I have finally decided to write this long-awaited article in order to answer the most frequent questions I receive about traveling in Africa by bicycle. Topic by topic I will try to tackle every answer to satisfy your needs and curiosities. Here we go:
The issue of safety is always one of the biggest concerns for mostly everyone and a subject that comes up over and over in the e-mails I receive. First off, there are two general things I can tell you about this subject, and that they are valid for all places in the world. The first is that absolute security does not exist anywhere and is mostly a superstition. Everything (or nothing) can happen anytime and anywhere we are, regardless of how safe we think we are. The second is that, to travel as safely as possible, the most important thing that you need is, on the one hand, common sense and on the other, paying attention to that common sense. In my experience, this protects us in life from most of the potential dangers that can affect us.
Having said that, in my experience, Africa is a continent where I had a very large sense of security most of the time. The moments in which I felt insecure were always those in which I knowingly exposed myself to greater risk even though I could have avoided it. I want to make it clear that it was invariably thanks to the very Africans in every corner of the continent, that I always felt very safe, protected and above all, loved.
Now to the point. In my opinion, the most delicate situations of general security to be taken into account in the continent are the following:
TRAFFIC: this is always one of the biggest risks when traveling by bicycle wherever we go. In Africa, in countries like Egypt (Cairo), Nigeria, Kenya and Tanzania, I experienced moments of great fear along the road. In the particular case of Nigeria, on two occasions I hitched rides because I was certain that I would die in a traffic accident.
This does not happen all the time but only in certain sectors, especially in the main throughfares that go to and out of the capital cities, or between the largest cities in each country. Depending on each one, these can be very dangerous, or totally safe. Therefore, my recommendation is always to try, as much as possible, to avoid them and to circulate along secondary roads or, better still, rural roads. If we cannot do it, we must conduct ourselves with the utmost caution and attention, trying to reduce the number of big roads in our route as much as we can and get out of them as soon as possible. If still we can’t, ignore the callings of your ego, err on the safe side and skip the super dangerous stretches asking for a ride to a safer place. In my mind, of all possible ways to die traveling by bicycle, without a doubt one of the worst is in a traffic accident: totally not worth it.
BIG SLUMS IN BIG CITIES: While the largest number of people living in slums is just as good or even more trustworthy than anywhere else in a country, it is true that sometimes there are also people living there willing to hurt you. Therefore, in cities with very bad reputation, such as Johannesburg, Cape Town, Nairobi and Lagos, it is better to avoid these areas or avoid the cities altogether.
Otherwise, the best thing you can do is to always ask the local people for advice, cycle around in broad daylight and try to pass through the most populous places. In Africa, for every place where there may be a person willing to hurt us or steal from us, it is likely that there are around 1000 people willing to protect us.
It should also be noted that, with the exception of a handful of more or less interesting cases, the truth is that the largest cities in Africa are not the most attractive and interesting that the continent has to offer. Therefore, the only reasons I had to include those I visited, were mostly bureaucratic ones such as visas.
WILD ANIMALS: this is certainly a potential risk in many parts of the continent, especially for all of us who leave the main roads and like to explore remote regions off-the-beaten track. I will talk specifically about this point in the corresponding section, but as far as security is concerned, the recommendation is similar to the previous one: always consult with the local people, and choose a route that avoids these areas if you do not want to expose yourself.
CAMPING: I have a very clear rule for security when it comes to camping and it is the same one that I use in almost every place I go, in order do it keep it as safe as possible. The rule is: camping with the people or totally away from them. This means that either I ask for permission and recommendation to the local people in the town or village where I want to camp for the night, or I camp in the middle of nature where absolutely nobody sees me. In any case, I try to avoid at all costs that intermediate point in which I am visible to others and yet I am in my own place separate from them. In Africa, in any village or town, one can always reach out to the chief/head of the village to ask for permission to spend the night there. The chief himself will help us and if not, there are always people who will try to guide us to a place where we can spend the night safely.
MALARIA: Further below I will dedicate a section on its own to this famous disease, but do know for now that it is always a potential danger in many parts of Africa and for which we must take the necessary precautions.
