Time Zone: -5 hours. No daylight savings time in 2008.
Tel. Country Code: 509
USADirect Tel.: 1
Electrical Standards: Electrical current is 110/60 (volts/hz). North American Style Adaptor Plug. Grounding Adaptor Plug A.
Travel Advisory - Haiti
Travelers to Central and South America and the Caribbean need to protect themselves against mosquito-transmitted viruses, such as dengue and Zika, as well as nighttime biting mosquitoes in countries where there is the threat of malaria. I recommend all travelers use a combination of DEET or Picaridin repellent on their skin and Permethrin fabric insecticide on their clothing for greater than 99% protection against mosquito and tick bites.
Dr. Rose Recommends for Travel to Haiti
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The Consular Section of the U.S. Embassy is located at 104, rue Oswald Durand, Port-au-Prince. The telephone numbers are  223-7011, 223-6440, 223-6443, 223-6421, 223-6426, 223-6424, 223-6407, 223-7008, 222-0200, the fax number is  223-9665, and the email address is firstname.lastname@example.org. Hours are 8:00 a.m. to 12:30 p.m., Monday through Friday. The Consular Section is closed on U.S. and local holidays. The U.S. Embassy is located at 5 Blvd. Harry Truman, Port-au-Prince; telephone  222-0200, 222-0354, 223-0955 or 222-0269; fax  223-1641. Website: http://portauprince.usembassy.gov
• Canadian Embassy
Delmas between Delmas 75 and 71
Tel:  249-9000
Fax:  249-9920
There is no British Embassy in Haiti. Travelers should contact the British Embassy in Dominican Republic.
• British Embassy
Ave 27 de Febrero No 233
Edificio Corominas Pepin
Tel:  472 7373
Fax:  472 7574
HIV Test: Not required.
Required Vaccinations: There is no risk of yellow fever in this country, however, there is a certificate of vaccination requirement if arriving from a yellow fever endemic zone country.
Passport/Visa: Haiti is one of the least developed and least stable countries in the Western Hemisphere. The availability of consumer goods and services is barely adequate in the capital, Port-au-Prince, but other parts of the country experience chronic shortages. Most consumer products are imported and expensive. Some tourism facilities in the large cities and resort areas are satisfactory, but many are rudimentary at best, and are difficult to find in most rural areas and small towns.
ENTRY/EXIT REQUIREMENTS: Haitian law requires U.S. citizens to have a passport to enter Haiti. In the past, officials have waived this requirement if travelers had a certified copy of their U.S. birth certificate. The U.S. Embassy strongly recommends that U.S. citizens obtain passports before travel to Haiti. Once in Haiti, an undocumented U.S. citizen can experience delays of several weeks for the issuance of a passport, as it is often more difficult to establish identity and citizenship overseas than in the United States.
U.S. Citizens traveling to and from Haiti must present a valid passport when entering or re-entering the United States. We strongly encourage all American citizen travelers to apply for a U.S. passport or passport card well in advance of anticipated travel. American citizens can visit travel.state.gov or call 1-877-4USA-PPT (1-877-487-2778) for information on how to apply for their passports.
The Haitian government requires foreigners to pay a departure fee. U.S. citizens are encouraged to contact the Embassy of the Republic of Haiti for more details regarding current entry, departure and customs requirements for Haiti. The Embassy of the Republic of Haiti is located at 2311 Massachusetts Avenue, NW, Washington, D.C. 20008; the telephone number is (202) 332-4090, and the Internet address is http://www.haiti.org/. There are Haitian consulates in Miami, and Orlando, Florida; Boston, Massachusetts; New York, N.Y., Chicago, Illinois and San Juan, Puerto Rico.
Vaccinations: Recommended and Routine
Hepatitis A: Recommended for all travelers >1 year of age not previously immunized against hepatitis A.
Hepatitis B: Recommended for all non-immune travelers at potential risk for acquiring this infection. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; when receiving medical or dental injections, or transfusions; by direct contact between open skin lesions. Recommended for any traveler requesting protection against hepatitis B infection.
Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.
Rabies: Recommended for travelers spending time outdoors in rural areas where there is an increased the risk of animal bites. Children are considered at higher risk because they tend to play with animals and may not report bites. Pre-exposure vaccination eliminates the need for rabies immune globulin in the event of a high-risk animal bite, but does not eliminate the need for treatment with the vaccine.
