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American Samoa

Samoa US Consular Information Sheet
January 23, 2008
COUNTRY DESCRIPTION:
Samoa consists of the two large islands of Upolu and Savai’i and seven small islets. The country has a stable parliamentary democracy with a developing economy. To
rist facilities are accessible by bus, taxi and car and are within walking distance of access roads. Infrastructure is adequate in Apia, the capital, but it is limited in other areas. Nearly all Internet connections use a relatively slow dial-up method. Samoa has two digital telephone service providers, and visitors can easily purchase prepaid phones that cover virtually the entire country. The Samoa Tourism Authority, at http://www.visitsamoa.ws/, provides a wide range of information of interest to travelers. Read the Department of State Background Notes on Samoa for additional information.

ENTRY/EXIT REQUIREMENTS:
U.S. nationals who are not U.S. citizens, and who are resident in American Samoa, must obtain a visitor permit prior to all travel to Samoa. U.S. nationals have not been permitted to travel to Samoa on certificates of identity since May 2005 except on a case by case basis. (U.S. law distinguishes between individuals who are citizens and those who are nationals. The U.S. passport bio-page shows one’s status as either a citizen or a non-citizen national.) As of March 22, 2006, visitor permits to travel to Samoa can be applied for at the new Samoa Consulate General office in Pago Pago, American Samoa. A valid passport and an onward/return ticket are required for all Americans (both citizens and nationals) to travel to Samoa. Visitor permits are not required for U.S. citizens (only for U.S. nationals) seeking to stay in Samoa for up to 60 days. All visitors are required to pay a departure tax of 40 Tala (approximately 17.50 USD) upon leaving the country. Further information about entry requirements and the departure tax may be obtained from the Samoa Mission to the United Nations at 800-2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196, fax (212) 599-0797. Visit the Embassy ofSamoa web site at http://www2.un.int/public/Samoa/ for the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:
In Apia and many villages, stray dogs wander the streets. Visitors should not approach or feed them; they can become aggressive in the presence of food or if they feel threatened.

Although there have been no major accidents involving the ferry service linking Upolu and Savai’i, vessels are sometimes overloaded. One of the ferries, a multi-deck automobile ferry, sometimes transports passengers on its automobile deck. Americans who choose to use this ferry are encouraged not to remain in the automobile deck during the crossing and to ride only in the passenger compartment in order to avoid injury from shifting vehicles.

Samoa has numerous “blowholes” (lava tubes open to the sea where wave action produces, often spectacular, geysers). These blowholes are popular tourist attractions. The footing around the mouths of most blowholes is very slippery. To avoid being swept in, visitors should not approach too closely and should never stand between the opening of the blowhole and the sea.

Snorkeling and diving in ocean lagoons is a popular activity for many visitors to Samoa. Tide changes can produce powerful currents in these lagoons. Visitors are encouraged to consult local residents and tour operators about hazards and conditions at a particular location before venturing into the water.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:
Overall, Samoa is considered a low threat environment. Nevertheless, visitors should remain aware of their surroundings, lock their doors at night, and not leave their belongings unattended. Incidents of petty theft/robberies of personal effects are common. Some such incidents have involved residential break-ins. While rare, violent assaults, including sexual assaults have occurred in Samoa. No specific groups have been targeted, nor have there been any racially motivated or hate crimes against Americans. Police responsiveness in Apia is generally good. Because of the very limited police presence elsewhere in Samoa (where order is maintained primarily by local village authorities), police responsiveness elsewhere is problematic.

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

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Health care facilities in Samoa are adequate for routine medical treatment, but are limited in range and availability; complex illnesses and life-threatening emergencies generally need to be treated elsewhere. Dental facilities do not meet U.S. standards, but good dental treatment and some emergency care can be obtained nearby at the LBJ Tropical Medical Center in Pago Pago, American Samoa. The national hospital and a small private hospital are located in Apia, and there are several small district hospitals on Savai'i and in outlying areas of Upolu. There are no hyperbaric chambers on any of the islands for the treatment of scuba diving related injuries. Serious cases of decompression sickness are evacuated to the nearest treatment center in Suva, Fiji, or Auckland, New Zealand. Serious medical conditions and treatments that require hospitalization and/or medical evacuation to the United States can cost thousands of dollars. Travelers should carry emergency evacuation insurance. Doctors and hospitals often expect immediate cash payment for health services. There is no reported incidence of malaria or rabies in Samoa. Occasional outbreaks of typhoid and non-hemorrhagic dengue do occur.

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 Samoa is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Safety of public transportation and rural road conditions in Samoa, are considered fair, while urban road conditions/maintenance is considered good. Taxis in particular are widely available and used by Samoans and visitors alike; buses are slow, generally crowded and uncomfortable, and rarely utilized by visitors. Rental cars can also be obtained. No roadside assistance is available. Most major roads are tar-sealed, but secondary roads are predominantly dirt and gravel and may be overgrown with vegetation. A four-wheel drive vehicle is recommended for travel on these roads. Travelers should be aware that vehicle safety regulations are rarely enforced and traffic violations occur routinely. Roads outside Apia are often narrow, winding, relatively steep, with narrow or no shoulders, and poorly lighted. Pedestrians as well as vehicles and livestock regularly travel these roads. Due to poor and deteriorating road conditions, night driving on unlit rural roads can be dangerous and should be avoided if possible. Roads in Samoa often traverse small streams. Drivers are urged to exercise extreme caution when fording these streams, which can become swollen and dangerous with little warning. Vehicles should never enter a stream if the roadbed is not visible or if the water’s depth exceeds the vehicle’s clearance.

Speed limits in Samoa are 25 miles per hour in the Apia area and 35 miles per hour outside Apia, with certain exceptions. At unmarked intersections, traffic on the left has the right of way. As in the United States, vehicular traffic moves on the right side of the road; although right-hand-drive vehicles (mainly from New Zealand) do exist in Samoa. Importing right hand drive vehicles to Samoa is currently legally forbidden.

Please refer to our Road Safety page for more information. Visit the web site of the country’s national tourist office at Samoa Tourism Authority at http://www.visitsamoa.ws/.

AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government ofSamoa’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Samoa’s air carrier operations. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:
Some overseas treatment centers, known as Behavior Modification Facilities, operate in Samoa. Though these facilities may be operated and staffed by U.S. citizens, the Samoan government is solely responsible for compliance with local safety, health, sanitation and educational laws and regulations, including all licensing requirements of the staff in country. These standards, if any, may not be strictly enforced or meet the standards of similar facilities in the U.S. Parents should be aware that U.S. citizens and non-citizen nationals 14 years of age and older have a right to apply for a passport and to request repatriation assistance from the U.S. government, both without parental consent. Any U.S. citizen or non-citizen enrollee has the right to contact a representative from the U.S. Embassy. For further information, consult the Department of State's Fact Sheet on Behavior Modification Facilities, available via the Bureau of Consular Affairs home page. Parents may also contact the U.S. Embassy in Apia or the country officer in the Office of American Citizens Services, Bureau of Consular Affairs at 202-647-5226.

Financial Transactions:
Although some businesses (especially those in Apia or those frequented by tourists) do accept credit cards, many (including gas stations) do not. Major credit cards (Visa, Master Card, and American Express) are accepted at major hotels and some restaurants and stores. Samoan currency can be obtained from ATMs, which are located in Faleolo Airport and in many locations in Apia. For more information on ATM locations and banking services see ANZ web site at http://www.anz.com/samoa/overview.asp and WESTPAC web site at http://www.westpac.com.ws/pacific/publish.nsf/Content/PFSA+HomePage.

Disaster Preparedness: Samoa is located in an area of high seismic activity. Although the probability that a major earthquake would occur during an individual trip is remote, earthquakes can and will continue to happen. Major cyclones have occurred in the past and are always a concern. Strong winds and very heavy rains are common, especially during the rainy season from November to April. During this period, Samoa receives most of its annual average of over 130 inches of rain. General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency’s (FEMA) web site at http://www.fema.gov/.

Customs: Samoa customs authorities may enforce strict regulations concerning temporary importation into or export from Samoa of items such as firearms, fruits, pets and other animals, and drugs. It is advisable to contact the Samoan Mission to the United Nations at 800 2nd Avenue, Suite 400J, New York, NY 10017, telephone (212) 599-6196 for specific information regarding customs requirements. Please see our Customs Information.

CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Samoa’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Samoa are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
Samoa is not a member of the Hague Convention on the Civil Aspects of International Child Abduction. 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 Samoa 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 withinSamoa. 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 in the Accident Compensation Board (ACB) Building, Fifth Floor, Apia. The Embassy is open to the public from 8:15 a.m. to 5:00 p.m. Monday - Friday. The Embassy's mailing address is U.S. Embassy, P.O. Box 3430, Apia, Samoa 0815. The telephone numbers are (685) 21436/21631/22696 and 21452. The fax number is (685) 22030. An Embassy officer can be reached after hours in an emergency involving the welfare of a U.S. citizen or non-citizen national at (685) 21514 or (685) 777-1776. Visit the U.S. Embassy’s web site at http://samoa.usembassy.gov/.
* * *
This replaces the Consular Information Sheet (now known as Country Specific Information) dated May 21, 2007, to update sections on Country Description and Crime.

Travel News Headlines WORLD NEWS

American Samoa. 8 Mar 2017.
(susp) as of mid-February 30 cases of Dengue.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific can be accessed at <http://healthmap.org/promed/p/380>
and a map of the island at <http://www.nationsonline.org/maps/tutuila-island-map.jpg>. - ProMED Mod.TY
Date: Sat 20 Sep 2014
Source: Radio New Zealand [edited]

Latest figures from Samoa's Ministry of Health show an increase of suspected and confirmed cases of chikungunya [virus infections] from 400 to 626 since the outbreak of the acute fever, rash and joint pain disease was reported in July [2014].

However, the ministry says so far presentation of the main signs and symptoms of those affected have largely been mild.

The highest number of people affected is recorded in the districts of Vaimauga west in the urban area with 151 cases; Faleata east, 139 cases; and 113 in Faleata west.  The majority of patients is young.

In American Samoa, the chikungunya outbreak is on the wane. Health officials say there are now 823 probable cases of the mosquito-borne illness, with 15 people requiring hospital care.
===========
[The chikungunya outbreak continues to grow in Samoa, from 269 cases reported on 25 Aug 2014 to 433 reported on 8 Sep 2014 and now to 626 cases. One hopes that a prompt and aggressive clean up of breeding sites will reduce the vector mosquito population enough to halt, or at least reduce, transmission.

On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month, apparently peaking at 823 probable cases reported above. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A map showing the location of Samoa in the Pacific Ocean can be accessed at <http://www.worldatlas.com/webimage/countrys/oceania/wsnewz.gif>. A HealthMap/ProMED-mail map showing the location of both Samoa and American Samoa in the Pacific Ocean can be accessed at <http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
Date: Mon 9 Sep 2014
Source: Radio New Zealand [edited]
<http://www.radionz.co.nz/international/pacific-news/253977/chikungunya-related-cases-reach-over-700-in-american-samoa

The latest reports from American Samoa reveal that chikungunya-related [febrile] cases have now reached over 700, and there is now one probable case in Ofu, Manua. The virus was discovered in the territory in July 2014, but there have been no reported cases in Manua until now.

Health officials are urging residents not to travel to Manua if they have chikungunya, and testing is being done to determine whether the case in Ofu is due to the virus. Since July 2014, there have been 11 hospitalisations with the virus but no deaths.

Health officials continue to urge those with symptoms to drink plenty of fluids, get a lot of rest, and visit the emergency department if symptoms become serious.
=======================
[On 26 Jul 2014, it was reported that American Samoa had about 100 cases, with 3 laboratory confirmed as chikungunya virus infections (see ProMED-mail archive no. 20140727.2638925). This is a sharp outbreak, with over 700 cases in a little over one month. Once introduced into American Samoa, spread of the virus is not surprising, because it has had dengue virus transmission in the past, and the same mosquitoes that transmit dengue viruses can transmit chikungunya virus as well.

