Albania US Consular Information Sheet November 04, 2008
Albania is a parliamentary democracy that is transforming its economy into a market-oriented system. Albania's per capita income is among the lowest in Eu
A passport is required. All travelers entering or exiting Albania must have six months or more validity on their passport. Customs officers strictly enforce this law. U.S. citizens do not require a visa prior to entering Albania, but those traveling without a visa will be charged a fee for an entry stamp at the point of entry, which is valid for a stay of up to 90 days. This fee is currently 10 Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Travelers without a visa who intend to stay in Albania for more than 90 days should be aware that Albanian law allows a traveler without a visa to remain in Albania for 90 days only within a specific 180-day period. That 180-day period is defined from the first day of entry. For example, a traveler entering without a visa on January 1 may remain in Albania for 90 days total during the period of time between January 1 and June 28. Departing Albania during this time period does not "restart the clock." Travelers attempting to reenter Albania without a visa and within 180 days of a previous entry and after an aggregate stay of 90 days may be denied entry. For stays exceeding 90 days within a 180-day period, those interested must apply for a Residency Permit at the police station with jurisdiction over the city of residence. Information on how to apply for a residency permit is available on the Embassy of Albania web site at http://www.embassyofalbania.org/. There is also a departure fee of ten Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Visit the Embassy of Albania web site at http://www.embassyofalbania.org/consular.html#visa for the most current visa information. Dual Nationality: The Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. If such persons are found guilty of draft evasion in Albania, they are subject to prosecution by the Albanian court. Those who might be affected should inquire at an Albanian Embassy or Consulate outside Albania regarding their status before traveling. In some instances, dual nationality may hamper U.S. Government efforts to provide protection abroad. 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 the overall security situation in Albania has improved in recent years, organized criminal activity continues to operate in all regions, and corruption is pervasive. US Government employees need permission to travel to the northern administrative districts of Shkoder, Malesi E Madhe and Tropoje (with the exception of the route along the national road to Montenegro and the city of Shkoder) and to the southern town of Lazarat, with such travel restricted to secure vehicles with escort. Travel restrictions for U.S. Government employees have been lifted for overnight stays in the city of Shkoder. In most cases, police assistance and protection is limited. A high level of security awareness should be maintained at all times. Photographing anything that authorities regard as being of military or security interest may cause travelers problems. All gatherings of large crowds should be avoided, particularly those involving political causes or striking workers. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the 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.
In the latest State Department assessment, Albania’s crime rating is “medium.” Crime against foreigners is rare in Albania, as targeting foreigners is often viewed as too risky. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Caution should be exercised in bars in Tirana where violent incidents, some involving the use of firearms, have occurred in the past, particularly in the early morning hours. Within the last years there have been fewer cases of carjacking compared with previous years. Anyone who is carjacked should surrender the vehicle without resistance. Armed crime continues to be more common in northern and northwestern Albania than in the rest of the country. Street crime is fairly common in Albania, particularly at night. Criminals do not seem to deliberately target U.S. citizens or other foreigners, but do seek targets of opportunity, and select those who appear to have anything of value. Vehicle theft is still one of the biggest problems in Albania. Pick-pocketing is widespread; U.S. citizens have reported the theft of their passports by pick-pockets. 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 is 129, though coverage is inconsistent at best. See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION
Medical facilities and capabilities in Albania are limited beyond rudimentary first aid treatment. Emergency and major medical care requiring surgery and hospital care is inadequate due to lack of specialists, diagnostic aids, medical supplies, and prescription drugs. Travelers with previously diagnosed medical conditions may wish to consult their physicians before travel. As prescription drugs may be unavailable locally, travelers may also wish to bring extra supplies of required medications. Recent electricity shortages have resulted in sporadic blackouts throughout the country, which can affect food storage capabilities of restaurants and shops. While some restaurants and food stores have generators to properly store food, travelers should take care that food is cooked thoroughly to reduce the risk of food-borne illness. Water in Albania is not potable. Visitors should plan to purchase bottled water or drinks while in country. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Albania. 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 (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en
The 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 Albania is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Major roads in Albania are often in very poor condition. Traveling by road throughout Albania is the most dangerous activity for locals and tourists. Vehicle accidents are the major cause of death, according to police statistics. Electricity shortages have resulted in sporadic blackouts throughout the country that can happen any hour of the day or night. Such outages affect traffic signals and street lights, making driving increasingly treacherous at any time of day. Travel at night outside the main urban areas is dangerous and should be avoided due to deplorable road conditions. During the winter months, travelers may encounter dangerous snow and icy conditions on the roads throughout mountainous regions in northern Albania. Buses travel between most major cities almost exclusively during the day, but they are often unreliable and uncomfortable. Many travelers looking for public transport prefer to use privately owned vans, which function as an alternate system of bus routes and operate almost entirely without schedules or set fares. Please note that many of these privately owned vans may not have official permission to operate a bus service and may not adhere to accepted safety and maintenance standards. Persons wishing to use privately owned vans should exercise caution. There are no commercial domestic flights and few rail connections. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.albaniantourism.com.
