in many other countries, including the United States. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.
CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Yemen are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site, and to obtain updated information on travel and security within Yemen. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Dhahr Himyar Zone, Sheraton Hotel District, PO Box 22347. The telephone number of the Consular Section is (967)(1) 755-2000, extension 2153 or 2266. The fax number is (967) (1) 303-175. The after-hours emergency number is (967) (1) 755-2000 (press 0 for extension) or (967) 733213509. The Embassy is open from Saturday through Wednesday.
* * *
This replaces the Country Specific Information for Yemen dated December 27, 2007, to update the sections on Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Criminal Penalties and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Wed 29 May 2019
Source: World Health Organization [edited]

Outbreak update - Cholera in Yemen, 27 May 2019
-----------------------------------------------
The Ministry of Public Health and Population of Yemen reported 16,827 suspected cases and 18 associated deaths during epidemiological week 20 (13-19 May 2019). 15 per cent of cases were severe. The cumulative total number of suspected cholera cases from 1 Jan 2018 to 28 Apr 2019 is 704 986, with 1114 associated deaths (case fatality rate [CFR] 0.16%). Children under 5 represent 22.6% of total suspected cases during 2019. The outbreak has affected 22 of 23 governorates and 295 of 333 districts in Yemen.

>From week 8 in 2019, the trend of weekly reported suspected cholera cases started increasing and peaked at more than 29 500 cases in week 14. During weeks 15 to 20, case numbers declined, although it is too early to conclude a downward trend. The decline may be attributed to enhanced outbreak control efforts such as community engagement and WaSH [water, sanitation, and hygiene] activities, and scaling up WHO and partners' response, including establishing additional DTCs [diarrhea treatment centres] and ORCs [oral rehydration corners].

The governorates reporting the highest number of suspected cases of cholera in 2019 are Amanat Al Asimah (55 065), Sana'a (41 094), Al Hudaydah (34 814), Ibb (31 725), Dhamar (29 889) and Amran (27 727).

Of a total 6144 samples tested since January 2019, 3264 were confirmed as cholera-positive by culture at the central public health laboratories. During this reporting period, the governorates reporting the highest number of positive cultures are Amanat Al Asimah (995), Taizz (741) and Sana'a (367).

WHO continues to provide leadership and support for activities with health authorities and partners to respond to this ongoing cholera outbreak, including case management, surveillance and laboratory investigations, hotspot mapping and oral cholera vaccination campaign planning, water sanitation and hygiene (WaSH), and risk communication.
===================
[The numbers reported in this continuing catastrophe are difficult to wrap one's head around. Given the low case fatality rate reported, it is likely that many of the cases of diarrhoea are not cholera. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Mon 12 May 2019
Source: WHO/EMRO, Epidemic and Pandemic Prone Diseases, Outbreaks, Cholera [edited]

Outbreak update - Cholera in Yemen, 12 May 2019
-----------------------------------------------
The Ministry of Public Health and Population of Yemen reported 18,171 suspected cases of cholera with 13 associated deaths during epidemiological week 18 (29 Apr-5 May) of 2019. 15% of cases were severe. The cumulative total number of suspected cholera cases from 1 Jan 2018 to 28 Apr 2019 is 668 891 with 1081 associated deaths (CFR 0.16%). Children under 5 represent 22.7% of total suspected cases during 2019. The outbreak has affected 22 of 23 governorates and 294 of 333 districts in Yemen.

From week 8 [18-24 Feb] in 2019, the trend of weekly reported suspected cholera cases started increasing and reached a peak of more than 29 500 cases in week 14 [1-7 Apr 2019]. During weeks 15 to 18 [8 Apr-5 May 2019] new case numbers began to fall, although it is too early to conclude a downward trend. The decline may be attributed to enhanced efforts to control the outbreak such as enhancement in the community engagement and WaSH [water, sanitation, and hygiene] activities, and scaling up of response by WHO and partners, including establishing of additional DTCs [diarrhoea treatment centres] and ORCs [oral rehydration corners]. Another factor is the 1st round of the OCV [oral cholera vaccination] campaign which took place in April 2019 in 3 districts of Amanat Al Asimah governorate, reaching 1 088 101 people (88% of the target).

The governorates reporting the highest number of suspected cases of cholera during 2019 were Amanat Al Asimah (50 166), Sana'a (36 527), Al Hudaydah (30 925), Ibb (26 421), Dhamar (26 421), and Arman (25 244).