A HealthMap/ProMED-mail map showing the location of American Samoa in the Pacific Ocean can be accessed at
Date: Tue 5 Aug 2014
Source: Radio New Zealand International [edited]

The American Samoan Department of Health says there are now more than 300 confirmed cases of chikungunya or 'chik' virus in the territory.

The Health Director Motusa Tuileama Nua says his department and LBJ hospital have confirmed the outbreak of fever, rashes, and joint pains among people on the main island of Tutuila is due to chikungunya.

He says there have been 343 recorded cases, with 6 patients hospitalised and no deaths, since the beginning of July [2014].

He recommends those who are ill with fever and body aches do not travel off island.
--------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
===============
[CHIKV has been circulating in Pacific islands this year (2014).

Maps showing the location of American Samoa in the Pacific Ocean can be accessed at
<http://healthmap.org/promed/p/380>. - ProMed Mod.TY]
****************************
American Samoa: confirmed
Date: Fri 8 Aug 2014
Source: Samoa News [edited]

The American Samoa Department of Health and the LBJ hospital have created a 24 hour a day hotline for the CHIK virus. The CHIK hotline number is 731-7511.

The Health Alert issued yesterday [7 Aug 2014] confirms chikungunya (CHIK) virus as the cause of fever, rash, and joint pains outbreak on Tutuila and there have been more than 390 recorded cases, with 7 patients hospitalized and no deaths since 1 Jul 2014.

According to the health alert, there is no cure for CHIK virus [infection, and] it can usually be treated at home by drinking lots of fluids, taking pain medicine like Tylenol, ibuprofen, or Aleve as needed but only as much and with cautions as recommended on the package.

The health alert urges not to work while your joints are painful, let them rest and apply ice or cold packs on the joints and this may protect against prolonged joint pain.

DOH notes you should go to the Emergency Room to see a doctor if symptoms persist more than 10 days, or if you have bleeding from any part of the body or bruised skin. Call the hotline "or come to the ER or clinic if you are worried about your condition getting worse."

The alert once again urges that people stay indoors in air-con, behind screens, or under bed nets while you are ill, because if you are bitten by mosquitoes while you are ill, you can spread the disease to your family and neighbors.

For travelers, the DOH urges those who are ill not to travel off island, including to Manu'a. "If you travel and become ill when you arrive, tell the doctor who sees you that you may have been exposed to the CHIK virus."  [Byline: B. Chen]
----------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
-----------------------------------
[Interestingly, the 5 Aug 2014 report above indicated that there were 343 reported cases, and in the subsequent report of 8 Aug 2014 above, that number has increased to 390 cases, indicating that transmission of CHIK virus is continuing. - ProMed Mod.TY]
******
Samoa: suspected cases
Date: Fri 8 Aug 2014
Source: Island Business [edited]

Samoa's Ministry of Health has reported 2 deaths from acute fever and rash, saying it is now an outbreak. A press statement from the Director General, Leausa Toleafoa Dr Take Naseri, says there have been 21 recorded cases as of earlier this week with 4 people hospitalised.

The cases are suspected to be chikungunya virus, similar to dengue fever, but results are yet to be confirmed and 3 children and one man have been admitted to the intensive care unit.

The ministry says collaboration with other government agencies, and media campaigns, aim to raise awareness of the outbreak and help its containment.

Samoa has also sought assistance from the Ministry of Health's development partners including the Secretariat of the Pacific Community and the World Health Organisation.

In neighbouring American Samoa, there have been more than 300 confirmed cases of chikungunya.
======================
[This is the 1st ever ProMED-mail report of a chikungunya outbreak in Samoa. Concerning the current outbreak, it would be unusual to have 2 deaths from chikungunya virus infections of a total of 21 recorded cases. One explanation for the high proportion of fatal cases could be significant underreporting of non-fatal cases. No mention is made indicating that there were contributory underlying medical conditions in these 2 fatal cases. ProMED-mail will be interested in receiving results of the laboratory tests when they become available.

Maps showing the location of Samoa in the Pacific Ocean can be accessed at
at <http://healthmap.org/promed/p/2>. - ProMed Mod.TY]
Date: Wed 14 May 2014
Source: Radio New Zealand International [edited]

Health officials in American Samoa are warning the public about an amoebic dysentery outbreak which has so far affected 26 people, half of which have been admitted to the LBJ hospital. A Pacific Island Health Officers' Association Epidemiologist, Mark Duran, says the department of health is leading an investigation into the source of the parasite.

Dr Duran says amoebic dysentery is spread through contamination of human waste. "It especially attacks the intestines and invades its way into the wall of the intestines; it causes abdominal pain, it causes bloody diarrhoea, fever." Dr Duran says in serious cases the parasite can travel through the body and cause abscesses especially in the liver.
===================
[Maps of American Samoa can be seen at
<http://healthmap.org/promed/p/380>. - ProMed Sr.Tech.Ed.MJ]
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Bouvet Island

General:
**********************************
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
the northern parts of the country. Temperatures of between 20C to 35C are fairly standard throughout the year. Generally the winter effects of the American continent only last for short periods.
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).
Road Safety:
**********************************
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.

Currency:
**********************************
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.
Health Facilities:
**********************************
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.
Summary:
**********************************
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

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Ethiopia

Ethiopia - US Consular Information Sheet
November 26, 2008
COUNTRY DESCRIPTION:
The Federal Democratic Republic of Ethiopia is a developing country in East Africa.
It is comprised of nine states and two city administrations (Addis Aba
a and Dire Dawa).
The capital is Addis Ababa.
Tourism facilities can be found in the most populous regions of Ethiopia, but infrastructure is basic.
The ruling EPRDF party and Prime Minister Meles Zenawi maintain strong control of the government and economy.
Despite several years of high economic growth, the country remains vulnerable to external economic shocks and recurring drought.

Read the Department of State Background Notes on Ethiopia for additional information.

ENTRY/EXIT REQUIREMENTS:
To avoid possible confusion or delays, travelers are advised to obtain a valid Ethiopian visa at the nearest Ethiopian Embassy prior to arrival, and must do so if entering across any land port-of-entry.
For example: travelers wishing to enter Ethiopia from Kenya at the land border at Moyale, must obtain an Ethiopian visa first.
Ethiopian visas ARE NOT available at the border crossing point at Moyale.
Travelers should apply for Ethiopian visas at the Ethiopian Embassy in Nairobi or at other Ethiopian embassies in other countries.
Ethiopian visas are available to U.S. citizens upon arrival at Bole International Airport in Addis Ababa.
U.S. citizens may obtain one-month or three month, single-entry tourist visas or 10-day single-entry business visas upon arrival at Bole International Airport.
This service is available only at Bole International Airport and is not available at any other ports of entry in Ethiopia.
The visa fee at Bole International Airport is payable in U.S. dollars.
Such visas can be extended by applying at the Main Immigration Office in Addis Ababa.
Business visas of up to three-months validity can also be obtained at Bole International Airport upon arrival if the traveler has a sponsoring organization in Ethiopia that has made prior arrangements for issuance through the Main Immigration Office in Addis Ababa.
Travelers whose entry visa expires before they depart Ethiopia, must obtain a visa extension and pay a monthly penalty fee of $20 USD per month.
Such travelers may also be required to pay a court fine of up to 4000 ETB (USD $435) before being permitted to depart from Ethiopia.
Travelers are required to pay the penalty fee before they will be able to obtain an exit visa (USD $20) permitting them to leave Ethiopia.

Individuals intending to stay in Ethiopia for a prolonged period of time are advised to contact the Ethiopian Embassy in Washington prior to traveling.
The Ethiopian Embassy is located at 3506 International Drive NW, Washington, DC 20008; telephone (202) 364-1200; fax (202) 587-0195.
For the most current visa information, visit the Embassy’s web site at www.ethiopianembassy.org.
Inquiries by Americans located overseas may be made at the nearest Ethiopian embassy or consulate.

Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
While Ethiopia is generally stable, domestic insurgent groups, extremists from Somalia, and the heavy military buildup along the northern border pose risks to safety and security, particularly along Ethiopia’s border areas and in the Somali region.
In the past year, there has been an increase in targeted bombings in Addis Ababa and in other parts of Ethiopia.
In November 2008, the Government of Ethiopia issued a warning to its citizens alerting them of the potential for terrorist attacks and subsequently increased security measures to unprecedented levels.

Throughout Ethiopia:
Americans are strongly advised to review their personal safety and security posture, to remain vigilant and to be cautious when frequenting prominent public places and landmarks.
Targeted bombings in Addis Ababa and south eastern Ethiopia in 2008 resulted in numerous injuries and deaths.
Americans are advised to avoid public gatherings and public places, including hotels, if possible, and using public transportation and transportation hubs.
They are advised to beware of unattended baggage or packages left in any location, including in mini-buses and taxis.

Ethiopia/Eritrea Border Area:
Ethiopia and Eritrea signed a peace agreement in December 2000 that ended their border war.
However, the border remains an issue of contention between the governments of Ethiopia and Eritrea.
The border area is a militarized zone where there exists the possibility of armed conflict between Ethiopian and Eritrean forces.
American citizens are advised to avoid travel in the areas along the Eritrean/Ethiopian border (within 50 km/30 miles of the Ethiopian/Eritrean border) because of the dangers posed by land mines and because of the possibility of conflict between Ethiopian and Eritrean defense forces.
Due to abductions and banditry, Americans are advised to avoid travel within 30 miles of the Ethiopian-Eritrean border west of Adigrat to the Sudanese border, with the exception of the town of Axum, and within 60 miles east of Adigrat to the Djiboutian border.
Embassy personnel are permitted to travel in these areas only on a case-by-case basis. Travel to the northern Afar Region towards the Eritrean border is also discouraged.
Embassy personnel are permitted to travel there only on a case-by-case basis.

Somali Region:
Since the mid-1990's the members of the Ogaden National Liberation Front (ONLF) have clashed with Ethiopian government forces near the city of Harar and in the Somali regional state, particularly in the Ogaden zones.
In April 2007, the ONLF claimed responsibility for attacking a Chinese oil exploration installation south of Jijiga, in Ethiopia's Somali region.
The attack resulted in deaths, kidnappings and the wounding of dozens of Chinese and Ethiopian citizens.
In 2008, a hotel in the town of Jijiga was bombed and two hotels in the town of Negele Borena were bombed.

American citizens are reminded that the U.S. Embassy strongly discourages travel to Ethiopia's Somali region and that a Travel Warning for Somalia has been issued that advises against all travel to that country.
Armed insurgent groups operate within the Somali, Oromiya and Afar regions of Ethiopia.
In December 2006, the Ethiopian Government, at the invitation of the Transitional Federal Government of Somalia, began military operations against extremists in Somalia.
As of November 2007, military operations continue in Mogadishu, where an African Union peacekeeping force, AMISOM, is deployed.
In 2008, two staff members of a non-governmental organization (NGO) were abducted in the Somali region.

Gambella Region:
Sporadic inter-ethnic clashes remain a concern throughout the Gambella region of western Ethiopia following outbursts of violence there in 2003 - 2004.
There is a heavy military and police presence in the town of Gambella.
While the security situation in the town of Gambella is calm, it remains unpredictable throughout the rest of the region, and violence could recur without warning.
Travel to this region is discouraged.

Travel in Ethiopia via rail is discouraged due to past episodes of derailment, sabotage, and bombings.
In southern Ethiopia along the Kenyan border, banditry and incidents involving ethnic conflicts are also common.
Travelers should exercise caution when traveling to any remote area of the country, including the borders with Eritrea, Somalia, Kenya and Sudan.
Ethiopian security forces do not have a widespread presence in those regions.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
CRIME:
Pick-pocketing, “snatch and run” thefts, and other petty crimes are common in Addis Ababa.
These are generally crimes of opportunity rather than planned attacks.
Travelers should exercise caution in crowded areas and should avoid visiting the Mercato in Addis Ababa, a large open-air market.
Violence in the Mercato has been on the rise.
In 2008 an explosion in the Mercato killed several and wounded more than a dozen individuals.
Also in 2008, there was a shooting in the Mercato.
Travelers should limit the amount of cash they carry and leave valuables, such as passports, jewelry, and airline tickets in a hotel safe or other secure place.
Travelers should keep wallets and other valuables where they will be less susceptible to pick-pockets.
Travelers should be cautious at all times when traveling on roads in Ethiopia.
There have been reports of highway robbery, including carjacking, by armed bandits outside urban areas.
Some incidents have been accompanied by violence.
Travelers are cautioned to limit road travel outside major towns or cities to daylight hours and travel in convoys, if possible.

