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Namibia



Capital: Windhoek

Time Zone: +1 hours. No daylight savings time at this time.
Tel. Country Code: 264
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plugs D, F, H.


Travel Advisory - Namibia

Sub-Saharan Africa has the highest incidence of insect-transmitted diseases, such as malaria, and all travelers need products to prevent mosquito and tick bites. 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 Namibia


Resource Links

NaTHNaC
World Health Organization
CDC
Travel Health Services
Country Insights
Travel Warnings
Consular Information
Foreign Commonweatlh Office

Embassies

• U.S. Embassy
14 Lossen Street
Ausspannplatz
Windhoek
Tel: [264] (61) 22-1061
Consular Section:
Tel: [64] [61] 295-8551 ext. 8551
E-mail consularwindho@state.gov.
Website: http://windhoek.usembassy.gov/.

• Canadian Embassy
8th Floor
Metje-Behnsen Building
Independence Avenue
Windhoek
Tel: [264] (61) 227-417

• British High Commission
116 Robert Mugabe Avenue
Windhoek
Tel: [264] (61) 274800
Email: general.windhoek@fco.gov.uk
Website: www.britishhighcommission.gov.uk/namibia

Entry Requirements

HIV Test: Not required.

Required Vaccinations: Travelers >1 year of age entering the country from an endemic area are required to present a certificate of immunization against yellow fever. Required also for travelers on unscheduled flights who have transited an infected area. Children <1 year of age may be subject to surveillance.

Passport Information

Passport/Visa: Namibia is a southern African country with a moderately developed economy. Facilities for tourism are good and generally increasing in quality. The capital is Windhoek. Read the Department of State Background Notes on Namibia for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are normally required. Bearers of U.S. passports who plan to visit Namibia for tourism for less than 90 days can obtain visas at the port of entry and do not need visas prior to entering the country. Travelers coming for work or study, whether paid or voluntary, must obtain a work or study permit prior to entering Namibia. 

All travelers traveling to or from Namibia via South Africa are strongly encouraged to have several unstamped visa pages left in their passports. South Africa requires two unstamped visa pages, and Namibia usually also requires an unstamped page to stamp a visa upon arrival. Visitors who do not have enough free visa pages in their passport risk being denied entry and returned to the U.S. at their own expense. 

Travelers should obtain the latest information from the Embassy of Namibia located at 1605 New Hampshire Avenue, NW, Washington, D.C. 20009, telephone (202) 986-0540 or from the Permanent Mission of Namibia to the U.N. at 135 E. 36th St., New York, NY 10016, telephone (212) 685-2003, fax (212) 685-1561. Overseas, inquiries should be made to the nearest Namibian embassy. See our Foreign Entry Requirements brochure for more information on Namibia and other countries. Visit the Embassy of Namibia's website at http://www.namibianembassyusa.org/ for the most current visa information.

Vaccinations: Recommended and Routine

Cholera: Cholera vaccine (not available in the U.S.) is recommended primarily for people at high risk (e.g., relief workers in refugee camps, certain healthcare personnel) who work and live in highly endemic areas under less than adequate sanitary conditions. Not recommended otherwise.

Hepatitis A: Recommended for all travelers >1 year of age not previously immunized against hepatitis A.

Hepatitis B: Recommended for all travelers who might be exposed to blood or bodily fluids from unprotected sex with a high-risk partner; from injecting drug use with shared/re-used needles and syringes; from medical treatment with non-sterile (re-used) needles and syringes; from contact with open skin sores; for long-term travelers and and expatriates. Recommended for any traveler requesting protection against hepatitis B virus.

Influenza: Vaccination recommended for all travelers >6 months of age who have not received a flu shot in the previous 12 months.

Meningococcal (Meningitis): Recommended for all travelers who will have close contact with the local population.

Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).

Rabies: Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection.

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.

Yellow Fever: Travelers entering the country from an endemic area are required to present a certificate of immunization against yellow fever.

Hospitals / Doctors

Good medical care is available in Windhoek and the larger towns, but is highly variable elsewhere. You may be expected to pay for treatment, even if you are insured. Evacuation from remote areas can take time.
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 - the equivalent drugs may not be available or may be of unreliable quality.
• 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. In the event of serious illness or injury requiring specialty care not available in this country, you will need aeromedical evacution to a facility in South Africa.
• Travelers should contact the U.S. Embassies for physican referals or go to the Embassy website at:
http://windhoek.usembassy.gov/doctors_and_lawyers.html

• Windhoek Medi-Clinic
Heliodoor and Eros Streets
Eros Park
Windhoek
Tel: [264] (61) 22 2687
(24-hour emergency)
Website: http://www.windhoekmc.co.za/
Windhoek Medi-Clinic is one of the hospitals in the Medi-Clinic group of private hospitals. Medi-Clinic is one of the largest private hospitals groups in Africa and currently owns over 40 private hospitals throughout South Africa and Namibia.

