You can still catch malaria even if you are taking anti-malarial drugs. Classic symptoms include headaches, chills and sweating, abdominal pains, aching joints and fever – some or all of which may come in waves. It varies tremendously, but often starts like a bad case of flu. If anything like this happens, you should first suspect malaria and seek immediate medical help. A definite diagnosis of malaria is normally only possible by examining a blood sample under the microscope. It is best to get the problem properly diagnosed if possible, so don't treat yourself if you can easily reach a hospital first.
If (and only if) medical help is unavailable, then self-treatment is fairly safe, except for people who are pregnant or under twelve years of age. Fansidar, mefloquine, high-dose chloroquine (preferably intravenous) and quinine can all be used in the treatment of malaria. In Namibia you should always be able to get experienced local advice to tell you which will be the most effective.
Quinine is very strong, but often proves to be an effective last defence against malaria. Include it in your medical kit, as occasionally rural clinics will have the expertise to treat you, but not the drugs. Treatment consists of taking two quinine tablets (600mg) every eight hours for up to seven days, until the fever abates. Quinine’s side effects are disorientating and unpleasant (nausea and a constant buzzing in the ears), so administering this whilst on your own is not advisable.
Sexually transmitted diseases
AIDS is spread in exactly the same way in Africa as it is at home, through body secretions, blood, and blood products. The same goes for the dangerous Hepatitis B. Both can be spread through sex.
Remember the risks of sexually transmitted disease are high, whether you sleep with fellow travellers or locals. About 40% of HIV infections in British people are acquired abroad. Use condoms or femidoms. If you notice any genital ulcers or discharge get treatment promptly.
This is a group of viral diseases which generally start with Coca-Cola-coloured urine and light-coloured stools. It progresses to fevers, weakness, jaundice (yellow skin and eyeballs) and abdominal pains caused by a severe inflammation of the liver. There are several forms, of which the two most common are typical of the rest: Hepatitis A (or infectious hepatitis) and Hepatitis B (or serum hepatitis).
Hepatitis A, and the newly-discovered Hepatitis E, are spread by the faecal-oral route, that is by ingesting food or drink contaminated by excrement. They are avoided in the same ways you normally avoid stomach problems: by careful preparation of food and by only drinking clean water. There is now an excellent vaccine against Hepatitis A, Havrix, which lasts for ten years and is certainly worth getting before you travel. See Recommended precautions.
In contrast, the more serious but rarer Hepatitis B is spread in the same way as AIDS (by blood or body secretions), and is avoided the same way as one avoids AIDS. There is a vaccine which protects against Hepatitis B, but this is expensive. It is usually only considered necessary for medical workers and others with a high risk of exposure, including expatriates.
There are no cures for hepatitis, but with lots of bed rest and a good low-fat, no-alcohol diet most people recover within six months. If you are unlucky enough to contract hepatitis of any form, use your travel insurance to fly straight home.
Rabies is contracted when broken skin comes into contact with saliva from an infected animal. The disease is almost always fatal when fully developed, but fortunately there are excellent post-exposure vaccines. It is possible, albeit expensive, to be immunised against rabies before you travel, but not really worthwhile unless your risk of exposure to it is high (eg: if you are working with animals). Even if you have been immunised, it is standard practice to treat all cases of possible exposure with two post-exposure jabs.
Rabies is rarely a problem for visitors, but the small risk is further minimised by avoiding small mammals. This is especially true of any animals acting strangely. Both mad dogs in town and friendly jackals in the bush should be given a very wide berth.
If you are bitten, clean and disinfect the wound thoroughly by scrubbing it with soap under running water for five minutes, and then flood it with local spirit or diluted iodine. Then seek medical advice. A post-bite rabies injection is needed even in immunised people, and those who are unimmunised need a course of injections.
These should be given within a week if the bites are to the face. The incubation period for rabies is the time taken for the virus to travel from the area of bite to the brain. This varies with the distance of the bite from the head – from a week or so, to many months. If the bites are further from the brain the incubation period is longer and you probably have more time; make sure you get the injections even if you are a very long way from civilisation.
Never say that it is to late to bother. The later stages of the disease are horrendous – spasms, personality changes and hydrophobia (fear of water). Death from rabies is probably one of the worst ways to go.