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

There is no local equivalent to the “911” emergency line in Ethiopia.
Distress calls should be made to the local police station, the telephone number of which can be obtained by calling directory assistance at 997.
This is the number for directory assistance throughout Ethiopia.
In Addis Ababa, the number for police is 991, for the fire brigade 939, and for an ambulance 907.

MEDICAL FACILITIES AND HEALTH INFORMATION:
Health facilities in Addis Ababa are very limited and are generally inadequate outside the capital.
Even the best hospitals in Addis Ababa suffer from inadequate facilities, antiquated equipment, and shortages of supplies (particularly medicines).
There is a shortage of physicians.
Emergency assistance is limited.
Psychiatric services and medications are practically nonexistent.
Serious illnesses and injuries often require travelers to be medically evacuated from Ethiopia to a location where adequate medical attention is available.
Such “medevac” services are very expensive and are generally available only to travelers who either have travel insurance that covers medevac services or who are able to pay in advance the considerable cost of such services (often in excess of USD 40,000).
See Medical Insurance below.
Travelers must carry their own supplies of prescription drugs and preventive medicines, as well as a doctor's note describing the medication.
If the quantity of drugs exceeds that which would be expected for personal use, a permit from the Ministry of Health is required.
Malaria is prevalent in Ethiopia outside of the highland areas.
Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area and up to one year after returning home should seek prompt medical attention and explain to the health care provider their travel history and which anti-malarials they have been taking.
For additional information on malaria, protection from insect bites, and anti-malarial drugs, please visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/index.htm.
Tuberculosis is an increasingly serious health concern in Ethiopia.
For further information, please consult the CDC's Travel Notice on TB at http://wwwn.cdc.gov/travel/yellowBookCh4-TB.aspx

Ethiopia is a mountainous country and the high altitude may cause health problems, even for healthy travelers.
Addis Ababa is located at an altitude of 8,300 feet.
Travelers may experience shortness of breath, fatigue, nausea, headaches, and inability to sleep.
Individuals with respiratory (including asthma) or heart conditions should consult with a health care professional before traveling to Ethiopia.
Travelers to Ethiopia should also avoid swimming in any lakes, rivers, or still bodies of water.
Most bodies of water have been found to contain parasites.
Travelers should be aware that Ethiopia has a high prevalence of HIV/AIDS.
Ethiopia has had outbreaks of acute watery diarrhea, possible cholera, typhoid, or other bacterial diarrhea in the recent past, and the conditions for reoccurrences continue to exist.
Further information on prevention and treatment of cholera and other diarrheal diseases can be found at the CDC web site at http://wwwn.cdc.gov/travel/contentDiseases.aspx.
Ethiopian authorities are monitoring the possibility of avian influenza following the deaths of poultry and birds; preliminary results are negative.
For additional information on avian flu please visit the CDC website at http://www.cdc.gov/flu/avian/.
The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Ethiopia.
Please verify with the embassy of Ethiopia before you travel.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site 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.
Specific medevac insurance, which generally covers evacuation of a patient from Ethiopia to a location where adequate medical attention is available, is often inexpensive and available through a variety of companies that can be accessed online.
Medicare and Medicaid recipients are not covered overseas and are advised to purchase supplemental health and medical evacuation insurances.
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 Ethiopia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
According to the World Health Organization (WHO), Ethiopia has the highest rate of traffic fatalities per vehicle in the world.
Roads in Ethiopia are poorly maintained, inadequately marked, and poorly lighted.
Road travel after dark outside Addis Ababa and other cities is dangerous and discouraged due to hazards posed by broken-down vehicles left in the road, pedestrians walking in the road, stray animals, and the possibility of armed robbery.
Road lighting in cities is inadequate at best and nonexistent outside of cities.
Excessive speed, unpredictable local driving habits, pedestrians and livestock in the roadway, and the lack of basic safety equipment on many vehicles are daily hazards on Ethiopian roads.
While travel during daylight hours on both paved and unpaved roads is generally considered safe, land mines and other anti-personnel devices can be encountered on isolated dirt roads that were targeted during various conflicts.
Before undertaking any off-road travel, it is advisable to inquire of local authorities to ensure that the area has been cleared of mines.
Please refer to our Road Safety page for more information.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of Ethiopia’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Ethiopia’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/.
The Ethiopian government has closed air routes near the border with Eritrea and has referred to the airspace as a “no-fly zone.”
The FAA currently prohibits U.S. aircraft and U.S. pilots from flying in Ethiopian airspace north of 12 degrees north latitude, the area along the country's northern border with Eritrea.
For complete information on this flight prohibition, travelers may visit the FAA's web site at http://www.faa.gov/airports_airtraffic/air_traffic/publications/notices/2008-11-20/PART3_SEC1.cfm.
SPECIAL CIRCUMSTANCES:
Ethiopia does not recognize dual nationality.
The government of Ethiopia considers Ethiopians who have become naturalized U.S. citizens to be Americans.
Such individuals are not subject to Ethiopian military service.
The Ethiopian government has stated that Ethiopian-Americans in almost all cases are given the same opportunity to invest in Ethiopia as Ethiopians.
Several years ago the government of Ethiopia arrested people of Eritrean origin who initially failed to disclose their U.S. citizenship.
However, this has not occurred in recent years.
Ethiopian officials have recently stated that Eritrean-Americans are treated as U.S. citizens and are not subject to arrest simply because of their ties to Eritrea.
For additional information, see our dual nationality flyer.
Permits are required before exporting either antiques or animal skins from Ethiopia.
Antique religious artifacts, including "Ethiopian” crosses, require documentation from the National Museum in Addis Ababa for export.
Foreign currency should be exchanged in authorized banks, hotels and other legally authorized outlets and proper receipts should be obtained for the transactions.
Exchange receipts are required to convert unused Ethiopian currency back to the original foreign currency.
Penalties for exchanging money on the black market range from fines to imprisonment.
Credit cards are not accepted at most hotels, restaurants, shops, or other local facilities, although they are accepted at the Hilton and Sheraton Hotels in Addis Ababa.
Some hotels and car rental companies, particularly in Addis Ababa, may require foreigners to pay in foreign currency or show a receipt for the source of foreign exchange if paying in local currency.
However, many hotels or establishments are not permitted to accept foreign currency or may be reluctant to do so.

Ethiopian institutions have on occasion refused to accept 1996 series U.S. currency, although official policy is that such currency should be treated as legal tender.
Ethiopian law strictly prohibits the photographing of military installations, police/military personnel, industrial facilities, government buildings, and infrastructure (roads, bridges, dams, airfields, etc.).
Such sites are rarely marked clearly.
Travel guides, police, and Ethiopian officials can advise if a particular site may be photographed.
Photographing prohibited sites may result in the confiscation of film and camera.
There is a risk of earthquakes in Ethiopia.
Buildings may collapse due to strong tremors.
General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/
Please see our Customs Information.
CRIMINAL PENALTIES:
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating Ethiopia’s laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Ethiopia are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.

CHILDREN'S ISSUES:
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in Ethiopia are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration website so that they can obtain updated information on travel and security within Ethiopia.
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 Entoto Avenue, P.O. Box 1014, in Addis Ababa; telephone: 251-11-124-2424; emergency after-hours telephone: 251-11-124-2400; consular fax: 251-11-124-2435; web site: http://ethiopia.usembassy.gov/
* * *
This replaces the Country Specific Information for Ethiopia dated April 30, 2008 to update sections on Country Description, Entry/Exit Requirements, Safety and Security, Crime, Information for Victims of Crime, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.

Travel News Headlines WORLD NEWS

Date: Thu 31 Oct 2019
Source: News 18 [abridged, edited]

For the past 10 months, Ethiopia has been experiencing a measles outbreak, which began in Oromio region and later affected 3 additional regions: Afar, Amhara and Somali. Since the beginning of the year [2019], a total of 8514 suspected measles cases, including 57 deaths (case fatality ratio 0.67%), were reported.

The World Health Organisation (WHO) says measles is endemic in Ethiopia with outbreaks reported annually. A quarter of the people affected during the current outbreak are 15 years and above, and more than 82.6% of cases were either not vaccinated or their vaccination status was unknown.
Date: Sun 20 Oct 2019
Source: WHO-AFRO [abridged, edited]

Weekly bulletin on outbreaks and other emergencies Week 42: 14-20 Oct 2019
Summary: Cases: 8514; deaths: 57; CFR [case fatality ratio]: 0.67%

Description
=======================
Ethiopia has been experiencing a measles outbreak since late December 2018. The outbreak was initially reported in Oromia region and later affected 3 additional regions: Afar, Amhara, and Somali.

In week 41 (week ending 13 Oct 2019), 24 suspected cases with no deaths were reported. Between week 1 and week 41 in 2019, a total of 8514 suspected measles cases, including 57 deaths (CFR 0.67%), were reported. Of the 8514 suspected cases, 180 samples were tested, and 14 tested IgM-positive for measles virus infection at the Ethiopian Public Health Institute laboratory in Addis Ababa. The peak of the outbreak was reached in week 9 (week ending 3 Mar 2019), with 642 cases reported, followed by a gradual decline in the number of cases to 24 cases reported in week 41.

A total of 4 regions have confirmed measles outbreaks, including 28 zones and 113 woreda [districts]. Oromia region is the most affected, accounting for 58% of the total reported cases, followed by Somali (28%), Amhara (8%), and Afar (6%) regions.

The majority of affected cases are children under 5 years old, comprising 50.4% of all cases, followed by the age group 15-44 years (25.4%) and 5-14 years (23.3%). Upon investigation of the vaccination status of the cases, it was noted that 72.6% had never received a single measles dose.

Public health actions
======================
- A national coordination committee was set up at the Ethiopian Public Health Institute to coordinate the response to the measles outbreak as well as regional coordinating committees in each of the affected regions.
- Enhanced surveillance activities continue to enable the early detection of cases and prompt treatment.
- The Ethiopian government together with WHO, UNICEF, and other partners supported a responsive vaccination campaign in Somali region.
- In early February 2019, Ethiopia launched a measles vaccine 2nd dose (MCV2) vaccination into the routine immunization programme in the 2nd year of life.
- Management of measles cases is ongoing at healthcare facilities in the affected regions.

Situation interpretation
======================
Measles is endemic in Ethiopia with outbreaks reported annually. A quarter of the people affected during the current outbreak are 15 years and above, and more than 82.6% of cases were either not vaccinated or their vaccination status was unknown. In addition, an effective cold-chain system for storage and transport of the vaccine is lacking in a number of regions, especially Afar and Somali regions. The estimated measles vaccine 1st dose (MCV1) coverage by WHO and UNICEF in 2018 was 61%, and the administrative coverage for the same period was 88%. This is suboptimal to protect a community against an outbreak (to achieve herd immunity, usually 95% and above coverage is required).

There is a need to apply simple yet innovative approaches to address the health system challenges that impact the effective delivery of measles vaccines, and other vaccines, to the population, especially those located in the hard-to-reach areas of the country. Routine measles vaccination for children, combined supplemental immunization activities (SIAs) and strong community engagement are key public health strategies to reduce the incidence of the disease.
================================
[Also see
and
Date: Tue, 15 Oct 2019 20:35:37 +0200 (METDST)

Addis Ababa, Oct 15, 2019 (AFP) - Rescue workers on Tuesday used excavators to dig out bodies after a landslide in southern Ethiopia washed away homes and killed more than 20 people, a local official said.    The landslide in the remote district of Konta occurred Sunday following 10 hours of heavy rains, said the official, Takele Tesfu.   "There are 22 people dead and we have only been able to dig up 17 using manpower and machine power," Takele told AFP.   "So far, we cannot get the others, so tomorrow we will continue to dig."     He said the victims included nine women and six children.

