Yemen (Republic of Yemen)
Time Zone: +3 hours.
Tel. Country Code: 967
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). United Kingdom Style Adaptor Plug and North American Style Adaptor Plug. Grounding Adaptor Plugs C, F.
Travel Advisory - Yemen (Republic of Yemen)
There is a low risk of malaria in North Africa and the Middle East, but other insect-transmitted diseases, such as leishmaniasis and viral infections, are potential threats. Safe water precautions, safe needle, and insect-bite prevention measures are important.
Dr. Rose Recommends for Travel to Yemen (Republic of Yemen)
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• Canadian Embassy
Yemen Computer Co. Ltd.
Building 4,11th Street
Tel:  (1) 20-88-14
Passports and visas are required for travel to Yemen. Visas may be obtained at Yemeni Embassies abroad; all travelers to Yemen can also potentially obtain entry visas at ports of entry. Travelers to Yemen are no longer required to have an affiliation with and arrange their travel through a Yemeni-based individual or organization to enter Yemen. However, individuals may be asked for supporting evidence of their character, purpose of visit and length of stay. Upon arrival at ports of entry, travelers may be issued a visa valid for a maximum of three months.
Yemeni law requires that all foreigners traveling in Yemen obtain exit visas before leaving the country. In cases of travelers with valid tourist visas and without any special circumstances (like those listed below), this exit visa is obtained automatically at the port of exit as long as the traveler has not overstayed the terms of the visa.
In certain situations, however, foreigners are required to obtain exit visas from the Immigration and Passport Authority headquarters in Sanaa. All minor/underage U.S. citizens should be accompanied by their legal guardian(s) and/or provide a notarized letter in Arabic of parental consent when obtaining exit visas to depart Yemen. In all of these more complex cases, obtaining an exit visa requires the permission of the employing company, the sponsoring Yemeni family member, the sponsoring school or the court in which the legal action is pending. Without this permission, foreigners - including U.S. Citizens - may not be allowed to leave Yemen.
American women who also hold Yemeni nationality and/or are married to Yemeni or Yemeni-American men often must obtain permission from their husbands for exit visas. They also may not take their children out of Yemen without the permission of the father, regardless of who has custody.
For more details, travelers can contact the Embassy of the Republic of Yemen, Suite 705, 2600 Virginia Avenue NW, Washington, D.C. 20037, telephone 202-965-4760; or the Yemeni (Mission to the U.N., 866 United Nations Plaza, Room 435, New York, NY 10017, telephone (212) 355-1730.
Visit the Yemeni Embassy home page for more visa information athttp://www.yemenembassy.org/.
Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
HIV Test: Not required.
Required Vaccinations: A yellow fever vaccination certificate is required of all travelers arriving from infected areas.
The Republic of Yemen was established in 1990 following unification of the former Yemen Arab Republic (North) and the Peoples Democratic Republic of Yemen (South). Islamic and traditional ideals, beliefs, and practices provide the foundation of the customs and laws in this country. Yemen is a developing country and modern tourist facilities are widely available only in major cities.
Vaccinations: Recommended and Routine
A yellow fever vaccination certificate is required of all travelers arriving from infected areas.
Hospitals / Doctors
Medical facilities, particularly away from the main towns, are poor. A new hospital is being built in Sanaa that is state-of-the-art.
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 counterfeit, 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 a serious illness or injury that cannot be treated locally, every effort should be made to arrange medical evacuation to a more advanced medical facility in Israel or Europe.
The U.S. Embassy maintains a list of medical providers at:http://yemen.usembassy.gov/yemen/medical_info.html
• The Saudi German Hospital Sanaa
The hospital was opened in June 2006 by President of Republic of Yemen. This newly-built multi-specialty 300-bed facility was opened in June 2006. Specialties include orthopedics, vascular surgery, neurosurgery, open heart surgery, oncology, radiotherapy, ENT, dermatology, urology, and eye. The hospital states it has the latest state of the art diagnostic and therapeutic equipment comparable to any modern hospital in USA or Europe.
• Yemeni-German Hospital
Tel:  (1) 418-000 or 418-690/1
• Modern German Hospital
Tel:  (1) 600 000
Fax:  (1) 601 889
Full-service hospital; all specialties; 24-hour emergency department.
Destination Health Info for Travelers
AIDS/HIV: The prevalence of HIV in the Middle East is estimated at 0.3% to 0.4%. As in other regions, known high-risk groups include men who have sex with men, female sex workers and their clients, injecting drug users and prisoners. The quality of the available data, however, is seriously lacking. No country in the Middle East conducts systematic surveys of groups at high risk of infection.
• The development of 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 or blood of another person. 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.
Cholera: A cholera outbreak was reported from the Bani Qais district in the Hajjah governorate in February 2008 and from the Al-Jawf governorate in February 2006. Sporadic cases occur as well, but the threat to tourists is very low. Cholera is an extremely rare disease in travelers from developed countries. 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)
Crime/Security/Civil Unrest: You should reconsider your need to travel to Yemen because of the very high threat of terrorist attack. On 12 December 2008, the US Embassy issued placed all Western hotels in Yemen off limits to Embassy personnel and visitors. The US Embassy also continues to advise its employees to avoid tourist areas and to strictly limit time spent in public places until further notice. Since May 2008, US embassy staff have not been authorised to travel outside Sanaa or to the Bab Al Yemen area in the old city of Sanaa. An attack on the US Embassy in Sanaa in September 2008 killed 17 people and the group claiming responsibility for the attack has also threatened to target British, Saudi and Emirati missions.
