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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, 15 Nov 2019 01:13:41 +0100 (MET)
By Sophie PONS

Dakhla, Western Sahara, Nov 15, 2019 (AFP) - In the heart of disputed Western Sahara, a former garrison town has become an unlikely tourist magnet after kitesurfers discovered the windswept desert coast was perfect for their sport.  In Dakhla, an Atlantic seaport town punctuated with military buildings in Morocco-administered Western Sahara, swarms of kitesurfers now sail in the lagoon daily.y    "Here there is nothing other than sun, wind and waves. We turned the adversity of the elements to our advantage: that's the very principle of kitesurfing," said Rachid Roussafi. 

After an international career in windsurfing and kitesurfing, Roussafi founded the first tourist camp at the lagoon at the start of the 2000s.    "At the time, a single flight a week landed in Dakhla," the 49-year-old Moroccan said.   Today, there are 25 a week, including direct flights to Europe.   "Dakhla has become a world destination for kitesurfing," said Mohamed Cherif, a regional politician.

Tourist numbers have jumped from 25,000 in 2010 to 100,000 today, he said, adding they hoped to reach 200,000 annual visitors.    The former Spanish garrison is booming today with the visitor influx adding to fishing and trade revenue.   Kitesurfing requires pricey gear -- including a board, harness and kite -- and the niche tourism spot attracts well-off visitors of all nationalities.    Peyo Camillade came from France "to extend the summer season", with a week's holiday costing about 1,500 euros ($1,660). 

Only the names of certain sites, like PK 25 (kilometre point 25), ruined forts in the dunes and the imposing and still in-use military buildings in Dakhla, remind tourists of the region's history of conflict.   In the 1970s, Morocco annexed Western Sahara, a former Spanish colony, and fought a war with the Algeria-backed Polisario Front from 1975 to 1991, when a ceasefire deal was agreed.   A United Nations mission was deployed to monitor the truce and prepare a referendum on Western Sahara's independence from Morocco, but it never materialized.   Without waiting for the political compromise that the UN has been negotiating for decades, hotels have sprouted from the sand along the coast, and rows of streetlights on vacant lots announce future subdivisions.

- 'Good communication' -
"The secret to success is to develop kitesurfing with good communication focused on the organisation of non-political events," said Driss Senoussi, head of the Dakhla Attitude hotel group.    Accordingly, the exploits of kitesurfing champions like Brazilian Mikaili Sol and the Cape Verdian Airton Cozzolino were widely shared online during the World Kiteboarding Championships in Dakhla last month.   The competition seemed to hold little interest for Dakhla's inhabitants however.

Only a few young people with nothing to do and strolling families found themselves on the beach for the finals.   Just as rare are the foreign tourists who venture into the town of 100,000 residents to shop.   Like her friends, Alexandra Paterek prefers to stay at her hotel, some 30 kilometres (19 miles) from downtown.    "Here is the best place in the world for learning kitesurfing," said the 31-year-old Polish stewardess.    On her understanding of the broader regional context, she said: "It's an old Spanish colony and they have good seafood, for sure."

Like many tourists, she was under the impression that the area belonged to Morocco, as the destination tends to be marketed in the travel industry as "Dakhla, Morocco".   That angers the Polisario, which wants independence for the disputed region and tried last year in vain to sue businesses it said were "accomplices to the occupying military power."   The independence movement is now focused on challenging commercial deals between Morocco and the European Union that involve Western Sahara, according to the group's French lawyer Gilles Devers.   Moroccan authorities are looking actively for investors for their development projects on the west coast, the most ambitious being the Dakhla Atlantique megaport with a budget of about $1 billion to promote fishing.

- Environmental concerns -
On the lagoon, surrounded by white sand and with its holiday bungalows, "there is a struggle between developing aquaculture and tourism," said a senior regional representative, who spoke on condition of anonymity.    "One has less impact on the environment, but the other generates more revenue and jobs," said the representative, adding that "pressure from real-estate investors is very high."

With the influx of tourists, the protection of the environment has become a major concern.   "Everything is developing so quickly... we need to recycle plastic waste and resolve the issue of wastewater," said Rachid Roussafi.    Daniel Bellocq, a retired French doctor, worries for the future of this lagoon, that was "once so wild" that he has kitesurfed in for 20 years.   "There is green algae that wasn't there before, it's becoming a septic tank," he said.   Regional councillor Cherif, though, insists the bay is clean, saying: "All the hotels are equipped with wastewater management systems."   For him, the real threat is from plastic waste, whether it is dropped by tourists or brought by sea currents.
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.
More ...

United States of America

FCO - UK information on the United States
Updated: 25 July 2002

SUMMARY
Most visits to the United States are trouble-free. However, visitors should continue to be vigilant about their personal security.

SAFETY AND SECURITY<
R />Travellers to the United States should use common sense and take basic precautions.

If staying in a hotel, do not leave your door open at any time.

Do not wear ostentatious jewellery and avoid walking in obviously run down areas.
If arriving at night, take a taxi to your hotel and collect your hire car the next day.
If departing on an evening flight avoid leaving luggage and souvenirs in view in your hire car during the day. Thieves are targeting these vehicles and stealing the contents.
Drive on main highways and use well-lit car parks.

Do not stop if your car is bumped from behind. Instead, indicate to the other driver to follow you to the nearest public area and call for police assistance.
Do not sleep in your car on the roadside or in rest areas.
LOCAL LAWS AND CUSTOMS
Travellers wishing to visit Canada during their stay should contact the Canadian Consulate and US Immigration and Naturalisation Service for entry clearance requirements. If travellers have 90 day visa waiver for US, they should not wait until the end of their stay to travel between US and Canada. Travellers must not overstay past expiration date of their visa as they may risk being denied entry in either country or be deported. Travellers need to carry passports, round trip airline tickets showing their confirmed departure for return from US or Canada to country of origin, and they may need to show proof of sufficient funds to cover their stay.

Travellers should be aware that the age of consent varies from state to state in the US, as does the age at which someone may legally buy and consume alcohol.
ENTRY REQUIREMENTS
Foot and Mouth Disease:
Travellers are prohibited from carrying into the US any agricultural products, particularly animal products – including dairy products – that could spread FMD. (Some hard cheeses and canned meats are permitted. If you are in any doubt, you must check with a US customs or US Department of Agriculture (USDA) official immediately on arrival in the airport terminal). Passengers are required to tick the appropriate box on the US Customs declaration form if they have recently visited a zoo, or been on a farm or in contact with livestock. Passengers are specifically required to identify any farm contacts to US Customs and USDA officials. All luggage is subject to inspection. Penalties for not declaring farm visits or prohibited items can run to $1,000.

All US ports of entry and airports are on heightened alert to ensure that passengers, luggage and cargo are checked as appropriate. This includes placing additional inspectors and dog teams at airports to check incoming flights and passengers.

USDA are saying that soiled shoes, clothing or luggage will be disinfected on arrival. Food products and any other items suspected of potentially carrying the FMD virus will be confiscated and destroyed.
HEALTH
Medical treatment can be very expensive; there are no special arrangements for British visitors. The British Embassy and Consulates-General cannot assist with medical expenses.

Travellers who are HIV-positive
Travellers to the United States who are HIV-positive are not eligible, under current United States visa law, to travel visa free under the Visa Waiver Programme. They are required to apply for a visa and a waiver of the ineligibility before travelling. US immigration authorities state applicants’ details will remain confidential and an applicant’s HIV status will not/not be declared on their passport. For more details contact the US Embassy in London.
GENERAL
Comprehensive travel and medical insurance is essential.
NATURAL DISASTERS
Visitors to the United States will be aware of reports of large-scale wild and forest fires throughout the country. Those travelling to affected areas should be particularly vigilant and pay attention to advice from local authorities and press and radio announcements about personal safety and how to avoid starting fires. Further information can be obtained from the National Interagency Fire Centre, 3833 S. Development Avenue, Boise, Idaho, 83705-5354; tel: +1 208 387 5512; Website: www.nifc.gov

Travel News Headlines WORLD NEWS

Date: Fri 15 Nov 2019
Source: Food Safety News [edited]

Authorities are investigating an ongoing outbreak of scombrotoxin fish poisoning traced to yellowfin tuna. They have blocked all incoming shipments of the fish from a Vietnamese company that has refused to initiate a recall. Public health officials have confirmed at least 47 people from unspecified states as outbreak patients. The most recent illness began 15 Oct 2019, according to an outbreak investigation notice posted today by the U.S. Food and Drug Administration. The 1st known patient became ill on 8 Aug 2019.

Scombrotoxin fish poisoning occurs when fish begins to spoil and histamine levels in it increase. Histamine cannot be destroyed by freezing or cooking. The FDA reported that all yellowfin tuna from Truong Phu Xanh Co. Ltd. of Vietnam with 2019 production dates is implicated and should be thrown away.

Stores, restaurants, and other foodservice operators are expected to pull the tuna, but the FDA wants consumers to shoulder some responsibility, too. The agency's notice tells consumers to ask whether yellowfin tuna -- also called ahi tuna -- being sold is from the specific company named by the FDA.

FDA officials have not used the agency's power to force the Vietnamese company to recall the tuna, even though the firm has been determined to have supplied the fish. "FDA asked for the supplier of yellowfin tuna associated with most of the illnesses, Truong Phu Xanh Co. Ltd. of Vietnam, to initiate a voluntary recall of all of its imported yellowfin tuna with production dates from January 2019 to the present. At this time, the firm has not recalled any product," the FDA reported today [15 Nov 2019]. "Because scombrotoxin fish poisoning causes temporary or medically reversible adverse health consequences, this incident did not meet the threshold for the use of FDA's mandatory recall authority."

Although the Vietnamese supplier has not issued a recall, some companies in the United States have posted recalls for the implicated tuna, the FDA reported. The agency, working with officials in unnamed states, gathered information from victims and entities in the supply chain that led to those 3rd-party recalls.

The FDA notice says some of the tuna could still be on the market. "Tuna from this supplier could have been sold thawed or frozen, and could have been sold as ground tuna meat, poke cubes, steaks, or loins; this product could still be within its shelf life," the notice states. Because of the outbreak investigation and findings to date, the FDA placed Truong Phu Xanh Co. Ltd. of Vietnam on "Import Alert," which means the firm's yellowfin tuna can be detained at U.S. borders and ports of entry without physical examination.

A concurrent investigation of cases of scombroid fish poisoning by the Seattle-King County Public Health Department is not related to the FDA's investigation of Truong Phu Xanh Co. Ltd., according to federal officials.

Standard tests used during enforcement activities and other kinds of foodborne illness investigations are not effective for situations of suspected scombrotoxin fish poisoning, according to the FDA's outbreak notice. The samples collected thus far by federal and state investigators cannot be linked to samples from patients by whole-genome sequencing (WGS) or pulsed-field gel electrophoresis (PFGE) analysis. Pathogens such as specific strains of _Salmonella_ or _E. coli_ are generally pinpointed with WGS or PFGE processes, but the spoilage factor in the scombroid scenario makes that impossible.

"Scombrotoxin fish poisoning occurs when fish begin to spoil, resulting in increased histamine levels," FDA's notice says. "Multiple samples have been collected and analyzed, with positive results for decomposition or high histamine levels in products imported from Truong Phu Xanh Co. Ltd."

Symptoms of scombroid poisoning can become evident within minutes to 2 hours following consumption of contaminated fish, according to the FDA. Initial signs can mimic an allergic response and include facial flushing, sweating, burning-peppery taste sensations about the mouth and throat, dizziness, nausea, and headache. Symptoms can intensify to facial rash, hives, swelling, diarrhea, and abdominal cramps. Severe reactions to the poison can include blurred vision, respiratory stress, and swelling of the tongue.  [Byline: Coral Beach]
Date: Thu 14 Nov 2019
From: Larry Lutwick <lutwick.larry@mayo.edu> [edited]

Over the past 5 days, our health care facility in northwest Wisconsin, USA, has seen 3 women hospitalized with _E coli_ O157 infection. All presented with significant abdominal pain without fever and watery diarrhoea which in 2 progressed to bloody diarrhoea. None of the 3 have manifested any evidence of haemolytic-uremic syndrome. Both of the women seen by the Infectious Diseases service stated that their diet contains a lot of salads.