While the district -- located in Ethiopia's Southern Nations, Nationalities, and Peoples' Region -- sees landslides with some regularity, Takele said this was the deadliest he could remember.    "The area where this occurred is very mountainous, and this means the landslide was very dangerous," he said.    Ethiopia is nearing the end of its rainy season, but security forces are nonetheless relocating some families for fear that more rain in the coming days could lead to similar disasters, Takele said.
Date: Thu, 10 Oct 2019 20:02:59 +0200 (METDST)
By Robbie COREY-BOULET

Addis Ababa, Oct 10, 2019 (AFP) - A palace that once housed Ethiopia's emperors and also served as a torture site under the communist Derg regime is to open to the public in a controversial government tourism project.    The palace compound in Addis Ababa, which Prime Minister Abiy Ahmed's government has rebranded "Unity Park", was formally launched Thursday and will be open from Friday.    Abiy's office said on Twitter Thursday that the project "symbolises our ability to come together".

But critics have dismissed it as vanity project for Abiy that could prove divisive.   Backed by the United Arab Emirates, the project cost more than $160 million (145 million euros), Ethiopian officials told reporters at a briefing earlier this week.    Built in the late 1800s by Emperor Menelik II, who founded Addis Ababa, the palace was the residence of Ethiopia's rulers for more than a century.   Abiy himself does not live there, and it has seen little activity in recent years.    Abiy's advisers say he has taken a keen interest in transforming the palace into a tourist attraction since coming to power in April 2018 -- visiting the site every day in recent weeks to monitor progress.

The government's "Home-Grown Economic Reform" agenda, unveiled last month, describes tourism as a primary engine of potential job creation.    On Thursday, government officials and the diplomatic corps toured the expansive site before attending a banquet that was expected to draw five regional heads of state and other dignitaries.    The restored rooms feature items like Menelik's sword and a life-size wax replica of former Emperor Haile Selassie, who lived at the palace and was then etained there after the Derg overthrew him in 1974.

The site also includes a sculpture garden with installations representing Ethiopia's nine regions, and a zoo is expected to open by the end of the year.    Aklilu Fikresilassie, an Ethiopian employee of the United Nations who attended the launch Thursday, said he was "really fascinated" to set foot inside a place that had been closed to the public his entire life.    "For us it's like a government house, so now when you enter that palace it tells you that we are getting somehow closer to our leaders," he said.

But not everyone is convinced the palace will succeed in bringing Ethiopians together.   In a country grappling with ethnic divisions, some worry that the palace could alienate ethnic Oromos who contend that their ancestors were forced off their land when Addis Ababa was built.    Journalist and former political prisoner Eskinder Nega said the renovations were undertaken "without consultation from the public", which he called "a huge mistake."    "This is all about heritage, about preserving heritage. The people should have had a say in it," he said.    "Like everything else this was decided from the top and implemented only by the decision of the prime minister."
Date: Tue 2 Jul 2019
Source: Anadolu Agency [edited]

Ethiopia has diagnosed 871 people with cholera, an acute infectious diarrheal disease, an official said. "So far, 871 people have been diagnosed with cholera in different areas," the local broadcaster FANA stated, quoting the Director General of Ethiopian Public Health Institute, Getachew Tolera. The cholera cases have spread in Oromia, Amhara, Tigray, Somali and Afar provinces, as well as in 2 major cities of the country. The disease has so far caused deaths of 17 persons, FANA quoted Getachew as saying.

The majority of cases have been reported from Oromia province, with 350 people diagnosed with the infectious disease. As many as 202 people have contracted it in Amhara, 19 in Tigray, 131 in Afar and 33 in Somali regions. Some 125 persons have been diagnosed with the disease in the capital Addis Ababa and one in Dire Dawa city in Eastern Ethiopia. In a bid to control further spread of the disease, 26 quarantine centres have been set up across the nation. Getachew said medicines are being made available to the affected areas. At least 291 000 people have been vaccinated in the West Harerghe zone of Oromia province, according to the local broadcaster.  [Byline: Addis Getachew Tadesse]
More ...

Turkey

Geographical Information:
*****************************************
Turkey is officially known as the Republic of Turkey and is bordered on the northwest by Bulgaria and Greece, on the north by the Black Sea and on the south by Syria, Iraq and t
e Mediterranean Sea. The capital is Ankara with a population of about 2.5 million though Istanbul is a much larger city (6.6 million). The population of the country is estimated at 62 million with the majority in the cities and along the costal regions.
Climate:
*****************************************
The Mediterranean and Aegean shores of Turkey have long and hot summers with a milder winter. In Istanbul the average July temperature reaches 230C while in January it can drop to 00C. Throughout the country the annual rainfall is about 29". This is mainly during the months of December and January.

Health Care Facilities:
*****************************************
The level of adequate health facilities vary considerably within the country. Most of the better hotels will have access to English speaking doctors but care may be required if hospital admission is required.
Disease Profile:
*****************************************
Cholera and other water borne diseases are frequently reported from Istanbul. In the southeastern city of Diyarbakir there are regular reports of dysentery, typhoid, meningitis and other contagious diseases.

General Food & Water Hygiene:
*****************************************
There can be little doubt that travellers to Turkey who disregard basic hygiene precautions will run a risk of developing significant illness and a ruined holiday. With simple general care most tourists will remain healthy.

Food Rules:
*****************************************
Always eat in clean restaurants and hotels. Eat freshly cooked hot food. Stay away from cold salads, especially lettuce. Don’t eat any of the bivalve shellfish dishes such as oysters and mussels. Never eat food prepared by street vendors. Always peel your own fruit if at all possible.
Water Rules:
*****************************************
Never use the hotel tap water for drinking or brushing your teeth unless you can easily smell chlorine. Don’t allow ice in your drinks and be wary of the hotel water jug which may be in your room each day. Any of the canned drinks or bottles are usually quite safe. Just check the seal first!
Rabies in Turkey:
*****************************************
This disease is only a particularly risk for travellers who plan to have extended trekking holidays throughout Turkey. Most tourists travelling for a ‘sun’ holiday would be very unfortunate to be exposed but nevertheless care should be taken at all times to ensure that there is no contact with warm blooded animals. This is mainly true for dogs and cats but any infected
warm blooded animal can transmit the disease through its saliva. Any bite, lick or scratch should be treated seriously.
*
Wash out the area
*
Apply an antiseptic
*
Attend for urgent medical attention
Sun Stroke:
*****************************************
The immense strength of the sun in the Middle East can often be underestimated by the Irish traveller. This is especially true for small children and the elderly. Try and stay out of the direct sunlight between 11am to 4pm. Use a wide brimmed hat if possible to protect yourself. Drink plenty of fluid (about 2 or 3 times as much as in Ireland) and remember to increase your salt intake unless this is contraindicated because of high blood pressure or heart disease etc. Any signs of dehydration should be recognised and treated early (dry lips, headache etc.).
Anthrax:
*****************************************
This bacterial disease is sometimes contracted by travellers who purchase untreated leather goods while abroad.
Drug Trafficking:
*****************************************
Remember that Turkey is regarded as a gateway to Europe. Never agree to carry belongings for others unless you are certain of the contents.
Malaria in Turkey:
*****************************************
The risk of malaria in Turkey is very limited and transmission usually only occurs between the months of March to November in the Çukurova / Amikova areas and from mid-March to mid-October in southeast Anatolia. These are mainly away from the standard tourist routes and so prophylaxis will usually not be required. Nevertheless there may be an abundant supply of mosquitoes and other insects around. Travellers should carry insect repellents and wear longer sleeved clothing when at risk.
Vaccinations for Turkey:
*****************************************
There are no compulsory vaccines for entry to Turkey from Ireland. However, travellers are advised to ensure that they are adequately covered against Poliomyelitis, Typhoid, Tetanus and Hepatitis A. Those spending longer in the country or undertaking a trekking holiday may also need to consider vaccination cover against Rabies and Hepatitis B .
Further Information:
*****************************************
Travellers can obtain further health information for overseas travel by contacting either of our offices. Useful web sites for information on Turkey include;

www.WHO.int
www.CDC.gov
www.FCO.gov.uk

Travel News Headlines WORLD NEWS

Date: Wed 6 Nov 2019
Source: FreshPlaza [edited]

Turkish Health Minister Fahrettin Koca urged citizens not to panic amid an increasing number of food poisoning cases due to spinach consumption.

The number of patients poisoned from spinach mixed with toxic herbs has risen to 196, Minister Fahrettin Koca said on [Tue 5 Nov 2019], adding there was no need for panic as none of the cases was life threatening.

Koca said all patients were located in Turkey's north-western provinces, namely Istanbul, Edirne, Tekirdag, and Kocaeli. The minister said only 21 patients remained hospitalized and that all instances were considered food poisoning cases.

"What we actually see is the patients come in with (complaints of) food poisoning but what they all have in common is they have all consumed spinach. The patients were admitted with symptoms of dry mouth, flushed skin, nausea, vomiting, and blurred vision -- common side effects of atropine overdose. The problem seems to be weeds growing around the same area mixing with the produce," Koca said. The minister urged citizens to carefully inspect any produce they buy and thoroughly wash them.

Murak Kapikiran, an official from the Istanbul Chamber of Agriculture Engineers, said a wild plant very similar in appearance to spinach might be the likely culprit. While officials from the Ministry of Agriculture and Forestry on [Mon 4 Nov 2019] said weeds from the Solanaceae plant family were suspected to be the cause for the poisoning, Kapikiran said it was a wild plant called _Atropa belladonna_, also known as deadly nightshade, [which, with other members of the Solanaceae or nightshades family contains] the naturally occurring chemical atropine.

Kapikiran said both spinach and deadly nightshade grew around the same times and were visually similar, which could have easily fooled farmers, causing them to be mixed up.

"The other option is adulteration. Since they look very similar, nightshade might have been intentionally mixed to increase the harvest. And the amount needed to be consumed to show poisoning symptoms is somewhat substantial. We hope this is not the case," he said. Kapikiran urged more inspections for produce, adding that a potential mix-up could happen in the future again with other leafy greens.

A food technology expert urged citizens to wash their spinach with baking soda instead of vinegar, which is a common habit in Turkish kitchens. "Vinegar can make some pesticides and herbicides more potent. Therefore, it is important to use baking soda instead of vinegar. The consumer should first let spinach sit in water with baking soda and then rinse it," Sibel Bolek said.
Date: Tue 5 Nov 2019
Source: Ahval News [edited]

Health officials in Istanbul said on Tuesday (5 Nov 2019) the number of people admitted for care after eating tainted spinach had risen to 108, Turkish news site Diken reported.  The Istanbul Health Directorate said 28 patients had stayed in hospital for observation, and the rest had been discharged.

Health authorities said they suspected foreign plants containing poisonous chemicals had been mixed in with spinach. They said scopolamine and atropine, both chemicals found in many plants in the nightshade family, had caused the poisoning.

The symptoms include blurred vision, dry skin, constipation, a rapid heartbeat, and hypertension, the directorate said.

News of a poisoned spinach outbreak spread quickly over the weekend as dozens of people were admitted to hospitals after eating the leaves.
======================
[The clinical signs associated scopolamine, and atropine, mentioned in the article make me think of a Datura species, specifically Jimsonweed, a _Datura_ sp.

Jimsonweed grows wild and is used as an ornamental plant in much of the United States and other countries. It contains alkaloids such as atropine and scopolamine, which can cause anticholinergic toxicity. The concentration of anticholinergics can vary over time and in different parts of a plant, with the seeds having the highest concentration, containing approximately 0.1 mg of atropine per seed (1). A dosage of 10 mg or more of atropine can be fatal (1).

