Greece offers a great variety of attractions for the international traveller. A beautiful climate linked with great beaches, a vibrant nightlife and historical monuments to rival any other location throughout the world. All of this located
Situated in southern Europe the country enjoys mild winters but very hot summers. There may be occasional cool breezes (meltemia) but these can serve only to fool the traveller into thinking that they are unlikely to burn. Rain is very uncommon during the height of summer (July and August) and all travellers should be advised to use very adequate sun-block lotion at all times.
Slip, Slop, Slap
Following the Australian mantra of Slip, Slop and Slap makes perfect sense. Slip on a shirt, slop on sunscreen and slap on a hat when out and about during the day and this should help protect against the intense suns rays. Nevertheless, despite all their best intentions, travellers get burnt. This is particularly a problem in the first few days after their arrival when they do not realise the intensity of the suns rays and how easily they can be exposed. Falling asleep beside the hotel's swimming pool or on the beach is a very common problem and must be avoided against. The tips of the ears, shoulders (especially along the bra-strap line, ankles and behind the knees are commonly exposed and forgotten areas.
After Sun care
To treat significant sunburn it is important to increase fluid intake but also to take extra salt on your food (unless medically contraindicated for some specific condition like high blood pressure etc). Soothing water soluble lotions (especially ones containing a mild anaesthetic and/or steroid cream) are probably best but certainly avoid any of the ones which paste the skin with a thick layer - which is almost impossible to remove without causing serious pain! The more severe sunburn cases may need medical care and even hospitalisation which really ruins a holiday.
Food & Water
As a European destination Greece has a good level of food and water hygiene. Unfortunately this can vary - especially as you move away from the main tourist destinations and also as the summer temperatures rise and food goes 'off' more quickly. Eating hot food, avoiding cold foods (side-salads, lettuce etc) and never eating undercooked bivalve shellfish (mussels, oysters, clams etc) makes perfect sense. Eating food or taking fruit juice drinks from street vendors is a risk just not worth taking.
There may be both mosquitoes and sandflys about so having good repellents (DEET based ones) is worthwhile. The biggest problem will be early in the morning and towards the end of the daylight hours. However sitting in the shade while having lunch may be nice and cool but it is also often a place where these insects tend to hover looking for their next meal. Just don't allow that meal to be the blood in your unguarded ankle!
Seeing the Monuments
As mentioned previously Greece is covered with ancient monuments and these attract many thousands of tourists each year. The ruins are often not the most hospitable places for sun-sensitive tourists so taking care against the suns rays is essential - especially while standing carefully listening to the tour guide explain some complicated piece of history while the back of your legs get roasted! The other issue, for those trekking through the ruins, is the distinct possibility of a nasty twisted ankle.
Laser Night shows
Many of the ancient sites have beautiful night shows which depict something of the past splendour and are definitely worth seeing. However it is wise to wear good shoes as stumbling across loose stones is a particular problem at night and also bring a small torch, if possible, to guide your way. Getting separated from your travelling companions, or not being able to find your return bus, can lead to some understandable panic so listen carefully to any instructions and look out for some land marks before you get too far away into the night time crowd.
Some tourists may forget that rabies is a problem in many countries throughout the world and, even though Greece is regarded as rabies-free', there is always a problem if someone should get bitten. The possibility that this animal could have been recently smuggled into the country cannot be out ruled and so many would advise full post exposure treatment should this contact occur. Children may be at particular risk due to their inquisitive nature.
Sunburn and swimming go hand in hand but drowning can also occur all too frequently within this region. Strong currents, swimming after meals (or alcohol) and the ever popular romantic midnight swim are all serious risk factors. Also children running around the deep end of the pool may lose their footing and topple in without warning. Unfortunately a very small child sinks instantly with very little sign of the emergency to those close by. Parents need to keep aware of this risk at all times.