Of a total 5610 samples tested since January 2019, 2920 have been confirmed as cholera-positive by culture at the central public health laboratories. During this reporting period the governorates which reported the highest number of positive culture were Amanat Al Asimah (893), Taizz (704), and Sana'a (342).

WHO continues to provide leadership and support for activities with health authorities and partners to respond to this ongoing cholera outbreak, including case management, surveillance and laboratory investigations, hotspot mapping and OCV campaign planning, water, sanitation, and hygiene (WaSH) and risk communication.
========================
[The numbers reported in this continuing catastrophe are difficult to wrap one's head around. - ProMED Mod.LL]

[Maps of Yemen: <
Date: Fri, 19 Apr 2019 16:36:32 +0200

Khokha, Yemen, April 19, 2019 (AFP) - Oxfam has warned that war-torn Yemen risks a "massive resurgence" of cholera, with around 195,000 suspected cases of the disease recorded so far this year.   "Fears that the world's worst cholera outbreak could be set for a massive resurgence are growing," the relief organisation said Thursday.   It said aid agencies were struggling to reach suspected cases.

In a statement, Oxfam pointed to "fighting and restraints on access, including checkpoints and permit requirements imposed by the warring parties", and warned the coming rainy season was likely to accelerate the spread of the disease.   The water-borne bacterial infection has claimed more than 3,000 lives in Yemen since the outbreak began in 2016, according to Oxfam.

At a medical centre for the displaced in the government-held western town of Khokha, Qassem Suleiman had brought his son Alaa for tests after a serious case of diarrhoea.   Doctor Wadah al-Tiri told AFP that several patients had been transferred to Aden while others had been treated at the Khokha centre.   He said a tent was to be set up for suspected cases.

The doctor said Yemen badly needed international aid to combat the epidemic.   The UN's humanitarian coordination office OCHA said last month that children under the age of five make up nearly a third of this year's cases.   The spike, which comes two years after Yemen suffered its worst cholera outbreak, was concentrated in six governorates including in the Red Sea port of Hodeida and Sanaa province, both combat zones, it said.

Yemen's conflict, which pits Iran-linked rebels against a regional pro-government alliance led by Saudi Arabia, has left some 10,000 people dead since 2015 and pushed millions to the brink of famine.   Aid groups say the actual death toll could be five times as high.    The war has created the perfect environment for cholera to thrive, as civilians across the country lack access to clean water and health care.
Date: Fri 5 Apr 2019
Source: Associated Press [edited]

Cholera is surging once again in Yemen, with the UN reporting that the number of suspected cases has doubled in March 2019 over previous months and doctors in overwhelmed health facilities fearing it could rival a 2017 outbreak that spiraled into the world's worst flare-up. The surge underscores how Yemen, which has endured multiple outbreaks of cholera amid 4 years of civil war, still isn't able to stop its spread.

At al-Sabeen Hospital in the capital of Sanaa, beds are full and patients sleep in tents in a courtyard. Some of them wait for treatment by lying on cardboard under trees, with IVs dangling from the branches. "We receive cases around the clock. Sometimes 3 to 4 cases a minute," said Dr. Ismail al-Mansouri. "The hospital is under heavy pressure, as it receives patients from across the country." Even the doctors are not immune: al-Mansouri and several other staff have caught cholera. On 28 Mar 2019, one of their colleagues, a well-loved pediatrician, died of the disease.

Two other outbreaks since 2016 caused more than 1.4 million suspected cases and killed more than 3000 people. Most of those stemmed from an outbreak that began in April 2017 and grew into the world's biggest. The spread has slowed since late 2018, although it never stopped. Now, seasonal rains that began earlier than usual in 2019 have caused a spike in the disease.

There were 76,152 new suspected cases and 195 deaths in March 2019, compared with about 32,000 cases in February 2019 and 39 000 in January 2019. The March toll brought the number of those believed to have died from cholera this year [2019] to nearly 300. The rates in March 2019 are comparable with the 1st weeks of 2017, when cases jumped to 10 000 and 20 000 a week. It accelerated to 50 000 a week at its height and went on to infect more than 1 million people before waning in mid-2018. "The outbreak this year [2019] is much worse and the situation is very dangerous," said Adel al-Alamni, head of the cholera treatment center at al-Sabeen.

In a statement last week, the WHO said it was "doing everything possible to avoid the 2017 scenario." But it noted it faces restrictions on access and "bureaucratic hurdles" to bringing in supplies. Speaking to the Associated Press on Fri 5 Apr 2019, WHO spokesman Christian Lindmeier said rates of cholera fatality overall this year are still lower than in 2017, but the situation is exacerbated because of the early rains and because "infrastructure is more destroyed than it used to be."