Routine Immunizations: Immunizations against tetanus-diphtheria, measles, mumps, rubella (MMR vaccine) and varicella (chickenpox) should be updated, if necessary, before departure. MMR protection is especially important for any female of childbearing age who may become pregnant.
• The new Tdap vaccine, ADACEL, which also boosts immunity against pertussis (whooping cough) should be considered when a tetanus-diphtheria booster is indicated.
Typhoid: Recommended for all travelers with the exception of short-term visitors who restrict their meals to major restaurants and hotels, such as business travelers and cruise passengers.
Yellow Fever: Yellow fever vaccination is required for all travelers arriving from any country in the yellow fever endemic zones, but is not recommended or required otherwise.
Hospitals / Doctors
Medical facilities in Haiti are scarce and for the most part sub-standard; outside the capital standards are even lower. Medical care in Port-au-Prince is limited, and the level of community sanitation is extremely low.
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit as well as antibiotics to treat travelers diarrhea or other infections; they should bring drugs for malaria prophylaxis, if needed according to their itinerary. Travelers who are taking regular medications should carry them properly labeled and in sufficient quantity to last for the duration of their trip; they should not expect to obtain prescription or over-the-counter drugs in local stores or pharmacies in this country.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage. Policies should cover: ground and air ambulance transport, including evacuation to home country; payment of hospital bills; 24-hour telephone assistance. Serious illness or injury may require medical evacuation to the United States.
• Michel Theard, MD
#31 Ave. Charles Sumner
General practice & cardiology.
• Hopital du Canape Vert
rue Canape Vert
Tel:  245-1052, 245-1053
Used by U.S. Embassy personnel. Some specialty services; no physician on duty in emergency department; care must be prearranged.
• Hopital Adventiste de DiQuini
Route de Diquini
Tel:  234-0521 or 234-2000
Run by the Seventh-Day Adventist Church
Private hospital; modern equipment; 24-hour emergency room physicians on duty; ambulance service.
Destination Health Info for Travelers
AIDS/HIV & Sexually-Transmitted Diseases (STD): The most important sexually transmitted diseases and infectious agents are AIDS, HIV, hepatitis B, syphilis, gonorrhea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts. Infection occurs during unprotected sexual intercourse. Hepatitis B, hepatitis C, HIV and syphilis may also be transmitted by contaminated blood, body fluids, and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing. Source: www.wordtravels.com
After sub-Saharan Africa, the Caribbean has a higher HIV prevalence than any other area of the world, with 1.6% of the adult population infected. Due largely to their close geographic locations, the Caribbean is usually grouped with Latin America in discussions about HIV and AIDS, but the epidemics in these regions are very different.
At one extreme, Haiti has the highest HIV prevalence in the entire western hemisphere (3.8%); at the other, Cuba has one of the lowest (0.1%). The Bahamas (3.3%), Trinidad and Tobago (2.6%) and Guyana (2.4%) are all heavily affected, while Puerto Rico is the only Caribbean country apart from Cuba where it is thought that less than 1% of the population is living with HIV. Both HIV prevalence and AIDS cases are thought to be widely underestimated in the region.
Haiti has seen a general decline in HIV prevalence since the mid-1990s, although this drop has been more pronounced in urban areas than rural ones (some of which have seen little change). HIV prevalence is still alarmingly high, though, and there are indications that condom use is decreasing and that young Haitians are becoming sexually active at an earlier age. Source: http://www.avert.org/aids-caribbean.htm
• Transmission of HIV can be prevented by avoiding: sexual contact with a high-risk partner; injecting drug use with shared needles; non-sterile medical injections; unscreened blood transfusions.
Note: There is a risk of exposure to unsafe blood and blood products in Haiti. Travelers may need to specifically request the use of sterilized equipment.
• The threat of HIV/AIDS should not be a primary concern for the traveler. However, there may be a concern for a subset of travelers who may be exposed to HIV, the virus that causes AIDS, through contact with the body fluids of another person or their blood. Although travel has contributed in a general way to the global spread of AIDS, fear of traveling because of this disease is not warranted.
Accidents & Medical Insurance: Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes.
• Heart attacks cause most fatalities in older travelers.
• Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.
• Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.