We would appreciate any reports of upswings in the number of cases of this process in the upper Midwest USA or elsewhere.
--------------------------------------------
Larry Lutwick MD
Eau Claire, Wisconsin
=========================
[Although the classical source of enterohemorrhagic _E. coli_ infections is ground beef, fresh produce as in salad ingredients are also well represented as vehicles of transmission. ProMED would appreciate any further reports as the country health departments work on this as yet small outbreak. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Wisconsin, United States: <http://healthmap.org/promed/p/250>]
Date: Mon 4 Nov 2019
Source: WGME [edited]

Bath [Maine] police say they had another rabid fox attack Sunday [3 Nov 2019]. Police say around 11:45 am, they received a report in the area of 305 Washington Street that a fox had bit a 52-year-old man.

The man had been in his yard doing yardwork when he was attacked. He suffered bites and scratches on his legs.

Officers say they located the fox and killed it. The fox was confirmed to be rabid at the DHHS Health and Environmental Testing Lab in Augusta [Maine]. According to the lab, Bath has had 13 positive test results for rabies this year [2019].
======================
[In the USA, there exist several wildlife variants of _Lyssavirus_ that circulate in bats, raccoons, skunks, foxes and coyotes. Transmission rarely occurs between species, and these "spillover events" generally are not perpetuated in the recipient species.

While bats with rabies are found throughout the USA, main terrestrial reservoirs differ depending on the geographical location. Foxes are common carriers of rabies in New Mexico, Nevada and Alaska but not in Maine (see map here: <https://www.cdc.gov/rabies/exposure/animals/wildlife_reservoirs.html>). The main host for rabies in Maine is raccoons.

It is very important to make sure to keep the vaccination schemes of all domestic carnivores (i.e., dogs, cats, ferrets) in the area up to date and not to approach wildlife with unusual behavior. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map:
Bath, Maine, United States: <http://healthmap.org/promed/p/26463>]
Date: Sun 3 Nov 2019
Source: The Citizen's Voice [edited]

A rare mosquito-transmitted virus that can be fatal to humans was recently confirmed in a deer found in Luzerne County. On [9 Oct 2019], the Pennsylvania Game Commission received a report of an emaciated deer standing on Swamp Road in Hunlock Township.

According to the agency, the deer -- a doe -- stood with its head down and didn't respond when humans approached. The animal was euthanized by Game Commission officials, and subsequent testing revealed it was infected with eastern equine encephalitis [EEE].

While there have been no reported cases of EEE in humans in the state, there have been several confirmations of the virus appearing in wildlife and livestock during October [2019].

In addition to the deer in Hunlock Twp, EEE has also been found in captive pheasants in Monroe County, horses in Carbon County, and 2 wild turkeys in Erie County.

Kevin Wenner, a biologist with the Game Commission in the Northeast Region Office, said the deer in Hunlock Twp represents the 1st instance of EEE in wildlife in the area, but it's difficult to predict if more cases will follow.

"We're not experiencing any significant mortality with deer and this happens to be one individual that was tested," he said. "It's possible that we're not aware of every case because a sick animal could die and never be found, but we're not getting an increase in calls regarding sick deer."

Equine encephalitis is transmitted to people, mammals, and birds through the bites of mosquitoes that have fed on infected birds. Most birds with EEE do not show any symptoms and never become ill. However, EEE can cause illness and death in some bird species -- most often pigeons, pheasants, turkeys and quail.

According to the Centers for Disease Control, symptoms of EEE in people develop 4 to 10 days after being bitten by an infected mosquito.

There are 2 types of illness that occur -- systemic and encephalitic. The former resembles flu-like symptoms and lasts up to 2 weeks. In the case of encephalitic illness (swelling of the brain), approximately a 3rd of all people afflicted die from the disease, according to the CDC. An average of 7 human cases of EEE are reported annually in the United States.

While the occurrence of EEE is not widespread in the region or state, Wenner said the threat will go away once cold weather arrives and knocks out the mosquito population.

"It sounds like this is a disease that comes and goes. It's not new, but we'll go through stretches where there are no cases for years and then it shows up," he said.

But right now, EEE is here, and since the disease has infected a deer in the wild, what does it mean for hunters? With archery deer season remaining open until [16 Nov 2019] and the statewide firearms season set to begin on [30 Nov 2019], are hunters at risk simply contacting a deer that harvest?

"There shouldn't be a fear that every deer out there has this and they shouldn't be consumed," Wenner said. "It's pretty uncommon in deer, and while people shouldn't be scared, they should be aware and take simple precautions to help prevent exposure."

Additionally, EEE can only be transmitted via a bite from an infected mosquito and not by direct contact, such as field dressing a deer. There is also no evidence that transmission can occur from consuming the meat of an infected animal, according to the Game Commission.

And even though birds are the primary host for the virus, Wenner said it doesn't mean that people should refrain from feeding birds. "Just take the necessary precautions to avoid being bitten by mosquitoes, such as using repellent and getting rid of any standing water around your home," he said.

Equine encephalitis is one of several diseases in Pennsylvania that can impact deer. Chronic wasting disease turned up in 2012 and has spread through parts of the south-central and south-western areas of the state, and epizootic hemorrhagic disease -- which is transmitted by biting flies -- has turned up in Pennsylvania in localized areas since 2002.

"It makes you think," said Game Warden Gerald Kapral, whose district includes Hunlock Twp. "Everyone sees a sick deer and they assume its chronic wasting disease, but this EEE case is an example that there's more out there."  [Byline: Tom Venesly]
===================
[Eastern equine encephalitis (EEE) virus (Togaviridae, _Alphavirus_) is maintained in an enzootic transmission cycle involving ornithophagic mosquitoes, specifically _Culiseta melanura_ (Diptera: Culicidae), and passerine birds in freshwater swamp foci. The virus is focally endemic in eastern North America, the Caribbean, and Central and South America.

Because there are very few reports of disease due to EEEV in deer, coupled with a relatively high antibody prevalence at endemic sites, we believe that deer are commonly infected with this virus but are relatively refractory to clinical disease. EEE, therefore, may not be an important disease in white-tailed deer in the eastern United States. - ProMED Mod.PMB]

[HealthMap/ProMED-mail map of Pennsylvania, United States:
Pennsylvania county map:
Date: Sun 3 Nov 2019
Source: The North Platte Telegraph [edited]

The Southwest Nebraska Public Health Department has confirmed a case of [a] hantavirus [infection] in the 9-county [Chase, Dundy, Frontier, Furnas, Hayes, Hitchcock, Keith, Perkins, and Red Willow] health district. This is the 1st reported case of hantavirus in the southwest Nebraska area in over 6 years.

According to the Centers for Disease Control and Prevention, hantavirus infection is usually found in rural areas where forest, fields, and farms offer suitable habitat for rodents. Hantavirus in the US is spread to people from rodents like mice, most commonly when fresh rodent urine, droppings, or nesting materials are stirred up. Tiny droplets containing the virus get into the air and are then breathed in.

"This can easily happen when cleaning out grain bins, barns or old abandoned buildings," said Melissa Propp, RN.

Symptoms of hantavirus usually start out with vague flu-like symptoms approximately several days to 6 weeks after exposure. A fever for 3-5 days, headache, muscle aches, chills, non-productive cough, nausea, vomiting or other gastrointestinal symptoms like diarrhea or abdominal pain are common. Tiredness and lightheadedness may also be present. Most people recover fully but some cases of hantavirus may be severe or even fatal. "If you have flu-like symptoms and have cleaned out a building with evidence of rodents, alert your provider," states Propp.  It is important not to stir up dust by sweeping or vacuuming.
Hantavirus [infections] can be prevented by following these tips:
- air out the building for a least 30 minutes prior to starting your cleaning. Open doors and windows to allow good air flow and leave the area while airing out;
- wear gloves while cleaning up urine and droppings. A dust mask may also be worn as additional protection;
- dampen the urine, droppings, and nesting materials with a mixture of 1-part bleach to 10 parts water or use a disinfectant. Allow to soak for 5 minutes prior to removal;
- clean counters, cupboards and other surfaces with disposable towels;
- mop floors rather than sweeping or vacuuming;
- for dirt floors wet the area down with bleach solution or disinfectant before removal of debris to keep down the dust;
- disinfect any tools used in the cleaning process with a bleach solution.
- wash hands thoroughly with soap and water after cleaning tools and disposing of materials.

For more information about hantavirus visit
====================
[This is not the 1st case of a hantavirus infection in Nebraska. In May 2005, a western Nebraska man in his early 50s died after being infected with hantavirus. A 37-year-old rural Grant man became the state's 4th person to test positive for the potentially deadly hantavirus on 31 Aug 2002. A 30-year-old male of Lyman became the 1st person in 2002 to die from the disease in Nebraska on 13 Jun 2002. Other Nebraska cases include those of a 41-year-old male, of Champion, who was hospitalized in Kearney from 24 Jun 2002 to 14 Jul 2002 and another male, age not specified, of Benkleman, was diagnosed with the 1st known case of hantavirus in Nebraska in 1998. Both recovered. As of January 2017, Nebraska has reported 9 cases of hantavirus infection (<https://www.cdc.gov/hantavirus/surveillance/reporting-state.html>)

Although not mentioned, the hantavirus involved in these and the above case is likely Sin Nombre virus and its rodent host is the deer mouse (_Peromyscus manipulates_). Nebraska is within the geographic range of this rodent. Individuals in Nebraska and elsewhere within the range of this rodent are well advised to follow the recommendations listed above to avoid exposure to this virus.

An image of a deer mouse (_Peromyscus maniculatus_) can be accessed at

[HealthMap/ProMED-mail map of Nebraska, United States:
Nebraska county map:
More ...

Equatorial Guinea

Equatorial Guinea US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Equatorial Guinea is an oil-rich, developing country on the western coast of central Africa.
Its capital and main port, Malabo, is located on the isla
d of Bioko, off the coast of Cameroon.
A secondary port, Luba, is also on Bioko.
The mainland territory of Equatorial Guinea is bordered by Cameroon and Gabon.
The principal city on the mainland is Bata.
Facilities for tourism are limited but growing.
Official languages are Spanish, which is widely spoken, and French, which is not widely understood, but sometimes used in business dealings.
Read the Department of State Background Notes on Equatorial Guinea for additional information.

ENTRY/EXIT REQUIREMENTS:
A passport and evidence of a yellow fever vaccination are required to enter Equatorial Guinea.
Visas are not required for U.S. citizens unless the traveler will be there for an extended stay or is intending to work there.
U.S. citizens entering without a visa but staying longer than 90 days should register with the local police station.

Private vessels landing in an Equato-Guinean port must get clearance prior to approaching the shore.
Travelers should obtain the latest information and details from the Embassy of the Republic of Equatorial Guinea, 2020 16th Street NW, Washington, DC
20009, telephone (202) 518-5700, fax (202) 518-5252.

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:
Although large public demonstrations are uncommon, U.S. citizens should avoid large crowds, political rallies, and street demonstrations.

In February 2009, approximately 50 gunmen arriving by speedboats attacked government buildings in Malabo but were repelled by Equato Guinean military and police.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, 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:
Violent crime is rare and the overall level of criminal activity is low in comparison to other countries in the region.
However, there has been a rise in non-violent street crime and residential burglaries.
Travelers should exercise prudence and normal caution, including avoiding dark alleys, remote locations, and traveling alone.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the U.S. Embassy in Malabo at (240) 098895; Embassy personnel will assist in contacting the local police.
If you are the victim of a crime while in Equatorial Guinea, please remember to report the incident to local police, and contact the U.S. Embassy in Malabo for assistance.
The Embassy staff can, for example, assist you in finding 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, the consular officer can help you understand the local criminal justice process and to find an attorney if needed.

