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Anguilla

Anguilla US Consular Information Sheet
March 03, 2009
COUNTRY DESCRIPTION: Anguilla is a British overseas territory in the Caribbean, part of the British West Indies. It is a small but rapidly developing island with particularly well-developed
ourist facilities.

ENTRY/EXIT REQUIREMENTS:
The Intelligence Reform and Terrorism Prevention Act of 2004 requires all travelers to and from the Caribbean, Bermuda, Panama, Mexico and Canada to have a valid passport to enter or re-enter the United States. U.S. citizens must have a valid U.S. passport if traveling by air, including to and from Mexico.
If traveling by sea, U.S. citizens can use a passport or passport card. We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

In addition to a valid passport, U.S. citizens need onward or return tickets, and sufficient funds for their stay.
A departure tax is charged at the airport or ferry dock when leaving. For further information, travelers may contact the British Embassy, 19 Observatory Circle NW, Washington, DC
20008; telephone (202) 588-7800; or the nearest consulate of the United Kingdom in Atlanta, Boston, Chicago, Dallas, Los Angeles, New York, Denver, Houston, Miami, Orlando, Seattle, or San Francisco. Visit the British Embassy web site for the most current visa information.

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:
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 A Safe Trip Abroad.

CRIME:
While Anguilla's crime rate is relatively low, both petty and violent crimes
do occur. Travelers should take common-sense precautions to ensure their personal security, such as avoiding carrying large amounts of cash or displaying expensive jewelry. Travelers should not leave valuables unattended in hotel rooms or on the beach. They should use hotel safety deposit facilities to safeguard valuables and travel documents. Similarly, they should keep their lodgings locked at all times, whether they are present or away, and should not leave valuables in their vehicles, even when locked.

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 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 emergency line in Anguilla is 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
There is only one hospital, Princess Alexandra Hospital (telephone: 264-497-2551), and a handful of clinics on Anguilla, so medical facilities are limited.
Serious problems requiring extensive care or major surgery may require evacuation to the United States, often at considerable expense.

There are no formal, documented HIV/AIDS entry restrictions for visitors to and foreign residents of Anguilla, but there have been anecdotal reports of exclusion.
Please verify this information with the British Embassy 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 Anguilla is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Unlike the U.S., traffic in Anguilla moves on the left. The few roads on the island are generally poorly paved and narrow. While traffic generally moves at a slow pace, with the increasing number of young drivers in Anguilla, there are occasional severe accidents caused by excessive speed. Although emergency services, including tow truck service, are limited and inconsistent, local residents are often willing to provide roadside assistance. For police, fire, or ambulance service dial 911.

Please refer to our Road Safety page for more information.
Visit the Government of Anguilla web site for further road safety information.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in Anguilla fall under the jurisdiction of British authorities. The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Anguilla’s air carrier operations.
For more information, travelers may visit the FAA web site.

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 Anguilla laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Anguilla 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.
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 Anguilla 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 Anguilla. 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 with consular responsibility over Anguilla is located in Bridgetown, Barbados in the Wildey Business Park in suburban Wildey, southeast of downtown Bridgetown.
The main number for the Consular Section is (246) 431-0225; after hours, the Embassy duty officer can be reached by calling (246) 436-4950.
Visit the U.S. Embassy Bridgetown online for more information.
Hours of operation are 8:30 a.m. – 4:30 p.m. Monday through Friday, except Barbadian and U.S. holidays.
* * *
This replaces the Country Specific Information for Anguilla dated April 2, 2008, to update sections on Country Description, Entry/Exit Requirements, Information for Victims of Crime, and Medical Facilities and Health Information.

Travel News Headlines WORLD NEWS

Date: Sat, 9 Sep 2017 19:31:32 +0200

Paris, Sept 9, 2017 (AFP) - France's meteorological agency on Saturday issued its highest warning for the Caribbean islands of St Martin and St Barts as Hurricane Jose bore down, three days after they were hit by Hurricane Irma.   The alert warned of a "dangerous event of exceptional intensity," with winds that could reach 120 kilometres (75 miles) per hour, and strong rains and high waves.

St Barts is a French overseas territory, as is the French part of St Martin, which is divided between France and the Netherlands.   Twelve people were killed on the two islands by Hurricane Irma, thousands of buildings were flattened and the authorities are struggling to control looting.   The French state-owned reinsurer CCR on Saturday estimated the damage at 1.2 billion euros ($1.4 billion).   Irma is now heading for Florida, where a total of 6.3 million people have been ordered to evacuate, according to state authorities.
Date: Tue 29 Apr 2014
Source: National Institute for Public Health and the Environment [edited]

1 Oct 2013-29 Apr 2014 (week 18) St Maarten - Since the last report (week 15 [17?]) 52 new cases have been confirmed among St Maarten residents. Up to 29 Apr 2014, now a total of 343 confirmed cases have been reported. One of these confirmed cases was hospitalized.

The median age of the confirmed patients was 44 years, range 4-92 years. Of those cases for which gender was available, 201 were female and 130 were male.

- On 6 Dec 2013, the 1st indigenous chikungunya [virus infection] case of St Maarten was reported. Retrospectively, the 1st patient with suspected complaints was reported in mid-October 2013 in St Martin.
------------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
=====================
[The report also has graphs showing case numbers over time.

Maps of St Martin/St Maarten can be accessed at
Date: 5-11 May 2014
Source: Institut de Veille Sanitaire (French Institute for Public Health Surveillance, InVS) [edited]

Cases since the beginning of the outbreak in December 2013:
- St Martin: (susp) 3240 cases; deaths 3; stable.
- St Barthelemy: (susp) 500 cases; stable.
- Martinique: (susp) 24 180; deaths 3; increasing.
- Guadeloupe: (susp) 13 600 cases; deaths 1; increasing.
- French Guiana: (susp) not available; (probable or confirmed) 122 cases with 83 locally acquired; increasing, with a new cluster in Kourou and 2 near Cayenne.
======================
[The 16 May 2014 report from Guyaweb (<http://www.guyaweb.com/actualites/news/sciences-et-environnement/le-chik-revient-kourou-setend-cayenne-desormais-saint-laurent/>) states that there are 2 new cases in Saint-Laurent-du-Maroni, overlooking the Suriname River, of which one is certainly autochthonous, and a new focal point occurred in Kourou with 4 cases.

Maps of the area can be seen at
and <http://healthmap.org/promed/p/35574>. - ProMed Mod.TY]
Date: 7-13 Apr 2014
Source: INVS Point Sanitaire No. 14 [in French, trans. ProMed Mod.TY, edited]

Cases since the beginning of the outbreak in December, 2013:
- St. Martin: (susp.) 2980 cases, (probable and conf.) 793 cases; Deaths 3; Decreasing.
- Saint Barthelemy: (susp.) 460 cases, (probable or confirmed) 135 cases; Decreasing.
- Martinique: (susp.) 16 000, (probable or confirmed) 1473 cases; Deaths 2; Increasing.
- Guadeloupe: (susp.) 4710 cases, (probable or confirmed) 1261 cases; Deaths 1; In epidemic status.
- French Guiana: (susp.) 7 cases with 4 locally acquired, (probable or confirmed) 39 cases with 26 locally acquired) 30 cases; (imported) 16 cases; Moderate to increasing; Half of probable and confirmed cases are located in Kourou; however indigenous cases have also been recorded from the Cayenne Matoury, Remire and Macouria communities.
=================
[Maps showing case distributions on each island can be accessed at the above URL. - ProMed Mod.TY]
Date: Thu 27 Mar 2014
Source: The Daily Herald [edited]

As St. Maarten continues to take measures to combat the spread of the chikungunya virus, the number of cases continues to climb.

Health Minister Cornelius de Weever announced on Wednesday [26 Mar 2014], that the total number of confirmed chikungunya cases thus far stood at 224.

De Weever also announced that government will be signing a Memorandum of Understanding (MOU) with French St. Martin as a means of collectively responding to the mosquito threat that puts the population at risk. He said both sides have been working closely together to address the dengue and chikungunya threats.

The MOU will cover, amongst other things, a regular exchange of epidemiological information on vector-borne diseases and collectively publishing and representing data collected under the agreement.

The need for collective information campaigns and enhancement of the mosquito vector-control programme will also be included in the MOU. The MOU also describes the need for planning execution and evaluation of collective responses to the chikungunya threat.
=========================
[The increase in the number of chikungunya virus infections over the past week in St. Maarten is of concern, rising from 123 cases to 224 cases. This number is confirmed in another report that also indicates that there are an additional 325 suspected cases (<http://www.rivm.nl/dsresource?type=pdf&disposition=inline&objectid=rivmp:239786>).  - ProMed Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/35574>.]
More ...

Morocco

General
********************************************
Morocco is a North African country and a favourite destination for many Irish tourists. The climate, relative shortness of the flights and the idyllic swimming conditions encourage many to vis
t.
Safety & Security
********************************************
The border regions of the country can be volatile and travellers planning to visit away from the main tourist routes should take extra precautions. The Western Sahara region is still in dispute though there has been an official cease-fire in place since 1991. The possibility of unexploded mines exists though it should be remembered that this area is many miles away from the normal tourist resorts. The level of street crime in Morocco is low but growing. Busy market places, parks and beaches are popular locations for petty criminals. Tourists should take care not to flaunt personal wealth and to avoid travelling away from the main tourist zones late at night. Travelling alone is a particular risk and only authorised guides and taxis should be used. Tourists have been threatened with serious injury at knife point if they have refused to purchase cannabis.
Laws & Customs
********************************************
It is an Islamic country and ladies in particular should take care to dress modestly. Islamic festivals can cause significant changes to occur which affect tourists including the holy month of Ramadan when all street cafés close until 5.30pm each day as strict Muslims do not eat during the daylight hours. The main tourist hotels continue to serve food as normal but many shops will remain closed. During these times tourists will need to carefully check their tickets and any travel arrangements may need to be changed. Banks and larger shops will remain open between 9am and 3pm Monday to Friday. Drug offences are treated very seriously and those visiting the Rif Mountains should realise this is a major cannabis growing area. Visitors with Arabic Bibles or those involved in any perceived outreach activity may find they are subjected to prolonged interrogation.
Health Facilities
********************************************
The level of health care available in many of the main hotels and resorts is perfectly adequate but care should be taken if your illness necessitates admission. Communication in English may be difficult and many medications will be unavailable. Frequently small private hospitals are used where standards vary greatly. Check that your travel insurance provides adequate cover for repatriation if required.
Food & Water Facilities
********************************************
The food and water provided in many of the main tourist resorts is very satisfactory but variations can easily occur and travellers should be careful at all times. Lettuce, undercooked bivalve shellfish (mussels, oysters, clams etc) and untreated water are all frequently implicated in sickness among travellers. Eating previously peeled fruit is also unwise and should be avoided. Bottled water purchased from main shops or hotels should be used for drinking and brushing your teeth.
Insect Bites & Mosquitoes
********************************************
There is only a very small risk of malaria transmission throughout Morocco and prophylaxis is not recommended for the majority of tourists. However, sandflies do abound during the summer months and can transmit a nasty disease known as Leishmaniasis. These small flies tend to hover close to the ground in shaded areas and can easily bite without the individual noticing. It is essential to use good insect repellent when at risk and to report any slow healing bite or sore to a doctor after your return home.
Sun Exposure
********************************************
The level of sun exposure in Morocco during the summer months can be intense. Take care to avoid the midday sun and use high sun blocking creams at all relevant times. Take particular care of children while in such a hot climate. Extra water and salt will be required to replace the amounts lost through perspiration. Salted crisps and nuts will be a useful source of salt.
Water Sports & Activities
********************************************
Many tourist locations in Morocco offer extended water sport facilities for tourists. Always check out what the standard of care is before agreeing to take part. Ask tourists who arrived before you and check with your holiday representative if possible. Confirm that good safety procedures are in place and that your travel insurance covers any accidents as a result of your activities.
Cash Facilities
********************************************
Traveller’s cheques and credit cards are accepted in many of the main tourist resorts. ATM machines are available in Casablanca and Rabat. It may be difficult to reconvert Moroccan money back to sterling and so care should be taken not to change too much initially until you clarify your expenses.
Travel by Train
********************************************
To visit other parts of the country many travellers use the train journey south from Tangier. However, be wary of any invitation from fellow passengers to alight at Asilah rather than continuing the journey south. A number of tourists have been held hostage and forced to make credit card transactions or cash withdrawals before being freed.
Road Transport
********************************************
Many tourists to Morocco hire motorbikes or cars to see more of the country. This is regarded as a high-risk activity and special care will be required at all times. Driving practices throughout Morocco are poor and traffic signals do not always function. Modern freeways link the main cities of Tangier, Rabat, Fez and Casablanca. Flash flooding can occur during the rainy season (November – March).
Rabies
********************************************
Rabies does occur in Morocco and it is essential that you avoid any and all contact with at risk animals. Typically this includes dogs, cats and monkeys but this viral disease can infect any warm-blooded animal. Take particular care to warn children to avoid animals and to report any contact as soon as possible.
Vaccinations
********************************************
There are no essential vaccines for entry into Morocco from Ireland. However most tourists are advised to consider adequate cover against:
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water disease)
*
Hepatitis A (food and water disease)
Those planning a longer or more rural trip will also need to consider cover against diseases like Hepatitis B and Rabies.
Summary
********************************************
The majority of tourists visiting Morocco will remain very healthy and well. However, following simple precautions against food and water disease and sun exposure will be essential.

Travel News Headlines WORLD NEWS

Date: Fri, 27 Sep 2019 06:34:45 +0200 (METDST)
By Sophie Pons

Casablanca, Morocco, Sept 27, 2019 (AFP) - In Morocco, the struggle against HIV has been so successful in recent years that campaigners worry about losing funding for combatting the virus, but for people living with the disease it remains a heavy stigma.   In Casablanca, a group therapy workshop offers HIV patients a rare opportunity to speak openly about their disease.   "Here I feel normal, I'm treated like a human being," said Zineb, a 29-year-old mother.

Organised by the Association for the Fight Against AIDS (ALCS), on a recent Thursday the workshop brought 12 HIV patients together with a psychologist and a therapist.   The ALCS also organises follow-up therapeutic care in hospital, and prevention and screening campaigns, with funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.   These programmes were developed shortly after the first HIV case was detected in Morocco in 1986.   This early start is partly why UNAIDS, the Joint United Nations Programme on HIV/AIDS, calls Morocco a "model country" for its HIV response.   Thanks to improved screening, access to treatment and monitoring, new HIV infections in Morocco declined by 42 percent between 2010 and 2016, compared to an average reduction of four percent across the rest of the Middle East and North Africa.

Morocco had 350 deaths from AIDS in 2018, from a population of about 35 million.   But some groups remain vulnerable, with intravenous drug users, men who have sex with other men, and sex workers accounting for two thirds of Morocco's 21,000 identified cases.   And the stigma attached to those infected remains high, even within the family.   "My mother treated me like a murderer. For a long time I felt alone in the world," said Youssef, a 28-year-old who has twice attempted suicide.   Like other HIV patients interviewed by AFP, he asked to be identified by a pseudonym.   And all of them -- save for a 40-year-old considered very lucky by the group -- have either hidden their illness or been rejected by loved ones.

- 'Don't tell him anything' -
In this conservative Muslim society, where sex outside marriage and homosexuality are illegal, HIV patients seldom talk publicly about the virus.   "The subject is taboo, because the infection is linked to sex, itself a taboo subject in Morocco," said Yakoub, a 25-year-old ALCS worker.   "The social rejection is such that some (HIV patients) lose everything: family, friends, work, home," he said.

Zineb, like many HIV patients, hides her medication to conceal her illness.   For 10 years, the former teen mother has told her family that she is being treated for diabetes. "My 17-year-old son knows nothing, I can't bring myself to tell him, I'm too afraid," she said with a sad smile.   "Once you're sick, you're no longer a person," said Sakina, a mother who says she never speaks of her illness except with doctors, the ALCS staff and other HIV patients.