AVIATION SAFETY OVERSIGHT
As there is no direct commercial air service to the United States by carriers registered in Albania, the U.S. Federal Aviation Administration (FAA) has not assessed Albania's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa SPECIAL CIRCUMSTANCES: Albania's customs authorities may enforce strict regulations concerning temporary importation into or export from Albania of some items. It is advisable to contact the Embassy of Albania in Washington, D.C. or one of Albania's Consulates in the United States for specific information regarding customs requirements. As noted previously, the Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. See our information pertaining to dual nationality. Albania is a cash economy. Credit cards and travelers checks are not generally accepted, except at the major new hotels in Tirana and some international airline offices. Travelers' checks can be changed at banks in larger towns. Automated Teller Machines (ATMs) are available in most cities. Please see our Customs Information CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Albania’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Albania 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. Under Albanian law, police can detain any individual for up to 10 hours without filing formal charges. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times to show proof of identity and U.S. citizenship if questioned by local officials.
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 Albania 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 Albania. 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 Rruga Elbasanit 103, tel. (355)(4) 2247285; fax (355)(4) 2232222. The U.S. Embassy web site is http://tirana.usembassy.gov/ * * * This replaces the Consular Information Sheet dated June 10, 2008, to update sections on Entry and Exit Requirements, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.
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Tirana, March 9, 2018 (AFP) - The military has been deployed in northern Albania to help hundreds of people trapped by floods following heavy rainfall, authorities said on Friday. More than 9,230 hectares (22,800 acres) of agricultural land is underwater in the Shkodra region, including villages where the only means of transport is by boat, the defence ministry said.
Army personnel are evacuating residents and securing food supplies in the affected areas, 100 kilometres (60 miles) north of the capital, Tirana. The torrential rain in recent days has caused landslides damaging dozens of homes and flooding roads, said the transport ministry. The rain has also forced the Albanian authorities to release excess water from a hydroelectric plant, which has added to the flooding in northern areas of the country. Weather forecasters say the rain is likely to ease from Saturday.
Tirana, Dec 3, 2017 (AFP) - Thousands of police and soldiers have been deployed in Albania to rescue stranded residents after heavy rainfall triggered major flooding, and caused the death of a utility worker, officials and the power company said Sunday. The victim, Sabri Vlinga, died while he was working on a electricity pole at Roskovec in the flooded south of the country, the power company said in statement. Two other people were injured in similar accidents. it added. Some 6,400 police and soldiers have been sent to help rescue people stranded by the floods, Prime MInister Edi Rama said Saturday, calling the situation "very critical".
Around 1,500 people in the affected areas have been rescued, while several thousand homes were without electricity as many utility poles have been swept away by mudslides, said Shemsi Prenci, head of civil protection. More than 7,874 hectares (19,450 acres) of farm land as well as 3,193 homes are under water and several roads in the south remained impassable.
Army forces have built a temporary bridge at Darezeze, about 70 kilometres (44 miles) from the capital Tirana, to come to the aid of 2,000 residents stranded by the floods, the defence ministry said. In neighbouring Macedonia, the heavy rains have also caused flooding as several rivers include the main Vardar river have burst their banks, the MIA news agency reported.
