Traveling to Africa with Kids

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Archived Q&A and Reviews

Questions

Weighing the health risks of a trip to Tanzania with a 4-year-old

Jan 2014

We have the opportunity to visit Tanzania in the spring and are trying to assess whether this would be a good trip to make with our four-year-old. We'd be staying with friends who have been making regular long-term visits there for about ten years (including several trips with their own child who is also four). I'm mainly concerned about health risks. We're willing to get all the recommended shots, but then there is the risk of malaria and other illnesses. I'd love to hear concrete advice from people who have been there or made similar trips with their small kids (or who decided against it for health-related reasons).

I lived in Tanzania for 6 months about a decade ago. While it is a beautiful country, with incredibly friendly people, I would caution you to investigate how much drug resistant malaria there is. It was a major issue, one that was growing when I was there. Keep in mind that a small child who contracts a case of drug resistant malaria can be very dangerous. I plan on travelling with my children in East and Southern africa when they are older for a variety of reasons but the main one being their bodies will be stronger to deal with illness. Good luck with your decision. love to travel

What a fantastic opportunity for an amazing adventure for your family!

I haven't had the chance to visit Africa before but my husband and I were in a similar situation a few years back when the opportunity to visit India came up and we had to decide wether or not to take our then 2 year old. We were really keen to take her with us but before making any firm decisions we visited our local travel doctor to talk about the health risks with them. The travel doctor wasn't too concerned as our daughter was old enough to take all of the required vaccinations. We skipped on the malaria medication only because the part of India we were visiting had a lower malaria risk and the short length of our trip (1 week) meant that if we were to contract malaria we'd be back home with access to good heath care before any symptoms were to set in. Some of the vaccinations that you'll need to take may need a few doses before you go and maybe even one after you return. I'd make sure to see the doctor about this sooner rather than later as they may need a month or two between shots.

I was a little worried about the diseases that can not be vaccinated against, most of which are either water borne or carried by mosquitos. We made sure to slather ourselves in mosquito repellant containing a high level of DEET several times a day. I know that a lot of people aren't too keen on DEET, especially for children, but it really is the best for preventing mosquito bites. Our travel doctor was able to provide a child friendly repellant with a lower amount of DEET for our daughter (still higher than regular tropical strength). Wearing long pants and sleeves was also recommended. A mosquito net over the bed might also come in handy depending on where you are staying. You could also take citronella candles with you to burn in your room at night.

When it came to avoiding water borne diseases we made sure to educate our daughter in the risks of drinking the tap water. We made sure to keep an extra sharp eye on her when she bathed or went swimming to make sure that she didn't swallow any water and brushed her teeth with bottled water. And as much as she desperately wanted to use the 'bum squirter' hose attached to every toilet we didn't let her! As for drinking water, we made sure to thoroughly check each bottle that we purchased. Not sure about Tanzania, but in India it's pretty common place for used water bottles to be refilled with tap water and sold again. If we weren't too sure about the bottled water available we bought juice boxes for our daughter instead. Or fresh coconuts to drink from - no risk of contamination (as long as they are cut open right then and there) and great for preventing dehydration. Remember, it will be a lot hotter than the Bay Area!

As far as food was concerned we made sure to pack a lot of snacks and prepackaged toddler meals from home. Eating the local food is always a fun part of the adventure but we didn't want to risk our daughter getting sick. Plus, as a two year old she wasn't too keen on Indian food apart from rice, papadums and naan anyway. We also avoided most fruit unless it had a thick peel (bananas and oranges).

As for other safety concerns, I was a little worried about car and boat travel. I didn't want to lug around a booster seat however I knew that there wouldn't be any available in taxis and the driver that we booked for the week wasn't able to provide one either. I ended up packing a simple 5 point harness that could be attached to a regular seat belt. Turns out we couldn't use it though as none of the cars we went in had an anchor point to attach it to! As for boat travel, we spent a few days on a houseboat and while the company that ran the trip confirmed there would be adult sized life jackets on board they were unable to provide any small enough for a two year old. We ended up taking a lightweight child's life jacket with us and our daughter wore it pretty much the whole time we were on the houseboat (apart from while sleeping, of course).