Like 70 percent of HIV positive women in Morocco, Sakina was infected by her husband. She cannot bring herself to tell her 15-year-old son that he is also infected.    She has always lied to him but she can "no longer sleep at night", she told the group through tears.    "My advice: above all, don't tell him anything," said a young man.   "For your sake, let him find out from someone else," another group participant suggested.   Then the psychologist interjected to say that private sessions are available to "reflect on these difficult questions".

The shame of HIV is so entrenched, it even permeates the medical establishment.   "For 30 years we've been talking about it, the virus is well known but the discrimination is still there," said Dr Kamal Marhoum El Filali, head of the infectious diseases department at Ibn Rochd Hospital in Casablanca, which hosts an ALCS branch.    "The stigmatisation isn't just from society but also from medical staff within the hospital environment."

Amina, another group therapy participant, experienced this first hand.   "When I went to the hospital to give birth, no one wanted to take care of me, no one wanted to touch me, I ended up in intensive care," she recalled indignantly.   Others in the session though were grateful for the care they had received.    "We are lucky to be under the care of the infectious diseases department: we are well cared for compared to others, considering the lack of funding and disrepair in Moroccan hospitals," said another participant

- 'Victim of own success' -
The emergency room at Ibn Rochd is sometimes overwhelmed with doctors each seeing up to 40 patients a day.   But the infectious diseases department is always spotlessly clean, providing personalised support as ALCS staff liaise with the medical teams.   But how much money Morocco will receive to continue its fight against HIV will be determined at a three-yearly conference for the Global Fund in October.   With funding declining globally and controversy surrounding the management of UNAIDS, ALCS president Mehdi Karkouri fears financial cuts.   "We are a victim of our own success: because our results are good, we risk losing funding," he said.
Date: Mon, 2 Sep 2019 21:08:54 +0200 (METDST)

Rabat, Sept 2, 2019 (AFP) - Morocco authorities said Monday they had found the body of a person missing after a flood hit a football pitch, bringing to eight the number of people killed in last week's tragedy.   The flood took place when a nearby river burst its banks in the southern region of Taroudant on Wednesday.   A 17-year-old boy and six elderly men were killed and have since been buried, while rescuers continued the search for an eight victim who was swept away by the flood, authorities said.

The last body was found some 20 kilometres (12 miles) from the village of Tizret near where an amateur football tournament had been taking place.   Photographs and videos shared on social media showed muddy waters carrying away people who had clambered on top of a building flattened by the flood.   Authorities have opened an investigation and the government has promised to take several measures to avoid such tragedies in the future.   Morocco's national weather service had warned of the risk of stormy rains on Wednesday afternoon in several provinces.    The heavy downpour followed a dry spell, making the floods more violent, local media reported.

Floods are common in Morocco. In late July, 15 people died in a landslide caused by flash floods on a road south of Marrakesh.   In 2014, floods killed around 50 people and caused considerable damage in the south of the country.   Between 2000 and 2013, a series of 13 major floods killed a total of 263 people in Morocco and caused considerable damage to infrastructure worth $427 million, according to the World Bank.   A study published in 2015 pointed to multiple failures in infrastructure maintenance, prevention, warning and emergency management.
Date: Thu, 29 Aug 2019 00:08:33 +0200 (METDST)

Rabat, Aug 28, 2019 (AFP) - At least seven people died Wednesday when a river burst its banks and flooded a village football pitch where a game was being played in south Morocco, local authorities and a witness said.   Eight men who had sought refuge in the changing rooms were swept away in the floodwater after heavy showers hit the Taroudant region late in the day, an eyewitness told AFP on condition of anonymity.   "We're in shock, I'm 64 years old and I've never seen such a downpour," the witness said.

Search and rescue operations were under way to find further victims, officials said.   Photographs and videos shared on social media showed muddy waters carrying away people who had clambered on top of a building flattened by the flooding.    Morocco's national weather service had warned of the risk of stormy rains on Wednesday afternoon in several provinces.    The heavy downpour followed a dry spell, making the floods more violent, local media reported.   Floods are common in Morocco. In late July, 15 people died in a landslide caused by flash floods on a road south of Marrakesh.
Date: Fri, 26 Jul 2019 15:26:58 +0200

Rabat, July 26, 2019 (AFP) - Moroccan emergency crews pulled 15 bodies from the mud after a rare summer downpour triggered a landslide that buried a minibus, authorities said Friday, providing the first official toll.   The victims -- eleven women, three men and one child -- were found in the bus buried some 20 metres (more than 60 feet) under the masses of earth and rock dislodged by the rain, local authorities said.    "There are no survivors," they said in a statement.

The official toll comes after public broadcaster 2M reported Friday morning that 16 bodies had been recovered.   The bus was buried Wednesday evening when a deluge in the Atlas mountains south of Marrakesh triggered flash flooding.   Images released by the authorities show excavators working to dig a path to the bus, more than 24 hours after it was engulfed by the debris.

A weather alert on Tuesday warned of storms in several provinces in the North African country, which rarely receives summer rains.   Investment in Morocco's road network has largely focused on the main transport arteries and many rural areas can be reached only by dirt tracks that are vulnerable to extreme weather.   Every year, nearly 3,500 people are killed on the North African country's roads.
Date: Sat, 2 Feb 2019 14:22:56 +0100

Rabat, Feb 2, 2019 (AFP) - An outbreak of swine flu in Morocco has left nine people dead in the past week, the kingdom's health minister said Saturday.   The spread of the H1N1 virus was "normal" for the time of the year, said Anas Doukkali, quoted by Morocco's official MAP news agency.   The first death in Morocco from the influenza-type virus was reported by local media on Wednesday, since when anxious rumours have spread on social media.   "Vigilant efforts continue to detect possible cases in different hospitals across the kingdom," said government spokesman Mustapha Khalfi.

H1N1 is a respiratory disease contracted through contact between humans and pigs and transmitted between people through inhalation.   A major H1N1 outbreak sparked a World Health Organization pandemic alert in June 2009. It killed around 18,500 people in 214 countries before the alert was lifted in August 2010.
More ...

Turkmenistan

Turkmenistan - US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Turkmenistan is a Central Asian nation roughly the size of California.
It shares borders with Kazakhstan, Uzbekistan, Afghanistan, and Iran.
Turkmen
stan gained its independence in 1991 during the dissolution of the Soviet Union.
Primarily a desert country, it has a population of around six million people. Tourist facilities, especially outside of the capital city of Ashgabat, are not highly developed.
Many of the goods and services taken for granted in North American and Western European countries are not yet available. Travel within the country can be difficult due to limited infrastructure and government-imposed internal travel restrictions.
Read the Department of State Background Notes on Turkmenistan for additional information.
ENTRY/EXIT REQUIREMENTS:
American citizens must have a valid passport and visa and/or letter of invitation from the Government of Turkmenistan to enter and exit Turkmenistan.
To apply for a visa, all U.S. citizens must complete an application and have a letter of invitation approved by the State Migration Service (SMS), formerly known as the State Service for the Registration of Foreigners (SSRF), in Ashgabat.
An individual or organization in Turkmenistan must submit the letter of invitation on behalf of an American citizen to the SMS accompanied by a copy of the traveler's passport ID page.
Each traveler’s passport must be valid for at least 6 months following the date of the application.
The SMS requires at least 15 working days for approval.
The U.S. Embassy in Ashgabat does not issue letters of invitation to citizens interested in private travel to Turkmenistan.
Applications for a visa can be submitted to the Embassy of Turkmenistan in Washington, D.C., or directly to the SMS in Ashgabat.
Under local law, a traveler with a stamped and approved invitation letter may also obtain a visa at the Ashgabat International Airport upon arrival in Turkmenistan; however, some travelers have reported difficulties with airlines not boarding passengers who only have approved invitation letters in lieu of a visa for onward travel to Turkmenistan.
Travelers are strongly recommended to obtain a visa before traveling.

The price for the visa will vary according to the intended length of stay.
For an additional charge, the SMS can extend a visa in Ashgabat beyond its initial validity.
Any traveler arriving without a visa or without the documents necessary to obtain a visa will be denied entry and may be held at the airport or border until the traveler has secured transportation out of Turkmenistan.
Based on past incidents, the Embassy discourages travelers from planning to use transit visas in lieu of obtaining tourist visas through a travel agency.
The U.S. Embassy in Ashgabat is unable to intervene with Turkmenistani authorities regarding the admission of private travelers to Turkmenistan.
Travelers departing Turkmenistan must have a current valid visa or they will be denied exit until they have extended the validity of the visa through their departure date.
In addition, U.S. citizens traveling in Turkmenistan should be aware that they need special permission from the SMS to travel to areas of the country that have been restricted by the Government of Turkmenistan, including almost all border areas.

Upon arrival at an airport or border entry point, foreigners will be charged approximately $12 for an immigration card issued by Turkmen authorities.
All foreigners are required to carry this immigration card for the duration of their stay in Turkmenistan.
Authorities will collect the immigration card upon departure.
Those departing Turkmenistan from the Ashgabat airport and flying with a non-Turkmenistani flagged carrier are required to pay a $25 departure fee.

In addition to the immigration requirements mentioned above, foreigners are subject to local registration requirements.
Americans who plan to stay more than three working days in Turkmenistan must register with the SMS.
SMS offices are located in all of Turkmenistan's five major cities: Ashgabat, Dashoguz, Mary, Turkmenabat and Turkmenbashy.
Foreigners who plan to travel outside of the city in which they will register must inform the SMS in advance; otherwise travelers will face fines or deportation.
One day prior to their departure from Turkmenistan foreigners must return to an SMS office to register the departure.
Foreigners should be registered and deregistered at the SMS in the city in which their sponsoring organization is located.
Foreigners who fail to register their departure may be prevented by immigration authorities from leaving the country until they have done so.
The penalties for remaining in Turkmenistan with an expired visa or for failing to register with SMS include fines, arrest, and/or deportation.
Foreigners who are deported for these violations may be prohibited from returning to Turkmenistan for up to five years.
American citizens in Turkmenistan are strongly urged to ensure that their visas do not expire and that they register with SMS upon arrival and upon departure.

Visitors holding tourist visas organized by a travel agency must stay in hotels; other visitors may stay in private accommodations whose owner must register the visitor's presence.
Visit the Embassy of Turkmenistan web site for the most current visa information.

Several popular travel guides discuss traveling by “ferry” across the Caspian Sea from Baku, Azerbaijan, to the port of Turkmenbashy in western Turkmenistan.
Some travelers have faced problems attempting to travel to Turkmenistan by boat.
Travelers should be aware that these “ferries” are in fact cargo ships that take on some passengers incidental to their primary function.
Passengers are generally not provided food or water on these ships, and sleeping and sanitary facilities are likely to be rudimentary.
Travelers should be aware that ships arriving at the port of Turkmenbashy often wait days offshore for outgoing ships to vacate the dock to allow incoming ships to disembark.
Some travelers have spent more than a week offshore while their ship awaited permission to enter the port, and they have run out of stores of food and water, or had their Turkmen visas expire before they could be used.
For this and other reasons travelers, especially those who plan to enter Turkmenistan by boat, are discouraged from using transit visas to enter Turkmenistan.

At Ashgabat International Airport, most airlines do not accept payment for tickets by credit card, or in any currency other than US dollars or Turkmen manat.
Travelers planning direct transit through Turkmenistan en route to another country should be aware that if they are stranded due to a missed connection, they will not be allowed to leave the arrival detention area until they are able to buy a ticket for an onward flight out of Turkmenistan.
For this reason, the Embassy discourages travelers from planning to directly transit through Ashgabat International Airport.

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:
Those considering travel to Turkmenistan should take the country's proximity to regions of past and current instability into account before making any plans.
The Government of Turkmenistan has designated many areas throughout the country as “restricted zones,” particularly the border areas next to Iran, Uzbekistan, and Afghanistan, the entire region of Dashoguz (including Dashoguz city), and areas of the Caspian coast.
Travel to these areas by foreigners is forbidden without special permission from the Government of Turkmenistan.
Turkmenistan Airlines, the national airline, will not sell a ticket to any traveler who intends to travel to a “restricted zone” without proof of permission from the government.
Travelers who wish to visit a “restricted zone” must have a valid passport and visa and must apply to the Ministry of Foreign Affairs for a special permit.
There is a minimum processing time of 10 working days for these permits.

Visible police and military presence in Turkmenistan is common.
Both uniformed and plainclothes officials frequently ask to see passports, visas, migration cards, and SMS registrations.
Travelers should ask to see identification if they are not certain that the person requesting the information is an official.
These documentation checks, and residence and vehicle searches, are common.
Security personnel maintain checkpoints on major roads.

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, such as government buildings, may result in problems with authorities.
Visitors should ask whether buildings may be photographed.

Supporters of extremist groups such as the Islamic Movement of Uzbekistan, Al-Qaeda, and the Eastern Turkistan Islamic Movement remain active in Central Asia.
These groups have expressed anti-U.S. sentiments and may attempt to target U.S. Government or private interests in the region, including in Turkmenistan.
Terrorists do not distinguish between official and civilian targets.
Because of increased security at official U.S. facilities, terrorists are seeking softer civilian targets such as residential areas, clubs, restaurants, places of worship, hotels, schools, outdoor recreation events, resorts, beaches, maritime facilities, and commercial aircraft.

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 A Safe Trip Abroad.

CRIME:
Although the government's official policy is to report that there is no violent crime, there are incidents of assault, rape, and murder sometimes directed at foreigners.
Prostitution, heroin use, and economic conditions are all factors contributing to the incidence of violent crimes.
Petty theft is common in crowded public places such as the local bazaars.
Visitors should take appropriate measures to safeguard their passports and valuables in such areas.
Also, visitors should not leave their valuables in plain view within a parked vehicle.
Several recent cases suggest that there has been an increase in theft from parked vehicles.

Foreign visitors, including American citizens, present an attractive target for criminals.
Travelers should exercise the same common sense, good judgment, and caution as they would in any major U.S. city.
For instance, one should avoid carrying large sums of money in public.
Travelers should avoid walking alone after dark, and women specifically should avoid being alone in isolated areas.
Most taxis are not regulated by any government licensing agency and drivers are usually private citizens looking to make money.
The majority of cars will not have seat belts or other safety devices, and drivers may not have had any formal driver training.
For safety reasons, visitors should strongly consider hiring a private car and driver through their travel agency or hotel.
There is one government-owned and regulated taxi company, operating in Ashgabat, which charges a flat fee of 45,000 Old Turkmen Manat/9 Denominated Turkmen Manat (about $3.25 at the February 2009 exchange rate) for a one-way trip within Ashgabat city limits.
Its telephone number is: (993 12) 32-97-75.
If using local unregulated taxis, passengers should always negotiate fares with taxi drivers in advance, and extreme caution should be used when using taxis after dark, especially when there are other passengers in the vehicle.

Prostitution is illegal, and prostitutes have been known to accompany men to their residences or hotel rooms in order to steal from them, sometimes with the help of an accomplice.
The authorities will generally consider any woman leaving a discotheque with a foreign man late at night to be a prostitute, and on that basis, the foreigner may be detained.
In recent years, at least one foreigner was kept in jail for fifteen days on charges of soliciting prostitution.
Travelers should be aware that U.S. law provides for criminal prosecution in U.S. federal courts of American citizens who have solicited a prostitute under the age of 18 while traveling abroad.

Police can ask anyone to present identity papers at any time, but authorities are especially aggressive late at night.
Even if valid papers are presented, the police may ask for a bribe.
For this reason, those going from place to place late at night should consider using a trusted driver.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law. In addition, bringing these products back to the United States may result in forfeitures and/or fines. More information on this serious problem is available from the U.S. Department of Justice, Computer Crime & Intellectual Property Section.

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, help you 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 Turkmenistan is 03.
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 Turkmenistan’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Turkmenistan 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.
Please see our information on Criminal Penalties.

SPECIAL CIRCUMSTANCES:
Turkmenistan has a cash-only economy.
However, several new hotels accept credit cards.
Vnesheconombank and the National Bank of Pakistan cash traveler’s checks and personal checks for a fee, although cashing a personal check is a lengthy process that could require up to two months.
Vnesheconombank also accepts Visa for cash advances, for a fee.

