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Angola

Angola - US Consular Information Sheet
June 20, 2008
COUNTRY DESCRIPTION:
Angola is a large, developing country in south-west central Africa.
The capital city is Luanda.
Portuguese, the official language, is widely spoken through
ut the country.
Despite its extensive oil and mineral reserves and arable land suitable for large-scale production of numerous crops, Angola has some of the world's lowest social development indicators.
Development was severely restricted by a 27-year long civil war that broke out upon independence in 1975, which destroyed the majority of the country's infrastructure.
Since the conflict's conclusion in 2002, the government has initiated extensive infrastructure reconstruction and development projects, and there are growing signs of economic recovery.
However, Angola still faces challenges with its infrastructure and with providing government services, especially in basic social services, aviation and travel safety, accommodation availability and quality and communications. Facilities for tourism, particularly outside the capital of Luanda, are often rudimentary. Read the Department of State Background Notes on Angola for additional information.
ENTRY/EXIT REQUIREMENTS:
A passport and visa are required and must be obtained in advance.
An International Certificate of Vaccination is required.
Visitors should allow several weeks for the processing of their visa application.
Angola does not issue airport visas.
Persons arriving without visas are subject to arrest or exclusion.
Travelers may also encounter delays if they do not have at least one completely blank visa page in their passports for entry stamps.
As of November 1, 2007, Angola no longer requires travelers to have an exit visa.
Travelers whose international immunization cards do not show inoculations against yellow fever within the past ten years may be subject to exclusion, on-the-spot vaccination, and/or heavy fines.
Visitors remaining in Angola beyond their authorized visa duration are subject to fines and arrest.
It is illegal to attempt to carry local currency out of Angola and persons found attempting to carry local currency out of Angola are subject to having this currency confiscated by customs officers.
Current information on entry requirements may be obtained from the Embassy of Angola at 2100-2108 16th Street NW, Washington, DC, tel. (202) 785-1156, fax (202) 785-1258. See our information on dual nationality, the prevention of international child abduction and customs regulations.
SAFETY AND SECURITY:
The overall security situation in Angola has improved markedly since the end of the civil war; however, Americans should still exercise caution when traveling in Angola.
Although the war has ended, ground travel throughout Angola can be problematic due to land mines, which were used extensively during the war.
Travelers should not touch anything that resembles a mine or unexploded ordinance.
Frequent checkpoints and poor infrastructure contribute to unsafe travel on roads outside of the city of Luanda.
Police and military officials are sometimes undisciplined, but their authority should not be challenged.
Travel in many parts of Luanda is relatively safe by day, but car doors should be locked, windows rolled up, and packages stored out of sight.
Visitors should avoid travel after dark, and no travel should be undertaken on roads outside of cities after nightfall.

Americans located in, or planning to visit, the northern province of Cabinda should be aware of threats to their safety outside of Cabinda city.
In 2007 and 2008 armed groups specifically targeted and attacked expatriates in Cabinda; these armed attacks resulted in the rape, robbery and murder of a small number of expatriates working in Cabinda.
Those responsible have declared their intention to continue attacks against expatriates.
Occasional attacks against police and Angolan Armed Forces (FAA) convoys and outposts also continue to be reported.
These incidents, while small in overall numbers, have occurred with little or no warning.
American citizens are, therefore, urged to exercise extreme caution when traveling outside of Cabinda city and limit travel to essential only.

Americans are advised to undertake only essential travel to Lunda North and South provinces.
As the government of Angola is sensitive to the travel of foreigners in the diamond producing areas of the provinces, proper permission and documentation is required to frequent these areas.
One can be subject to restriction or detention.
There have been reports of crime or banditry in these areas, especially on roads leading into these areas.

Visitors to Angola are advised not to take photographs of sites and installations of military or security interest, including government buildings, as this can result in fines and possibly arrest.

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 security can also be obtained by calling 1-888-407-4747 toll free in the U.S., 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 AM to 8:00 PM Eastern Standard Time, Monday through Friday (except on U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Crime is a serious problem throughout Angola.
While most violent crime occurs between Angolans, foreigners have occasionally been attacked as well.
Street crime is a regular occurrence in Luanda.
The most common crimes are pick-pocketing, purse-snatching, vehicle theft, and vehicle break-ins.
Armed muggings, robberies, and carjacking involving foreigners are not frequent but do occur.
Americans are advised to avoid Roque Santeiro and Rocha Pinto, and to only travel the “Serpentine Road” in front of the U.S. Embassy by car.
In general, movement around Luanda is safer by day than by night.
Touring after dark should be avoided.
Police and military officials are sometimes undisciplined, but their authority should not be challenged.
Air travelers arriving in Luanda are strongly advised to arrange reliable and secure ground transportation in advance; there is no regular taxi service.
American citizens are advised to avoid the use of the public transportation known as “candongueiros” or “taxistas”; these multi-passenger vans are largely unregulated and often dangerous.

Motorists should stop at all police checkpoints if so directed.
Police officers may solicit bribes or request immediate payment of "fines" for alleged minor infractions.
American citizens asked for bribes by the police should politely ask the traffic police to write them a ticket if the police allege a moving violation.
If the police officer writes the ticket, then the motorist would pay the fine at the place indicated on the ticket.
If no moving violation is alleged and the officer is asking for a bribe, the motorist should, without actually challenging the officer's authority, politely ask the officer for his/her name and badge number.
Officers thus engaged will frequently let motorists go with no bribe paid if motorists follow this advice.
Motorists are reminded to have all proper documents in the vehicle at all times (i.e. vehicle registration, proof of insurance, and driver's license), as the lack of documentation is a violation and can also be a reason an officer would solicit a bribe.
Local law requires that every driver in Angola have the proper permission to drive.
Further information on driving in Angola can be obtained from the Embassy of Angola.
Police are not always responsive to reports of crime or requests for assistance.
Most police are on foot and are assigned to designated stationary posts.
The Rapid Intervention Police (PIR) unit is frequently seen patrolling various areas of the city.
This unit, which is well trained and organized, will respond to major criminal incidents.

There have been police operations against illegal aliens and private companies resulting in deportation of illegal resident foreign nationals and loss of personal and company property.
Independent entrepreneurs in Angola should carry relevant immigration and business documents at all times.

Travelers should be alert to fraud occasionally perpetrated by Luanda airport personnel.
Immigration and customs officials sometimes detain foreigners without cause, demanding gratuities before allowing them to enter or depart Angola.
Airport health officials sometimes demand that passengers arriving without proof of current yellow fever vaccination accept and pay for a vaccination at the airport.
Travelers are advised to carry their yellow fever vaccination card and ensure their yellow fever vaccine is up-to-date.
If travelers forget to bring their yellow fever vaccination card and do not wish to receive the vaccine offered at the airport, they should be prepared to depart the country on the next available flight.
Searches of travelers' checked baggage is common; travelers are advised to take precautions against this possibility.
Travelers should also be aware that criminals sometimes attempt to insert items into baggage at the airport, particularly for flights from Luanda to South Africa.
It is important that travelers maintain control of their carry-on baggage at all times, and if they believe something has been inserted into their baggage, they should report the incident immediately to airport authorities.
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, to contact family members or friends, and explain how funds could be transferred.
Although the investigation and prosecution of crimes are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

In addition to reporting crime to local police and the U.S. Embassy in Angola, victims of crime who are residing in Angola are also encouraged to report the crime to the security department of their employer.
Short-term visitors are encouraged to report the crime to the management of the hotel where they are staying if the crime occurred in or near the hotel.
The local equivalent to the “911” emergency line in Angola for police is 113; for fire fighters: 115, and for ambulance services: 112.
Please be advised that the emergency numbers listed may or may not have an English speaking operator available.
See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities and services are available in Angola, but are limited and often do not meet U.S. standards.
Adequate care for medical emergencies is limited to Luanda, where there are some good private clinics that usually have a 24-hour service provided by a general practice physician and with specialists on call.
A list of such facilities can be found at http://angola.usembassy.gov/medical_information.html.
Routine operations such as appendectomies can be performed.
Local pharmacies provide a limited supply of prescriptions and over-the-counter medicines/drugs.
Travelers are, therefore, urged to carry with them an adequate supply of properly-labeled medications they routinely require for the duration of their projected stay in Angola.
Malaria is endemic in most areas of Angola.

