January 23, 2008
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
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.
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.
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.
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.
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.
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.
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.
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/.
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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
(susp) as of mid-February 30 cases of Dengue.
and a map of the island at <http://www.nationsonline.org/maps/tutuila-island-map.jpg>. - ProMED Mod.TY
[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.
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.
[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 of American Samoa can be seen at
Cuba is an independent island country situated in the Caribbean. It is the largest of the islands and covers 42,000sq miles. The climate is sub tropical throughout the year with most of the rainfall in
Safety & Security:
The majority of tourists visiting Cuba will have no difficulty but bag snatching and other street crime appears to be increasing. The old Havana area and other major tourist resorts may be particular areas of concern in this regard. On arrival be careful to only use your recognised tour operator. If you are taking a taxi at any stage make sure it is a registered one and not a private vehicle. It is unwise to carry large quantities of money or jewellery away from your hotel and try not to flaunt wealth with your belongings. Pickpockets are too common an occurrence on buses and trains and at train stations so be careful with your essential documents and credit cards. Valuables should not be stored in suitcases when arriving in or departing from Havana as there have been a number of thefts from cases during the time the cases are coming through baggage handling. There is an airport shrink-wrap facility for those departing Havana which reduces the risk of tampering. Remember to carry a photocopy of your main documents (passport, flight tickets etc).
Following a number of serious road accidents involving tourists, you are advised not to use mopeds for travelling around Cuba or in Havana. Also, if you are involved in any accident a police investigation will be required to clear you and this may significantly delay your travel plans. On unlit roads at night there have been a number of accidents associated with roaming cattle (sounds like Ireland!). The traffic moves on the right side of the roads. There is a main highway running the length of the country but many of the country roads are in poor repair.
Local Laws & Customs:
When arriving into Cuba make sure you are not carrying any items which could be considered offensive. Any illicit drug offense is treated very seriously and Cuban law allows for the death penalty to be used under these circumstances. If you require personal medication for your health, make sure it is in original packing and carry a letter from your doctor describing the medication. Never agree to carry any item for another individual and always secure your cases once they are packed. Taking photographs of military or police installations or around harbours, rail and airport facilities is strictly forbidden.
Since 1993 it is now possible to use US dollars for all transactions within Cuba. Remember, there is a 20$ airport departure tax. Certain travellers cheques and credit cards may not be acceptable within Cuba. This is particularly true of American Express cheques and cards but check your situation with the travel operator before departure.
Generally healthcare facilities outside of Havana are limited and many standard medications may not be available. It is important to carry sufficient quantities of any medications which may be required for the duration of your time in Cuba.
Food & Water:
The level of food and water hygiene varies throughout the country and between resorts. On arrival check the hotel cold water supply for the smell of chlorine. If it is not present then use sealed bottled water for both drinking and brushing your teeth throughout your stay. Cans and bottles of drinks are safe but take care to avoid pre-cut fruit. Peel it yourself to make sure it is not contaminated. Food from street vendors should be avoided in most cases. Bivalve shellfish are also a high risk food in many countries and Cuba is no exception in this regard. (Eg Mussels, Oysters, Clams etc)
Malaria & Mosquito Borne Diseases:
Malaria transmission does not occur within Cuba and so prophylaxis is not required. However, a different mosquito borne disease called Dengue has begun to reoccur in the country over the past few years. This viral disease can be very sickening and even progress to death. It is rare for tourists to become infected but avoiding mosquito bites is a wise precaution.
Swimming, Sun & Dehydration:
The extent of the Cuban sun (particular during the summer months (April to October) can be very excessive so make sure your head and shoulders are covered at all times when exposed. Watch children carefully as they will be a significant risk. Drink plenty of fluids to replace what will be lost through perspiration and, unless there is a reason not to,
take extra salt either on your food or in crisps, peanuts etc. Take care if swimming in the Caribbean to stay with others and to listen to local advice. Never swim after a heavy meal or alcohol.
Rabies Risk in Cuba:
This viral disease does occur throughout Cuba and it is essential that you avoid any contact with all warm blooded animals. Dogs, cats and monkeys are the most commonly involved in spreading the disease to humans. Don't pick up a monkey for a photograph! If bitten, wash out the wound, apply an antiseptic and seek urgent medical attention.
