Menu
Cart 0

Tajikistan



Capital: Dushanbe

Time Zone: +5 hours. No daylight saving time in 2008.
Tel. Country Code: 992
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plug. Grounding Adaptor Plug D.


Travel Advisory - Tajikistan

Europe, Russia and former the Soviet Union countries vary widely in travel risks and adequacy of health care delivery. Water- and food-borne illnesses such as travelers' diarrhea, typhoid and Giardia are threats outside of Western Europe. Insect-transmitted diseases, such as Lyme disease and tick-borne encephalitis are common in wooded, rural areas in most countries, including Western Europe.

Dr. Rose Recommends for Travel to Tajikistan


Resource Links

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

Embassies

• U.S. Embassy
109A Ismoili Somoni Avenue
Dushanbe
Main Phone: [992] 37-229-2000,
Consular Direct Line: [992] 37-229-23-00
Website: http://dushanbe.usembassy.gov

Diplomatic and consular services for Tajikistan are handled by the Canadian Embassy in Kazakhstan.
• Embassy of Canada
34 Karasai batyr Street
Almaty, Kazakhstan
Tel: [7] (3272) 501-151
Fax: [7] (3272) 582-493
E-Mail: almat@international.gc.ca
Website: http://www.international.gc.ca/canadaeuropa/kazakhstan

• British Embassy
65 Mirzo Tursunzade Street
Dushanbe
Tel: [992] (37)2 24 22 21
Email: dushanbe.reception@fco.gov.uk
Website: www.britishembassy.gov.uk/tajikistan

Entry Requirements

ENTRY/EXIT REQUIREMENTS: A passport and visa are required to enter Tajikistan, as well as for registration at hotels. Failure to produce a valid visa will require the traveler to leave the country immediately. Travelers planning to arrive in Tajikistan from countries that have Tajik embassies or consulates must obtain Tajik visas abroad prior to their travel. Tajikistan is represented by embassies and consulates in the following countries: United States of America, Austria, Germany, Belgium, Turkey, China, Afghanistan (Kabul, Mazori Sharif), Iran, Pakistan, India, Russian Federation, Belarus, Kazakhstan, Kyrgyzstan, Uzbekistan, and United Arab Emirates (Dubai). Travelers arriving in Tajikistan from countries in which there are no Tajik embassies or consulates must have Tajik visa support, a letter confirming that a visa may be issued, from the Tajik Ministry of Foreign Affairs (MFA) in order to receive a Tajik visa at the Dushanbe International Airport upon arrival. Travelers need to have two passport-size photos and a passport valid for at least six month longer than the duration of the planned stay in Tajikistan. Visas issued at the Dushanbe airport are normally valid for only 45 days. This “upon arrival” visa service does not apply to any other Tajik airports or land borders.

Travelers staying in Tajikistan three days or longer must, within three days of arrival in Tajikistan, obtain registration stamps at the Ministry of Foreign Affairs (MFA) or the Ministry of Internal Affairs (OVIR), depending on whether the purpose of the visit to Tajikistan is for official or personal travel. Immigration authorities may deny the departure of travelers who failed to register their visas until they pay a fine and obtain the registration stamps at the Ministry of Foreign Affairs or OVIR.

Travelers who would like their visas extended need to apply for extension in advance through the Ministry of Foreign Affairs (official travelers) or OVIR (tourist or commercial travelers).

Furthermore, entry into the Gorno-Badakhshan region, both from inside and outside of Tajikistan, requires special authorization in advance in addition to a valid Tajik visa. Tajik authorities advise that sponsoring organizations in Tajikistan submit requests for travel authorization for the Gorno-Badakhshan Autonomous Region to the Ministry of Foreign Affairs or the Department of Visas and Registration (OVIR) at least two weeks in advance of the planned travel. The Tajik MFA or OVIR will list the names of settlements and cities in Gorno-Badakhshan, which the traveler plans on visiting, in the travel authorization stamp and stamp it. The Gorno-Badakhshan travel authorization is not written on a Tajik visa sticker. It is a separate note put in a passport.

The government of Tajikistan requires visitors who remain in country for more than 90 days to present a medical certificate showing that they are HIV-free, or to submit to an HIV test in Tajikistan. HIV is a growing health threat in Tajikistan.

Visit the Embassy of Tajikistan website at: http://www.tjus.org for the most current visa information.


HIV Test: The government of Tajikistan requires visitors who remain in country for more than 90 days to present a medical certificate showing that they are HIV-free, or to submit to an HIV test in Tajikistan.