Cyclosporosis: Haiti is one of the countries that is known to be highly endemic for the parasite Cyclospora. Symptoms of cyclosporiosis include prolonged watery diarrhea, abdominal cramping, weight loss, anorexia, myalgia, and occasionally vomiting and/or fever. Symptoms generally begin approximately 1 week (5-8 days) after ingestion of the oocysts and these may persist for a month or more. Cyclospora is treatable with trimethoprim-sulfamethoxazole (Bactrim).
Read more: http://www.cdc.gov/ncidod/dpd/parasites/cyclospora/factsht_cyclospora.htm
Dengue Fever: There are episodically small outbreaks of dengue fever. There is year-round risk, especially in coastal urban areas, increasing April through September. Dengue fever is a mosquito-transmitted, flu-like viral illness widespread in the Caribbean and is the most common cause of fever in travelers returned from this region. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash.
• Dengue is transmitted via the bite of an infected Aedes aegypti mosquito. Aedes mosquitoes feed predominantly during daylight hours. All travelers are at risk and should take measures to prevent daytime mosquito bites.
• There is no vaccination or medication to prevent dengue.
Filariasis: Bancroftian filariasis occurs in coastal areas, primarily in the north and around the Gulf of La Gonave. Another focus is reported near Leogane. To prevent filariasis, travelers to risk areas should take protective measures against mosquito bites.
Hepatitis: ll travelers not previously immunized against hepatitis A should be vaccinated against this disease. Travelers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Travelers who will have access to safe food and water are at lower risk. Those at higher risk include travelers visiting friends and relatives, long-term travelers, and those visiting areas of poor sanitation.
• Hepatitis E may be endemic but levels are unclear. Sporadic cases may be underdiagnosed or underreported. Transmission of the hepatitis E virus (HEV) occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. Farm animals, such as swine, and also deer and wild boar, may serve as a viral reservoirs. (HEV is one of the few viruses which has been shown to be transmitted directly from animals through food.) In developing countries, prevention of hepatitis E relies primarily on the provision of clean water supplies and overall improved sanitation and hygiene. There is no vaccine.
• Hepatitis B is moderately erendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 2% to 7%. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from non-sterile medical or dental injections, and acupuncture; from unscreened blood transfusions; by direct contact with open skin lesions of an infected person. The average traveler is at low risk for acquiring this infection. Vaccination against hepatitis B is recommended for: persons having casual/unprotected sex with new partners; sexual tourists; injecting drug users; long-term visitors; expatriates, and anybody wanting increased protection against the hepatitis B virus.
• Hepatitis C is endemic at a moderate level with a prevalence of 2.0% in the general population. Most hepatitis C virus (HCV) is spread either through intravenous drug use or, in lesser-developed countries, through blood contamination during medical procedures. Over 200 million people around the world are infected with hepatitis C - an overall incidence of around 3.3% of the population of the world. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.
Influenza: Influenza is transmitted year-round in the tropics. The flu vaccine is recommended for all travelers over age 6 months.
Malaria: Malaria is a major public health problem in Haiti. Peak transmission occurs from November through January, with a secondary peak from April through June. There is increased risk of malaria in the northern coastal areas. Malaria precautions are essential in forest areas of Chantal, Gros Morne, Hinche and Jacmel Maissade, year-round. The risk in other areas is lower. Falciparum malaria accounts for 99% to 100% of cases.
Chloroquine-resistant falciparum malaria has not been reported, although one published study found that 6.3% of P. falciparum isolates collected in the Artibonite Valley in 2006 and 2007 carried a mutation associated with parasite resistance to chloroquine. Chloroquine prophylaxis failure has not been documented in travelers and prophylaxis with weekly chloroquine is currently still recommended.
A malaria map is located on the Fit for Travel website (www.fitfortravel.nhs.uk), which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go to www.fitfortravel.nhs.uk and select Malaria Map from the Haiti page on the Destinations menu or A-Z Index.
Malaria is transmitted via the bite of an infected female Anopheles mosquito. Anopheles mosquitoes feed predominantly during the hours from dusk to dawn. All travelers should take measures to prevent evening and nighttime mosquito bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, applying permethrin spray or solution to clothing and gear, and sleeping under a permethrin-treated bednet. DEET-based repellents have been the gold standard of protection under circumstances in which it is crucial to be protected against insect bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
NOTE: Picardin repellents (20% formulation, such as Sawyer GoReady or Natrapel 8-hour) are now recommended by the CDC and the World Health Organization as acceptable non-DEET alternatives to protect against malaria-transmitting mosquito bites. Picaridin is also effective and ticks and biting flies.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.