An outbreak of Marburg hemorrhagic fever, a severe and often fatal disease, occurred in Uige province in the spring of 2005; however, on November 7, 2005, the Ministry of Health of the Republic of Angola and the World Health Organization (WHO) declared that the Marburg outbreak in Angola had ended.
This announcement came after 45 consecutive days without a new case of the illness.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.

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 Angola is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Since the end of the civil war in 2002, overland access to the interior has increased.
However, fighting in most of the country damaged or destroyed many roads and bridges, and services for motorists outside urban areas cannot be counted on.

Road travel can be dangerous, especially during the rainy season (October - March), which can cause large potholes and erosion and due to the presence of landmines.
Road conditions vary widely outside the capital from acceptable paved surfaces to virtually impassable dirt roads, particularly secondary routes.
Many secondary roads, including secondary roads in urban areas, are impassable during the rainy season.
Overloaded, poorly marked, and disabled vehicles, as well as pedestrians and livestock, pose hazards for motorists.
Ground travel in rural areas should be undertaken during daylight hours only.
Landmines also pose a continuing hazard to travelers.
Many areas were heavily mined during the war, including roads, bridges, and railroad tracks.
Areas with suspected landmines are generally clearly marked and travelers should heed these warnings.
Primary roads are considered to be landmine free in most provinces, but travelers should not venture far from the margins of the road.
Extensive government, commercial, and NGO demining projects continue throughout the country.

Traffic in Luanda is heavy and often chaotic, and roads are often in poor condition.
Few intersections have traffic lights or police to direct vehicles.
Drivers often fail to obey traffic signals and signs, and there are frequent vehicle breakdowns.
Itinerant vendors, scooters and pedestrians often weave in and out of traffic, posing a danger to themselves and to drivers.
Most public transportation, including buses and van taxis, should be avoided as the vehicles are generally crowded and may be unreliable.
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 Angola, the U.S. Federal Aviation Administration (FAA) has not assessed Angola’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA’s web site at www.faa.gov/safety/programs_initiatives/oversight/iasa/. The U.S. Embassy in Luanda prohibits its employees from using TAAG, Angola’s national airline, for domestic or international flights due to concerns regarding safety and maintenance.
SPECIAL CIRCUMSTANCES:
Customs Regulations:
Angolan customs authorities may enforce strict regulations concerning temporary importation into or export from Angola of sensitive items including firearms, antiquities, and currency.
It is advisable to contact the Embassy of Angola in Washington, DC or one of Angola's consulates in the United States for specific information regarding customs requirements.

Financial Transactions:
Angola is generally a cash-only economy; neither traveler’s checks nor credit cards are used outside the capital of Luanda.
In Luanda, credit cards are accepted in extremely limited circumstances, namely large hotels.
Although, in April 2007 a major campaign was launched to expand credit card acceptance this effort has yet to expand beyond the capital city.
In general, Automated Teller Machine’s (ATM’s) are only accessible to those individuals who hold accounts with local banks.
Dollars are generally accepted in all provincial capitals; travelers should carry a sufficient supply of U.S. dollars with them.
Only the newer series U.S. dollar bills (with large faces) are accepted.
U.S. dollars can be converted to local currency at exchange businesses authorized by the Angolan government.
Angolan currency (the Kwanza) may not be taken out of the country and travelers, who attempt to carry currency out of Angola, are subject to having the currency confiscated.

Personal Identification: U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times so that, if questioned by local officials, proof of identity and U.S. citizenship is readily available.
The Consular Section of the U.S. Embassy in Luanda can prepare copies of American passports at no charge for individuals who register with the Embassy.
To avoid the risk of theft of or confiscation of original documentation, the U.S. Embassy recommends that Americans keep their passport in a secure place and carry a copy to avoid the possibility of authorities confiscating identity and travel documents.

Labor Disputes: American performers traveling to Angola to perform in concerts and/or other events should be aware that there have been several serious allegations made against talent agencies making arrangements for foreign performers.
These allegations include, among other things, several charges of breach of contract and the forcible retention of passports and persons.
Performers should assure themselves of the reputation of any agency they may contract with before traveling.
Many find it useful to contact performers who have previously worked in Angola and are familiar with agencies in Angola.
Persons experiencing any incidents of this nature in Angola should report these to the local Angolan police and the U.S. Embassy.

Long Delays in Renewal of Visas: U.S. citizens who opt to renew their work or other visa while in Angola should expect delays of 2-10 weeks or more, during which time the Angolan immigration authorities will retain one's passport and one will not be able to travel.
U.S. citizens are advised to plan accordingly, and if travel during this time cannot be avoided, one should apply for a second U.S. passport PRIOR to turning over the primary passport to Angolan authorities for visa renewal.
To apply for a second U.S. passport, you must write a letter explaining the need for the second passport, as well as meet all the requirements for a normal application for passport renewal, including being able to show a current valid passport.
Receiving a second passport will take 7-10 business days.
Expatriates who stay beyond their visa expiration date are subject to steep fines.

Hotel Availability:
Hotels are limited in Angola, and demand for the limited number of rooms is high.
Hotels are often booked months in advance, especially in the capital city of Luanda.
Only a few large hotels in Luanda accept credit cards; hotels in the provinces generally do not accept credit cards.
Adequate hotels are found in most provincial capitals, but some provide limited amenities.
Please see our information on Customs Regulations.

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 Angolan laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession or use of, or trafficking in illegal drugs in Angola are severe, and convicted offenders can expect long jail sentences 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.

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 Angola 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 Angola.
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 Consular Section is located at the American Embassy Complex, Rua Houari Boumedienne #32, in the Miramar area of Luanda, P.O. Box 6468, tel. (244) 222-641-000,
(244) 222-447-028, (244) 222-445-481, (244) 222-446-224; 24-hour duty officer (244) 923-404-209; fax (244) 222-641-259.
The Consular Section may be contacted by e-mail at consularluanda@state.gov.
Further information on travel to Angola is also available at the Embassy web site at http://angola.usembassy.gov/.
*

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This replaces the Consular Information Sheet dated April 29, 2008, to update the Country Description, Entry/Exit Requirements, Safety and Security, Crime, Traffic Safety and Road Conditions, Aviation Safety Oversight, and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu 9 May 2019 19:02 WAT
Source: Diario de Noticias [in Portuguese, machine trans., abridged, edited]

The measles outbreak in the Angolan province of Lunda Sul has caused 47 deaths since the start of the year [2019], among almost 1300 registered cases, Angola's national director of Public Health told Lusa today [9 May 2019].

Isilda Neves [Director, Program in Technical Assistance to the MOH] told Lusa that a vaccination campaign to identify children who are not yet immunized against the disease, will start at the weekend [11 May 2019], lasting for 10 days.

Along with this campaign, the vaccination intensification in the districts of Saurimo, capital of Lunda Sul, and in the other municipalities of the province, has been underway since the 2nd week of April [2019].

"At the end of the week we are going to make a big intervention: We are training the teams to go all out. We have at least 100 teams, each with 4 elements -- 2 coaches, one support team for the mobilization, and another to register the vaccinated children," she said.

The campaign, according to the national public health official, takes place first in Saurimo, followed by the remaining 3 municipalities in the province.

"Since the beginning of the year [2019], there were 1297 cases and 47 deaths, mostly in Saurimo," added Isilda Neves.