Vaccinations for Cuba:
There are no essential vaccines for entry / exit if coming from Ireland. However, for your own personal protection travellers are advised to have cover against the following;
Tetanus (childhood booster)
Typhoid (food & water borne disease)
Hepatitis A (food & water borne disease)
For those planning a longer or more rural trip vaccine cover against conditions like Hepatitis B and Rabies may also need to be considered.
Cuba is becoming a popular destination for tourists and generally most will stay very healthy. However commonsense care against food and water borne disease is essential at all times. Also take care with regard to sun exposure, dehydration and mosquito bites.
November 26, 2008
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
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.
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.
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.
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.
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.
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
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.
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.
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.
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
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.
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."
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
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.
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.
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.
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
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.).
This bacterial disease is sometimes contracted by travellers who purchase untreated leather goods while abroad.
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 .
Travellers can obtain further health information for overseas travel by contacting either of our offices. Useful web sites for information on Turkey include;
Travel News Headlines WORLD NEWS
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.
Source: Time Turk [in Turkish, machine trans., edited]
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 <email@example.com> [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:
The People’s Republic of China is the world’s third largest nation in land mass and shares borders with 16 other countries. It is the worlds most populated country. Nowadays many Irish travellers will b
During the summer, warm moist maritime air masses bring heavy rains to eastern China, and hot humid summer weather is typical. Winter offers a sharp contrast when Siberian air masses dominate. In late winter and spring strong north winds sweep across north China and hazy days caused by dust storms are common. Beijing’s spring is mostly dry. In July and August the weather turns hot and humid. Autumn is the nicest time of the year with many warm, clear days and little wind usually. Chest Complaints Because of the prevailing dust, increased transportation and the burning of soft coal during the winter, Beijing and other major cities in China have a high rate of pollution. This may exacerbate bronchial and/or sinus complaints. The dust level in Lhasa is also very high and this may lead to respiratory problems.
Safety & Security:
The risk of crime against tourists is low but care of personal belonging should be observed at all times. Maintenance of buildings and general safety precautions may not always be in place and so checking for fire exits (and that they are unblocked) is wise. Use the hotel safety boxes and carry photocopies of any important documents rather than the originals where possible.
Western brand-name drugs or non-prescription medicines are seldom available locally although some Chinese equivalents are to be found at reasonable prices. Always carry your own medication (well marked) on your person and bring enough for your trip.
Rabies is a serious problem throughout China. Reports indicate that as many as five million people are bitten each year by rabid dogs and that approximately 5,000 of these patients die. Travellers should stay well clear of any warm blooded animals, especially dogs. Any contact (lick, bite or scratch) should be treated seriously and immediately by washing out the wound, applying an antiseptic and then seeking urgent medical attention.
River Boat Travel:
Many of the older river boats in China use untreated river water for washing dishes and in the bathrooms. This increases the risk of illnesses such as traveller’s diarrhoea and a parasitic disease called schistosomiasis (Bilharzia). Also be careful that the ferry is not overcrowded and be aware of any sharp corners or rusty edges due to lack of maintenance.
Altitude Sickness in Tibet:
Virtually all of the Tibetan Autonomous region, much of Quinghai and Xinjiang, parts of Sichuan, Yannan and Gansu are above 13,000 feet in altitude. Some main roads in Tibet, Qinghai and Xinjiand go above 17,000 feet. At these levels the available oxygen is very low and altitude sickness may occur. Travellers may experience severe headaches, nausea, dizziness, shortness of breath or a dry cough. These symptoms usually settle over a few days with rest, but if not travellers should seek medical assistance and, if possible, descend to a lower altitude. Travellers with a history of cardiac problems or respiratory difficulties should avoid such high altitudes where possible.
Insect Bites and Malaria:
During the summer months, carry a supply of insect repellent ointments for your trip and use sensible, light coloured clothing to cover yourself when there are mosquitoes or sandflies about. The risk of malaria in most of China is limited but prophylactic tablets may be prescribed depending on your actual itinerary. Other serious mosquito borne diseases do occur so these will need to be considered.
The sunlight during the summer months and in Tibet at high elevations can be intense so travellers should bring sun screen and sun-glasses and a sensible wide-brimmed hat.
Many tourists are tempted to experience this oriental art in its homeland while visiting China. It is essential to ensure that sterile needles are used at all times as otherwise there may be a risk of transmission of a blood borne disease such as the HIV virus or Hepatitis B.