This article does not provide enough information to estimate how much Jimson weed could have been in the spinach or how much could have been ingested. Cooking does not substantially affect the potency of the leaves, and atropine and scopolamine remain intact during baking (2).

Jimsonweed poisoning causes dry mucous membranes and skin, thirst, flushing, fever, blurred vision, altered mental status, mydriasis, urinary retention, tachycardia, coma, and, in rare cases, death (1,4). Treatment with physostigmine is indicated only in severe cases to reverse anticholinergic toxicity (1). Jimsonweed is sometimes consumed intentionally by persons seeking to experience its hallucinogenic effects (1,4), often in a jimsonweed tea (1). Because previous reports of toxicity have involved adolescents and young adults using jimsonweed to experience its hallucinogenic effects (1,4), health-care providers might be less likely to suspect ingestion of jimsonweed in older adults with signs and symptoms of anticholinergic toxicity.

The diagnosis of jimsonweed poisoning can be difficult because of the wide range of signs and symptoms associated with anticholinergic toxicity and the inability to obtain an accurate history of exposures (1,6,7). No clinical laboratory tests are routinely available to detect anticholinergic toxicity. The diagnosis generally is based on history, physical findings, and symptoms. The signs and symptoms among the patients described in this report varied over time.

Again, this article does not provide us much information regarding the patients. However, patients often report thirst, hallucinations, and dizziness. Clinicians might not suspect jimsonweed poisoning in a lone patient with coma or altered mental status, tachycardia, and mydriasis (6), especially if no specific exposure history is available.

Health-care providers and public health officials should be aware of the signs of anticholinergic toxicity and should consider jimsonweed poisoning as a cause of any compatible food-related outbreak of anticholinergic toxicity. A thorough history of food consumption and drug exposures should be obtained, if possible, for all persons with anticholinergic toxicity. Health departments might have limited experience investigating the types of noninfectious foodborne illnesses, as described in this report. Consultation with horticulturalists, poison control centers, and specialized laboratories can be an important component of such investigations.

Hopefully, the suspect spinach will be taken to the appropriate facility to verify whether it is tainted with Jimsonweed, or whether some other plant has contaminated the spinach.

References:
1. CDC. Jimson weed poisoning---Texas, New York, and California, 1994. MMWR 1995;44:41--3.
2. Friedman M, Levin C. Composition of jimson weed (_Datura stramonium_) seeds. J Agric Food Chem 1989;37:998--1005.
3. US National Library of Medicine. Toxicology data network (TOXNET). Available at <http://toxnet.nlm.nih.gov>. Accessed 28 Jan 2010.
4. Spina SP, Taddei A. Teenagers with Jimson weed (_Datura stramonium_) poisoning. CJEM 2007;9:467--8.
5. Shervette RE, Schydlower M, Lampe RM, Fearnow RG. Jimson "loco" weed abuse in adolescents. Pediatrics 1979;63:520--3.
6. Lazzarini D, Baffoni MT, Cangiotti C, et al. Food poisoning by Datura stramonium: an unusual case report. Intern Emerg Med 2006;1:88--90.
7. Chang SS, Wu ML, Deng JF, Lee CC, Chin TF, Liao SJ. Poisoning by Datura leaves used as edible wild vegetables. Vet Hum Toxicol 1999;41:242--5.

Portions of this comment were extracted from:

[HealthMap/ProMED map available at:
Date: Thu, 26 Sep 2019 15:59:36 +0200 (METDST)

Istanbul, Sept 26, 2019 (AFP) - A 5.7-magnitude earthquake shook Turkey's largest city on Thursday, driving residents to evacuate buildings, AFP journalists witnessed.   Eight people were "lightly injured", President Recep Tayyip Erdogan told a press conference in Istanbul.   "Some buildings have been lightly damaged," he added.

Istanbul's Bogazici University Observatory and Earthquake Research Institute said the quake's centre was in the town of Silivri, around 80 kilometres (50 miles) west of the city.    It said the quake measured magnitude 5.7 and struck at 1:59pm (1059 GMT). Several smaller after-shocks were also recorded.   Turkish broadcasters showed images of a minaret tower that had been snapped in two.    Schools in Istanbul and nearby provinces of Bursa and Yalova were closed for the day, NTV broadcaster reported.

Istanbul lies near a major fault line and experts have forecast that a severe earthquake is due there in the coming years.  On August 17, 1999, a huge earthquake measuring 7.4 magnitude centred on the city of Izmit devastated vast areas in the country's densely-populated north-western zone, notably around Istanbul.    At least 17,400 people were killed including 1,000 within Turkey's economic capital.   A large quake could devastate the city of 15 million, which has allowed widespread building without safety precautions.
Date: Mon 5 Aug 2019 20:42 TRT
Source: Daily Sabah [edited]

A group of Turkish scientists has identified 4 rare viruses in Turkey that cause haemorrhagic fever and lead to death due to renal failure, a scientist said [Mon 5 Aug 2019].

A team from the Biology Department of Bulent Ecevit University, led by Professor Mehmet Ali Oktem of Dokuz Eylul University's Medical Virology Department, conducted research on hantavirus types that develop in rodents and small mammals in Turkey and 4 particular subspecies that can cause human disease.

Oktem said he has been doing fieldwork on the hantavirus since 2000, adding that the presence of the virus in rodents was discovered in Turkey for the 1st time in 2004 in the Black Sea region. Meanwhile, the 1st cases in which the viruses developed in humans were reported in 2004 in the Aegean region, and subsequently in Zonguldak and Bartin provinces in the western Black Sea region in 2009.

The newly-identified rare viruses which can be transmitted to humans from rodents, have been named after the provinces or towns they were found in, namely the "Dobrava Hantavirus Igneada", "Dobrava Hantavirus Giresun", "Puumala Hantavirus Bartin", and "Tuula Hantavirus Palandoken."
=====================
[Cases of hantavirus haemorrhagic fever with renal syndrome have been reported in Turkey previously. In January-March 2009 there were 12 laboratory confirmed cases that were serologically positive for Puumala virus subtype.

Reference
---------
Ertek M, Buzgan T; Refik Saydam National Public Health Agency; Ministry of Health, Ankara, Turkey: An outbreak caused by hantavirus in the Black Sea region of Turkey, January-May 2009. Euro Surveill. 2009; 14(20). pii: 19214;  <https://www.eurosurveillance.org/content/10.2807/ese.14.20.19214-en>

Finding Puumala virus in rodents in Turkey is not surprising, since it has caused human cases there in the past. Dobrava-Belgrade orthohantavirus (DOBV) was first isolated from yellow-necked mice (_Apodemus flavicollis_) found in Dobrava village, Republic of Slovenia. It was subsequently isolated in striped field mice in Russia and other parts of Eastern Europe and this rodent occurs in Turkey. The report above indicates that it harbors DOBV in Turkey. It will be interesting to see a genomic comparison of these viruses from Turkey with sequences of these same viruses from other geographic areas. - ProMED Mod.TY]

[HealthMap/ProMED-mail map of Turkey:
Date: Tue 30 Jul 2019
Source: Time Turk [in Turkish, machine trans., edited]
<https://www.timeturk.com/mus-ta-15-kisi-brucella-hastaligina-yakalandi/haber-1150899>

A total of 15 people engaged in animal fattening in the town and highlands of Kirkoy have been infected with brucellosis. A resident of the town said that many small ruminants in the town had suffered a miscarriage during the birth season and that 4 people in one family are now being treated for brucellosis. The patients had been seen at the Elazig Ataturk Research Hospital and "the doctors made the examinations and tests and as a result a brucellosis diagnosis was made. The patients were constantly sluggish and sleepy.

Currently, 15 people are receiving treatment for the same disease, "he said. Mus Provincial Health Director Serdal Turkoglu stated that 119 cases were encountered in Muay in 2019 and that the patients were treated in the hospitals in the province and that they made the necessary studies and tests on the subjects in the field. He reminded that the source of animal products should not be consumed in order to prevent the disease: "cheese, cream, butter, cream, ice cream made from pasteurized or well boiled milk should be preferred. Pickled cheeses should be consumed after waiting for at least 3 months. Frequent abortions and stillbirths should be examined by a veterinarian immediately.

The animals' wastes and the feeds that these wastes come into contact with, should be buried in sealed bags. Animals should be vaccinated against brucella," he said. -- Communicated by: ProMED-mail <promed@promedmail.org> [This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the United States and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications. - ProMED Mod.LL]

[HealthMap/ProMED map available at: Turkey:
<http://healthmap.org/promed/p/87>]
More ...

Mauritius

General:
************************************
Mauritius is a Republic island nation situated in the southwestern Indian ocean towards Madagascar. There are excellent tourist facilities and English is well understood throughout the country. The c
imate is subtropical and quite humid. This is particularly the case between December to March each year and cyclones occasionally occur at this time also.
Security Situation:
************************************
The security situation within the country is very
good but petty crime can be a problem against tourists. At night, it is probably unwise to venture alone outside the grounds of your hotel. The central market place in Port Louis is known to be a site for pickpockets so remember to take care. Grand Baie and Flic en Flac are also known concerns for petty crime. Those having a self-catering holiday should be aware that house breaking is becoming more common and so make sure any valuables are well hidden away and not left out on view.
Health Facilities:
************************************
Generally the level of health care is reasonable throughout the main tourist areas and hospital care may be provided free of charge. However, many tourists choose to obtain private medical care while in Mauritius. Make sure your travel and health insurance is up to date before you leave home.
Food & Water Facilities:
************************************
In the main hotels the level of food hygiene is good and with care tourists should be well able to stay perfectly healthy during their time in the country. However, like many other destinations, it is wise to maintain certain commonsense rules regarding what you eat and drink. All food should be freshly prepared and it is much wiser to avoid bivalve shellfish altogether. These include mussels, oysters and clams. Fried prawns are usually okay and boiled crab and lobster should be fine. Cold unprepared vegetables such as lettuce is best avoided. Tap water should be checked for a smell of chlorine and if it is not present that it should not be used for either drinking or brushing your teeth. Brucellosis is a small risk so avoid any unpasteurized milk products.

Insects Bites & Malaria Risks:
************************************
The risk of malaria throughout Mauritius is extremely small and currently (2001) the World Health Organisation does not recommend routine prophylaxis for tourists. However, there is a small amount of transmission in the northern part of the country away from the normal tourist routes. Rodrigues Island is free of this disease. Nevertheless, mosquitoes do occur and can transmit other conditions such as Dengue Fever apart from their rather unpleasant bite. Thus avoid mosquito bites is excellent advice and should be followed at all times.
The mosquitoes mainly bite in the evening out of doors and so at these times wear sensible pale coloured clothing to cover your exposed arms and legs,
don't use perfumes and after shaves and apply plenty of good insect repellent. Ones containing high concentrations of DEET are usually recommended.
The risk of Rabies:
************************************
Mauritius is currently regarded as being free of Rabies but tourists are strongly advised to avoid all contact with warm-blooded animals such as dogs, cats and monkeys. Any close contact (bite, lick, scratch) should be immediately reported to see if treatment may be recommended.
Swimming in Mauritius:
************************************
There have been a number of reports of those swimming in the sea being hit by speedboats while close to the hotel beaches. Take care to swim in recognised safe zones and remember to watch out for warning signs of strong currents etc. The risk from sharks etc is small but never swim alone or far out from the shore. Listen to the local advice and stay safe. If swimming in some of the rivers and lakes throughout the country there is a risk of a fresh water disease known as Schistosomiasis. This disease is mainly found in Port Louis, Pamplemousses and Grand Port.
If you have been at risk remember to contact your travel health advisor on return to talk this through.
Sun Exposure:
************************************
The level of sunshine in Mauritius can be significant so take care not to get over exposed. The main strength of the sun will be between 11am to 4pm and it is probably unwise to sunbathe during these times.
Road Safety:
************************************
In Mauritius they drive on the left side of the road and the conditions are quite variable throughout the country. Hiring cars or motorbikes abroad is one of the most significant risk factors for tourists and generally should be avoided. Hiring a cab to drive you to your destination is usually a safer option but always pick a good quality car and fix your price before leaving.
Local Laws and Customs:
************************************
Always carry photocopies of your passport and other essential travel documents. These may be required by customs and so you can then keep the originals in a safe location. The carrying of pharmaceutical drugs into Mauritius can cause difficulties. In certain cases the customs officials have been known to confiscate drugs which tourists are using for their own personal health. Under these circumstances it is wise to carry any medications in their original packing and also to have a letter from the prescribing doctor outlining your requirements for the medication in question. This is mainly a problem with some of the higher dose painkillers and general asthma, diabetes, blood pressure or heart medication should not present difficulties. The importation of spear-fishing equipment into Mauritius is prohibited.
Vaccinations for Mauritius:
************************************
Providing you are not arriving into Mauritius from a destination in Africa there will be no vaccines required for entry/exit purposes. However, for your own protection it is usually wise to consider cover against the following;
*
Poliomyelitis (childhood booster)
*
Tetanus (childhood booster)
*
Typhoid (food and water borne disease)
*
Hepatitis A (food and water borne disease)
For those undertaking a longer more rural trip other vaccines may need to be considered including Hepatitis B.
Summary:
************************************
Staying healthy and enjoying your time in Mauritius is perfectly possible so long as some commonsense rules are followed at all times. Further information is available through the Tropical Medical Bureau

Travel News Headlines WORLD NEWS

12th May 2019

Mauritius - National.
22 Apr 2019. In total, there are 75 people infected with the dengue virus. During the weekend, a 1st case of dengue fever type 2 was recorded in a 3-year-old child. He is currently hospitalized in a Plaines-Wilhems clinic. "We have not yet done any analysis to find out how this type 2 dengue case happened in Mauritius. It will be done in the coming days," says the Ministry of Health.