Although the manat is the official currency, U.S. dollars are widely accepted and are required as payment for certain goods and services.
Travelers may wish to bring sufficient U.S. currency to exchange into manat to cover expenses not payable in U.S. Dollars.
Old U.S. dollar bills (issued before 1990) and/or those in poor condition (with tears, writing or stamps) are not acceptable forms of currency in Turkmenistan.
Banks frequently do not have small bills for change.
In 2008, the government of Turkmenistan unified its dual currency exchange rate by bringing the commercial and governmental exchange rates together.
This change occurred incrementally, contributing to wild currency speculation by average citizens, many of whom keep their savings in U.S. dollars in their homes, rather than in bank accounts.
As a result, the banks, at times, have imposed limits on the amount of currency that could be exchanged by an individual on a particular day.
Travelers should check with their travel agencies to discuss options for currency exchange if a limitation should happen during their visit to Turkmenistan.

Turkmenistan customs authorities may enforce strict regulations concerning temporary importation into or export from Turkmenistan of items such as carpets, jewelry, musical instruments, pieces of art, archaeological artifacts, antiques, protected animals, etc.
It is advisable to contact the Embassy of Turkmenistan in Washington for specific information regarding customs requirements.
Travelers who wish to take carpets out of Turkmenistan must obtain a certificate from the Carpet Museum in central Ashgabat indicating that the carpet is not of historical value.
Some private shops may have carpets for sale for which they have already obtained certificates; buyers should be sure to ask about customs certificates before purchasing any carpet.
In addition, buyers may have to pay a tax calculated according to the size of the carpet.
Travelers who have purchased other items that could be perceived to be of historical value, such as jewelry, have also reported difficulties in taking these items out of Turkmenistan.
Turkmenistan's indigenous dog, the Alabay, is considered a national treasure and is banned for export without prior permission.
American citizens should also check to ensure that any item they intend to bring into the United States is permitted by U.S. customs regulations.

U.S. citizens are encouraged to carry a copy of their U.S. passports and visas with them at all times, so that, if questioned by local officials, proof of identity and U.S. citizenship, are readily available.

Travelers to Turkmenistan should be aware that there are several types of poisonous snakes and insects indigenous to the country. Even in cities, it is common to encounter cobras and scorpions, especially in areas covered with tall grass.
Travelers are advised to be alert to these dangers to avoid being bitten or stung. Please see our Customs Information sheet.
MEDICAL FACILITIES AND HEALTH INFORMATION: Medical care in Turkmenistan is limited and well below North American and Western European standards.
All visitors are strongly advised to purchase medical evacuation insurance to cover costs associated with transporting them to adequate medical facilities in the event of serious illness or injury.
Such travel can be expensive if undertaken under emergency conditions, and absent this insurance, medical evacuation travel may be logistically impossible on an emergency basis.
Travelers with medical conditions should consult their regular physician to determine whether travel to Turkmenistan is advisable in light of the level of available health care.
Resident American citizens travel to Western Europe or North America for treatment of any serious medical condition.
The U.S. Embassy maintains a list of public hospitals and English-speaking physicians in the country, however the standard of care at these hospitals cannot be considered comparable to Western standards.
Basic medical supplies, including disposable needles, anesthetics, and antibiotics are often in short supply.
Two private clinics have foreign medical practitioners (generally Turkish) who may be available for consultations and treatment; these clinics, however, have refused in some cases to admit patients with serious conditions, regardless of the patient’s ability to pay for treatment.
Even at these hospitals, the standard of care is low compared to Western standards.
Travelers requiring prescription medications should bring sufficient supplies of all necessary medications and appropriate documentation to ensure no problems with customs officials upon arrival.

Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Turkmenistan.
Currently, HIV tests are not required for applicants requesting tourist visas; however, should an individual be discovered to be HIV positive, that status would be grounds for denial of a visa or deportation.
All individuals requesting residence visas are required to submit to an HIV test.
Please verify this information with the Embassy of Turkmenistan 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 Turkmenistan is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Road conditions in Turkmenistan make driving difficult and sometimes dangerous.
Most roads outside of major cities are narrow, riddled with potholes, unlit at night, and without proper road signs.
Driving at night on these roads should be avoided.
City roads are better in comparison to rural routes but may be hazardous due to potholes, uncovered manholes, poor lighting, and heavy pedestrian traffic.
Pedestrians frequently cross against traffic and create dangerous conditions.
Traffic accidents involving serious injury to drivers, passengers, and pedestrians are common.

In general, visitors should use caution when driving in Turkmenistan.
Drivers pay little attention to lanes and other road markings, with weaving and sudden lane changes a common occurrence (usually without use of a turn signal).
Drivers will often encounter cars going the wrong way on one-way streets or divided highways.
Cars also frequently make left-turns from the right lane and vice-versa.
Pedestrians regularly walk or stand in the middle of busy streets during the day and night, often without paying attention to oncoming traffic.

Roadside assistance does not exist in Turkmenistan, where vast stretches of highway are often unmarked.
Police checkpoints (where cars are required to stop and register) are a common feature on major routes between cities.
The U.S. Embassy in Ashgabat has received reports that police stationed at checkpoints may arbitrarily fine motorists.
Local law requires that traffic fines be paid within 12 hours.
If a fine is not paid within that period, the amount may double every 12 hours up to 72 hours, after which time the vehicle in question may be seized.

Travelers who wish to drive in Turkmenistan must have a valid international driving permit.
Foreigners who plan to reside in Turkmenistan must apply for a local driver's license with the Road Police Department of the Ministry of Internal Affairs of Turkmenistan.
American citizens who want more specific information about driving in Turkmenistan should contact the Embassy of Turkmenistan at 2207 Massachusetts Ave. NW, Washington DC
20008, telephone (202) 588-1500.
Please refer to our Road Safety page for more information.
For specific information concerning Turkmenistan driving permits, vehicle inspection, road tax and mandatory insurance, contact the Turkmenistan National Tourist Organization offices at its Permanent Mission in New York.
The address is: 136 East 67th Street, NY, NY 10021.
The phone number is 1-212-472-5921.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Turkmenistan, the U.S. Federal Aviation Administration (FAA) has not assessed Turkmenistan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.

Travelers may experience significant delays, unexpected re-routing, and sudden cancellations of flights, including those of Turkmenistan Airlines (Turkmenhowayollary), the national airline.
Travelers have reported difficulties securing reservations and purchasing tickets from Turkmenistan Airlines on both domestic and international flights, which are routinely overbooked.

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 Turkmenistan are encouraged to register with the 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 Turkmenistan.
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 9 1984 (Pushkin Street), off Magtymguly Street, tel. (993-12) 35-00-45; fax (993-12) 39-26-14.
The Consular Section can also be contacted by e-mail.
The Consular Section is open for American Citizens services every Monday through Friday afternoon, excepting holidays.
American Citizens are requested to call for an appointment for services except in cases of emergency.
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This replaces the Country Specific Information for Turkmenistan dated September 2, 2008 without substantive changes.

Travel News Headlines WORLD NEWS

Date: Fri, 9 Sep 2016 19:53:02 +0200

Avaza, Turkmenistan, Sept 9, 2016 (AFP) - Turkmenistan strongman President Gurbanguly Berdymukhamedov on Friday opened a giant five-star hotel worth over $100 million, shaped like a cruise ship, at the country's main Caspian Sea resort.   The 13-floor, 350-room hotel is the biggest in Turkmenistan's Avaza tourist zone, which the government is trying to promote despite an incredibly restrictive visa regime for foreigners.

"The purpose of this resort is to create the best conditions for interesting recreation time for the Turkmen people," Berdymukhamedov said of Avaza, adding that the hotel was called "Gami", or "Boat" to symbolise "the boat of our friendship."    "And since we are on a boat, we will be having nautical pasta -- a cheap Soviet pasta dish with minced pork and beef -- for lunch," he joked, before the dish was served to officials, diplomats and journalists at the ceremonial lunch.   The Central Asian country's leader, 59, also quoted a nautically-themed poem by Russian wordsmith Mikhail Lermontov.   The 90-metre by 200 metre (300 by 650 feet) white marble-clad hotel was built to echo a "snow-white ocean ship" a representative of the state company that ordered it built, told AFP.

A giant portrait of Berdymukhamedov spanned three floors of the building as dancers performed in front of it.   The hotel was built by the Turkish construction and logistics firm Ekol.   Hydrocarbon-rich Turkmenistan's secretive government has a reputation for lavish spending on frivolous architectural projects, even in times of economic crisis.   The country devalued its manat currency by around twenty percent in early 2015 under pressure from low prices for hydrocarbons, which account for practically all of the country's exports.

On the black market the currency's value can fetch up to 6 manats to the dollar against an official rate of 3.5 to the dollar, down from 2.8 to the dollar in 2014.    Despite Berdymukhamedov officially encouraging belt-tightening, the country has continued to spend heavily on infrastructure ahead of the 2017 Asian Indoor and Martial Arts Games it will host in the capital Ashgabat.

In 2013 Ashgabat earned a Guinness World Record as the city with the highest density of white marble-clad buildings.    "If the marble was laid out flat, there would be one square metre of marble for every 4.87 m³ of land," Guinness said at the time.   The city also hosts a golden statue of Berdymukhamedov and a similar statue of predecessor Saparmurat Niyazov, which once rotated with the movements of the sun.
Date: Wed, 6 Apr 2016 16:21:20 +0200

Ashgabat, Turkmenistan, April 6, 2016 (AFP) - Turkmenistan has passed a law making HIV tests mandatory prior to marriage, state media reported on Wednesday, in a sign the reclusive Central Asian state fears the spread of a disease it has always downplayed.    The law is the closest the highly secretive state of 5 million has come to acknowledging a public health threat from the disease which is prevalent throughout the former Soviet Union.

The law, which aims to "create conditions for healthy families and prevent the birth of HIV-infected children" was published in the state newspaper on Wednesday and is effective immediately.    An official from the country's national AIDS Center, speaking on condition of anonymity, told AFP that the new law was "very necessary" given the "high risk" of the spread of the virus.   The official cited use of intravenous drugs, mostly sourced from neighbouring Afghanistan, and prostitution as the main means of transmission.

Other than "persons entering marriage", the legislation also enforces HIV tests for blood donors, "persons suspected of narcotics use", prisoners, citizens of foreign countries applying for work visas and stateless persons.    According to the law signed by President Gurbanguly Berdymukhamedov, the government will guarantee anonymity and free treatment for sufferers of the disease.

Turkmenistan, which remains largely closed to the outside world, has always downplayed the prevalence of HIV, a disease that attacks the human immune system and is transmitted from person to person via bodily fluids.   In 2002, the health ministry, which does not publish data on infectious diseases, claimed the country had only two cases of HIV and that both patients had been infected outside Turkmenistan.
Date: Tue, 21 Jul 2015 17:03:00 +0200 (METDST)

Ashgabat, Turkmenistan, July 21, 2015 (AFP) - Health-obsessed former Soviet Turkmenistan is the country with the world's lowest proportion of smokers, World Health Organisation chief Margaret Chan said during a visit to the isolated nation on Tuesday.    Chan said that  just 8 percent of the population smoked, according to WHO figures.   "Recently a WHO overview showed that in Turkmenistan only 8 percent of the population smokes," Chan told the country's authoritarian President Gurbanguly Berdymukhamedov, who is a dentist by training.   "This is the lowest national indicator in the world. I congratulate you on this achievement," she said at a health forum in the capital Ashgabat.

Cited by state media, Chan noted that the country ratified the Framework Convention on Tobacco Control in 2011 by which time it had already banned smoking in public places.   Also speaking at the forum, Vera Luiza da Costa e Silva, Head of the Convention Secretariat, challenged the Central Asian state to drive smoking down to five per cent of the population in the coming years.   In 1990, 27 percent of Turkmen males over 15 and 1 percent of females smoked.

A decade later Turkmenistan banned smoking in public places, state buildings and the army, as well as all forms of tobacco advertising.   By comparison, 31.1 percent of the global male population over the age of 15 smoked in 2012, while 6.2 percent of females were smokers.   President Berdymukhamedov, in power since the death of eccentric predecessor Saparmurat Niyazov in 2006, is a keen equestrian, while Niyazov campaigned against smoking and built a 36-kilometre "path of health" into the mountains surrounding Ashgabat which government officials were forced to walk.   This April the gas-rich country of more than five million held a month of public exercises and sporting events under the slogan "health and happiness."
Date: Wed, 1 Jul 2015 17:54:35 +0200 (METDST)

Ashgabat, Turkmenistan, July 1, 2015 (AFP) - Turkmenistan reported its hottest June on record Wednesday, as a heat wave envelops former Soviet Central Asia.   "June 2015 was the hottest June since 1891 when records began. Daytime temperatures exceeded 40 degrees Celsius in the shade 16 times," a spokeswoman at Turkmenistan's state meteorological service in the capital Ashgabat told AFP Wednesday.   She noted that Tuesday, when temperatures reached 47.2 degrees Celsius, was the hottest June day in Ashgabat in the recorded history of the energy-rich country.   Many Muslims fasting for the Ramadan holy month in the secluded Caspian state have taken time off work and are shutting themselves away in air conditioned rooms, one observant Muslim who did not wish to be named told AFP.

In Kazakhstan temperatures, while set to vary in the coming week, remain very high in the southern regions of the country.   "In the afternoon the streets are empty," said Shafarat Sataeva, 72, from the southern region of Kyzylorda, where temperatures reached 42 degrees Celsius in the shade on Wednesday, the highest anywhere in the country.   In Tajikistan over 50 people including three Russian soldiers stationed at Russia's military base in the country drowned in mountain rivers and lakes as they sought to cool themselves.   The country's meteorological service said temperatures are expected to pass 40 degrees Celsius in the capital Dushanbe and warned of mudflows from high levels of glacial melt in the mountainous country.
Date: Tue, 15 Jul 2014 05:22:34 +0200 (METDST)
by Igor Sasin

AVAZA, Turkmenistan, July 15, 2014 (AFP) - Better known for its inhospitable desert plains than beach breaks, isolated ex-Soviet Turkmenistan this month welcomed an unlikely group of visitors: a sun-tanned crop of the world's top windsurfers.   Bordering Iran and Afghanistan, the energy-rich Central Asian country played host to a leg of the windsurfing World Cup at a sparkling new Caspian Sea resort that authorities hope can turn the once hermit state into a water sports hub.

International competitors bobbed and weaved through the foaming surf as their sails glistened in the sweltering heat -- an unfamiliar sight in a nation that until 2006 was cut off from the rest of the world by the eccentric two-decade rule of former dictator Saparmurat Niyazov.   "This is such a chance for me!" said a joyous Orazmyrat Arnamammedov, one of only a handful of windsurfers in Turkmenistan.   "It's happiness for me to take part in a competition with sportsmen who are known around the world," the 32-year-old sports instructor told AFP.

Turkmenistan is on a drive to promote itself as a destination for sports, adventure travel and even beach holidays in a bid to boost tourist numbers from the current 15,000 visitors per year.   "Holding world-class windsurfing competitions will be a significant step, taking Turkmenistan to a new level," President Gurbanguly Berdymukhamedov said at the opening of the Turkmenistan PWA World Cup windsurfing event.

Turkmen officials said holding sporting championships is part of the government's plan to develop tourism.   Next year the country will host the world championship in belt wrestling -- a traditional form of the sport -- in November and the 2017 5th Asian Indoor-Martial Arts Games.   "Sports and travel are the new trend for international tourism in Turkmenistan," said an official in the state tourism committee who asked not to be named.

- Resort rising from desert -
The sprawling Caspian Sea town of Avaza, which hosted the windsurfing competition from its 16 kilometres of beach, is a key part of that plan.    By 2020 Ashgabat hopes to transform the desert resort, whose name means "singing wave" in Turkmen, into a vast complex that can compete with Turkey's huge southwestern sea resort of Antalya.   "Avaza has every chance of becoming a major attraction for tourists, both from neighbouring countries and also from overseas," Berdymukhamedov said recently.   "In this part of the Caspian, the water is exceptionally clean and there are good beaches and a mild climate."   Since work started in 2007, six hotels and other accommodation for some 7,000 visitors has been built by mainly Turkish firms at a cost of around $2 billion (1.5 billion euros). 