Our travel doctor also gave us a kit of antibiotics, electrolyte powder and other various medications for 'just incase'. If your doctor gives you a kit make sure to keep a copy of the prescription with you incase you need to show it to customs when entering the country. Keep a copy of your vaccination records with you as well as you may be required to show that you're covered for Yellow Fever if you're going to an area where this is a problem. Our travel doctor gave us a vaccination booklet from the WHO which is recognized globally. It's a little yellow booklet the same size as a passport. We didn't end up having to show ours to anyone but a workmate who visited parts of Africa on her honeymoon was required to show her vaccination booklet each time she crossed a border to another African country.

I know it sounds like a lot of precautions to go through for a holiday but it will be so worth it. We loved our trip to India, as short as it was, and our daughter loved it too. She was only two at the time but even now (she's almost seven) she talks about it quite a lot. Traveling to a place with such a different culture was a real eye opener for us all and such a wonderful experience. Have fun! Sally

I say go! What an amazing opportunity. Your daughter would likely go wild over the animals in Tanzania. We have been traveling to places like Indonesia, Thailand, Peru, and Malaysia with our daughter (now 8) since she was 1.5 years of age and have never regretted it. She absolutely loves our trips abroad. We are headed to South Africa this Spring for vacation. The flight was always the main challenge for us when our daughter was younger as she never really slept on planes and was not accustomed to watching movies or games on devices. So we would bring along a lot of activities and take turns sleeping and playing with her. As far as being in a country with diseases and lower hygiene standards we never have had much of a problem beyond some looser bowel movements and rashes from the sun (actually more likely from the sunscreen we were using). Our daughter has tolerated the malaria medication recommended for kids without any problems and we have always gotten her the recommended vaccinations for each country without issues as well. We use a great non-toxic mosquito repellant that is Deet free and works well if applied often. It's called Bite Blocker. Traveling with kids you want to be careful about what you and they eat - making sure fruit and vegetables are cooked or peel it yourself. Though when we stay in high-end resorts abroad we generally eat everything (cooked and raw) in those places without problems. Hope that helps and feel free to email me with further questions. Dana

Taking my 4-year-old to Senegal - malaria and carseat concerns

October 1998

I'm wondering if anyone has any new insights into safety while traveling/living with a young child (4.5 years old, still under 40 pounds) in a third world country. My son will be with me in Dakar, Senegal for 7 weeks and I'm mostly concerned about automobile safety given that most vehicles there won't have functioning seatbelts. I'm also trying to find some magic child safety seat that will work on the airplane, in whatever cars do have seatbelts AND is light enough to carry around airports and through a week of travel in Europe on trains in the middle of winter. I have a seat that works well on airplanes now, but it is very heavy and awkward to carry around. I've called around, but none of the stores seem to have much to offer. (By the way, I haven't found much of anything helpful on the web. There is a site, which is interesting, but basically repeats the less than satisfactory information given on the FAA site about child safety on airplanes, http://www.airsafe.com/kidsafe.htm)

I also have some concerns about health - particularly malaria (even tho' he seems to be especially sweet to mosquitos, I don't want my son to be taking prophylactic doses of Meflaquine/Larium) , and food-bourne illnesses. I am aware of all the standard precautions, have checked out the CDC page and am going to Senegal at a time of year when malaria isn't that prevalent, but any hints/advice would be greatly appreciated. Martha

I hate giving advice but I will share my experience. I was a Peace Corps volunteer in Cameroon, West Africa for 2.5 years, in the early 90's. During that time, I had malaria three times even though I was taking chloroquin and fansidar prophylactically. By the time I left Cameroon, there were resistant strains to both these drugs. While I was in Africa , three volunteers DIED of malaria in the continent. I used to be much more knowledgeable about the various strains than I am now, but PLEASE PLEASE do not take a child to sub-Saharan Africa without prophylactics. If you do not want to give him drugs, then I would say don't take him. No amount of separation anxiety can be as lethal as a bad case of malaria.