What is certain, however, is that of the 75 cases identified, at least 4 cases were imported. At the Ministry of Health, it is said to be certain that these people were infected in India and Reunion. "Moreover, the dengue virus type 2 is prevalent in Reunion," says one.

- National. 29 Apr 2019. Port Louis 37 cases with 29 of those in Roche-Bois. Cases rise to 115.

- National. 9 May 2019. Mauritius passes 127 cases, including one in Grand Bay and one in Trou aux Biches
Mauritius - Residence La Cure. 12 Apr 2019

A 3rd case of dengue was detected this Friday [12 Apr 2019] at Residence La Cure. The 3 victims are from the same family. According to a source from the Ministry of Health, this family was visited by infected people of Vallee-des-Pretres some time ago.
[in French, trans. Corr.SB]
Date: Mon 23 Jul  2018
Source: Outbreak News Today [edited]

The World Health Organization (WHO) says 3 people have died while 453 cases of measles have been confirmed since the latest outbreak hit Mauritius late in March [2018].

According to the WHO African weekly outbreaks bulletin for the week ending 20 Jul, Mauritius has reported measles cases since 21 Mar [2018]. Infections peaked in the week ending 18 Jun, with more than 80 cases confirmed. All came from 9 districts, while the case fatality ratio averaged 0.7 percent.

"The 3 deaths have been in young women with unknown vaccination status, all between the ages of 29 and 31 years. All were immuno-deficient, resulting in the disease being complicated by encephalitis or septicaemia.

"The incidence rate was highest in those aged 0--9 years of age,followed by those aged 20--39 years. The incidence rate of the disease was highest in the districts located in the west of the island including Port Louis, Black River and Plaines Wilhems," the WHO said.

The confirmed cases were notified to the Communicable Disease Control Unit (CDCU) in the Mauritian capital Port Louis. The government has concluded a case analysis which found that 45 percent of the infected people were never vaccinated for measles.

Only 29 percent have previously received at least one dose of some measles-containing vaccine (MCV1), while 26 percent are of unknown vaccination status. Most of the patients are being isolated at home and a public call has been made to limit travels to avoid spreading the disease.

A total of 10 health teams are operating across the island, screening for fever/rash and checking public vaccination status for MMR (measles, mumps, rubella) in all schools in the affected areas.

The WHO said the current outbreak of measles in Mauritius demonstrates the importance of maintaining high levels of vaccination coverage against the disease.

"Prior to this current outbreak, the last detected case of measles in Mauritius was in 2009 and the country consistently had one of the highest (measles) vaccination rates in the WHO African region.

However, the vaccination coverage dropped in the past 2 years, leading to the current outbreak. Supplementary immunisation activities are being planned to halt the spread of the disease.  [Byline: Oscar Nkala]
=======================
[Healthmap/ProMED map of Mauritius:
Date: Thu 16 Oct 2014
Source: International SOS [edited]

"The authorities in several countries have implemented entry restrictions to curtail the spread of Ebola from countries that have Ebola cases...."

Entry restrictions
------------------
Kenya on 10 Oct [2014] announced that it had closed the Suam border crossing (Trans-Nzoia county) with Uganda due to reports of an Ebola-related death in Bukwo district (Uganda). Earlier, the Kenyan authorities on 19 Aug [2014] suspended entry of passengers travelling from and through Guinea, Liberia and Sierra Leone, excluding health professionals supporting efforts to contain the outbreak and Kenyan citizens.

Cape Verde on 9 Oct [2014] announced that it would now deny entry to non-resident foreigners coming from countries with 'intense Ebola transmission' -- Sierra Leone, Guinea and Liberia -- or who have been to those countries in the previous 30 days.

Mauritius on 8 Oct [2014] banned entry to all travellers who have visited Nigeria, Sierra Leone, Guinea, Liberia, Senegal and Congo (DRC) in the last 2 months, rather than just citizens of those countries, as was the case previously. The authorities have announced that entry restrictions for travellers from Senegal and Nigeria will be lifted on 10 Oct & 17 Oct [2014] respectively, if no further cases of Ebola infection are reported [from them].

Seychelles on 8 Oct [2014] suspended entry to travellers who have visited Sierra Leone, Liberia, Guinea-Bissau, Guinea, Nigeria or Congo (DRC) 28 days prior to their journey, with the exception of Seychellois citizens.

Cote d'Ivoire has reopened in early October [2014] its borders with Guinea, Sierra Leone and Liberia.

Equatorial Guinea is denying entry to travellers whose journeys originated in countries affected by Ebola.

Cameroon on 17 Sep [2014] reopened its borders to travellers from Senegal. An 18 Aug [2014] ban remains in place on travel from Nigeria, Guinea, Liberia and Sierra Leone.

Southern African Development Community (SADC) member states -- Angola, Botswana, Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Seychelles, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe -- have stated that travellers coming from Ebola-affected countries (according to the World Health Organisation, WHO) would be monitored for 21 days and that travel to member countries for any gatherings would be discouraged. The SADC provided no details as to how member countries will carry out the associated screening and follow-up and it is likely that countries will have individual processes. There are also reports that some countries require health documentation for entry. Travellers are advised to contact the embassy or health ministry of their destination country to clarify their individual circumstances and prepare their trips accordingly.

South Sudan has placed a ban on travellers coming from Guinea, Sierra Leone, Liberia or Congo (DRC), or those who have travelled to those countries in the preceding 21 days. According to the health ministry, entry of travellers from Nigeria depends on their travel history in that country and whether they have visited Ebola-affected areas.

Namibia's foreign ministry on 11 Sep [2014] announced that foreigners travelling from countries affected by Ebola would be prohibited from entering the country.

Gambia on 1 Sep [2014] suspended entry of persons who have visited Guinea, Liberia, Sierra Leone or Nigeria in the 21 days prior to travel. Those travelling indirectly from any of the aforementioned countries to Gambia via another country also come under this measure.

Cote d'Ivoire announced on 23 Aug [2014] that it had closed its land borders with Guinea and Liberia.

Gabon stated on 22 Aug [2014] that it was restricting the issuance of entry visas to travellers from Guinea, Liberia, Sierra Leone and Nigeria on a case-by-case basis.

Rwanda, according to the US Department of State on 22 Aug [2014], has banned entry to travellers who have visited Guinea, Liberia or Sierra Leone in the 22 days prior to travel.

Senegal on 21 Aug [2014] closed its land border with Guinea, while the country's sea and air borders will also be closed to vessels and aircraft from Guinea, Liberia and Sierra Leone.

Chad on 21 Aug [2014] closed its land border with Nigeria at Lake Chad. The country previously reportedly banned the entry of any travellers originating or transiting through Guinea, Liberia, Nigeria or Sierra Leone, with airlines serving the country reportedly rerouting flights.

South Africa on 21 Aug [2014] restricted entry for all non-citizens travelling from Guinea, Liberia and Sierra Leone. The government subsequently clarified that this was not a blanket ban and could be waived for 'absolutely essential travel'.

Flights and other transport
---------------------------
Countries that have implemented Ebola-related travel restrictions:

Gambia has banned the entry of flights from Guinea, Liberia, Nigeria and Sierra Leone.

Gabon has banned the entry of flights and ships from countries affected by Ebola.

Senegal has banned flights from Guinea, Liberia and Sierra Leone.

Cameroon has banned flights to and from Nigeria.

Chad has suspended all flights from Nigeria.

Nigeria has suspended flights to the country operated by Gambian national carrier Gambia Bird.

Cote d'Ivoire has now lifted the ban on passenger flights from Guinea, Liberia and Sierra Leone.

Details of airlines that have restricted flights to Ebola-affected countries
----------------------------------------------------------------------------
Air France suspended flights to Sierra Leone from 28 Aug [2014].

The Togo-based carrier Asky Airlines has suspended flights to and from Guinea, Liberia and Sierra Leone.

Arik Air (Nigeria), Gambia Bird and Kenya Airwayshave suspended services to Liberia and Sierra Leone.

British Airways has extended their suspension of flights to Liberia and Sierra Leone until 31 Dec [2014].

Emirates Airlines has suspended flights to Guinea.

Korean Air suspended flights to and from Kenya from 20 Aug [2014].

Senegal Airlines has suspended flights to and from Conakry (Guinea) until further notice.

Other airlines have modified their routes but are still operating regular scheduled services. These include:
- Royal Air Maroc
- Brussels Airlines

Medical screening
-----------------
Entry and exit health screening is now in place in numerous countries throughout West Africa and is being introduced in Europe and North America countries as well; related measures can include the partial closure of land borders, ports and river crossings in an effort to restrict cross-border travel. Members should allow additional time to pass through medical screening and not travel if they are sick. Staff should continue to monitor local media and this website for developments.

[Land and sea border "closures" in Africa -- and elsewhere in the world are likely to be ineffective. Smugglers have always been able to largely circumvent them -- I'm willing to bet even the 3 hermit kingdoms (q.v.) also have smuggling routes -- including international colleagues resident in Switzerland bringing in cases of fine wine bought for less across the border  n France. Every so often, one was caught and fined.... (Like many other internationals, I lived in France, where the cost of living was lower, while working in Geneva, so had no incentive to do that.) - ProMed Mod.JW]
-----------------------------
Communicated by:
Jonathan Ezekiel
<jezekiel@his.com>
Date: Sun, 31 Mar 2013 14:09:00 +0200 (METDST)

PORT LOUIS, Mauritius, March 31, 2013 (AFP) - Ten people were killed in floods caused by sudden rains in Port Louis, the capital of the Indian Ocean island of Mauritius, the police information centre said Sunday.   Police said six bodies were found in a pedestrian subway. One body was found near the port and two more in an underground carpark, while one victim reportedly died of a heart attack as the flood waters rose.   "152 millimetres (six inches) of rain were recorded in the country in less than an hour and a half" on Saturday afternoon, a statement from the island's meteorological services said Sunday.

Average rainfall for the entire month of March, the wettest month of the year, in Port Louis is around 220 millimetres.   "We had forecast bad weather and rain, but not on that scale and not in such a short period of time," said Balraj Dumputh, the head of the meteorological service.   People have been advised to stay at home Sunday as further torrential rain is expected.