By Briseida MEMA
Tirana, Feb 6, 2017 (AFP) - Emira Sela covers her face with her hand to hide a disfiguring abscess, the traumatic result of unregulated cosmetic treatments now rampant across Albania. The 31-year-old began to worry when wrinkles appeared on her face. Sela's hairdresser told her that a simple injection, costing around 60 euros ($65), would banish the signs of ageing. "She assured me that I would not risk anything. She even listed well-known names" of women who had undergone such treatment, said Sela. "I did not think twice, I trusted her without asking questions," said the blonde woman with green eyes, her voice trembling.
Albanian hair and beauty salons lacking expertise and medical supervision are offering such cosmetic treatments, unregulated in a legal vacuum, much to the alarm of qualified doctors. A single injection of a product whose content and dosage Sela knew nothing about was enough to ruin her life in late August. Despite antibiotics she has permanent pain, fever and nausea, while the abscess on her right cheek forces her eye to half-close and her face is nearly paralysed. "I am so disfigured that I tried to commit suicide," said Sela, who lost her job in a bank. Her only hope now is corrective surgery at an Italian hospital, scheduled for this month.
- Desiring Kardashian look -
"There are more and more impostors with syringes," said Panajot Papa, a plastic surgeon at a private clinic in Tirana. "The problem is also the products... Forbidden in Europe, they enter illegally from Turkey or China." Eriona Shehu, a dermatologist at Tirana's university hospital, said these unregulated synthetic products, such as injected liquid silicone and acrylamide, were being offered at temptingly low prices.
"Cosmetic interventions have become a lucrative industry. The patient is only a customer, exposed to a number of risks." Shehu said the desire to look like voluptuous US reality television star Kim Kardashian was "destroying the lives of young Albanian girls looking for beauty". Albanian doctors say the typical age of clients for such procedures is between 16 and 28. In the country of about three million people, the demand for cosmetic interventions rose more than 50 percent in 2015, according to a study published by Albania's economic magazine Monitor.
Promotional offers can be seen everywhere, such as a beauty salon advertising 20 percent reductions for three people coming together for treatment during the holiday season. Papa says he has treated a dozen young women aged between 20 and 27 who suffered complications after having their lips and cheekbones swollen with injected liquid silicone for 40 to 50 euros. The product has been banned for cosmetic use in countries such as Italy and France for more than 15 years. Papa said such botched interventions left these women prone to particularly bad swellings during their menstrual period, requiring further treatment -- and he warned they may suffer such symptoms for life.
- Closing legal gap -
Albanian doctors are worried about foreign practitioners who come from Italy, Turkey and Greece to work just for a weekend. "They may not have a diploma, qualification or licence for these kind of interventions or for assuming the responsibility of a patient's medical follow-up," said Besim Boci, head of the otolaryngology department at Tirana's university hospital. Due to legal loopholes, the judiciary cannot step in. A spokesman at Tirana's tribunal, Alba Nikolla, admits that it is currently impossible to "open investigations and prosecute based only on complaints" against practitioners.
But authorities are set to tackle this with a draft law to control cosmetic products and beauty salons, which is due to be introduced in parliament in the next few months. The law complies with the requirements of the European Union, which Albania aspires to join, and will enable authorities to shut down rogue establishments using synthetic products. When health is adversely affected, practitioners could be imprisoned for three to 10 years. Such regulations could go some way to easing the trauma of women like Elisa Lura, a 22-year-old economics student. She underwent a laser treatment to restore her natural look after paying 50 euros to a neighbourhood salon for permanent eyebrow tattoos, which went wrong. But the laser made things much worse. "Everything is spoiled!" she said of her face now covered with painful scars.
By Briseida MEMA
Tirana, Albania, Jan 13, 2016 (AFP) - With her sick daughter in the arms, Mira Lela pushes her way through the hallway of the doctor's clinic, crowded with patients ailing from heavy pollution in Albania's capital. "This is an emergency, she has difficulty breathing," said the tearful woman, forcing open the door to the office of Bardhyl Vaqari, who has worked in the specialist Tirana clinic for more than 20 years. "An acute asthma attack," said the doctor on seeing the child. "The number of people with respiratory allergies and cardiovascular problems has greatly increased," he told AFP, adding that the number of patients on the clinic's books has more than doubled to 8,000 in the last four years.