Cholera is spread primarily by water and food tainted with faeces. It usually can be treated if caught early, but it can kill swiftly by dehydrating its victims through vomiting and severe diarrhea. The destruction wreaked by Yemen's civil war has created prime conditions for cholera's spread. The conflict is between Shiite rebels known as Houthis who control the northern part of the country and a Saudi-led coalition backing the internationally recognized government, based in the south.

Fighting and airstrikes have damaged sewage systems and water stations. Most people don't have access to clean water, particularly the more than 3 million driven from their homes by the war. The main water treatment facility outside Sanaa has broken down. Sewage water is often used to irrigate fields, potentially infecting food supplies, and it leaks into wells, the main source of water. Health services and trash collection have further broken down because about 1 million government employees have largely gone unpaid since the Central Bank was moved in 2016 from Houthi-controlled Sanaa to the southern city of Aden. Nearly half the prewar health facilities are no longer working, often because they were damaged by airstrikes.

The cholera adds to what is already the world's worst humanitarian crisis. Nearly two-thirds of Yemen's 23 million people are in need of some sort of aid and possibly tens of thousands have died of malnutrition, preventable diseases and epidemics. The surge in cholera has been centered in districts around Sanaa and other parts of the north. The relief agencies Doctors Without Borders and Save the Children warned last week of an "alarming spike" with 1000 children infected with suspected cholera every day.

Most of the patients at al-Sabeen Hospital are children under 10 years of age, al-Mansouri said. Among the most recent deaths were 2 pregnant women, along with their unborn babies. Among the dead was al-Mansouri's colleague who had treated children during the recent waves of cholera. His colleagues and family believe he was infected as he did his morning rounds, checking the dozens of patients in his care, before having breakfast at the hospital cafe. He died of kidney failure, a common complication from cholera.

Health workers dealing with cholera patients have not received vaccinations, al-Mansouri said, noting doctors are left without protection. Infection control in health facilities is almost nonexistent because of the lack of resources, making staff vulnerable, he said. Hardly anyone in Yemen has been vaccinated against cholera. UN officials have said agencies largely have been unable to bring in vaccines because of the difficulty in delivering them amid the conflict. The only vaccination campaign so far took place in a few districts in 2018 and covered 400,000 people.  [Byline: Ahmed Al-Haj]
========================
[The numbers reported in this continuing catastrophe are difficult to wrap one's head around. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
Wednesday 27th March 2019
http://www.emro.who.int/yem/yemen-news/two-years-since-world-largest-outbreak-of-acute-watery-diarrhoea-and-cholera-yemen-witnessing-another-sharp-increase-in-reported-cases-with-number-of-deaths-continuing-to-increase.html

Two years since world-largest outbreak of acute watery diarrhoea and cholera, Yemen witnessing another sharp increase in reported cases with number of deaths continuing to increase
From Geert Cappelaere, UNICEF Regional Director in the Middle East and North Africa and Dr Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean

MUSCAT / AMMAN / CAIRO, 26 March 2019 – “In Yemen, since the beginning of the year until 17 March, nearly 109 000 cases of severe acute watery diarrhoea and suspected cholera were reported with 190 total associated deaths since January. Nearly one third of the reported cases are children under the age of 5. This comes 2 years since Yemen witnessed the world-largest outbreak when more than 1 million cases were reported.

“We fear that the number of suspected cholera cases will continue to increase with the early arrival of the rainy season and as basic services, including lifesaving water systems and networks have collapsed. The situation is exacerbated by the poor status of sewage disposal systems, the use of contaminated water for agriculture, unreliable electricity to store food and families’ displacement as they flee escalating violence especially in Hudaydah and Tai’z.

“Our teams in Yemen are working day and night with a wide network of local partners to respond and stop the further spread and transmission of the diseases. Focusing on 147 priority districts, additional health, water, hygiene and sanitation supplies are being mobilized. Rapid response teams have been deployed. A total of 413 diarrhoea treatment centres and oral rehydration centres are operational in all 147 priority districts. Partners are repairing water and sanitation systems. In the past weeks, we scaled up chlorination activities to disinfect water in 95 priority districts and provided fuel and spare parts to keep going water supply and sanitation networks. A round of oral cholera vaccine campaign reached over 400 000 people in several districts. Meanwhile, community-based awareness raising reached 600 000 people in house-to-house campaigns since early 2019 to provide families with hygiene practices and improve reporting symptoms and seeking treatment.