Health authorities are trying to control the situation, in which more than 90% of cases are being registered in children who have not been vaccinated, she said.

"One of the problems we identified is that many children who have passed the age of measles vaccination have not been vaccinated. Since there are a large number of children in the same household, we are also finding cases in children under 9 months and this is our concern too," she said.
======================
[HealthMap/ProMED-mail map of Lunda Sul province, Angola:
26th December 2018

Angola (Cunene province). 29 Nov 2018. (reported) 25 cases of microcephaly. Samples sent to the central laboratory in Luanda to determine if they are Zika virus related. There were no cases of microcephaly during the same period in 2017.

[HealthMap/ProMED-mail map Angola:
Date: Sat 11 Aug 2018
Source: World Health Organization [edited]
<http://www.who.int/neglected_diseases/news/Surveillance-presence-of-dracunculiasis-in-Angola/en/>

Disease surveillance confirms the presence of dracunculiasis in Angola. The World Health Organization (WHO) has received confirmation of a human case (29 Jun 2018) of dracunculiasis (guinea worm disease) in Angola -- a country not known to have had any cases in the past. "The patient is an 8 year old girl from Cunene Province.

Signs of worm emergence in April this year [2018] were characteristic of guinea worm disease and the worm appeared identical to _Dracunculus medinensis_," said Dr Maria Cecília de Almeida of the Angolan Guinea Worm Eradication Programme and who is also director of Control Programmes for Neglected Tropical Diseases, Ministry of Health. "The case-management protocol was observed, including the preservation of the worm specimen, and we are investigating further to determine the extent of transmission and burden of the disease." The case was detected through a nationwide guinea worm case search during the national immunization campaign against measles and rubella.

The specimen was sent to the WHO Collaborating Center for Dracunculiasis Eradication at the US Centers for Disease Control and Prevention, where a polymerase chain reaction (PCR) [1] test confirmed the worm as _Dracunculus medinensis_ [2]. "This is the first confirmed case of human infection in Angola. The discovery is part of measures taken by the Ministry of Health, following a WHO evaluation mission to Angola in 2016 to assess the country's level of readiness to finalize its dossier requesting a WHO certification," said Dr Dieudonné Sankara, team leader of WHO's guinea worm eradication programme.

After the evaluation mission of 2016, the International Commission for the Certification of Dracunculiasis Eradication recommended that Angola should use all available opportunities to gather robust evidence of absence of guinea worm disease in the country before submitting its certification request. WHO is supporting Angola through all 3 of its operating levels -- Country Office, Regional Office and Headquarters -- to implement its roadmap for certification of dracunculiasis-free status. "With the discovery of this new case, measures are being put up to strengthen surveillance, reporting and investigation of all suspicious cases through the country's Integrated Disease Surveillance and Response," said Dr Nzuzi Katondi, field officer, WHO Country Office, Angola. "Intelligence and alerts are being reported and rumours are being followed up and investigated."

Efforts are also being made through the country's broader mapping exercise of other neglected tropical diseases. To achieve global certification of dracunculiasis eradication, WHO must formally certify every individual country even if no transmission has ever taken place in that particular country. Confirmation of the 1st case in Angola comes as the global guinea worm eradication programme is tackling _Dracunculus medinensis_ infection in both humans and dogs, mainly in Chad. From 1 Jan to 31 May 2018, Chad reported 3 human cases and 534 infected dogs. Ethiopia and Mali, 2 other countries with recent cases, reported zero human cases.

South Sudan, which reported its last human case in November 2016, declared interruption of dracunculiasis transmission in March 2018. The latest confirmation from Angola brings the global total, so far this year [2018], to 4 human cases. Dracunculiasis is a crippling parasitic disease caused by a long threadlike worm. The infection is transmitted mostly when people drink water contaminated with parasite-infected water fleas. When the eradication campaign began in 1986, there were an estimated 3.5 million cases.  PCR is a technique used in medical and biological research laboratories. It is used in the early stages of processing DNA for sequencing, for detecting the presence or absence of a gene to help identify pathogens during infection, and when generating forensic DNA profiles from tiny samples of DNA.  _Dracunculus medinensis_, a nematode (worm), is the causative agent of guinea worm disease.
============================
[According to the latest guinea worm update from WHO (Weekly Epidemiology Report 2018;32:409-16. 10 Aug 2018; <http://apps.who.int/iris/bitstream/handle/10665/273782/WER9332.pdf>) the reported numbers for other countries in 2018 are Chad, 5544; Ethiopia, 5044; Mali, 91; Sudan, 0. South Sudan did not file a report. Even though this is just a single case, the finding indicates that there is a focus. - ProMED Mod.EP]

[Cunene province is in the south of Angola bordering Namibia (<https://en.wikipedia.org/wiki/Cunene_Province>).

HealthMap/ProMED map available at: Angola: <http://healthmap.org/promed/p/165>.]
Date: Tue 8 May 2018
Source: AllAfrica.com [edited]

A total of 21 positive cases of sleeping sickness were diagnosed in the last 2 weeks in the municipality of Banga, Kwanza Norte province, during the prospecting campaign held by the Provincial Department of the Institute of Combat and Control of Trypanosomiasis (Icct).

Angelino Francisco Correia, the supervisor of the campaign, said that 2800 had been examined, and 21 cases were diagnosed, of which 5 were confirmed as sleeping sickness patients.

The official called the active participation of the population in the campaigns of prospection of the disease.
=====================
[A review of human trypanosomiasis (sleeping sickness) in Africa (Fevre EM, Wissmann Bv, Welburn SC, Lutumba P (2008) The Burden of Human African Trypanosomiasis. PLoS Negl Trop Dis 2(12): e333. <https://doi.org/10.1371/journal.pntd.0000333>) found that Angola is a highly endemic country with more than a 1000 cases annually. For background information on human trypanosomiasis in Africa see the ProMED posting "Trypanosomiasis - Angola http://promedmail.org/post/20110709.2081".

A map of Kwanza Norte Province, Angola:
Monday 16th April 2018

- Ndalatando. 11 Apr 2018. At least 78 suspected cases recorded in the period 4-9 Apr 2018 in northern Cuanza Norte Province.
More ...

Namibia

Namibia US Consular Information Sheet
August 16, 2007
COUNTRY DESCRIPTION: Namibia is a southern African country with a moderately developed economy.
Facilities for tourism are good and generally increasing in quality.
The capital is
indhoek.
Read the Department of State Background Notes on Namibia for additional information.
ENTRY/EXIT REQUIREMENTS: A passport and visa are normally required.
Bearers of U.S. passports who plan to visit Namibia for tourism for less than 90 days can obtain visas at the port of entry and do not need visas prior to entering the country.
Travelers coming for work or study, whether paid or voluntary, must obtain a work or study permit prior to entering Namibia.

All travelers traveling to or from Namibia via South Africa are strongly encouraged to have several unstamped visa pages left in their passports.
South Africa requires two unstamped visa pages, and Namibia usually also requires an unstamped page to stamp a visa upon arrival.
Visitors who do not have enough free visa pages in their passport risk being denied entry and returned to the U.S. at their own expense.