Required Vaccinations: None required.

Passport Information

Tajikistan remains the poorest of the former Soviet republics in Central Asia. It is a nominally constitutional, democratic, and secular republic, dominated by President Emomali Rahmon who has been in power since 1992. Tourist facilities are undeveloped and many goods and services usually available in other countries are unavailable.

Vaccinations: Recommended and Routine

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

Hepatitis B: Vaccination against hepatitis B should be considered for all travelers at potential risk for acquiring this infection. Infected blood or bodily fluids transmit Hepatitis B. Travelers may be exposed by needle sharing; by unprotected sex a high-risk partner; when receiving medical or dental injections with re-used/non-sterile equipment; by unscreened blood transfusions; by direct contact between open skin sores. Vaccination is 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.

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: Recommended for travelers spending time in remote locations, or outdoors in rural areas where there is an increased the risk of animal 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 additional treatment with rabies 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: Typhoid vaccine is recommended for all travelers except short-term visitors taking meals exclusively in first-class hotels and restaurants.

Hospitals / Doctors

AIDS/HIV: The results of the a survey conducted by the Ministry of Health in 2005 – 2006 in two cities showed a high level of HIV infection among drug users, sex workers, prisoners and migrant populations of Tajikistan. The survey also indicates that HIV is spreading rapidly among the general population, as a spillover from those already infected. Results of the survey showed 20% and 5% HIV prevalence among IDUs and commercial sex workers, respectively, an indication that injecting drug use remains the main mode of transmission. In Tajikistan, The HIV prevalence rate in the adult aged 15 to 49 is estimated 1.7%.
• 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.
• 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.

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.

Acute Mountain Sickness/HACE/HAPE: The three highest mountains in Tajikistan are Ismoil Somoni Peak (7495 m), formerly known as Communism Peak; Independence Peak (7,165 m); and Pik Korzhenevskoi (7,105 m). Ismoil Somoni Peak is the highest peak in the Pamirs, and the highest in the former Soviet Union. It is situated on the junction of the Academia Nauk and Pyotr Pyervy ridges and so remote that it took explorers twenty years to find a way to it. Communism Peak is a huge craggy mountain, heavily glaciated despite its rising above a dry, barren region. The rock is poor and the approach is difficult, but because it is the highest of all peaks in the region, climbers have been active on the mountain for decades, and a variety of routes exist to the summit.
Acute mountain sickness (AMS), also known as altitude illness, is a common malady above 2,400 m (8,000 ft), especially if you have not had a chance to acclimatize by ascending gradually. The prevalence of AMS varies between 15% and 75%, depending on your speed of ascent, altitude gained, sleeping altitude, and individual susceptibility. Acute mountain sickness can progress to high altitude cerebral edema (HACE) or be associated with high altitude pulmonary edema (HAPE). You should intersperse your ascent with rest days and avoid, if possible, increasing your sleeping altitude by more than 1,000 - 1,500 feet each night. To reduce further your risk of AMS, take acetazolamide (Diamox), starting the day prior to beginning your ascent. Acetazolamide is a respiratory stimulant that speeds acclimatization and is about 75% effective. It may also reduce the risk of HAPE.
• Symptoms of AMS include mild to moderate headache, loss of appetite, nausea, fatigue, dizziness and insomnia. Mild AMS usually resolves with rest plus medication for headache and nausea. You can also take acetazolamide to treat mild AMS.
• Under no circumstances should you continue to ascend (especially to a higher sleeping altitude) if you have any persistent symptoms of altitude illness. In the absence of improvement or with progression of symptoms you should descend (at least 500 m) to a lower altitude.
• Dexamethasone (Decadron) is a steroid drug used for treating AMS and HACE. You should carry stand-by treatment doses. You can take dexamethasone together with acetazolamide to treat mild- to moderate-AMS.
• More severe AMS (increasing headache, vomiting, increasing fatigue or lethargy) may indicate the incipient onset of high-altitude cerebral edema (HACE)—recognized by confusion, difficulty with balance and coordination, staggering gait. Start treatment with dexamethasone and descend immediately.
• Increasing dry cough and breathlessness at rest may indicate high altitude pulmonary edema (HAPE). Nifedipine, sildenafil (Viagra), or tadalafil (Cialis) can be used for both the prevention and treatment of HAPE. Dexamethasone and the asthma drug salmeterol (Serevent) also will prevent HAPE.
• Descent, combined with medication (and oxygen, if available) is the best treatment for more severe AMS, HACE or HAPE. Consider helicopter evacuation if the situation is urgent.