REGIONS OF HIGH POLITICAL OR SOCIAL INSTABILITY: Needless to say that it is not a good idea to try to venture in places like these. In Africa there are some, but most of them cannot be accessed even if we were stupid enough to want to get there. In the case of countries where it is still possible to do it, it is important to know that almost always, this occurs in very concentrated spots but not likely in the whole region, let alone the entire country So don’t be totally turned off if you hear bad things going on in a determined country, it will most likely be in a specific spot. Stability in several countries varies from one day to the next and there are places that should definitely be avoided, so, as always, it is imperative to constantly consult local people and relevant authorities as we get closer.
VISAS AND PASSPORTS
The visa and entry permits’ situation for African countries ranges from the easiest and most accessible, to the plain impossible and inaccessible, passing through all the intermediate levels of bureaucratic nightmares. It would be practically useless and a waste of time to talk about visas individually because in much of Africa, the policies in this regard are unpredictable, almost schizophrenic. In some countries, the rules may change from one day to the next depending on the mood and whims to which the president in turn woke up to. This can even force us to change the entire course of our trip. Sometimes it is the requirements that change, sometimes the prices, sometimes the points of entry and so on. Everything I can say about my experience is valid only for when I was on the continent between 2014-2017.
What’s more, the requirements and regulations vary around the world depending on our country of origin and passport that we carry. In my case, I travel with Argentine and Italian passports and I have used both without major inconveniences according to the particular benefits I’d get from one or the other. In general, I did not find a relevant difference between the two nationalities that I have, but each one of you must do the individual task of researching the visa policies of each country that apply to yours. Do not ask me questions for indiviual countries.
One point that may be important to note is that South Africa does NOT recognize citizens with dual citizenship, therefore it is impossible to switch passports when entering South Africa (this also applies to the neighbouring countries of Lesotho and Swaziland).
Having said that, as a general rule, visas in the eastern half of Africa are much easier and cheaper to obtain than in the western half. While in many Eastern countries, visas are obtained at the borders just by filling out a form and paying on the spot, and now there are regional visas (a visa for several countries in one, like the East African visa), in many countries of the western half, they have long and complicated application procedures that require documentation, letters of invitation, a lot of money, time and first and foremost lots of patience, ingenuity and perseverance.
Finally, you have to understand that visas are obtained as we move along our trip. Traveling by bicycle makes it practically impossible to apply for many visas in advance for many countries at the same time. As a conclusion, this is a subject that you must solve individually, by calling the embassies or visiting them personally. You can also use Google, and also try to contact travellers who are or have been recently in the regions to which you are coming.
WEATHER AND SEASONS
It is very difficult to plan a one-size-fits all route to be at the right place and time when it comes to climate. However, there are some general rules to follow that can help us plan it to experience as many pleasant conditions as possible. Two of the main determinants for most trips are summer in the Sahara and the dominant wind in North Africa. For these reasons, many people decide to start their African journey, either in the east or in the west, from north to south (dominant wind on you tail) and at the beginning of winter or late autumn in Egypt or Morocco. In this way you avoid suffering the brutal heat of the desert, which can be intolerable and dangerous in the long Saharan summer, nor suffer the relentless furious wind you must deal with when coming from the south. It is obvious that this is much easier to work out for those who only cycle one half of the continent or just a few countries.
For those planning to cycle the entire African continent, something has to give and sooner or later you’ll have to deal with very shitty conditions. In my case, I suffered both. On the one hand, having left late from Cairo resulted in facing temperatures of up to 60C in Sudan in April / May. On the other, and even worse perhaps, I had to endure the infernal northerly winds in the Sahara in Senegal, Mauritania and Western Sahara, which was one of the toughest physical and mental challenges I ever had to face on a bicycle.
In regard to sub-Saharan Africa, the determining factor is the rainy season, which renders many stretches of the tropical regions and the equatorial rainforest completely impassable outside the main roads. While it does not prevent you from continuing your trip, it greatly limits the experience and also exacerbates the risk of contracting malaria due to the increased presence of mosquitoes.
As a conclusion, it is important to understand that it is very difficult to plan the perfect route. Unless one takes several years to travel and adjust one’s pace to catch the perfect season in each region, there will always be a point in which you will have to face the unforgiving harshness of the weather. The important thing is to organize yourself as much as possible in order to reduce these to a minimum.