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 Equato-Guinean laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Equatorial Guinea 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:
It is not uncommon for a uniformed member of the security forces to stop motorists on the pretext of minor or nonexistent violations of the local motor vehicle regulations in order to extort small bribes.
Visitors are advised not to pay bribes, and to request that the officer provide a citation to be paid at the local court.
If visitors encounter any of these problems they should contact the Embassy Consular Officer at 516008 and inform him/her of the situation.

Equatorial Guinea has a strictly cash economy.
Credit cards and checks are not accepted; credit card cash advances are not available and there are no ATMs.
In addition, most local businesses do not accept travelers' checks, dollars or euros.
However, dollars can be changed at local banks for CFA.
Cash in CFA is usually the only form of payment accepted throughout the country.

Special permits from the Ministry of Information and Tourism (or from the local delegation if outside Malabo) are required for virtually all types of photography.
Police or security officials may charge a fine, attempt to take a violator into custody, or seize the camera and film of persons photographing the Presidential Palace and its environs, military installations, airports, harbors, government buildings, and other areas.

Travelers are advised that the possession of camouflage-patterned clothing, large knives, binoculars, firearms, or a variety of other items may be deemed suspicious by the security forces and grounds for confiscation of the item and detention of the carrier.
Please see our Customs Information sheet.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities are extremely limited. Pharmacies in Malabo and Bata stock basic medicines including antibiotics, but cannot be counted on to supply advanced medications. Outside of these cities, many medicines are unavailable. Travelers are advised to carry any special medication that they require. The sanitation levels in even the best hospitals are very low though the new Israeli-built and staffed La Paz Hospital in Bata approaches European standards of sanitation and is reported by Red Cross officials to be the best in the region. Doctors and hospitals often require immediate payment for health services, and patients are often expected to supply their own bandages, linen and toiletries.
The Malabo hospital is likewise undergoing a complete update, with expected completion in late 2009.

Malaria is a serious and sometimes fatal disease. The national government, along with U.S. oil companies in the country, has taken aggressive steps to control the mosquito population and limit the impact of malaria on the population centers in Malabo and Bata.
Plasmodium falciparum malaria, the type that predominates in Equatorial Guinea, is resistant to the anti-malarial drug chloroquine. Because travelers to the country are at high risk for contracting malaria, the Centers for Disease Control and Prevention (CDC) advises that travelers should take one of the following anti-malarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what anti-malarials they have been taking.
Visit the CDC travelers’ health page for additional information on malaria, including protective measures.

There are periodic outbreaks of cholera in Equatorial Guinea. Yellow fever can cause serious medical problems, but the vaccine, required for entry, is very effective in preventing the disease.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Equatorial Guinea.

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.
Hospitals, clinics, and other businesses and hotels do not accept credit cards.
If there are any concerns that travelers may need medical care or assistance while in Equatorial Guinea, they should make arrangements to have access to enough cash to cover possible expenses.
There are companies such as Western Union where international money orders can be arranged and cash obtained.
There are no ATM machines in the country (See SPECIAL CIRCUMSTANCES Section above).
You can see more 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 Equatorial Guinea is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Generally, Equatorial Guinea's road networks are underdeveloped.
There are few road and traffic signs, though more signs are becoming evident.
Livestock and pedestrians create constant road hazards.
During the rainy season, many roads are passable only with four-wheel-drive vehicles.
However, new road construction and repair is taking place all over the country and road conditions have improved markedly over the course of the past year.
If you plan on staying and driving around the country for any length of time you should attempt to purchase a cell phone for assistance in case of an emergency.

Travelers outside the limits of Malabo and Bata may expect to encounter occasional military roadblocks.
Travelers should be prepared to show proper identification (for example, a U.S. passport) and to explain their reason for being at that particular location.
The personnel staffing these checkpoints normally do not speak or understand English or French; travelers who do not speak Spanish would do well to have their reason for being in the country and their itinerary written down in Spanish before venturing into the countryside.

Please refer to our Road Safety page for more information.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Equatorial Guinea, the U.S. Federal Aviation Administration (FAA) has not assessed Equatorial Guinea’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.

Commercial air travel to and from Equatorial Guinea can be difficult.
Malabo is served by European airlines a few times per week.
The island of Bioko and the African mainland are connected by several small local airlines offering daily service.
Schedules are subject to change or cancellation without notice; flights are often overbooked and reservations may not guarantee seats.

Malabo Airport has navigational aids and can accommodate night landings.
There are no navigational aids at Bata Airport.
Special clearances are required to land in or overfly Equatorial Guinea territory.

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 Equatorial Guinea are encouraged to register with the U.S. Embassy in Malabo through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Equatorial Guinea.
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 in Malabo to contact them in case of emergency.

The United States reopened its Embassy in Malabo in October 2003.
However, due to reduced staffing, it can offer only limited services to U.S. citizens in distress.
The U.S. Embassy in Malabo can be contacted at (240) 098-895.
Additional services are provided through the U.S. Embassy in Yaoundé, Cameroon, located on Avenue Rosa Parks in the Mbankolo Quartier, adjacent to the Mount Febe Golf Club; mailing address P.O. Box 817; embassy tel. (237) 2220-1500, fax: (237) 2220-1572.
The Embassy Branch Office in Douala, Cameroon, is located on Rue Flatters, in the Citibank Building, tel.: (237) 3342-53-31, fax: (237) 3342-77-90.
* * *
This replaces the Country Specific Information for Equatorial Guinea, dated November 15, 2007, to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Special Circumstances, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Sun, 26 May 2019 06:31:33 +0200
By Camille MALPLAT

Sipopo, Equatorial Guinea, May 26, 2019 (AFP) - Gleaming but eerily empty, the luxurious Sipopo resort with its five-star hotel and exclusive facilities rises from a tropical beach, symbolising the dilemma of Equatorial Guinea -- a notoriously closed country that has turned to tourism to help fill its coffers.  The purpose-built town was carved out of an ancient forest in 2011 at a cost of 600 million euros ($670 million), initially to host a week-long African Union summit and showcase the rise of the tiny oil-rich state.   A 16-kilometre (10-mile) drive from Equatorial Guinea's capital Malabo, the resort boasts a vast conference centre, the Sofitel Malabo Sipopo Le Golf hotel, as well as 52 luxury villas -- one for every head of state to attend the summit -- each with its own swimming pool.    There is also an 18-hole golf course, several restaurants and exclusive beaches guarded by police.

For almost a decade, Sipopo has been the crown jewel in a strategy to lure high-end visitors to Equatorial Guinea to diversify an economy badly hit by a slump in oil revenue.   But the town, visited by an AFP reporter two months ago, seemed quite empty -- an impression strengthened by conversations with people who live or who work there.   "It's depressing, there's no-one," said a visiting Gabonese consultant.   A worker, who asked not to be named, said the complex was quiet year-round: "You can hear the sound of your own footsteps."   The occasional visitors tend to be well connected, rich and in search of privacy, the sources said.    Many are guests of a government described by Human Rights Watch as corrupt and repressive.    One of the villas, according to the sources, was occupied by former Gambian dictator Yahya Jammeh after he fled his country in 2017.

- Empty lobby -
At Easter, the 200-room hotel's guests included a Spanish couple on honeymoon, a few families and some businessmen, who were all foreigners.   In the echoing lobby, a huge black and white portrait of the country's 76-year-old authoritarian president, Teodoro Obiang Nguema -- Africa's longest-serving ruler -- hung on the wall, watching over the vacant reception area.   A 1.5-kilometre (nearly mile-long) beach -- an artificial shore secluded from curious eyes -- was virtually deserted, in contrast to a public beach near the capital. The three-lane highway leading from Malabo to Sipopo was mostly empty of traffic.   A hospital was added after the villas were built, but is unused, the sources said.   In 2014, a mall was built at the resort to house 50 shops, a bowling alley, two cinemas and a children's play area.   But a hotel receptionist said the complex was not open yet, adding: "If you want to buy a souvenir, you will have to go to Malabo." At night-time, shiny limousines arrived at a luxury restaurant to drop off diners.

- Tourism hopes -
Located on the mid-Atlantic coast of central Africa, Equatorial Guinea has flooded social media with messages of its allure as a holiday destination.   Plans to build a new passenger terminal at the airport in Bata city have also just received a 120-million-euro ($133-million) injection from the Development Bank of Central African States.   Figures for visitors are unavailable, and the tourism ministry in Malabo did not respond to AFP's requests for information. In the latest global compilation of figures posted by the World Bank, the number of tourists for Equatorial Guinea has been left blank.   But much of the tourism in evidence are business people, such as oil company workers, relaxing for a few days, or attending energy or economic conferences. 

A few travel firms offer trips tailor-made for both luxury and adventure, but they also allude to the difficulties, notably of being allowed to enter the country.   "The country has been a mystery to outsiders, who were discouraged from entering by a difficult visa process and a lack of tourism infrastructure," says the website of British tour operator Undiscovered Destinations.   The firm claimed, however, that "things are changing fast... with an excellent road network and numerous hotels springing up seemingly overnight."   Few Equatoguineans have the chance of staying in such places. At Sipopo's hotel, a basic room costs the equivalent of more than 200 euros ($224) a night, while exclusive accommodation tops 850 euros.   The discovery of vast oil reserves off the coast in the mid-1990s has boosted the country's gross national income to a theoretical annual $19,500 per person per year, according to the UN Development Programme.   But that wealth benefits a small elite among the country's 1.2 million inhabitants. More than two-thirds of Equatoguineans live below the poverty line, and 55 percent of the population aged over 15 are unemployed.
Date: Wed 14 Jan 2015
Source: Eye Witness News [edited]

The Africa Cup of Nations (Afcon) finally gets underway on Sat [17 Jan 2015] after a controversial build-up to the 30th edition, which included a hasty late switch of hosts to Equatorial Guinea in the wake of concerns over the Ebola virus.

16 nations again line up for the biennial continental championship, seeking Africa's top sporting prize at the tournament, which starts on Sat [17 Jan 2015] and finishes on 8 Feb [2015].

Few previous editions have had such a dramatic backdrop, with the hosting of the 2015 finals being switched 2 months ago after Morocco asked for a postponement in the wake of the spread of the Ebola virus in West Africa. That request precipitated a crisis that left the tournament having to be organised almost from scratch in a few weeks.

Fears that travelling fans could spread Ebola and damage Morocco's tourist industry were seen as alarmist by the Confederation of African Football (CAF), who rejected the request and then stripped Morocco of their hosting rights.

>From a country with plentiful resources, who have previously bid to host the World Cup, Afcon is now being played in one of Africa's smallest and most enigmatic countries.

Equatorial Guinea is a family-ruled former Spanish colony which has newfound oil wealth and is reveling in rescuing the continent's most eagerly anticipated sporting event. ... - more
Date: Thu 17 Apr 2014
Source: WHO Global Alert and Response [edited]

Update on polio in central Africa -- polio confirmed in Equatorial Guinea, linked to outbreak in Cameroon
--------------------------------------------------------------------------------
In Equatorial Guinea, 3 new wild poliovirus type 1 (WPV1) cases have been reported, the 1st polio in the country since 1999. Genetic sequencing indicates these cases are linked to an on-going WPV1 outbreak in Cameroon which has subsequently been detected in Equatorial Guinea. The cases had onset of paralysis on [28 Jan 2014], [19 Jan 2014] and [24 Mar 2014], from Centro Sur, Bioko Norte and Litoral. Outbreak response in Equatorial Guinea is currently being planned, including National Immunization Days (NIDs) with bivalent oral polio vaccine (OPV) on [21-24 Apr 2014]. An estimated 40 percent of children are fully immunized against polio in the country.

