Cuba is an independent island country situated in the Caribbean. It is the largest of the islands and covers 42,000sq miles. The climate is sub tropical throughout the year with most of the rainfall in
Safety & Security:
The majority of tourists visiting Cuba will have no difficulty but bag snatching and other street crime appears to be increasing. The old Havana area and other major tourist resorts may be particular areas of concern in this regard. On arrival be careful to only use your recognised tour operator. If you are taking a taxi at any stage make sure it is a registered one and not a private vehicle. It is unwise to carry large quantities of money or jewellery away from your hotel and try not to flaunt wealth with your belongings. Pickpockets are too common an occurrence on buses and trains and at train stations so be careful with your essential documents and credit cards. Valuables should not be stored in suitcases when arriving in or departing from Havana as there have been a number of thefts from cases during the time the cases are coming through baggage handling. There is an airport shrink-wrap facility for those departing Havana which reduces the risk of tampering. Remember to carry a photocopy of your main documents (passport, flight tickets etc).
Following a number of serious road accidents involving tourists, you are advised not to use mopeds for travelling around Cuba or in Havana. Also, if you are involved in any accident a police investigation will be required to clear you and this may significantly delay your travel plans. On unlit roads at night there have been a number of accidents associated with roaming cattle (sounds like Ireland!). The traffic moves on the right side of the roads. There is a main highway running the length of the country but many of the country roads are in poor repair.
Local Laws & Customs:
When arriving into Cuba make sure you are not carrying any items which could be considered offensive. Any illicit drug offense is treated very seriously and Cuban law allows for the death penalty to be used under these circumstances. If you require personal medication for your health, make sure it is in original packing and carry a letter from your doctor describing the medication. Never agree to carry any item for another individual and always secure your cases once they are packed. Taking photographs of military or police installations or around harbours, rail and airport facilities is strictly forbidden.
Since 1993 it is now possible to use US dollars for all transactions within Cuba. Remember, there is a 20$ airport departure tax. Certain travellers cheques and credit cards may not be acceptable within Cuba. This is particularly true of American Express cheques and cards but check your situation with the travel operator before departure.
Generally healthcare facilities outside of Havana are limited and many standard medications may not be available. It is important to carry sufficient quantities of any medications which may be required for the duration of your time in Cuba.
Food & Water:
The level of food and water hygiene varies throughout the country and between resorts. On arrival check the hotel cold water supply for the smell of chlorine. If it is not present then use sealed bottled water for both drinking and brushing your teeth throughout your stay. Cans and bottles of drinks are safe but take care to avoid pre-cut fruit. Peel it yourself to make sure it is not contaminated. Food from street vendors should be avoided in most cases. Bivalve shellfish are also a high risk food in many countries and Cuba is no exception in this regard. (Eg Mussels, Oysters, Clams etc)
Malaria & Mosquito Borne Diseases:
Malaria transmission does not occur within Cuba and so prophylaxis is not required. However, a different mosquito borne disease called Dengue has begun to reoccur in the country over the past few years. This viral disease can be very sickening and even progress to death. It is rare for tourists to become infected but avoiding mosquito bites is a wise precaution.
Swimming, Sun & Dehydration:
The extent of the Cuban sun (particular during the summer months (April to October) can be very excessive so make sure your head and shoulders are covered at all times when exposed. Watch children carefully as they will be a significant risk. Drink plenty of fluids to replace what will be lost through perspiration and, unless there is a reason not to,
take extra salt either on your food or in crisps, peanuts etc. Take care if swimming in the Caribbean to stay with others and to listen to local advice. Never swim after a heavy meal or alcohol.
Rabies Risk in Cuba:
This viral disease does occur throughout Cuba and it is essential that you avoid any contact with all warm blooded animals. Dogs, cats and monkeys are the most commonly involved in spreading the disease to humans. Don't pick up a monkey for a photograph! If bitten, wash out the wound, apply an antiseptic and seek urgent medical attention.