“UNICEF and WHO are committed to continue scaling up the response to assist immediately the people affected and to prevent the disease from spreading further. We are doing everything possible to avoid the 2017 scenario including the timely use of proven effective measures, including oral cholera vaccination. However, we face several challenges, including the intensification of fighting, access restrictions and bureaucratic hurdles to bring lifesaving supplies and personnel to Yemen.

“UNICEF and WHO are calling to lift all restrictions on our humanitarian operations to respond to the spread of the disease and other areas. Our humanitarian teams must have full access to reach every child, every woman, every man in need of medical and other humanitarian assistance.

“Above all, we jointly reiterate the calls for the fighting to end. It is time for the 4-year long war to come to an end. If not, Yemen will continue to be trapped in a web of diseases, malice and sink deeper in endless humanitarian disasters, with the most vulnerable paying the highest price.

For further information, please contact:

Inas Hamam
Mobile: +2 01000 157 385
E-mail: hamami@who.int

Tarik Jašarević
Mobile: +41 793 676 214
E-mail:  jasarevict@who.int
More ...

World Travel News Headlines

Date: Sun, 16 Jun 2019 12:02:50 +0200

Patna, India, June 16, 2019 (AFP) - Severe heat has left dozens dead over a 24-hour period in India's Bihar state, as the country enters a third week of searing temperatures, officials said Sunday.   The deaths occurred in three districts of the poor northern state, where temperatures have hovered around 45 degrees Celsius (113 Fahrenheit) in recent days, senior health official Vijay Kumar told AFP.

Forty-nine people died in three districts of the Magadh region that has been hit by drought, he said.   "It was a sudden development on Saturday afternoon. People affected by heatstroke were rushed to different hospitals," Kumar added.   "Most of them died on Saturday night and some on Sunday morning during treatment."   Kumar said about 40 more people were being treated at a government-run hospital in Aurangabad.   "Patients affected by heat stroke are still being brought, the death toll is likely to increase if the heatwave continues."

Most of the victims were aged above 50 and were rushed to hospitals in semi-conscious state with symptoms of high fever, diarrhoea and vomiting.   Twenty-seven people died in Aurangabad district, 15 in Gaya and seven in Nawada district, officials said.    State Chief Minister Nitish Kumar has announced a compensation of 400,000 rupees ($5,700) for the family of each victim.   Harsh Vardhan, India's health minister, said people should not leave their homes until temperatures fall.    "Intense heat affects brain and leads to various health issues," he said.

Large parts of northern India have endured more than two weeks of sweltering heat. Temperatures have risen above 50 degrees Celsius (122 Fahrenheit) in the desert state of Rajasthan.   A heatwave in 2015 left more than 3,500 dead in India and Pakistan.   In 2017, researchers said South Asia, which is home to one fifth of the world's population, could see heat levels rise to unsurvivable levels by the end of the century if no action is taken on global warming.
Date: Sun, 16 Jun 2019 01:30:52 +0200

Wellington, June 15, 2019 (AFP) - A powerful 7.4 magnitude earthquake stuck near the uninhabited Kermadec islands northeast of New Zealand Sunday, the US Geological Survey said as authorities monitored for signs of a tsunami.   New Zealand's civil defence organisation said it was monitoring the situation and if a tsunami was generated it would take at least two hours to reach the country.   The Pacific Tsunami Warning Center said "hazardous tsunami waves from this earthquake are possible within 300 km of the epicentre along the coasts of the Kermadec islands."   The earthquake struck at 10:55am (2255 GMT Saturday) some 928 kilometres (575 miles) north-northeast of the New Zealand city of Tauranga in North Island at a depth of 34 km.
Date: Sun, 16 Jun 2019 00:59:42 +0200

Wellington, June 15, 2019 (AFP) - A magnitude 6.1 earthquake struck Sunday centred 97 kilometres (60 miles) north-east of Ohonua, on the Pacific island of Tonga, the US Geological Survey reported.   The quake hit at 2156 GMT Saturday with an epicentre depth of 10 kilometres, the US global quake monitor said.   The Pacific Tsunami Warning Centre issued no alerts, and there were no immediate reports of damage or casualties.   The reported epicentre lies within the so-called Pacific Ring of Fire, an area of regular seismic activity.   In February 2018, a 7.5 magnitude earthquake in Papua New Guinea killed 150 people and destroyed hundreds of buildings.
Date: Sun, 16 Jun 2019 00:19:43 +0200