Travelers should obtain the latest information from the Embassy of Namibia located at 1605 New Hampshire Avenue, NW, Washington, D.C. 20009, telephone (202) 986-0540 or from the Permanent Mission of Namibia to the U.N. at 135 E. 36th St., New York, NY 10016, telephone (212) 685-2003, fax (212) 685-1561.
Overseas, inquiries should be made to the nearest Namibian embassy.
See our Foreign Entry Requirements brochure for more information on Namibia and other countries.
Visit the Embassy of Namibia's website at http://www.namibianembassyusa.org/ for the most current visa information.
See Entry and Exit Requirements for more information pertaining to dual nationality and the prevention of international child abduction.
Please refer to our Customs Information to learn more about customs regulations.
SAFETY AND SECURITY:
American citizens wishing to cross into Angola from Namibia should do so only at official border crossing areas and should consult the State Department's Consular Information Sheet for Angola.
American citizens should avoid street demonstrations.
However, such events are rare in Namibia.
American citizens traveling in Namibia are urged to contact the consular section of the U.S. Embassy in Windhoek for the latest safety and security information.
For the latest security information, Americans traveling abroad should regularly monitor the Department's Internet web site, where the current Worldwide Caution Public Announcement, Travel Warnings and Public Announcements 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., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad.
CRIME: Crime is a serious concern in Namibia, but visitors who employ common-sense preventive measures normally enjoy an incident-free stay.
Incidents of violent crime directed specifically against Americans or other foreigners are rare, but the number of overall incidents continues to increase.
The most common crimes are property-motivated crimes of opportunity, including pick pocketing, purse snatching, vehicle theft, and vehicle break-ins.
Taxi drivers have robbed several American passengers; if taxis must be used, radio taxis that display the NABTA logo (Namibia Bus and Taxi Association) are the most reliable.
Violent crimes are less frequent than non-violent incidents.
Common sense measures such as being alert to one's surroundings, avoiding isolated areas of town, not leaving valuables in parked cars, keeping car doors locked and windows up while driving, safeguarding purses, wallets and especially cellular phones are the best deterrents against becoming a victim.
Drivers should exercise caution at rest stops outside of towns or away from gasoline stations.

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, 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: Windhoek has a small number of private medical hospitals and clinics capable of providing emergency care and performing many routine procedures.
Doctors, both general practitioners and specialists, as well as dentists, generally have training and facilities that are comparable with U.S. standards.
Facilities outside the capital vary widely.
Several large towns have well-equipped facilities similar to those available in Windhoek, while smaller towns generally do not.
Malaria is prevalent only in the north of the country.
Malaria prophylaxis is not required in Windhoek but is suggested for travel to the north.
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); fax 1-888-CDC-FAXX (1-888-232-3299), or via the CDC's Internet site at http://www.cdc.gov/travel.
For information about outbreaks of infectious diseases abroad consult the World Health Organization's (WHO) website at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith.
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 Namibia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
In Namibia, driving is done on the left-hand side of the road.
Many of Namibia's rural roads are gravel.
Although these roads are generally well maintained, controlling a vehicle on gravel is significantly more difficult than on pavement.
Drivers should not drive in excess of 80km per hour (45 mph) on gravel roads, should reduce speed significantly for curves or turns, and should heed all warning signs.
Hitting a sand patch or driving around a curve too fast can easily result in a rollover or spinout.
Many accidents on gravel roads occur when tourists exceed safe speeds on corners or in areas recently damaged by rains.
Visitors are reminded that motor vehicle accidents are one of the primary causes of injury and death in Namibia, and drivers are therefore strongly urged to drive with caution.

For those driving outside of the capital, distances between cities can be considerable, and often gasoline is only available at a few service stations along a route.
Fuel availability can be impacted by power outages as well.
All travelers are encouraged to plan their route to ensure a sufficient supply of fuel, and are recommended to bring five liters of water per person when traveling on dirt roads to guard against dehydration if an accident should occur.
Turning on a red traffic light is not permitted in Namibia.
Seat belts are required for all vehicle occupants.
Motorcyclists are required by law to wear protective helmets.
While child car seats are not required, they are recommended.
To drive legally while in Namibia, visitors staying more than a few weeks need an international driving permit.
International driving permits must be obtained prior to leaving the U.S. and are available from either the American Automobile Association or the American Automobile Touring Alliance.
Short-term visitors do not need an international driving permit; a valid U.S. driver's license is sufficient.
Roads in Namibia are generally well maintained.
However, few have shoulders or “pull-off” lanes for broken vehicles.
Wildlife wandering on roads is a special driving hazard in Namibia, especially at night.
An encounter at high speeds with antelope or cattle can be fatal.
The salt-surfaced roads at the coast can also be deceptively dangerous, especially when they have been made slick by morning or evening mist.
Robbery has occurred at roadside "rest stops" and motorists are advised to take rest breaks in towns and/or at gasoline stations.
Most major roads are undivided with one lane in each direction.
Drivers should remain alert for passing vehicles and exercise caution when passing slow moving vehicles.
Accidents involving drunk drivers are an increasing problem on major roads where there are high speed limits.
Driving under the influence is illegal in Namibia.
A charge of culpable homicide can be made against a driver involved in an accident resulting in death.
Roadside assistance and emergency medical services outside of Windhoek may be unreliable or non-existent.
Assistance on main roads that link Namibia's larger towns, however, is generally good due to quality cell phone networks.
Emergency services contact numbers vary from town to town.
The Namibian telephone directory has a list of emergency contact numbers at the beginning of each town listing.
It is recommended that Americans maintain a list of contact numbers for the area in which they plan to drive.
Telephone numbers may change, and 24-hour availability of these numbers is not guaranteed.
Public transportation is not widely available outside of the capital.
Taxis and municipal buses are the only forms of public transportation in Windhoek.
Schedules and routes are limited.
Car rentals or radio taxis are generally the best means of transport but may be relatively expensive.
The Embassy has received reports of foreign citizens being robbed by drivers of taxis hailed on the streets of Windhoek.
The Embassy has not received any such reports regarding radio taxis.
Flashing of high beams and similar signals could mean anything from a friendly greeting to a warning.
When encountering a motorcade, motorists are encouraged to make way immediately and follow promptly any instructions given by the officials present.
Because of the possibility of intoxicated and/or reckless drivers, the poor mechanical condition of some motor vehicles, and the high incidence of single-vehicle rollover accidents, Americans are urged to avoid hitchhiking in Namibia.
Please refer to our Road Safety page for more information.
Visit the website of the country's national tourist office and national authority responsible for road safety: http://www.met.gov.na/default.htm
AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service between the United States and Namibia, the U.S. Federal Aviation Administration (FAA) has not assessed Namibia's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA's Internet web site at www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES: Wild animals may pose some danger.
Travelers are advised that, even in the most serene settings, animals are wild and can pose a threat to life and safety.
Travelers are cautioned to observe all local or park regulations and heed all instructions given by tour guides.
In addition, tourists are advised that potentially dangerous areas sometimes lack fences and warning signs.
Appropriate caution should be used in all unfamiliar surroundings.

Namibia does not recognize dual citizenship for adults over the age of 18.
Therefore, despite the fact that these individuals possess U.S. citizenship, they must enter and exit Namibia bearing a Namibian passport.
Namibia recognizes dual citizenship up until the age of 18; however, such children must enter Namibia on their Namibian passport and may face questioning by an immigration officer before being permitted entry.
Please see our information on customs regulations.

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 offences.
Persons violating Namibian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Namibia 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.
Americans should avoid purchasing diamonds and other protected resources outside of licensed retail establishments.
The penalty for illegal dealing in diamonds in Namibia is stiff -- up to U.S. $20,000 in fines or five years in prison -- and the courts generally impose the maximum sentence.
The purchase and exportation of other protected resources, such as elephant ivory, may also be prohibited by Namibian, international, and/or U.S. law.
CHILDREN'S ISSUES: For information on international adoption of children and international parental child abduction, see the Office of Children's Issues website.
REGISTRATION / EMBASSY LOCATION: Americans living or traveling in Namibia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website and to obtain updated information on travel and security within Namibia.
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 14 Lossen Street, Ausspannplatz, Windhoek, telephone (264-61) 295-8500, fax (264-61) 295-8603.
You can reach the Consular Section at extension 8551; i.e., (264-61) 295-8551 or via e-mail consularwindho@state.gov.
The mailing address for the Embassy is Private Bag 12029, Windhoek, Namibia.
The U.S. Embassy Windhoek website is http://windhoek.usembassy.gov/.
* * *
This replaces the Consular Information Sheet dated August 1, 2006, to update the sections on Entry/Exit Requirements, Crime, Medical Facilities and Health Information, Traffic Safety and Road Conditions and Special Circumstances.

