* A yellow fever vaccination certificate is required by travellers over one year of age.

All water should be regarded as being a potential health risk. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised. Avoid dairy products that are likely to have been made from unboiled milk. Only eat well-cooked meat and fish. Vegetables should be cooked and fruit peeled.

Bilharzia (schistosomiasis) is present; avoid swimming and paddling in fresh water. Hepatitis B and E are present and meningococcal meningitis may occur. There is a very high risk of diarrhoeal diseases, the dysenteries and various parasitic worm infections. Ebola outbreaks have occurred. Avoid tick bites which spread African tick typhus. Wear shoes to avoid soil-borne parasites. Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay.

Government expenditure on health is low and the quality of hospitals is poor. It is advisable to take specific personal medicines as well as supplies such as syringes and drip needles, as medical facilities are available only in larger centres. Doctors and hospitals expect cash payment in full for health services. Health insurance is essential and it is advisable to include cover for emergency air evacuation.