AIDS risk in China:
Official figures suggest that AIDS is a very limited risk in China. Only 707 cases were reported up to October 2000. These very low figures are very difficult to verify and so all travellers should take care not to place themselves at risk where possible.
Never carry any medication for another individual unless they are part of your family. The Chinese authorities have strict drug regulations which may be enforced.
There are no vaccination requirements for entry / exit purposes but travellers on short trips should consider the following ... * Poliomyelitis (childhood booster) * Typhoid (food & water disease) * Tetanus (childhood booster) * Hepatitis A (food & water disease) Those planning to spend a longer time in China should consider additional vaccination against conditions like Rabies, Hepatitis B, Japanese B Encephalitis, Meningococcal Meningitis, Diphtheria and Mantoux Test / BCG vaccination.
China is teeming with people and a culture very different to ours. It is a land of many contrasts. Travellers generally stay healthy if they follow standard commonsense healthcare advice.
Travel News Headlines WORLD NEWS
Dili, East Timor, March 5, 2015 (AFP) - An American tourist has returned to the United States after six months trapped in East Timor over the discovery of drugs in a taxi that she was sharing. Stacey Addison arrived back in Portland, Oregon, on Wednesday, embracing her mother tightly during an emotional reunion at the city's airport, TV reports showed. "It's a great feeling, it's a relief to finally be back home, be out of there," she told a local station, adding her experience in East Timor, a tiny half-island nation bordering Indonesia, had been an "emotional rollercoaster". A Facebook group set up to advocate for her release carried a celebratory message on Tuesday announcing that she had left East Timor: "IT'S FINALLY HAPPENED! STACEY IS ON HER WAY HOME!!!!" Addision was arrested on September 5 after methamphetamine was found in the shared taxi that was en route to the capital Dili, but denied any wrongdoing.
The veterinarian, who had just crossed from Indonesia when she was arrested, wrote on Facebook that another passenger -- who was a stranger -- picked up a package containing the drugs, and police later detained everyone in the car. She was initially released from jail after several days but was later re-arrested, although no charges were laid against her. Addison was released again in December, but East Timor authorities hung on to her passport while they continued to investigate her case. Her lawyer had warned that the probe could take two years but last week the East Timor government announced that prosecutors had decided not to pursue her case and "Ms. Addison is now free to leave". The State Department had supported Addison and pressed for her release. East Timor, a poor half-island nation that was occupied by Indonesia for over two decades, imposes tough punishments for drugs cases, including the death penalty for traffickers.
JAKARTA, Feb 03, 2014 (AFP) - A strong 6.1-magnitude earthquake hit eastern Indonesia Tuesday but there was no tsunami alert, seismologists said. The quake struck at 7:36 am local time (2236 GMT Monday), 318 kilometres (197 miles) east-northeast of the East Timor capital Dili in the Banda Sea at a depth of 18 kilometres, the US Geological Survey said.
The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between East Timor and the Maluku islands. In an initial assessment, the USGS said there was a low likelihood of damage or casualties.
Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity. A 6.1-magnitude quake struck Indonesia's main island of Java in January, damaging dozens of buildings. Another 6.1 quake that hit Aceh province on Sumatra island in July 2013 killed at least 35 people and left thousands homeless.
AMBON, Indonesia, Dec 01, 2013 (AFP) - A 6.3-magnitude quake hit off eastern Indonesia and East Timor Sunday, seismologists said, but there was no tsunami alert or reports of damage or casualties. The quake struck at 10:24 am local time (0124 GMT), 351 kilometres (217 miles) east-northeast of the East Timor capital Dili at a relatively shallow depth of 10 km, the US Geological Survey said.
The Pacific Tsunami Warning Center did not issue any alerts following the tremor in the remote region at the eastern end of the Indonesian archipelago between the islands of Timor and New Guinea. In an initial assessment, the USGS said there was a low likelihood of damage or casualties. Indonesian officials said they had not received any reports of casualties or damage so far. "From data, the epicentre is quite a distance from the nearest cities and the intensity of shaking is not destructive," Suharjono, the technical head of Indonesia's geophysics and meteorology agency, told AFP.