As you can see in National Geographic documentaries, Africa has indeed many regions where it is still possible to meet wild animals, to whom we are especially exposed when traveling by bicycle.
Sometimes it leaves me speechless when someone who reads my stories about my direct encounters with wild animals such as lions or elephants tells me: “Wow, that is so cool!” And I think to myself “are you stupid or what ?!
I am going to say it clearly: Even when you venture in regions where you know there are wild animals, YOU DO NOT WANT TO FIND YOURSELF FACE TO FACE WITH LIONS, ELEPHANTS, HYENAS, NOR MANY OTHERS.
It is one thing to be in awe and totally fascinated when you are reading the story on your mobile from the comfort and security of your home and another very different is to be completely defenceless in front of these beasts, that while they are no doubt wonderful, they can end your life in the blink of an eye. And I do not think that you want to be devoured by a pride of lions, or crushed by elephants.
I have crossed almost all the wild regions of the continent and I have had encounters, particularly two, in which I sincerely believed that I might not live to tell them. Going through them is not particularly pleasant, even when they can serve you as the best anecdotes of your life later to amuse others.
If still, like me, you decide to take the risk and venture through wild regions, the crucial element to stand a chance to survive, is to learn a lot about animal behaviour beforehand, and that's what I did. I want to be clear about this. All the experts in animals agree that although one can prevent a lot from proper research and knowledge, nothing is infallible, and in the end, you never know what can happen as animals are unpredictable. As a Tanzanian park ranger put it through to me when he caught me cycling in the middle of Katavi National Park (incredibly stupid thing to do): "When you come face to face with a lion, you are not the one who decides”
Each one must be responsible for her/his own actions and make sure to understand enough about animal behaviour. Here are some brief tips that I have learned from experts that I have found along my way. In no way should they replace your own research.
As a general rule, the best protection and most efficient form of prevention against wild animals is fire. Almost all animals fear fire. If you want to have the highest degree of protection during your nights in wild regions, you must have a fire going on all night.
ELEPHANTS: It’s curious that in the imaginary of most people outside Africa, the lion is the most dangerous animal to be feared, but ask any African and they will tell you that elephants are what they fear the most. Elephants do not hunt humans to feed themselves. They only attack when they feel threatened and in danger, and with good reason, human beings are very dangerous in their minds. It is a very emotional animal and with a lot of memory, they know perfectly well that we exterminate them for their ivory tusks and that is why they resent us and fear us.
Elephants have an extraordinary sense of smell, and if the wind carries our scent in their direction, they can smell us hundreds of meters and even a few kilometres in advance. That very fact will put them on a state of alert.
If we come across them on the road, face to face, it is imperative to come to a full stop and remain still without doing anything that could make the elephant feel threatened. We must become 100% predictable. When you are so close to them, I can assure you that it is a nerve-wracking experience and it is incredibly difficult to repress your instinct of escaping to stay put but you must do it. Otherwise, trying to escape by pedalling fast, the risk of an attack is very high, and remember that despite its 5 tons, an elephant can reach 40km/h, so your chances of escaping are few or none at all. When the elephant feels safe again, it will leave, at which moment we can continue
LIONS: the most dangerous lions for the human being are the old ones because they are the ones that lose the necessary speed to hunt for prey. They are also excluded from the group and that leaves them adrift looking for anything easy they can hunt to avoid starvation. That’s where we come in. On the other hand, even though young lions are not particularly interested in hunting people, an encounter with them can be equally fatal.
They hunt from dusk, during the night and until dawn. During the day they mostly sleep and it would be rare to find them willing to eat you, unless they are old and desperate. In any case, you have to avoid encounters at all costs.
If you spend nights in lions’ territory, it is IMPERATIVE to keep a fire going on all night, at least if what you want is to be on the safer side.
Whether you have a fire going or not, lions do not apparently break-in. That is to say that, if you are inside your tent when they come but do not see you, it is likely that they will soon be on their way ignoring it as any other inanimate object. So, if you finish cooking and eating preferably before sunset, get in your tent and try not to leave until the morning after.