Vaccinations for Cuba:
There are no essential vaccines for entry / exit if coming from Ireland. However, for your own personal protection travellers are advised to have cover against the following;
Tetanus (childhood booster)
Typhoid (food & water borne disease)
Hepatitis A (food & water borne disease)
For those planning a longer or more rural trip vaccine cover against conditions like Hepatitis B and Rabies may also need to be considered.
Cuba is becoming a popular destination for tourists and generally most will stay very healthy. However commonsense care against food and water borne disease is essential at all times. Also take care with regard to sun exposure, dehydration and mosquito bites.
Travel News Headlines WORLD NEWS
Buenos Aires, May 17, 2018 (AFP) - Tourism regulation in Antarctica has become an urgent matter due to environmental threats, officials from the 53 member countries of the Antarctic Treaty warned at their annual meeting, held this week in Buenos Aires.
In the absence of rules, travel agencies offer trips to the region on boats sometimes equipped with helicopters or submarines, according to Segolene Royal, French ambassador for the Arctic and Antarctic poles. "This activity creates considerable disturbance ... we are witnessing a race toward large-scale tourism that is dangerous for ecosystems," she said at the assembly on Wednesday.
During the austral summer of 2016/2017, around 44,000 tourists set off for Antarctica, compared with just 9,000 in 1995/1996, according to French authorities. However, the push for regulation is not about banning tourism, former environmental minister Royal said, but rather about ensuring it is managed in compliance with the treaty and its environmental protection protocol.
In Buenos Aires, the Antarctic Treaty Consultative Meeting -- whose mission is to regulate human activity on the continent -- also sought to encourage scientific cooperation between countries that have collectively set up around 100 research bases across the ice. Also up for analysis is China's proposed fifth permanent scientific station in Antarctica, which would be located in the Ross Sea area south of New Zealand.
By Marlowe HOOD
Paris, July 5, 2017 (AFP) - A chunk of ice bigger than the US state of Delaware is hanging by a thread from the West Antarctic ice shelf, satellite images revealed Wednesday. When it finally calves from the Larsen C ice shelf, one of the biggest icebergs in recorded history will be set adrift -- some 6,600 square kilometres (2,550 square miles) in total, according to the European Space Agency (ESA).
The iceberg's depth below sea level could be as much as 210 metres (almost 700 feet), or about 60 storeys, it said. "The crack in the ice is now around 200 kilometres (125 miles) long, leaving just five kilometres between the end of the fissure and the ocean," the ESA said in a statement. "Icebergs calve from Antarctica all the time, but because this one is particularly large its path across the ocean needs to be monitored as it could pose a hazard to maritime traffic."
Scientists tracking the berg's progression expect it to break of within months. The Larsen C shelf will lose more than 10 percent of its total surface area. The massive ice cube will float in water and by itself will not add to sea levels when it melts. The real danger is from inland glaciers. Ice shelves float on the sea, extending from the coast, and are fed by slow-flowing glaciers from the land. They act as giant brakes, preventing glaciers from flowing directly into the ocean. If the glaciers held in check by Larsen C spilt into the Antarctic Ocean, it would lift the global water mark by about 10 centimetres (four inches), researchers have said.
The calving of ice shelves occurs naturally, though global warming is believed to have accelerated the process. Warming ocean water erodes the underbelly of the ice shelves, while rising air temperatures weaken them from above. The nearby Larsen A ice shelf collapsed in 1995, and Larsen B dramatically broke up seven years later. The ESA is keeping an eye on Larsen C with its Copernicus and CryoSat Earth orbiters.
Man-made global warming has already lifted average global air temperatures by about one degree Celsius (1.8 degrees Fahrenheit) since pre-industrial levels. Antarctica is one of the world's fastest-warming regions. The world's nations undertook in the Paris Agreement, inked in 2015, to cap average global warming at "well under" 2 C.
By Jean-Louis SANTINI
Washington, June 22, 2016 (AFP) - Two sick workers were evacuated from a remote US research station near the South Pole on Wednesday in a risky rescue mission carried out in the dead of Antarctica's winter, a US official said. A Twin Otter turboprop plane flew in dark and cold conditions to pick up the workers from the Amundsen-Scott station, about 250 meters from the geographic South Pole, a spokesman for the US National Science Foundation (NSF), Peter West told AFP.