Travel News Headlines WORLD NEWS

Date: Thu 16 May 2019
Source: The Namibian [edited]

Health minister Kalumbi Shangula announced at a press conference in Windhoek yesterday [Wed 15 May 2019] that of the 6 reported cases of Crimean-Congo haemorrhagic fever (CCHF), only one had tested positive for the fever, while 3 were found to be negative. The results of the remaining 2 cases are still pending.

Shangula said a 54-year-old woman from Onethika B Village in the Olukonda constituency, who had since recovered and was discharged on 11 May [2019], had tested positive for the disease, also known as Congo fever.

The minister, however, stated that a 77-year-old man who died after admission to the Onandjokwe District Hospital due to a history of tick bites, a high fever, vomiting of blood, and confusion tested negative for Congo fever.

A 50-year-old man who was admitted at the Outapi District Hospital on 8 May [2019] for a tick bite also tested negative, and so did a 40-year-old man who was admitted to the Windhoek Central Hospital.

The 2 pending cases are of a 27-year-old male who was admitted at the Onandjokwe District Hospital on 8 May [2019] but was discharged on 11 May [2019], and of a 57-year-old woman who was admitted at the Engela District Hospital at Oshikango on 9 May [2019].

Yesterday [Wed 15 May 2019], the government, through the health and agriculture ministries, started educating farmers at Onethika B on tick control by applying acaricides to livestock in areas where cases of CCHF had been confirmed.

The health ministry has put together a team of 25 people consisting of 5 committees with veterinary experts, medical officers, nurses, and doctors to control the outbreak. The process, which will go on until tomorrow [Fri 17 May 2019], will help prevent any further spread of the disease.

The Namibian yesterday [Wed 15 May 2019] visited Onethika B and observed officials applying decaspot pour-on. This method is used to control ticks, stable flies, horn flies, and nuisance flies (e.g., house flies), and it protects against blackflies on cattle.

The fever virus is transmitted from humans through bodily fluids, including blood, vomit, and urine. CCHF is a deadly disease classified in the same group as Ebola. The 2 diseases have similar symptoms. The common symptoms include excessive headache, high fever, back pain, joint pain, stomach pain, bleeding, and vomiting.

Shangula said although cases of Congo fever have become more frequent over the past 3 years, there has been confusion, with some conditions caused by other viruses that exhibit similar symptoms. He said apart from Congo fever, there are other viral haemorrhagic diseases such as Marbug, Lassa fever, and yellow fever, amongst others. He thus urged members of the public not to panic, but to seek immediate medical attention if they exhibit any of the symptoms.

Everyone is at risk, but Shangula said those at most risk are cattle herders, livestock handlers, slaughterhouse workers, animal health workers, and public health workers who deal with CCHF patients. He added that regular tick control should be carried out on livestock every 2 weeks in summer and once a month during the dry season.

Mathew Ashipala, animal health technician in the Oshikoto region, advised farmers to carry out this exercise after 7 days, just to ensure that there are no more ticks left on the animals. He said the pour-on method being used was effective only for goats, sheep, and cattle. Dogs and pigs are not covered, although they can also be tick carriers.

[AS], a subsistence farmer and resident of Onethika B, brought 17 of his cattle for the pour-on procedure. "We need this kind of assistance. We have never had this kind of help before, as usually we just get the routine animal vaccination," he said, adding that officials have made every farmer aware that this process is to be repeated every week.

[AJA] (54) brought only 7 cattle. "We are happy that they came because of the suspected cases surrounding us. My concern is that some of my livestock are not here, as they search for grazing, so they will not be treated," [AJA] lamented.

[AA] (64), who brought 33 goats, said he was happy that the government was helping those who cannot afford the medicine, although he indicated he will repeat the process himself. He pointed out that the officials had advised them they cannot slaughter a treated animal within the next 3 weeks.  [Byline: Tuyeimo Haidula and Ndanki Kahiurika]
======================
[Based on the above report, out of 6 suspected cases, only one positive case has been found so far, while the report for 2 is pending. The contact tracing and follow-up of suspected cases and contacts as well as raising community awareness are important measures taken by the department of health in response to this outbreak. - ProMED Mod.UBA]

[HealthMap/ProMED-mail map:
Date: Sat 11 May 2019
Source: Informante [edited]

An elderly man is dead and 4 more people have been isolated in different hospitals as a result of an outbreak of Congo fever [Crimean-Congo haemorrhagic fever] in Namibia. The 4 new cases have been admitted to hospitals for treatment and observation purposes in different regions across the country.

Selma Robert, National Surveillance Officer on the spread of disease in the Ministry of Health confirmed that a 77-year-old man died as a result of the viral infection on [Tue 7 May 2019].

Robert said the diseased elderly man was the neighbour of the 1st confirmed Congo fever case patient, a 54-year-old female from Ontananga village [Oshikoto region] who visited the health facility with complaints of tick-bite, headache, body weakness and blood-stained vomit on [26 Apr 2019]. She added that the 54-year-old female is still alive and is under medical treatment and tight observation.

According to Robert of the 4 new incidents of possible infection, 2 patients were admitted and isolated in the Oshikoto region, one in Outapi [Omusati region], and one person in Windhoek [Komas region].

Robert added that Congo fever has been a seasonal occurrence in Namibia with outbreaks in different towns reported in places such as Gobabis [Omaheke region] last year [2018], Keetmanshoop [!Karas region], and the Omusati region in previous years.

She stated that infected ticks are almost everywhere in the country and that the situation is worsened by the drought as human to animal contact has increased due to the deteriorating health of livestock.

She advised members of the public to wear bright clothing in high risk areas in order to easily notice if they have ticks on them and to wear protective clothing and gloves when handling animals.

Crimean-Congo haemorrhagic fever is a viral disease transmitted by ticks. It can be responsible for severe outbreaks and death in humans.

Symptoms of Congo fever include muscle ache, dizziness, neck pain and stiffness, backache, headache, sore eyes, and photophobia (sensitivity to light). There may also be nausea, vomiting, diarrhoea, abdominal pain, and sore throat early on, followed by sharp mood swings and confusion.

The disease was first described in the Crimea in 1944 and given the name Crimean haemorrhagic fever. In 1969 it was recognized that the pathogen causing Crimean haemorrhagic fever was the same as that responsible for an illness identified in 1956 in the Congo, and linkage of the 2 place names resulted in the current name for the disease and the virus.  [Byline: Zorena Jantze]
========================
[From the information above, it is quite possible that one the 4 suspected cases mentioned had contact with the recently reported fatal case (see Crimean-Congo hem. fever - Africa (05): Namibia (OT) http://promedmail.org/post/20190509.6460573) but information on the remaining cases is not available. Further epidemiological data and the final laboratory results in this regard would be quite helpful and any updates would be appreciated. - ProMED Mod.UBA]

[Maps of Namibia:
Date: Tue 7 May 2019
Source: The Namibian [edited]

A 54 year old woman from Onethika village in the Oshikoto region was admitted to Onandjokwe Hospital after she was diagnosed with Crimean Congo haemorrhagic fever (CCHF).

A letter written by acting Oshikoto regional health director, Helena Nkandi-Shiimi states that the woman went to the hospital on [21 Apr 2019] complaining of a headache, fever, and vomiting blood after she got bitten by a tick around [18 Apr 2019].

"The patient was sent home, and again reported at the Ontananga clinic on [26 Apr 2019] with the same complaints," Nkandi-Shiimi said, adding that the patient was admitted, and tests were done on her blood, which discovered the virus.

The virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after an animal slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians.