On the noisy and congested streets outside, clapped-out bangers and Hummer trucks cross paths with Mercedes, BMWs and overloaded buses that leave a trail of black smoke and heavy odour. Having been cut off from the world under a strict communist regime until 1991, the Western Balkan city had just a few hundred cars on its roads in the 1990s.
But today, through a mixture of pride, luxury-seeking and necessity, given the lack of public transport, there are more than 190,000 cars circulating in a city of about one million people. "Albanians take the car even when going to buy bread in a nearby store. That's why the traffic is overloaded all day and this increases pollution levels," said Altin Duka, a despairing 65-year-old shopkeeper.
The average age of vehicles on Tirana's roads is around 16 years, twice the European average, according to Gani Cupi, deputy manager of Albania's Road Transport Services. Many of the vehicles do not meet the standards of the European Union, which Albania hopes to join. "The traffic load, the age of vehicles, their technical condition but also the poor quality of fuel are all factors contributing to the capital's pollution," said Cupi.
- Taxing dilemmas -
In a bid to clean up the air, Albanian authorities considered doubling taxes on ageing vehicles but then dropped such plans. Analysts suggested the cost would weigh too heavily on citizens in one of the poorest countries in Europe. New cars are already exempt from paying annual tax for the first three years, but authorities in 2012 lifted a levy on the import of old vehicles as the EU considered it a "fiscal discrimination".
Tirana's Mayor Erion Veliaj has pledged to battle against the fumes by increasing the number of green spaces, introducing hybrid buses and improving infrastructure in the city, which is crammed with mostly illegal constructions. "The number of vehicles does not stop growing," he told AFP, pointing out that about 500 people die in the city each year "because of respiratory or cardiovascular problems related to pollution".
A report this year from the European Environment Agency noted a 20 to 30 percent decrease in Tirana's concentration levels of PM10 and PM2.5 -- damaging particulate matter -- according to data assessment from 2011 to 2013. But Laureta Dibra, head of the air and climate change department at Albania's Environment Ministry, told AFP that PM10 levels had actually been rising in areas of heavy traffic in recent years. Tirana remains "among the most polluted cities in Europe", added the director of the National Environment Agency, Julian Beqiri. "The level of the population's exposure to pollutants is still a problem," he said.
- On your bikes -
In an effort to improve air quality in the capital and educate residents, Tirana organised two car-free days in 2015, when the air was said to be at least four times less polluted than usual. Worried activists are campaigning to promote the bicycle as a means of transport and a way of life. Ecovolis, a bike sharing system, rents out at least 200 bicycles from different tations around Tirana, at 60 leke (44 euro cents, $0.47) per bike per hour -- but many people still prefer getting behind the wheel.
Although Albania's energy minister claims that 95 percent of fuel meets the required standards, even Prime Minister Edi Rama attacked its quality in May last year. "It is so bad that even a strong car like a Mercedes ends up being bad for Albanians' lungs," he said, calling for urgent measures to improve fuel controls. The government says restrictions have since been tightened, but those at the frontline of the fumes remain unhappy. "I come home in the evening with a completely dry throat and a bitter taste my mouth," said Bequir Veseli, 37, a traffic policeman who spends eight hours a day at the centre of a chaotic roundabout. "I have trouble breathing but what can I do? The next day I have to go back to my post".
May 21, 2008
The Union of the Comoros is a developing nation located in the Indian Ocean off the east coast of Africa.
Comoros consists of three islands, Ngazidja (also known
A fourth island, Mayotte, is claimed by Comoros but remains a territory of France.
Ngazidja is home to the capital city, Moroni, and is the most developed of the three islands.
Facilities for tourism are limited and telecommunication links are unreliable.
French, Arabic, Swahili, and Comorian Creole are spoken.
Read the Department of State Background Notes on the Union of Comoros for additional information.
A passport and onward/return ticket are required.
Visas are available from the Comoran Mission to the United Nations in New York; American citizens visiting Comoros can obtain a free, 24-hour transit visa upon entry.
The following day, visitors are required to go to the immigration office in Moroni to change their visa status.
A fee is charged, depending on length of stay.