As far as car seat, I would say, take one anyway. I have traveled extensively in West Africa and I agree that transportation safety is nonexistent, but it cant hurt. Dysentery is sure to happen unless you really live in a vacuum and don't go near fresh fruit or produce. It does pass though. I am sure your doctor can prescribe something for it. All that said, I hope you have a good time! I love it there. Niloufar

I haven't been to Senegal, but if it's anything like Cameroon, you'll be lucky to get a SEAT on local transportation (private taxis, bus-like vans, etc), let alone a place for a carseat or a seatbelt. This varies by location, of course, but the further out in the bush you are, the more likely they will cram as many people as possible into the car, meaning your son will probably be on your lap. Also, the drivers in some areas will try to get you into their car by grabbing at anything you're carrying, so a clumsy carseat (on top of whatever luggage you have AND your small child) could be a real nightmare. I'm sure it varies by what you're doing there and who you're with. I was a Peace Corps volunteer, so we saw essentially what the local population saw. I'm sure it would be different if you have escorts or business companions or anything like that, or if you're spending a lot of money (a lot to them, not necessarily to you). As for the malaria, most of us got it at least once (in a roughly 2 yr period) even while on Mefloquine. I agree that you probably shouldn't give it to your child, especially if it's just for a short visit. Anopheles (the malaria mosquito) only bites at night (say 4:30 pm and later), so keep you and your child well-protected at those times (maybe mosquito repellent would do the trick when you're up and about; definitely nets over sleeping areas help cut down on problems). There's not really enough known on the effects of Mefloquine to feel good giving it to a growing child... even adults have reported some pretty bizarre problems. It doesn't sound like it's worth the risk in your case. If either of you DO get malaria (another problem is that Mefloquine can muffle the symptoms, causing misdiagnosis), there are treatments that seem to be pretty effective. The real problem is getting it and ignoring it, but I think it would be tough to miss the symptoms normally (fever that cycles is the prime one). Good luck!

I've read about an inflatable carseat that I think still meets safety regulations. I think it was in the book ``Baby Bargains.''

I've been to Dakar and elsewhere in Senegal myself. You may be right to fear the lacking seatbelt issue, though I wouldn't be so sure. Dakar is very cospmopolitan and there is huge population of professional foreigners. Many taxis are likely to be Mercedes, since those are common in Europe and Dakar's connection to France is significant. I took buses, so I can't be sure.

I realize the malaria medication is a tough choice, but I just wanted to encourage you to talk to as many people as possible before deciding to forgo malaria prophylaxis. There is most definitely quinine-resistant malaria in Senegal today, as is the case in many of the malaria-plagued places of the world today. You can get forms of malaria there that stick with you so that years later, suddenly, a person has malaria again. And if you come down with malaria, you have to take the same type of medicine but in very huge doses, plus you are suffering. Probably you know all this already and are making the best choice, but my own experience was that I didn't take medication before I went (as you're supposed to), largely because I was afraid of all the side effects I'd heard about. And while it wasn't very humid, I still got occasional mosquito bites and then would become very scared. What if this is the one? Finally, someone I met told me I was a nut not to take the drugs and I started right away and had no side effects, even taking two kinds. And I didn't get sick at all.

Have a great time! It's a fascinating place of gorgeous people - on every sidewalk there seems to be a parade of bright colors and beautiful clothes. Do be wary in the central market where things can easily be stolen off you. and do get out of the city! Monica

In 1984 I went with a male friend to Tanzania. We were both taking chloroquin and fansidar as malarial prophylactics, but get this -- we were on the same doses, even though he outweighed me by forty pounds or more. In travelling from Dar to Moshi, we were bitten extensively by mosquitos -- I counted 89 bites between the wrist and elbow of my left forearm (while waiting around the next afternoon in Moshi). I did not come down with malaria, but he DID. So, and here's the advice part so ignore it if you like... not only should you make sure your child has prophylaxis or leave him/her home, but you should make sure the dosages all of you get are appropriate for your own size. Also, get all recommended vaccinations, and never drink anything that has not been sterilized -- order your coffee as kahawa na maziwa moto (with boiled milk) if you can't take it black (but it's great in Tanzania and Kenya, so do try it ;-), order your coca cola sealed in the bottle -- if you have to have it cold, put the bottle into ice, and WIPE the opening thoroughly before drinking it. No orange squash if you value your health, no cut fruits, take water purification tablets along for the water in hotels, etc., and take along pepto bismol tablets or some other such to be chewed to prevent the runs. That worked well for us -- he only got malaria, and neither of us got anything else although we were in Tanzania and Kenya for eight weeks, and not staying in the fanciest hotels, either (well, except once in Nairobi!). Another friend of mine picked up some intestinal bug and has never gotten rid of it -- she still has an occasional bout. And, all that aside, have a GREAT time! The people are wonderful, despite often having to cope with difficult circumstances.  Heather

