Travel Insurance Sierra Leone

Dental care

There is little dental care available in Sierra Leone, and what there is, the standards of care and hygiene cannot be guaranteed

Medication Availability

Medication in short supply and even when available is often out of date or heat damaged and therefore should be avoided

Blood supplies

Blood supplies should be considered as unsafe

Medical facilities

Medical facilities fall critically short of Western standards. Persons with medical conditions that may require treatment or medications are discouraged from travelling to Sierra Leone. Medicines are in short supply, sterility of equipment is questionable, and treatment is unreliable. Many primary health care workers, especially in rural areas, lack professional training. Instances of misdiagnosis, improper treatment and administration of improper drugs have been reported.

General caution

Recent medical and dental exams should ensure that the traveler is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescription and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary. Drink only bottled beverages (including water) or beverages made with boiled water. Do not use ice cubes or eat raw seafood, rare meat or dairy products. Eat well-cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors. Swim only in well-maintained, chlorinated pools or ocean water known to be free from pollution; avoid freshwater lakes, streams and rivers. Wear clothing which reduces exposed skin and apply repellents containing DEET to remaining areas. Sleep in well-screened accommodations. Carry anti-diarrheal medication. Reduce problems related to sun exposure by using sunglasses, wide-brimmed hats, sunscreen lotions and lip protection.

Specific concerns

AIDS occurs. Blood supply may not be adequately screened and/or single-use, disposable needles and syringes may be unavailable. When possible, travelers should defer medical treatment until reaching a facility where safety can be assured. Fungus and skin disorders are common during the rainy season. If washing clothes, towels or bedding, machine-dry them to avoid tumba fly infestation. The Department of State has warned that travelers to Freetown, Sierra Leone's capital, should be aware that there were two crashes involving helicopters serving the Lungi airport in early 1990. Two helicopter service companies provide a transportation service from the airport across Peninsular Bay to Freetown and, according to the State Department, both services have poor safety records. The State Department cautions that travelers may wish to consider alternate means of transportation from Lungi airport to Freetown, such as car or ferry.

Immunization

Cholera: Although limited in effectiveness, vaccination may be appropriate for persons living and/or working in less than sanitary conditions for more than 3 months where medical facilities are unavailable. Vaccination may also be appropriate for travelers with impaired gastric defenses who are planning an extended visit or being exposed to unsanitary conditions. Vaccination is not advised for pregnant women, infants younger than 6 months old, or persons with a history of severe reaction to the vaccine. Hepatitis A: Consider active immunization with hepatitis A vaccine or passive immunization with immune globulin (IG) for all susceptible travelers. Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. It is particularly important for persons who will be living in or visiting rural areas, eating or drinking in settings of poor or uncertain sanitation, or who will have close contact with local persons (especially young children) in settings with poor sanitary conditions. Hepatitis B: Vaccination is advised for health care workers, persons anticipating direct contact with blood from or sexual contact with inhabitants, and persons planning extended stays of 6 months or greater (especially those who anticipate using local health care facilities, staying in rural areas, or having intimate contact with the local population). Polio: A one-time booster dose is recommended for travelers who have previously completed a standard course of polio immunization. Refer to CDC guidelines for vaccinating unimmunized or incompletely immunized persons. Pregnancy is a relative contraindication to vaccination; however, if protection is needed, either IPV or OPV may be used, depending on preference and time available. Rabies: Preexposure vaccination should be considered for persons staying longer than 30 days who are expected to be at risk to bites from domestic and/or wild animals (particularly dogs), or for persons engaged in high risk activities such as spelunking or animal handling. Need for vaccination is more important if potential exposure is in rural areas and if adequate postexposure care is not readily available. Typhoid: Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited. Contraindications depend on vaccine type. Yellow fever: Vaccination is recommended for travelers over 9 months of age going outside of urban areas. Note: All routine vaccines (such as DTP or Td, Hib, MMR, polio, varicella, influenza and pneumococcal) should be kept up-to-date as a matter of good health practice unrelated to travel.

Disease risk summary

Insect-borne diseases: are major causes of illness. Many diseases, including yellow fever, are endemic to the area and sporadic cases are reported but from time to time more extensive outbreaks occur. Filariasis - prevalent Leishmaniasis - occurs (both cutaneous and visceral types may be found, particularly in the drier areas) Loiasis - prevalent Malaria - common Onchocerciasis (river blindness) - prevalent Relapsing fever - occurs Trypanosomiasis (sleeping sickness) - occurs (human type - mainly in small, isolated areas - is reported) Tungiasis - prevalent Typhus - occurs (louse-, flea-, and tick-borne types occur) Food-borne and water-borne illness: highly endemic. The dysenteries and diarrheal diseases, giardiasis, the typhoid fevers and viral hepatitis are widespread. Echinococcosis (hydatid disease) is widespread in animal-breeding areas. Cholera - occurs Dracunculiasis - occurs Helminthic (parasitic worm) infections - prevalent Lassa fever - occurs (risk in eastern areas, and people visiting these areas should take particular care to avoid rat-contaminated food or food containers) Schistosomiasis - common Other hazards: Diseases such as measles and diphtheria are commonly reported, and cases of polio still occur regularly. Influenza risk extends throughout the year. Rabies - prevalent Trachoma - prevalent

Entry requirements

Yellow fever: A yellow fever vaccination certificate is required from travelers coming from infected areas. (Contrary to published requirements, the U.S. Embassy reports that proof of yellow fever vaccination is required for all travelers.)