Travelers should obtain the latest details from the Mission of the Union of Comoros, 420 East 50th Street, New York, NY 10022; telephone number (212) 972-8010, fax (212) 983-4712.
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:
Comoros has experienced frequent strikes and civil unrest, resulting in violent clashes between police and demonstrators.
The most recent unrest involved the de facto separation of Anjouan from the Union government.
In March 2008, Union forces re-took Anjouan and are preparing the island for elections.
The former leader of Anjouan, Mohamed Bacar, has applied for asylum with France and is being held on the French Island of Reunion while his asylum claims is adjudicated.
As the government completes the transition to constitutional federalism and as Bacar’s asylum claim is pending, periodic strikes and protests will likely continue to occur.
U.S. citizens should avoid political rallies and street demonstrations as even demonstrations intended to be peaceful can turn confrontational and possibly escalate into violence.
American citizens are therefore urged to avoid the areas of demonstrations if possible, and to exercise caution if within the vicinity of any demonstrations.
Conditions are subject to rapid change on each of the three islands of the Comoros due to weak political institutions and a lack of economic development.
In a rare, apparently religious-based attack, a clinic run by a foreign Christian organization was firebombed on the island of Grande Comore in August 2007.
Religious intolerance and religious-based violence remain very unusual in Comoros.
Although foreign residents and visitors have not been targeted, the potential for further outbreaks of civil disorder remains high, and Americans should exercise caution and good judgment, keep a low profile, and remain vigilant with regard to their personal security.
U.S. citizens are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar, if visiting or residing in Comoros.
Embassy contact information is provided below.
For the latest security information, Americans traveling abroad should regularly monitor the Department’s web site, where the current Travel Warnings and Public Announcements, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
U.S. travelers are advised to be vigilant against pick-pocketing and other forms of petty crime when visiting crowded market areas, parks, and at the beaches.
Violent crime is uncommon.
The most commonly reported crime is breaking into homes.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, help you find appropriate medical care, to contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in Comoros are poorly equipped.
Travelers should bring their own supplies of prescription drugs and preventive medicines. Malaria is prevalent in Comoros.
Travelers to Comoros should take malaria prophylaxis.
The serious and sometimes fatal strain of malaria, P. falciparum, is resistant to the anti-malarial drug chloroquine.
Because travelers to Comoros are at high risk for contracting malaria, the Center for Disease Control and Prevention (CDC) advises that travelers should take one of the following antimalarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™).
The CDC has determined that a traveler who is on an appropriate antimalarial drug has a greatly reduced chance of contracting the disease.
In addition, other personal protective measures, such as the use of insect repellents, help to reduce malaria risk.
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, protection from insect bites, and anitmalarial drugs, please visit the CDC Travelers' Health web pages.
The East African Indian Ocean islands have seen a rise in the cases of chikungunya, a viral dengue-like ailment, and dengue itself.
As with malaria, chikungunya and dengue are transmitted by mosquitoes.
Every effort should be made to use repellants, proper clothing and barriers that discourage/prevent mosquito bites.
The CDC web site contains further information on chikungunya at http://www.cdc.gov/ncidod/dvbid/chikungunya/ and dengue at http://wwwn.cdc.gov/travel/yellowBookCh4-DengueFever.aspx.
There have been occurrences of measles in Comoros, with outbreaks of greater severity on the islands of Anjouan and Moheli.
Travelers are advised to ensure that their measles vaccinations are up to date.
Further, information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.
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 if 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 Comoros is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Comoros, one drives on the right side of the street.
Roads are ill-maintained, congested, very narrow and poorly lit at night.
Travelers should exercise extreme caution when driving after dark.
Most urban roads are paved, but many rural roads are not.
Many roads are full of potholes and dangerous curves.
Most roads have no posted speed limits, but road conditions limit speeds to below 30 miles an hour.
Drivers and front seat passengers are required to wear seat belts.
There are no laws regarding child safety seats.
There are no organizations in Comoros that provide emergency or roadside assistance.
Individuals involved in accidents rely on passersby for assistance.
Taxis or a rental car with driver are preferable to public transportation.
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 Comoros, the U.S. Federal Aviation Administration (FAA) has not assessed Comoros’ Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.