The summer working holiday
Many of our students head towards Greece for 2 to 3 months during the summer to work. The attractions are obvious but commonsense and sensible life-style choices are needed throughout their stay to lessen the risk of illness or them returning home with an infection they had not bargained for. Unfortunately many return home with life-long illnesses which have been contracted from a single unprotected sexual contact.
Vaccinations for Greece
As a general rule the usual travel vaccines are not recommended for most short-term travellers to this region. However for the student planning to spend a more prolonged period it would be sensible to consider cover against both Hepatitis A and Hepatitis B and also to check that their Tetanus cover is up-to-date.
This is still one of the most popular destinations for northern European travellers and, in the vast majority of cases, they will have a fantastic time with only good memories. Unfortunately some less prepared folks will end up with serious sunburn and other illnesses or diseases which perhaps are frequently associated with their own lack of care and protection rather than anything specific to this beautiful country.
Travel News Headlines WORLD NEWS
Athens, Nov 27, 2019 (AFP) - A strong 6.1-magnitude undersea earthquake shook the Greek island of Crete on Wednesday and was felt in other parts of the country, officials said. "It was a major earthquake, the whole island shook but fortunately so far no damage has been reported," Crete regional governor Stavros Arnaoutakis told state TV ERT. The Athens observatory said the quake struck at 9:23 am (0723 GMT) and had a depth of over 70 kilometres (44 miles).
The tremor occurred a day after a 6.4-magnitude earthquake in Albania that has left more than 20 dead and hundreds injured. Shortly after the Albania tremor, a 5.4-magnitude shock hit Bosnia, the European-Mediterranean Seismological Center reported on Tuesday. Greece lies on major fault lines and is regularly hit by earthquakes but they rarely cause casualties. In July 2017, a 6.7-magnitude earthquake killed two people on the island of Kos in the Aegean sea, causing significant damage.
Athens, Oct 2, 2019 (AFP) - Greek workers staged a fresh 24-hour strike Wednesday against government plans to deregulate the labour market, paralysing road and rail transport, closing banks and shutting down news outlets. Buses and trams stayed in their depots, the Athens metro was shut down and ferries serving islands on both sides of Greece stayed in port. The action also hit rail services, including to Athens airport. Banks were closed Wednesday and Poesy, the journalists' union, said there would be no news bulletins over the 24-hour strike period.
The strike caused long traffic jams in Athens as the GSEE, the largest union representing private-sector workers, organised a rally in the city centre to protest the planned legislation. It denounced "the suppression of collective conventions" and what it said was an assault on the unions. This was the second strike in a week against the planned reforms of conservative Prime Minister Kyriakos Mitsotakis, which he argues will open the way to investment and encourage growth of more than two percent. A strike last week hit transport, hospitals, schools and the courts. The unions say the proposed reforms will undermine collective agreements and make it harder to organise strikes.
The proposed law would require a more-than 50 percent turn-out of the workforce in any strike vote for it to be valid. Union leaders have also denounced a law passed in August which they say makes it easier to sack people in the private sector. Adedy, the federation of public-sector unions, which organised last week's strike, called on its members to join Wednesday's action. Mitsotakis came to power in July, replacing the left-wing government of Alexis Tsipras.
Athens, Sept 15, 2019 (AFP) - More than 160 firefighters on Sunday battled to contain a large fire near Athens blazing for a second day amid gale force winds, officials said. And in another emergency, authorities evacuated dozens of people from two villages and a hotel on the island of Zakynthos after a new fire broke out on Sunday.
The fire department said the blaze near Athens burned in the mountains above Loutraki, a coastal resort some 60 kilometres (35 miles) west of Athens. "The fire is burning near the top of the mountain," Stefanos Kolokouris, the fire department's deputy chief of operations, told state TV ERT. "We are trying to create a perimeter but the terrain is very difficult, with ravines," he said. Four water bombers and six helicopters were participating in operations. Given a lack of roads in the area, two squads of firefighters had to be carried to the mountaintop by Super Puma helicopter, state agency ANA said. Officials had already evacuated 50 people from a local monastery when the fire broke out on Saturday, but stressed that other inhabited areas were not in danger.