But the resort -- where US pop star Jennifer Lopez was jetted in to perform last summer -- is set to grow into a vast complex with at least 60 hotels, as well as sanatoriums, rest homes, cottages and camp sites, that the the state tourism committee boasts will be "up to world standards".   An artificial river runs through the town and a new airport has been opened in the nearby city of Turkmenbashi.    A winter sports stadium with an ice rink and a 2,000 seat Palace of Congress are also in the pipeline, with the total price tag for the development expected to hit $7 billion.

- 'Why go to Avaza?' -
But some locals are not convinced that the Turkmen resort can bring in the crowds.   A week's package holiday for international visitors costs around $1,500, said Mukhamet Begliyev, who works at a private travel agency.   "Even if someone rich enough turns up, what do we have to offer except the sea and the hotels? The entertainment sphere isn't developed at Avaza at the moment," Begliyev said.   The "international" airport in Turkmenbashi so far only accepts domestic flights and getting a visa to the country is still a major hurdle.

For the moment that means the resort is largely attracting domestic holidaymakers, although Turkmenistan's low wages mean it is beyond the means of many.    For 28-year-old Gozel Akhundova from Dashoguz, a city in the country's north, even a brief stay in an Avaza hotel at $70 a night was an expensive treat.   "We'll only spend three days here. If it was cheaper, we'd stay longer," she said.   And the fledgling resort still has a long way to go to compete with more established holiday spots.     "Why should I go to Avaza, when there is Antalya?" asked Akhmet, a 22-year-old student in Ashgabat who said he planned to holiday in Turkey this summer.   "The service is good, there's plenty of fun activities and it's cheap," he said.
More ...

Turks and Caicos Islands

Turks & Caicos US Consular Information Sheet
November 17, 2008
COUNTRY DESCRIPTION:
The Turks and Caicos Islands are a British Overseas Territory comprising a small archipelago of eight major islands and numerous uninhabited keys, 500 mile
southeast of Miami.
Most tourist facilities are located on Providenciales ("Provo") Island.
The U.S. dollar is the unit of currency and the larger hotels and shops accept credit cards.
The U.S. Embassy in Nassau, Bahamas, has jurisdiction for consular matters in the Turks and Caicos.
ENTRY/EXIT REQUIREMENTS:
U.S. citizens do not need to obtain visas to visit the Turks and Caicos Islands.
All Americans traveling by air outside the United States are required to present a passport or other valid travel document to enter or re-enter the United States.
This requirement will be extended to sea travel (except closed-loop cruises), including ferry service, by the summer of 2009.
Until then, U.S. citizens traveling by sea must have either a WHTI-compliant document (such as a valid U.S. passport or passport card) or both a government-issued photo identification and a document showing their U.S. citizenship (for example, a certified U.S. birth certificate or certificate of nationalization).
Sea travelers should also check with their cruise line and countries of destination for any foreign entry requirements.
Applications for the new U.S. Passport Card are now being accepted.
The card may not be used to travel by air and is available only to U.S. citizens. Further information on the passport card is available at http://travel.state.gov/passport/ppt_card/ppt_card_3926.html and upcoming changes to U.S. passport policy can be found on the Bureau of Consular Affairs web site at http://travel.state.gov/travel/cbpmc/cbpmc_2223.html.
We strongly encourage all American citizen travelers to apply for a U.S. passport well in advance of anticipated travel.
American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.

Visit the British Embassy web site at http://ukinusa.fco.gov.uk/en for the most current entry information, including any visa requirements.
Information about dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
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, 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 United States and Canada, or for callers outside the United States 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:
Petty street crime does occur.
Visitors should not leave valuables unattended in their hotel rooms or on the beach.
Visitors should make sure that their hotel room doors are securely locked at all times.
In the Turks and Caicos, carrying illegal/undeclared firearms or ammunition is a very serious crime, as is possession of illegal narcotics.

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 are 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 the Turks and Caicos Islands is 999 or 911.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are available but limited in the Turks and Caicos Islands.
There is a small public hospital on Grand Turk and a private clinic on Provo, which has a hyperbaric chamber.
Most serious medical problems require medical evacuation by air from the Turks and Caicos to the United States.

The Turks and Caicos Islands do not have a pathologist to perform services in cases of death.
Medical examiners from neighboring countries visit the island regularly to provide this service.
It can take up to two weeks for the Government of the Turks and Caicos Islands to release the remains of the deceased under normal circumstances, and severe weather during the hurricane season could delay the process even more.The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of the Turks and Caicos Islands.

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 website 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
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 the Turks and Caicos Islands is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Driving in the Turks and Caicos Islands is on the left.
Traffic tends to be light, and the terrain is flat.
When entering roundabouts and other intersections without signs or traffic signals, drivers are required to give way to those on their immediate right.
Driving under the influence of alcohol is illegal, and drivers convicted of the offense may face fines, detention, or both.
Wild donkeys are a common sight and often walk on the roads, presenting a hazard to drivers, especially at night.
Road signs are not prevalent, but as there are few roads on the island, finding one's way with a tourist map is generally not a problem.
Drivers should be alert for unmarked hazards such as blind intersections or changes in road conditions.
Primary roads are generally drivable in both urban and rural areas.
Secondary roads are often unpaved, and have ruts and potholes.
Be aware that, in the event of a breakdown, roadside assistance is generally not available.
For emergencies, drivers may call 999 or 911 for police, fire, or medical assistance.
Visitors require a valid driver's license from their country of residence.
Safety of public transportation in the Turks and Caicos is generally good.
Most car and motor scooter rental agencies will not rent to anyone under the age of 21.
A government tax is levied on all car and motor scooter rentals (insurance is extra).Please refer to our Road Safety page for more information.
Visit the website of the country’s national tourist office at http://www.turksandcaicostourism.com.

AVIATION SAFETY OVERSIGHT:
Civil aviation operations in the Turks and Caicos Islands fall under the jurisdiction of British authorities.
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the United Kingdom’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of the UK’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES:
The importation of firearms to the Turks and Caicos is strictly forbidden without prior approval in writing from the Commissioner of Police.
U.S. citizens may contact the Turks and Caicos Customs Department at (649) 946-2867 for specific information regarding customs requirements. Please see our Customs Information.

The Turks and Caicos Islands, like all countries in the Caribbean basin, are vulnerable to hurricanes.
Hurricane season officially runs from June 1 to November 30, although hurricanes have been known to occur outside that time period.
Visitors to the Turks and Caicos Islands during hurricane season are advised to monitor weather reports in order to be prepared for any potential threats.
General information about disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov
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 Turks and Caicos laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Turks and Caicos 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.
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 residing or traveling in the Turks and Caicos Islands 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 the Turks and Caicos Islands.
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 42 Queen Street, Nassau, The Bahamas.
It is next to the McDonald’s Restaurant on Queen Street and may be reached Monday-Friday at telephone (242) 322-1181 x4406; after-hours (242) 328-2206; fax (242) 356-7174.
The U.S. Embassy web site is http://nassau.usembassy.gov.
Office hours are from 9:00 a.m. to 11:00 a.m. and 1:00 p.m. to 3:00 p.m. Monday-Thursday; 9:00 a.m. to 11:00 a.m. Friday (except for U.S. and Bahamian holidays).
* * *
This replaces the Country Specific Information for the Turks and Caicos Islands dated March 14, 2008, without substantive changes.

Travel News Headlines WORLD NEWS

Date: Wed, 4 Sep 2019 23:41:56 +0200 (METDST)

St. John's, Antigua and Barbuda, Sept 4, 2019 (AFP) - Masked gunman have shot dead a 71-year-old British holidaymaker in a robbery on the tourist paradise of Turks and Caicos, police said Wednesday.

The victim had been visiting a friend in the British territory, around 150 miles (200 kilometres) north of Haiti, when two assailants burst into the home shortly after 11:00 pm Tuesday (0300 GMT Wednesday).   They demanded money, but it was not immediately clear how the situation escalated before the gunmen made off with an undisclosed amount of cash, a ring and a watch, said police spokeswoman Takara Bain.   The friend was treated for non-life threatening injuries at a private residence in Cooper Jack on the tiny island's south coast.

It is the second murder in three days in the archipelago, home to just 35,000 people, taking the 2019 homicide toll to 10, Police Commissioner Trevor Botting said in a statement.   A shooting at a nightclub in Providenciales on Saturday night left one man dead and a second wounded.   "This spike in gun crime simply has to change," Botting said. "No one should be happy with how gun crimes are increasing in the Turks and Caicos Islands."   Earlier this year, the US State Department warned travellers to "exercise increased caution" when visiting the archipelago 600 miles (970 kilometres) southeast of Miami.
Date: Tue, 6 Aug 2019 20:04:36 +0200 (METDST)

St. John's, Antigua and Barbuda, Aug 6, 2019 (AFP) - Three American tourists have drowned in the Turks and Caicos Islands after apparently getting caught in a fast-moving tide fueled by high winds, authorities and local residents said Tuesday.   The victims -- two men and a woman -- were from two families from Texas who were spending the holidays together, along with their two girls, police said.

They had been exploring scenic Bambarra Beach on the sparsely populated island of Middle Caicos when disaster struck on Monday, police and local residents said.   The children were plucked from the ocean by rescuers and were being cared for by local social welfare services.   The body of a 34-year-old woman washed ashore shortly after the incident. Searchers scouring the beaches recovered the second body a few hours later. The third was discovered early this morning with assistance from the US Coast Guard.   Residents said the families may have been attempting to cross the half-mile distance through shallow water from Bambarra Beach to nearby Pelican Cay.

Police Commissioner Trevor Botting described the incident as a "terrible tragedy."   "Five tourists from two families got into difficulties in the waters off Middle Caicos. Whilst two children were thankfully recovered alive from the water, two adults related to one of the girls were recovered but sadly they had died. One other man, related to the other child, was found early today and has also died," he said.   The tragedy has triggered calls locally for increased warning signs on the islands' often deserted beaches.   The Turks and Caicos Islands is British overseas territory that consists of two island chains southeast of the Bahamas.
Date: 12 Jun 2017
Source: TC weekly News [edited]

The Ministry of Health is advising the public of an increase in the number of cases of conjunctivitis in the Turks & Caicos Islands [TCI].

Conjunctivitis, also called "pink eye," is defined as an inflammation of the conjunctiva and can be caused by viruses, bacteria, or an allergy. It can affect children and adults.

Viral conjunctivitis is typically caused by a virus that can also cause the common cold. A person may have symptoms of conjunctivitis alone or as part of a general cold syndrome like fever, a sore throat and runny nose.

Viral conjunctivitis is highly contagious; usually people catch it from touching something that has been in contact with an infected person's eye (e.g. door handle, towel or pillow case), and then that person touches his or her eyes.

Some of the most common symptoms of conjunctivitis are pink or red eyes; the eyes might secrete a gooey liquid or become itchy or burn, get stuck shut, especially when you 1st wake up. These symptoms tend to last for several days.

The ministry stated in a press release: "The treatment depends on the cause. When pink eye is caused by a virus, antibiotics will not help. You can use warm or cool compresses to relieve the pain and irritation in the eyes.

"Most cases of pink eye go away on their own without treatment, but it is best to see your primary care physician if you are experiencing these symptoms so that you can be treated properly.

"Simple hygiene measures can help minimise transmission to others. Adults or children with bacterial or viral conjunctivitis should not share handkerchiefs, tissues, towels, cosmetics, or bed sheets/pillows with uninfected family or friends. Hand washing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds.

"Teach children to wash their hands before and after eating and after touching the eyes, coughing or sneezing. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available."

Anyone with viral conjunctivitis should remain home from school and work to avoid spreading the virus to others.
================
[The report above does not specify any laboratory confirmation of the conjunctivitis cases.

Conjunctivitis can result from many causes, including viruses, bacteria, allergens, contact lens use (especially the extended-wear type), chemicals, fungi, and certain diseases. Viral conjunctivitis can be caused by the following viruses, with adenoviruses being the most common cause: adenoviruses, picornaviruses (particularly enterovirus 70 and coxsackievirus A24), measles virus, and several herpes viruses.

Viral conjunctivitis is highly contagious. Most viruses that cause conjunctivitis are spread through hand-to-eye contact by hands or objects that are contaminated with the infectious virus. Hands can become contaminated by coming into contact with infectious tears, eye discharge, faecal matter, or respiratory discharges.

Many of the viruses that cause conjunctivitis may be associated with an upper respiratory tract infection, cold, or sore throat. - ProMED Mod.UBA]

[A HealthMap/ProMED-mail map can be accessed at:
Date: Mon 9 May 2016
Source: Outbreak News Today [edited]

Health officials on the Caribbean island group, Turks and Caicos (TCI), are reporting a significant increase in chickenpox [varicella] cases during the 1st 4 months of 2016.

As of the end of the week of 23 Apr 2016, a total of 327 cases have been reported for the year. Of these, 41 (13 percent) were reported by persons younger than 5 years old and 296 (87 percent) were reported by persons older 5 years old.

These cases were reported by TCI Hospital on Providenciales 234 (72 percent) and Grand Turk 5 (1 percent); with 28 cases in North Caicos and 60 (18 percent) cases in clinics in Providenciales. In summary, the majority cases are being reported from Providenciales (90 percent).

By comparison, in all of 2015, a total of 98 cases of chickenpox were reported by TCI Hospital in Providenciales.

Chickenpox is a common, usually benign childhood disease caused by the varicella-zoster virus (VZV), a member of the herpes family. This virus causes 2 distinct diseases; varicella (chickenpox) is the primary infection, and later when VZV reactivates, herpes zoster (shingles).

Chickenpox is highly contagious and is spread by coughing and sneezing, by direct contact, and by aerosolization of the virus from skin lesions. You can also get it by contact with the vesicle secretions from shingles.

The disease is characterized by fever and a red, itchy skin rash of that usually starts on the abdomen, back, or face and then spreads to nearly all parts of the body. The rash begins as small red bumps that appear as pimples or insect bites. They then develop into thin-walled blisters that are filled with clear fluid which collapse on puncture. The blisters then breaks, crusts over, and leaves dry brown scabs.

The chickenpox lesions may be present in several stages of maturity and are more abundant on covered skin rather than exposed. Lesions may also be found in the mouth, upper respiratory tract, and genitals.

Chickenpox is contagious from 1-2 days before the rash forms and continues until all the lesions are crusted over (usually about 5 days).

This disease is more serious in adults than in children. Complications of chickenpox are rare, but include pneumonia, encephalitis, and secondary bacterial infections.

Infection with this virus usually gives lifelong immunity, although 2nd attacks have been documented in immunocompromised people. The viral infection remains latent, and disease may recur years later as shingles.

The TCI Ministry of Health strongly advises persons affected with chickenpox to remain at home during their sick leave period to prevent further spread of this illness within the community and schools.  [Byline: Robert Herriman]
=====================
[Varicella-zoster virus, a member of the herpesvirus family is the causative agent for chickenpox. Humans are the only reservoir of the virus, and disease occurs only in humans. After primary infection as varicella (chickenpox), the virus remains dormant in the sensory-nerve ganglia and can reactivate at a later time, causing herpes zoster (shingles).

Varicella occurs worldwide. In temperate climates, varicella tends to be a childhood disease, with peak incidence among preschool and school-aged children during late winter and early spring. In these countries, less than 5 percent of adults are susceptible to varicella. In tropical climates, the highest incidence was described in the driest, coolest months; overall, infection tends to be acquired later in childhood, resulting in higher susceptibility among adults than in temperate climates, especially in less densely populated areas.

All people, including those traveling or living abroad, should be assessed for varicella immunity, and those who do not have evidence of immunity or contraindications to vaccination should receive age-appropriate vaccination. Vaccination against varicella is not a requirement for entry into any country (including the United States), but people who do not have evidence of immunity should be considered at risk for varicella during international travel.