An AFP correspondent in Dili said no tremor was felt. Johanes Huwae, a police official in the Maluku provincial capital Ambon, one of the cities closest to the epicentre, said "there was no shaking, everything's safe", while the national disaster management agency reported "slight shaking for three to five seconds" in Southwest Maluku. Indonesia sits on the Pacific "Ring of Fire", where tectonic plates collide, causing frequent seismic and volcanic activity. A 6.1-magnitude quake that struck Aceh province on Sumatra island in July killed at least 35 people and left thousands homeless.
[ProMED-mail thanks Dr Helen Hanson for this 1st hand report. These types of reports from health professionals in the field who are dealing with outbreaks are especially valuable sources of reliable, current information. Her report confirms the circulation of dengue virus 3 in East Timor.
<http://healthmap.org/r/1KlU>. - ProMed Mod.TY]
World Travel News Headlines
By Nicolas DELAUNAY
Cousin Island, Seychelles, Jan 16, 2020 (AFP) - Giant tortoises amble across Cousin Island as rare birds flit above. The scene attests to a stunning success for BirdLife International, a conservation group that bought the tiny Seychelles isle in 1968 to save a songbird from extinction. Thick vegetation smothers ruins that are the only reminder of the coconut and cinnamon plantations that covered the island when the group stepped in to protect the Seychelles Warbler.
Now teeming with flora and fauna and boasting white beaches, Cousin Island is firmly on the tourist map, with managers scrambling to contain visitor numbers and soften their negative environmental impact. More than 16,000 people visited the island in 2018, compared with 12,000 a decade earlier. "Tourism is important for Cousin. That's what allows us to finance the conservation projects we run here. "But 16,000 tourists... that was too much," said Nirmal Shah, director of Nature Seychelles, which is charged with running the special reserve.
Before the island was in private hands, the population of Seychelles Warblers was thought to have shrunk to just 26, barely hanging on in a mangrove swamp after much of their native habitat had been destroyed. Now, they number more than 3,000 and the greenish-brown bird has been reintroduced to four other islands in the archipelago. The former plantations have transformed into native forests, teeming with lizards, hermit crabs and seabirds, and the island is the most important nesting site for hawksbill turtles in the western Indian Ocean. The International Union for Conservation of Nature (IUCN) waxes lyrical about the "unique biodiversity and conservation achievements" of Cousin, "the first island purchased for species conservation", a model since replicated around the world.
- Nature first -
Tourists have been allowed onto the island since 1972, but the message is clear: nature comes first. In a well-oiled routine, every morning a handful of luxury sailboats and small motorboats anchor off the island, where their occupants wait for Nature Seychelles to skipper them ashore on their boats. "Tourist boats cannot land directly on the island, the biohazard risk is too big," Shah said. "Non-indigenous animals who may accidently be on board could come to the island and threaten its (ecological) balance." Too many tourists can also upset this balance.
Nature Seychelles in July increased the price of visits from 33 to 40 euros ($36 to $44) and removed a free pass for children under 15, resulting in a welcome 10-percent reduction in visitor numbers. "Something had to be done, there was too much pressure on the environment," said Dailus Laurence, the chief warden of the island. "When there are too many tourists it can bother nesting birds and turtles who want to come and lay their eggs on the island."
One guide said that some tourists, bothered by the island's ubiquitous mosquitos, would "leave the paths, move away from the group and walk where they are not supposed to", putting fragile habitats at risk. Shah said that if they wanted to increase the number of tourists, it would require hiring more wardens and guides who live on the island, which would also have a negative impact on nature. "Our absolute priority is nature, and it comes before tourists. If we have to take more steps to protect it and reduce the number of tourists, we will," he said.
By Ivelisse RIVERA, con Leila MACOR en Miami
Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid. Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.
In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA. "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning. "We are living in constant fear of another powerful tremor," he said.
He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said. Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake. The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.
Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old. "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later. "It's different to a hurricane. What is happening now is much nastier," he said.
As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted. The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant. The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.
- Seeking disaster designation -
Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more. The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said. On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.
In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster. It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests. The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.
Malabo, Equatorial Guinea, Jan 15, 2020 (AFP) - Firefighters battled to bring a blaze at Malabo's cathedral under control on Wednesday, as flames engulfed parts of the historic building, considered the most important Christian church in Equatorial Guinea. Dozens of people gathered in silence near the cathedral in the early evening as the fire service sprayed water jets onto the century-old structure.