The plane's crew and a medical team had made the 10-hour journey to the South Pole in the middle of Antarctica's 24-hour winter on Tuesday night to reach the unidentified patients, who could not be treated on site. The NSF -- the US research agency that operates the Amundsen-Scott Station -- organized the rescue mission last week given the condition of the first patient, which was not disclosed for privacy reasons. "It was really an emergency," West said. It later became apparent that the second worker also needed to be evacuated.
The sick workers -- employees of the US company Lockheed Martin who worked on base logistics -- were then taken to the Rothera base, a British research station some 2,200 kilometers (about 1,365 miles) away, the spokesman said. The pair, who were not identified, were then to be transferred to a hospital in South America, West said, without giving further details. The Amundsen-Scott base was home to 48 people -- 39 men and nine women -- who work on-site throughout the austral winter, which spans February through October.
- Rare rescue mission -
Near the world's southernmost point, workers spend this period withstanding nearly complete darkness and dramatically low temperatures -- on Tuesday, the thermometer dropped to -60 degrees Celsius (-76 degrees Fahrenheit). It was only the third time that an emergency rescue operation has been launched in the middle of winter. In 2001, the only doctor at the Amundsen-Scott station was suffering from a life-threatening pancreatic condition and required urgent evacuation. A second medical evacuation was carried out that year.
In 1999, the US station's doctor Jerri Nielsen, who was self-treating her own breast cancer, required medical evacuation but weather conditions were more favorable, as the mission took place in the spring. The Twin Otter plane, operated by the Canadian company Kenn Borek Air, is specially designed to operate in extremely cold temperatures.
Research projects at the Amundsen-Scott station include monitoring long-term levels of carbon dioxide (CO2) in the atmosphere. The station also operates two telescopes that observe "cosmic microwave background" radiation -- the faint light signature left by the Big Bang -- to study the origins of the universe, dark energy and dark matter.
by Martin PARRY
SYDNEY, June 18, 2014 (AFP) - Antarctic scientists warned Wednesday that a surge in tourists visiting the frozen continent and new roads and runways built to service research facilities were threatening its fragile environment. Tourist numbers have exploded from less than 5,000 in 1990 to about 40,000 a year, according to industry figures, and most people go to the fragmented ice-free areas that make up less than one percent of Antarctica. A growing number of research facilities are also being built, along with associated infrastructure such as fuel depots and runways, in the tiny ice-free zones.
It is these areas which contain most of the continent's wildlife and plants, yet they are among the planet's least-protected, said a study led by the Australian government-funded National Environmental Research Programme (NERP) and the Australian Antarctic Division. "Many people think that Antarctica is well protected from threats to its biodiversity because it's isolated and no one lives there," said Justine Shaw from the NERP of the study published in the journal PLoS Biology. "However, we show that there are threats to Antarctic biodiversity. "Most of Antarctica is covered in ice, with less than one percent permanently ice-free," she added. "Only 1.5 percent of this ice-free area belongs to Antarctic Specially Protected Areas under the Antarctic Treaty System, yet ice-free land is where the majority of biodiversity occurs." Five of the distinct ice-free areas have no protection at all while all 55 of the continent's protected zones are close to sites of human activity.
- Fragile ecosystems -
Steven Chown of Monash University, another collaborator in the study, said the ice-free areas contain very simple ecosystems due to Antarctica's low species diversity. This makes its native wildlife and plants extremely vulnerable to invasion by outside species, which can be introduced by human activity. "Antarctica has been invaded by plants and animals, mostly grasses and insects, from other continents," he said. "The very real current and future threats from invasions are typically located close to protected areas. "Such threats to protected areas from invasive species have been demonstrated elsewhere in the world, and we find that Antarctica is, unfortunately, no exception."
