Information about information and advice on health vaccinations in tokyo





 

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1.  Asia More
2.  Afghanistan More

Afghanistan Practical information
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Health & safety
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Contents
Before you go

Dangers & annoyances
In transit

While you're there
Before you go

Insurance
To say Afghanistan can be an unpredictable place is something of an
understatement, so travel insurance is essential. However, many
insurance companies regard Afghanistan as a conflict zone. Coupled
with advice from government travel advisories, this means that not all
brokers will issue insurance for a trip to Afghanistan. Discuss this
with your broker and check the small print for exclusions on the
policy before signing up. Note that insurers may make a distinction
between ‘active’ and ‘passive’ war zones, where premiums reflect the
level of risk. Cover for land mine injuries are often specifically
excluded by some companies. A minimum of US$1 million medical cover
and a ‘medivac’ clause covering the costs of being flown to another
country for treatment is essential.

Specialist policies are available with some brokers aimed specifically
for those working in conflict zones, although they’re not always
cheap. AKE Group (in the UK 020 7816 5454, in the USA 678-560 2336;
www.akegroup.com), a dedicated security and risk management company
has been recommended. In the UK, also try Medicare (020 7816 2033;
www.medicare.co.uk) or J&M Insurance (01992 566939; www.jmi.co.uk). In
the USA, try New York International Group (212-268 8520; www.nyig.com)
or Safe Passage International (303-988 9666; www.spibrokers.com).
In Afghanistan, medical services insist on payment on the spot, so
collect all the paperwork you can when being treated for a claim
later. Some policies ask you to call them (they’ll usually call you
back) so that an assessment of your problem can be made.

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Health matters often get left to the last minute before travelling. A
little planning is advisable, however – some vaccines don’t ensure
immunity for two weeks, so visit a doctor four to eight weeks before
departure.

Travellers can register with the International Association for Medical
Advice to Travellers(IAMAT; www.iamat.org). Their website can help
travellers to find a doctor with recognised training. Those heading
off to very remote areas (particularly for work) may find a first-aid
course useful.
Bring medications in their original, clearly labelled, containers. A
signed and dated letter from your physician describing your medical
conditions and medications, including generic names, is also a good
idea. If carrying syringes or needles, be sure to have a physician’s
letter documenting their medical necessity. See your dentist before a
long trip; carry a spare pair of contact lenses and glasses (and take
your optical prescription with you).

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Insurance

Adequate health insurance is vital when travelling to Afghanistan.
Check in advance that your insurance plan will make payments directly
to providers or reimburse you later for overseas health expenditures –
doctors in Afghanistan expect payment on the spot. Your policy should
ideally also cover emergency air-evacuation home, which may be
essential for serious problems.
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Recommended vaccinations
Specialised travel-medicine clinics are your best source of
information; they stock all available vaccines and will be able to
give specific recommendations for you and your trip. Ask your doctor
for an International Certificate of Vaccination (otherwise known as
the yellow booklet), which will list all the vaccinations you’ve
received.

Yellow fever vaccination is mandatory if arriving from a country where
the disease is endemic. The World Health Organization also recommends
the following vaccinations for travellers to Afghanistan:
Adult Diphtheria & Tetanus Single booster recommended if none in the
previous 10 years. Side effects include sore arm and fever.

Hepatitis A Provides almost 100% protection for up to a year; a
booster after 12 months provides at least another 20 years’
protection. Mild side effects such as headache and sore arm occur in
5% to 10% of people.
Hepatitis B Now considered routine for most travellers. Usually given
as three shots over six months, a rapid schedule is also available, as
is a combined vaccination with Hepatitis A. Side effects are mild and
uncommon, usually headache and sore arm. In 95% of people lifetime
protection results.

Measles, Mumps & Rubella Two doses required unless you have had the
diseases. Occasionally a rash and flulike illness can develop a week
after receiving the vaccine. Many young adults require a booster.
Polio Only one booster is required as an adult for lifetime
protection.

Typhoid Recommended unless your trip is for less than a week. The
vaccine offers around 70% protection, lasts for two to three years and
comes as a single shot. Tablets are also available, but the injection
is usually recommended as it has fewer side effects. Sore arm and
fever may occur.
These immunisations are recommended for long-term visitors (more than
one month) or those at special risk:

Japanese B Encephalitis Three injections, with a booster recommended
after two years. Sore arm and headache are the most common
side-effects.
Meningitis Single injection. There are two types: the quadrivalent
vaccine gives two to three years’ protection; the meningitis group C
vaccine gives around 10 years’ protection. Recommended for long-term
visitors aged under 25.