It was not immediately known whether anyone was hurt in the fire, in which huge flames consumed part of the facade of the building. "We have just extinguished the fire, it's finished. The roof is gone, it is a catastrophe," firefighter Alfredo Abeso told AFP. Another firefighter at the scene said: "The whole roof is gone, the interior is burned." The cause of the fire is not known but the cathedral has been closed to the public since January 7 for restoration work. Built in a neo-gothic style between 1897 and 1916, the cathedral is one of the central African country's main tourist attractions.
The blaze brought comparisons to the devastating fire that ravaged the 13th century Notre-Dame cathedral in Paris in April 2019. The French Embassy in Malabo said the fire was a "cruel reminder" of the fire at Notre Dame. "We share the emotion of our friends in Malabo and Equatorial Guinea and hope that the fire can be brought under control quickly," it said on Twitter. Paris engineers are still working to stabilise the 13th century cathedral in the French capital after fire tore through its roof and dramatically toppled its spire last year.
Rio de Janeiro, Jan 15, 2020 (AFP) - Widespread complaints over foul-smelling drinking water in Rio de Janeiro have triggered a run on supermarket bottled water, though the public utility denied any health risk Wednesday. Rio governor Wilson Witzel set alarm bells ringing in a Twitter post on Tuesday, saying the situation -- fuelled by social media rumours -- was "unacceptable" and calling for a "rigorous investigation."
Moving to calm growing fears, public water utility Cedae attributed the problems to the presence of geosmin, a harmless organic compound, insisting the resulting earthy-tasting tap water was safe to drink. "The results of the analyses show the presence of geosmin, at a rate sufficient to change the taste. But there is no risk to health," Sergio Marques, the official in charge of water quality, told a press conference. Cedae later said it had fired the head of the Guandu treatment plant, which supplies nearly 80 percent of Rio's drinking water. It said the supply from Guandu would be treated with carbon in the coming days to get rid of the geosmin.
According to O Globo newspaper, nearly 70 districts of the capital have been affected. It reported that more than 1,300 cases of gastroenteritis were recorded over the last 15 days in Santa Cruz in the west of Rio, where water quality complaints were rife. Cedae's president Helio Cabral apologized "to the whole population for the problems in the water supply," which began earlier this month.
The problem has been exacerbated by false rumours circulating on social media that the water was toxic. Despite assurances, many Rio citizens were taking no chances. In supermarkets, mineral water stocks have been selling out and long queues are formed as soon as they are replenished. Geosmin is also responsible for the earthy taste in some vegetables.
Lima, Jan 15, 2020 (AFP) - Five tourists arrested for damaging Peru's iconic Machu Picchu site will be deported to Bolivia later on Wednesday, police said. A sixth was released from custody and ordered to remain in Machu Picchu pending trial after paying bail of $910. The six tourists -- four men and two women -- were arrested for damaging Peru's "cultural heritage" after being found in a restricted area of the Temple of the Sun on Sunday. They were also suspected of defecating inside the 600-year-old temple, an important edifice in the Inca sanctuary. "We've got the order. Today the five foreign tourists will be expelled," Cusco police official Edward Delgado told AFP. "We're going to take them by road to the city of Desaguadero, on the border with Bolivia." The border town, a nine-hour drive away, is the nearest frontier point to the southern Cusco region where Machu Picchu is located.
The sixth tourist, 28-year-old Nahuel Gomez, must sign at a local court every 10 days while awaiting trial. He admitted to removing a stone slab from a temple wall that was chipped when it fell to the ground, causing a crack in the floor. He could face four years in prison if found guilty of damaging Peru's cultural heritage. Several parts of the semicircular Temple of the Sun are off limits to tourists for preservation reasons. Worshipers at the temple would make offerings to the sun, which was considered the most important deity in the Inca empire as well as other pre-Inca civilizations in the Andean region. The group -- made up of a Chilean, two Argentines, two Brazilians, including one of the women, and a French woman -- allegedly entered the Inca sanctuary on Saturday and hid on site so they could spend the night there -- which is prohibited.
A source with the public prosecutor's office told AFP that Nahuel admitted to the damage but said "it wasn't intentional, he only leant against the wall." The Machu Picchu complex -- which includes three distinct areas for agriculture, housing and religious ceremonies -- is the most iconic site from the Inca empire, which ruled over a large swath of western South America for 100 years before the Spanish conquest in the 16th century. Machu Picchu, which means "old mountain" in the Quechua language indigenous to the area, is at the top of a lush mountain and was built during the reign of the Inca emperor Pachacuti (1438-1471).