The study said the current level of protection was "inadequate by any measure" with Shaw saying more was needed to guard against the threat posed by the booming tourism industry. "(We need) to protect a diverse suite of native insects, plants and seabirds, many of which occur nowhere else in the world," she said. "We also need to ensure that Antarctic protected areas are not going to be impacted by human activities, such as pollution, trampling or invasive species." Antarctica is considered one of the last frontiers for adventurous travellers. Most travel by sea, some paying in excess of US$20,000 for a luxury cabin in the peak period from November to March. There is also a healthy market for sightseeing flights.
Approximately 30 nations operate permanent research stations on the continent including the US, China, Russia, Australia, Britain, France and Argentina, and more are on the way. China's state media said in December that the country was building its fourth base and a fifth was being planned. Fellow study author Hugh Possingham, from NERP, said that without better protection "this unique and fragile ecosystem could be lost". "Although we show that the risks to biodiversity from increasing human activity are high, they are even worse when considered together with climate change," he added. "This combined effect provides even more incentive for a better system of area protection in Antarctica."
WASHINGTON, Nov 17, 2013 (AFP) - A powerful 7.8 magnitude undersea earthquake struck in the Scotia Sea, a remote region in the far south Atlantic near Antarctica, US earthquake monitors reported Sunday. The quake struck at 0904 GMT in the ocean some 893 kilometers (550 miles) southwest of Grytviken, South Georgia, and 1,140 kilometres (710 miles) southeast of Ushuaia, Argentina, said the US Geological Survey, which monitors earthquakes worldwide. The epicenter was at a depth of 10 kilometers (6.2 miles), and was near that of a 6.8 magnitude undersea earthquake that the USGS registered in the Scotia Sea some 30 hours earlier.
The quake occurred at the boundary between the Antarctic tectonic plate and the Scotia Sea plate, said geophysicist Randy Baldwin at the National Earthquake Information Center in Golden, Colorado. "They're sliding past one another horizontally, it's not a subduction zone," Baldwin told AFP. "There will be aftershocks probably for weeks." There were no tsunami warnings since there were no vertical movements in the seafloor as occur in a subduction quake, when one tectonic plate moves under another one, Baldwin said. Yet despite the enormous energy unleashed the area is so remote that there is little or no impact to humans, he said. "You couldn't pick a more remote area for an earthquake," he said.
December 19, 2008
The Republic of Suriname is a developing nation located on the northern coast of South America. Tourist facilities are widely available in the capital city of
ENTRY/EXIT REQUIREMENTS: A passport, valid visa, and, if traveling by air, return ticket are required for travel to Suriname. There is a processing fee for business and tourist visas, and visas must be obtained before arrival in Suriname. A business visa requires a letter from the sponsoring company detailing the reason for the visit. There is an airport departure charge and a terminal fee, normally included in the price of airfare. Travelers arriving from Guyana, French Guiana, and Brazil are required to show proof of a yellow fever vaccination. For further information, travelers can contact the Embassy of the Republic of Suriname, 4301 Connecticut Avenue, NW, Suite 460, Washington, DC 20008, telephone (202) 244-7488, email: email@example.com, or the Consulate of Suriname in Miami, 7235 NW 19th Street, Suite A, Miami, Fl 33126, telephone (305) 593-2697.
Visit the Embassy of Suriname web site at www.surinameembassy.org for the most current visa information.
Important information for foreigners who have the intention of staying longer than three months:
s of October 1, 2008, persons who intend to stay longer than three months in Suriname must apply for an Authorization for Temporary Stay (MVK) before travel to Suriname. The above implies that foreigners who need a visa (with the exception of foreigners of Surinamese origin) who have traveled to Suriname on a tourist or business visa will not be able to apply for residence during their stay in Suriname.
Information about dual nationality or the prevention of international child abduction can be found on our website.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
Demonstrations do occur, primarily in the capital or second cities, and are usually peaceful, but American citizens traveling to or residing in Suriname should take common-sense precautions and avoid large gatherings or other events where crowds have congregated to demonstrate or protest. Travelers proceeding to the interior may encounter difficulties due to limited government authority. Limited transportation and communications may hamper the ability of the U.S. Embassy to assist in an emergency situation.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States and Canada, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
Criminal activity throughout the country is on the rise and foreigners, including Americans, may be viewed as targets of opportunity. Burglary, armed robbery, and violent crime occur with some frequency in Paramaribo and in outlying areas. Pick-pocketing and robbery are increasingly common in the major business and shopping districts of the capital. Visitors should avoid wearing expensive or flashy jewelry or displaying large amounts of money in public.