On [17 Mar 2014], the World Health Organization (WHO) had elevated the risk assessment of international spread of polio from Cameroon to 'very high' (http://www.who.int/csr/don/2014_03_17_polio/en/). The risk assessment was elevated due to: confirmation of 3 additional WPV1 cases (with onset of paralysis on [6, 25 and 31 Jan 2014]) from 3 new regions of Cameroon, confirming continued WPV transmission and geographic expansion of infected areas following detection of 4 cases in October 2013; gaps in surveillance; and, influx of vulnerable refugee populations from Central African Republic. The confirmation of new cases in Cameroon resulted in planning additional emergency outbreak response activities, including converting a subnational immunization campaign to a full nationwide activity on [11-13 Apr 2014], and implementing nationwide campaigns in May and June 2014. Critical to success will be to ensure substantial improvement in the quality of immunization campaigns that reach all children multiple times with OPV. Equally important will be efforts to rapidly improve the quality of surveillance so that the full extent of the outbreak can be determined and tracked.

Immunity levels and surveillance sensitivity are also being assessed in neighbouring countries, in particular in Gabon and the Republic of Congo. In Gabon, a nationwide immunization campaign is planned for [22-26 Apr 2014] (targeting all children aged less than 15 years), and in the Republic of Congo, a nationwide activity will be conducted on 1 May 2014.

It is important that all countries, in particular those with frequent travel and contacts with polio-affected countries and areas, strengthen surveillance for acute flaccid paralysis (AFP) cases in order to rapidly detect any new virus importations and to facilitate a rapid response. Countries, territories and areas should also maintain uniformly high routine immunization coverage at the district level to minimize the consequences of any new virus introduction.

WHO's International Travel and Health (http://www.who.int/ith/chapters/en/) recommends that all travellers to and from polio-affected areas be fully vaccinated against polio.
Date: Sat 23 June 2012
Source: Guinea Equatorial [in Spanish, trans. ProMed Mod.JG, edited]

After the last measles vaccination campaign that took place last April 2012, a new outbreak of the disease has been reported in some communities in Malabo district, and for this reason, the Ministry of Health initiated a new vaccination campaign [Malabo is the capital of Equatorial Guinea, located on the northern coast of Bioko Island. - ProMed Mod.CP].

Activities started last Thursday, with the cooperation of the National Vaccination Programme (PAV, according to its Spanish initials). The campaign will concentrate its activities in the most severely affected communities, such as Santa Maria III, Lampert and Sunco.

Some medical officers gathered in Madre Bisila Health Centre in order to organise local vaccination units and to deal with mothers who brought their children to the Health Centre in order to have them vaccinated. Vaccine will be dispensed throughout the next 10 days, and subsequently, the vaccination campaign will continue in the Continental region of Equatorial Guinea.

Local officials from the Ministry of Health are inviting the population, particularly mothers, to bring their children to local health centres or to bring their children to mobile vaccination units when these teams arrive to their communities.
=====================
[According to La Voz de Rusia (<http://spanish.ruvr.ru/2012_06_22/Guinea-epidemia-sarampion/>), the last major measles epidemic in the country occurred in November 2008, when more than a dozen children died in various hospitals in Equatorial Guinea. No fatalities have been reported in the current outbreak so far.

Equatorial Guinea, officially the Republic of Equatorial Guinea, is a country located in central Africa. It has 2 parts: a Continental Region (Rio Muni), including several small offshore islands including Corisco, Elobey Grande and Elobey Chico; and an insular region containing Annobon island and Bioko island (formerly Fernando Po), where the capital Malabo is situated. A map of Equatorial Guinea can be accessed at: <http://www.africa.upenn.edu/CIA_Maps/Equatorial_Guinea_19871.gif>. - ProMed Mod.CP]

[The ProMED HealthMap for Equatorial Guinea can be found at
<http://healthmap.org/r/1KlO>.]
Date: Wed 30 Dec 2009
From: Patricio Leite (translated and edited)

Three people are sick with malaria in the Madeira archipelago of Portugal. One is in intensive care for complications of the disease in the Central Hospital of Funchal; the other 2 remain hospitalized but stabilized.

These people from Madeira were working in Equatorial Guinea and returned for the Christmas holidays. There is a 4th, a Brazilian national who also may be infected and is undergoing diagnostic tests.

Although they are cases of imported malaria, it is noteworthy that the archipelago of Madeira has a sub-tropical humid climate, conducive to the development of emerging diseases which are usually more prevalent in the tropics.

For example, for about the last 3 years the presence of the vector _Aedes aegypti_ has been documented, and it is now endemic in Madeira, posing the threat of dengue in the short term. In the archipelago, including the island of Porto Santo, weather conditions have allowed the survival of _Anopheles_.

Studies indicate that the next 30 years will see the emergence of diseases in Madeira, such as dengue, yellow fever, and malaria.
-------------------------------------------
Patricio Leite, MD
Specialist in General & Family Medicine
Regional Health Administrator for Lisbon & the Tejo Valley, Ministry
of Health, Portugal
Ex-collaborator of Travel Medicine Consultation, Institute of Hygiene
& Tropical Medicine,
New University of Lisbon
Portugal
========================
[Portugal reported 41 imported malaria cases in 2008 (Source: <http://data.euro.who.int/cisid/>). The climate of Madeira in December with temperatures below 20 C do not support local transmission of _Plasmodium falciparum_. Malaria is endemic in Equatorial Guinea, and the risk of infection is high without proper prophylaxis.

The introduction of dengue fever is a possibility, as in most of southern Europe. The introduction of yellow fever is a risk because the vector is present; however, yellow fever is limited to tropical areas, and Madeira probably does not, at present, have a climate which supports sustained transmission of yellow fever. - ProMed Mod.EP]
More ...

Uganda

Uganda - US Consular Information Sheet
March 02, 2009
COUNTRY DESCRIPTION:
Uganda is a landlocked, developing country in central eastern Africa. Infrastructure is adequate in Kampala, the capital, but is limited in other areas.
Read t
e Department of State Background Notes on Uganda for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport valid for three months beyond the date of entry, visa and evidence of yellow fever vaccination are required.
Visas are available at Entebbe Airport upon arrival or may be obtained from the Embassy of the Republic of Uganda.
The current fee for a three month tourist visa obtained upon arrival at Entebbe Airport is $50.00.
Travelers should be aware that a visa does not determine how long a person may remain in Uganda.
The Ugandan immigration officer at the port of entry will determine the length of authorized stay, which is generally from one to three months as a tourist.
Extensions of duration of stay may be requested at Ugandan immigration headquarters on Jinja Road in Kampala.
Airline companies may also require travelers to have a visa before boarding.
Travelers should obtain the latest information and details from the Embassy of the Republic of Uganda at 5911 16th Street, NW, Washington, DC
20011; telephone (202) 726-7100.
The Ugandan Embassy may also be contacted by email.
Travelers may also contact the Ugandan Permanent Mission to the United Nations, telephone (212) 949-0110. Overseas, inquiries may be made at the nearest Ugandan 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:
U.S. citizens residing in or planning to visit Uganda should be aware of threats to their safety posed by insurgent groups operating in the Democratic Republic of the Congo and southern Sudan, and the potential of cross border attacks carried out by these armed groups.
In addition, U.S. citizens traveling to the area commonly known as Karamoja in northeastern Uganda should also be aware of ongoing conflict and armed banditry in this region.

Northern Uganda:
After years of conflict, relative stability has returned to northern Uganda with the departure of the Lord’s Resistance Army (LRA) insurgent group in 2006.
Recent LRA activity has been restricted to the remote region of Garamba National Park in the Democratic Republic of the Congo (DRC), where LRA insurgents have continued to attack and terrorize civilian populations.
LRA attacks have also occurred in the neighboring Central African Republic and southern Sudan.
The Governments of Uganda, the DRC, and southern Sudan initiated joint military operations against LRA bases in Garamba National Park on December 14, 2008, after LRA leader Joseph Kony refused to sign a peace agreement following two years of negotiations.
These military operations continue and in order to deter an LRA return to Uganda, the Uganda Peoples Defense Force (UPDF) maintains a significant presence in the northern districts.
Given the continued threat to regional security posed by the LRA, American citizens should exercise caution when traveling in those districts of northwestern Uganda that border the DRC and southern Sudan and which could potentially be subject to LRA incursions.
The Ugandan Government also continues to expand and improve the capacity of the civilian police force in northern Uganda by deploying additional personnel and concentrating resources to further recovery and re-development activities throughout the north.

American citizens traveling to northern Uganda are advised to ensure that they have made appropriate travel, lodging, and communication arrangements with their sponsoring organization before visiting the region.
Local officials in northern Uganda have expressed concern for the safety and security of foreigners visiting the area to assist with relief efforts, but without any specific arrangements with a sponsoring organization.
Foreign citizens who travel to the region without a sponsoring organization may not find secure lodging or safe transport, and may become more susceptible to crime.
They may also find that local officials are unable to provide assistance in the event of an emergency.
There is a general lack of infrastructure throughout northern Uganda, and services such as emergency medical care are nonexistent.
Given crime and other security concerns in northern Uganda, American citizens are advised to restrict travel to primary roads and during daylight hours only.

Cattle rustling, armed banditry, and attacks on vehicles are very common in the Karamoja region of northeastern Uganda, and the UPDF continues to implement a program to disarm Karamojong warriors.
Past incidents have included ambushes of UPDF troops, and attacks on vehicles, residences, and towns that resulted in multiple deaths.
Most of the violence occurred in the districts of Kaabong, Kotido, and Abim, although some violent incidents also occurred in Moroto and Nakapiripirit Districts.
American citizens are advised to avoid travel to the Karamoja region given the frequent insecurity.
Any travel to Karamoja (excluding charter flights to Kidepo National Park) by U.S. Embassy personnel must first be authorized by the Chief of Mission.

Southwestern Uganda:
American citizens traveling in southwestern Uganda should also exercise caution given the ongoing conflict in the districts of North and South Kivu in the DRC, and the close proximity of fighting to the Ugandan border.
During spikes in the conflict, refugee flows across the border number in the thousands and there is also a risk of incursions by armed combatants.
American citizens should review the Travel Warning for the Democratic Republic of the Congo for the most up-to-date information regarding the conflict in the DRC.

On August 8, 2007, a group of armed assailants entered Uganda from the DRC and raided Butogota, a town in Kanungu District, southwestern Uganda.
Three Ugandans were killed and many others assaulted during the raid.
Ugandan officials believe that the perpetrators of the attack were members of one of the various militia groups operating in the southeastern region of the DRC or possibly remnants of the "Interahamwe," a group that participated in the 1994 genocide in Rwanda and was also responsible for the 1999 attack on Bwindi Impenetrable National Park.
The 1999 Bwindi attack killed four Ugandans and eight foreign tourists.
The 2007 raid on Butogota is in an area transited by tourists traveling to Bwindi, a popular gorilla-trekking destination.
Within Bwindi Impenetrable National Park, armed security personnel accompany tourists on the daily gorilla hikes and the UPDF maintains a military presence.
At Ishasha Camp, another popular tourist destination located in the southern sector of Queen Elizabeth National Park, the UPDF also maintains a small military base near the park headquarters for security purposes.

Eastern Uganda:
In February 2008, an isolated incident occurred in Mount Elgon National Park in eastern Uganda that resulted in the death of a foreign tourist.
A Belgian tourist climbing Mt. Elgon in the company of park rangers was shot and killed.
The attack occurred while the group was camped for the night and assailants fired into the campsite.
The tourist was reportedly struck by gunfire when exiting her tent in the darkness.
Ugandan security and park officials suspected that the attack was perpetrated by smugglers engaged in cattle rustling or other illicit activities that are common in the border area.