Varicella vaccine contains live, attenuated varicella-zoster virus. Single-antigen varicella vaccine is licensed for people aged 12 months and older, and the combination measles-mumps-rubella-varicella (MMRV) vaccine is licensed only for children 1-12 years. CDC recommends varicella vaccination for all people aged 12 months and older without evidence of immunity to varicella who do not have contraindications to the vaccine: 1 dose for children aged 1-4 years and 2 doses for people aged 4 years and older. The minimum interval between doses is 3 months for children aged less than 13 years and 4 weeks for people aged 13 years and older. Contraindications for vaccination include allergy to vaccine components, immune-compromising conditions or treatments, and pregnancy. When evidence of immunity is uncertain, a possible history of varicella is not a contraindication to varicella vaccination. Vaccine effectiveness is approximately 80 percent after 1 dose and 95 percent after 2 doses.

(Excerpted and edited from

Maps of the Turks and Caicos Islands may be accessed at
and <http://healthmap.org/promed/p/48358>. - ProMED Mod.LK]
Date: 7 Jul 2014
Source: TC Weekly News [edited]

Pet owners are being cautioned about a tick disease which is becoming a problem in dogs in the Turks and Caicos Islands. Licensed veterinarian Mark Woodring said that the disease, babesiosis, can be transmitted by bites from ticks.

Infected dogs show a number of signs, including decreased appetite, weight loss, fever, an enlarged abdomen, and dark orange or yellow skin and urine. The disease causes the dog's red blood cells to be destroyed, leading to pale gums and fatigue due to anemia. All dogs, including potcakes, (the local indigenous dog of the islands) can be infected. Some breeds are more susceptible to infection, especially greyhounds and all pitbull breeds, both purebred and mixed.

Woodring said that this disease can develop in a dog without ticks after an infected dog bites him or her, even playfully. He said that an infected female will pass along the disease to her puppies before birth.

"Accurate testing for babesiosis can be done with blood sent to the US for DNA studies, but most cases in the TCI are diagnosed by experienced veterinarians based on signs and physical exam. Although the disease is treatable with antibiotics, not every dog responds."

Early treatment is best, but even then, the disease can be fatal. The veterinarian said that another problem is that since 2012, the antibiotics most commonly used to treat tick-borne diseases have tripled in cost.

"Some antibiotics are in very short supply worldwide, to the point of restricting veterinarians from even ordering the medication. Preventing babesiosis means treating dogs and their environments to limit tick exposure."

He said that many prescription and non-prescription flea and tick prevention medications as well as yard treatments like Diatomaceous Earth and chemical preparations are available.

"This can be a difficult, expensive and frustrating task, as ticks eventually can become resistant to most products. To stop the spread of babesiosis, infected dogs should be treated with a full course of antibiotics."

Even after a dog recovers, he or she may still carry the disease. Females who have had the disease, even healthy-appearing ones, should not be bred. Adopting puppies from previously infected dogs or dogs with an unknown infection history is risky. Puppies are more likely to die from it than adult dogs.

Woodring said that the good news is that dogs cannot transmit this to humans.
===============
[Canine babesiosis is a disease caused by the intra-erythrocytic protozoan parasites _Babesia canis_ and _Babesia gibsoni_. Babesiosis is transmitted by ticks to susceptible canine hosts. _Rhipicephalu ssanguineus_ is the most common tick vector in the United States. Splenectomized dogs, immunocompromised dogs and young dogs between the ages of 2 and 8 months are most susceptible to infection. Canine babesiosis occurs worldwide. Within the United States, it is most common in the southeast. Although canine babesiosis is considered uncommon in the U.S., it is of clinical significance due to its morbidity and mortality. It is an important differential when history and clinical signs are consistent with infection and other more common diseases have been ruled out.

Hemolytic anemia and hypotensive shock are typical clinical syndromes of infection. Hemolytic anemia results from direct erythrocyte damage by the parasite, and both intravascular and extravascular immune-mediated destruction of red blood cells. Infection can produce thrombocytopenia, the mechanism of which consists of immune-mediated destruction and sequestration in the spleen. Physical examination reveals splenomegaly, lymphadenomegaly, fever and, less frequently, lethargy, vomiting, hematuria, and icterus. Hypotensive shock results from the release and production of vasoactive amines and cytokines which produce vasodilation. It most often occurs in puppies with the peracute form of the disease. Death may occur and is seen most often in _B. gibsoni_ infections and in puppies affected with _B. canis_ and _B.gibsoni_. Chronic infections, subclinical carrier states and atypical canine babesiosis may also occur.

Infection with _B. canis_ or _B. gibsoni_ is definitively diagnosed by demonstration of the parasites on red cells. Blood smears may be stained with Diff-Quik or preferably Wright's or Giemsa stain.

The most effective drugs used in the treatment of canine babesiosis include diminazene aceturate, phenamidine isethionate, and imidocarb dipropionate, which are not available or approved for use in the United States. Treatment of canine babesiosis in the U.S. is, therefore, mostly aimed at treating signs. The majority of babesia cases diagnosed in dogs in the U.S. are caused by the less virulent strains of _B. canis_, and dogs frequently recover from these infections naturally with supportive therapy. Clindamycin has been successfully used to treat canine babesiosis and may be considered in refractory or more severe and virulent infections.

Prevention of canine babesiosis is mostly aimed at controlling the vector. It is an important aspect since treatment is not always successful. The environment should be treated to decrease tick numbers, dogs should be treated to control tick infestations, and ticks should be removed from parasitized animals as quickly as detected.

Recently, a vaccine which minimizes the severity of infection was developed. The vaccine is reported to be 70 to 100 percent effective in diminishing the pathologic effects which typically ensue upon infection. The vaccine is currently available in Europe where canine babesiosis is a more common life-threatening disease.

Blood transfusion poses a significant risk to recipient animals; therefore, it is recommended that donor animals be tested for infection with babesia organisms. Splenectomy prior to testing significantly improves the likelihood of finding organisms in a blood sample from an infected donor.

Portions of this comment were extracted from:

Turks and Caicos Islands, a British Overseas Territory, may be located on the interactive HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/6007>. - ProMed Mod.TG]
More ...

Mexico

General Information
************************************
Mexico is becoming a very popular destination for Irish travellers. The country has many well known tourist destinations including the idyllic resort of Acapulco on the Pacific Ocean and t
e Yucatan Peninsula stretching out between the Caribbean and the Gulf of Mexico. There is a rapidly developing economy and luxury hotels are widely available throughout the country. Tourist facilities in the more remote regions (seldom visited by tourists) may be very limited.
Climate
************************************
The country experiences a wide temperature profile with cool to cold temperatures on the mountainous ranges to a hot sub-tropical climate on the sea coasts. There is a rainy season from June to October and a dry season from November to May each year. Temperatures in April May and June tend to be in the mid 20’s centigrade. The southern and eastern regions tend to experience the heaviest rainfall.
Food & Water
************************************
Some tourists visiting Mexico will undertake a trekking holiday for part of their time in the country. This will bring them out from the major cities into many of the poorer regions of the country. In these areas the level of food and water hygiene may be poor and travellers need to exercise continuous caution in this regard. Typically great care should be taken with the consumption of any cold foods. Lettuce would be a common cause of illness and should be avoided. Undercooked shellfish (prawns, oysters, mussels etc.) should be avoided at any time. The risk of contamination with a variety of diseases is just too high.
Street Vendors
************************************
Many of the larger towns have a number of street vendors selling their produce on the side of the road. In general purchases of food from these vendors should be avoided. This is especially true with regard to buying ‘freshly squeezed’ fruit juice drinks. In some cases potentially contaminated tap water may have been used to supplement the supply. Another particular risk in Mexico involves the purchase of water melons from the market place. These are usually sold by their weight and it is reported that certain vendors may inject them with tap water to increase their value. Be sensible and take care.
Rabies
************************************
This is another viral disease that occurs throughout Mexico. 69 cases of human Rabies were reported in 1990 but this figure has dropped to 24 in 1995. The disease is transmitted through the bite of any infected warm blooded animal (dog, cats, monkey etc.). Animals should be avoided at all costs and any bite (lick or scratch) should be immediately washed out with water and then have a strong antiseptic applied. The individual should then always seek urgent competent medical attention. Cycling in the early morning is a high risk time. Dogs may become agitated and run out at the bicycle.
Protection against Mosquitoes & Sandflys
************************************
Travellers will need to exercise care against mosquito bites throughout the year and this has become particularly important due to regular outbreaks of Dengue Fever. This viral disease has swept through the Caribbean region over the past decade and Mexico has also been involved. There were approx. 4,500 cases during 1995 with about 16 deaths. More recently (Oct ‘99) the disease has been reported close to the US border with over 5000 patients affected. The disease seldom kills travellers but causes a severe flu like illness and pronounced skin rash in many of those infected. It is an unpleasant disease and can leave an individual ill for many weeks after infection. The mosquitoes can bite during the day or night. Most tourists should take care against mosquitoes by;
*
Using adequate Insect Repellent
*
Covering up well with pale coloured clothing
*
Refraining from using Perfumes or Aftershaves at the risk times for bites.
Malaria
************************************
For many tourists to Mexico the chance of contracting malaria is negligible. The disease does occur in some of the country and those planning to trek through the rural areas may be advised to consider prophylaxis. The states most affected are Oaxaca, Hiapas, Sinaloa, Campeche, Quintana Roo, Nayarit, Tabasco, Michoacán, Chihuahua and Hidalgo. The risk extends throughout the year and visitors to these regions always should consider adequate malaria prophylaxis.

Larva Migrans
************************************
Walking on the beach above the high tide mark in many of the hotter countries without shoe covering may expose the traveller to infection with the Larva Migrans parasite. Mexico is no exception. This minute worm penetrates through the skin and causes a significant irritation just under the skin in those infected. The rash moves and becomes very itchy. Treatment is straightforward once a diagnosis is reached. Travellers walking along the beaches (above the high tide mark) should always wear shoe covering and avoid sitting straight on the sand.
Vaccinations
************************************
No vaccines are essential for entry to Mexico however, in most cases, short term travellers will be advised to consider vaccination cover for;
*
Tetanus (childhood booster)
*
Typhoid (food & water borne)
*
Hepatitis A (food & water borne)
For those undertaking a trekking holiday (or those who will live in the region for some months) vaccination cover against Rabies (animal bites), Meningococcal Meningitis (air borne) and Hepatitis B (accidents) may need to be considered.
General Health
************************************
Further information on staying healthy while abroad may be obtained from the Tropical Medical Bureau.

Travel News Headlines WORLD NEWS

Date: Sat, 21 Sep 2019 00:59:40 +0200 (METDST)

Mexico City, Sept 20, 2019 (AFP) - Lorena made landfall Friday as a Category 1 hurricane, lashing the turquoise waters of popular beach destination Los Cabos on Mexico's Baja California peninsula.   "The eye of Hurricane Lorena is now passing over the coast of Los Cabos," Mexico's hurricane monitor, CONAGUA, wrote on Twitter.

The hurricane, which has been churning up the Pacific coast, first made landfall Thursday in west-central Mexico, then was briefly downgraded to a tropical storm before moving back over the water and regaining strength.   According to CONAGUA, Lorena was packing sustained winds of 140 kilometres (87 miles) per hour as it battered Los Cabos, making it a Category One hurricane on the scale of one to five.   After moving slowly northwest throughout the morning, it ground to a halt 70 kilometres from the beach town of Cabo San Lucas, dumping torrential rain on the area.

The US National Hurricane Center said the storm was expected to pour up to 20 centimetres (eight inches) of rain on the region, which "may result in flash flooding."   It warned that the storm's trajectory was "highly uncertain."   "Some weakening is forecast during the next 48 hours if Lorena moves inland. If the hurricane moves over the Gulf of California, it could strengthen instead," it said in its 2100 GMT update.

Lorena already buffeted west-central Mexico with strong winds, torrential rain and high waves, leading officials to cancel school in the affected areas.   Authorities suspended classes in Los Cabos for Friday, and ordered all boats and ships to remain docked.   The army said it had deployed troops to set up 14 emergency shelters in case they were needed.
Date: Fri 2 Aug 2019
Source: Edinburgh Evening News [abridged, edited]

British holidaymakers visiting Mexico are being warned about an intestinal parasite that is ravaging resorts in the country.  A total of 14 tourists staying at luxury hotels in the Riviera Maya resort and Cancun have experienced crippling stomach pains, sickness and diarrhoea due to an illness that is passed on through contaminated food.  The cause of the illness is the _Cyclospora cayetanensis_ parasite, which is transmitted by faeces coming into contact with water and food. This the 5th year in a row that the parasite has infected tourists in the region.

Nearly 600 British people have been infected with the bug since 2015, and the same areas of Mexico were the subject of a public health warning 3 years ago. Now medical experts are advising anyone who has visited the affected resorts and is feeling ill to seek medical attention.  Advice on the Health Protection Scotland website reads, "All travellers to Mexico are strongly advised to maintain a high standard of food, water and personal hygiene even if staying in luxury resorts. "Infection is transmitted through consumption of contaminated food or water; direct person to person spread does not occur. Foods often implicated in outbreaks include soft fruits like raspberries and salad products such as coriander, basil and lettuce. "On return from Mexico, if travellers have any symptoms such as those described above, they should seek medical attention."

A spokesperson for Health Protection Scotland confirmed an outbreak of _Cyclospora_ in Mexico, stating, "There have been seasonal outbreaks of _Cyclospora_ infection in returning travellers from Mexico over the past 4 years.  "The majority of cases stayed at the Riviera Maya and Cancun regions of Mexico. Health Protection Scotland is aware of 8 cases in Scotland this year [2019] with a history of travel to Mexico. "_Cyclospora_ infection can cause diarrhoea and illness. The infection can be more serious in individuals with an impaired immune system. Prevention is through following good food and water hygiene practices at all times while on holiday."  [Byline: Lloyd Bent]
==========================
[Products originating from Mexico have been behind several multistate outbreaks of cyclosporiasis in the USA and Canada and are currently the source of an multistate outbreak in the USA (see ProMED posting from the 27 Jul 2019 below).

Cyclosporiasis has also been reported in tourists returning from Mexico to the UK, France and Canada (see ProMED reports below). Therefore, it is not surprising that there is a current increase in cases at the same time as the outbreak in the USA. - ProMED Mod.EP]

[HealthMap/ProMED-mail map:
Quintana Roo, Mexico: <http://healthmap.org/promed/p/506>]
Date: Mon, 1 Jul 2019 02:10:47 +0200

Guadalajara, Mexico, July 1, 2019 (AFP) - A freak hail storm on Sunday struck Guadalajara, one of Mexico's most populous cities, shocking residents and trapping vehicles in a deluge of ice pellets up to two meters (yards) deep.   "I've never seen such scenes in Guadalajara," said the state governor, Enrique Alfaro.   "Then we ask ourselves if climate change is real. These are never-before-seen natural phenomenon," he said. "It's incredible."

Guadalajara, located north of Mexico City and with a population of around five million, has been experiencing summer temperature of around 31 Centigrade (88 Fahrenheit) in recent days.   While seasonal hail storms do occur, there is no record of anything so heavy.

At least six neighbourhoods in the city outskirts woke up to ice pellets up to two meters deep.   While children scampered around and hurled ice balls at each other, Civil Protection personnel and soldiers brought out heavy machinery to clear the roads.   Nearly 200 homes and businesses reported hail damage, and at least 50 vehicles were swept away by the deluge of ice in hilly areas, some buried under piles of pellets.   While no casualties were reported, two people showed "early signs of hypothermia," the state Civil Protection office said.
Wednesday 26th June 2019
https://mexiconewsdaily.com/news/2-dead-in-reynosa-rain-storm/

Floodwaters in Reynosa.

The toll from a rainstorm that hit the city of Reynosa on Monday night is two deaths and 57 flooded neighbourhoods, authorities say.  The intense rains flooded thousands of homes across the Tamaulipas border city, and in some places floodwaters were over a meter and a half deep. United States authorities had warned that the storm could affect cities in the Río Grande Valley. But Mexico’s National Meteorological Service had only forecast moderate to intense rains.