There have been several reports of criminal incidents in the vicinity of the major tourist hotels and night walks outside the immediate vicinity of the hotels are therefore to be avoided.
Visitors should avoid the Palm Garden area (“Palmentuin” in Dutch) after dark, as there is no police presence and it is commonly the site of criminal activity.
Theft from vehicles is infrequent, but it does occur, especially in areas near the business district. Drivers are cautioned not to leave packages and other belongings in plain view in their vehicles. There have been reports of carjackings within Paramaribo, particularly in residential areas. When driving, car windows should be closed and doors locked. The use of public minibuses is discouraged, due to widespread unsafe driving and poor maintenance.
Travel to the interior is usually trouble-free, but there have been reports of tourists being robbed. Police presence outside Paramaribo is minimal, and banditry and lawlessness are occasionally of concern in the cities of Albina and Moengo and the district of Brokopondo, as well as along the East-West Highway between Paramaribo and Albina and the Afobakka Highway in the district of Para. There have been reports of attempted and actual carjackings committed by gangs of men along the East-West Highway. Travelers proceeding to the interior are advised to make use of well-established tour companies for a safer experience.
The emergency number 115 is used for police, fire, and rescue and normally does not provide English-language services.
Fire and rescue services provide a relatively timely response, but police response, especially during nighttime hours, is a rarity for all but the most serious of crimes.
In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime are solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical care, including emergency medical care, is limited and does not meet U.S. standards. There is one public emergency room in Paramaribo with only a small ambulance fleet providing emergency transport with limited first response capabilities. The emergency room has no neurosurgeon, and other medical specialists may not always be available. As a rule, hospital facilities are not air-conditioned, although private rooms with individual air-conditioning are available at extra cost and on a space-available basis. Emergency medical care outside Paramaribo is limited and is virtually non-existent in the interior of the country.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en
The 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 Suriname is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Traffic moves on the left in Suriname; left-hand-drive cars are allowed on the road. Excessive speed, unpredictable movements by vehicles, and motorcyclists/bicycles, unusual right of way patterns, poorly maintained roads, and a lack of basic safety equipment on many vehicles are daily hazards on Surinamese roads. As of January 2007, seatbelts are required for all passengers of automobiles, and drivers must use a hands-free device if using a mobile phone while driving. Visitors are encouraged to use automobiles equipped with seat belts and to avoid the use of motorcycles or scooters. An international driver's license is necessary to rent a car.
The major roads in Paramaribo are usually paved, but not always well maintained. Large potholes are common on city streets, especially during the rainy seasons, which last from approximately mid-November to January, and from April to July (rainy seasons can differ from year to year by as much as six weeks). Roads are often not marked with traffic lines. Many main thoroughfares do not have sidewalks, forcing pedestrians, motorcycles, and bicycle traffic to share the same space.
The East-West Highway, a paved road that stretches from Nieuw Nickerie in the west to Albina in the east, runs through extensive agriculture areas; it is not uncommon to encounter slow-moving farm traffic or animals on the road. Travelers should exercise caution when driving to and from Nieuw Nickerie at night due to poor lighting and sharp road turns without adequate warning signs.
There are few service stations along the road, and western style rest stops are non-existent.
The road is not always well maintained, and during the rainy season, large, sometimes impassable, sink holes develop along the road.
Police recommend that travelers check with the police station in Albina for the latest safety information regarding travel between Paramaribo and Albina.
Roads in the interior are sporadically maintained dirt roads that pass through rugged, sparsely populated rain forest. Some roads are passable for sedans in the dry season, but they deteriorate rapidly during the rainy season. Interior roads are not lit, nor are there service stations or emergency call boxes. Bridges in the interior are in various states of repair. Travelers are advised to consult with local sources, including The Foundation for Nature Conservation in Suriname, or STINASU, at telephone (597) 421-683 or 476-579, or with their hotels regarding interior road conditions before proceeding.
