GENERAL CONSIDERATIONS Health services in Mozambique
More than 60 per cent of Mozambique’s population lives in rural areas with little or no access to health services. A network of health posts and clinics feeds into a few regional hospitals. There are only about three doctors per 100,000 people across the country. Therefore, publically accessible health services are often very rudimentary, and it is important to have made independent plans to acquire high-quality care in the case of an emergency. This usually requires suitable pre-planning and the purchase of health and evacuation insurance. (See p.159.) Fortunately, this is generally quite cost-effective.
Avoiding common illnesses
You can expect your body to take some time to adjust to a new environment, particularly if coming from abroad. Jet lag is common, and can be reduced by setting your watch to the Mozambique time-zone when you board your flight, getting some exercise before bed when you land, and allowing yourself some time to adjust before starting to dive. Gastrointestinal upsets are common, and can vary from simple traveller’s diarrhoea to more serious infections. The use of strict hand-washing practices, caution in using local water sources, good personal hygiene and probiotics (or natural culture yoghurt) will reduce the risks. Sunburn is unpleasant at best and debilitating at worst, but is completely preventable with appropriate attire and the liberal use of sunscreen. Remember, if you are not used to the African sun, you will burn easily. Don’t forget sunglasses with UV protection to wear on the beach and the boat – solar keratitis (sunburn of the cornea of the eye, akin to snow-blindness) will ruin your trip and prevent you from diving.
An injury from a long-spined urchin Diadema setosum can be very painful.
Mozambique Adventure Trips Photo Gallery
A problem that is particular to diving, especially in the tropics, is the development of ear canal infections (called otitis externa, or ‘swimmer’s ear’). This happens with frequent dives in areas with high humidity, where the ear canal remains warm and moist, allowing bacteria to proliferate. This is best prevented by carefully rinsing and drying the ears after each dive; alcohol-containing eardrops are very useful. If you have suffered from this condition previously, or are undertaking a long trip, it may be worth taking some antibiotic- and steroid-containing eardrops.
Malaria, which is endemic in Mozambique, is a parasitic disease carried by mosquitoes. It remains the deadliest disease in Africa. All areas of Mozambique (and all the diving regions described in this book) are considered high risk for malaria. Many misconceptions exist regarding malaria in travellers. For instance, some people believe that prophylaxis can hide infection (it can), and because malaria is easy to treat (it generally is), it is better to forgo preventative medicines and simply deal with the infection if it occurs. This is dangerous and inadvisable. While most cases of malaria are easily treated with modern drugs, it still is responsible for many deaths and lasting disability (such as recurrent cerebral malaria), even in healthy travellers. Prophylaxis and measures to prevent being bitten by mosquitoes are thus always recommended. Measures to avoid being bitten include covering exposed skin (with long sleeves and trousers) or moving indoors during the dawn and dusk hours, using insect repellent, mosquito screens and nets.
It is worthwhile to consult a travel doctor or clinic for advice before your trip, but the information below may be useful. Around 90 per cent of the malaria in Mozambique is of the Plasmodium falciparum subtype, to which (at the time of writing) there is local resistance to chloroquine. The US Centers for Disease Control (CDC, www.cdc.gov) maintains an excellent resource on the current recommendations for anti-malaria prophylaxis, which currently include atovaquone-proguanil, doxycycline and mefloquine (although mefloquine is not recommended for divers). When obtaining prescriptions for prophylaxis, make sure to mention that you are diving. Some more in-depth information about the specific medications can be found in the box on p.156.