SPECIAL CIRCUMSTANCES: While religions other than Islam are permitted in Comoros, evangelization is illegal.
Violators of this law can be fined or imprisoned.
Few establishments accept credit cards in the Comoros and most prefer Comoran Francs or Euros to dollars.
Please see our Customs Information.
CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating the laws of Comoros, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use or trafficking in illegal drugs in Comoros are strict, with convicted offenders receiving a mandatory minimum five-year jail sentence and heavy fines.
Engaging in sex 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.
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
The United States has no Embassy in Comoros.
Americans living or traveling in Comoros are encouraged to register with the U.S. Embassy in Antananarivo, Madagascar through the State Department's travel registration web site, and to obtain updated information on travel and security within Comoros.
Americans without Internet access may register in person at the U.S. Embassy in Antananarivo.
By registering, American citizens make it easier for the Embassy to contact them in case of emergency. The U.S. Embassy is located at 14-16 Rue Rainitovo, Antsahavola, Antananarivo.
The mailing address is B.P. 620, Antsahavola, Antananarivo, Madagascar; telephone  (20) 22-212-57; fax  (20) 22-345-39.
The Embassy web site is http://www.usmission.mg/.
This replaces the Country Specific Information dated October 26, 2007 to update the section on Safety and Security.
Travel News Headlines WORLD NEWS
The number of reported cases has remained stable since the beginning of April  (on average, 4 to 5 reported cases per week). Since the beginning of the health alert, human cases have remained mainly in the center and northwest of the island." (<https://lejournaldemayotte.yt/2019/05/11/fievre-de-la-vallee-du-rift-a-mayotte-stabilite-du-nombre-de-nouveaux-cas/>).
By Philippe ALFROY
Bambao, Comoros, March 25, 2019 (AFP) - The Bambao hospital, nestled in a tropical forest on Anjouan island in the Comoros, was meant to bring state-of-the-art medical care to the poor Indian Ocean nation. Just two years later, the hospital is deep in debt and shunned by potential patients who find it too costly. "A poisoned chalice", "a colossus with feet of clay", "a sinking ship" are among the cliches that chief paediatrician Ahmed Rakibou used to describe the facility funded and built under a Chinese aid scheme. "If they had consulted us while building it, this could have been a jewel," the doctor said, regretting that "today it's all going straight to hell". The hospital is some 30 kilometres (about 20 miles) east of Mutsamudu, the capital of Anjouan, the poorest of the three islands comprising the Union of the Comoros.
The aim was to make the hospital a flagship of Comoran healthcare, with 120 beds in a brand-new building, a team of 167 staff, many recruited locally, and modern equipment including a digital radio scanner. China's ambassador to the Comoros, Xiao Ming, hailed a "new page in the annals of cooperation" at the opening ceremony, saying "public health has always had a priority place in Sino-Comoran cooperation". But a project that cost four billion Comoran francs (8.1 million euros, $9.2 billion) today looks more like a ghost ship, with a handful of patients wandering its corridors in stifling heat. For lack of funds, about 100 staff jobs have not been filled.
- 'Not many patients' -
In the emergency ward, a doctor silently examines a child's injured arm. The lethargic mood is broken only by the arrival of an ambulance carrying the victim of a motorcycle accident. "Our activity is very varied," nurse Ali Mosthadoi says cautiously before going further. "In fact, we don't have many patients."
Deputy director Sidi Chaanbane was more forthcoming. Since the hospital was opened by President Azali Assoumani in 2017, it has faced mounting difficulties, he said. "At the start, the road from Mutsamudu was in a very bad state and patients had trouble getting here," the administrator said. "It's been repaired since, but our real problem is that we sorely lack equipment and staff." In addition to staff salaries, the Comoran state provides just five million francs (10,000 euros) a month, but the hospital needs three times as much to pay its bills. "We can't balance the budget," Chaanbane said.
Day-to-day management is a nightmare. The scanner broke down soon after it was first used. Repairs were not covered by the Chinese cooperation agreement, so the hospital took out a loan to get the machine working again. The main problem is the cost of treatment, which is not free in the former French colony, independent since 1975. Much of the funding comes from the French Development Agency (AFD) in its aid budget. France still rules over the fourth major island in the archipelago, Mayotte. The three islands forming Comoros lack the standard of living on Mayotte and are far from able to make up the remaining health budget.