Demonstrations:
Demonstrations take place in Kampala and other Ugandan cities from time to time in response to world events or local developments.
In most cases, these demonstrations occur with no warning and demonstrations intended to be peaceful can turn confrontational and possibly violent.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if they find themselves in the vicinity of any demonstration.
American citizens should stay current with media coverage of local events and be aware of their surroundings at all times.
Because many demonstrations are spontaneous events, the U.S. Embassy may not always be able to alert American citizens that a demonstration is taking place and to avoid a specific area.
If employed with an institution or other large organization, American citizens may find it helpful to request that local employees notify expatriates when they learn of a demonstration from local radio reports or other sources.
Recent protests have occurred over land disputes involving Kampala market areas, university closures and strikes, opposition political party demonstrations, and protests by taxi drivers over the enforcement of traffic regulations.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State's, 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:
Crimes such as pick pocketing, purse snatching, and thefts from hotels and parked vehicles or vehicles stalled in traffic jams are common.
The Embassy receives frequent reports of theft of items from locked vehicles, even when the stolen items were secured out of sight and the vehicle was parked in an area patrolled by uniformed security personnel.
Pick pocketing and the theft of purses and bags is also very common on public transportation.
Armed robberies of pedestrians also occur, sometimes during daylight hours and in public places.
Although infrequent, the Embassy also receives reports of armed carjackings and highway robbery.
In May 2007, two American citizens reported an attempted robbery when they were traveling near the town of Bugiri in eastern Uganda.
The Americans reported that a second vehicle with at least one armed assailant tried to stop their vehicle by forcing it off the road.
This incident occurred during daylight hours.
On June 27, 2007, two American citizens were robbed and held at gunpoint when the vehicle transporting them to Entebbe Airport was stopped by a group of armed men.
This incident occurred during the early morning hours on Entebbe Road.
Although some of these attacks are violent, victims are generally injured only if they resist.
U.S. Embassy employees are advised against using roads at night, especially in areas outside the limits of cities and large towns. Home burglaries also do occur and sometimes turn violent.
In April 2008, the Ugandan police reported an increase in armed robberies in the Kampala neighborhoods of Bukoto, Kisaasi, Kiwatule, Naalya, Najera, and Ntinda.
Several of these robberies occurred as the victims were arriving at their residences after nightfall and the assailants struck as they were entering their residential compounds.

Women traveling alone are particularly susceptible to crime.
In early 2008, there was an increase in reports of sexual assaults against expatriate females.
In some instances, the victims were walking alone, or were single passengers on one of the common modes of public transport which include "boda boda" motorcycle taxis.
If the victim of a sexual assault, medical assistance should be sought immediately and counseling provided regarding prophylactic treatment to help prevent the transmission of HIV and other sexually transmitted diseases. The U.S. Embassy provides a list of local medical providers for those with medical needs.

American citizens visiting Uganda are advised not to accept food or drink offered from a stranger, even a child, because such food may contain narcotics used to incapacitate a victim and facilitate a robbery or sexual assault.
In addition, patrons of bars, casinos, nightclubs, and other entertainment centers should never leave their drink or food unattended.
When visiting such establishments, it is advisable to remain with a group of friends as single individuals are more likely to be targeted.
Victims have included female patrons who reported they were drugged, and taken to another location and sexually assaulted.
Robberies have been facilitated on public transportation under similar circumstances.
In 2006, an American citizen traveling by bus from Kenya to Uganda was incapacitated and robbed on the bus when the passenger accepted a sealed beverage from a fellow traveler.
Expatriates traveling by bus to the popular tourist destination of Bwindi Impenetrable National Forest in southwest Uganda were also incapacitated and robbed when they accepted snacks from fellow bus passengers.

There has been a recent, marked increase in financial crime, including fraud involving wire transfers, credit cards, checks, and advance fee fraud perpetrated via email.
The U.S. Embassy recommends using money orders for all fund transfers and protecting all bank account and personally identifiable information such as social security numbers and other types of information.

An increasing number of U.S. exporters (primarily vendors of expensive consumer goods such as computers, stereo equipment, and electronics) have been targeted by a sophisticated check fraud scheme.
A fictitious company in Uganda locates a vendor on the Internet, makes e-mail contact to order goods, and pays with a third-party check.
The checks, written on U.S. accounts and made out to entities in Uganda for small amounts, are intercepted, chemically "washed" and presented for payment of the goods with the U.S. vendor as payee and an altered amount.
If the goods are shipped before the check clears, the U.S. shipper will have little recourse, as the goods are picked up at the airport and the company cannot be traced.
American companies receiving orders from Uganda are encouraged to check with the Political - Economic Section of the Embassy to verify the legitimacy of the company.
The Embassy strongly cautions U.S. vendors against accepting third-party checks as payment for any goods to be shipped to Uganda.

Additional information about the most common types of financial fraud can also be found in the State Department Financial Scams brochure.

INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.
The embassy/consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

The local equivalent to the "911" emergency line in Uganda is: 999.
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 Ugandan laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Uganda 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:
Please note that U.S. currency notes in $20 and $50 denominations are exchanged at a lower rate than $100 currency notes.
In addition, travelers often find that they cannot exchange or use U.S. currency printed earlier than the year 2000.
Travelers who find they cannot pay for accommodation or expenses often must request that friends or family wire money to them in Uganda.
There are offices that facilitate Western Union, MoneyGram, and other types of money transfers in Kampala and other cities throughout the country.
ATMs are available in Uganda, particularly in downtown Kampala, but usually only customers who have an account with a specific Ugandan bank may use them.
A few machines function with overseas accounts.

The U.S. Embassy frequently receives requests from American citizens to verify the bona fides of nongovernmental (NGO) and charity organizations operating in Uganda.
The Embassy is unable to provide information regarding the bona fides of these organizations and American citizens traveling to Uganda to work for an organization are encouraged to request that the charity provide references of past volunteers whom they may contact.
American citizens have also reported intimidation and harassment by directors of organizations, when the Americans questioned the organization's activities or use of donated funds.
While the vast majority of NGOs operating in Uganda are legitimate organizations aiding development efforts, there have been reports from concerned Americans regarding the suspected diversion of charity funds for personal gain, etc.

Ugandan Customs authorities may enforce strict regulations concerning the importation of pets.
A Ugandan import permit is required, along with an up-to-date rabies vaccination certificate and a veterinary certificate of health issued by a USDA-approved veterinarian no more than thirty days before arrival.
Travelers are advised to contact the Ugandan Embassy in the United States for specific information regarding customs requirements.
Please see our Customs Information sheet.

Photography in tourist locations is permitted.
However, taking pictures of military/police installations or personnel is prohibited.
Military and police officers have detained tourists for taking photographs of Entebbe Airport and of the area around Owen Falls Dam, near Jinja, although the prohibition on taking photographs is not publicly displayed on signs.

The U.S. Embassy receives frequent inquiries from American citizens wishing to register a nongovernmental organization (NGO) in Uganda.
Information about registering an NGO can be obtained from the Ugandan NGO Board which has offices within the Ministry of Internal Affairs.
The NGO Board can be reached on phone number: 256 414 341 556.
One of the requirements for registering an NGO is that a foreign national employee or volunteer must provide a Certificate of Good Conduct/Criminal Background Check.
The U.S. Embassy Kampala cannot provide a Certificate of Good Conduct or Criminal Background Check, so American citizens intending to travel to Uganda as an employee an NGO or who plan to register an NGO should obtain a Certificate of Good Conduct from their local police or the Federal Bureau of Investigation (FBI) before departing the United States.
More information on how to obtain a Criminal Background Check can be found on the FBI web page about Identification Record Requests.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Uganda, including Kampala, are limited and not equipped to handle most emergencies, especially those requiring surgery. Outside Kampala, hospitals are scarce and offer only basic services.
Recently, American citizens involved in automobile accidents required immediate evacuation from Uganda as surgery could not be performed due to insufficient blood supplies at the hospital where they sought treatment.
Equipment and medicines are also often in short supply or unavailable.
Travelers should carry their own supplies of prescription drugs and preventive medicines.
A list of medical providers is available at the U.S. Embassy.

Tuberculosis is an increasingly serious health concern in Uganda.
For further information, please consult the CDC's Travel Notice on TB.

Malaria is prevalent in Uganda.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and tell the physician their travel history and what antimalarials they have been taking.
For additional information on malaria, including protective measures, see the CDC’s information on malaria.

In January, 2009, the CDC’s Special Pathogens Branch retrospectively diagnosed a case of Marburg hemorrhagic fever in a U.S. traveler, who had returned from Uganda in January, 2008. The patient developed illness four days after returning to the United States.
The Amcit had visited the “python cave” in Queen Elizabeth Park, western Uganda, which is a popular destination among tourists to see the bat-infested cave.
For additional information on Marburg hemorrhagic fever, including protective measures, visit the CDC web site.

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. Uganda has experienced recent outbreaks of Marburg Hemorrhagic Fever, Ebola Hemorrhagic Fever, Pneumonic Plague, Meningitis, and other types of infectious diseases.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Uganda.
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.
American citizens who are seriously injured in vehicle or other types of accidents in Uganda generally seek medical evacuation to Kenya or other destinations for more advanced emergency medical treatment.
These medical evacuations can be very expensive, and in the event the American citizen does not have sufficient insurance coverage, the evacuation is carried out at their personal expense.
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 Uganda is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Most inter-city transportation in Uganda is by small van or large bus.
Many drivers of these vehicles have little training and some are reckless.
Small vans and large buses are often poorly maintained, travel at high speeds, and are the principal vehicles involved in the many deadly single and multi-vehicle accidents along Ugandan roads.
Accident victims have included American citizens traveling in small vans and personal cars, passengers on motorcycle taxis locally known as "boda bodas," and pedestrians.
Large trucks on the highways are often over-loaded, with inadequately secured cargo and poor braking systems.
Alcohol frequently is a contributing factor in road accidents, particularly at night.
Drivers are advised to take extra care when driving.
Nighttime driving and road transportation should be avoided whenever possible.
Pedestrians often walk in the roads and may not be visible to motorists.
Large branches or rocks in the road sometimes indicate an upcoming obstruction or other hazard.
Highway travel at night is particularly dangerous, including the road between Entebbe Airport and Kampala.
The Embassy recommends caution on this road and use of a reliable taxi service to and from the airport.

Traffic accidents draw crowds.
Ugandan law requires that the drivers stop and exchange information and assist any injured persons.
In some cases where serious injury has occurred, there is the possibility of mob anger.
In these instances, Ugandans often do not get out of their cars, but drive to the nearest police station to report the accident.

Please refer to our Road Safety page for more information.
For specific information concerning Ugandan driving permits, vehicle inspection, road tax and mandatory insurance, please contact Tourism Uganda, IPS building, 14, Parliament Avenue, Kampala, Uganda; telephone 256-414-342 196. You may also wish to consult the Tourism Uganda web site or, for information on government agencies, see the My Uganda web site.

AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Uganda, the U.S. Federal Aviation Administration (FAA) has not assessed Uganda's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.

International airlines offer several weekly flights to Europe and the United Arab Emirates, and Kenya Airways has daily flights between Entebbe Airport and Nairobi.
Other regional airlines operate weekly flights to other destinations in Africa, such as Dar es Salaam, Addis Ababa, Cairo, and Johannesburg.

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 Uganda are encouraged to register with the U.S. Embassy in Kampala through the State Department’s travel registration web site to obtain updated information on travel and security within Uganda.
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 1577 Ggaba Road, Kampala; telephone 256-414-259-791 or 256 414 306 001; fax 256-414-258-451.
You may contact the Embassy via e-mail.
* * *
This replaces the Country Specific Information dated May 6, 2008, to update sections on Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Medical Insurance, Traffic Safety and Road Conditions, Special Circumstances, Aviation Safety Oversight, Special Circumstances, and Registration/Embassy Location.

Travel News Headlines WORLD NEWS

Date: Wed, 20 Nov 2019 12:59:15 +0100 (MET)

Kampala, Nov 20, 2019 (AFP) - Global health charity Marie Stopes said Wednesday it had recalled hundreds of thousands of faulty condoms on sale in Uganda, where HIV rates are among the highest in the world.   The recall followed a warning from Uganda's National Drug Authority (NDA) that the Life Guard brand condoms had failed manufacturing "quality tests" because they contained holes and may burst.   The affected condoms were manufactured by India-based MHL Healthcare in April 2019 and have an expiry date of April 2024, the government regulator said.   Marie Stopes Uganda spokesman David Kamu told AFP on Wednesday that the two affected batches each contained "around 400,000" condoms.