Geneva, June 15, 2019 (AFP) - A woman has drowned in Lake Geneva when her sightseeing boat sank as a violent storm battered parts of Switzerland on Saturday, police said.   A man who was in the same boat was able to swim to another vessel from where he fired "two flares", Joanna Matta, police spokeswoman for the canton (region) of Geneva, told AFP.   The man told officers that the woman had been "passing through Geneva" and that the storm had taken them "by surprise", Matta said.   Three police boats and emergency services rushed to the scene. Police divers later retrieved the woman's body from the lake.

The victim, whose nationality remains unknown, was then taken to a hospital in Geneva where she was declared dead.   In a separate incident, the storm also damaged some of the 465 boats taking part in the 81st edition of the Bol d'Or, an annual regatta on Lake Geneva, the event's press service said.   Heavy rain and strong winds lashed the participants on Saturday afternoon, causing boats to capsize although nobody was injured.

However, the storm broke the mast of the ultra-fast "Real Team" catamaran, which had been in the lead and was forced to pull out of the race.   The bad weather struck western Switzerland on Saturday afternoon, bringing hail and winds reaching up to 110 kilometres (70 miles) per hour, according to the national forecaster MeteoSwiss.   In the neighbouring French region of Haute-Savoie the storm also caused damage and left a 51-year-old German tourist dead after a tree came down at a campsite.
Date: Sat, 15 Jun 2019 16:27:09 +0200

Windhoek, June 15, 2019 (AFP) - Drought-hit Namibia has authorised the sale of at least 1,000 wild animals -- including elephants and giraffes -- to limit loss of life and generate $1.1 million for conservation, the authorities confirmed Saturday.   "Given that this year is a drought year, the [environment] ministry would like to sell various type of game species from various protected areas to protect grazing and at the same time to also generate much needed funding for parks and wildlife management," environment ministry spokesman Romeo Muyunda told AFP.

The authorities declared a national disaster last month, and the meteorological services in the southern African nation estimate that some parts of the country faced the deadliest drought in as many as 90 years.    "The grazing condition in most of our parks is extremely poor and if we do not reduce the number of animals, this will lead to loss of an animals due to starvation," Muyunda said.

In April, an agriculture ministry report said 63,700 animals died in 2018 because of deteriorating grazing conditions brought on by dry weather.   Namibia's cabinet announced this week that the government would sell about 1,000 wild animals.   They include 600 disease-free buffalos, 150 springbok, 65 oryx, 60 giraffes, 35 eland, 28 elephants 20 impala and 16 kudus -- all from national parks.   The aim is to raise $1.1 million that will go towards a state-owned Game Products Trust Fund for wildlife conservation and parks management.

The government said there were currently about 960 buffalos in its national parks, 2,000 springbok, 780 oryx and 6,400 elephants.   The auction was advertised in local newspapers from Friday.   Namibia, a country of 2.4 million people, has previously made calls for aid to assist in the drought emergency that has already affected over 500,000 people.   In April the government announced that it will spend about $39,400 (35,200 euros) on drought relief this year to buy food, provide water tankers and provide subsidies to farmers.
Date: Fri, 14 Jun 2019 18:27:56 +0200
By Rosa SULLEIRO

Sao Paulo, June 14, 2019 (AFP) - A nationwide strike called by Brazil's trade unions disrupted public transport and triggered road blocks in parts of the country Friday, ahead of protests against far-right President Jair Bolsonaro's pension reform.   Hours before the opening match of the Copa America in Sao Paulo, some metro lines in the country's biggest city were paralyzed as professors and students also prepared to take to the streets over the government's planned education spending cuts.    It will be the latest mass demonstration against Bolsonaro since he took office in January, but the timing could not be worse for the embattled president as Brazil prepares to play Bolivia in South America's showcase football tournament.

Bolsonaro was expected to attend the opener at Morumbi stadium where police sharpshooters will be deployed as part of increased security for the competition.    One of Brazil's main trade unions estimated 45 million workers had taken part in the strike.   Some 63 cities had been affected by the stoppage, with more than 80 cities recording demonstrations, G1 news site said.   The number of protesters is expected to balloon in the afternoon with demonstrations planned in Brazil's major cities.   Protesters have already blocked some roads in several cities, including Rio de Janeiro and Sao Paulo, where G1 said police had used tear gas to disperse demonstrators and clear the streets.   Brazilians were divided over the partial strike.   "This current government wants to destroy everything that we built decades ago so that's why I'm in favor (of the strike) and I am fighting against social inequality," Vania Santos, 49, told AFP in Rio.    In Sao Paulo, Flavio Moreira opposed the stoppage, however, saying it "hurts the commercial part" of the city.

