If you have been posted to Mozambique with a reputable employer, it is likely that you have medical cover included in your employment package. But you should be aware of certain risks specific to your location and take all necessary precautions to ensure you stay happy and healthy while working away from home.
Hospital facilities are generally poor in Mozambique, especially in the north of the country. In cases of serious illness or injury, medical evacuation to South Africa may be necessary. Make sure your contract includes adequate health insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation if necessary.
You can protect yourself from the most common health risks through immunisation and other preventative measures. Let’s look at them in turn:
In the 2010 Report on the Global AIDS Epidemic, the UNAIDS/WHO Working Group estimated that around 1,200,000 adults aged 15 or over in Mozambique were living with HIV; prevalence was estimated at around 11.5% of the adult population. HIV is only transmitted via unprotected sex, transfusion with infected blood, mingling of blood with someone infected (e.g. in an industrial injury) or shared needles among injecting drug users. It is not transmitted via kissing, sharing of food or utensils or any other means other than the above. Exercise normal precautions to avoid exposure to HIV/AIDS, such as condom use during sex.
If you have any reason to believe you have been exposed to HIV, for example if you have been injured in a site accident involving co-workers, or if you have been sexually assaulted, contact your nearest clinic or medical practitioner immediately for post-exposure prophylaxis (PEP). PEP is antiretroviral treatment taken immediately after potential infection that prevents the virus from establishing itself in your system. You must start PEP within 72 hours of exposure and preferably 48, and take it for one month. You must then have a follow-up HIV test six months later.
Other infectious diseases: immunisations
Before you go, make sure your immunisations and boosters are up to date, including vaccines required for occupational risk of exposure, lifestyle risks and underlying medical conditions.
- Courses or boosters usually advised: Diphtheria, Hepatitis A, Tetanus, Typhoid.
- Other vaccines to consider: Cholera, Hepatitis B, Rabies.
- Yellow fever vaccination certificate is not required for entry into Mozambique from South Africa but is required from travellers over one year of age arriving from countries with a known risk of yellow fever transmission and for travellers who have transited through a country with risk of yellow fever transmission.
Things you should know about the diseases mentioned above:
- Cholera is spread through consumption of contaminated water and food. It is more common during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. You are unlikely to contract cholera if you take basic precautions with food and water and maintain a good standard of hygiene.
- Diphtheria is spread person to person through respiratory droplets. The risk is in poor, overcrowded living conditions.
- Hepatitis A is spread through consumption of contaminated food and water or person to person through the faecal-oral route. The risk is higher where personal hygiene and sanitation are poor.
- Hepatitis B is spread through infected blood and blood products, contaminated needles and medical instruments and sexual intercourse. The risk is higher for those at occupational risk, long stays or frequent travel, children (exposed through cuts and scratches) and individuals who may need surgical procedures abroad.
- Rabies is spread through the saliva of an infected animal, usually through a bite, scratch or lick on broken skin, particularly dogs and related species, but also bats. The risk is higher in remote areas (as you may not be able to promptly access appropriate treatment in the event of a bite) and with long stays. Even if you have pre-exposure vaccination, urgent medical advice should be sought after any animal or bat bite.
- Tetanus: is spread through contamination of cuts, burns and wounds with tetanus spores. Spores are found in soil. A booster is usually recommended prior to travel to Mozambique.
- Typhoid is spread mainly through consumption of contaminated food and drink. The risk is higher where access to adequate sanitation and safe water is limited.
Malaria is a serious and sometimes fatal disease transmitted by mosquitoes. You cannot be vaccinated against malaria but you can take precautions. In Mozambique malaria precautions are essential in all areas, all year round, as follows:
- Avoid mosquito bites by covering up with clothing such as long sleeves and long pants, especially after sunset, using insect repellents on exposed skin and, when necessary, sleeping under a mosquito net.
- Check with your doctor or travel clinic about suitable antimalarial tablets. Atovaquone/proguanil OR doxycycline OR mefloquine is usually recommended.
- If you develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
- Mozambique has areas with high altitude (2400m or more) and areas with very high altitude (3658m or more). If you are working in an area of high altitude you should take care to avoid the ill effects of being at altitude including Acute Mountain Sickness, a potentially life-threatening condition, by making sure you take two to three days to acclimatise, i.e. gradually ascending to your final altitude.
- Schistomiasis is a parasitic infection (also known as bilharzia) that is transmitted to humans through contact with fresh water. The parasite enters humans through the skin and prevention is avoidance of swimming or paddling in fresh water lakes and streams. With thanks to www.fitfortravel.nhs.uk
- Dengue fever is a viral illness transmitted to humans by mosquitoes. The mosquito that spreads dengue bites during the day and is more common in urban areas. Symptoms include fever, headache, severe joint, bone and muscular pain – hence its other name ‘breakbone fever’. There is no vaccine and prevention is purely avoidance of mosquito bites.