Nkandi-Shiimi further said the patient, who is in a stable condition, is in strict isolation, and infection protocols were enforced. The patient shows no more signs or symptoms of CCHF.

"A team was sent to Onethika village to do a case investigation and tracing," she said, but none of the people she was in contact with showed any symptoms. She noted that an active case search will be done, especially in the health facilities and areas around Onethika village.  [Byline: Okeri Ngutjinazo]
============================
[CCHF is viral illness that occurs in Africa, the Balkans, the Middle East, and Asia. The principal reservoir and vector of CCHF are ticks of the genus _Hyalomma_, although other tick genera can be infected with CCHF virus. The CCHF virus is transmitted to humans mainly by tick bites (70 percent of CCHF cases have a history of tick bite) or through contact with infected animal blood or tissues during and immediately after slaughter.

88 percent of people infected will have subclinical symptoms. One in 8 people will develop a severe disease. Case fatality ratio can reach 15 percent among patients hospitalized with severe presentation.

Symptoms are non-specific; clinical diagnosis may be difficult. Differential diagnosis includes other viral haemorrhagic fevers, malaria, typhoid fever, shigellosis, and other viral and bacterial diseases which may present difficulty in absence of good laboratory services. Definitive diagnosis requires testing: reverse transcriptase polymerase chain reaction (RT-PCR) assay; IgG and IgM antibodies enzyme-linked immunosorbent assay (ELISA); antigen detection tests; virus isolation by cell culture. Handling and processing specimen requires suitably equipped laboratories under maximum biological containment conditions and staff collecting samples should be trained in biosafety.

Patient history is essential and should include: exposure to ticks; or exposure to wild animals and livestock; and/or area/village endemic for CCHF; and/or contact with CCHF cases.

In healthcare settings, the following should be considered when handling CCHF cases:
"- implement standard precautions with all patients -- regardless of their diagnosis -- in all work practices, at all times, including safe injection practices (<http://www.who.int/csr/resources/publications/standardprecautions/en/index.html>);
- healthcare workers treating patients with CCHF should apply extra infection control measures to prevent contact with the patient's blood and body fluids and contaminated surfaces or materials such as clothing and bedding (<http://www.who.int/csr/resources/publications/ebola/filovirus_infection_control/en>);
- laboratory workers are also at risk. Samples taken from suspected human CCHF cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories."  (<https://www.who.int/emergencies/diseases/crimean-congo-haemorrhagic-fever/introduction.pdf>)

Maps of Namibia:
Oshikoto is one of the 14 regions of Namibia
Date: Tue 19 Feb 2019
Source: Reliefweb, a New Era report [edited]

Statistics from the Ministry of Health and Social Services show that as of [27 Jan 2019], a total 4432 hepatitis E cases had been reported in Namibia. So far, 40 deaths have been reported and the death toll is disproportionately highest among pregnant women and those who have given birth, constituting 17 cases, which translates to 42.5% of deaths. Minister of Health and Social Services, Dr. Kalumbi Shangula said he has had a chance to interact with teams that are charged with the hepatitis E outbreak control at national and regional levels.

"Though we note progress made, the fact that the outbreak is persisting and has the potential to become endemic in Namibia is a wake-up call to action. The latent apathy that permeates through the public towards the disease is frightening phenomenon," said Shangula. He said a rapid assessment that was conducted late in 2018 revealed certain gaps and weaknesses in the current control environment.
======================
[Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Acute epidemic hepatitis E is attributable to infection with hepatitis E virus genotypes 1 and 2. Many of the deaths are in pregnant women, characteristic of genotype 1.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus. - ProMED Mod.LL]

[HealthMap/ProMED map available at:
Date: Thu 31 Jan 2019
Source: New Era [edited]

The Ministry of Health and Social Services, together with other stakeholders in Gobabis, have been working around the clock to come up with the regional response plan that will mitigate effects of a hepatitis E outbreak in town. Since the 1st case was reported in December 2018 -- a pregnant woman who has since miscarried -- 6 other cases have recently been confirmed out of the suspected 25, and the figure keeps rising steadily.

Most of the reported cases are coming from informal settlements with poor sanitation, especially Kanaan C, whose residents have no access to clean water and toilets, which is why the regional directorate of health has been meeting with officials from the town council, regional council, and office of the governor to see how fast they could provide these key services to the said settlement.

According to the chief medical officer for Omaheke Region, Dr Leonard Kabongo, the emergency regional management meetings held Tuesday and Wednesday, 29-30 Jan 2019, yielded favourable fruits towards the mitigation of hepatitis E in the affected areas. Kabongo said they planned to install three 10 000 L [2642 gal] clean-water tanks and 10 portable toilets yesterday afternoon [Wed 30 Jan 2019] in Kanaan C, where most of the cases originated from.

"We are probably going to purchase and install more, but we will see how the budget will allow," he said. Kabongo has also revealed that his directorate has sent health-extension workers to the affected settlements, and especially to the affected households, to conduct informative meetings.

They will also start with the distribution of water purification tablets to the affected communities. In addition, there will be a clean-up campaign on Sat 9 Feb 2019 in the said areas, and Kabongo is calling on stakeholders to come on board and assist with necessary tools and equipment as well as trucks to add to the 2 availed by town council.

Hepatitis E, a liver disease mostly associated with poor sanitation, was reported in 2018 in Windhoek and Omusati Region, respectively.  [Byline: Hileni Mwandingi]
========================
[Hepatitis E is found worldwide, and different genotypes of the hepatitis E virus determine differences in epidemiology. For example, genotype 1 is usually seen in developing countries and causes community-level outbreaks, whereas genotype 3 is usually seen in developed countries and does not cause outbreaks. Acute epidemic hepatitis E is attributable to infection with hepatitis E virus genotypes 1 and 2. Many of the deaths are in pregnant women, characteristic of genotype 1.

The highest seroprevalence rates (number of persons in a population who test positive for the disease) are observed in regions where low standards of sanitation increase the risk for transmission of the virus. - ProMED Mod.LL]

[HealthMap/ProMED-mail map:
More ...

World Travel News Headlines

Date: Tue, 21 May 2019 12:37:30 +0200

Khartoum, May 21, 2019 (AFP) - Sudanese protest leaders called on their supporters Tuesday to prepare for a general strike after talks with the country's military rulers stalled on who will lead an agreed three-year transition.   Protest leaders had reached agreement with the ruling military council on the other main aspects of the transition.   But early on Tuesday, the generals who overthrew veteran president Omar al-Bashir last month baulked at protesters' demands for a civilian head and a civilian majority for an agreed new sovereign council to lead the transition.

"In order to achieve a full victory, we are calling for a huge participation in a general political strike," said the Sudanese Professionals Association, which took the lead in organising the four months of nationwide protests that led to Bashir's ouster.   "The strike is our revolutionary duty and the participation in the sit-in ... is a crucial guarantee to achieve the goals of the revolution."

Protest leader Madani Abbas Madani told AFP the preparations for a "general political strike and civil disobedience" were already under way.   "Whenever we will decide on applying these plans, we will make an announcement," said Madani, a prominent leader of protest umbrella group the Alliance for Freedom and Change.   The two sides launched what had been billed as a final round of talks on the transition late on Sunday.

The military council has faced pressure from Western government and the African Union to agree to a civilian-led transition -- the central demand of the thousands of demonstrators who have spent weeks camped outside army headquarters in Khartoum.   When talks broke up early on Tuesday, neither side said when they would resume.