Bilharzia or schistosomiasis
Though a very low risk in Namibia, bilharzia is an insidious disease, contracted by coming into contact with contaminated water. It is caused by parasitic worms which live part of their lives in freshwater snails, and part of their lives in human bladders or intestines. A common indication of an infection is a localised itchy rash – where the parasites have burrowed through the skin – and later symptoms of a more advanced infection may include passing bloody urine. Bilharzia is readily treated by medication, and only serious if it remains untreated.
The only way to avoid infection completely is to stay away from any bodies of fresh water. Obviously this is restrictive, and would make your trip less enjoyable. More pragmatic advice is to avoid slow-moving or sluggish water, and ask local opinion on the bilharzia risk, as not all water is contaminated. Generally bilharzia snails do not inhabit fast-flowing water, and hence rivers are free of it. However, dams and standing water, especially in populated areas, are usually heavily contaminated. If you think you have been infected, don’t worry about it – just get a test done on your return at least six weeks after your last possible exposure.
Sleeping sickness or trypanosomiasis
This is really a cattle disease, which is rarely caught by people. It is spread by bites from the distinctive tsetse fly – which is slightly larger than a house fly, and has pointed mouth-parts designed for sucking blood. The bite is painful. These flies are easily spotted as they bite during the day, and have distinctive wings which cross into a scissor shape when they are resting. They are not common in Namibia, but do occur occasionally in Bushmanland and the Caprivi. Note that not all tsetses carry the disease.
Prevention is easier than cure, so avoid being bitten by covering up. Chemical insect repellents are also helpful. Dark colours, especially blue, are favoured by the flies, so avoid wearing these if possible.
Tsetse bites are nasty, so expect them to swell up and turn red – that is a normal allergic reaction to any bite. The vast majority of tsetse bites will do only this. However, if the bite develops into a boil-like swelling after five or more days, and a fever starts two or three weeks later, then seek immediate medical treatment to avert permanent damage to your central nervous system. The name ‘sleeping sickness’ refers to a daytime drowsiness which is characteristic of the later stages of the disease.
Because this is a rare complaint, most doctors in the West are unfamiliar with it. If you think that you may have been infected, draw their attention to the possibility. Treatment is straightforward, once a correct diagnosis has been made.
Many tropical diseases have a long incubation period, and it is possible to develop symptoms weeks after returning home (this is why it is important to keep taking anti-malaria prophylaxis for at least four weeks after you leave a malarial zone). If you do get ill after you return home, be certain to tell your doctor where you have been. Alert him/her to any diseases that you may have been exposed to. Several people die from malaria in the UK every year because victims do not seek medical help promptly or their doctors are not familiar with the symptoms, and so are slow to make a correct diagnosis. Milder forms of malaria may take up to a year to reveal themselves, but serious (falciparum) malaria will become apparent within four months.
If problems persist, get a check-up at one of the hospitals that specialise in tropical diseases. Note that to visit such a hospital in the UK, you need a letter of referral from your doctor.
For further advice or help in the UK, ask your local doctor to refer you to the London Hospital for Tropical Diseases, 4 St Pancras Way, London NW1; tel: 0171 387 4411.
Namibia is not a dangerous country. Generally it is amazingly crime-free. Outside of the main cities, crime against visitors, however minor, is exceedingly rare. Even if you are travelling on local transport on a low budget, you are likely to experience numerous acts of random kindness, but not crime. It is certainly safer for visitors than the UK, USA, or most of Europe.
To get into a difficult situation, you’ll usually have to try hard. You need to make yourself an obvious target for thieves, perhaps by walking around at night, with showy valuables, in a less affluent area of the city. Provided you are sensible, you are most unlikely to ever see any crime here.
Most towns in Namibia have townships, and often these are home to many of the poorer sections of society. Generally they are perfectly safe to visit during the day, though casual tourists with valuables would be wise to avoid wandering around there at night. If you have friends or contacts who are local and know the areas well, then take the opportunity to explore with them a little. Wander around during the day, or go off to a nightclub together. You’ll find that they show you a very different facet of Namibian life from that seen in the more affluent areas.
For women travellers, especially those travelling alone, it is important to learn the local attitudes about how to behave acceptably. This takes some practice, and a certain confidence. You will often be the centre of attention, but by developing conversational techniques to avert over-enthusiastic male attention, you should be perfectly safe. Making friends of the local women is one way to help avoid such problems.
Theft is not a problem in Namibia – which is surprising given the poverty levels amongst much of the population. The only real exception to this rule is theft from unattended vehicles, which is common in Windhoek (especially) and the larger towns. If you leave your vehicle with anything valuable on view, then you will probably return to find a window smashed and items stolen. Aside from this, theft is really very rare. I have never even heard of a visitor being mugged in Namibia.