In case of running into them, according to a Namibian conservation expert who advised me in the middle of a lion infested area I was cycling through and who coincided with several others: "If you are on a bicycle and see a lion ahead of you, you should NOT stop. You must keep pedalling at constant speed, neither speed up nor slow down. That way he/she will confuse you with a vehicle and ignore you. If the lion is behind you and you speed up, you will certainly become his dinner, because seeing you fleeing will confuse him thinking that you are prey, thus activating his hunting mechanism ". This is equally true for hyenas. Now, I never got to experience this myself, but needless to say that when I was cycling in lions’ territory the idea of seeing one next to me terrified me to death, let alone having the nerves to cycle past them while keeping my speed constant without having a complete nervous breakdown that would kill me right there. As I said before, YOU DO NOT WANT to come across them.
HYENAS: one hyena is not dangerous; more than one can result in certain death because hyenas attack in groups. Hyenas, unlike lions, do break in, and being inside your tent does not protect you at all. They will tear it to pieces to devour you, like it happened to a motorcycle traveller while camping in remote Kenya. Fire is your best chance since you cannot know whether one or a whole group of them will come to visit you during the night, in which case if you don’t have a fire going, it is likely that you will never live to tell about it, but I will definitely include your story in this article so it doesn’t happen to others.
HIPPOS AND BUFFALOS: Never stand in their way and stay away from them. They are very territorial and irritable animals.
How do you keep a fire going all night you may wonder? Well, first I would make sure to camp well before sunset and, in a place, where there would be abundant dry shrubs around. Before pitching the tent, I would spend the first 15 or 20 minutes gathering the first pile of firewood. At that point, I would light the fire and from then on I would continue looking for more firewood to stack a very good amount that I thought would last me all night long. The pile would lie within my reach next to the door of my tent and the fire a meter or so further away. Depending on the speed of consumption, I would set my alarm clock every one or two hours, at which time I would stretch my arm out of the tent half-asleep and add more firewood to the fire. I would then continue sleeping one more hour and repeat the process until the morning after.
ROUTE PLANNING AND ORIENTATION
This point is very personal and I think it must conform to your personal tastes and choices. I do not usually plan my routes much in advance. In general, there are always specific places that I know I want to visit and things that I do not want to miss, so based on that I then start trying to connect the dots, investigating how to get in and get out of them. There are also the inevitable stops one has to include, for example, the entry and exit border posts of each country and whether I have to pass through the capital city in order to apply for a visa for the next country.
In practical terms, a specific case of my reasoning from the general to the particular may be as follows: “My plan is to cross the entire African continent by bicycle. I know that I do not want to miss visiting this or that country and in this or that country there is this or that place that I want to go through”. So let’s say that I have to go through Ethiopia. I know I will arrive there from Sudan and I will have to continue through it all the way to Kenya. Once in Ethiopia, I am certain that I want to visit the rock churches of the Tigray and the tribal regions of the Omo Valley. Further on, I know that I want to visit the tribes of Lake Turkana in Kenya. I also know that I need to get my Kenyan visa in Addis Ababa because it is not possible to get it at the border crossing at Lake Turkana. " With all this as a basis, the only thing remaining is to connect the dots. Needless to say that it is a completely flexible plan and that I will amend it or modify it as many times as I wish depending on the myriad of events that may arise on the way.
I usually do not carry maps, although if I find someone who has some, I will take some pictures of it with my camera so I can check them later. I also take screenshots of Google Maps when I have internet access. However, I do not trust them as a reliable reference since Google Maps created way more problems for me than solutions in Africa. I have a GPS, but I only use it to mark where I sleep, so I can have fun looking at my route in the future. If you carry a GPS, my best recommendation is the free maps that you can download from Velomap which are not perfect, but they are the most complete for Africa. If you find them useful, do not hesitate to donate some money to the author for such a valuable reference he created for all of us.
My true biggest and most reliable reference comes from chatting with the local people as I move forward. If I do not want to cycle along the main roads to avoid traffic and I intend to stay mostly in small towns and villages, I then ask people whether they know how I can achieve this. This way I build my route as I go, along the way, without much planning and deciding mostly on a day to day basis.