For specific information concerning Suriname driving permits, vehicle inspection, road tax, and mandatory insurance, please contact the Embassy of Suriname in Washington, D.C., or the Consulate of Suriname in Miami.
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 at http://www.suriname-tourism.org/cms/
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Suriname’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Suriname’s air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
Credit cards are not widely accepted outside the major hotels and upscale restaurants. Travelers should contact their intended hotel or tour company to confirm that credit cards are accepted. Currently, only one bank, Royal Bank of Trinidad and Tobago (RBTT), has Automatic Teller Machines (ATMs) accepting foreign ATM cards. In order to withdraw money from the ATM machines of other banks, you must have a local Surinamese bank account and ATM card. Visitors can exchange currency at banks, hotels, and official exchange houses, which are called “cambios.” Exchanging money outside these locations is illegal and can be dangerous. Telephone service within Suriname can be problematic, especially during periods of heavy rains. Please see our Customs Information.
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 Surinamese laws, even unknowingly, may be expelled, arrested, or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Suriname 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.
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans residing or traveling in Suriname are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Suriname.
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 Dr. Sophie Redmondstraat 129, telephone (011) (597) 472-900, web site http://suriname.usembassy.gov. The Consular Section hours of operation for routine American citizen services are Mondays and Wednesdays from 8:00 to 10:00 AM, or by appointment, except on American and Surinamese holidays. U.S. citizens requiring emergency assistance on evenings, weekends, and holidays may contact an Embassy duty officer by cell phone at (011) (597) 088-08302. The U.S. Embassy in Paramaribo also provides consular services for French Guiana.
* * *
This replaces the Country Specific Information for Suriname dated April 11, 2008, to update the sections on Entry/Exit Requirements, Crime, and Registration/Embassy Location.
Travel News Headlines WORLD NEWS
[This case would suggest local transmission of yellow fever in Suriname which isn't surprising given the on-going outbreak in Brazil. This case would also suggest travelers to the area consider getting vaccinated for yellow fever prior to entering the country. One wonders if perhaps the local wildlife may be acting as a reservoir as well based on the outbreaks seen in monkeys in Brazil. - ProMED Mod.JH]
A Dutch traveller returning from Suriname in early March 2017, presented with fever and severe acute liver injury. Yellow fever was diagnosed by (q)RT-PCR and sequencing. During hospital stay, the patient’s condition deteriorated and she developed hepatic encephalopathy requiring transfer to the intensive care. Although yellow fever has not been reported in the last four decades in Suriname, vaccination is recommended by the World Health Organization for visitors to this country.
Yellow fever virus (YFV) is known to be enzootic in South America, causing periodic outbreaks of disease in monkeys and humans in some countries. In Brazil, there has been an outbreak of yellow fever ongoing since December 2016 with 1,500 cases as at 9 March [1,2]. Here we report an imported case of human infection with YFV in a traveller returning from Suriname, on the north-eastern coast of South America, from where the last case of yellow fever was reported 45 years ago.
In March 2017, a Dutch Caucasian female in her late 20s from the Netherlands was referred to the University Medical Center Groningen in the Netherlands because of high fever and signs of severe acute liver injury after returning from a two-week stay in Suriname. She had no co-morbidities apart from obesity (body mass index around 40 kg/m2, norm: 18.5–25 kg/m2). During her visit she stayed in the capital of Suriname, Paramaribo, and she made several daytrips by boat and car, of which two in the tropical rainforest (Figure).