• Long-term travelers who may not have access to medical care within 24 hours and who are not on prophylaxis should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches. Self-treatment medications include Coartem (artemether plus lumefantrine) and Malarone (atovaquone plus proguanil).
Marine Hazards: Swimming related hazards include jellyfish, spiny sea urchins, and sharp coral.
• Ciguatera poisoning occurs and can result from eating coral reef fish such as grouper, snapper, sea bass, jack, and barracuda. The ciguatoxin is not destroyed by cooking.
• Scuba Diving-Hyperbaric Chamber Referral: Divers' Alert Network (DAN) maintains an up-to-date list of all functioning hyperbaric chambers in North America and the Caribbean. DAN does not publish this list, since at any one time a given chamber may be non-functioning, or its operator(s) may be away or otherwise unavailable. Through Duke University, DAN operates a 24-hour emergency phone line for anyone (members and non-members) to call and ask for diving accident assistance. Dive medicine physicians at Duke University Medical Center carry beepers, so someone is always on call to answer questions and, if necessary, make referral to the closest functioning hyperbaric chamber. In a diving emergency, or for the location of the nearest decompression chamber, call 919-684-8111.
Other Diseases/Hazards: Brucellosis (from consumption of raw dairy products or occupational exposure)
• Helminthic infections
• Relapsing fever (louse-borne)
Rabies: An increase of animal and human rabies cases has been reported over the last several years in Haiti. Although there have been efforts to control wandering animals and vaccinate domestic cats and dogs, Haiti accounts for the majority of human rabies cases reported in 2007 in America (out of 22 cases declared, 14 occurred in Haiti).
• All animal bites, licks, or scratches, especially from a dog, should be taken seriously, and immediate medical attention sought. Rabies vaccination may be required. Although rabies is rare among tourists - there is risk. No one should pet or pick up any stray animals. All children should be warned to avoid contact with unknown animals. Pre-exposure rabies vaccine is recommended for: travel longer than 3 months; for shorter stays for travelers who plan to venture off the usual tourist routes; where they may be more exposed to the stray dog population.
Travelers' Diarrhea: Sanitary conditions in Haiti are the poorest in the Western Hemisphere. Outside of hotels and resorts, we recommend that you boil, filter or purify all drinking water or drink only bottled water or other bottled beverages and do not use ice cubes. Avoid unpasteurized milk and dairy products. Do not eat raw or undercooked food.
Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• A quinolone antibiotic, azithromycin, or rifaximin (Xifaxin), combined with loperamide (Imodium), is recommended for the treatment of diarrhea. Diarrhea not responding to antibiotic treatment may be due to a parasitic disease such as giardiasis, amebiasis, or cryptosporidiosis.
• Seek qualified medical care if you have bloody diarrhea and fever, severe abdominal pain, uncontrolled vomiting, or dehydration.
Tuberculosis: Tuberculosis is highly endemic in Haiti with an annual occurrence was greater than or equal to 40 cases per 100,000 population. Tuberculosis (TB) is transmitted following inhalation of infectious respiratory droplets. Most travelers are at low risk. Travelers at higher risk include those who are visiting friends and relatives (particularly young children), long-term travelers, and those who have close contact, prolonged contact with the local population. There is no prophylactic drug to prevent TB. Travelers with significant exposure should have PPD skin testing done to evaluate their risk of infection.
Typhoid Fever: In 2003, the WHO Regional Office for the Americas reported 200 cases of typhoid and 40 deaths affecting remote villages in the Grand Bois Area, bordering the Dominican Republic.
Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people (with the exception of short-term visitors who restrict their meals to hotels or resorts) traveling to or working in Haiti, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water. Current vaccines against Salmonella typhi are only 50-80% protective and do not protect against Salmonella paratyphi, the cause of paratyphoid fever. (Paratyphoid fever bears similarities with typhoid fever, but the course is generally more benign.) Travelers should continue to practice strict food, water and personal hygiene precautions, even if vaccinated.
Yellow Fever: This disease is not active in this country, but a yellow fever vaccination certificate is required for all travelers arriving from a yellow fever endemic zone country in Africa or the Americas. Vaccination is not recommended or required otherwise.