Protest leader Siddiq Yousef told reporters they had been suspended.   "The main point of dispute that remains is concerning the share of representatives of the military and the civilians in the council and who will be the head of the new body," the two sides said in a joint statement.   The military council has been pushing for its chairman General Abdel Fattah al-Burhan to head the new sovereign council but protest leaders want a civilian.
Date: Tue, 21 May 2019 05:22:30 +0200
By John WESSELS with Samir TOUNSI in Kinshasa

Butembo, DR Congo, May 21, 2019 (AFP) - People in Ebola-hit eastern DR Congo are struggling to come to terms with high-security burials that are part of a hard-pressed strategy to roll back the disease.   Anyone who dies of the highly infectious haemorrhagic fever has to be buried in carefully-controlled conditions designed to minimise the risk of infection from body fluids.   But that means ceremonies are carried out in sanitised conditions, with relatives and friends kept at a distance -- for many, a traumatic break with traditions that demand the body of a loved-one be seen or touched.   "We're astonished she's being buried like this," said Denise Kahambu as she watched the specially-prepared burial in Butembo of her 50-year-old cousin, Marie-Rose.   "They said she died of Ebola," she said sceptically.   First declared last August, the epidemic has now claimed nearly 1,200 lives -- 200 of them in May alone.    The outbreak is the second deadliest on record, after an epidemic that killed more than 11,300 people in West Africa in 2014-16.

The burial in Butembo followed strict precautions. A pick-up truck delivered the coffin to the burial site, where a grave had been prepared, as the family stood by at a distance.   Gloved Red Cross workers handled the burial, which took place in silence and without a religious ceremony.   A family member or loved one was allowed only to place a cross on the tomb, once they too had donned protective gloves.   Half a dozen police officers escorted the convoy and remained on guard throughout.    On Friday, two burial teams from the treatment centres were attacked by stone-throwing crowds at Butembo and Bunia, a little further north in Ituri province, according to the health ministry. One burial worker was injured.

- Culture shock -
"The custom is that the body of the deceased first returns to the home. And once people have mourned, they have the chance to touch the body for the last time," said Seros Muyisa Kamathe, a guide and interpreter in Beni and Butembo.   "Before going to the cemetery, you open the coffin so people can take one last look at the deceased."

And normally it would be the family and neighbours who would take responsibility for digging the grave -- and deciding where if should be.   Ebola experts say denial and resistance were familiar obstacles in the 2014-16 epidemic in the West African states of Guinea, Liberia and Sierra Leone.   The World Health Organization (WHO) has a 12-step protocol for dealing with burials so that handling of the remains is kept to a minimum, but it also emphasises the importance of respect and mourning.   "The burial process is very sensitive for the family and the community and can be the source of trouble or even open conflict," it acknowledges.    No burial should begin until family agreement has been obtained, and workers should engage with the community "for prayers to dissipate tensions
and provide respectful time," it says.

- Armed escorts -
The burial process is part of the notoriously time-consuming and labour-intensive task of combatting Ebola.   And in this troubled region, the challenge has been further complicated by bloody deadly attacks on Ebola treatment centres by local militias.   Suspicion, political infighting in the capital Kinshasa and militia violence provide a fertile breeding ground for the virus.   Sometimes local people cover the graves overnight as a sign of their opposition, the ministry said.   In Butembo, health workers need an armed escort when they go looking for cases of Ebola in some neighbourhoods, an AFP photographer noted during one outing Saturday evening.

WHO Director-General Tedros Adhanom Ghebreyesus, at the opening of the organisation's annual assembly on Monday, described the outbreak as "one of the most complex health emergencies any of us have ever faced."   "Unless we unite to end this outbreak we run the risk it will become more widespread and more expansive and more aggressive," he said.   "We are not just fighting a virus," Tedros insisted. "We're fighting insecurity. We're fighting violence. We're fighting misinformation... and we're fighting the politicisation of an outbreak."   On the plus side, health officials are keen to emphasise some important gains. More than 118,000 have been vaccinated against the virus, and no cases have been recorded in neighbouring Rwanda and Uganda.
Date: Mon, 20 May 2019 15:09:54 +0200

Milan, May 20, 2019 (AFP) - Alitalia has scrapped around half its flights scheduled for Tuesday after a call to strike by Italian pilots, cabin crew and ground staff.   The industrial action by employees of Alitalia, Blue Air and Blue Panorama was confirmed Monday over the future of the sector and specifically that of the troubled national carrier.   Alitalia has cancelled around half its flights on Tuesday, as well as some late Monday and early Wednesday. The company said it hoped to get 60 percent of passengers to their destination.

Unions lamented "on the one hand, a rising number of passengers and flights, and on the other a proliferation of bankruptcies", a statement said.   They are worried about Alitalia's future and want their jobs protected.   The Italian government earlier this month extended to June 15 a deadline for the state railway to submit a concrete takeover offer, following a request from Alitalia's administrators for more time.   Italy's state railway Ferrovie dello Stato (FS) floated a bid to buy Alitalia at the end of October, but it does not want to hold more than 30 percent in the airline.   The railway has been discussing a potential partnership with Atlanta-based Delta airlines, which is interested in a 15-percent stake.
Date: Sun, 19 May 2019 21:55:33 +0200

Giza, Egypt, May 19, 2019 (AFP) - A bomb blast hit a tourist bus near Egypt's famed Giza pyramids on Sunday, wounding some of them, including South Africans, in the latest blow to the country's tourism industry.   The roadside bomb went off as the bus was being driven in Giza, also causing injuries to Egyptians in a nearby car, medical and security sources said.   Security and medical sources in Egypt said 17 people were injured, without giving a breakdown of their nationalities. No deaths were reported.   South Africa said in a statement that the "bus explosion" injured three of its 28 citizens who were part of the tourist group.   They would remain in hospital while the rest would return home on Monday, said the statement from the department of international relations.   "A device exploded and smashed the windows of a bus carrying 25 people from South Africa and a private car carrying four Egyptians," the security source said.

Video footage captured by AFP showed the bus and car with broken windows on the side of the road.   According to the security source, the wounded were being treated for scratches caused by the broken glass.   Sunday's incident comes after three Vietnamese holidaymakers and their Egyptian guide were killed when a roadside bomb hit their bus as it travelled near the Giza pyramids outside Cairo in December.   It also comes just little more than a month before the African Cup of Nations hosted by Egypt is to kick off.   Egypt has been battling an insurgency that surged especially in the turbulent North Sinai region following the 2013 military ouster of Islamist president Mohamed Morsi, who was replaced by former army general Abdel Fattah al-Sisi.   In February 2018, the army launched a nationwide operation against militants, focusing mainly on the North Sinai region.

- Tourism recovery -
Some 650 militants and around 45 soldiers have been killed since the start of the offensive, according to separate statements by the armed forces.   Since first being elected in 2014, Sisi has presented himself as a bulwark against terrorism, promising stability and increased security.   Recently, the country's vital tourism industry has started to slowly rebound after suffering strong blows due to deadly attacks targeting tourists following the turmoil of the 2011 uprising that toppled longtime ruler Hosni Mubarak.   Figures by the official statistics agency showed that tourist arrivals reached 8.3 million in 2017, compared with 5.3 million the previous year.    Authorities have gone at great lengths to lure tourists back, touting a series of archaeological finds and a new museum next to the pyramids, as well as enhanced security at airports and around ancient sites.    But that figure was still far short of the record influx of 2010 when more than 14 million visitors flocked to see the country's sites.
Date: Sun, 19 May 2019 05:17:37 +0200

Tegucigalpa, May 19, 2019 (AFP) - Four Canadians and an American pilot died Saturday when their small plane plunged into the sea off the Honduran island of Roatan where they were vacationing, firefighters said.   The plane crashed near the town of Dixon Cove, a few minutes after taking off from the island's airport, rescuers said.   The dead were identified as Bradley Post, Bailey Sony, Tomy Dubler and pilot Patrick Forseth.