There has so far not been any official government reaction. Patrick Assirvaden, head of the ruling labour party, said: "It's unprecedented." He put the torrential rain down to "climate change" and said: "We have to adapt to this situation and to the damage caused by nature."   The head of the opposition Alan Ganoo for his part said the government had not been up to dealing with the situation.   Mauritius, with its palm-fringed white sand beaches, is best known as a top-end holiday and honeymoon destination.
More ...

World Travel News Headlines

Date: Thu, 5 Dec 2019 09:54:04 +0100 (MET)
By Joseph Schmid

Paris, Dec 5, 2019 (AFP) - A nationwide strike shut down public transport, schools and other services across France on Thursday as unions kicked off an open-ended strike against President Emmanuel Macron's plans for a "universal" pension system they say will force millions of people to work longer.

Parents scrambled to organise daycare as teachers walked off the job or were unable to get to work, and many employees were working from home or forced to take the day off as trains, metros and buses were cancelled.   Union leaders have vowed to keep up their protest unless Macron drops the pension overhaul, the latest move in the centrist president's push to reform wide swathes of the French economy.   "The idea of social concertation that Macron says is so important in fact doesn't exist," the head of the CGT union, Philippe Martinez, said on BFM television Thursday.

Around 90 percent of high-speed TGV trains as well as regional lines were cancelled, and Air France has axed 30 percent of domestic flights and 15 percent of short-haul international routes.   In Paris, 11 of the 16 metro lines were shut down and others had just bare-bones service during the morning rush hour, and the Eiffel Tower turned away tourists because of the strike.   "There are not enough employees to open the monument in secure conditions," the tower's operator said in a statement.

The strike -- which is open-ended and could last several days -- has drawn comparisons with the showdown between government and unions over pensions in November-December 1995, when the country was paralysed for around three weeks.   Unions won that battle, and are banking on widespread support from both public and private-sector workers against Macron's reform.   The government has yet to unveil the details of the project, but officials have conceded that people will have to work longer for the system to remain financial viable.

- Outcome uncertain -
The strikes will be a major test of whether Macron, a former investment banker who came to power on the back of a promise to transform France, has the political strength to push through one of his key campaign pledges.   He has already succeeded in controversial labour and tax reforms aimed at encouraging hiring, as well as an overhaul of the state rail operator SNCF, long seen as an untouchable union bastion.

He has also largely seen off the "yellow vest" protests against declining living standards that erupted a year ago, but that anger could feed into the latest protest.   "The moment of truth for Macron," the Le Monde daily wrote in Thursday's edition. "The next days are a decisive test for the head of state."   The SNCF said international lines including the Eurostar and Thalys services were severely disrupted, and Education Minister Jean-Michel Blanquer said Wednesday that he expected just three in 10 schools would be able to open.

- 'Special regimes' -
The strike is the latest in a series of protests against Macron this year by the "yellow vests" as well as police, firefighters, teachers, hospital workers and lawyers.   Macron wants to implement a "universal" retirement system that would do away with 42 "special regimes" for sectors ranging from rail and energy workers to lawyers and Paris Opera employees, which often grant workers higher pensions or early retirement.

But unions say the changes would effectively require millions of private-sector workers to work beyond the legal retirement age of 62 if they want to receive the full pension they have been promised.   Prime Minister Edouard Philippe, who has acknowledged French workers will gradually have to work longer, is set to unveil details of the reform on December 12.

Interior Minister Christophe Castaner said Wednesday that some 250 demonstrations are expected nationwide, warning that a radical fringe of protesters could cause trouble.   Paris police chief Didier Lallement said around 6,000 members of the security forces would be deployed in the capital alone, with 180 motorbikes used to respond fast to any rioting.   Two major demonstrations are planned for Paris that will converge on the Place de la Nation, with officials ordering Paris businesses along the routes to close on Thursday.   British low-cost carrier EasyJet has cancelled 223 domestic and short-haul international flights and warned others risk being delayed.
Date: Thu, 5 Dec 2019 08:13:04 +0100 (MET)
By Sofia CHRISTENSEN

Johannesburg, Dec 5, 2019 (AFP) - South African Airways was placed under a state-led rescue plan on Thursday as part of a massive restructuring following a costly week-long strike last month.   Thousands of South African Airways (SAA) staff walked out on November 15 after the cash-strapped airline failed to meet a string of demands, including higher wages and job in-sourcing.   The strike was called off the following week after SAA management and unions eventually clinched a deal.

But the walkout dealt a severe blow to the debt-ridden airline, which has failed to make a profit since 2011 and survives on government bailouts.   "The Board of SAA has adopted a resolution to place the company into business rescue," said a statement by South Africa's Public Enterprises Minister Pravin Gordhan, adding that the decision was also supported by the government.   "It must be clear that this is not a bailout," said Gordhan. "This is the provision of financial assistance in order to facilitate a radical restructure of the airline."   South Africa is struggling to get state-owned companies back on track after nine years of corruption and mismanagement under former president Jacob Zuma.

- Costly strike -
Its national airline -- which employs more than 5,000 workers and is Africa's second largest airline after Ethiopian Airlines -- had been losing 52 million rand ($3.5 million) a day during the strike.   SAA's board said the business rescue, scheduled to start immediately, was decided after consultations with shareholders and the public enterprises department "to find a solution to our company's well-documented financial challenges".   "The considered and unanimous conclusion has been to place the company into business rescue in order to create a better return for the company's creditors and shareholders," said the SAA board of directors in a statement.

Business practitioners were set to be appointed "in the near future" to oversee the process, they added.   Unions did not immediately respond to AFP's requests for comment.   They have agreed to a 5.9-percent wage increase backdated to April, but which would only start to be paid out next March depending on funding.   SAA had initially refused any pay rise.    The cash-strapped airline needs two billion rand ($136 million) to fund operations through the end of March.   "SAA understand that this decision presents many challenges and uncertainties for its staff," said the board.   "The company will engage in targeted communication and support for all its employee groups at this difficult time."
Date: Thu, 5 Dec 2019 07:01:49 +0100 (MET)

Manila, Dec 5, 2019 (AFP) - The number of people killed by Typhoon Kammuri's pounding of the Philippines this week has hit 13, officials said Thursday, as authorities confirmed reports of storm-related deaths.   Kammuri's fierce winds toppled trees and flattened flimsy homes across a swathe of the nation's north on Tuesday, and forced a rare 12-hour shutdown of Manila's international airport.   Authorities said on Wednesday one person had drowned while three died after being hit by trees and flying objects.

Disaster officials did not offer details on how the other victims died, but local police reports indicated some may have drowned or been crushed by trees.   Mark Timbal, spokesman for the national disaster agency, said no new bodies have been found but the death toll could rise as reports on the ground are verified.    "There is the possibility of an increase in the number, but we are hoping against it," Timbal told AFP.    Hundreds of thousands of people living in exposed or low-lying areas were evacuated from their homes before Kammuri made landfall late Monday, which authorities said had saved lives.

Still the storm damaged 135 schools and destroyed nearly 1,200 homes, with crop damage in the hardest hit areas estimated to reach nearly $16 million.   The Philippines is hit by an average of 20 storms and typhoons each year, killing hundreds and putting people in disaster-prone areas in a state of constant poverty.    President Rodrigo Duterte is scheduled to visit on Thursday the Bicol region, a peninsula south of Manila which was hit hard by the typhoon.     Ninoy Aquino International Airport was closed half of Tuesday as a precaution, affecting over 500 flights, while roughly half the day's programme at the Southeast Asian Games, hosted by Manila and nearby cities, had to be postponed.
Date: Thu, 5 Dec 2019 05:14:37 +0100 (MET)

Bogota, Dec 5, 2019 (AFP) - Thousands of protesters took part in anti-government demonstrations in Colombia's capital Bogota and other cities Wednesday during the country's third general strike in two weeks.   Strike leaders say they intend to maintain pressure on right-wing President Ivan Duque's government, after brushing aside his appeals to cancel the strike on the grounds its effects were crippling the economy.   But crowds were smaller than previous demonstrations as protests took place for a 14th consecutive day.   Some roads were blocked in the capital and in the northeastern city of Cali, but many businesses remained open.   Around 250,000 people took part in the first demonstration against Duque's 15-month-old government on November 21, when the initial general strike brought the country to a standstill.

Interior Minister Nancy Patricia Gutierrez estimated that 40,000 people took part in demonstrations across the country on Wednesday, but organizers said the number of participants was much higher.   "The Colombian people have woken up!" shouted Paola Jiminez, a 41-year-old lawyer taking part in a pot-banging "cacerolazo" demonstration in Bogota.   "Colombians are finding it more and more difficult financially," she said.   A student taking part in one of several peaceful protests in Bogota, who gave his name as Nicolas, held up a banner saying: "The state lies more than my ex."

Police were deployed in nearby streets, but there were no confrontations of the kind that have marred some protests over the last two weeks, during which four people died. Some 500 have been injured.   On Tuesday, the Colombian National Strike Committee -- comprising unions, students and teacher organizations, indigenous groups and the opposition -- met directly with Duque's advisors for the first time, but reached no agreement.    Another meeting was scheduled for Thursday.

Under fire for his economic policies and corruption in the country, Duque launched a national dialogue with mayors and other officials 10 days ago.   The strike committee has presented Duque with a list of 13 demands, including the withdrawal of his proposed tax reforms, and full compliance with the 2016 peace deal with FARC guerrillas.   Among them is a call to dismantle the feared ESMAD riot police, widely criticized for its heavy handed response to protesters.   Duque has yielded to some of the demands on tax reform, announcing the return of Value Added Tax to the poorest 20 percent of the population and benefits for companies that hire young people.
Date: Thu, 5 Dec 2019 00:51:07 +0100 (MET)
By Neil SANDS

Wellington, Dec 4, 2019 (AFP) - Samoa entered a two-day lockdown Thursday as authorities launched an unprecedented mass vaccination campaign to contain a deadly measles outbreak that has devastated the Pacific island nation.   Officials ordered all businesses and non-essential government services to close, shut down inter-island ferry services and told private cars to keep off the roads.

Residents were advised to stay in their homes and display a red flag if they were not yet immunised as hundreds of vaccination teams fanned out across the nation of 200,000 in the early hours of the morning.   The operation, carried out under emergency powers invoked as the epidemic took hold last month, is a desperate bid to halt an inexorably rising death toll that reached 62 on Thursday, most of them young children.   "I've seen mass mobilisation campaigns before, but not over an entire country like this," UNICEF's Pacific island chief Sheldon Yett told AFP.   "That's what we're doing right now. This entire country is being vaccinated."

Immunisation rates in Samoa were about 30 percent before the outbreak and have risen to more than 55 percent since a compulsory mass vaccination campaign began a fortnight ago.   Yett said the aim of this week's two-day drive was to push the rate above 90 percent, which should help curb the current outbreak and stop future epidemics.   He said the normally busy streets of the capital Apia were almost deserted early Thursday.   "It's very, very quiet out here. I can just hear a few barking dogs. The streets are empty. There are no cars," he said.   "People are staying at home waiting for the vaccination campaign. The teams are getting their supplies together and getting ready to go out."   Even Prime Minister Tuilaepa Sailele Malielegaoi's residence had a red flag fluttering outside it, with the leader saying his nephew had recently arrived from Australia and needed a measles shot.

Malielegaoi said he was angered by anecdotal reports that some parents were encouraging their children to hide from the vaccination teams to avoid the mandatory immunisation injection.    "The message is that we have vaccinated a lot of people and they are OK," he told reporters.   "The only cure for this is vaccination... having your children vaccinated is the only way."   Children are the most vulnerable to measles, which typically causes a rash and fever but can also lead to brain damage and death.