As the water began to rise, the army responded to rescue people from their homes. A total of 92 people were taken to temporary shelters set up in the municipal auditorium, the stadium and the Rodhe campus of the Autonomous University of Tamaulipas.  The rains also damaged Reynosa’s electrical grid, leaving 100,000 people without power for 12 hours.

Governor Francisco Javier García Cabeza de Vaca said that municipal governments need to take measures to prevent similar flooding from happening again.  “When the hurricane season started, we were working with Civil Defense in the state, and they recommended that every municipal government should work on preventative measures, especially cleaning out drains,” he said. “Because when drains are full of trash, the water level rises, and it leads to flooding.”

Date: Mon 6 May 2019, 6:23 PM
Source: NBC San Diego [edited]

The California Department of Public Health (CDPH) says oysters harvested from Baja California Sur, Mexico are linked to a gastrointestinal illness outbreak in California. The CDPH said 12 people between [February and April 2019] have reported getting sick after eating raw oysters from stores and restaurants in San Diego County, Los Angeles County, Orange County, and Santa Barbara County.

The investigation is ongoing, but so far, laboratory testing of oysters harvested from Estero El Cardon revealed 6 different toxic pathogens, including non-O157 Shiga toxin-producing _E. coli_. Mexican authorities are also investigating.

The CDPH says shellfish sold at stores and restaurants is required to have tags indicating where the product is from. People who become ill after eating raw oysters or undercooked shellfish should contact a doctor, the CDPH says. The CDPH also says shellfish should be cooked to at least 145 degrees Fahrenheit internal temperature. The department also warns against quick steaming.  [Byline: Rafael Avitabile]
=========================
[It is not stated what gastrointestinal pathogen(s) were acquired by the affected individuals. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
California, United States: <http://healthmap.org/promed/p/204>]
More ...

Rwanda

Rwanda US Consular Information Sheet
May 19, 2008
COUNTRY DESCRIPTION:
Rwanda is a landlocked developing country in central Africa which has made considerable progress in rebuilding its infrastructure and establishing security since the 19
4 civil war and genocide in which at least 800,000 people were killed. Economic activity and tourism are on the rise in Rwanda. Hotels and guesthouses are adequate in Kigali, the capital, and in major towns, but are limited in remote areas. Read the Department of State Background Notes on Rwanda for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and evidence of yellow fever immunization are required. Visas are not required for American citizens entering Rwanda for less than 90 days. U.S. citizens planning on working in Rwanda should apply for a work permit at the Directorate of Immigration as soon as possible after arrival in Rwanda. Detailed entry information may be obtained from Rwanda’s Directorate of Immigration at: http://www.migration.gov.rw/ or from the Embassy of the Republic of Rwanda, 1714 New Hampshire Avenue NW, Washington DC 20009, telephone 202-232-2882, fax 202-232-4544, web site http://www.rwandaembassy.org. Overseas, inquiries may be made at the nearest Rwandan Embassy or Consulate.
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:
There are currently no travel restrictions in place within Rwanda, but travelers should use caution when traveling near or crossing the border into Burundi, eastern Democratic Republic of the Congo (DRC), and Uganda.

In March 2005, the Congo-based Democratic Forces for the Liberation of Rwanda (FDLR), comprising ex-Rwandese Armed Forces, Interahamwe, and other extremists, announced it would end its armed struggle against the Government of Rwanda, but thousands of combatants are estimated to remain in eastern Congo. The combatants currently are not well-organized or funded, nor do they pose a serious threat to Rwandan security. However, in early March 2007, in Gisenyi Province (near the Volcanoes National Park in northwestern Rwanda) they launched a mortar round and rocket into Rwandan territory. There were no casualties, and it appears to have been an isolated incident. While visitors may travel freely to Volcanoes National Park, they are not permitted to visit the park without permission from Rwanda's Office of Tourism and National Parks (ORTPN). ORTPN stipulates that the park can only be used for gorilla tours and nature walks. Since December 2006, all restrictions have been lifted in the Nyungwe Forest near the Burundian border in southwestern Rwanda. In the past, the FDLR infiltrated Rwanda from Burundi through the Nyungwe Forest, but the last reported incident in the park was in November 2003. However, FDLR rebel factions are known to operate in northeastern DRC, Burundi, Tanzania, and Uganda, including near the popular tourist area of Bwindi Impenetrable Forest National Park. For information on travel to those and other countries, and for the latest security information, American citizens 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, as well as the Worldwide Caution, can be found.
From time to time, travel by U.S. Embassy personnel may be restricted based on changing security conditions. Visitors are encouraged to contact the appropriate U.S. Embassy Regional Security Office or Consular Section for the latest security information, including developments in eastern Congo, Uganda and Burundi. (See Registration/Embassy Location section below.)

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: Pick-pocketing in crowded public places is common, as is petty theft from cars and hotel rooms. Although violent crimes such as carjacking, robbery, and home invasion occur in Kigali, they are rarely committed against foreigners. Americans are advised to remain alert, exercise caution, and follow appropriate personal security measures. Although many parts of Kigali are safe at night, walking alone after dark is not recommended since foreigners, including Americans, have occasionally been the targets of robbery.

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.

See our information on Victims of Crime. The U.S. Embassy provides some information on its web site about criminal justice in Rwanda at http://rwanda.usembassy.gov/criminal_justice_in_rwanda.html.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical and dental facilities are limited, and some medicines are in short supply or unavailable. Travelers should bring their own supplies of prescription drugs and preventive medicines. In Kigali, Americans may go to King Faisal Hospital, a private facility that offers limited services and dental facilities. There is also a missionary dental clinic and a few private dentists. American-operated charitable hospitals with some surgical facilities can be found in Kibagora, in southwestern Rwanda, in Ruhengeri, near the gorilla trekking area, and in Rwinkavu, near the entrance to Akagera National Park. The U.S. Embassy maintains on its website a current list of healthcare providers and facilities in Rwanda at http://rwanda.usembassy.gov/medical_information.html; this list is also included in the Consular Section’s welcome packets for American citizens. There are periodic outbreaks of meningitis in Rwanda. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease. Malaria is endemic to Rwanda. All visitors are strongly encouraged to take prophylactic medications to prevent malaria. These should be initiated prior to entry into the endemic area. Because of possible counterfeit of antimalarial medications, these should be obtained from a reliable pharmaceutical source. Multiple outbreaks of ebola have been reported in neighboring Democratic Republic of Congo and Uganda in the past year, but none within Rwanda.
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 website 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.

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 Rwanda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Due to safety concerns, the use of motorbikes or van taxis for transportation is not recommended. Regulated orange-striped (along the base of the vehicle) sedan auto taxis are safer, but be sure to agree on a fare before beginning the trip. Public transportation can be dangerous due to overloading, inadequate maintenance, and careless drivers.
While the main roads in Rwanda are in relatively good condition, during the rainy season many side roads are passable only with four-wheel drive vehicles. Nighttime driving, particularly outside major cities, is hazardous and is discouraged. Often, roadways are not marked and lack streetlights and shoulders. Many sections have deteriorated surfaces. Due to possible language barriers and lack of roadside assistance, receiving help may be difficult. Travelers may be stopped at police roadblocks throughout the country, where their vehicles and luggage may be searched. Service stations are available along main roads.
In Rwanda, as in the U.S., traffic moves on the right-hand side of the road. Cars already in a traffic circle have the right of way. Until 2004, cars entering traffic circles had the right-of-way. Drivers should exercise caution at traffic circles, since some drivers might forget this change. Excessive speed, careless driving, and the lack of basic safety equipment on many vehicles are hazards on Rwanda's roads. Many vehicles are not well maintained, and headlights are either extremely dim or not used. Drivers also tend to speed and pass other cars with little discretion. Some streets in Kigali have sidewalks or sufficient space for pedestrian traffic; others do not, and pedestrians are forced to walk along the roadway. With the limited street lighting, drivers often have difficulty seeing pedestrians. Drivers frequently have unexpected encounters with cyclists, pedestrians and livestock.
Third-party insurance is required and will cover any damages from involvement in an accident resulting in injuries, if one is found not to have been at fault. The driver’s license of individuals determined to have caused an accident may be confiscated for three months. Causing a fatal accident could result in three to six months' imprisonment. Drunk drivers are jailed for 24 hours and fined Rwandan Francs 20,000 (approximately $35). In the city of Kigali, contact the following numbers for police assistance in the event of an accident: Kigali Center, 08311112; Nyamirambo, 08311113; Kacyiru, 08311114; Kicukiro, 08311115; Remera, 08311116. Ambulance assistance is very limited. Wear seat belts and drive with care and patience at all times. In case of an emergency, American citizens can contact the Embassy duty officer at 0830-0345.
For specific information concerning Rwandan driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Rwandan Office of Tourism and National Parks, B.P. 905, Kigali, Rwanda, telephone 250-76514, fax 250-76512.
Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.gov.rw/.
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Rwanda, the U.S. Federal Aviation Administration (FAA) has not assessed Rwanda’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.

In recent months, Rwandair, which charters aircraft to fly its routes, has had difficulties maintaining its schedule, resulting in delayed and cancelled flights which have left passengers stranded for extended periods.

SPECIAL CIRCUMSTANCES:
Telephone communication to and from Rwanda is generally reliable. Cellular telephones and Internet connections are available in Kigali and large towns.
Non-biodegradable plastic bags have been banned in Rwanda, and travelers carrying them upon arrival at the Kayibanda International airport may have them confiscated and have to pay approximately $4 for a reusable cloth replacement.
International ATMs are not available in Rwanda. The Rwandan franc is freely exchangeable for hard currencies in banks and the Bureaux de Change. Several Kigali banks can handle wire transfers from U.S. banks, including Western Union. Credit cards are accepted at only a few hotels in Kigali and only to settle hotel bills. Hotels currently accepting credit cards for payment include the Kigali Serena (formerly Intercontinental) Hotel, the Hotel des Mille Collines, the Novotel Umubano, Stipp Hotel and the Kivu Sun Hotel. Note that there may be an added fee for using a credit card. Travelers should expect to handle most expenses, including air tickets, in cash.

Traveler's checks can be cashed only at commercial banks. Because some travelers have had difficulty using U.S. currency printed before the year 2000, the Embassy recommends traveling with newer U.S. currency notes.
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 Rwandan laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Rwanda 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. Please see our information on Criminal Penalties.
The U.S. Embassy provides some information on its website about criminal justice in Rwanda.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction. Both foreigners and Rwandans taking Rwandan children to live outside Rwanda, e.g., after adoption, must obtain an exit permission letter from the Ministry of Family and Gender located within the Primature complex at P.O. Box 969, Kigali, Rwanda; Tel: 011-250-587-128; Fax: 011-250-587-127.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Rwanda are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Rwanda. 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 2657 Avenue de la Gendarmerie; the mailing address is B.P. 28, Kigali, Rwanda; tel. (250) 596-400,; fax: (250) 596-591. The Consular Section’s email address is consularkigali@state.gov. The Embassy's web site is http://rwanda.usembassy.gov/. American Citizen Services hours are Tuesdays from 9:00 -17:00 and Fridays from 9:00 - 12:00 except on U.S. and Rwandan holidays.
* * *
This replaces the Country Specific Information for Rwanda dated October 4, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Information for Victims of Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions, Aviation Safety Oversight, Criminal Penalties, Children’s Issues, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Tue 6 Aug 2018
Source: New Times (Kigali, Rwanda) [summ., edited]
<https://www.newtimes.co.rw/news/livestock-vaccinations>

Livestock farmers have appealed to the government to ensure that cows get timely vaccination in order to effectively control deadly epidemics in cattle. The appeal comes after an outbreak of Rift Valley Fever [RVF] -- a deadly and infectious viral disease -- killed 154 cows countrywide since May [2018], according to figures from Rwanda Agricultural Board (RAB). Gahiga Gashumba, the chairman of Rwanda National Dairy Farmers' Federation, told The New Times that in their performance contracts, districts set themselves targets to inoculate cows, which leaves a gap in achieving effective vaccination.

Efforts to contain the recent outbreak of RVF included vaccinating 257 902 cows countrywide of which 119 520 were from Ngoma, Kirehe, and Kayonza -- the hardest hit by the disease. "All cows should be vaccinated at least in areas prone to given diseases," Gashumba said adding, "We need a clear vaccination calendar detailing the cows that should be immunised in a given period of time. When there are heavy rains, we should be prepared of [immunising cows against] East Coast fever."

Also known as theileriosis, East Coast fever is a deadly tickborne disease in cattle. Ngoma district vice mayor for Finance and Economic Development, Jean Marie Vianney Rwiririza, said that this year [2018], they want many cows to get vaccines against different diseases, including RVF and foot and mouth disease [FMD]. "With using funds from the district's budget alone, we cannot manage to give vaccines to all cows.

We request farmers' cooperatives and the farmers themselves to partake in the activity so that all the cows can be inoculated," he told The New Times. In Kirehe district, there are over 52 000 cows and over 30 000 of them were vaccinated against different diseases, including Rift Valley fever in the 2017/2018 financial year, according to Jean Damascane Nsengiyumva, Kirehe district vice mayor for Finance and Economic Development. "We have increased funding for the vaccination activity so that we inject all cows which we should vaccinate because we do not want the recurrence of such a problem," he said referring to RVF.

Rwanda Agriculture Board (RAB) said that they do not vaccinate all the cows because it can be wastage of resources or poor management when vaccination is done in areas where a disease has not been reported while it can be contained by vaccinating livestock in the risk zone. Instead of spending money on vaccinating all cows, currently estimated at over a million countrywide, appropriate strategies are devised to control the spread of outbreaks, said RAB director general Dr Patrick Karangwa. "We give more attention to diseases that spread faster than others. We do impact assessment based on spread pattern of a disease.

If a disease can be transmitted through air, measures taken to prevent its spreading should be different from the disease that cows or people catch through contact," Karangwa said. He cited FMD which often affects cattle on areas bordering Tanzania, such as Gatsibo, Kayonza, and Nyagatare, observing that when the disease has been checked in those areas, it dose spread elsewhere, pointing out that if all cows in the country are vaccinated, all the funds used [for the development of the livestock] sector might be consumed by such a single activity. Some vaccines are given free of charge, while others have to be paid for by farmers with government subsidy. [byline: Emmanuel Ntirenganya]
=======================
[RVF has become, according to local media, active in Rwanda in April 2018, as reported from the districts of Ngoma, Kirehe, and Kayonza, in the south west of the Eastern province. It was expressed mainly by cattle death and abortions. Later, Kamonyi, a southern province was added. The Rwandan Ministry of Agriculture and Animal Resources announced on [Mon 30 Jul 2018] the lifting of the ban imposed since mid-June [2018] on the movement of cattle in several parts of Eastern province. According to the ministry, 99 of the 147 604 cows in the affected districts died, and 452 aborted. This differs from other statistics from various sources, including the 154 deaths in cattle, as mentioned in the above media report, quoting the Rwanda Agricultural Board.

Official statistics are expected to be included in Rwanda's RVF report to the OIE, which all member countries are obliged to submit. In the absence of data on the number of susceptible animals on the affected holdings, the mortality rate in cattle is not known. Based on accumulated field observations and experimental RVF infection trials, the mortality in adult cattle would, generally, not exceed 10 per cent. No human cases have been reported in Rwanda during the recent event. Vaccination of livestock against RVF can be applied either with a live attenuated (Smithburn) vaccine (relatively cheap, several years immunity rendered, but may cause foetal abnormalities or abortion in pregnant animals).

Alternatively, particularly in pregnant animals, an inactivated (formalin-killed) RVF vaccine can be selected (more costly, safer in all breeds/ages/reproductive stages of cattle, sheep, and goats, but requires a booster 3-6 months after the initial vaccination, then followed by yearly boosters). For the considerations related to vaccine policies, vaccines to be selected, and other tools for the prevention and control of RVF under various epidemiological situations, please refer to references 1-3.