- Pension savings cut -
Bolsonaro's proposed overhaul of Brazil's pension system -- which he has warned will bankrupt the country if his plan is not approved -- is seen as key to getting a series of economic reforms through Congress.    But the changes, including an increase in the retirement age and workers' contributions, have faced resistance from trade unions and in the lower house of Congress, where Bolsonaro's ultraconservative Social Liberal Party has only around 10 percent of the seats.    A pared-back draft of the reform presented to Congress on Thursday -- which reduces expected savings from 1.2 trillion reais ($300 billion) in 10 years to around 900 billion reais -- did little to appease union leaders, who vowed to go ahead with the shutdown.   Such savings are seen as vital to repairing Brazil's finances and economy, which were devastated by a 2015-2016 crisis.

Economy minister Paulo Guedes, who is spearheading the government's reform agenda, has threatened to resign if the bill is not passed or is watered down significantly.   It caps a tumultuous six months for Bolsonaro, who has seen his popularity nosedive as he struggles to push his signature reform through a hostile Congress and keep Latin America's biggest economy from sliding back into recession.   More than 13 million people are unemployed, the latest data shows, with a record number giving up looking for a job.     Fighting between military and far-right factions of Bolsonaro's government has fueled chaos in his administration where his sons and right-wing writer and polemicist Olavo de Carvalho wield enormous influence.   Bolsonaro sacked his third minister on Thursday -- retired general Carlos Alberto dos Santos Cruz, who had been the government secretary and seen as a moderate voice.   That came on the same day Bolsonaro broke his silence to defend Justice Minister Sergio Moro, who has been accused of wrongdoing while serving as a judge in the sprawling Car Wash anticorruption investigation.
Date: Fri, 14 Jun 2019 06:02:40 +0200
By Clotilde RAVEL

Abidjan, June 14, 2019 (AFP) - "Cover your goods," Diakaria Fofana, a doctor of public health, warns food vendors as a thick cloud of insecticide spray wafts down a street in Abidjan, Ivory Coast's economic capital.   Men in protective clothes, goggles and masks are disgorging plumes of mosquito-killing chemicals in a bid to roll back an outbreak of dengue.   Two people have died and 130 have fallen ill since the fever returned to the West African state last month.

The toll, so far, is tiny compared with other tropical countries, especially in Southeast Asia, where the painful and sometimes deadly disease is an entrenched peril.   But tackling the outbreak is a major challenge for Ivory Coast, a poor country that is having to resort to time-honoured, labour-intensive methods of spraying and neighbourhood awareness campaigns to prevent its spread.   Female mosquitoes carrying the dengue virus transfer the pathogen when they tuck into a blood meal from someone. 

A vaccine does exist, but is not available in Ivory Coast because "it has many secondary effects (and) it's expensive"," explained Joseph Vroh Benie Bi, director of the National Institute for Public Hygiene (INHP).    Developed by French pharmaceutical group Sanofi Pasteur, the vaccine is recommended for use in people aged nine and older, and only for individuals who have already been infected.    Usually accompanied by flu-like symptoms, dengue makes some people very sick indeed, developing into a haemorrhagic fever that can cause difficulty breathing, heavy bleeding or even organ failure. While a first bout of dengue is rarely fatal, subsequent infections are usually worse.

- 'Fighting the mosquito' -
The UN's World Health Organization (WHO) says there are up to 100 million cases of dengue worldwide every year, and almost half the world's population lives in countries where the disease is endemic.   It kills more than 20,000 people each year. Southeast Asia and the Western Pacific are the worst-hit areas.   There is no cure, and the WHO recommends that patients take paracetamol, rest and drinking plenty of fluids.   Five new vaccines are in development, but in the meantime Fofana says: "The only effective means of fighting (dengue) is fighting the mosquito."   In Ivory Coast, most recorded cases have occurred in Abidjan.

