General health precautions

In addition to vaccinations and malaria protection, there are a number of other important health considerations for your time in Madagascar:

• Food and water hygiene
• Sun protection
• Diseases for which there is no immunisation available
• Sexually transmitted diseases
• Parasites
• Personal first aid kit and medicines

Food and water hygiene

At ReefDoctor we make every effort to ensure that your food and water are safe. We bring all of our drinking water in from Toliara, and our cooking water is treated with chlorine-based purifiers. However, conditions in Ifaty and Toliara are such that traveller’s diarrhoea is always a risk.

In the rainy season (December - February) you should observe the strictest food and general hygiene precautions. In particular, avoid buying food from street vendors. When you are away from the ReefDoctor camp you advised to only to drink water from bottles where seals are unbroken at the time of purchase, and ensure that ice in drinks has been made with mineral water.

To help protect yourself ensure that you wash your hands with an anti-bacterial soap (we have Santex on site) and be more conscious about general hygiene when eating or preparing food.

Sun protection

We advise that use high factor sunscreens all year round in Madagascar. Remember that while you are on the boats or after you come up from a dive you may not feel the sun, but still need to take precautions. In the summer months in particular (December to February) the sun is very strong and we advise wearing a hat on the boat and using sunscreens, or covering up, all the time.

You will need to bring enough sunscreen for the length of your stay in Madagascar. We recommend Factor 15 as a minimum, and higher if you are fair or burn more easily. Also note that taking Doxycycline anti-malaria prophylaxis can make your skin more sensitive to sunlight, so be conservative.
At certain times we have sun cream available in camp. Check with us to see if you need to bring suncream for your stay.

Diseases for which there is no immunisation available

Unfortunately there are some diseases for which there are no vaccinations or preventive medicine.  The most widely reported of these are Dengue fever and the Chikungunya virus. Both diseases are transmitted by mosquitoes so you should take precautionary measures to avoid being bitten at all times - unlike malaria the carrying mosquitoes are also active during daylight hours.

Avoid mosquito bites by wearing clothes with long sleeves and long trousers; use insect repellents on exposed skin, we suggest 20% DEET; and sleep under a mosquito net, ReefDoctor has mosquito nets in all of its accommodation but remember to bring your own if you plan to travel in Madagascar after your stay with us.

Further information and factsheets on avoiding insect bites and Chikungunya can be found at the National Travel Health Network and Centre.
http://www.nathnac.org/pro/factsheets/iba.htm
http://www.nathnac.org/pro/clinical_updates/chik_210706.htm

Sexually transmitted diseases and HIV/AIDS

Sexually Transmitted Diseases, STDs, include HIV/AIDS, hepatitis B, gonorrhoea, chlamydia, and syphilis and are prevalent throughout Madagascar.
You should be particularly alert to the dangers of unprotected sex, we advise that you bring good quality condoms with you - you may not think you’ll need them, but ...

In the case of HIV/AIDS, also be aware of the cleanliness of any medical facilities you visit - we suggest you carry your own emergency kit with sterile needles and syringes in case you need them.

Parasites

Parasitic diseases are also prevalent in Madagascar. Although we have not seen these diseases in Ifaty, we recommend that you avoid swimming and paddling in fresh water (swimming pools which are well chlorinated are safe) as Schistosomiasis, or Bilharzia, has been recorded in the north of Madagascar.

More common in Ifaty are parasites such as ticks, fleas and lice. In themselves they may not represent a large problem, but it is possible for them to carry other more serious diseases.

We recommend that you follow precautions to avoid bites, do not encourage local dogs or cats in to your sleeping area, and bring a high percentage DEET insect repellent to spray around your sleeping area to discourage them.

We do periodically check all of our accommodation and treat if necessary.

Personal first aid kit and medicines

Although ReefDoctor has a comprehensive medical cabinet on site you will need to bring a first aid kit, general medicines and any personal medication that you may use. If you plan to travel independently in Madagascar before or after your time with us, we strongly advise that you bring a travel first aid kit.

Remember, medical treatment and facilities in Madagascar are limited and not to Western standards. In addition, should you fall ill and need to go to hospital you will be required to buy all medicines and treatment materials prior to any treatment being given. So having basic first aid materials with you can speed up getting treatment.

For more information on first aid materials and medicines visit our What to bring section.

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