References
------------------------------
1. Consultative Group for RVF Decision Support. Decision-support tool for prevention and control of Rift Valley fever epizootics in the Greater Horn of Africa. Am J Trop Med Hyg. 2010. 83(2 Suppl): 75-85. DOI: 10.4269/ajtmh.2010.83s2a03; <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913494/>.

2. Anonymous. Risk-based decision-support framework for prevention and control of Rift Valley fever epidemics in eastern Africa. EU Collaborative Project, Seventh Framework Programme. 2015. (Grant Agreement no. 266327); <http://www.healthyfutures.eu/images/healthy/deliverables/d5.4%20risk-based%20decision-support%20framework.pdf>.

3. Mariner J. Rift Valley fever surveillance. FAO animal production and health manual no. 21. Rome: FAO. 80 pages; <http://www.fao.org/3/i8475en/I8475EN.pdf>. - ProMED Mod.AS]

[Maps of Rwanda: <http://www.geographicguide.com/pictures/map-rwanda.jpg>
and <http://healthmap.org/promed/p/173>.]
Date: Mon 30 Jul 2018
Source: Journalducameroun.com, APA News report [summ., edited]
<https://www.journalducameroun.com/en/rift-valley-fever-rwanda-lifts-quarantine-on-cattle-movement/>

The Rwandan Ministry of Agriculture and Animal Resources, on [Mon 30 Jul 2018] announced it was lifting the quarantine on the movement of cattle that was imposed to control the deadly Rift Valley fever [RVF] in several parts of Eastern province. A quarantine on cattle in the country's 4 affected eastern districts has been imposed since mid-June [2018] after about 100 heads of cattle were killed by the virus. In a notice issued [Mon 30 Jul 2018], the minister Ministry of Agriculture and Animal Resources, Gérardine Mukeshimana, said the quarantine is no longer serving the purpose of slowing the spread of the deadly Rift Valley fever.

Reports indicate that the outbreak was first detected on 18 May 2018 in 4 districts in Eastern Rwanda including Ngoma, Kirehe, Rwamagana, and Kayonza. Of the 147 604 cows in the affected districts, the ministry says 99 died while 452 aborted. The ministry says it has treated 1638 cows, with 36 930 sheep and 245 goats vaccinated against the disease. To combat further deaths among animals, the ministry says it has dispatched veterinary doctors across the affected districts. Official reports indicate that no human case has been reported so far in Rwanda, yet the number of affected livestock is thought to be much higher.

According to the Director General of Rwanda Agriculture Board (RAB), Dr Patrick Karangwa, the cause of the outbreak is unusually heavy rains, which have created ponds and lakes where mosquitoes can breed, in this region which is normally dry. "Most human infections result from contact with the blood or organs of infected animals", Dr Karangwa said.
========================
[RVF, expressed mainly by cattle death and abortions, became active in Rwanda in April 2018, in the districts of Ngoma, Kirehe and Kayonza, in the southwest of the Eastern Province. Later, Kamonyi, a southern province was added.

An administrative map of Rwanda and detailed districts maps are available at
<https://en.wikipedia.org/wiki/Districts_of_Rwanda#Eastern_Province>.

In the absence of data on the number of susceptible animals on the affected holdings, the mortality rate in cattle is not known. Based on accumulated field observations and experimental RVF infection trials, the mortality in adult cattle would, generally, not exceed 10 percent. No human cases have been reported in Rwanda during the recent event. The tests upon which RVF, an OIE-listed disease, has been confirmed and statistics pertaining to the number, locations, morbidity, and mortality rates in Rwanda's animal population, are expected to be included in an official report to the OIE, as anticipated from all OIE member countries. - ProMED Mod.AS]

[HealthMap/ProMED-mail map of Eastern Province, Rwanda:
<http://healthmap.org/promed/p/15277>]
Date: Sun, 11 Mar 2018 11:43:19 +0100

Kigali, March 11, 2018 (AFP) - At least 16 people were killed and dozens more injured after lightning struck a Seventh-Day Adventist church in Rwanda, a local official said Sunday.   Fourteen victims were killed on the spot as lightning hit the church in the Nyaruguru district in the Southern Province on Saturday, local mayor Habitegeko Francois told AFP over the phone.

Two others died later from their injuries, he said.   He added that 140 people involved in the incident had been rushed to hospital and district health centres, but that many had already been discharged.   "Doctors say that only three of them are in critical condition but they are getting better," he said.   According to the mayor, a similar accident took place on Friday when lightning struck a group of 18 students, killing one of them.
Date: Wed, 26 Jul 2017 11:31:06 +0200
By Fran BLANDY

Volcanoes National Park, Rwanda, July 26, 2017 (AFP) - Nicaraguan singer Hernaldo Zuniga brought his entire family to trek through the lush forests and mist-shrouded volcanoes of northwestern Rwanda in search of mountain gorillas.   He described their encounter with the critically endangered primates as "an almost spiritual" experience, and said it was the only reason they made Rwanda a stop on a trip taking in a safari in Kenya, and a tour of South Africa.

But Rwanda is no longer content with being a whirlwind stop on a tourist's itinerary, and is working hard to broaden its appeal beyond its world-famous mountain gorillas while narrowing its niche market to the wealthiest of visitors.   Zuniga counts himself lucky that his family of five scored their permits to see the gorillas before Rwanda's eyebrow-raising move to double the cost to $1,500 (1,300 euros) per person in May.   "I think that is going to be a drawback for many people. It is just going to be an elite group of people who can pay that," said Zuniga, a well-known star in Latin America.

For Rwanda however, the price hike is part of a careful strategy to boost conservation efforts while positioning itself as a luxury tourist destination.   "The idea behind (the increase) is that it is an exclusive experience which also needs to be limited in numbers. Our tourism is very much based on natural resources and we are very serious about conservation," said Clare Akamanzi, the chief executive of the Rwanda Development Board.   It is a high-value, low-impact strategy that has worked well for countries such as Botswana and Bhutan.

- Safe and clean -
The remote, mountainous border area straddling Rwanda, the Democratic Republic of Congo and Uganda is the only place in the world where one can see the gorillas, whose numbers have slowly increased to nearly 900 due to conservation efforts.   Permits in the DRC ($400) and Uganda ($600) are far cheaper, but Rwandan officials are not concerned that they will lose tourists to their neighbours, arguing the country offers an experience that is rare in the region.   Ever since the devastating 1994 genocide in which 800,000 mainly Tutsis were killed, the country has been praised for a swift economic turnaround.   "When you come to Rwanda it is a clean, organised, safe country with zero tolerance for corruption. We have concentrated on creating a good experience," said Akamanzi, also highlighting a quick visa process.

The challenge is getting tourists to make Rwanda their main destination, and spend more than the usual four days it takes to visit the gorillas and maybe the genocide museum before heading elsewhere.   "We want to keep it high-end as an anchor for tourism but provide other offerings," said Akamanzi. She said tourism is already the country's top foreign exchange earner, but believes they "have only scratched the surface".   So the country, known as the Land of a Thousand Hills is looking into sports tourism such as cycling, cultural tourism and becoming a Big Five safari destination in its own right.   In the past two years Rwanda has re-introduced both lions and rhino to its Akagera National Park -- which had gone extinct due to poor conservation -- and visitor numbers to the reserve have doubled, said Akamanzi.

- 'There will be an impact' -
However gorillas remain the main lure, and industry players are concerned about the impact the price increase could have on the whole tourism chain.   "We risk losing substantial revenue for the industry and government as a whole. Currently a number of gorilla permits are already not sold in the low season," the Rwanda Tours and Travel Association (RTTA) said in a statement after the decision was announced.   Mid-range hotels around the Volcanoes National Park say it is too soon to tell what the fallout will be, but several managers expressed concerns they would lose their main clientele.   "Either way there will be an impact," said Fulgence Nkwenprana, who runs the La Palme hotel.

Aloys Kamanzi, a guide with Individual Tours, acknowledged there has been an initial slowdown in reservations, but is convinced people will keep coming, adding his clients are mostly "retired tourists who have saved their whole lives", some of whom come three or four times.   The singer Zuniga said coming to Rwanda was a hard decision, as he had not heard much about what the country was like today from Mexico, where he lives with his family.   "Rwanda has a lot of sensitive echoes in my generation, the genocide ... we had to cross over all these personal obstacles to make the decision to come here," he said.   "They have to do better in promoting their tourism. Once you are here it is amazing, the people are unique, the country is beautiful. I would like to stay longer."
Date: Tue, 2 May 2017 16:29:01 +0200
By Cyril BELAUD

Kigali, May 2, 2017 (AFP) - Around 20 of Africa's endangered Eastern black rhinos are returning in an "extraordinary homecoming" to Rwanda after the species disappeared there 10 years ago, the African Parks organisation said Tuesday.   The rhinos are being moved from South Africa to the Akagera national park in eastern Rwanda, according to the non-profit group that manages protected areas for African governments.   "This extraordinary homecoming will take place over the first two weeks of May," it said in a statement.   The Eastern black rhino, one of the sub-species of the rhinoceros, is in critical danger of extinction, according to the International Union for Conservation of Nature (IUCN).   Back in the 1970s, more than 50 black rhinos thrived in the savannah habitat of the Akagera park, but their numbers declined due to wide-scale poaching and the last confirmed sighting was in 2007.

- 'Great symbol of Africa' -
"Rhinos are one of the great symbols of Africa yet they are severely threatened and are on the decline in many places across the continent due to the extremely lucrative and illegal rhino horn trade," said African Parks CEO Peter Fearnhead.    According to the conservationists, there are fewer than 5,000 black rhino in the wild worldwide, with only about 1,000 of the Eastern sub-species.

Since 2010 African Parks has boosted security at  Akagera and has prepared to accept the rhinos with financial help from the Howard Buffett Foundation, headed by the son of US billionaire Warren Buffett.   The measures taken include deploying a helicopter for air surveillance and an expert rhino tracking and protection team as well as a canine anti-poaching unit.   "We are fully prepared to welcome them (rhinos) and ensure their safety for the benefit of our tourism industry and the community at large," said Clare Akamanzi, chief executive of the Rwanda Development Board.

In July 2015, Rwanda had reintroduced lions in the Akagera park, 15 years after they had disappeared. The lions were decimated in the years after Rwanda's genocide in 1994 as Rwandans who had fled the slaughter returned and occupied the park killing the lions to protect their livestock.   The park, which takes its name from the nearby Kagera river, is located near the border with Tanzania.   With the reintroduction of the rhinos, Akagera, which welcomed more than 36,000 visitors last year, will now boast being home to Africa's "big five" -- rhino, lion, elephant, leopard and buffalo.
More ...

World Travel News Headlines

Date: Tue, 12 Nov 2019 13:10:01 +0100 (MET)
By Holly ROBERTSON, Andrew BEATTY, with Daniel De Cartert in Hillville

Sydney, Nov 12, 2019 (AFP) - Bushfires raging across eastern Australia singed Sydney's suburbs on Tuesday, with firefighters scrambling planes and helicopters to douse a built-up neighbourhood with water and red retardant.   Experts have described the conditions as the worst on record, as spring temperatures climbed toward 40 degrees Celsius (104 Fahrenheit) and winds topped 80 kilometres (50 miles) per hour across a zone which has been plagued by persistent drought.   Although the bushfire season is in its infancy, scientists predict it to be one of Australia's toughest ever, with climate change and unfavourable weather cycles helping created a tinderbox of strong winds, low humidity and high temperatures.

Twin blazes in the north shore suburb of Turramurra -- around 15 kilometres (nine miles) from the centre of Australia's largest city -- tore through a eucalypt forest park and sparked spot fires in homes, before eventually being brought under control.   As night fell, authorities said they were bringing another "clearly suspicious" blaze in a national park in the city's southern suburbs under control.    Throughout the day, more than 300 bushfires burned up and down Australia's east coast, fanned by gale-force winds, scorching temperatures and tinder-dry bushland that has brought some of the most dangerous conditions the country has seen.

In Turramurra, gardens smouldered, thick smoke hung heavy in the air and cars, houses and roads were caked in raspberry-red retardant as if hit by a giant paintball.   "It was the embers that floated up that actually went across and set off spot fires in the front yards" resident Nigel Lush told AFP, adding that one roof had been set alight.   Another resident, Julia Gretton-Roberts, said the blaze spread shockingly quickly.   "Next thing I know the fire was opposite our house and it was massive and the police came and grabbed our kids and took them away," she said.   "My daughter is pretty freaked out."   Firefighter Andrew Connon told AFP "a number of homes were threatened but it was contained by the aerial bombing".

- 'Catastrophic conditions' -
From early morning thousands of firefighters spread out across New South Wales in anticipation of what they called "off the scale" fire risk and "catastrophic" conditions.   They were unable to prevent several bushfires from breaching containment lines and trapping residents who had not already evacuated.   New South Wales Rural Fire Service Commissioner Shane Fitzsimmons said so far only a dozen buildings had been damaged Tuesday and a handful non-life-threatening injuries were reported, but the crisis was far from over.

Firefighters will be "working on these fires for days and weeks given the enormity of the firegrounds," he said.    Even before unfavourable weather hit, days of fires had killed three people and destroyed at least 150 homes.   "The conditions are expected to get worse," Fitzsimmons said, warning residents in adjacent areas to stay alert.   "Complacency kills," he added.   Up to 600 schools were closed, as well as many national parks, a total fire ban was introduced for the affected area and Rally Australia -- due to be held in Coffs Harbour at the weekend -- was cancelled.   The military pitched in, helping firefighters with logistics and water-dropping sorties using more than 100 aircraft.

- 'We'll fight it first' -
In the town of Hillville a fire that has ripped through an area the size of 25,000 soccer fields approached the home of Daniel Stevens.   Like many, his family -- including his mother nursing a broken leg -- have packed their bags, but have resisted leaving their house and everything they own.    "We'll fight it first," he told AFP, "but if it jumps the fence line into the paddock, we'll go."

In the nearby town of Taree, dozens of people have already moved to a showground that has become a makeshift evacuation centre.   Fifty-nine-year-old Caroline Watson arrived last night with her husband and their dog.    "The fires are just rife. They are absolutely everywhere" she told AFP. "They didn't ask us to get out, but we figured it was coming."

Further south in the Blue Mountains on the outskirts of Sydney, veteran Winmalee firefighter Alan Gardiner said locals were "terrified and on edge".    The town still bears the scars of a 2013 blaze that destroyed 200 homes, and residents are acutely aware that with few roads in and out of the mountains, a decision to leave late can be fatal.   Efforts to burn fuel in a controlled way have been limited by months of drought-like conditions that made it too dangerous.
Date: Tue, 12 Nov 2019 10:03:07 +0100 (MET)

Denpasar, Indonesia, Nov 12, 2019 (AFP) - An Australian tourist who fly-kicked a motorcyclist and assaulted a man in his own home during a drunken rampage was jailed for four months on Tuesday.   The ruling comes after Nicholas Carr's antics were caught in a viral video that saw him carry out a campaign of destruction in Seminyak, a popular tourist area on the Indonesian holiday island.   "The defendant Nicholas Carr is found guilty and is sentenced to four months" in jail, presiding judge Soebandi, who goes by one name, told the Denpasar District Court.    A lawyer for Carr, charged with assault and property damage, said the 26-year-old would not appeal the ruling.    He is expected to be released next month because of time already served.   In August, Carr ran barefoot on to a street and shouted expletives before the apprentice builder slammed into the bonnet of a moving car and then fly-kicked an unsuspecting motorcycle rider.

The biker, who was thrown from the moving scooter, sustained minor injuries -- later the pair embraced during a court hearing as Carr apologised to the victim.   Carr also shattered a convenience store's glass door before stealing a motorcycle.   Later, he broke into a house where he assaulted the sleeping homeowner, leaving him with injuries, police said earlier.    He was eventually caught by locals and police and taken to hospital.    Pictures that circulated on social media showed at the time showed Carr bloodied and bruised, and trussed with hosepipe and rope.   Shortly after his arrest, Carr apologised and admitted drinking more than 10 small bottles of vodka as well as other alcohol.