On Zakynthos, officials ordered the evacuation of the villages of Agalas and Keri in the south of the island. Some 120 tourists were also relocated to a safe area. The Greek fire department on Sunday said it had been called to nearly 80 fires over the past 24 hours. It has already faced more than 9,600 rural and urban fires this year.
Information for Bali
Bali is one of the main tourist destinations for many Irish travellers to Indonesia. The island is well developed for the tourist industry and genera
Safety & Security
Throughout Indonesia there are many regions where it is unsafe to travel. The Parliament in Indonesia may impeach the President in the near future. Civil disturbance with student demonstrations in the capital Jakarta, earthquakes in the island of Sumatra, unrest regarding the independence of Timor and profound warring fractions on the island of Borneo has the potential to spill over into Bali. Nevertheless during the past years Bali has remained stable and there have been few reports of serious disturbances that have affected tourists or business travellers. Lombok is an island close to Bali often visited by tourists. It is regarded as more unstable and recently (Dec 2000) four explosions during fighting between two villages (Bongor & Parampuan). The main tourist region around Senggigi has remained quiet.
The laws against illegal drugs are severe and travellers should ensure that they carry sufficient well-marked medication that they may require for their time in Indonesia. Travellers are required to show identification at any time and so carrying photocopies of your passport is a wise precaution. Keep all valuable documents in a safe place and do not flaunt personal wealth while travelling around the island.
The nightlife in Bali is one of the main attractions for many tourists but sensible precautions are required. Travelling alone is unwise. Take care to ensure that your drink could not be spiked at any stage and do not walk at night, use an authorised taxi where possible. The level of HIV infection among the bar workers is high and close personal contact is very unwise.
The level of available health facilities varies greatly through Bali and other parts of Indonesia. In general most of the main hotels will have English speaking doctors but care would be required if your illness requires hospitalisation.
Food and Water
It is wise to maintain a high level of care with regard to your food and water while in Indonesia. This includes even those in high quality hotels but also particularly for those eating from street vendors. Bivalve shellfish (e.g. oysters, mussels, clams etc) should be avoided at all times due to inadequate cooking. Bottled water should be purchased from your hotel or good quality shops to ensure that it is pure.
Mosquitoes and Insect Bites
Malaria transmission occurs throughout Indonesia all year but the risk in Bali is so low that prophylaxis is not generally recommended for most tourists. Nevertheless for those visiting Lombok (overnight visits) the risk exists and prophylaxis should be considered. Other mosquito borne diseases also occur throughout Indonesia and care must be taken to avoid insect bites. In Jakarta and other main cities there is a particular problem with a viral disease called Dengue Fever. The mosquito, which transmits this disease, typically bites during the day and in main urban centres.
The strength of the sun in Bali is considerable higher than that experienced in Ireland at any time of the year. Sufficient head covering should be worm when exposed and travellers should ensure that their fluid intake is sufficient. Salt depletion also needs to be replaced in times of significant perspiration.
If swimming in pools, make sure that sufficient chlorination has been used. Take care with small children when close to the deep end of the pool. If sea swimming make sure that there are always others around and that you heed any local advice and warning signs. Never swim soon after alcohol or for an hour after mealtime.
The extent of jet lag, which you will experience, depends on the duration of your flight and the amount of rest you were able to get before arrival. Try to rest for the first 24 hours to allow your body to acclimatise and make sure you do not fall asleep beside the swimming pool during this initial period.
Vaccinations for Bali
There are no essential vaccines or entry to Bali from Western Europe. However for your personal protection travellers are recommended to consider vaccination cover against;
Poliomyelitis (childhood booster)
Tetanus (childhood booster)
Typhoid (food & water disease)
Hepatitis A (food & water disease)
Other travellers planning a more rural or extensive trip may need to consider other vaccine cover against diseases like Hepatitis B, Japanese B Encephalitis, Rabies.