WHERE TO SLEEP
In Africa, I have camped in the wild and I have also slept in churches, schools, clinics, hospitals, brothels, police stations, fire stations, service stations, rangers’ posts, infirmaries, public and private offices, back and front yards, abandoned buildings, border posts, cemeteries, huts, houses of friends or local people, in the houses of members of Couchsurfing or Warmshowers, and even in a morgue once. A few times, I have paid for accommodation as well.
Africa is the easiest place on the planet to find a safe place to sleep every night so it should be the last of your concerns.
WHAT TO EAT
The availability and above all, the quality and variety of food varies drastically throughout the continent. In Arab Africa, the north, the food is fantastic. There’s variety of choice, the cost is low and the flavours exquisite as long you are into north-African/middle Eastern tastes.
In South Africa and to a lesser extent all of its area of influence (bordering countries) there is high availability and variety of food. The South African supermarket chains have everything as if it were any supermarket in the economically developed world. It is very easy to stock up and at a very affordable cost.
It is in sub-Saharan Africa where the real challenge lies. In the eastern half, the variety is limited, but in almost all countries there is somehow good access to food and in general there is always some flavoury dishes. It is also not difficult to find fruit. In the western half, on the other hand, from Namibia to Senegal, everything is much more limited in general, even in the capitals. It is in the equatorial regions and the Sahel where everything becomes noticeably more complicated as there are many regions in which it is even hard to find fruit. In Central Africa and the Sahel, I have spent months eating the same tasteless thing over and over while endlessly losing essential nutrients every day. Needless to say, it was tough and it took a toll on my body afterwards.
In these regions, when I had to cook, I fed myself a fixed basic menu of cheap pasta or rice accompanied by a processed tomato paste coming in suspicious sachets and cans of Moroccan sardines widely available everywhere. In villages or towns, in all sub-Saharan Africa the basic food is reduced to a dry dough made of manioc (cassava flour) in the west and centre of the continent, or maize flour (in the east and south) accompanied by the basic local garnishes of each country. In some they would be beans, in other vegetables. It is rare and very expensive for local people to eat meat, but in case of being able to access it, they usually get their protein from chicken or bush meats, e.g. monkey, porcupine, rodents, small antelopes and everything the jungle provides. I ate them all.
In the west and centre of Africa, the only respite would be found in the capitals, where there are always supermarkets owned by Lebanese immigrants established in the region for several generations. The costs are high for the African standard because almost everything is imported from Europe, but at least there is access to better food, which is essential after weeks of feeding yourself poorly.
CHARGING YOUR ELECTRONIC SHIT
With the exception of the more remote regions, such as the equatorial rainforest and the Sahel, in general terms, it’d be very strange to spend more than a whole day without being able to access electricity in Africa. Having said that, outside of the north of the continent and South Africa, access to it can be erratic at best and it is equally strange to find places where electricity is available 24 hours a day. Blackouts are very frequent and can last for several hours or most of the day. That is why I would say that although access is mostly frequent, it can also be very limited.
In villages and small towns that are not connected to a power grid, there are electric generators that people use to light bulbs at night and also charge their mobile phones. They usually turn them on during the early evening for about 2 or 3 hours.
Also, in many towns there are usually small dedicated stalls to charge electronics for a few coins.
In remote regions, the situation is notably more difficult and in three months crossing the jungle of central Africa, outside the large towns, I have spent about 3 months having access to electricity between no more than 3 or 4 hours per week. But you really have to go very remote to be in a situation like this, otherwise, it’s not bad at all.
My strategy in remote places is simple: I become very stingy with the use of LCD screens on all my devices and charge all my batteries at every chance I’ve got. For example, If I stop in a village or town in which there is a canteen, or service station or public office that has electricity, I take the opportunity to take a break, eat something and in the meantime plug everything in for as long as I stay there. I do not need everything to be charged 100% but I never waste any minute to continue adding charge since I never know when it will be next time I’ll find it. This is mostly valid to charge batteries. The use of the computer in remote regions on the other hand is mostly out of the question.
With the immense amount of different tribes and ethnic groups present in Africa, speaking in hundreds of different languages and dialects, it is impossible not to feel intimidated, but it must not be so. Throughout Africa, from the big cities to the small villages there are always people who speak the colonial language. With good management of the three main languages of the former colonies (English, French and Portuguese), one can move around the entire continent with absolute ease. Knowing Arabic will definitely be of great benefit for the north, but it is not absolutely necessary.