Health workers are striving to enlist the public in tackling the mosquito, targeting its life cycle.   "The larvae multiply in stagnant water, for example inside used tyres," said Fofana, deputy director of the vector control unit at the INHP.   "People should never store water in buckets in the open air and they should regularly throw out the water in plates under houseplants."   But he faces an uphill job in a sprawling port city of 4.4 million people in the middle of the rainy season.   What's more, people who are infected, even without knowing it, and can bring the virus to new areas when they are bitten by local mosquitoes.    The WHO has set a goal to halve the number of dengue deaths by 2020, but incidence of the disease has increased 30-fold in the last 50 years.   "Before 1970, only nine countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries," it says.

- 'Malaria's big brother' -
In Ivory Coast, where malaria accounts for a third of all medical consultations, many people self-medicate when they experience symptoms such as high fever, vomiting, nausea or aches and pains.   "This is a real problem, because the symptoms of malaria, dengue, typhus and yellow fever are similar. Doing a blood test is absolutely indispensable," said Fofana.   Treatment with the wrong medicines can worsen the situation, he stressed -- aspirin or ibuprofen can increase the risk of bleeding, for example.   In the meantime, the spraying goes on.    "We know the risks," said Bamba Segbe, an Abidjan resident watching the masked men in action. "It's not for nothing that we call dengue malaria's big brother."
Date: Thu, 13 Jun 2019 17:37:51 +0200
By Grace Matsiko

Mpondwe, Uganda, June 13, 2019 (AFP) - At the bustling Mpondwe border post, a woman crossing from the Democratic Republic of Congo into Uganda is whisked away to an isolation unit after a thermal scanner picks up her high temperature.   Health workers keep Mulefu Kyakimwa, a 32-year-old vegetable oil trader, under observation but later discharge her, once Ebola has been ruled out as the cause of her fever.

The border post is on high alert after a family with suspected Ebola escaped isolation on the Congolese side and entered Uganda, where two of them died this week.   The spread of the deadly virus to Uganda comes after months of efforts in a region of porous borders to contain an outbreak in Congo which has killed 1,400 people, according to the latest official data.    "Since the start of the outbreak, the total number of cases is 2,084, of which 1,990 have been confirmed and another 94 are probable," the Congolese health ministry said in its daily bulletin from Wednesday.   "In all, there have been 1,405 deaths -- 1,311 confirmed and 94 probable -- and 579 people have recovered," the bulletin said, adding that 132,679 people had been vaccinated.

- 'We expected it' -
Few people seem to be surprised that Ebola would eventually make its way to Uganda -- which has experienced outbreaks in the past.   "The outbreak is not a surprise. We expected it. People cross the borders all the time and interact a lot," said Dorcus Kambere, a 29-year-old Ugandan bar attendant who feels her job puts her at risk.

At Mpondwe -- where 25,000 people cross daily -- travellers undergo rigorous health checks to detect the lethal virus, which attacks the organs and leads to internal and external bleeding.   Soldiers carrying automatic rifles guide travellers through the screening process, making sure they wash their hands with disinfectant.   The travellers then pass through a shelter with a thermal scanner that feeds people's body temperatures into a computer.   "This is a situation we go through every day since the Ebola outbreak," said Ambrose Nyakitwe, 34, a Ugandan trader returning from the Congo side.   "It is good. I have a family. I have to see that they don't get affected," he added, after passing through the scan.   Outside the busy border post, business carries on as usual, with children swimming and playing in the muddy Lhubiriha river that draws a natural boundary between the two nations.

- 'Not safe' -
A woman serves pancakes with her bare hands from a bucket as pot-bellied money changers lounging next to her carry out their trade.   However, while some carry on seemingly oblivious to the dangers posed by the virus, others are increasingly suspicious.   "It is not safe. If they say people with Ebola crossed into Uganda, how sure are we there are not many who will infect us and are yet to be got?" asked Bernadette Bwiso, 41, a trader.    "Government must do a house-to-house search," she said.   Meanwhile, Nyakitwe is anxious about how the infected patients managed to cross into Uganda despite heightened surveillance.   A Congolese woman -- who is married to a Ugandan -- her mother, three children and their nanny had travelled to DRC to care for her ill father, who later died of Ebola.

The World Health Organization said 12 members of the family who attended the burial in Congo were placed in isolation in the DRC, but six "escaped and crossed over to Uganda" on June 9.   The next day, a five-year-old was checked into hospital in Bwera vomiting blood. Tests confirmed he had Ebola and the family was placed in an isolation ward.   His three-year-old brother was also confirmed to have Ebola, as was their grandmother who died late Wednesday.   Uganda and the RDC are discussing what can be done to intensify collaboration between the two countries to prevent the spread, the Congolese authorities said.