The majority of those visiting Bali will enjoy the many tourist attractions on the island. However commonsense and care is required to ensure that you do not expose yourself to unnecessary risk. The staff of the Tropical Medical Bureau can be contacted at either of the numbers below if you require further information.
Travel News Headlines WORLD NEWS
Banda Aceh, Indonesia, Jan 7, 2020 (AFP) - A strong earthquake jolted Indonesia's northwest on Tuesday, but no tsunami warning was issued and there were no immediate reports of injuries or damage. The 6.2 magnitude quake struck at a depth of 20 kilometres (12.5 miles) just off the coast of Simeulue island, west of Sumatra, according to the US Geological Survey. Indonesia's weather and geophysics bureau said there was no tsunami threat. People panicked and ran outside their homes when the quake hit. "We are now watching at the beach to monitor the movement of seawater," Simeulue resident Ahmadi told AFP.
No casualties or infrastructure damage have been reported so far. Indonesia suffers frequent seismic and volcanic activity due to its position on the Pacific "Ring of Fire", where tectonic plates collide. More than 2,200 people died and another 1,000 were declared missing in 2018 after a 7.5 magnitude quake and subsequent tsunami on Sulawesi island. A 9.1 magnitude earthquake on Boxing Day in 2004 struck Aceh province, causing a tsunami that claimed the lives of more than 170,000 people in Indonesia alone.
Jakarta, Jan 6, 2020 (AFP) - Indonesians were told on Monday to brace for more heavy downpours after record rains triggered flooding and landslides that authorities said had killed at least 66 people in and around Jakarta. Whole neighbourhoods in the capital -- a megalopolis home to around 30 million people -- were submerged last week by floodwaters that forced tens of thousands into temporary shelters.
Authorities have warned residents to take precautions and safeguard their possessions ahead of more pounding storms over the coming weeks. "There is still potential for mid to heavy rainfall with lightning, thunder and strong winds" in greater Jakarta, Indonesia's weather bureau said in a statement Monday. Last week's deluge was the heaviest in the capital since record keeping began in the 19th century, the agency said, leading to the city's deadliest flood disaster in years. Some 377 millimetres (14.8 inches) of rain pounded sections of the vast city, with floodwaters reaching up to the second floor of some buildings after rivers overflowed.
At least two people in Jakarta's west were hospitalised on Monday after the collapse of a five-storey building, which Indonesia's search and rescue agency said may have been caused by a build-up of rainwater. Authorities said Monday the death toll had climbed again to 66 with two more reportedly missing in Lebak, west of the capital.
Flash flooding killed more than half a dozen people in Lebak, including a seven-year-old boy who was reportedly swept away by the water. Thousands remained in cramped Jakarta shelters Monday as authorities pushed to reach isolated communities outside the city affected by the disaster. A day earlier, health workers and soldiers sprayed ravaged parts of the capital with disinfectant in a bid to prevent disease outbreaks.
Jakarta, Jan 1, 2020 (AFP) - Nine people died after Indonesia's capital was hit by its deadliest flooding in years, authorities said Wednesday, as torrential rains on New Year's Eve left vast swathes of the megalopolis submerged. Thousands were evacuated to temporary shelters as electricity was switched off in scores of waterlogged neighbourhoods across greater Jakarta, home to about 30 million people, with some train lines and one of the city's airports also shut. Indonesia's National Disaster Mitigation Agency called on residents to leave flood-hit areas. "The first priority is saving lives," said agency head Doni Monardo.
A 16-year-old was electrocuted by a power line, while three more people died of hypothermia, according to the disaster agency. "My son's body was covered with newspaper when my two other children passed by," said Fadrid, who identified himself as the dead teen's father. "People asked them whether they knew the victim. If they hadn't been passing by, we wouldn't have known my son had been killed," he told AFP.
Among the victims was an elderly couple trapped inside their home in a district where floodwaters reached as high as four metres (13 feet) after a river burst its banks. Another victim drowned while four people were killed after the Tuesday evening downpour triggered landslides in the city's outskirts. "We have shut down power (in many areas) to avoid more electrical shocks," Ikhsan Asaad, an official at state firm PLN, told AFP.