She recalled having been bitten by mosquitoes during her hike at Brownsberg, a nature resort in the rainforest with wildlife. Before her travel, she did not visit a travel clinic and did not receive yellow fever vaccination. On day 12 of her visit in Suriname, she experienced mild muscle pain, headache and nausea and she developed a high-grade fever. She returned to the Netherlands on day 15 and visited the emergency department of a secondary care centre, from where she was referred to our University hospital. At physical examination she was not icteric. Except for a temperature of 39.9 °C, vital parameters were normal. The results of the remaining physical examination were unremarkable. Laboratory testing revealed leukopenia (leukocytes 0.9x109/L, norm: 4.0–10.0x109/L) and massive liver injury (aspartate aminotransferase 5,787 U/L, norm: <31 U/L; alanine aminotransferase 4,910 U/L, norm: <34 U/L), with mildly elevated bilirubin levels (total bilirubin 20 µmol/L, norm: <17 µmol/L). Liver synthesis was impaired as revealed by increased clotting times (activated partial thromboplastin time (APTT): 49s, norm: 23–33s; prothrombin time (PT): 26.6s, norm: 9.0–12.0s) and reduced antithrombin (49%, norm: 80–120%). Fibrinogen was diminished suggestive of diffuse intravascular coagulation. Renal function was normal apart from severe albuminuria (up to 22.6 g/24h, norm: 0g/24h). Malaria, viral hepatitis (A, B, C, E, Epstein Barr virus, cytomegalovirus, herpes simplex virus), dengue, chikungunya and Zika were ruled out (Table). Diagnostic tests to exclude leptospirosis performed on day 6 post onset of symptoms (dps 6) were inconclusive (Table) and a convalescent serum was going to be tested at the time of publication. Because of the combination of fever, leukopenia, thrombocytopenia, liver injury and travel history, yellow fever was included in the differential diagnosis. Real-time reverse transcriptase PCR (qRT-PCR) was positive for YFV in serum taken on dps 3. On dps 7 the patient’s condition deteriorated due to hepatic encephalopathy (ammonia 149 µmol/L, norm: 15–45 µmol/L). Cerebral oedema and bleeding was ruled out by computed tomography (CT)-scan. The patient was transferred to the intensive care unit for close observation of vital parameters. Vitamin K was administered. Hepatic encephalopathy was treated with rifaximin and lactulose. Ceftriaxone (2g per day intravenously) was given for 7 days as antibiotic prophylaxis. Consequently, possible leptospirosis was also treated. Her neurological condition stabilised on dps 10 together with the coagulation parameters. On dps 13 the patient was transferred back to the ward.
a Performed on day 5 post onset of symptoms (dps 5).
b ELISA (in-house ELISA Dutch Leptospirosis Reference Center) performed on dps 6 showed IgM 1:80 (cut-off positive IgM ≥1:160). IgM results were negative on dps 3 and dps 7 using Leptocheck-WB (Zephyr Biomedicals, Goa, India).
qRT-PCR and/or pan-flavivirus RT-PCR on blood samples on dps 3 did not detect chikungunya virus (CHIKV), dengue virus (DENV), or Zika virus (ZIKV) (Table) [3,4]. In four consecutive samples of dps 3–6, YFV-RNA was detected (Figure) [4-6], with increasing Ct values (from 23 to 31 from dps 3 to dps 5  and 39 on dps 6 ). Sequencing of a 176 bp pan-flavivirus hemi-nested RT-PCR product, targeting part of the NS5 genomic region confirmed YFV infection . The sequence was deposited in the GenBank database under the following accession number: KY774973.
On dps 3, indirect immunofluorescence assays (IFA) was negative for IgM and IgG against YFV (Flavivirus Mosaic, Euroimmun AG, Luebeck, Germany). A convalescent sample of dps 6 was clearly positive for YFV IgM (titre 1:10, Figure), with non-reactive IgG. This anti-YFV IgM response on dps 6 is in line with literature stating that IgM antibodies usually appear during the first week of illness. Neutralising IgG antibodies are likely to appear towards the end of the first week after onset of illness and will be tested for in convalescent serum .
YFV is a mosquito-borne virus in the genus Flavivirus, family Flaviviridae, related to DENV, ZIKV, tick-borne encephalitis virus and West Nile virus. YFV is maintained in a sylvatic cycle between non-human primates and so-called ‘jungle’-mosquitoes (Hemagogus and Sabethes spp. in South America) . Sporadic infection of humans with sylvatic YFV can occur when unprotected humans are exposed while entering the habitats where the viruses circulate. Subsequent introduction of a viraemic human case to urban areas with high population densities and Aedes aegypti mosquitoes can initiate an urban transmission cycle . YFV is endemic in (sub)tropical areas of South America and Africa. The risk for YFV infection in South America is the highest in tropical regions and during the rainy season (January–May) when mosquito population densities peak . In 2011, Suriname was identified by the World Health Organization (WHO) as one of 14 South American countries at risk for YFV transmission based on current or historic reports of yellow fever, plus the presence of competent mosquito vectors and animal reservoirs .