Alicante, Spain, Jan 15, 2020 (AFP) - A fire broke out Wednesday on the roof of the airport in Alicante, a city on the eastern Mediterranean coast which is a tourism hotspot, forcing its closure to air traffic. "The fire is under control but it has not been extinguished. Firefighters are continuing to work," a spokesman for Spanish airport operator Aena told AFP, adding the airport will remain closed to air traffic until noon on Thursday.
Ten flights which were due to land at Alicante were cancelled, as were 12 which were supposed to depart from the airport, he said. Another four flights which were due to land at Alicante were diverted to other Spanish airports. The flames were visible from inside the terminal, according to an AFP photographer at the scene. Passengers and workers stood outside as dense smoke rose from the terminal building. No one was injured and the authorities are still not sure what caused the fire.
The airport serves the eastern region of Valencia, which is home to several popular resorts such as Benidorm. It handled just under 14 million passengers last year, making it Spain's fifth busiest airport. Aena recommended in a tweet that passengers contact their airline before heading to Alicante airport to see what the status of their flight was. "We are coordinating with airlines. Consult your company to know if your flight is cancelled or will operate from an alternative airport," it said.
Beijing, Jan 15, 2020 (AFP) - A new virus from the same family as the deadly SARS pathogen could have been spread between family members in the Chinese city of Wuhan, local authorities said Wednesday. The outbreak, which has killed one person, has caused alarm because of the link with SARS (Sudden Acute Respiratory Syndrome), which killed 349 people in mainland China and another 299 in Hong Kong in 2002-2003. One of the 41 patients reported in the city could have been infected by her husband, Wuhan's health commission said in a statement on Wednesday. The announcement follows news that a Chinese woman had been diagnosed with the novel coronavirus in Thailand after travelling there from Wuhan.
No human-to-human transmission of the virus behind the Wuhan outbreak has been confirmed so far, but the health commission said the possibility "cannot be excluded". The commission said that one man who had been diagnosed worked at Huanan Seafood Wholesale Market, which has been identified as the centre of the outbreak, but his wife had been diagnosed with the illness despite reporting "no history of exposure" at the market. At a press conference on Wednesday following a fact-finding trip to Wuhan, Hong Kong health officials also said that the possibility of human-to-human transmission could not be ruled out despite no "definitive evidence".
Dr Chuang Shuk-kwan, from Hong Kong's Centre for Health Protection, said there were two family group cases among the recorded cases in Wuhan, including the husband and wife and a separate case of a father, son and nephew living together. However, he said mainland doctors believed the three men were most likely to have been exposed to the same virus in the market. The market has been closed since January 1. The woman diagnosed in Thailand, who is currently in a stable condition, had not reported visiting the seafood market, the World Health Organization (WHO) said on Tuesday.
WHO doctor Maria Van Kerkhove said Tuesday that they "wouldn't be surprised if there was some limited human-to-human transmission, especially among families who have close contact with one another". The US Centers for Disease Control and Prevention issued a Level 1 "Watch" alert for travellers to Wuhan after the patient was diagnosed in Thailand, saying they should practice normal precautions and avoid contact with animals and sick people.
Wuhan's health commission said on Wednesday that most of the patients diagnosed with the virus were male, and many were middle-aged or elderly. In Hong Kong, hospitals have raised their alert level to "serious" and stepped up detection measures including temperature checkpoints for inbound travellers. Hong Kong authorities said on Tuesday that the number of people hospitalised with fever or respiratory symptoms in recent days after travelling to Wuhan had grown to 71, including seven new cases since Friday. Sixty of that total, however, have already been discharged. None have yet been diagnosed with the new coronavirus.
By Emile Kouton with Celia Lebur in Lagos
Lome, Jan 15, 2020 (AFP) - After he was struck down by malaria and typhoid, Togolese tailor Ayawo Hievi thought he was set to recover when he started taking drugs prescribed by his doctor. But far from curing him, the medication he was given at the neighbourhood clinic made him far worse -- eventually costing him one of his kidneys. The drugs were fake. "After four days of care, there was no improvement, but I started to feel pain in my belly," Hievi, 52, told AFP.