Asaad said he could not estimate how many residents had been affected by the power shutdown. "We're currently focusing on taking measures to ensure people's safety," he added. Angelina Widiyanti was among scores of residents whose houses were flooded with their possessions ruined by the disaster. "We've had flooding several times before but it was never this high," she said from her home, where the power had been cut. "We weren't prepared for this."
Authorities said about 19,000 people were evacuated, but that figure did not include residents in Jakarta's satellite cities. "We're evacuating people right now," Jakarta governor Anies Baswedan told reporters. "Everyone living near rivers should anticipate (more) flooding," he added. Images from across the region showed waterlogged homes and cars submerged in muddy floodwaters, while some people took to paddling in small rubber lifeboats or tyre inner-tubes to get around.
The disaster marked Jakarta's worst flooding since 2013 when several dozen people were killed when the city was inundated by monsoon rains. Jakarta is regularly hit by floods during Indonesia's rainy season, which started in late November. On Wednesday, service at Halim Perdanakusuma airport, which handles commercial and military planes, was temporarily shut due to severe flooding on its runways, according to the transport ministry. Many flights were transferred to Jakarta's main Soekarno-Hatta International Airport.
A media statement can be found at
A map of the island of Bali can be accessed at
Travel News Headlines WORLD NEWS
by Neil Sands
ALOFI, Niue, July 23, 2011 (AFP) - In a once-thriving village on the Pacific island of Niue, homes lie abandoned, their stucco-clad walls mildewed and crumbling as the jungle slowly reclaims them. "These villages used to be bustling with people -- now you go there in the afternoon and there's no one," says the Niue Tourism Authority chairman Hima Douglas. The number of people living on the lush coral atoll, about 2,500 kilometres (1,550 miles) northeast of New Zealand, has been declining for decades as inhabitants seek a better life overseas.
The population, which peaked at more than 5,000 in the mid-1960s, has dwindled to just 1,200, according to a New Zealand parliamentary report, raising doubts about the island nation's economic viability. Douglas said a major cyclone in 2004, which destroyed much of Niue's infrastructure, accelerated the exodus, and the threat of future natural disasters was discouraging people from returning. "Of course it's concerning but it's not something we can do too much about until we can build an economy that will give them the confidence to come back," Niue's Premier Toke Talagi told reporters this month. "There aren't simple and easy answers to people leaving. We've got to build a strong economy and hope to attract them back." Known locally as "The Rock", Niue was settled by Polynesian seafarers more than 1,000 years ago and the palm-dotted island's name in the local language means "behold, the coconut".
The British explorer captain James Cook tried to land there three times in 1774 but was deterred by fearsome warriors, eventually giving up to set sail for more welcoming shores and naming Niue "savage island" on his charts. But modern day Niueans are desperate for visitors, with Talagi unveiling plans this month to turn it into a boutique tourism destination in a bid to put his nation on a sound economic footing. Using aid from New Zealand, with which Niue has a compact of free association giving its people dual citizenship, Talagi has overseen construction of a new tourism centre and expansion of the island's Matavai Resort.
Paths have also been cut through the jungle to give visitors access to swimming spots on the rugged limestone coastline, and cruise liners are being encouraged to include Niue on their itineraries. "We can become self-sustaining in the long term (and) reduce New Zealand assistance to Niue," Talagi said, estimating that visitor numbers could quadruple to 20,000 a year in the next decade. Addressing a visiting delegation of New Zealand business executives this month, Talagi acknowledged doubts about the nation's ability to meet the challenge. "I know some of you are a bit sceptical about our ability to become self sustaining... (but) tourism is not going to fail and I don't expect it to fail given the numbers that are being generated," he said.
