How to prevent health issues whilst travelling in Cabo Verde (part I)


'I take to the open road, healthy, free, the world before me' – Walt Whitman


Cabo Verde is considered a ‘safe’ country to visit when you are concerned about staying healthy during your stay. Indeed, this seems true in many aspects such as the fact that it does not suffer from many of the diseases that pose a threat to travellers on the mainland of Africa. Malaria for instance, is not prevalent in the archipelago apart from the islands of Santiago and Boavista.  Moreover, the risk of malaria is only present in those two islands from August to November. Therefore malaria prophylaxis is not recommended. 

 

Generally, the most common diseases that you will encounter are foodbourne diseases such as diarrhea and cholera. Fortunately, on the islands of Sao Vicente, Santiago and Sal, a hospital and a private medical clinic are available where you can get the proper treatment and even an operation in case of an acute illness. 

 

That said, it is worthwhile to take a few things into account to reduce your risk of getting seriously ill. This is especially important if you decide to particpate in a nature conservation project located in a remote location, like we have done last year with Turtle Foundation in Boavista!

Santa Maria beach, Boavista
Santa Maria beach, Boavista

PART I: specific health risks when you participate in a remote nature conservation project

How do you deal with common medical problems whilst you are working in a remote location? 

Cabo Verde is a beautiful country to visit: open and friendly people, stunning nature and an abundance of wildlife. The latter was what made us decide to come here in the summer of 2015.  We participated in the Turtle Foundation program on Boavista as interns and  we spent two to four months working to protect the loggerhead sea turtles in the desert environment of Lacacao camp in the south of the island.

The plateau provides a good overview of our camp

Oddly enough, during our stay in the field camp, we noticed that most volunteers and interns got ill. The most common issues in camp were small wounds that became infected and led to infected ulcers. Next to this, quite few cases of gastro-intestinal problems were reported, often combined with high fever and extreme fatigue. So what have we learned from this experience? Is there certain advice that we can provide to upcoming volunteers and interns?

 

Our health recommendations for joining a nature conservation project on Cabo Verde are as follows:

ADVICE 1: Make sure you have a good overall fitness level: invest in a healthy and strong body beforehand

Make sure you possess of a good overall fitness level if you want to join a nature conservation organization as the work is usually pretty active and involves a lot of walking in the sand. Prepare yourself by doing sports, preferably three times a week if not more. Sports such as swimming and running are perfect as they will help you to work on endurance. In case you are not a runner or a hiker, consider to practice with walking on the beach regularly. This can help to avoid a stress fracture which is a very painful, red and inflamed foot caused by overuse. If you end up with one (Mia did experience this unfortunately last year!) you won’t be able to walk much for a couple of days and you need to rest your foot so it can heal.

Even in Viana dessert some exercises to stay fit are part of the daily routine!
Even in Viana dessert some exercises to stay fit are part of the daily routine!

“Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.”  ~John F. Kennedy


ADVICE 2: Prevent wounds from getting infected: treat small skin infections immediately

Infected cuts and wounds

 

In tropical environments a simple cut can become easily infected. A small cut can rapidly lead to a larger skin infection in warm climate, especially when the hygienic conditions are poor and your immune system is lower than normal. In our camp for instance, more than one member did develop wounds over time and quite few of them had more than one wound on their bodies that they had to take care of. 

 

Wounds in remote and warm environments are usually caused by an insect bite that gets infected with bacteria  through scratching of the itchy spot. Any mosquito bite gives an opportunity for bacteria to pass the body's defenses and the skin infection can start surprisingly quick. The most common bacteria to cause skin infections are Staphylococcus aureus and Streptococcus pyogenes. 

 

If you are unlucky enough to have to deal with an infected scratch it is essential to clean the wound thoroughly and cover it. Ideally you should try to expose the cut to direct sunlight and clean the wound twice a day with an antiseptic product like a good drying antiseptic like iodine or potassium permanganate. A drying antiseptic is more effective than a cream because it keeps the wound dry and is therefore preferable. 

 

Quite often a wound is infected by both a bacteria and a fungal infection, so ideally you should use a product that treats both organisms such as an antiseptic product and an anti-fungal lotion such as Canesten (clotrimazole). Fungal infections are prone to start between the toes and it is fairly easy to prevent when you use an anti-fungal footpowder (especially advisable before you go on long walks). 

 

If you see that the wound starts to ooze a lot of pus, is surrounded by a red area that gets bigger or start to develop fever, it is wise to consult a doctor. In this situation you will most likely need to take antibiotics because the infection is spreading from the wound to the rest of the body. 

 

General advice on preventing infected wounds: keep your finger nails short, wash your hands thoroughly after going to the toilet and most important don't scratch the mosquito bites!

ADVICE 3: Drink only boiled water to limit chances of getting traveller's diarrhea

Traveller's diarrhea

 

Contaminated food and water are the most common causes of illness.  