After a string of embarrassing incidents by tourists, Bali officials recently warned that boorish visitors may be kicked off the island, which attracts millions annually to its palm-fringed beaches, colourful nightlife and ancient temples.   Australian professional rugby league player David Fifita returned home this week after he was briefly arrested in Bali for assaulting a nightclub security guard.   Several days after Carr's arrest, a Czech couple who were slammed for disrespecting a Balinese temple took part in a ritual purification ceremony.
Date: Mon, 11 Nov 2019 16:19:54 +0100 (MET)

Lyon, Nov 11, 2019 (AFP) - An unusually strong earthquake hit south-eastern France on Monday, injuring four people, one of them seriously, authorities said.   A physicist at a geophysics institute the IPGP said that quakes of this strength are rare in that region, but warned of possible aftershocks and said people should leave fragile buildings.   The quake, with a magnitude of 5.4, was felt in a vast area between the cities of Lyon and Montelimar which are about 150 kilometres (93 miles) apart, the national seismological office said.   "I was leaning against the oven in my mother's bakery when I felt the tremor," said Victoria Brielle, a resident in Privas, some 25 kilometres from the quake's epicentre.   "A customer said her sideboard had moved and all her crockery was broken,"  she said.

Another resident in the area, Didier Levy, who lives in a 15th century castle, told AFP that "chandeliers were still trembling" several minutes after the quake.   Levy, who said his dog starting barking even before humans felt the tremors, added: "I have never experienced anything like it, I could feel the trembling even though these wall are one metre thick."   One person was seriously hurt when some scaffolding collapsed, the regional prefect's office said.   Three other people in the neighbouring Ardeche region were slightly injured.

Quakes in this region are rarely higher than Magnitude 5, said Mustapha Meghraoui of the IPGP's office in Strasbourg.   "We can say that this is a rare one," he added. But he said there might be an aftershock of around 4.5.   "If people are in a fragile house, they would be better leaving it" for something more robust for a while, he said.   The scale of the damage suggested the quake happened at a depth of between five and 10 kilometres, he added. But they were working on a more accurate reading.
Date: Mon, 11 Nov 2019 13:19:54 +0100 (MET)

Goma, DR Congo, Nov 11, 2019 (AFP) - A local radio station that has been involved in the fight against Ebola in eastern DR Congo said Monday it was closing down after one of its broadcasters was murdered.   Joel Musavuli, head of Lwemba radio in Mambasa in Ituri province, told AFP that the station had been targeted by armed groups hostile to the campaign to roll back the Ebola epidemic.

"Each of us have received threats since last month. We have now decided to stop broadcasting, Musavuli said, adding that he himself had escaped two kidnap attempts.   "We are victims of our commitment to the awareness campaign about the spread of Ebola virus disease. We don't know why the militiamen are targeting us."   Nearly 2,200 people have died since the notorious haemorrhagic disease erupted in eastern Democratic Republic of Congo in August 2018, according to the latest official figures.

The fight against the outbreak has been hampered by local fears and superstititions, exploited by militia groups that are rampant in the remote region.   Several health workers have been killed and media that have supported the campaign have received threats.

Several radio stations in the Mambasa area say they have stopped broadcasting anti-Ebola messages because of intimidation.   On November 2, Lwemba broadcaster Papy Mahamba was killed at his home by unidentified men. His wife was injured and their house set ablaze.    The station said the authorities had failed to take action against the threats. It said it would resume broadcasts after "the state has restored authority in the area".
Date: Mon, 11 Nov 2019 11:38:15 +0100 (MET)

Kuwait City, Nov 11, 2019 (AFP) - Hundreds of workers at Kuwait's international airport held a one-hour strike Monday to demand better working conditions, threatening to stage longer walkouts in the coming days.    Ahmed Mohammed al-Kandari, a union representative, said workers were calling for improved treatment and to be compensated for daily exposure to pollution and noise.  Monday's strike by Kuwaiti staff did not affect flights, officials said.   The right to strike is guaranteed for citizens in Kuwait, but such actions remain rare in the Gulf country.

Foreign workers do not have the right to strike.  "Airport traffic is very normal," Sheikh Salman Al-Hamoud Al-Sabah, head of the General Directorate of Civil Aviation, told AFP.    Another official, Saleh Al-Fadaghi, the airport's director of operations, also said flights were not affected. "During the one-hour strike, 19 flights were operated as scheduled. There were five departures and 14 arrivals," he told AFP.

Kandari said the purpose of the strike was not to disrupt operations but "to make our voices heard". He added that Kuwaiti workers would hold a further two-hour strike on Wednesday and a 24-hour strike on Sunday if their demands are not met.    Of 4,500 civil aviation employees, 1,500 took part in Monday's strike, he said.
Date: Mon, 11 Nov 2019 10:39:09 +0100 (MET)

La Jonquera, Spain, Nov 11, 2019 (AFP) - Catalan separatist activists blocked traffic on Monday on a motorway linking Spain and France, in a fresh protest against the sentencing last month of nine of their leaders to lengthy jail terms.   Demonstrators cut the AP7 motorway at La Jonquera near the city of Girona in eastern Spain, a day after a repeat general election in which Prime Minister Pedro Sanchez's Socialist emerged as winners but weakened, while far-right party Vox surged to third place on the back of its hardline stance against separatism.   Dozens of vehicles blocked the motorway near the border with France while some 300 people set up a barricade, according to an AFP photographer at the scene.   Some demonstrators began to set up a stage and speakers which they brought to the scene in vans.   Catalonia's regional road department confirmed the motorway was cut in both directions at La Jonquera.

The protest was called by a new, mysterious organisation called "Democratic Tsunami" which last month sent thousands of people to block access to Barcelona airport in a protest which ended in clashes between demonstrators and police.   "This mobilisation is a cry to the international community so that it makes the Spanish state understand that the only possible path is to sit down and talk," the group said in a message sent to its followers on encrypted messaging service Telegram.   Radical separatist group CDR also called on its supporters to head to La Jonquera to block the highway.   Catalonia was rocked by days of mass, sometimes violent, pro-independence rallies after Spain's Supreme Court on October 14 sentenced nine politicians and activists to jail for up to 13 years for their role in a failed secession bid in 2017.   Demonstrators have frequently cut road and rail links between Spain and France while many shops in downtown Barcelona have been shut during the rallies and there are growing concerns about the impact of the unrest on business in Spain's second largest city.
Date: Sat, 9 Nov 2019 18:59:25 +0100 (MET)

MOUSOUNI ISLAND, India, Nov 9, 2019 (AFP) - Cyclone Bulbul hit India and southern Bangladesh on Saturday, leaving two dead as authorities in the countries ordered more than two million people to get out of the path of the storm.   The cyclone, packing winds of up to 120 kilometres (75 miles) per hour, has "weakened" and "started crossing" India's West Bengal and Bangladesh's Khulna coast at about 9:00 pm (1500 GMT), Dhaka's Meteorological Department said in a special bulletin.   "It is likely to move in a northeasterly direction" and "weaken gradually, and may complete crossing West Bengal-Khulna coast by midnight tonight," the department said.     Airports and ports were shut down and the deaths were reported before the full force of the cyclone had hit.   One person was killed by an uprooted tree in Kolkata and another by a wall that collapsed under the force of the winds in Odisha state, authorities said.

More than 60,000 people were moved away from the coast on the Indian side of the border.   Bangladesh disaster management secretary Shah Kamal told AFP that "2.028 million" have been evacuated and moved to more than 5,500 cyclone shelters.   He said there was no reports of casualties and rejected reports in local media that dozens of local fishermen were missing on the southern coast.    Bangladeshi troops were sent to some villages, while about 55,000 volunteers went door-to-door and making loudspeaker announcements in the streets to get people away from the danger zone in villages, many of which were below sea level.

- Ports closed, flights halted -
A storm surge up to two metres (seven feet) was predicted along the coast, Bangladesh's Meteorological Department said.   About 1,500 tourists were stranded on the southern island of Saint Martin after boat services were suspended due to bad weather.   Bangladesh's two biggest ports, Mongla and Chittagong, were closed because of the storm, and flights into Chittagong airport were halted.   In India, flights in and out of Kolkata airport were suspended for 12 hours because of the storm.   On the West Bengal island of Mousouni, which lies in the path of the storm, frightened residents took shelter in schools and government buildings because they had not been able to escape.   Military planes and ships have been put on standby to help in emergencies, Indian authorities said.

Bulbul hit the coast at the Sundarbans, the world's largest mangrove forest, which straddles Bangladesh and part of eastern India, and is home to endangered species including the Bengal tiger and the Irrawaddy dolphins.   Bangladesh's low-lying coast, home to 30 million people, is regularly battered by cyclones that leave a trail of destruction.   Hundreds of thousands of people have been killed in cyclones in recent decades.   While the frequency and intensity have increased, partly due to climate change, the death tolls have come down because of faster evacuations and the building of 4,000 cyclone shelters along the coast.   In November 2007, Cyclone Sidr killed more than 3,000 people. In May this year, Fani became the most powerful storm to hit the country in five years, but the death toll was about 12.
Date: Sat, 9 Nov 2019 14:18:27 +0100 (MET)

Beirut, Nov 9, 2019 (AFP) - Several petrol stations in protest-hit Lebanon stopped services Saturday, as reserves ran dry due to a shortage of US dollars to pay suppliers, a syndicate head said.   The shuttering of petrol stations came as demonstrators again took to the street across the country, keeping up their three-week-long movement against a political class regarded as inefficient and corrupt.    "The petrol stations that opened today are the ones that still have reserves. They will close down as soon as supply runs out," said Sami Brax, the head of the Syndicate of Gas Station Owners.   He said if officials do not facilitate access to dollars by Tuesday, "we will be forced to stop imports and close down all petrol stations."

Petrol stations receive payment from customers in Lebanese pounds but have to pay importers and suppliers in dollars.    For two decades, the Lebanese pound has been pegged to the US dollar, with both currencies used interchangeably in daily life.   But banks have been reducing access to dollars since the end of the summer, following fears of a shortage in central bank dollar reserves.   In recent days, banks halted all ATM withdrawals in dollars and severely restricted conversions from Lebanese pounds.   Many Lebanese have had to instead buy dollars from money changers at a higher exchange rate, in what amounts to a de-facto devaluation of the local currency that has sparked price hikes.

The official exchange rate has remained fixed at 1,507 Lebanese pounds to the dollar, but the rate in the parallel market has surpassed 1,800.   "The banks are under pressure from people, both inside Lebanon and abroad," said economist Naseeb Ghabreel, after many rushed to withdraw their dollar savings or convert Lebanese pound accounts.   Since September, petrol station owners have accused banks of failing to provide them with the dollars they need and threatened strikes.    In response, the central bank last month pledged to facilitate access to the greenback for importers of petroleum products, wheat and medicine.   But the measure has not yet gone into effect.

Lebanon has since October 17 witnessed an unprecedented popular uprising against everything from power cuts and poor social security to alleged state corruption.   The government yielded to popular pressure and stepped down last month, with the World Bank urging for the quick formation of a new cabinet to prevent the economy from further deteriorating.
Date: Fri, 8 Nov 2019 19:25:02 +0100 (MET)

Madrid, Nov 8, 2019 (AFP) - Spanish health authorities confirmed Friday a case of a man spreading dengue through sex, a world first for a virus which until recently was thought to be transmitted only by mosquitos.   The case concerns a 41-year-old man from Madrid who contracted dengue after having sex with his male partner who picked up the virus from a mosquito bite during a trip to Cuba, said Susana Jimenez of the Madrid region's public health department.

His dengue infection was confirmed in September and it puzzled doctors because he had not travelled to a country where the disease, which causes severe flu-like symptoms such as high fever and body aches, is common, she added.   "His partner presented the same symptoms as him but lighter around ten days earlier, and he had previously visited Cuba and the Dominican Republic," Jimenez said.   "An analysis of their sperm was carried out and it revealed that not only did they have dengue but that it was exactly the same virus which circulates in Cuba."

A "likely' case of sexual transmission of dengue between a man and a woman was the subject of a recent scientific article in South Corea, Jimenez said.   In an e-mail sent to AFP, the Stockholm-based European Centre for Disease Prevention and Control (ECDC), which monitors health and disease in Europe, said this was "to our knowledge, the first sexual transmission of the dengue virus among men who have sex with men."

According to the World Health Organization's website, dengue is transmitted mainly by the Aedes Aegypti mosquito, which thrives in densely-populated tropical climates and breeds in stagnant pools of water.    It is most serious -- and deadly -- in children, especially young girls though scientists don't know why.

Dengue is most commonly caught by people travelling to hotter climates such as southeast Asia, Africa, Australia, the Caribbean and South and Central America.
Date: Sun 10 Nov 2019
Source: The News [abridged, edited]

Another young man is awaiting death in an isolation ward of the Jinnah Postgraduate Medical Centre (JPMC) after developing full-blown rabies, as he was bitten by a rabid dog some 3 months ago but was not administered the rabies vaccine, officials said on Saturday [9 Nov 2019].

"18-year-old Z.K., a resident of Jeva Khan Goth in the Nooriabad area of District Jamshoro, has been brought to the casualty ward of the JPMC with full-blown rabies," Dr Seemin Jamali, the hospital's executive director, told The News.

"According to his family members, the teenager was bitten by a stray dog on the leg around 3 months ago. Unfortunately, neither did the family know about vaccination nor did anybody tell them to get the teenager vaccinated, which resulted in the development of the lethal disease."

Sindh Health Department officials said that this is the 22nd case of rabies in the province this year [2019].

M.K., the ill-fated youngster's father, said that after his son was bitten on the leg, he was taken to a local doctor, who had dressed the wound and given him some medicines but had not asked for the teenager to be vaccinated or referred him to a tertiary-care hospital.

Officials said that right now, dog-bite incidents are on the rise in Karachi as well as in other districts of Sindh, with so far more than 200 000 people falling victim to canine attacks.

They added that the population of rabid dogs is also on the rise, and the animals are not only transmitting the disease to their own species but also attacking humans throughout the province.

Dr Seemin said: "These days any person who is bitten by a dog should be given immunoglobulin as well as the full course of the rabies vaccine to prevent the victim from a painful death. Once rabies is developed in a person, there is no cure for their condition."

She deplored the fact that on the one hand incidents of dog-bite are on the rise and on the other, hospitals in the entire province are facing a shortage of the rabies vaccine, due to which the cases are being referred to the JPMC in Karachi.

"Even the Abbasi Shaheed Hospital, which is considered to be a tertiary-care hospital, is referring dog-bite victims to the JPMC after administering one dose of the vaccine," she said.

"As we don't know the status of their vaccination, we have to vaccinate these patients from zero, but this practice is extremely unprofessional, and it can result in the loss of a precious life."

On the other hand, the shortage of rabies vaccine is becoming a serious issue in Pakistan, especially in Sindh, which requires hundreds of thousands of doses to prevent the people from developing rabies encephalitis.

Pakistan used to get most of its rabies vaccine supplies from Indian biotechnology giants and pharmaceutical companies, but after the deterioration of relations between the 2 countries, Pakistan's next-door neighbour reduced those supplies, while production at the NIH is insufficient to meet the local requirements.

In this scenario, experts say there is an urgent need to control the population of stray dogs in the country by hook or by crook. They believe that at a time when there is not enough rabies vaccine available, the authorities should take measures to save people from canine attacks by reducing the dog population by any means.  [Byline: M. Waqar Bhatti]
=====================
[We have received recently several reports from Pakistan, describing human rabies cases; e.g.
(published 7 Nov 2019),
(published 3 Nov 2019),
(published 15 Oct 2019].

Hopefully, this post will help the professionals involved in getting due attention and required means from the health and municipal authorities for immediate measures undertaken, including timely supply of the required medical preparations.

According to Pakistan's Health Minister, Dr Azra Fazal Pechuho, (on Fri 8 Nov 2019), dog-bite cases were "mishandled" by citizens, as the victims were often brought to hospitals quite late, and the delay caused their deaths (see <https://www.dawn.com/news/1515803>).

WHO's most recent available position paper addressing rabies vaccines and immunoglobulins is available at

[HealthMap/ProMED map available at: