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The health standard in Madagascar is not as high as in some of the most developed countries of the West, but a broad range of specialties is represented by foreign physicians present in Antananarivo. The standard of health care in hospitals differs from each other. The government takes care of the Medical facilities in Madagascar. However, many private organizations like the Malagasy Lutheran Church also work alongside it. A list of health centers and hospitals is maintained by the Embassies, so that tourists have quick access to quality care in case of an emergency. In Antananarivo medications of foreign origin are available in many pharmacies, but outside the capital medical facilities are of lower standard. Travellers are advised to carry their own personal medical kit as the Malagasy Lutheran Church is mainly limited to the capital. Ambulance service in Madagascar is easily accessible. Many of the hospitals have general physicians as well as specialists. There are foreign physicians as well. Vaccination is done against many diseases. Hospitals in Madagascar provide all kind of health care. There are general physicians as well as specialists like child specialists ENT, eye specialists, cardiologists, orthopaedics, dentists, psychiatrists, neurologists etc. The hospitals are accessible for everybody. MALARIAMalaria is a risk throughout the year and is highest on the coast; it is important to protect yourself by avoiding mosquito bites between dusk and dawn and also by taking tablets. There is some chloroquine resistance in Madagascar so Mefloquine (Lariam) taken weekly or Doxycycline taken once daily is probably the best prophylaxis if it suits you. With Lariam around one quarter of people will experience unacceptable side effects, so take it two and half weeks(three doses) before departure and if it makes you feel weird or gives you nightmares stop it and take another product. Malarone, taken once a day, is a new alternative although this is only presently licensed for use up to 28 days and it is by far the most expensive prophylactic drug. Another good alternative, although unsuitable in pregnancy and while breast-feeding or for children under 12, is one Doxycycline capsules a day. Get advice from a travel clinic, your GP or the website: www.fitfortravel.scot.nhs.uk. All prophylactics are best taken on an empty stomach. If pregnant or planning a pregnancy takes medical advice before travelling. Some travellers like to carry tablets for the emergency treatment of malaria; if you choose to do so make sure you understand when and how to take them. Also pack a non-mercury thermometer. INSURANCE We insist that all clients travelling with Mada Treasure’s Visit insist have appropriate medical insurance cover for the emergency transport required to get you to a good hospital or all the way home by air and with medical attendant if necessary. Not all insurances cover this, so please make sure that your insurance covers any activities you may wish undertake: rafting, paragliding etc ...If you need medical help, your insurance company might be able to help locate the nearest hospital or clinic, or you can ask at your hotel. In an emergency, contact your embassy or consulate. The African Medical and Research Foundation (www.amref.org) provides an airevacuation service in medical emergencies in some African countries including MADAGASCAR as well as air-ambulance transfers between medical facilities. Pease note there are currently no decompression facilities in Madagascar.SEXUALLY TRANSMITTED INFECTIONS These are common in Madagascar and HIV is on the increase. If you enjoy nightlife, male or female condoms will make encounters less risky. VACCIN Vaccinations are not compulsory, but we recommend that you are vaccinated against tetanus, polio, measles, rubella, mumps and diphtheria, as well as hepatitis A and B, rabies and typhoid. Yellow fever is not risk in the region but the certificate of yellow-fever vaccination is an entry requirement if travelling from an infected region. WATER High–quality water is available almost everywhere, and you need not fear drinking from taps. Bottled water is also sold throughout the country. Drinking from streams might put you at risk of waterborne diseases. If travelling with small children you can take a thermos flask; almost boiling water kept in this for 15minutes will kill any bacteria. Remember that the health standards in Madagascar are not as high as in some of the most developed countries of the West, but broad range of specialties is represented by the foreign physicians present in Antananarivo. PLANTS Madagascar has quite a few plants which cause skin irritation .The worst one is a climbing vegetable plant with pea-pod-like fruit that look furry. This fur penetrates the skin like thousands of tiny needles which then have to be painstakingly extracted one by one with tweezers. Prickly pear fruits have the same defence mechanism. INSECT BITES& STINGS Bee and wasp stings cause real problems only to those who have a severe allergy to the stings (anaphylaxis), in which case carrying an adrenaline (epinephrine) injection is advisable. Scorpions are frequently found in arid or dry climates. They can cause a painful sting that is sometimes life-threatening. If stung by a scorpion, try taking a painkiller. Medical treatment should be sought if collapse occurs. Bed bugs are often found in hostels and in cheap hotels or in hotel in small villages. They lead to very itchy, lumpy bites. Spraying the mattress with crawling insect killer after changing bedding will get rid of them. Scabies is also frequently found in cheap accommodation .These tiny mites live on the skin, particular between the fingers. They because an intensely itchy rash. The itch is easily treated with Malathion and permethrin lotion from a pharmacy. TRADITIONAL MEDICINE Although western medicine is available in larger cities and towns, fanafody (traditional medicine often herbal) plays an important role in Madagascar. Many urban dwellers prefer traditional methods, visiting market kiosks to procure age-old remedies. Ombiasy (healers) hold considerable social status in many parts of Madagascar, particularly in more remote areas where traditional practises are still strong. They are often consulted for a variety of ailments. INTERNET RESOURCES There is a wealth of travel health advice on the internet: World Health Organisation :www.who.int/ith MD Travel Health :www.mdtravelhealth.com Centre for Disease Control and Prevention:www.cdc.gov Fit for Travel:www.fitfortravel.scot.nhs.uk Australia:www.dfat.gov.au/travel/ Canada:www.hs-sc.gc.ca/pphb-dgfspsp/tmp-pmv/pub_e.html United Kingdom:www.doh.gov.uk/traveladvice/index.htm United State:www.cdc.gov/travel MEDICAL CHECKLIST
minor illness or injury. Following is a list of items you should consider packing.
reactions.
Given the prevalence of malaria, consider taking a self-diagnostic kit that can identify malaria in the blood from a finger prick like Mala-Quick. CLINICS & HOSPITALS ANTANANARIVO
ANTSIRANANA
FIANARANTSOA
MAHAJANGA
TOAMASINA
TOLIARY
DRUG STORE ANTANANARVO
ANTSIRABE
ANTSIRANANA
FIANARANTSOA
MAHAJANGA
MORAMANGA
TOAMASINA
TOLIARY
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It is good idea to carry a medical and first-aid kit with you, to help yourself in the case of 