The New Zealand parliamentary report, released last December, estimates that about 50,000 Niueans and their children now live in Australia and New Zealand, creating a shortage of skilled labour in one of the world's smallest states. "Niue is caught in a vicious cycle, with its economic difficulties both exacerbated by, and reflected in, the long-term decline of its population," it said, adding that 40 years of New Zealand aid "has yielded almost no return". The report's authors suggested Niue should concentrate on promoting itself as a retirement destination for elderly New Zealanders, who could help revitalise the economy. "The climate is excellent, existing buildings could be brought into service, and health facilities are satisfactory," it said. "Retirees would bring steady cash flow and contribute to stable employment options."
Asked about the suggestion, Talangi said "we'll look at everything", although one long-time resident, who asked not to be named, was unenthusiastic at the prospect. "How depressing to think that we might be turned into a major geriatric ward," she said. "Not that I have anything against old people, mind." Another resident said that whatever steps Niue took to improve its economy must result in major changes, pointing out people could earn more by moving to New Zealand and claiming unemployment benefits than working on the island. "It's pretty hard when your cuzzies (cousins) call you and say 'we're getting more on the dole in Auckland than you're getting paid'," he said.
February 23, 2009
Bhutan is a small, land-locked Himalayan country that completed its transition from an absolute monarchy to a constitutional monarchy in June 2008.
The United States does not have full diplomatic relations with Bhutan and there is no U.S. diplomatic presence there.
Consular issues relating to Bhutan, including assistance to U.S. citizens, are handled by the U.S. Embassy in New Delhi.
Read the Department of State Background Notes on Bhutan for additional information.
Independent travel is not permitted in Bhutan. Visitors are required to book travel through a registered tour operator in Bhutan. This may be done directly or through a travel agent abroad.
Further information, including a list of authorized tour operators in Bhutan, may be obtained from the Tourism Council of Bhutan, PO Box 126, Thimphu, Bhutan, telephone +975-2-323251, 2-323252, fax +975-2-323695.
Entry by air is available only via India, Bangladesh, Nepal, and Thailand. The border with China is closed. The minimum daily tariff is set by the Bhutanese Department of Tourism and cannot be negotiated. The rate includes all accommodations, all meals, transportation, services of licensed guides and porters, and cultural programs where and when available. The rate is the same for both cultural tours and treks. Travelers should contact the Tourism Council for the latest daily tariff.
At this time, the only carrier servicing Bhutan is Drukair, the Bhutanese government airline. Drukair will board only travelers with visa clearance from the Tourism Authority of Bhutan.
A passport and visa are required for entry into and exit from Bhutan.
Visa applications are available from selected travel agencies.
Travel agencies will usually arrange for a traveler’s entry visa and clearance.
Visitors, including those on official U.S. government business, should obtain visas prior to entering the country.
For additional entry/exit information, please contact the Bhutan Mission to the United Nations (Consul General), 763 First Avenue, New York, NY
10017, telephone (212) 682-2268, fax (212) 661-0551.
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:
Recent efforts to resettle many of the approximately 100,000 Bhutanese refugees of Nepali ethnic origin currently living in Nepalese refugee camps, coupled with the transition to democracy, have given rise to some civil unrest in usually peaceful Bhutan.
Bhutanese Maoists and Communist groups (including the Bhutan Communist Party and the Bhutan Tiger Force operating from the camps in Nepal), who denounce the monarchy and demand that the refugees be repatriated to Bhutan, have been linked to violence in the country.
A series of small bombs were set off between October 2006 and December 2008; most took place in small cities and towns on the southwestern border, near India, except for one in the capital, Thimphu.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
There is relatively little crime in Bhutan. Petty crime, such as pick-pocketing and purse snatching, is occasionally reported.
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 U.S. Embassy in New Delhi.
If you are the victim of a crime while in Bhutan, in addition to reporting to local police, please contact the U.S. Embassy in New Delhi for assistance.
(See the contact information below.)
The Embassy’s consular 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 crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The local equivalent to the “911” emergency line for Bhutan police in Bhutan is 113.
The emergency number for ambulance service is 112.
Please see our information on Victims of Crime, including possible victim compensation programs in the United States.
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 Bhutanese laws, even unknowingly, may be expelled, arrested or imprisoned.
Bhutan recently implemented extremely strict restrictions on the sale or use of cigarettes and other tobacco products.
A traveler caught selling tobacco products could be charged with illegal smuggling and fined or imprisoned.
Smoking is prohibited in public places.
Penalties for possession, use, or trafficking in illegal drugs in Bhutan 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.
Visitors are advised to carry cash or travelers checks, since credit cards are not widely accepted in Bhutan.
When credit cards are accepted, usually during bank hours, an extra service fee, usually a percentage of the overall purchase, is often charged.
Druk Air, the only carrier servicing Bhutan, has rigid restrictions on the amount and size of luggage passengers may carry into the country. Passengers are advised to book bulky items ahead as unaccompanied baggage, since the aircraft servicing Bhutan have limited space available for large bags, and airline employees may not load large pieces of luggage. Flights into and out of Paro Airport are restricted to daylight hours and are dependent on suitable weather conditions. Flights are sometimes delayed or cancelled, particularly during the monsoon season between June and August. Passengers are advised to allow at least 24 hours' transit time for connecting flights from Paro Airport and to travel on non-restricted air tickets so that they can be rebooked on the first available air carrier if a connecting flight is missed.
Bhutanese customs authorities enforce strict regulations concerning temporary importation into or export from Bhutan of items such as firearms, ammunition, explosives and military stores; narcotics and drugs (except medically prescribed drugs); tobacco products; wildlife products, especially those of endangered species; and antiques. It is advisable to contact the Bhutan Mission to the United Nations (Consulate General), 763 First Avenue, New York, NY
10017, telephone (212) 682-2268, fax (212) 661-0551, for specific information regarding customs requirements.
Please see our Customs Information.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Medical facilities in the populated areas in Bhutan such as Thimphu and Paro are available but may be limited or unavailable in rural areas.
If Americans need urgent medical care, they should try to get to the General Hospital in the capital city, Thimphu.
Medical services may not meet Western standards, and some medicines are in short supply.
Certain emergency medical services are provided free of charge to all tourists.
Visitors planning to trek in Bhutan should pay special attention to the risk of altitude illness.
Treks in Bhutan can take visitors days or weeks away from the nearest medical facility.
Helicopter evacuation from remote areas is available in Bhutan through the registered tour operators, or by contacting the U.S. Embassy in New Delhi.
Some HIV/AIDS entry restrictions exist for visitors to and foreign residents of Bhutan.
There are no disclosure regulations or restrictions for HIV/AIDS patients who enter Bhutan on a tourist visas for a maximum two week visit.
For longer stays applicants must present the results of an HIV/AIDS test completed within the six months prior to their visit.
The test can also be administered by Bhutanese officials upon arrival. Travelers should verify this information with the Bhutan Mission to the United Nations at (212) 682-2268.
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.
For information about outbreaks of infectious diseases abroad, consult the World Health Organization’s (WHO) web site.
Further health information for travelers is available from the WHO.
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 Bhutan is provided for general reference only and may not be totally accurate in a particular location or circumstance.
General road conditions outside of urban areas are poor, and emergency services generally are not available.
Because of the mountainous terrain, roads tend to have steep drop-offs and blind curves.
However, because tourists to Bhutan are required to arrange their trips through registered tour operators, tourists do not drive themselves, but travel in groups with experienced drivers.
Please refer to our Road Safety page and Bhutan’s Ministry of Economic Affairs for more information.
AVIATION SAFETY OVERSIGHT:
As there is no direct commercial air service to the United States by carriers registered in Bhutan, the U.S. Federal Aviation Administration (FAA) has not assessed Bhutan’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.
For more information, travelers may visit the FAA web site.
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:
There is no U.S. Embassy or Consulate in Bhutan. Although no formal diplomatic relations exist between the United States and Bhutan, informal contact is maintained through the U.S. Embassy in New Delhi, India. Updated information on travel and security in Bhutan may be obtained at the U.S. Embassy in New Delhi, at any other U.S. Consulate in India, or at the U.S. Embassy in Kathmandu, Nepal, as well as at the U.S. Embassy in Bangkok, Thailand.