The only exception would be the tribal regions where only the local dialects are spoken but one does not spend most of the time in them either. In that case, the sign language is always infallible to communicate, if we have good will, good humor and a genuine intention to communicate.
TELECOMMUNICATIONS AND CONNECTIVITY
In these times of compulsive connectivity, there is nothing that I have enjoyed more than having crossed 2/3 of the African continent without a mobile phone and extremely limited use for the remaining third. I’m very proud and happy about this. My only connection to the world was limited to the places where I found Wi-Fi, for which I would use my computer or my Ipod Touch.
In Africa it is much more difficult to find Wi-Fi than access to mobile phone networks though. Thanks to this, those with severe addiction to connectivity will be able to sleep peacefully (if that is even possible suffering from this disease) since the mobile telephone network in Africa is highly developed and, except for the most remote regions, access to it is easy and at a price so cheap that it barely counts as a travel expense. All the countries have one or two large dominant telecommunications companies such as the South African MTN, the French Orange, the Indian Airtel which split the cake of the whole continent between themselves.
Now, as I mentioned in the case of electricity, the fact that there is access to the network does not necessarily mean that it is reliable. Logically, the fastest speed is found in the capital cities, and depending on the country, when leaving them, the speed will fall more or less dramatically until reaching the points where despite having signal, it becomes unusable. Having said that, I believe that this will improve a lot over time. Even today, 2019, you can already see travellers streaming live video on Instagram in several regions and with an acceptable quality.
The rule par excellence when it comes to water issues is very simple: wherever there are people, there will always be water to drink, and in Africa there are very few regions where you can spend more than 1 or 2 days without finding people.
Now, my own personal rule with water is this one: wherever I am, I drink the water that local people drink. So: If there are people, there is water, and if people drink the water, I can also drink it. I never carried filters of any kind with me nor purifying tablets and never filtered the water I drank, no matter how murky it would look as long as people would drink it too.
The capital cities are the only place in which I would drink bottled water or in plastic bags as it is so common in West Africa, unless It was water coming from a borehole. Outside the capital cities, there are hand-operated pumps in all the villages of sub-Saharan Africa and it is the best water that any one can drink in the whole continent. This is the water that the great majority of Africans drink and is completely fit for the consumption of any human being.
I understand that there are people who are more sensitive to bacteria than me and suffer more from adaptation and I know of very specific cases, in which there are travellers who never adapt and must always filter the water they drink. But aside from these, it is also important to know that every change of country/region, means a change of water that in turn brings a change of bacteria. It is not uncommon (nor worrying either) to experience light diarrhea during one or two days during the change. This does not create any major inconvenience and it’s not even an annoyance. The body adopts the bacteria quite quickly and continues to function normally afterwards.
I was carrying two debit cards. One on the VISA network and another on the Chinese Union Pay network. Both networks are widely available throughout Africa. With them, and with a little ingenuity, I was able to have access to my money in almost the entire continent.
Already in 2014, the availability of ATMs in large cities, as well as in several smaller ones, was enough so that I wouldn’t have to be carrying large sums of cash with me.
As the border crossings are generally far from large cities and rarely have ATMs, I used to make sure I had a sufficient surplus of the outgoing country's currency, so that I could change it at the border to the currency of the country I was going into. Also, I would try to make sure that I would have enough to last me until I would reach the first town or city in which I’d be able to withdraw money in the new currency. I repeated this procedure throughout all Africa
It is also important to carry some cash in US dollars (in notes issued after 2010 otherwise it is almost impossible to exchange them) and in euros, preferably in small denominations, such as 20 or 50 notes. This money is for emergencies and for some visas that are paid in those currencies only. I used to carry anywhere between 300 and 500 dollars and some euros, all very well hidden in different parts of my paniers.
SPARE PARTS AND BICYCLE REPAIRS
During the period I spent pedalling in Africa, the availability of good quality spare parts was limited mostly to South Africa alone, where you can get everything you want and high quality. Namibia has also a very good bike shop in Windhoek. In Cairo, Senegal and Luanda and I suspect that in Morocco too (although I do not know) there are more or less decent bike shops with availability of some usable spare parts, but not much.
If spare parts are needed in the rest of the continent, there will be no other option than buying them online, but shops do not ship to almost all of sub-Saharan Africa.
Therefore, the only and last option that remains in this case, and this is valid also for the case of finding mechanics with moderate knowledge, is to contact the local cycling clubs. Almost all the capital cities and some smaller ones have a cycling club, and all of them have at least one mechanic who knows how to make proper repairs. Not only that, but many of them recycle bicycle components to be reused, so it is sometimes possible to get used parts through the stock they have.
MEDICAL INSURANCE, HEALTH AND VACCINES
I have not taken medical insurance of any kind during all of my 5 year-long-trip, and certainly this is one of the least intelligent things that any traveller can do. While I had my reasons and my logic to make such a decision and assume the risks involved, the truth is that carrying travel insurance is very important and I would never recommend anyone not to have it.
The most important thing when choosing insurance in our specific case, is to make sure that the policy covers you for bicycle accidents. Many companies do NOT cover this because they consider it a risky sport, in which case it is an insurance that will not serve us for a huge portion of our potential accidents. Companies like World Nomads, include this type of activities and many others considered risky, and I understand that there are other companies that cover them as well.
HOSPITALS AND MEDICAL ATTENTION
Access to medicine in Africa is, needless to say, very limited, and access to high quality medicine, virtually non-existent outside of South Africa. In case of encountering complex problems, there will be no other option but to return home. Having had direct contact with western medical personnel in different parts of the continent, it is important to know that, in many regions, local doctors have a very limited training and, in some cases, dangerously limited training.
Hospitals and health facilities are generally very precarious and almost always lack basic hygiene and the most basic things. The pharmacies of the continent meanwhile abound in fake or expired medicines for several years.
If you need medical help, the first thing you should do to get advice is to call your health insurance company so they can provide you with the list of the most appropriate places to go to. In case you don’t have medical insurance, a good option is to call your embassy to ask for recommendations of local doctors.
If you do not have insurance or a local embassy, in large cities you can naturally contemplate the idea of going to general hospitals, or go directly to private clinics, which very often the only extra thing they offer is facilities in better conditions (usually at an outrageous price) but other than that, just wish for the best.
In the case of rural areas, the best bet is to approach the Catholic missions, since these often have a small clinic with nurses with decent knowledge to deal with the most frequent problems, including malaria. Their clinics also receive donations of good-quality medicines.
Finally, here is my best recommendation. Several years before starting my trip, I met a prestigious American doctor who had spent more than 30 years healing people in rural regions of Asia and Africa. After becoming very good friends I told him about my travelling intentions. He then gave me a book that would become invaluable to me. When he gave it to me, he told me: "Nico, you have to have this book, and remember one very important thing: you do not need to be a doctor to be able to diagnose, and treat the majority of the things that can happen to us. Therefore, study this book thoroughly and take it always with you, because you might also be able to help others. "
The book is called "Where there's no doctor" and it is an extraordinary ultra-detailed manual of about 800 pages, developed by experts in rural medicine, for employees of rural clinics in remote regions and with restricted access to resources.
I could write 10 pages to convey just a portion of the value it had and still has for me. This book is the great reason why I have had so few health problems in Africa, and the perfect solution for almost all the problems I had.
Almost every day without exception I would read and study fragments of it, and it quickly became my reference material par excellence during all the time I spent on the continent. I cannot recommend it enough.
The book used to be free for download by individual chapters in PDF. Although now it is no longer possible, I believe that $ 26 is absolutely nothing for the immeasurable value it has, and it is money destined to the foundation that updates it, whose work is also extraordinary. More info here
The most important vaccine, not as much for health reasons as it is for bureaucratic ones, is that of the yellow fever. Without the certificate of that vaccine in our international vaccination card, you are not allowed to enter many countries, and for many of them even, it is a necessary requirement to be able to apply for the visa.