Reporting thefts to the police
If you are the victim of a theft then report it to the police – they ought to know. Also try to get a copy of the report, or at least a reference number on an official-looking piece of paper, as this will help you to claim on your insurance policy when you return home. However, reporting anything in a police station can take a long time, and do not expect any speedy arrests for a small case of theft.
To get arrested in Namibia, a foreigner will normally have to try quite hard. Though most Namibians are not paranoid about spies, it is always wise to ask for permission to photograph near bridges or military installations. This simple courtesy costs you nothing, and may avoid a problem later.
One excellent way to get arrested in Namibia is to try to smuggle drugs across its borders, or to try to buy them from ‘pushers’. Drug offences carry penalties at least as stiff as those you will find at home – and the jails are a lot less pleasant. Namibia’s police are not forbidden to use entrapment techniques or ‘sting’ operations to catch criminals. Buying, selling or using drugs in Namibia is just not worth the risk.
Failing this, argue with a policeman or army official – and get angry into the bargain – and you may manage to be arrested. It is essential to control your temper; stay relaxed when dealing with officials. Not only will you gain respect, and hence help your cause, but you will avoid being forced to cool off for a night in the cells.
If you are careless enough to be arrested, you will often only be asked a few questions. If the police are suspicious of you, then how you handle the situation will determine whether you are kept for a matter of hours or days. Be patient, helpful, good-humoured, and as truthful as possible. Never lose your temper, it will only aggravate the situation. Avoid any hint of arrogance. If things are going badly after half a day or so, then start firmly, but politely, to insist on seeing someone in higher authority. As a last resort you do, at least in theory, have the right to contact your embassy or consulate, though the finer points of your civil liberties may end up being overlooked by an irate local police chief.
Bribery may be a fact of life in much of Africa, but in Namibia it is very rare. Certainly no normal visitor should ever be asked for, or offer, a bribe. It would be just as illegal as offering someone a bribe back home.
Safety for women travellers
When attention becomes intrusive, it can help if you are wearing a wedding ring and have photos of ‘your’ husband and children, even if they are someone else’s. A good reason to give for not being with them is that you have to travel in connection with your job – biology, zoology, geography, or whatever. (But not journalism, that’s risky.)
Pay attention to local etiquette, and to speaking, dressing and moving reasonably decorously. Look at how the local women dress, and try not to expose parts of yourself that they keep covered. Think about body language. In much of Southern Africa direct eye contact with a man will be seen as a ‘come-on’; sunglasses are helpful here.
Don’t be afraid to explain clearly – but pleasantly rather than as a put-down – that you aren’t in the market for whatever distractions are on offer. Remember that you are probably as much of a novelty to the local people as they are to you; and the fact that you are travelling abroad alone gives them the message that you are free and adventurous. But don’t imagine that a Lothario lurks under every bush: many approaches stem from genuine friendliness or curiosity, and a brush-off in such cases doesn’t do much for the image of travellers in general.
Take sensible precautions against theft and attack – try to cover all the risks before you encounter them – and then relax and enjoy your trip. You’ll meet far more kindness than villainy.
Driving in Namibia
Driving yourself around Namibia is, for most visitors, far the best way to see the country. It is much easier than driving around Europe or the USA: the roads are excellent, the traffic is light, and the signposts are numerous, clear and unambiguous.
Further, if you choose to visit private camps or concession areas, you can then use the skills of the resident guides to show you the wildlife. You’re not restricted to the car, to be in it every day. Driving yourself gives you freedom to explore and to go where you like, when you like.
It’s generally easiest to hire a vehicle for your whole time in Namibia, collecting it at the airport when you arrive, and returning it there when you depart. This also removes any worries that you may have about bringing too much luggage (whatever you bring is simply thrown in the boot on arrival).
However, if your budget is very tight then you may think about just taking a vehicle for a few days, perhaps from Windhoek to Swakopmund via the Sesriem area, or to drive around Etosha. However long you keep the vehicle, the type you choose and the company you hire from can make an enormous difference to your trip.
HIRING A VEHICLE
Think carefully about what kind of vehicle to hire, and where to get it from, well before arriving in the country. It is usually better to organise this in advance. Check out the deals offered by overseas operators before you buy your flights. Arranging flights, car and accommodation with one operator, based in your home country, can sometimes be cheaper and easier than making all the bookings separately.