• Central Hospital
Ooievaar Street
Windhoek
Tel: [264] (61) 203-9111
General medical/surgical facility; maternity.

• Travel Doctor Group (TVMC)
403 Maerua Park
Windhoek
Tel: [264] (61) 24-6000, 24-5729)
Website: http://www.tmvc.com.au/

Destination Health Info for Travelers

AIDS/HIV: Both HIV prevalence rates and the numbers of people dying from AIDS vary greatly between African countries. In Somalia and Senegal the HIV prevalence is under 1% of the adult population, whereas in South Africa and Zambia around 15-20% of adults are infected with HIV. In four southern African countries, the national adult HIV prevalence rate now exceeds 20%. These countries are Botswana (24.1%), Lesotho (23.2%), Swaziland (33.4%) and Zimbabwe (20.1%). AIDS has less affected West Africa. HIV prevalence there is estimated to exceed 5% in Cameroon (5.4%), Côte d’Ivoire (7.1%) and Gabon (7.9%)
. Some states in Nigeria are already experiencing HIV infection rates as high as those now found in Cameroon. Adult HIV prevalence in East Africa exceeds 6% in Uganda, Kenya and Tanzania.
• Namibia ranks close to the top with an adult HIV prevalence rate of 19.6 percent.
Most experts agree that the vast majority of HIV infections in Africa are the result of unsafe sex, not unsafe injections. The World Health Organization (WHO) estimates that unsafe injection practices (excluding unsafe blood transfusions) account for about 2.5% of HIV infections in sub-Saharan Africa, concluding that unsafe sex is by far the predominant mode of transmission in sub-Saharan Africa. (Source: www.Avert.org)
• 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.
• 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 another person’s body fluids or 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.
• MEDICAL INSURANCE: 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.

African Sleeping Sickness (Trypanosomiasis): Sporadic cases have been reported. Travelers at most risk are those on safari and game-viewing holiday. Travelers to urban areas are at very low risk. The tsetse fly comes out in the early morning and the late afternoon. Insect repellent applied to the skin does not prevent tsetse fly bites, so travelers should wear protective clothing and sleep under a bed net.
• Initial symptoms: The bite of tsetse fly can be painful and may develop into a raised red sore, called a chancre. The initial sore may subside or develop into an expanding red, tender, swollen area, followed by a generalized illness with fever, myalgia, abdominal discomfort, diarrhea, vomiting, headache, rigors, and sweats.
Read more: hthttp://www.phac-aspc.gc.ca/tmp-pmv/info/af_trypan-eng.php

Animal Hazards: Animal hazards include snakes (mambas, adders, vipers, cobras, coral snakes), scorpions, sac spiders, brown widow and black widow spiders.

Cholera: As of May 2008, over 1,400 suspected cases of cholera including 19 deaths were reported in the Ohangwena Region. Although this disease is active in this country, the threat to tourists is considered low and cholera vaccine is recommended only for relief workers or health care personnel who are working in a high-risk endemic area under less than adequate sanitary conditions, or travelers who work or live in remote, endemic or epidemic areas and who do not have ready access to medical care. Canada, Australia, and countries in the European Union license an oral cholera vaccine. The cholera vaccine is not available in the United States.
• The main symptom of more severe cholera is copious watery diarrhea.
• Antibiotic therapy is a useful adjunct to fluid replacement in the treatment of cholera by substantially reducing the duration and volume of diarrhea and thereby lessening fluid requirements and shortening the duration of hospitalization.
• A single 1-gm oral dose of azithromycin is effective treatment for severe cholera in adults. This drug is also effective for treating cholera in children. (NEJM:http://content.nejm.org/cgi/content/short/354/23/2452)

Dengue Fever: The mosquitoes that transmit dengue fever are found in this country, but the incidence of infection is unclear. The disease is reported active next door in Angola. Dengue fever is a mosquito-transmitted, flu-like viral illness that occurs in Africa and many other countries. Symptoms consist of sudden onset of fever, headache, muscle aches, and a rash. A syndrome of hemorrhagic shock can occur in severe cases.
• 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. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin and applying permethrin spray or solution to clothing and gear.
• There is no vaccination or medication to prevent or treat dengue.