For the rest of the vaccines, the best thing in this case is to consult with your own doctor. In my case, I got vaccinated after having crossed half of the continent already. My medical specialist in infectiology and travelling medicine recommended me vaccines for polio, meningitis and a tetanus update. I should also note that several years before, I had already been given the triple dose (valid for life) of the vaccine for the different types of Hepatitis.
This disease prevalent in almost all of Africa is a permanent potential risk and one for which we must always stay alert. There is a lot of information on the internet (and also in the book that I recommended above) about it, and it is crucial to study it very carefully and take it very seriously.
From everything I learned and from all the time I spent in Africa, I can tell you several things. The first is that I happily never contracted malaria in two and a half years and with a very high exposure to it in several regions. Also, due to my long stay in the continent, I never took prophylaxis treatment, but I always took several treatments with me in case I needed them urgently. The main medicines are called Coartem and/or Artesunate, both widely available in all Africa and very cheaply. At the point I was there, they were the most reliable and effective drugs to treat the largest number of cases of P.Falciparum which is the main strain. You should research up to date information about this.
In my experience, I believe that never having contracted the disease was due to three factors. One is the exhaustive study I did before, and during my trip, about the disease. The other one was my absolute obsession to avoid bites at all times during the high-risk hours. Finally, I surely had a bit of luck too.
Perhaps the most important thing is to know which are the hours of greatest risk, hours in which the females of the Anopheles mosquito are more active, and avoid at all costs, almost obsessively the bites during that period. The hours vary according to the reports, but a good reference is, the hours of sunset, and the period that goes between 12 at night and 4 in the morning. This does not imply in any way that there will be no risk in the rest of the hours though. The entire night is the period of greatest risk with the aforementioned hours being the worst. During the day there is no risk at all.
I have slept rigorously under my mosquito net every night, whether or not there were mosquitoes, and I have tried not to get out of it or to leave it as little as possible. It is imperative, I reiterate IMPERATIVE that the mosquito net is impregnated in a solution of a chemical called permethrin. Otherwise, it is almost the equivalent of not having any mosquito net, since all mosquitoes will land on it and will bite you when you inadvertently lean on the sides while you sleep. Some of them may be so tiny that they may make it through their small perforations.
Many commercial mosquito nets come already impregnated in permethrin. Otherwise we have to do it ourselves, as it was my case. Permethrin is hard to come by. For what I know, you cannot get it in Africa. In Europe you get it in pharmacies and in many countries, you even need a prescription. You can’t use it in pure state, you have to dilute it in water at a determined percentage. You can search on YouTube for plenty of tutorials about it.
It is also possible to get it already diluted and ready to apply in camping shops but the cost is much higher. For this reason, these commercial versions are generally used to apply to light clothes like T-shirts.
Finally, in rainy season you have to triple the precautions and paranoia, always impregnate yourself with repellent at the end of the day and stay as much as possible under the mosquito net during the night.
I repeat, malaria must be taken with the utmost seriousness. Although most cases are treatable with tablets and recovery is fairly quick, there is always the possibility of contracting cerebral malaria, in which case we will have anywhere between 24 and 48 hours of life left unless we get immediate intravenous quinine treatment. This strain has claimed more than the life of one cyclist.
This point is always subjective and will vary from person to person depending on the degree of comfort that each one desires. Still, in general terms you could say that the costs in most of Africa are very low, regardless of the luxuries you want, because there simply is no variety or availability of sophisticated things in the vast majority of the continent in which to spend our money. Everything is very simple, basic and repetitive. The canteens generally sell the same menu for less than a dollar and the cost of pasta, rice, vegetables and fruits in villages is practically marginal. The hospitality of the people is also enormous, and invitations to eat and sleep in the villages are very frequent.
Similarly, it is not surprising that costs increase as we get closer to South Africa, where even though the prices are still very accessible, the mere access to practically everything we want, inevitably leads us to spend more money, especially when you get there after months of living in scarcity. Therefore, and with good reason, you tend to spend more to spoil yourself, but prices are still very reasonable.
This is the temporary end of this series of answers to the most frequently asked questions I receive. All my answers should not be taken as established and universal truths. These are merely the result of what I have learned in my own personal experience. Many of them may not fit you, therefore, use them only as a reference.
This is an open article, which means that if you have a question or topic that I have not covered, do not hesitate to use the contact form to send it to me.