- 'Expensive' -
Rakibou said the hospital charges 125,000 Comoran francs for a Caesarean birth. "What Comoran can pay that?" he asks. "No -- this hospital is not made for the population." Kanissa Adbou, 27, brought her eight-year-old daughter who trod on a nail to the hospital. "The treatment is expensive. If I could afford it, I would go to Mayotte because there, hospital is free." Those who believed that providing a modern hospital on Anjouan would dissuade Comorans from trying their luck on Mayotte have been disappointed, although the trip is illegal. "People here prefer to pay 1,000 euros to go to Mayotte by kwassa kwassa (human traffickers' dugouts) than to come to us," a nurse said. "They trust only white doctors."
The failure to put the sophisticated equipment at Bambao to regular good use enrages Ahmed Abdallah, secretary general of the Hombo public hospital in Mutsamudu. "The money spent there would have been enough to repair our buildings, replace our equipment and build roads so that sick people could come from nearby villages," he said. "We don't have even a single ambulance, yet the government has I don't know how many four-wheel drives." Health Minister Fatma Mbaraka declined to respond to requests for comment from AFP. But Rakibou refuses to throw in the towel. He hopes that the winner of Sunday's presidential election and the international community will come up with increased funding. "It wouldn't take much to change our lives!" he said.
- since the beginning of the health alert, human cases have been located mainly in the centre and north west of the island, with nearly 60% of cases in Chiconi and Tsingoni.
World Travel News Headlines
By Nazeer al-Khatib with Hashem Osseiran in Beirut
Maaret al-Numan, Syria, May 22, 2019 (AFP) - Syrian government air strikes killed 18 civilians, including a dozen people at a busy market, as fierce fighting raged for the jihadist-held northwest, a war monitor said on Wednesday. Regime forces battled to repel a jihadist counteroffensive around the town of Kafr Nabuda that has left 70 combatants dead in 24 hours, the Syrian Observatory for Human Rights said. The Hayat Tahrir al-Sham alliance, led by Syria's former Al-Qaeda affiliate, controls a large part of Idlib province as well as adjacent slivers of Aleppo, Hama and Latakia provinces. The jihadist-dominated region is nominally protected by a buffer zone deal, but the government and its ally Russia have escalated their bombardment in recent weeks, seizing several towns on its southern flank. At least 12 people were killed and another 18 wounded when regime warplanes hit the jihadist-held Idlib province town of Maarat al-Numan around midnight (2100 GMT) on Tuesday, the Observatory said.
The market was crowded with people out and about after breaking the daytime fast observed by Muslims during the holy month of Ramadan. The bombardment blew in the facades of surrounding buildings, and ripped through the flimsy frames and canvas of stalls in the market square, an AFP photographer reported. The bodies of market-goers were torn apart. "Residents are still scared," stallholder Khaled Ahmad told AFP. Three more civilians were killed on Wednesday by air strikes in the nearby town of Saraqib, the Observatory said. Two others were killed in strikes on the town of Maaret Hermeh, it added. Another civilian was killed in air raids on the town of Jisr al-Shughur, the monitor said. The Britain-based Observatory relies on a network of sources inside Syria and says it determines whose planes carried out strikes according to type, location, flight patterns and munitions.
- 'Worst fears'-
The strikes came as heavy clashes raged in neighbouring Hama province after the jihadists launched a counterattack on Tuesday. Fresh fighting on Wednesday took the death toll to 70 -- 36 regime forces and militia and 34 jihadists, the Observatory said. It said the jihadists had recaptured most of Kafr Nabuda from government forces, who had taken control of the town on May 8. State news agency SANA on Wednesday however said the army repelled a jihadist attack in the area, killing dozens of insurgents.