The other Canadian pilot, Anthony Dubler, briefly survived the crash but died at the Roatan hospital of his injuries.   The causes of the crash and the registration information for the aircraft were not immediately available.   It occurred as the tourists were headed toward the city of Trujillo, about 77 kilometres (48 miles) from Roatan.
Date: Fri, 17 May 2019 16:32:13 +0200

London, May 17, 2019 (AFP) - London warned British-Iranian dual nationals against all travel to Iran on Friday due to Tehran's "continued arbitrary detention and mistreatment" of such citizens.   The move comes as Britain continues to try to secure the release from jail of dual national Nazanin Zaghari-Ratcliffe.   Tehran has also recently sentenced an Iranian British Council employee, Aras Amiri, to 10 years in prison on charges of spying.   In a statement, the Foreign Office said British-Iranian dual nationals faced an "unacceptably higher risk of arbitrary detention and mistreatment" than nationals of other countries.   "The security forces may be suspicious of people with British connections, including those with links to institutions based in the UK, or which receive public funds from, or have perceived links to, the British government," the statement said.   British-Iranian mother Zaghari-Ratcliffe was arrested by Iranian authorities in 2016 as she was leaving Tehran.

Zaghari-Ratcliffe, who worked for the Thomson Reuters Foundation, was put on trial and is now serving a five-year jail sentence for allegedly trying to topple the Iranian government.   "Dual nationals face an intolerable risk of mistreatment if they visit Iran," Foreign Secretary Jeremy Hunt said.   "Despite the UK providing repeated opportunities to resolve this issue, the Iranian regime's conduct has worsened.   "Having exhausted all other options, I must now advise all British-Iranian dual nationals against travelling to Iran.   "The dangers they face include arbitrary detention and lack of access to basic legal rights, as we have seen in the case of Nazanin Zaghari-Ratcliffe, who has been separated from her family since 2016."   The Iranian government does not recognise dual nationality, meaning the Foreign Office's ability to provide consular support is limited.   Hunt added: "Regrettably, I must also offer a message of caution to Iranian nationals resident in the UK -- but who return to visit family and friends -- especially where the Iranian government may perceive them to have personal links to UK institutions or the British government."
Date: Fri, 17 May 2019 11:42:01 +0200

Nairobi, May 17, 2019 (AFP) - Flooding in Tanzania has killed five people and forced about 2,500 to flee their homes after a week of torrential rain in the country's south, an official said Friday.   Schools have closed in Kyela, a district on the border of Lake Malawi, and families fled to shelters after losing everything in the rising waters.   "The damage from these floods is enormous," Salome Magambo, the district's administrative secretary, told AFP.   "Since the beginning of the week we have reported five people killed and 2,570 homeless, some of whom are staying with friends or in schools and churches."

Food and medical services have been extended to those stranded, she added.   Farming land in the district known for its rice production has also been inundated, destroying crops and raising fears of food shortages in coming months.   In April 2018 at least 14 people were killed in torrential rains and flooding in Dar es Salaam, Tanzania's economic capital.
Date: Thu, 16 May 2019 23:41:35 +0200

Washington, May 16, 2019 (AFP) - The Church of Scientology said Thursday all the passengers from a cruise ship that was quarantined over a measles case had been cleared to leave.    "All passengers and crew (100%) of the Freewinds have been fully cleared of any possible risk of being infected by the measles or infecting others," the organization said in a statement.   "All passengers and crew are free to come and go as they wish," a spokesman added to AFP.

The infected individual was a member of the crew who, according to the Church, had fully recovered and was given a clean bill of health a week ago. She had been earlier confined on the ship.   The ship, which is based in Willemstad on the island of Curacao in the Dutch West Indies, was quarantined after its arrival in Saint Lucia on April 30.   It remained there for two days before returning to Willemstad on May 4 where local authorities ordered a fresh quarantine to give them time to confirm the passengers were either immunized or had no risk of contracting the virus.
Date: Thu, 16 May 2019 18:37:39 +0200

Bamako, May 16, 2019 (AFP) - Heavy floods claimed 15 lives Thursday in the Malian capital Bamako along with serious property damage, authorities said.   A statement said the flooding claimed a "provisional toll" of 15 dead and two injured.   "Teams are in place to rescue the distressed people," the government said, calling on residents to be "prudent" in the face of the disaster.   Flooding is common in Mali, located in the semi-desert Sahel region.
Date: Thu, 16 May 2019 04:40:13 +0200
By Ashraf KHAN

Rato Dero, Pakistan, May 16, 2019 (AFP) - Parents nervously watch as their children wait to be tested for HIV in a village in southern Pakistan, where hundreds of people have been allegedly infected by a doctor using a contaminated syringe.   Dispatched to keep order, police scan the anxious crowd as families hustle into one of five different screening rooms set up in the last month in the village of Wasayo, on the outskirts of Larkana in Sindh province.

Health officials say more than 400 people, many of them children, have tested HIV positive in recent weeks as experts warn of a surge in infection rates across Pakistan, due to the use of unsanitary equipment and rampant malpractice -- often at the hands of quack doctors.   Anger and fear continue to swell in the desperately poor village hit hard by the epidemic, which authorities say could be linked to either gross negligence or malicious intent by a local paediatrician.   "They are coming by the dozens," says a doctor at the makeshift clinic, beset by a lack of equipment and personnel to treat the surging number of patients.

Mukhtar Pervez waits anxiously to have her daughter tested, worrying a recent fever may be linked to the outbreak. For others, their worst fears have already become a reality.   Nisar Ahmed arrived at the clinic in a furious search for medicine after his one-year-old daughter tested positive three days earlier.   "I curse [the doctor] who has caused all these children to be infected," he says angrily.   Nearby Imam Zadi accompanies five of her children to be examined after her grandson tested positive.   "The entire family is so upset," she tells AFP.   Others worry their children's futures have been irreparably harmed after contracting HIV, especially in a country whose masses of rural poor have little understanding of the disease or access to treatment.   "Who is she going to play with? And when she's grown up, who would want to marry her?" asks a tearful mother from a nearby village, who asked not to named, of her four-year-old daughter who just tested positive.  

- 'Helpless'-
Pakistan was long considered a low prevalence country for HIV, but the disease is expanding at an alarming rate, particularly among intravenous drug users and sex workers.    With about 20,000 new HIV infections reported in 2017 alone, Pakistan currently has the second fastest growing HIV rates across Asia, according to the UN.   Pakistan's surging population also suffers the additional burden of having insufficient access to quality healthcare following decades of under-investment by the state, leaving impoverished, rural communities especially vulnerable to unqualified medical practitioners.    "According to some government reports, around 600,000 quack doctors are operating across the country and around 270,000 are practicing in the province of Sindh," said UNAIDS in a statement.

Provincial health officials have also noted that patients are at particular risk of contracting diseases or viruses at these clinics, where injections are often pushed as a primary treatment option.   "For the sake of saving money, these quacks will inject multiple patients with a single syringe. This could be the main cause of the spread of HIV cases," said Sikandar Memon, provincial programme manager of the Sindh Aids Control Programme.

The large number of unqualified doctors along with the "reuse of syringes, unsafe blood transfusions, and other unsafe medical practices" have all led to the spike in HIV cases in recent years, explains Bushra Jamil, an expert on infectious diseases at the Aga Khan University in Karachi.   "Rampant medical malpractices without any effective checks and balances are causing repeated outbreaks in Pakistan," said Jamil.   Authorities investigating the outbreak in Sindh say the accused doctor has also tested positive for HIV.

From a ramshackle jail cell in the nearby city of Ratodero, he denied the charges and accusations he knowingly injected his patients with the virus, while complaining of being incarcerated with common criminals.   But for the parents of the newly diagnosed, the ongoing investigation means little if they are unable to secure access to better information and the necessary drugs that can help stave off the deadly AIDS virus.   "We are helpless. I have other children and I am afraid they might catch the disease," says another mother whose daughter recently tested positive for HIV.   "[Please] send some medicine for our children so that they can be cured. If not, all of our children will die, right?"