The latest figures show that 54 of the 62 dead were aged four or less and infants account for most of the 4,217 cases recorded since the outbreak began in mid-October.   There have also been measles epidemics in neighbouring Fiji and Tonga, but higher immunisation rates mean they have been more easily contained, with no fatalities.
Date: Wed, 4 Dec 2019 22:05:06 +0100 (MET)

Goma, DR Congo, Dec 4, 2019 (AFP) - Doctors Without Borders (MSF) said Wednesday it was pulling its non-local staff from an eastern region of Democratic Republic of Congo after it said an armed group tried to enter its compound.    The NGO becomes the latest aid agency to withdraw its staff from the Biakato region after an unclaimed attack last week saw three Ebola workers killed at an accommodation camp in Biakato Mines in Ituri province, causing the World Health Organization to withdraw its staff from the area.     MSF and an Ebola Treatment Centre (ETC), which is treating two people with confirmed cases of Ebola and nine suspected cases, decided to stay in the Biakato region despite last week's incident.

The NGO said that on Tuesday night a group wielding machetes and sticks broke into the Biakato Health Centre, which houses the ETC, but did not cause any casualties and did not enter the Ebola facility.   A separate group with the same weapons then tried but failed to enter the MSF facility in Biakato Mines. The NGO said they threw stones but did not do any damage.   "Due to a deterioration in the security situation, MSF made the difficult decision to withdraw all non-local staff from the Biakato region," MSF said in a statement.    According to local authorities, the attackers from last week's incident are likely to be members of the Mayi-Mayi militia group.

The Democratic Republic of Congo is undergoing its 10th Ebola epidemic, which is the second deadliest on record.    An outbreak of the much-feared haemorrhagic virus has killed 2,206 people mainly in North Kivu and neighbouring Ituri, according to the latest official figures.   Insecurity has complicated the epidemic from the outset, compounding resistance within communities to preventive measures, care facilities and safe burials.   On November 4, the authorities said more than 300 attacks on Ebola health workers had been recorded since the start of the year, leaving six dead and 70 wounded, some of them patients.
Date: Wed, 4 Dec 2019 15:50:07 +0100 (MET)
By Ish MAFUNDIKWA, with Zinyange AUNTONY in Bulawayo

Harare, Dec 4, 2019 (AFP) - The floor is dusty, the walls filthy and the furniture decrepit, but for two weeks last month a tiny flat in a Harare township was transformed into a maternity clinic where scores of babies were born.   Its owner, 69-year-old Esther Gwena, says she helped to deliver 250 infants as Zimbabwe's health sector tottered -- a feat that earned comparisons to Florence Nightingale, the pioneer of modern nursing.

Hundreds of junior medics at state hospitals began a strike three months ago because their salaries -- less than $200 a month -- are not enough to live on in a country gripped by 500 percent inflation.   Nurses are only working two days a week.   Those who can't afford private care -- the majority of the 14 million people reeling under an economic crisis compounded by acute food shortages -- suffer at home or seek help from people like Gwena.   Senior doctors, in a letter last week, said state hospitals had become a "death trap" and warned of a "slow genocide".   Gwena, a widow and member of the local Apostolic Faith sect, is a self-taught midwife.   When the health services strike peaked last month, she came to the rescue.

- 'I had to do something' -
"A man came to me and said there were two women in advanced labour at (a nearby clinic) but the place was closed because the nurses were on strike," she told AFP in her two-room flat in Mbare township.   She rushed there and found that one of the women had a baby which had died.   "I took the other one to my place, where I helped her. The baby survived. From that time, I knew I had to do something," she said.   Word that she was helping deliver babies for free spread quickly.

The state-owned television ZBC described her as "a modern Zimbabwean version of Florence Nightingale" and First Lady Auxillia Mnangagwa visited Gwena and donated food, detergents and blankets.   A funeral services company chipped in with a mobile water tank and pitched a tent outside to serve as a waiting room for women before they went into advanced labour.   "I helped to deliver 250 babies ... (they) are alive and kicking and at home with their mothers," Gwena said.   Two weeks later, the government asked her to stop after a nearby maternity clinic reopened.   Winnie Denhere, 35, cradled her two-day-old baby boy outside the clinic, where she had taken him for an immunisation injection.   "Everything went very well, she didn't ask us for money," she said, speaking of Gwena, who brought her child into the world.

- 'People dying' -
But while some laud Gwena as a selfless do-gooder, doctors worry that she exposed herself, the mothers, the babies to infection.   "We need to do something about our facilities so no one goes to her," Harare's director of medical services Prosper Chonzi, said.   Medicines have been in short supply and broken machines go unrepaired.   The government has fired 448 junior octors for striking.    Senior doctors last week also stopped work in protest over the sacking of junior colleagues. Dozens marched in Harare on Monday.   "People dying has become the order of the day in our hospitals," said the vice-president of the Senior Hospital Doctors Association Raphael Magota.

He told AFP machines were breaking down and that intensive care units were only able to treat two or three people "due to lack of equipment".     A senior doctor, speaking on condition of anonymity, said the situation has become untenable.   "There is no public health in Zimbabwe at the moment; everything has come to a standstill," he said.   Even the scarce equipment is often not right.   "One needs gloves that fit just right when performing delicate operations, but we get old gloves that are too big," said another doctor.   A UN special rapporteur on food security, Hilal Elver, last week spoke of "disturbing information" that public hospitals had exhausted food stocks, forcing them to seek humanitarian aid and that medical equipment in some cases was "no longer operational".

In the second largest city of Bulawayo, Zimbabweans living abroad are helping in a small way by crowdfunding and sending money back home to offer health care for the vulnerable.   One such initiative is Citizwean Clinic, which opened its doors last month and attended to hundreds of patients in the first five days -- providing free consultation and drugs.   "We go to the hospital these days it's bad, there are no doctors. We heard that there were doctors here," said hypertensive patient Elina Dzingire, 63.    "We've really been helped here," she told AFP from the clinic in the city's Cowdray Park township.    Health Minister Obadiah Moyo admitted the situation in hospitals is constrained but says the government will soon advertise the posts left vacant by the sacked doctors.
Date: Tue, 3 Dec 2019 13:55:04 +0100 (MET)
By Ron LOPEZ

Manila, Dec 3, 2019 (AFP) - Typhoon Kammuri killed at least two people in the Philippines on Tuesday as it tore roofs off houses and forced the international airport in Manila to shut down.   The storm roared ashore late Monday and passed south of Manila -- home to 13 million people -- and thousands of athletes at the regional Southeast Asian Games.   Just before it exited into the South China Sea, the typhoon killed two people in the central island of Mindoro, where one man was crushed by a falling tree and another killed by a flying piece of lumber, police said.    Ahead of the storm's arrival a 33-year-old man was electrocuted on Monday while securing a roof against the winds, which by late Tuesday weakened to a maximum of 130 kilometres (81 miles) per hour.

Authorities were still assessing the storm's impact, but a small local airport was seriously damaged, many power poles toppled and homes were battered.   "A lot of trees fell... There were a lot of roofs flying during the typhoon too," said Junie Castillo, a disaster officer in one of the areas first hit.   Manila's Ninoy Aquino International Airport was "closed for operations" due to high winds, leaving nearly 500 flights cancelled, general manager Ed Monreal told AFP.   Flights would resume at 11:00 pm (1500 GMT), Monreal later told a news conference.   One of the terminals AFP visited, which would normally be bustling with morning departures, was occupied by a handful of staff and stranded passengers.

One traveller, 23-year-old Canadian Constance Benoit, was hit with a nearly day-long delay to her flight back home.   She had arrived in Manila on a typhoon-buffeted flight Monday morning from the central island of Cebu.   "It was the most turbulent flight I ever took in my life," she told AFP. "I just discovered what airsickness is."   About 340,000 people had been evacuated from their homes in the central Bicol region, disaster officials said.   The Philippines is hit by an average of 20 storms and typhoons each year, killing hundreds and putting people in disaster-prone areas in a state of constant poverty.   The country's deadliest cyclone on record was Super Typhoon Haiyan, which left more than 7,300 people dead or missing in 2013.

- Games rescheduled -
Kammuri had already snarled some plans for the SEA Games, which opened Saturday and are set to run through December 11 in and around Manila.   The typhoon forced organisers to reschedule about half of the events set for Tuesday, but they pledged the competition would finish on time.   Kammuri wrought particular havoc on water-based and outdoor competitions, causing more than a dozen events to be postponed.   The storm is another difficulty for the Games, which suffered from a string of logistical glitches and a rush of last-minute construction in the run-up to Saturday's opening.    The competition, which is spread across three main sites that are hours' drive apart, includes a Games-record 56 sports and dozens of venues.   Around 8,750 athletes and team officials are expected at this year's 30th edition -- the biggest ever -- along with another 12,000 volunteers.
Date: Tue, 3 Dec 2019 06:24:08 +0100 (MET)

Sydney, Dec 3, 2019 (AFP) - A man and woman have been rescued after surviving two weeks in Australia's arid outback on little more than vodka, groundwater and biscuits, but a third person is still missing, police said Tuesday.   The three friends set out to explore the country's vast sun-baked interior near Alice Springs on November 19 when their car became bogged down in a river bed.   After three days staying put and waiting for a rescue, the group feared supplies were dwindling and two of them decided to walk along a property fence line in the hope of finding help.   Police said Tuesday that a local rancher had found the man, 40-year-old Phu Tran, "slightly disorientated" but in a "good condition" a two-day walk from the vehicle.

His discovery came after Tamra McBeath-Riley, 52, was found on Sunday less than two kilometres from the same vehicle suffering from dehydration.   McBeath-Riley told public broadcaster ABC that the trio -- accompanied by their blue Staffordshire terrier Raya -- had survived by drinking pre-mixed vodka drinks and water from a hole dug for cattle, eating biscuits and sheltering in a hole dug under her car.   But the third person, 46-year-old Claire Hockridge, has not been seen since splitting from Phu two days ago.   "She was still fine when he left but we obviously are now focusing our search to identify where she is," police superintendent Pauline Vicary said.   Police were "hopeful that she's still in that condition," Vicary added, as her colleagues resumed an aerial search.   McBeath-Riley and Hockridge live in Alice Springs, while Phu was visiting from elsewhere in Australia.
Date: Tue, 3 Dec 2019 06:07:45 +0100 (MET)

Wellington, Dec 3, 2019 (AFP) - The World Health Organisation warned of a "slide back" in global efforts to eliminate measles Tuesday, as the death toll from an outbreak that has killed dozens of children in Samoa continued to climb.   A total of 55 people have died since the epidemic began in mid-October, 50 of them children aged four or under, officials in the Pacific nation said Tuesday.   Another 18 infants are critically ill in hospital and the crisis shows no sign of slowing, with 153 new cases in the past 24 hours, taking the national total to 3,881 in a population of 200,000.   Emergency measures including compulsory mass immunisations and school closures have so far done little to stop the virus spreading in a country that was particularly vulnerable to measles due to low vaccination rates of about 31 percent.

World Health Organisation (WHO) medical officer for the western Pacific, Jose Hagan, said it was a grim reminder of the danger posed by "probably the most infectious disease that we know of".   "Unfortunately the case (to) fatality rate of measles is much higher than people realise," he told Radio New Zealand.   "This is quite a severe disease and we just aren't used to seeing it, so it comes as quite a surprise when we see how fatal it can be."   He said the fatality rate in Samoa was less than two percent but had been known to reach five percent in developing countries.

Hagen said increased access to measles vaccines was estimated to have saved 21 million lives over the past 20 years.   "But we are starting to have a slide back and there are outbreaks happening all over the world in all WHO regions and it's leading to the virus being exported through international travel," he said.   Cases have skyrocketed in Europe, leading to Britain, Greece, the Czech Republic and Albania all losing their measles-free status in August.   The United States narrowly maintained its "measles eliminated" status a few months later, despite experiencing its worst outbreak since 1992.   The WHO has pointed to various reasons for declining immunisation rates including lack of access to healthcare and complacency about the need to vaccinate.

Another major factor, which has been cited by the WHO as a reason for the severity of the Samoa outbreak, is misinformation about immunisation from anti-vaccine campaigners.   Prime Minister Tuilaepa Sailele Malielegaoi this week said vaccination was the only answer to the epidemic.   He has ordered the government to cease non-essential operations on Thursday and Friday so public servants can help a mandatory vaccination campaign that aims to give anti-measles jabs to everyone aged below 60.