- No surveillance -
Uganda's health ministry said that the surviving travellers and the Ugandan father -- five people in total -- had agreed to be repatriated to DRC on Thursday for treatment and "family support and comfort" from relatives on the other side of the border.   However, three unrelated patients are still in a Ugandan hospital awaiting the result of Ebola tests.

Uganda's Health Minister Jane Ruth Aceng said challenges remained at "unofficial entry points" between Congo and Uganda, which share a porous 875-kilometre (545-mile) border.   These unauthorised border crossings, known as "panyas" in the local Lukonzo language, are often merely planks laid down across a point in the river, or through forests and mountains where there is no surveillance.   In a bid to contain the spread of the disease the Ugandan government has suspended market days and urged people to stop shaking hands and hugging.
Date: Thu, 13 Jun 2019 16:33:58 +0200

Madrid, June 13, 2019 (AFP) - Spain will launch a campaign to urge young people to "always carry a condom on them" as the number of sexually transmitted infections (STI) surges, the government said Thursday.   The news comes a week after the World Health Organization expressed alarm at the lack of progress on curbing STI or diseases (STD), with one expert warning of complacency as dating apps spur sexual activity.   In Spain, videos and ads will be posted from Monday on social networks, music platforms and media that 14- to 29-year-olds most follow, the health ministry said.   "It's normal that you want to do it in your parents' bed. What isn't normal is that you want to complicate your life," reads one ad, going on to show the number of new cases of HIV and other infections.

In a statement, the health ministry urged "everyone -- and particularly the young -- to always have a condom on them and use it."   "The use of condoms has dropped among the 15- to 18-year-olds over the last few years," Health Minister Maria Luisa Carcedo told reporters.   She said there was complacency over STI, including infection by the HIV virus that causes AIDS.   The campaign is a "first shock measure" to challenge the rise of STI among young people, the statement said.   The number of cases of gonorrhoea, for instance, has risen an average of more than 26 percent annually between 2013 and 2017, according to the ministry.

Syphilis "has risen less but in 2017, it reached its highest peak since the start of statistics in Spain: 10.61 infections per 100,000 residents compared to 2.57 in 1995."   The highest rates of chlamydia, meanwhile, are among 20- to 24-year-olds and particularly women, the ministry said.   In 2017, Spain registered close to 24,000 cases of infection by gonorrhoea, syphilis, chlamydia and LGV, a sexually-transmitted disease, according to the statement.
Date: Thu, 13 Jun 2019 15:12:32 +0200

Vilnius, June 13, 2019 (AFP) - Lithuanian temperatures have hit record June highs, meteorologists said Thursday, as a heatwave forced school closures and threatened to reduce harvests in the draught-hit Baltic region.   Kaisiadorys in central Lithuania was the hottest place at 35.7 degrees Celsius (96.2 degrees Fahrenheit) on Wednesday, the highest-ever temperature recorded for June in the country, weather forecaster Paulius Starkus told AFP.   Six people drowned in the Baltic EU state on Wednesday, the deadliest day of the year to date, while some schools put classes on hold or cut lessons short due to the heatwave.

Scientists say the extreme weather is in part a result of climate change.   "Lithuania used to have heatwaves but now they occur more often and are more intense due to climate change," Vilnius University climatologist Donatas Valiukas told AFP.   Starkus said a downpour with thunder and hail could follow in some areas on Thursday afternoon.   Agriculture Minister Giedrius Surplys told lawmakers that some areas were experiencing "a real climatic draught" threatening harvests, while hydrologists warned that river water levels posed a threat to fish.   Demand for air-conditioning has also soared in recent weeks.   Lithuania's hot weather is expected to last through the week, then temperatures may ease below 30 degrees Celsius starting Monday.   Fellow Baltic state Latvia is also experiencing unusual heat for June, with temperatures over 32 degrees Celsius.

In recent days, Latvia's western region of Kurzeme saw thunderstorms with hail damaging buildings, smashing greenhouses and tearing power lines.   Two people have been hospitalised in the northern Latvian town of Cesis after a tree fell on their camper van while they were inside.    Fellow Baltic state Estonia had a heatwave last week and is now experiencing rainy and windy weather.   Poland has also been experiencing high temperatures this month, which has resulted in increased air-conditioner use. The power transmission system operator PSE said that on Wednesday there was record electricity demand for a summer morning at nearly 24.10 gigawatts (GW).   Forty-two people have already drowned in Poland this month, according to the government security centre RCB.