Since December 2016, an outbreak of sylvatic YFV is ongoing in Brazil; as at 9 March 2017, there were 371 confirmed and 966 suspected human cases, while a total of 968 epizootics in non-human primates have been reported, of which 386 were confirmed . So far, there has been no evidence for a change from sylvatic to an urban transmission cycle . In addition, Bolivia, Colombia and Peru have reported suspected and confirmed yellow fever cases in 2017 .
A subclinical infection with YFV is believed to occur in most infected people. In symptomatic cases, symptoms of general malaise occur after an incubation period of 3–6 days (range 2–9 days), followed by remission of the disease in the majority of patients. However, 15-25% of symptomatic persons develop a complicated course of illness, in which symptoms recur after 24–48 hours, with a reported mortality of 20-60% [7,12]. This phase is characterised by fever, abdominal symptoms, severe hepatic dysfunction and jaundice, multi-organ failure and haemorrhagic diathesis. As no specific antiviral treatment is currently available, treatment consists of supportive care [7,12].
Although Suriname is considered to be endemic for YFV, no human cases have been officially reported since 1971 . With a population of ca 570,000 people, Suriname has a YFV vaccination coverage of 80–85% in infants . Although WHO recommends vaccination for travellers to countries with risk of YFV transmission like Suriname, sporadic cases of imported yellow fever in returning travellers have been reported for example in Europe, the United States and Asia [15-17], with three reported cases related to the ongoing YFV outbreaks in South America in European travellers since 2016 [18,19]. The establishment of ongoing YFV circulation in Suriname extends the current YFV activity in South America to five countries . However, despite the presence of competent Ae. albopictus mosquitoes in France  and Ae. aegypti in Madeira, the risk for YFV transmission in Europe is currently considered to be very low due to the lack of vector activity . An effective, safe live-attenuated YFV vaccine is available for people aged ≥ 9 months and offers lifelong immunity . Vaccination is advised by the WHO for all travellers to Suriname, for the coastal area as well as the inlands . With regard to yellow fever, pre-travel health advice should take into account destination, duration of travel, season and the likelihood of exposure to mosquitoes (in rural areas, forests versus urban areas), and potential contraindications for vaccination with a live-attenuated vaccine.
The multi-country YFV activity might reflect current, wide-spread ecological conditions that favour elevated YFV transmissibility among wildlife and spill-over to humans. Thorough sequence analysis of currently circulating strains in Brazil, Bolivia, Colombia, Peru and Suriname should provide insight whether the human cases in these countries are epidemiologically linked or represent multiple, independent spill-over events without extensive ongoing community transmission. Because of its potential public health impact, our case of yellow fever was notified to the WHO and the European Union Early Warning and Response System on 9 March 2017, according to the international health regulations .
Clinicians in non-endemic countries should be aware of yellow fever in travellers presenting with fever, jaundice and/or haemorrhage returning from South America including Suriname. This case report illustrates the importance of maintaining awareness of the need for YFV vaccination, even for countries with risk of YFV transmission that have not reported cases for decades.
<http://healthmap.org/promed/p/37>. - ProMed Mod.TY]
[It would not be surprising if Zika virus has arrived in Suriname, since 2 other countries in northern South America -- adjacent Brazil and somewhat more distant Colombia -- have reported ongoing cases. The report does not indicate if these 2 cases are locally acquired or are imported cases of Zika virus infection. Sending samples to an outside international reference laboratory is prudent in situations when a new pathogen appears. The AZP laboratory should welcome confirmation of their test results.
<http://healthmap.org/promed/p/37>. - ProMED Mod.TY]
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]