Caution: Prior to departing for a high-altitude trip, consult with a physician about the use of medications for preventing/treating altitude illness.
Further advice:
http://www.ismmed.org
http://www.altitudemedicine.org
http://www.basecampmd.com/expguide/highalt.shtml
http://wwwn.cdc.gov/travel/yellowBookCh6-AltitudeIllness.aspx
• High-Altitude Illness (NEJM) http://content.nejm.org/cgi/content/extract/345/2/107
Pamir Mountains: http://en.wikipedia.org/wiki/Pamir_Mountains

Arboviral Diseases: Tahjna virus fever (mosquito-borne; virus circulates through much of the former USSR), sandfly fever (sandfly-borne; limited to regions of southern central Asia, April–October), dengue fever (mosquito-borne; no recent cases reported), West Nile fever (mosquito-borne; cases have occurred in the Tadzikstan), North Asian tick fever (occurs
wherever tick vectors are found).

Avian Influenza (Bird Flu): There have been no reported cases of avian influenza (bird flu) in Tajikistan during the current series of outbreaks. But the World Health Organisation (WHO) has confirmed cases elsewhere in the region.

Cholera: An outbreak of acute watery diarrhea in 2005 in south and west Tajikistan was suspected to be due to cholera. Cases of cholera may be underdiagnosed or underreported. Tourists are at very low risk for this disease. 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)

Crimean-Congo Hemorrhagic Fever: Also known as Central Asian hemorrhagic fever. Crimean Congo hemorrhagic fever (CCHF) is endemic in this country. Risk areas are rural steppe, savannah, semi-desert, and foothill/low mountain habitats below 2,000 meters elevation.
• CCHF is caused by a virus and is transmitted by tick bite or by exposure to blood or secretions from infected animals or humans. Anyone who has visited this country and is suffering from a fever, headache, chills, muscle aches, vomiting, red rash (which does not fade when pressed under glass), bleeding on the roof of the mouth, or any other unexplained symptoms should seek medical advice immediately. Risk is seasonal, associated with periods of high tick activity (usually March through September, but seasonal patterns may occur) and increases in tick and rodent host populations.

Hepatitis: All travelers not previously immunized against hepatitis A should be vaccinated against this disease. Hepatitis A is transmitted through 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 widely endemic in Central Asia and is a frequent cause of sporadic cases as well as acute outbreaks. 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.
• The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at 8% to 10%. 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 but prevalence in the general population is unclear. There is a high level of hepatitis C in injecting drug users (IDU) in this country. 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 world’s population. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.

Leishmaniasis: Cutaneous and visceral leishmaniasis are present in this country, but the distribution is not well defined. The parasites that causes leishmaniasis are transmitted by the bite of female phlebotomine sand fly. Sand flies bite in the evening and at night. Contrary to what their name suggests, sand flies are not found on beaches. They are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• All travelers should take measures to prevent sand fly 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.
The parasites that causes leishmaniasis are transmitted by the bite of female phlebotomine sand fly. Sand flies bite in the evening and at night. Contrary to what their name suggests, sand flies are not found on beaches. They are usually found in forests, the cracks of stone or mud walls, or animal burrows.
• All travelers should take measures to prevent sand fly 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.

Lyme Disease: Lyme disease occurs focally in rural forested areas below 1,500 meters elevation. All travelers who engage in hiking, camping, or similar outdoor activities in rural wooded regions of endemic areas should take measures to prevent tick bites. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A single 200-mg dose of doxycycline is effective in preventing Lyme disease if taken within 72 hours of being bitten by an infected tick. (Reference: http://content.nejm.org/cgi/content/abstract/345/2/79).

Malaria: There is a risk of malaria in Tajikistan from June to October, particularly in the southern border areas below 2,500 m (<8,200 ft) elevation particularly along the southern border in Khatlon Oblast; central (Dushanbe), western (Gorno- Badakhshan), and northern (Leninabad) areas. If you will be visiting a malaria risk area in Tajikistan, you will need to take one of the following antimalarial drugs: atovaquone/proguanil (Malarone), doxycycline, mefloquine (Lariam) or primaquine (Requires G6PD testing). Chloroquine-resistant malaria is prevalent. Chloroquine should not be taken to prevent malaria in this country.

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 Tajikistan page on the Destinations menu or A-Z Index.

• Malaria is transmitted via the bite of an infected 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 remain the gold standard of protection under circumstances in which it is crucial to be protected against mosquito bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
• You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.