Earlier reports had suggested millions of condoms could have been involved but NDA spokesman Fred Ssekyana told AFP the figure was below one million.   Marie Stopes Uganda said more than half of the condoms of concern had been recalled.   "While the LifeGuard brand follows strict quality controls, unfortunately two recent batches have fallen short of the quality we demand," the charity's country director, Carole Sekimpi, said in a statement Tuesday.   Marie Stopes is the largest and most specialised sexual reproductive health organisation in Uganda, the charity says on its website.   According to UNAIDS, 1.4 million Ugandans are living with HIV.   Last year 53,000 people were newly infected with the disease in the East African country, the UN agency said.
Date: Mon 28 Oct 2019
Source: Daily Monitor [edited]

Yellow fever vaccine cards are being sold on the streets for Shs 60,000 [about USD 16] to unvaccinated Ugandan travellers, who upon presenting them at Entebbe International Airport, are cleared to proceed to their destinations. Daily Monitor has established the scam has been ongoing for some time.

Our 3-week investigation shows how one can easily get a yellow fever immunisation card without being vaccinated. According to our investigations, these cards are acquired mainly by people scheduled to travel out of the country who do not want to pay the higher fee charged by hospitals accredited to administer the vaccine. Hospitals charge about Shs 100,000 [about USD 27] for the vaccination.

According to World Health Organisation (WHO), yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes of the _Aedes_ and _Haemagogus_ species [_Haemagogus_ mosquitoes are South American forest mosquitoes not found in Africa. - ProMED Mod.TY]. Its symptoms include fever, headache, jaundice, muscle pain, nausea, vomiting, and fatigue.

The yellow fever card became a mandatory requirement for travellers following the outbreak of the disease in Masaka and Rukungiri districts in 2016. The Ministry of Health directed that all travellers exiting or entering Uganda must be vaccinated against the disease to prevent infection or spreading. Yellow fever cards are only issued by the Health Ministry and given to accredited hospitals to administer the vaccine. The cards are engraved with the Ministry's logo but accredited hospitals are required to stamp and engrave them with a seal to validate them.

A list of all the accredited hospitals is sent to Entebbe airport and other border posts for officials to verify the seal of the hospital on the card when it is presented by a traveller. According to the Health ministry's guidelines, the card is supposed to be given only to someone who has been vaccinated against yellow fever. It is this card that a traveller presents to officials at either the airport or immigration offices at borders before being allowed to enter or travel out of the country.

However, our investigation shows that while officials at Entebbe airport and border immigration offices have a list of accredited hospitals, they cannot tell whether a traveller, who carries the card, was vaccinated or not because details of all those vaccinated remain at the hospitals. This has given leeway to unscrupulous people to forge the cards.

Mr Jacob Siminyu, the spokesperson of the Ministry of Internal Affairs, which oversees the directorate of Citizenship and Immigration, told Daily Monitor that the health ministry has not alerted them on the ongoing scam. But he added that whereas immigration officials are mandated to allow only travellers with the cards to leave the country, they do not have the means to determine whether a traveller was vaccinated or not. "The Ministry of Health needs to put mechanisms which can help our officials ascertain whether a traveller was vaccinated or not. Otherwise, it is very hard for our officials to identify those who were not vaccinated because they come with valid cards at the borders," Mr Siminyu said.

The scam involves a cartel of city medical practitioners, who use brokers to carry out the fraudulent transactions on their behalf to avoid detection. The brokers accept to meet you only after being satisfied that you are a genuine traveller, not a spy. Our reporter carried out an undercover [investigation] to unravel the cards scam and how it is executed. The reporter disguised as a labour worker scheduled to travel to South Africa. He shares his findings.

"I was connected to a medical officer working at Kisenyi Health Centre IV in Kampala's Central Division. The official asked for Shs 60,000 [about USD 16] but he declined to discuss much on phone and proposed that they meet the next day. He postponed the meeting several times and after 4 days of pleading, he told me to meet a man at Kisenyi Health Centre IV on 9 Oct [2019]. The health officer at the centre said he only had yellow fever cards from Norvik Hospital. Norvik Hospital, located on Bombo Road, Kampala, is one of the hospitals accredited to vaccinate against the disease.

"Upon reaching the health centre, a man ushered me into an office within the hospital. The official opened one of the drawers and pulled out a bundle of yellow fever cards and filled in the forged details of the passport number and name which I had given him.

"The bundles of cards were meticulously arranged in the drawer and were engraved with the Ministry of Health logo with a stamp and seal reading Norvik Hospital. He backdated the time of issuance to 14 Jul 2019, and forged the batch number of the yellow fever vaccine and signature. As I waited for the card, 2 women, who had made an earlier appointment, sauntered in to pick their cards too.

"I later learnt from their conversation with the health official that they were scheduled to travel to United Arab Emirates in the next 3 days. When I inquired why the official was issuing out cards from Norvik Hospital, a private facility, yet he works in a government one, he said they get the cards from their colleagues at the hospital. He also claimed that Norvik receives a big number of the cards from the Ministry of Health hence it becomes easy for his colleagues to get some of them, which they sell to desperate travellers on the black market. However, Daily Monitor could not independently verify the claims.

"Kisenyi Health Centre IV is among the 8 public facilities managed by Kampala Capital City Authority (KCCA). It is only City Hall Health Centre II out of the 8 that is accredited to administer the vaccine. The KCCA health centre charges Shs 102 000 [about USD 28] per vaccine but other hospitals in the country have varying charges. The official told us that many travellers prefer to acquire the cards without being vaccinated because of the high cost at the accredited hospitals and the urgency of the flight.

"We have helped very many people and they have never met any resistance at the airport and other borders. I am very sure of what I am giving you," he said before handing the card to me.

Vaccination at Norvik Hospital
------------------------------
To verify the authenticity of the yellow fever card, which we acquired undercover from Kisenyi Health Centre IV, I visited Norvik on 16 Oct [2019] to be vaccinated.

I was asked to pay Shs 60,000 [about USD 16] and a receipt was issued to me. My details, including date of birth, age, nationality, and date of vaccination, were entered in the system. Upon vaccination, I was asked to sign in a book to prove I had been vaccinated and given the card. The card bears the stamp and seal of the hospital and is also engraved with the logo of Ministry of Health.

Both the Norvik Hospital card and one I acquired undercover at Kisenyi bear the same stamp and Ministry of Health's logo. It is hard to detect forgery. However, the serial numbers differ in length. The genuine Norvik Hospital card's serial number has 6 digits while the forged one from the Kisenyi health centre has 9 digits. The rest of the features look the same.

When contacted yesterday [27 Oct 2019], Mr Emmanuel Ainebyoona, the Health Ministry senior spokesperson, advised that we ask Norvik Hospital to explain the variations since both cards bear their stamp and seal but with different serial numbers. He added that he was unable to confirm the features by yesterday.

However, this newspaper's attempt to speak to Norvik Hospital authorities for the past one week hit a snag. Ms Mildred Obeja, hospital's client care officer, declined to comment on the matter, saying it is only the medical director who is mandated to speak to the media. She promised to have an interview with me with the hospital's medical director, but our efforts to have it were futile. Our follow-up calls to her mobile phone number went unanswered. She did not reply our WhatsApp messages either.

When contacted on [Thu 24 Oct 2019], the health state minister for general duties, Ms Sarah Opendi, said the ministry was not aware of the cards scam. "I am shocked that this is happening because we thought that we had solved this challenge. Now that you have alerted me, I need to inform the officials at the Civil Aviation Authority about this fraud. We shall look into it and take action," she said.

Health warning
--------------
Ms Opendi wondered why someone would choose to travel with a fake card yet vaccination would prevent them from acquiring the deadly haemorrhagic disease. "Why are people risking their lives by travelling outside the country without vaccination? When you choose to use a fake card, it means you are taking your life for granted," she said.

Asked why the details of those who are vaccinated from accredited hospitals are not shared with officials at the airport for verification, Ms Opendi said the ministry would look into that option. However, she warned all accredited hospitals against loopholes in the issuance of the cards, saying such an anomaly not only points at laxity in their systems to fight fraud, but also breaches the agreement they made with the ministry.

Laxity at airport
-----------------
On 18 Oct [2019], I visited Entebbe airport to ascertain how immigration officials verify the cards presented by travellers. I found out that unlike passports, which are scanned to prove authenticity, yellow fever cards are not. Officials look at the seal and stamp of the hospital on the card and if these details correspond with the list of hospitals which they have, they let the traveller to proceed.

I also found out that officials cannot tell whether a traveller was vaccinated or not because they do not have details of all those who were vaccinated at the accredited hospitals. I spoke to at least 3 different officials at the airport and they intimated that they only look out for the Ministry of Health's logo, seal, and stamp of the accredited hospital and whether the card bears the passport number. If the name of the hospital on the seal corresponds with the list of the accredited hospitals they have, they allow the traveller to proceed. They also said there is no digital verification of the cards except that of the passport.

I also interviewed several people, who recently travelled out of the country to corroborate my findings at the airport and they confirmed immigration officials only looked at the seal and stamp of the hospital on the cards and allowed to travel."

Dr Simon Abachu, a [a member of] health personnel at Entebbe airport, confirmed by telephone on Friday [25 Oct 2019] that some travellers use forged cards. Dr Abachu said checking the cards at the airport is no longer done by medical officers. "Initially, our medical doctors used to check at the departure centre but there were some internal issues where it was found out that verifying the travellers' yellow fever cards was delaying flights. It is now handling agents who check the cards," he said. According to Dr Abachu, the scam is commonest among labour export companies, which he alleged acquire the cards for their workers without vaccination.

Asked how they intend to close this loophole, Dr Abachu said the Ministry of Health must give full mandate of verification of the cards to health officers at the airport, adding that currently, they do not have powers over the exercise.  [byline: Amos Ngwomoya]
======================
[Fake yellow fever (YF) vaccination cards have been a recurring problem in several African countries in the recent past. The sale of fake yellow fever vaccination cards to individuals who did not receive the vaccine presents a serious public health problem inside and outside of Uganda. The new cards were supposed to avoid purchase of cards without receiving the vaccine. Uganda has had an outbreak of sylvan-origin YF in 2016. Although it was declared ended on 6 Sep 2016, the risk of additional cases from forest sources remains. An unvaccinated, viremic individual with a fake card who becomes infected outside Uganda could carry YF virus to localities in the country where vector mosquitoes are present and initiate an outbreak of this serious disease. An unvaccinated individual who becomes infected in Uganda and travels to an area abroad where there are vectors could initiate a new outbreak.

One wonders, if the practice of issuance of fake YF cards continues, whether countries that are currently YF-free but are most at risk of ongoing transmission should the virus be introduced, in Central and North America, South and South East Asia, will deny visas to or admittance of individuals coming from Uganda unless they can prove that their cards are legitimate. The Ugandan government authorities should put a stop to these practices immediately. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Uganda:
Date: Tue 1 Oct 2019
From: John Frean <johnf@nicd.ac.za> [edited[]

The patient is a 23-year-old male international student, who has been studying in South Africa since late July 2019. Between [6 and 16 Sep 2019] he was on vacation in Uganda.

Places visited in Uganda were:
Entebbe: Jinja music festival for 3 days
Sipi Falls: hiking/waterfalls/homestay
Moroto: visited tribes
Murchison Falls: 2 days
Masindi: 1 day
Entebbe, then back to South Africa.

He did not see any tsetse flies, nor was he aware of any insect bites.

On [Sun 22 Sep 2019] he felt unwell and noticed a lesion on his chin. He was admitted to hospital and on [26 Sep 2019] underwent surgery for a presumed submandibular abscess. No abscess was found but histological examination of tissue removed at surgery showed some areas of necrosis, and evidence of fibrin thrombi compatible with disseminated intravascular coagulopathy. No organisms were seen.