Rabies Three injections in all. A booster after one year provides10
years’ protection Side effects are rare – occasionally headache and
sore arm.
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Medical checklist
Following is a list of other items you should consider packing in your
medical kit when you are travelling.
  • Antibiotics (if travelling off the beaten track)
  • Antibacterial hand gel
  • Antidiarrhoeal drugs (eg loperamide)
  • Paracetamol (eg Tylenol) or aspirin
  • Anti-inflammatory drugs (eg ibuprofen)
  • Antihistamines (for hay fever and allergic reactions)
  • Antibacterial ointment (eg Bactroban) for cuts and abrasions
  • Steroid cream or cortisone (allergic rashes)
  • Bandages, gauze, gauze rolls
  • Adhesive or paper tape
  • Scissors, safety pins, tweezers
  • Thermometer
  • Pocket knife
  • DEET-containing insect repellent for the skin
  • Permethrin-containing insect spray for clothing, tents, and bed nets
  • Sun block
  • Oral rehydration salts
  • Iodine tablets (for water purification)
  • Syringes and sterile needles (if travelling to remote areas)
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Internet resources
There is a wealth of travel health advice on the Internet. The World
Health Organization (www.who.int/ith/) is an excellent resource for
travel health information, along with MD Travel Health (www.mdtravelhealth.com),
which provides complete travel health recommendations for every
country.

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Further reading

Lonely Planet’s Healthy Travel Asia & India is packed with useful
information including pretrip planning, emergency first aid,
immunisation and disease information, and what to do if you get sick
on the road. Other recommended references include Travellers’ Health
by Dr Richard Dawood (Oxford University Press) and The Travellers’
Good Health Guide by Ted Lankester (Sheldon Press), an especially
useful health guide for long-term expatriates working in the region.
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Dangers & annoyances
Afghanistan presents unique potential risks to the traveller, with the
danger of an insurgency in the south, plus warlordism and terrorist
violence in some other parts of the country. It’s essential to keep
abreast of the current political and security assessments both before
travelling and while in-country.

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In transit

Deep vein thrombosis (DVT)
Deep vein thrombosis occurs when blood clots form in the legs during
plane flights, chiefly because of prolonged immobility. The longer the
flight, the greater the risk. Though most clots are reabsorbed
uneventfully, some may break off and travel through the blood vessels
to the lungs, where they may cause life-threatening complications.

The chief symptom of DVT is swelling or pain in the lower leg, usually
but not always on just one side. When a blood clot travels to the
lungs, it may cause chest pain and difficulty breathing. Travellers
with any of these symptoms should immediately seek medical attention.
To prevent the development of DVT on long flights you should walk
about the cabin, regularly contract your leg muscles while sitting and
drink plenty of fluids. Recent research also indicates that flight
socks, which gently compress the leg from the knee down, encourage
blood to flow properly in the legs and reduce the risk of DVT by up to
90%.

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Jet lag & motion sickness

Jet lag is common when crossing more than five time zones; it results
in insomnia, fatigue or nausea. To avoid jet lag, set your watch to
your destination’s time zone when you board your plane, drink plenty
of (non-alcoholic) fluids and eat lightly. Upon arrival, seek exposure
to natural sunlight and readjust your eating and sleeping schedule as
soon as possible.
Antihistamines such as dimenhydrinate (Dramamine) and meclizine
(Antivert, Bonine) are usually the first choice for treating motion
sickness. Their main side-effect is drowsiness. A herbal alternative
is ginger, which works like a charm for some people.

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While you're there

Women travellers
Afghanistan has a conservative culture where attitudes to women are
bound up with the protection of honour. Society generally seeks to
minimise contact between unrelated men and women. As a result foreign
women travelling or working on their own, away from male relatives,
are often viewed with a mixture of curiosity and astonishment. Being
disregarded is a common reaction, and if you’re with a male companion
you shouldn’t be surprised if an Afghan directs his attention and
conversation in that direction.

There is no legal obligation to wear a headscarf, but in practice all
foreign women do. Walking around Kabul with a bare head would attract
a lot of attention; in the countryside such behaviour would be nothing
short of scandalous. As a general rule, the more conservative or rural
the area you are in, the more discreetly you should dress. In keeping
with local sensibilities, your clothes should hide the shape of your
body. Bare arms and tight fitting clothes should be avoided, but
whatever you wear you’ll still have to get used to being stared at.
Trying to wear the burqa is both unnecessary and a cultural no-no for
foreign women. The pirhan tonban (traditional male clothes; also
called shalwar kameez) of baggy trousers and long shirt is comfortable
and popular with many women working in Afghanistan. Baggy clothes can
also provide useful cover should you need to go to the toilet while
travelling off the beaten track. Facilities in chaikhanas are usually
limited.
Foreign women can interact with Afghan women in a way impossible for
men. Afghan men may also make special allowances for your status. ‘I
often joke that there are three genders here: male, female, and
foreign woman’, commented one female NGO worker we met during
research. Afghan men can sometimes be unsure about the correct
protocol of dealing with a foreign woman. It’s best to wait for them
to offer a hand to shake rather than offering your own, and try to
avoid excessive eye contact with Afghan men you don’t know. If
harassed in a public place, several women have advised making a loud
scene to shame your harasser. Avoiding walking alone at night is
advice we’d equally extend to foreign men. You’ll also need to
cultivate patience and learn to trust your own instincts.

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More Practical information in Afghanistan

Money & costs
Visas

More about Afghanistan
Afghanistan overview

Places in Afghanistan
When to go & weather

Getting there & around
History

Work & study
Wildlife

Tips & articles
Afghanistan
-----------

Afghanistan Overview
Places in Afghanistan

When to go & weather
Getting there & around

 
Practical information

Money & costs
Health & safety

Visas
History

Work & study
Wildlife

Tips & articles
Advertising

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