Local Travel: Unclear and unheeded traffic laws, excessive speed, roaming animals and pedestrians are the cause of many road accidents. Avoid travelling after dark. Do not leave your vehicle unattended due to the risk of explosive devices being left in, on or near it. Drive with your car doors locked and windows closed due to the risk of car-jacking. Travel outside major cities is not encouraged, and should only be undertaken as part of an organised tour with military escort. Foreigners wanting to undertake independent travel outside Sanaa are required to apply for permission from the Ministry of Tourism.
Road travel: For further advice, see the bulletin on Overseas Road Safety from Smartraveller: (http://www.smartraveller.gov.au/zw-cgi/view/TravelBulletins/Overseas_Road_Safety)
Dengue Fever: An outbreak of dengue fever wasreported from Taiz province in December 2008. Previously, outbreak of dengue fever was reported in 2005 from the western coastal port cities of Hodeidah and Mokha and the hill area of al-Dali, resulting in a number of fatalities. Dengue fever is a mosquito-transmitted, flu-like viral illness occurring in parts of the Middle East. 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.
A dengue fever map is at:http://www.nathnac.org/ds/c_pages/documents/dengue_map.pdf
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 highly endemic with a hepatitis E virus (HEV) seroprevalence of 40% in healthy blood donors. Outbreaks and 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. 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 endemic. 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 with a prevalence of 2.6% 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 from November through March. The flu vaccine is recommended for all travelers over age 6 months.
Insects: Insect-bite precautions are recommended for rural travel and include use of a DEET-containing repellent applied to exposed skin, permethrin insecticide spray applied to clothing, gear, and mosquito nets, and use of a mosquito bednet at night while sleeping.
Leishmaniasis: Cutaneous leishmaniasis commonly occurs in semirural villages of the Asir mountains. Visceral leishmaniasis occurs sporadically in rural areas, usually in the foothill region or the Asir mountains, at elevations between 400 and 1,500 meters. The parasites that cause leishmaniasis are transmitted by the bite of the female phlebotomine sandfly. Sandflies bite mostly in the evening and at night. They breed in ubiquitous places: in organically rich, moist soils (such as found in the floors of rain forests), animal burrows, termite hills, and the cracks and crevices in stone or mud walls, and earthen floors, of human dwellings.
• 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: Transmission occurs year-round, with risk elevated October through March in endemic areas up to 2,000 meters elevation. Risk areas include rural and urban locales in foothill and coastal areas, including Socotra. Elevated risk occurs in irrigated agricultural areas and near wadis. The high mountain areas (over 2,000 meters elevation), northern and eastern desert regions, including Sanaa and Aden City, are risk-free.
• Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline or primaquine (G6-PD test required) 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 towww.fitfortravel.nhs.uk and select Malaria Map from the Yemen 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 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.
Onchocerciasis: Also called river blindness, this blackfly-transmitted disease probably occurs throughout the length of Yemen, in wadis flowing into the Gulf of Aden and the Red Sea. Known to be endemic in all westward-flowing permanent streams (wadis) between the northern Wadi Surdud (Al Hudaydah Province) and the southern Wadi Ghayl (Taiz Province) at elevations of 300 to 1,200 meters; cases have been reported from Al Hudafdah to Taiz, mostly in Al Barh between Mokha and Taiz. All travelers to these regions should take measures to prevent insect (blackfly) bites.
Other Diseases/Hazards: Filariasis (mosquito-borne; sporadically reported)
• Brucellosis (human cases usually related to exposure to unpasteurized dairy products, especially raw goat/sheep milk or milk products)
• Echinococcosis (reported sporadically in humans)
• Rift Valley fever (usually transmitted by mosquitoes, but may also be acquired by direct exposure to infected animals; aerosol transmission has been documented; most cases occur in people who work with livestock)
Poliomyelitis (Polio): Polio is present in Red Sea coastal towns. An outbreak of polio was reported in 2005 from the Hodeidah Governorate in southwest Yemen, on the Red Sea coast, followed by additional cases in most of the other Governorates.
• All travelers should be fully immunized. 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.
Rabies: High potential risk due to large population of stray dogs. All animal bites or scratches, especially from a dog, should be taken seriously, and immediate medical attention sought. Rabies vaccination is indicated following the unprovoked bite of a dog, cat, jackal, or fox. Access to rabies vaccine or rabies immune globulin may require emergency travel to another country. 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. 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. 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, but does not eliminate the need for two additional booster doses of vaccine. Prompt medical evaluation and treatment of any animal bite is essential, regardless of vaccination status. Note: If adequate rabies treatment is not available locally, medical evacuation is advised to a facility that can provide treatment.
Schistosomiasis: High potential risk. Transmission occurs year-round. Focally distributed (commonly associated with wadis, oases, aqueducts, cisterns, and irrigation canals) in urban and rural locales, particularly in foothill and highland areas; only Marib and Al Bayda are risk-free. Primary recognized risk areas occur in Ibb, Taiz, and Sanaa Provinces.
• Schistosomiasis is a parasitic flatworm infection of the intestinal or urinary system caused by one of several species of Schistosoma. 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, or streams. There is no risk in chlorinated swimming pools or in seawater.
Travelers' Diarrhea: High risk. Well water usually is contaminated. Piped water supplies are potentially contaminated. Bottled water or carbonated soft drinks are available and generally safe. 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 (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
• Wash your hands with soap or detergent, or use a hand sanitizer gel, before you eat. Good hand hygiene helps prevent travelers’ diarrhea.
• 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 Yemen 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 traveling to or working in the Middle East, 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.