The white cell count was about 3 x 109/L and platelets were 34 x 109/L, then 29 x 109/L, and postoperatively dropped to 4 x 109/L.

Blood films were examined and numerous trypanosomes were seen, estimated density of about 56,000/microlitre. On review of the blood sample from [26 Sep 2019], scanty trypanosomes were seen.

The patient was transferred to the care of an infectious diseases physician on [Sat 28 Sep 2019]. On admission he was very ill with unrelenting fever, tachycardia, periodically hypotensive, dyspnoeic, renal dysfunction (creatinine 300 micromol/L), jaundiced with raised transaminases, and slightly confused. Test dose and 1st dose of suramin were well tolerated, and the 2nd dose was given on [30 Sep 2019]. Clinically the patient is slightly improved today (1 Oct 2019), with a platelet count now 12 x 109/L and creatinine around 200 micromol/L.

According to WHO EAT [East African trypanosomiasis] experts, the infection was most likely acquired at Murchison Falls, where there have been sporadic cases; alternatively at Moroto [both in northern Uganda].

This is the 4th case of EAT evacuated to Johannesburg in 2019. The other cases acquired the infection in Zambia and Malawi.
----------------------------------------------
Lucille Blumberg
John Frean <johnf@nicd.ac.za>
National Institute for Communicable Diseases, GeoSentinel Site,
Johannesburg
Evan Shoul (infectious diseases specialist);
Pieter Ekermans (Ampath Laboratories)

[ProMED-mail thanks Lucille Blumberg, John Frean, Evan Shoul, and Pieter Ekermans for their submission. - Mod.ML]

[Sleeping sickness is endemic in 36 sub-Saharan Africa countries where there are tsetse flies that transmit the disease (WHO Trypanosomiasis fact sheet <https://www.who.int/news-room/fact-sheets/detail/trypanosomiasis-human-african-(sleeping-sickness)>).

Trypanosomiasis is endemic in the national parks in southern Africa, where there are tsetse flies and a reservoir of the trypanosomes in the wildlife. It is important to consider trypanosomiasis in febrile travellers to these national parks with negative tests for malaria. - ProMED Mod.EP]

[HealthMap/ProMED-mail map of South Africa:
Murchison Falls (Uganda):
Date: Thu, 29 Aug 2019 22:36:01 +0200 (METDST)

Kampala, Aug 29, 2019 (AFP) - A nine-year-old girl who had travelled from the Democratic Republic of Congo has been found to have Ebola, authorities in Uganda said on Thursday.   The child, who is of Congolese origin, was diagnosed after exhibiting symptoms at a border crossing in the southwestern Kasese district on Wednesday. She was subsequently isolated and transferred to an Ebola treatment unit.

A rapid response team had been dispatched to Kasese to support local teams, the Ugandan Health Ministry said in a statement.   Earlier this month, Uganda said it had started a trial of an experimental Ebola vaccine that may be used in neighbouring DR Congo where an outbreak of the disease has killed more than 1,900 people.   The trial of the MVA-BN vaccine developed by Johnson & Johnson is expected to last two years.   At present there is no licenced drug to prevent or treat Ebola although a range of experimental drugs are in development.

Uganda has suffered Ebola outbreaks in the past but nothing on the scale of the DR Congo epidemic, which began in August 2018.    It is the second-worst outbreak on record, eclipsed only by the 2013-2016 epidemic in West Africa, which killed more than 11,300 out of 29,000 documented cases.   Uganda has been declared Ebola-free but in June three people from one family died there from the haemorrhagic fever after crossing back from DR Congo.
Date: Tue, 27 Aug 2019 16:19:47 +0200 (METDST)

Kampala, Aug 27, 2019 (AFP) - Uganda on Tuesday re-launched its national airline after two decades with an inaugural flight to Nairobi, becoming the latest East African nation seeking to revive their aviation industry.   "The airline will first fly to seven destinations. Starting with Nairobi, Mogadishu, Juba and Dar es Saalam. And then to Mombasa, Kilimanjaro and Bujumbura," said Prime Minister Ruhakana Rugunda at Entebbe International Airport.

Uganda Airlines is launching into increasingly crowded East African skies, where both Rwanda and Tanzania have in recent years revived their national airlines in a bid to capture a slice of the booming market.   They are taking on regional giants Kenya Airways -- which continues to expand despite struggling with years of losses and management woes -- and Ethiopian Airlines, which largely dominates the skies.    Uganda Airlines is coming to compete in the market alongside other airlines", said Transport Minister Monica Azuba.
 
Uganda Airlines was founded by former Ugandan dictator Idi Amin in 1976 but the carrier was liquidated in 2001 after a failed bid to privatise the floundering company, dogged by corruption and mismanagement.   The country has acquired two new Bombardier CRJ 900 jets, and will take delivery of another two in September, while the addition of two Airbus A330-800 planes in 2020 will allow it to carry out long-haul flights.   "Uganda Airlines will have direct flights from Uganda to China plus other countries, and it will be very important in hitting the four million tourist goal the government has set," said Tourism Minister Ephraim Kamuntu.   Uganda welcomed 1.8 million tourists in 2018, according to official statistics.

Meanwhile, neighbouring Tanzania has invested heavily in reviving its airline, with the purchase of six planes including Bombardiers, Airbus and one Boeing dreamliner since 2016. Air Tanzania launched its first route outside of the continent to Mumbai, India, in July.    Rwanda has massively invested in its national airline Rwandair, with a fleet of 12 jets which now fly 29 routes around the world, with the most recent flight launched to Israel in June.   According to the International Monetary Fund (IMF) Rwanda breached its debt ceiling of $500 million by $87 million due to the lease of new aircrafts in 2018, and is seeking further loans to expand routes and make a profit.   Numerous airlines in Africa have failed to stay afloat, or survive on government bailouts.
More ...

World Travel News Headlines

Date: Thu, 21 Nov 2019 22:38:09 +0100 (MET)

Bogota, Nov 21, 2019 (AFP) - Tens of thousands of Colombians took to the streets of the capital Bogota on Thursday amid a general strike to protest the policies of President Ivan Duque's right-wing government.   There were no reported outbreaks of major violence as trade unions, students, opposition parties and the South American country's indigenous organizations challenged the full gamut of Duque's economic, social and security policies.   "It is an accumulation of situations that we hope to see reviewed after today, including a great national dialogue of conciliation," Robert Gomez, president of the main workers' union, told AFP.   The protest comes amid social upheaval across South America, as a wave of unrest over the past two months has battered governments in Chile, Bolivia and Ecuador.   The popularity of Duque's right-wing government -- a key US ally -- has been on the wane since his election 18 months ago, as it deals with hosting 1.4 million refugees from neighboring Venezuela's economic meltdown as well as the complex fallout of a 2016 peace deal with FARC rebels and rampant drug trafficking.

- Troops deployed -
Troops were deployed in the capital and other cities to protect "strategic facilities," authorities said.   The Colombian office of the UN High Commissioner for Human Rights voiced concern over the deployment, saying states must limit the use of military forces "for the control of internal disturbances."   Authorities said the protests were largely peaceful, though riot police fired tear gas to break up groups of demonstrators in isolated clashes in Bogota and the western city of Cali. Blocked roads in some areas snarled transportation.

The general strike was widely followed in Bogota, and other big cities like Bucaramanga in the northeast and Medellin in the northwest.   Several separate marches converged on Bolivar Square, the historic center of the capital close to the presidency.   "We are marching because in Colombia we are tired of corruption, of impunity, that the government does nothing for the poor," Olga Canon, 55, told AFP.   Organizations that participated in the strike take issue with Duque's security policy as well as attempts to introduce a more flexible labor market, weaken public pension funds and raise the retirement age.   Students are demanding more funding for education, while indigenous communities insist on greater protection in remote areas where 134 activists have been killed since Duque came to power in August 2018.

- 'Afraid to march' -
"We are very afraid to march in the streets but we do it anyway because the state is spreading so much fear with its militarization and by closing the borders," political science student Valentina Gaitan, 21, told AFP.    Duque admitted some of the criticisms were legitimate in a televised speech on the eve of the strike, but said the campaign against his government was based on lies seeking to provoke violence.   "We recognize the value of peaceful protests, but also guarantee order," he said.   The borders with Brazil, Ecuador, Peru and Venezuela were closed until Friday to avoid any threat to "public order and security," authorities said.   Political analyst Jason Marczak said the outrage against the government, the target of several demonstrations in recent months, is part of a "considerable demonstration of discontent in the region."   "The unsatisfied claims and deep polarization are the basis for this massive event," said Marczak, of the Washington-based Atlantic Council.
Date: Thu, 21 Nov 2019 09:12:36 +0100 (MET)

Bangkok, Nov 21, 2019 (AFP) - A shallow 6.1-magnitude earthquake hit north-western Laos near the Thai border early Thursday, the United States Geological Survey reported, alarming locals who felt buildings shake as far away as Bangkok.  The quake hit at 6:50am (2350 GMT Wednesday), roughly three hours after a 5.7-magnitude earthquake in the same region triggered an immediate suspension to Laos' largest-capacity power plant located near its epicentre.    Tremors could be felt more than 700 kilometres (435 miles) away in the Thai capital, where Pope Francis is currently on a four-day visit.    "The shaking... was the main shock from a quake in Laos at 6:50 am and was felt in northern and northeastern Thailand and Bangkok and suburbs," said Sophon Chaila, an official at the Thai Meteorological Department.

The department said the quake affected nine provinces in Thailand and there were four lesser aftershocks.    It also became a top trending topic on Twitter in Thailand, as locals shared videos of swaying overhead lights and rattling window blinds in office buildings.    Residents in the Vietnamese capital Hanoi also felt buildings sway.    "The ceiling lights were shaking quite strongly. I felt dizzy and scared," said Hanoi resident Tran Hoa Phuong, who felt the earthquake in her 27-storey apartment building.    After the first quake, the 1,878-megawatt Hongsa Power Plant -- Laos' largest-capacity thermal energy generator -- immediately suspended operations according to a statement from the Thai-owned company.

No "fundamental" damages or injuries have been found so far, "merely damages to the external texture of the buildings", it said, adding that Hongsa is expected to take 24 hours to complete its inspection.    Photos shared by Thai news showed portions of the power plant's walls had collapsed, and debris littered its premises.    Nearby Xayaburi dam project, one of Laos' largest hydropower dams, has seen "no impact" so far, and is continuing to generate electricity "as normal", said a statement from CK Power.   Information is slow to trickle out of the closed communist state, and there were similarly no official reports of injuries after the twin quakes hit early Thursday.

Impoverished Laos has ploughed ahead with ambitious dam-building projects that critics say lack transparency and stringent safety measures.   The cost was laid bare last year when a massive hydropower project collapsed in southern Laos, killing dozens and leaving thousands homeless.   Pope Francis arrived in Bangkok on Wednesday and has a busy agenda Thursday meeting officials and the Thai king before he leads a mass in the evening.    There was no word from his team on whether he felt the quake.    Powerful earthquakes occasionally strike hard in Southeast Asia.   In 2016 a 6.8-magnitude quake struck Myanmar, killing at least three people and damaging temples in the ancient temple town of Bagan.
Date: Tue, 19 Nov 2019 14:25:40 +0100 (MET)

Ottawa, Nov 19, 2019 (AFP) - Train operators at Canadian National Railway went on strike on Tuesday after months of contract talks failed, effectively shutting down the largest rail network in Canada.   The union representing more than 3,000 CN workers had given a midnight (0500 GMT) deadline to reach a deal to replace an agreement that expired in July.   "Unfortunately, we were unable to reach a deal with CN," the Teamsters Canada Rail Conference said in a statement.   "The company remains unwilling to address our member's health and safety issues. As a result, members at CN will be on strike... at 00:01 Eastern Time."