After two weeks of suffering he became unable to walk and was rushed into the university hospital in the West African nation's capital Lome. "The doctors told me that my kidneys had been damaged... the quinine and the antibiotics used to treat me in the medical office were fake drugs." Now, over four years later, he remains crippled by chronic kidney failure and has to go to hospital for dialysis regularly. Hievi's horror story is far from unique in a continent awash with counterfeit medicines. The World Health Organization (WHO) estimates that every year some 100,000 people across Africa die from taking "falsified or substandard" medication.
The American Society of Tropical Medicine and Hygiene estimated in 2015 that 122,000 children under five died due to taking poor quality anti-malaria drugs in sub-Saharan Africa. Weak legislation, poor healthcare systems and widespread poverty have encouraged the growth of this parallel -- and deadly -- market. Since 2013, Africa has made up 42 percent of the fake medicine seized worldwide. The two drugs most likely to be out-of-date or poor, ineffective copies are antibiotics and anti-malarials, say experts. And bogus drugs not only pose a risk to the patient -- they also play a worrying part in building resistance to vital frontline medications.
- 'Difficult to trace' -
In a bid to tackle the scourge, presidents from seven countries -- the Republic of Congo, Gambia, Ghana, Niger, Senegal, Togo and Uganda -- meet Friday in Lome to sign an agreement for criminalising trafficking in fake drugs. The goal is to bolster cooperation between governments and encourage other African nations to join the initiative. But even if leaders put pen to paper, the task of stamping out the flows of counterfeit medication is huge. Medicines spread out on plastic sheets or offered at ramshackle stalls are for sale at markets across West Africa.
Those hawked on the streets are often a fraction of the price of what's available in more reputable pharmacies where controls are stricter and supplies often have to come through official channels. "It is very difficult to trace where the fake medicines come from," said Dr Innocent Kounde Kpeto, the president of Togo's pharmacist association. "The countries which are mentioned on the boxes are often not the countries of origin or manufacture of these drugs. The manufacturers cover their tracks so as not to be identified".
It is estimated that between 30 and 60 percent of medicine sold in Africa is fake and Kpeto said most of it comes from China or India. Efforts to staunch the deadly torrents of counterfeits have made some headway. Some trafficking hubs have been dismantled, such as Adjegounle market in Cotonou that served as a key gateway for fakes heading to giant neighbour Nigeria. In mid-November, the police in Ivory Coast made a record seizure of 200 tonnes in Abidjan and arrested four suspects including a Chinese national.
Togo is one of the pioneer countries trying to stop the flow. It changed the law in 2015 and now traffickers can face 20 years in jail and a fine of some $85,000 (75,000 euros). In a show of force in July the authorities burnt over 67 tonnes of counterfeit pharmaceuticals discovered between But even given these recent successes, those in the industry like Dr Kpeto insist that the threat is still grave and involves "highly organised criminal networks". "The phenomenon remains major," he said. Traffickers can turn an investment of just $1,000 (900 euros) into a profit of $500,000, he claimed. The fake medicines are smuggled in the same way as guns or narcotics and often bring higher returns.
- 'Die for nothing' -
Nigeria, Africa's most populous country with a market of 200 million people, is the number one destination on the continent for fake drugs and a showcase of difficulties being faced. In September 2016 the World Customs Organization seized tens of millions of fake pills and medicines at 16 ports around Africa: 35 percent were intended for Nigeria. Across the vast nation there are tens of thousands of vendors selling the counterfeits. Competition between traffickers is fierce and the official agency meant to combat the problem is overwhelmed.
In a bid to improve the situation, Vivian Nwakah founded in 2017 start-up Medsaf and raised $1.4 million to help Nigerians track their medication from producer to user. "The country doesn't have a reliable and centralised distribution network," she said. "A hospital sometimes has to deal with 30 or 40 distributors for all the medications it needs. How can you have quality control with so many suppliers?" As a result, fake or faulty medicine has not just flooded markets but also pharmacies and hospitals -- both state and private. Sometimes, without hospital administrators even being aware, that means the drugs that reach the patients can be expired, poorly stored or the wrong doses.
Medsaf works to ensure the quality control of thousands of products at over 130 hospitals and pharmacies in Nigeria. It looks forward to expanding deeper into Nigeria as well as Ivory Coast and Senegal. The company uses technology, database management and analytics to monitor the movement of medications and verifies their official registration number, the expiry dates and storage conditions. "Technology we use can help to solve most of the issues related to fake drugs," Nwakah said. "People die for nothing. We can change that."