A warning before you sign up for any car hire, see the section on insurance and CDWs. There is often fine print in these agreements which may mislead the unwary.
2WD or 4WD?
Whether you need to hire a 2WD or a 4WD vehicle depends on where you want to go. For virtually all of the country’s main sights and attractions, and many of the more off-beat ones, a normal saloon 2WD car is ideal.
The only real exception to this advice is if you’re travelling anywhere during the rains, around January to March, when you might consider taking a 4WD, just in case you need to ford any shallow rivers that block the road. Additional advantages of a 4WD vehicle are:
Despite the disadvantages, if you want to get up to the northern Kaokoveld, further than Tsumkwe in Bushmanland, or to any of the really off-beat areas in the Caprivi – then you’ll need a high-clearance 4WD. The main point to remember is that in most of these areas, just one 4WD vehicle simply isn’t enough. Your party needs to have a minimum of two vehicles for safety, and you should have with you a couple of experienced bush-drivers. These areas are very dangerous if you drive into them alone or ill-equipped.
Hiring a 2WD (saloon car)
There are three big car hire companies in Namibia: Avis, Budget, and Imperial (which is associated with Hertz in the rest of the world). Their prices tend to be similar, as do their conditions of hire, which leaves quality and availability as appropriate criteria for choosing between them.
Having used all three, I now generally hire from Avis. They have the youngest and largest fleet, as well as a wide backup network in Namibia, so any problems get sorted out fast. There is the further advantage that they are well-represented throughout the subcontinent, so it is easy to arrange one-way trips between South Africa or Botswana and Namibia – which adds a lot of flexibility to your choice of route.
Aside from these three large firms, there are a plethora of smaller, local car hire companies in Windhoek, some of whom are good. Others have more dubious reputations, and even buy their cars from the big companies, who dispose of their vehicles after one or two years. This makes their rates cheaper. However, compromising on the quality of your vehicle is crazy when you rely upon it so completely. Economise on accommodation or meals – but rent the best vehicle you can.
Typical ‘per day’ on-the-road prices from the more reputable companies, based upon unlimited mileage and their maximum insurance (see the section on Insurance, CDWs and gravel roads below), are:
Costs are UK£ / US$ Total rental period / days
Group under 7 8–13 14–20 over 20
A Toyota Corolla 1.3 £70/$112 £60/$96 £55/$88 £53/$86
B Corolla 1.6 a/c r/t £81/$130 £73/$116 £66/$106 £64/$103
C VW Jetta a/c r/t p/s £96/$153 £88/$140 £78/$126 £75/$121
N Double-cab 4x4 £121/$194 £115/$183 £107/$170 £104/$166
Slightly cheaper deals are available from smaller local firms, but none has the same backup support as the big companies. Neither will you have the same chance of redress if there are any problems.
If time is not in short supply but money is, consider just hiring for a few days at a time to see specific sights – which would not be too expensive if you are planning on sitting by water-holes in Etosha all day.
What kind of 2WD?
This is really a question of budget. A simple ‘Group A’ – usually a basic 1.3 or 1.6 VW Golf, Toyota Corolla or Mazda Midge – is fine for two adults and most trips. (The harder suspension of the Golf is probably best on Namibian roads.)
If you’ve any flexibility in your budget, then get one up from the basic car if you can. A ‘Group B’ normally comes with air-conditioning and a radio/tape player, both of which can be useful. A larger vehicle is superfluous for two people, unless you need an automatic gearbox, want the sheer luxury of the space, or plan to drive huge distances.
For three or four people, look to a larger saloon, typically a Group C, like a VW Jetta 1.6. This has a cavernous boot (trunk) for luggage, and power steering is added to its refinements. If budget allows, then the Toyota Camry is excellent – and in many ways better than the more expensive Mercedes 220 which is sometimes offered.
Five or six people on a budget should consider a Toyota Venture, which is very spacious, or something similar. However, do get the more recent 2.2, rather than the older 1.8 model, as the latter are lamentably under-powered. If your budget is flexible, then consider either two small cars, or a VW Microbus (combi). Two cars will give more flexibility if the group wants to split up on occasions. These combis have lots of space to move around, and six window seats for game-viewing. Their main disadvantage is that they lack a secure, hidden boot. Like most 4WDs, you can’t safely leave the vehicle alone with any luggage in it.