Other Diseases/Hazards: Brucellosis (quired by ingestion of unpasteurized dairy products or, less commonly, ingestion of poorly cooked meat from infected animals, by direct or indirect exposure to the organism through mucous membranes or broken skin, or by inhalation of infectious material)
• Echinococcosis (dog feces are infective)
• Legionellosis
• Leptospirosis
• Rickettsialpox
• Tick-borne relapsing fever (reported from Kirghizstan, Turkmenistan, and Uzbekistan)
• Trichinosis
• Tularemia
• Strongyloidiasis and soil-transmitted and helminthic infections (roundworm, hookworm, and whipworm infections and )

Poliomyelitis (Polio): An outbreak of polio is currently ongoing in the Republic of Tajikistan. This outbreak represents the first importation of polio in the World Health Organization (WHO) European Region since it was certified polio-free in 2002.
As of May 21, 2010, the Tajikistan Ministry of Health has reported 432 cases of acute flaccid paralysis, the most common sign of polio. Of these cases, 129 have been confirmed as polio. Of the confirmed polio cases, 107 are in children 5 years old or younger. A total of 12 deaths have been reported.
Risk areas: Cases have been reported in the following 20 central and southwestern districts: Beshkent, Bokhtar, Djilikul, Dushanbe City, Faizabad, Gazimal, Gissar, Kabadien, Khodjamaston, Khovaling, Kofarnokhon, Kolkhozobad, Leninsk-Rudaky, Pandj, Sarband, Shajrinau, Shartuz, Tursunzade, Vakhsh, Varzob.

• Because polio is active in this country, 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: Rabies is endemic in this country. 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.

Tick-Borne Encephalitis (TBE): Peak transmission period is April through June. Risk is present primarily in rural brushy and forested areas below 1,500 meters elevation. TBE is usually known as “Central European tick-borne encephalitis” or “Russian spring-summer encephalitis” west of the Urals. Vaccination against TBE should be considered by those camping near forests or hiking and camping in rural endemic areas for extended periods, and for forest workers. The standard vaccination schedule consists of 3 doses given at 0, 1-3 months, and at 9-12 months. An 2-dose accelerated schedule is possible (0, 21 days), with 85% protection resulting. The European vaccine (FSME-IMMUN-Baxter) is available in health clinics in Germany, Austria, Slovakia, Czech Republic and Poland, as well as Canada, but the traveler would have to initiate the vaccine after arriving in the area and hiking/camping delayed for 3 weeks before adequate protection to kick in. This makes administration of vaccine generally impractical for the average traveler. Tick-bite protection is therefore essential.
• Travelers, especially those engaging in outdoor activities in rural areas, are advised to take measures to prevent tick bites during the peak transmission season, March to November. Tick-bite prevention measures include applying a DEET-containing repellent to exposed skin and permethrin spray or solution to clothing and gear.
• A map showing the distribution of TBE is here: http://www.nathnac.org/includes/contents/documents/TBEmap.gif
More information on TBE at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/TBE.htm




Travelers' Diarrhea: All water supplies are suspect, including municipal tap water, which may be untreated and grossly contaminated.
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 dairy products. Do not eat raw or undercooked food, especially meat and fish. Peel all fruits.
• Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
• 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 qualified medical care if you have bloody diarrhea and fever, severe abdominal pain, uncontrolled vomiting, or dehydration.

Tuberculosis (TB): Tuberculosis is a significant public health problem in Tajikistan. Tuberculosis is highly endemic in 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: Major epidemics of typhoid fever occurred in Tajikistan in the 1990s. including the city of Dushanbe. Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all people traveling to or working in Oceania, 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.

Destination Health Info for Travelers

The quality of Tajikistan’s medical infrastructure is significantly below Western standards, with severe shortages of basic medical supplies, including disposable needles, anesthetics, and antibiotics.
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; may be of dubious origin; may be counterfeit, or of unreliable quality.
• Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance medevac. In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange immediate aeromedical evacuation to Western Europe.

A list of doctors maintained by the U.S. Embassy is here: http://dushanbe.usembassy.gov/local_doctors.html

• Center of Family Medicine
City Policlinic #8, 13/1 Firdavsi St.
Dushanbe
Tel: [992] 31-87-21, 31-42-73

• Prospekt Medical Clinic
33, Sanoi St.
Dushanbe
Tel: [992] 37 224-30-62, 224-30-92
E-mail: prospekt-clinic@tajnet.com
Website: www.prospektclinic.com