Avoiding Disease in Afghanistan

Afghanistan is open for tourism. These days, travelers flying into Kabul are no longer just military contractors or aid workers. In 2005, Afghanistan’s Tourism Office estimated that 2,200 travelers into the country were tourists. Tour operators are offering escorted trips into this South Asian country while some individuals are traveling solo.

Visiting Afghanistan as it emerges into a democracy is exciting. However, it is a developing nation without the infrastructure, sanitation and health care system that Americans are accustom.

Following are immunizations recommended by the Centers for Disease Control and Prevention (CDC) for US citizens, as well as tips to keep travelers healthy when visiting Afghanistan. Importantly, visit your doctor at least 4 to 6 weeks prior to your departure date to ensure vaccinations take effect. In some cases, vaccinations are available only through your county health department. Your doctor will advise you accordingly.

Hepatitis A Virus (HAV). Given in the form of a shot. Protection against infection is 4 weeks following the initial dose. A second shot is needed 6 to 18 months later. HAV can be transmitted via person-to-person contact; exposure to contaminated water, fruits, vegetables and other raw foods.

Hepatitis B Virus (HBV). Given in the form of a series of three shots. After the initial shot, two additional ones are needed at 3 and 6 months. Twinnix, a vaccine protecting against both Hepatitis A and B, is also on the market. HBV is spread through infected blood and other bodily fluids.

Malaria. Antimalarial medication is prescribed and should be taken one week prior to your trip departure date. Malaria is transmitted by biting mosquitoes. Although the CDC states the risk of contracting malaria is between April and December in altitudes lower than 6,561 feet (2,000 meters), there are cases where people have contracted it outside of these parameters.

Rabies. If traveling to an area where you will be coming into contact with animals in an unprotected, outdoor setting, such as camping and hiking, the CDC recommends this vaccination. It is administered in a series of three doses, with the second shot given 7 days after the initial one and the final one given 21 or 28 days.

Typhoid Fever. An oral vaccine is available, consisting of four capsules and should be completed 1 week prior to trip departure. Or, a shot is available and should be received at least two weeks prior to departure. Typhoid Fever is contracted by consuming water or food that is contaminated, or if these were handled by someone infected with it.

Travelers to Afghanistan should also have the Tetanus-Diphtheria and Measles booster shots. Tetanus is a disease contracted when open wounds, including cuts and burns, are exposed to dirt, feces or saliva. Diphtheria is a bacterial disease contracted through person-to-person contact. A viral disease, Measles is contracted by being exposed to people infected with the disease.

In addition to immunization, while in Afghanistan:

DO:
Keep hydrated and drink only bottled water. Brush your teeth with bottled water, too.

Peel fruit, do not eat the fruit skin.

Eat only fully cooked vegetables and hot meals.

Use hand sanitizer and moist towelettes.

Apply insect repellent.

Get plenty of rest. There isn’t enough time in the day to experience everything.

Pack a basic first aid kit with pain reliever, cold medicine, adhesive bandages, any prescribed medications and first aid antibiotic ointment.

Bring a good diarrhea medicine, in addition to over-the-counter remedies. A 5 to 10-day supply of the antibiotic Ciprofloxacin (Cipro) is effective in combating severe diarrhea. Any medicine not used can be left with Afghanistan health officials.

Watch your step. Avoid open sewer lines found between the streets and sidewalks of Kabul. Be careful where walking and avoid falling into one of these sewer lines (which happened to someone I was traveling with). Also, trash is thrown onto Afghanistan streets and animals such as chickens and goats frequent the roads.

When drinking tea (you will be invited to drink lots of tea), hold the tea cup and drink from the left hand. Most Afghans drink with the right hand. Cups are usually not washed to American standards so holding your cup with the left hand means your lips will touch the opposite side someone else’s lips had touched. This will minimize opportunities of contracting a communicable disease.

Keep alert and be aware of your surroundings.

DO NOT:
Eat eggs and avoid consuming other chicken products.

Consume fountain drinks. Drink sodas from a can and ask for a straw in order for your mouth to avoid touching the can.

Get yourself in a situation where you require a trip to the hospital. Hospitals do not test blood for HIV, AIDS or any of the Hepatitis viruses.

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