The workers had expressed concerns over long hours and fatigue leading to dangerous working conditions. Wages are not in dispute.   The labour dispute follows layoffs of 1,600 staff in North America announced by CN on Friday.    Employment Minister Patty Hajdu has encouraged both sides to continue the negotiations and reach an agreement.    "We are monitoring the situation closely," she said on Saturday after the Teamsters gave a 72-hour strike notice.
Date: Tue, 19 Nov 2019 09:24:19 +0100 (MET)

Wellington, Nov 19, 2019 (AFP) - The death toll from a measles outbreak raging in the Pacific nation of Samoa has risen to 15, with most of the victims young children, UNICEF said Tuesday.   The UN children's agency said that suspected measles cases had topped 1,000 in the island nation, which has declared a state of emergency and launched a compulsory vaccination programme.   "The epidemic has claimed the lives of 14 children under-five years old and one adult," it said in a statement.   UNICEF said it was in the process of delivering more than 110,000 doses of measles vaccine to Samoa's population of about 200,000.   With the virus sweeping through the South Pacific, the agency said it had also sent vaccines to Tonga and Fiji.

Officials were also helping with preparations for potential outbreaks in Vanuatu, the Solomon Islands, Kiribati, the Cook Islands, the Marshall Islands and Micronesia.   It said Samoa, which is by far the worst affected, had low measles vaccination rates of 28-40 percent.   In Tonga and Fiji, which have vaccination rates of 99 percent and 81 percent respectively, the outbreak is more contained and there have been no fatalities.   Children are the most vulnerable to measles, which typically causes a rash and fever but can also lead to brain damage and death.   Samoa has closed all schools and kindergartens, as well as banning children from public gatherings, in a bid to halt the spread of the virus.    After initially facing criticism for its slow response, the government had opened a national emergency operations centre to roll out mass vaccinations.
Date: Mon, 18 Nov 2019 19:25:45 +0100 (MET)

Srinagar, India, Nov 18, 2019 (AFP) - An avalanche on Monday hit an Indian patrol in the world's highest militarised zone in the Himalayas, killing four soldiers and two porters, an army spokesman said.   The disaster was the latest on the Siachen Glacier at more than 5,000 metres (16,500 feet) that is claimed by India and rival Pakistan.

Hundreds of troops from both sides have died in avalanches and from the fierce climate in the region over the past three decades.   An Indian military spokesman told AFP that the avalanche engulfed eight people in the patrol at the northern end of the glacier in the Karakoram mountain range.   Rescue teams managed to dig the patrol members out of the snow, and they were taken by helicopter to hospital.   "Despite best efforts, six casualties which includes four soldiers and two civilian porters succumbed to extreme hypothermia," said the spokesman, Colonel Rajesh Kalia.

Avalanches are common on the 700-square-kilometre (270-square-mile) glacier, where temperatures regularly fall to minus 60 degrees Celsius (-76 Fahrenheit).   In 2016, 10 Indian soldiers were buried and killed.   About 900 Indian soldiers alone have died on the glacier since 1984, when Indian forces took complete control of Siachen.   The glacier is located at the northern end of the Line of Control that divides Kashmir, which India and Pakistan have fought over since 1947.
Date: Mon, 18 Nov 2019 16:10:29 +0100 (MET)

Vienna, Nov 18, 2019 (AFP) - A man died on Monday in a landslide that destroyed much of his home in southern Austria, which has been hit by heavy rainfall and snow affecting transport and electricity.   The retiree was behind his house in Carinthia state when part of the hill above it slid off, killing the 79-year-old, police said.   Earlier Monday, two women were rescued from the rubble of two houses after another landslide, this one in the spa town of Bad Gastein in Salzburg state.   Salzburg, Tyrol and Carinthia states have all seen heavy rain and snowfall since last week, leading to power cuts in thousands of homes.   Many roads and railway lines have also been cut, and several schools in these areas remained closed on Monday.
Date: Fri, 15 Nov 2019 13:19:27 +0100 (MET)

Karachi, Nov 15, 2019 (AFP) - Lightning strikes killed at least 18 people and injured several more during a deadly night in Pakistan's Thar desert, police said Friday, describing the deaths as "unprecedented".   Thunderstorms and a heavy downpour caused havoc in several villages, destroying dozens of homes, in an unusual rainfall event that a meteorologist says could be linked to climate change.

It was the lightning strikes in 18 different places which had the greatest impact.   "We have so far confirmation of 18 deaths in our district," Abdulah Ahmed, the police chief of the region -- which is located in southern Sindh province and stretches over 22,000 square kilometres (8,500 square miles)-- told AFP.   He said that officers in each village had verified that each death was caused by lightning strike.    In contrast, lightning kills an average of three people each year in the UK, according to the Royal Society for the Prevention of Accidents.

The Thar desert, straddling the Indian border and one of Pakistan's poorest areas, is dependent on monsoon rains.   But such a heavy rainfall in November is "unusual", while "lightning of that intensity is unprecedented," said Dr Syed Sarfraz, a senior meteorological officer in Karachi.   He said the causes were still being investigated but suggested hot air over the desert had met with a cold air mass entering from Iran, fuelling the storms. Climate change could also be playing a role, he added.    Dozens of tents and blankets were dispatched from Karachi in a relief effort for the families who lost their homes in the rain.
Date: Fri, 15 Nov 2019 09:41:09 +0100 (MET)

Phnom Penh, Nov 15, 2019 (AFP) - Cambodia will ban all elephant rides at the country's famed Angkor temple park by early next year, an official said Friday, a rare win for conservationists who have long decried the popular practice as cruel.   The Angkor archaeological complex in northern Siem Reap attracts the bulk of the kingdom's foreign tourists -- which topped six million in 2018 -- and many opt for elephants rides around the ancient temples.

But these rides "will end by the start of 2020", said Long Kosal, a spokesman with the Apsara Authority, which manages the park.   "Using elephants for business is not appropriate anymore," he told AFP, adding that some of the animals were "already old".   So far, five of the 14 working elephants have been transferred to a community forest about 40 kilometres (25 miles) away from the temples.   "They will live out their natural lives there," Kosal said.   The company that owns the elephants will continue to look after them, he added. 

Cambodia has long come under fire from animal rights groups for ubiquitous elephant rides on offer for tourists, also seen in neighbouring Thailand, Vietnam and Laos.    The elephants are broken in during training and rights groups have accused handlers of overworking them.   In 2016, a female elephant died by the roadside after carrying tourists around the Angkor Wat temple complex in severely hot weather.   The animal had been working for around 45 minutes before she collapsed.
Date: Fri, 15 Nov 2019 05:28:34 +0100 (MET)

Bangkok, Nov 15, 2019 (AFP) - A French tourist has died after falling from a waterfall while trying to take a selfie in Thailand, police said Friday.   The accident happened Thursday afternoon on the tropical island of Koh Samui, whose palm-fringed, white-sand beaches are a magnet for both backpackers and high-end tourists.   The 33-year-old man fell from Na Mueang 2 waterfall, the same spot where a Spanish tourist died in a fall in July, Lieutenant Phuvadol Viriyavarangkul of the island's tourist police told AFP.

"It took several hours to retrieve his body because the waterfall is slippery and steep," he said by phone, adding that the spot is roped off and there is a sign warning tourists of the danger.   "His friend said he was trying to take a selfie and then he slipped and fell."   Thailand is largely considered a safe destination for tourists and typically draws more than 35 million visitors each year.    But the industry took a hit in 2018 after a ferry carrying Chinese visitors in the country's south sank last year, killing 47 people.   The accident highlighted lax safety rules in the tourism sector and authorities have been scrambling to restore the country's image since.
Date: Fri, 15 Nov 2019 01:13:41 +0100 (MET)
By Sophie PONS

Dakhla, Western Sahara, Nov 15, 2019 (AFP) - In the heart of disputed Western Sahara, a former garrison town has become an unlikely tourist magnet after kitesurfers discovered the windswept desert coast was perfect for their sport.  In Dakhla, an Atlantic seaport town punctuated with military buildings in Morocco-administered Western Sahara, swarms of kitesurfers now sail in the lagoon daily.y    "Here there is nothing other than sun, wind and waves. We turned the adversity of the elements to our advantage: that's the very principle of kitesurfing," said Rachid Roussafi. 

After an international career in windsurfing and kitesurfing, Roussafi founded the first tourist camp at the lagoon at the start of the 2000s.    "At the time, a single flight a week landed in Dakhla," the 49-year-old Moroccan said.   Today, there are 25 a week, including direct flights to Europe.   "Dakhla has become a world destination for kitesurfing," said Mohamed Cherif, a regional politician.

Tourist numbers have jumped from 25,000 in 2010 to 100,000 today, he said, adding they hoped to reach 200,000 annual visitors.    The former Spanish garrison is booming today with the visitor influx adding to fishing and trade revenue.   Kitesurfing requires pricey gear -- including a board, harness and kite -- and the niche tourism spot attracts well-off visitors of all nationalities.    Peyo Camillade came from France "to extend the summer season", with a week's holiday costing about 1,500 euros ($1,660). 

Only the names of certain sites, like PK 25 (kilometre point 25), ruined forts in the dunes and the imposing and still in-use military buildings in Dakhla, remind tourists of the region's history of conflict.   In the 1970s, Morocco annexed Western Sahara, a former Spanish colony, and fought a war with the Algeria-backed Polisario Front from 1975 to 1991, when a ceasefire deal was agreed.   A United Nations mission was deployed to monitor the truce and prepare a referendum on Western Sahara's independence from Morocco, but it never materialized.   Without waiting for the political compromise that the UN has been negotiating for decades, hotels have sprouted from the sand along the coast, and rows of streetlights on vacant lots announce future subdivisions.

- 'Good communication' -
"The secret to success is to develop kitesurfing with good communication focused on the organisation of non-political events," said Driss Senoussi, head of the Dakhla Attitude hotel group.    Accordingly, the exploits of kitesurfing champions like Brazilian Mikaili Sol and the Cape Verdian Airton Cozzolino were widely shared online during the World Kiteboarding Championships in Dakhla last month.   The competition seemed to hold little interest for Dakhla's inhabitants however.

Only a few young people with nothing to do and strolling families found themselves on the beach for the finals.   Just as rare are the foreign tourists who venture into the town of 100,000 residents to shop.   Like her friends, Alexandra Paterek prefers to stay at her hotel, some 30 kilometres (19 miles) from downtown.    "Here is the best place in the world for learning kitesurfing," said the 31-year-old Polish stewardess.    On her understanding of the broader regional context, she said: "It's an old Spanish colony and they have good seafood, for sure."

Like many tourists, she was under the impression that the area belonged to Morocco, as the destination tends to be marketed in the travel industry as "Dakhla, Morocco".   That angers the Polisario, which wants independence for the disputed region and tried last year in vain to sue businesses it said were "accomplices to the occupying military power."   The independence movement is now focused on challenging commercial deals between Morocco and the European Union that involve Western Sahara, according to the group's French lawyer Gilles Devers.   Moroccan authorities are looking actively for investors for their development projects on the west coast, the most ambitious being the Dakhla Atlantique megaport with a budget of about $1 billion to promote fishing.

- Environmental concerns -
On the lagoon, surrounded by white sand and with its holiday bungalows, "there is a struggle between developing aquaculture and tourism," said a senior regional representative, who spoke on condition of anonymity.    "One has less impact on the environment, but the other generates more revenue and jobs," said the representative, adding that "pressure from real-estate investors is very high."

With the influx of tourists, the protection of the environment has become a major concern.   "Everything is developing so quickly... we need to recycle plastic waste and resolve the issue of wastewater," said Rachid Roussafi.    Daniel Bellocq, a retired French doctor, worries for the future of this lagoon, that was "once so wild" that he has kitesurfed in for 20 years.   "There is green algae that wasn't there before, it's becoming a septic tank," he said.   Regional councillor Cherif, though, insists the bay is clean, saying: "All the hotels are equipped with wastewater management systems."   For him, the real threat is from plastic waste, whether it is dropped by tourists or brought by sea currents.