Regarding the use of prophylaxis for malaria: most European doctors do NOT prescribe prophylaxis, partly for the reason that if we rich foreigners keep on routinely using the drugs of last resort their efficacy will be destroyed for everyone. Rather, the strategy is to respond very quickly to symptoms. If you will be far from medical help, you should carry the medications with you. My impression is that Mefloquine/Lariam is NOT cleared for young kids (please check this), at least as a prophylactic. I think chloroquine is considered safe enough that you COULD give it to your son as a prophylactic. I would try to find out as much as you can (doctors there will know more than here) about the symptoms & treatments of malaria in young children. The best thing, of course, is, as suggested to protect against mosquitoes in the evening & night (though daytime species carry dengue fever! - don't know if this disease occurs in Senegal...) Good luck & please keep us posted w/ any new info you come across (I, too, am contemplating taking a small one to Sub-Saharan Africa) Melanie

Here are a few more suggestions for travel in Third World countries (these may sound a little paranoid, but it's probably worthwhile to be more safe than sorry):

Consider bringing your own hypdermic needles, sterile syringe, and a note from your doctor explaining why you have them. In case you or your child needs an injection while there, do NOT rely on the clinic or doctor traeting you having sterile supplies.

Know your blood types.

Bring oral rehydration powder with you, too. The packets are light, small, and fairly cheap. If you don't use it, you can give it to people who live there, who probably will. (Dehydration from diarrhea is a very serious problem in children in 3rd world nations.)

PeptoBismol was mentioned before... it should be on your must bring list.

If you are going to be WAY out in the wilds and want to be as utterly safe as you can be, think about a few sterile hospital gloves and maybe even an IV drip.

There's a great book called Travel with Children by Maureen Wheeler. It's part of the Lonely Planet series, and I highly recommended it for adventure travelers. She's been amazing places with her kids, and her suggestions are quite detailed and useful. (BTW, I'm the author of a book on traveling with babies and small children called Baby Maneuvers. It's for parents whose kids are under five. And... there's one chapter focusing on overseas and adventure travel.)

A note: all this preparation sounds really scary, but once it's done, you'll be free to enjoy and experience. I think it sounds terrific! 

Ericka

I have travelled to the Senegal in July/August eight years ago. So, all I know refers to the transportation and living conditions at that time. The situation might have changed since then. Generally, there was a big difference in the standard of life between Dakar and the rest of the country particularly the inland. After having travelled around in Mali and the Senegal I did not find that Dakar was really a third world place.

Sanitary conditions: were great, water was treated and drinkable (outside of Dakkar nothing was guaranteed).

Mosquitos: I took Lariam. Good is however to avoid Mosquitos, dress accordingly in the evening, close windows, no lights, spray if neccessary. In Dakar I stayed in a house near the Medina with windows and everything. I do not recall any Mosquito problems there. To my view, in the City itself the risk is relatively low.

Transportation: Regular buses were fairly safe in Dakar. They were not less reliable as most busses that I have seen running in the Bay area. The same was true for taxis. You may want to avoid the colorful and funny-looking minibusses in the City (I forgot their name). They were fast, but very unsafe, badly maintained, e.g. brakes didn't work well, and frequently involved in accidents. Also local people often avoided them. For longer trips in the inside country I recommend checking over the taxi and choosing the most reliable one. It happened several times to me that the taxi broke down somewhere on a road, and we had to wait a couple of hours until the driver had finally managed to self-repair his vehicle. The drivers are also able to pile up people in the car to a point that it gets extremely uncomfortable. Also, try to avoid any Peugeot 4 x 4 without closable windows, or for else dress well. I got once in a violent sand wind and another time I got a terrible sore throat. I read somewhere that colds are the most common illnesses of tourists in Africa. Anyhow, as long as you are staying in Dakar, I don't think there is much to worry. There are a lot of Frenchmen who are really fond of living there. --Petra