Americans living or traveling in Bhutan are encouraged to register through the State Department’s travel registration web site or with the U.S. Embassy in New Delhi to obtain updated information on travel and security within Bhutan.
Americans without Internet access may register directly with the U.S. Embassy in New Delhi in person or via mail.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy in New Delhi is located on Shanti Path, Chanakya Puri, New Delhi 110 021, India, telephone +91-11-2419-8000, fax +91-11-2419-8407.
The following U.S. missions are included as they are Drukair destinations:
The U.S. Consulate in Kolkata is located at 5/1 Ho Chi Minh Sarani, Kolkata 700 071, India, telephone +91-33-3984-2400, fax +91-33-2282-2335.
The U.S. Embassy in Kathmandu is located at Maharajgunj in Kathmandu, Nepal.
The Consular Section can be reached through the Embassy switchboard at (977) (1) 400-7200 or directly by fax at (977) (1) 400-7281 or contacted by email.
The U.S. Embassy in Bangkok is located at 120/22 Wireless Road, Bangkok, Thailand, telephone +66-2-205-4000, fax +66-2-205-4103.
This replaces the Country Specific Information dated April 25, 2008, to update the sections on Country Description, Safety and Security, Traffic Safety and Road Conditions, and Medical Facilities and Health Information.
Travel News Headlines WORLD NEWS
Dengue fever cases in Phuentsholing are on the rise 2 months after the outbreak was 1st reported. Public awareness and campaigns have been of little help. Phuentsholing hospital saw a total of 2121 dengue-positive cases as of yesterday [6 Sep 2019], 313 more than the [1 Sep 2019] record. With 894 dengue-positive cases reported from private diagnostic centres in the town, Phuentsholing saw 3015 positive cases as of yesterday [6 Sep 2019].
Figures from the diagnostic centres, however, include both Bhutanese and people from across the border. The chief programme officer with Department of Public Health (DoPH), Ministry of Health, Rixin Jamtsho, said that 77% of the total cases in the country were reported from Phuentsholing hospital." The cases were reported from 19 dzongkhags [administrative district] till yesterday [6 Sep 2019]," Rixin Jamtsho said. "[The] majority of the cases reported from other districts had travelled to Phuentsholing prior to their illness."
1 Aug 2019. A total of 138 acute undifferentiated fever or dengue fever cases were reported in Doksum in Trashiyangtse as of yesterday [31 Jul 2019]. Health officials in Doksum tested 64 samples using dengue rapid test kit. Two tested positive for dengue NS1, 4 for dengue IgM, and 21 for 8 dengue IgG antibody.
THIMPHU, June 26 (Xinhua) -- Heavy rainfall in Bhutan has killed at least two people, triggered flash floods, landslides and road blocks, and damaged homes, streets and vehicles. The two were buried alive after the landslide washed away their home in southern district of Samtse on Tuesday due to massive landslide that was triggered by heavy rains. The continuous rainfall and flash floods have blocked more than four national highways, damaged bridges and affected many commuters and office goers.
According to the National Center for Hydrology and Meteorology, the southern belt of Bhutan has recorded heavy rainfall on Tuesday. The downpour continued on Wednesday, further affecting the lives of people living in southern part of the country. People residing in Phuentsholing said that they had to evacuate at early as 3 a.m. due to swollen rivers. The engineering workshops were overflown and drains were invisible due to landslides and flash floods. Falling of boulders and landslides damaged many vehicles, with some being submerged in mud. The schools in Phuentsholing town had to postpone their exams due to the damages caused by the heavy rainfall.
In Gelephu district a highway bridge was damaged. National highways between four districts were blocked. Many public buses and commuters were cancelled due to swollen rivers. In 2017 a monsoon rainfall washed away an entire town in southern district of Sarpang.
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."