Russia and rebel ally Turkey inked the buffer zone deal in September to avert a government offensive on the region and protect its three million residents. But President Bashar al-Assad's government upped its bombardment of the region after HTS took control in January. Russia too has stepped up its air strikes in recent weeks. The Observatory says nearly 200 civilians have been killed in the flare-up since April 30. The United Nations said Wednesday that Idlib's civilian population once again faced the threat of an all-out offensive. "A full military incursion threatens to trigger a humanitarian catastrophe for over 3 million civilians caught in the crossfire, as well as overwhelm our ability to respond," said David Swanson, a spokesman for the UN humanitarian office. Swanson said more than 200,000 people have been displaced by the upsurge of violence since April 28. A total of 20 health facilities have been hit by the escalation -- 19 of which remain out of service, Swanson said. Collectively they served at least 200,000 people, he added.
- 'Break the status quo' -
The September deal was never fully implemented as jihadists refused to withdraw from a planned buffer zone around the Idlib region. But it ushered in a relative drop in violence until earlier this year, with Turkish troops deploying to observation points around the region. The Syrian government has accused Turkey of failing to secure implementation of the truce deal by the jihadists. But Turkish Defence Minister Hulusi Akar accused the Syrian regime late Tuesday of threatening the ceasefire deal. "The regime is doing all that it can to break the status quo including using barrel bombs, land and air offensives," Akar told reporters. "Turkish armed forces will not take a step back from wherever they may be", he however added. Earlier, the US State Department said it was assessing indications that the government had used chemical weapons on Sunday during its offensive in Idlib. HTS accused government forces of launching a chlorine gas attack on its fighters in the northern mountains of Latakia. But the Observatory said Wednesday it had "no proof at all of the attack".
By Amelie BARON
Port-au-Prince, May 22, 2019 (AFP) - With no oxygen in intensive care or gloves in the emergency room, residents at Haiti's largest hospital have gone on strike to protest the filthy environment and demand six months of back pay. "We have almost nothing when we talk about emergency services," said Emmanuel Desrosiers, 24, one of the doctors-in-training at the State University of Haiti Hospital (HUEH) that began the work stoppage Monday. "When a patient arrives, when we should immediately take charge, we start by listing the things they or their family need to go buy." The HUEH, known as the "general hospital," is where the most disadvantaged families in this impoverished Caribbean country crowd. Buying the medical supplies themselves is a financial headache, but private clinics are far too expensive. In crumbling buildings in the center of Port-au-Prince, male and female patients are crowded together in tiny rooms, while trash cans overflow. "We feel ridiculous when we give hygienic advice to patients," one resident said of the situation.
The residents' selflessness as they work in an unsanitary environment is compounded by the fact that they have not been paid since the start of their residency, nearly six months ago. After five years of medical studies, the state is required to pay them 9,000 Haitian gourdes (HTG) per month -- only about $100, due to the devaluation of the national currency. Nothing is being done about the hospital's disrepair, with those in charge waiting for a new building to be completed, according to resident Yveline Michel. The new HUEH will have two floors and more than 530 beds once it's finished -- but it's unclear when that will be. The project began after the January 2010 earthquake, which destroyed more than half the hospital. The United States, France and Haiti invested $83 million in a new hospital, which should have been completed by 2016. Instead, there is little visible activity on the construction site, which can be seen through the windows of the current building.
Due to the heat, the windows are always open, letting in noise and dust from the street. There are only a few fans in the hospital rooms, which do little to combat the humidity or the flies. "At any moment we could lose patients, but the state isn't doing anything to save their lives," said Michel, 25. "We're striking for the population, since it should make these demands." But some locals question the residents' position because the strike prevents the already struggling hospital from functioning. Since the strike began, the poorest families in the area no longer know where to go for medical emergencies, as the residents are in charge of admitting patients. "Due to the lack of resources and the unsanitary environment, there are always people dying in the hospital, so it's not the strike causing that," said Michel in response.
For a description of Hwange national park, go to
Hwange is in the western part of the country bordering Botswana and Zambia
(<https://en.wikipedia.org/wiki/Hwange>). - ProMED Mod.MHJ]
One has to ask: Why are we seeing it in the USA?" is more and more relevant. We are seeing these outbreaks because of the inability to deal with marginalized populations among their midst. The dramatic cutbacks in public health infrastructure in some of these states clearly feed the fire of these outbreaks. They must be addressed by bolstering public health resources and education and directly addressing the needs of these marginalized populations. - ProMED Mod.LL]