The bacteria that can cause gastro intestinal issues are borne on traces of faeces. To avoid that you get infected with these bacteria you should only eat freshly cooked food or peeled fruit and vegetables. Be extra careful with stagnant water. This water can be the cause of recurrent gastro intestinal problems and even infections combined with extreme fatigue, diarrhea and high fever.

Cooking in camp, is doesn’t get more basic and thus creative than this!
Cooking in camp, is doesn’t get more basic and thus creative than this!

However, although this may all sound good, in a field camp situation it is impossible to be picky. If you stay in a field camp with a large (black) water tank with stagnant water (see picture below) the best thing you can do is not to drink stagnant water, boil it instead to make tea or coffee (this kills 99% of bacteria) and skip the salads.

 

Since the bacteria are transmitted from the faeces to the table through the hands, it is advisable to wash your hands after going to the toilet. A type of diarrhea that is prevalent on Cabo Verde is called 'Giardiasis'. This is a diarrheal disease caused by the microscopic parasite Giardia and it leads to loose, greasy and sometimes watery stools after an incubation period of approximately ten days. Other symptoms are stomach or abdominal cramps, nausea, gas or flatulence and it can lead to dehydration.

The main tent in camp, with our water supply on the left: the black tank is filled with drinkable water.
The main tent in camp, with our water supply on the left: the black tank is filled with drinkable water.

Practice good hygiene to prevent getting it in the first place. Ideally the camp you stay at should have a proper compost toilet to avoid rapid transmission of bacteria or parasites from one volunteer to another!

ADVICE 4: Use flax seeds as a natural remedy to treat constipation issues

Constipation

http://www.constipationexperts.co.uk
http://www.constipationexperts.co.uk

Constipation issues are often forgotten because most volunteers are more concerned with the risk of getting traveller's diarrhea.

 

Well, constipation can nearly as uncomfortable but fortunately easily solved with a natural laxantium such as flax seeds. 

 

Personally, I would never go to a tropical country without a bag of this wonderful natural and healthy remedy for constipation! 

 

The trick is to start using them from day one which is easy enough. You can mix them with your porridge or (very Cape Verdean): kamoka! 

In acute situations of pain and a bloated feeling: mix coffee and a couple of spoons in a glass and drink it, your intestines will start working within half an hour.

 

Another piece of advice: eat dried fruit like prunes daily and start your morning routine with a cup of black (no milk!) coffee, twenty minutes before breakfast. 

 

The conditions are pretty basic in the camp


ADVICE 5: Avoid swimming in strong currents

Strong currents and heavy waves

Swimming in  unknown waters van be challenging and even dangerous. It is quite easy to get hurt in the rough waters, as we experienced during our stay at the field camp in Lacacao in Boa Vista. Close to the camp there's a stunning beach named Curral Velho and it was common for the volunteers to take refreshing ‘rock-pool showers’ to cool down during the heat of the day. Although it was lovely indeed, it wasn't without risks. For instance, Lia once lost a bucket during a swim in this rock-pool shower!

Stunning but strong waves and currents at Ponta Pesquira beach, Boa Vista.
Stunning but strong waves and currents at Ponta Pesquira beach, Boa Vista.

Santa Monica beach in front of the RIU Hotel is another place that is not suitable for swimming. The strong currents can be unpredictable and dangerous. Our advice: never go for a swim alone in such areas! The golden rule is to use your common sense: watch what the local people are doing and to ask whether it is safe to bathe. 

 

Praia Santa Monica in Boa Vista is not safe for swimming!

ADVICE 6: Protect yourself from the sun: seek out the shade during the heat of the day

Sunburn and dehydration

The sun is extremely powerful on Cabo Verde and the archipelago is lacking shade so always use a high-factor sunscreen and reapply it frequently. Whenever you have the opportunity to keep out of the sun during the middle of the day, this is highly advisable. In the camp there was a communal eating and cooking area that we could use which was in the shade. Mid-day is also a perfect time for a nap to rest and rehydrate yourself, which is very much needed in an environment where temperatures are high during the whole day.

 

If you want to go for a hike be careful to prepare yourself for it. Try to go for a hike early in the morning or late in the afternoon and to avoid dehydration,  drink before you get thirsty. A person needs to drink approximately four liters of waters for a full day of walking in a hot climate. 

Strong sun and no shade nearby, Ponta Pesquira beach Boa Vista
Strong sun and no shade nearby, Ponta Pesquira beach Boa Vista

Sources of information

 

Guidebooks

Bradt Guidebook Cape Verde

Bradt Guide The Gambia

Bradt Guidebook Wildlife & Conservation Volunteering – The complete guide

Dominicus Kaapverdie (in Dutch)

The Rough Guide to First-Time around the world  

 

Information about Giardiasis 

https://www.cdc.gov/parasites/giardia/general-info.html

https://www.youtube.com/watch?v=-EGTyu8nD34

 

Information about infected wounds

http://www.nomadtravel.co.uk/infectionsandwounds

©Inside West Africa 2017