Hepatitis: All 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 is endemic with about 10% of the general population sero-positive for the hepatitis E virus (HEV). Sporadic cases and outbreaks occur. Transmission of HEV occurs primarily through drinking water contaminated by sewage and also through raw or uncooked shellfish. 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 hyperendemic. The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at >8%. 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 low levels, with a prevalence of 0.9% in the healthy 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.

Leishmaniasis: Sporadic cases of cutaneous leishmaniasis have been reported, primarily from the southern Keetmanshoop-Karasburg-Bethanie vicinity, and also from the central and more northern areas of the inland plateau and escarpment. Visceral leishmaniasis is not reported. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sand fly. Sandflies bite in the evening and at night. Sandflies are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• All travelers should take measures to prevent sandfly bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, permethrin (spray or solution) to clothing and gear, and sleeping under a permethrin-treated bednet.

Malaria: Malaria is endemic in northern Namibia, and presents a serious health risk during the main rainy season (January • April), and just afterwards. Endemic areas include the northcentral and northeastern rural regions along the borders with Angola, Zambia, and Botswana, including the Ovamboland, which borders Angola, and the Caprivi strip. Malaria risk has recently extended somewhat into the central plateau and eastern semi-arid areas, but not the coastal desert. Chloroquine-resistant falciparum malaria is widespread.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine is recommended.

A malaria map is located on the Fit for Travel website, 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 Namibia page on the Destinations menu.

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: Picaridin repellents (20% formulation, such as Sawyer Picaridin 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 should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours.

Meningitis (Meningococcal): In September 2007 the Namibian Ministry for Health confirmed meningitis outbreaks in Onamakulikwa, Ohambala, Onkumbula, Ohashipepe and Omakunde villages in Oshikoto Region.
Quadrivalent conjugate meningitis vaccine is recommended for those travelers anticipating living or working closely with local people. The risk is greatest in the dry season, from November to May/June. Vaccination is recomended for all travelers venturing into epidemic regions at any time of year.
• Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at: http://wwwn.cdc.gov/travel/yellowBookCh4-Menin.aspx#651

Other Diseases/Hazards: African tick typhus
• African tick-bite fever
• Brucellosis (low incidence)
• Dengue (incidence unclear)
• Tick-borne relapsing fever
• Rift Valley fever

Plague: Flea-borne; at least 80 cases were reported in late 1990, most from northern areas, particularly the Oshakati/Onandjokwe vicinity of Owambo District.

Poliomyelitis: There was an outbreak of polio in Namibia in July 2006 and the Namibian authorities co-ordinated a mass vaccination campaign. All travelers should be fully immunized. A one-time dose of IPV (Inactivated Polio Vaccine) is recommended for any traveler >age 18 who completed the primary childhood series but never received an additional dose of polio vaccine as an adult.

Rabies: Urban rabies, with dogs the primary source of human infection, occurs mainly in northern areas. Jackals may also be a source of rabies. Travelers should avoid stray dogs and wild animals and seek immediate treatment of any animal bite. Pre-exposure rabies vaccine is recommended for travel longer than 3 months, for shorter stays in rural when travelers plan to venture off the usual tourist routes and where they may be more exposed to the stray dog population; when travelers desire extra protection; or when they will not be able to get immediate medical care.
• All animal bite wounds, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure treatment, regardless of your vaccination status. Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Even if rabies vaccine was administered before travel, you will need a 2-dose booster series of vaccine after the bite of a rabid animal.

Schistosomiasis: Risk is present in the northeast along the Angolan border, extending into the Caprivi Strip.
• Schistosomiasis is transmitted through exposure to contaminated water while wading, swimming, and bathing. Schistosoma larvae, released from infected freshwater snails, penetrate intact skin to establish infection. All travelers should avoid swimming, wading, or bathing in freshwater lakes, ponds, streams, cisterns, aqueducts, or irrigated areas. There is no risk in chlorinated swimming pools or in seawater.

Travelers' Diarrhea: Water- and food-borne diseases are prevalent with sporadic outbreaks of diarrheal diseases occurring, especially during the rainy season. The water in major urban areas is treated, and in Swakopund, Walvis Bay, and Windhoek, the major hotels and restaurants serve generally safe food and drink. Outside of these areas, all water sources should be considered potentially contaminated. Some surface water in shallow lakes contains dangerously high concentrations of minerals and nitrites and is unsafe for consumption.
• 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 and undercooked food (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
• A quinolone antibiotic, or azithromycin, 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 medical advice if you have severe or bloody diarrhea, diarrhea associated with fever and abdominal pain, or dehydration.

Tuberculosis: Tuberculosis a major health problem in this country. Tuberculosis is highly endemic in Namibia 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: 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) traveling to or working in Namibia, 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.