Information and guidelines for relatives and friends visiting Gabon.
Gamba is a great place to bring family and friends to stay for a while, but it is isolated and health facilities in Gabon are limited. Here are some points to remember when considering their visit:
1) Make sure they are aware of the health issues relevant to Gabon, especially the risk of malaria and need for anti-malarial pills if they are non-immune, and all the vaccinations they require. Information on health in Gabon is available of the Shell health web site and also in a PDF file in the outpost website (which is accessible on the normal internet and does not need access to the Shell intranet).
2) If they are elderly or if they have health problems, it is very important that they discuss the trip in detail with their own doctor to decide if they are fit enough for the flights and the visit. It would be very helpful for their doctor to be aware of the health issues in Gabon, so they should take the Shell Health information on Gabon with them when they see their doctor.
If they are on medications, or have certain health conditions, this may affect what antimalarial the doctor prescribes. If their treating doctor wants to email me for advice or information I or one of my colleagues would be happy to give it.
3) Visitors on medications should ensure they bring sufficent medications for their stay, with enough to last if their return is delayed. Because of the different drugs and brands prescribed in different countries, it is often very difficult to obtain the same replacement medications here in Gamba at short notice. Visitors should take their medications in their hand luggage in case their suitcases are lost. If they are carrying syringes (eg for insulin) or controlled drugs-eg valium or opiates or similar, it would be prudent to carry a letter from their own doctor advising that the medications are medically required. GP's will be agreeable to do this, provided adequate time is given.
4) Please be aware, that although Gamba patios can be idyllic for grandparents etc, it is deep in the Central African jungle and we are a long way from hospitals which would be classed as centres of excellence. For example, high tech cardiac investigation and treatment (eg coronary angiography and stenting, a common early treatment for acute heart attacks in Europe) is not available in Gabon. Even when everything runs perfectly, a medical evacuation to a centre of excellence in Europe usually takes between one to two days to complete. This is due to the need to stabilse the patient, transfer to a hospital Libreville, organise appropriate medical teams and an air ambulance, or a stretcher on a commercial flight.
5) Please ensure that they have adequate health insurance for their trip, including, most importantly, insurance cover for overseas medical evacuation to a centre of excellence.
Getting everything in place, getting correct advice, and making an informed judgement about the suitability of trip is the best way to ensure that visitors to Gamba have a safe, enjoyable, and uneventful stay.
Dr Andrew Benc, Shell Health, March 2013.
Very important document on health, diseases & treatment, on Malaria and many other challenges of life in Gabon.
Intestinal parasites: are common in many parts of the world and also occur in Gabon. They often cause minimal symptoms, and can be effectively treated with anti-worm medicines. Here are some types we see in Gamba.
Ascaris and strongoloides – transmission by faecal contamination of food, by flies and dirty hands – can give complaints of vague abdominal pain;
Hookworm transmission via larvae, which can penetrate the skin of the human feet, living in wet soil contaminated by the faeces of a hookworm sufferer – symptoms are abdominal pain and, in heavy infestation, anaemia;
Oxyuris – also well known in Europe as “pinworm” and is common in toddlers – symptoms: perianal itching, especially at night time as adult worms, thin white threads 1 cm long, leave the bowels to lay eggs in the perianal region – reinfection occurs by swallowing eggs trapped under the nails of fingers after scratching of the anus, or picked up from dirt on the floor – therefore keep the fingernail of your children short and in a case develops it is often advisable to treat the whole family.
Diarrhea : It is well known that in the tropics diarrhea is more prevalent than in areas with a more moderate climate. The hot climate, different food and water often result in more frequent and looser stools, especially in the first months after arrival. Poor hygiene standards, e.g. sewage disposal, water purification, food handler control etc., can result in the transmission of all kinds of organism which can provoke anything from mild viral gastroenteritis to severe dysentery. High standards of personal hygiene, especially in the kitchen, are very important in the prevention of the transmission of germs causing abdominal upsets.
Always handle poultry separately from other food as it is often contaminated with strains of salmonella bacteria;
Defrost frozen food in the refrigerator or microwave, never in hot water, which is the best environment for germs to multiply;
Wash and peel vegetables thoroughly – boiling will render them safe;
Peel fruits or disinfect as for lettuce;
Never re-freeze food once defrosted;
Keep left-over’s (after allowing to cool down) in the refrigerator;
Inspect your refrigerator regularly and clean out weekly;
Keep your kitchen free of flying and crawling insects.
Some forms of diarrhea regularly seen in Gabon
-Viral gastro enteritis (often during the change of seasons) ,vomiting, diarrhea, most often with no fever – clears up within 48 hours;
-Food poisoning due to toxins produced by bacteria – occurs 6-8 hours after ingestion of contaminated food – vomiting, diarrhea – clears up normally within 24 hours;
-Amoebic dysentery – acute form symptoms: frequent diarrhea (Up to 15 times a day), stools contaminated with blood, severe abdominal cramps, possible fever – less acute form: persistent diarrhea without blood;
-Lambliasis – symptoms varying from acute diarrhea (most often in children) to lose fatty sticky stools often accompanied by excessive wind.
Treatment: As a general rule it is best to stop all solid foods for at least 24 hours, but to continue with and increase fluid intake, especially for babies and small children. The most important part of the treatment of diarrhoea of any sort is to replace all the fluids lost to prevent dehydration. The introduction and promotion worldwide of oral rehydration solutions has dramatically reduced morality rates.
If the diarrhea contains blood or is accompanied by vomiting or fever or does not improve within 24 hours contact the clinic for medical treatment and investigation.