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Other Infection risks to consider Leishmaniasis, Old world Cutaneous Leishmaniasis is extremely prevalent in Afghanistan. It is spread by the bite of an infected sand fly. Incubation of Cutaneous Leishmaniasis can be weeks - months, it presents as papules, nodules and ulceration of the skin. You are most at risk between dusk and dawn when the sandflies are most prevalent. Most lesions self heal although it can go on for several months and generally heals with a scar. The risks are allergic reactions, fugal infections and mycobacterial/bacterial infections. Protection against Leishmaniasis |
is to ensure that you sleep under insecticide treated bed nets. Use strong insect repellent (DEET) and ensure that one is fully covered - long trousers and sleeves. It is useful to spray ones living and sleeping area with the insecticide. Many areas now use vector control programmes along with malaria control programmes. Malaria - there is a significant risk of malaria between the months of May - November in areas below 2000m. Most of the strain around Kabul is due to Plasmodium vivax (95%), however Plasmodium falciparum is also present see map. It must be noted that Faizabad and Baharak have had outbreaks of malaria. It is important to take the appropriate prophylaxis, malaria can be fatal and it far outweighs the risk of side effects from the medication. Please talk to your GP further about this. There is a variety of antimalarial drugs available, Chloroquine plus proguanil is recommended in Afghanistan in the low lying areas. Prevention of being bitten is highly advised. The mosquitoes bite between dusk and dawn so sleeping under a permethrin - impregnated mosquito net can be highly effective. Use the DEET insect repellent on oneself and spray the room, wear long sleeves and trousers and the mosquito coils. Altitude Sickness - Problems faced at high altitudes and information regarding expedition medicine can be downloaded here from The British Mountaineering Council. Giardia Lamblia- Is one of the most common causes of waterborne disease. The parasite effects both humans and other mammals and infection occurs by the faecal-oral route and contaminated water & food. Once ingested the parasite will live in the intestine and is passed in the stool. Symptoms include, foul smelling greasy stools, cramping, nausea, fatigue, flatulence, bloating and intermittent diarrhoea. The Giardia cyst can survive for months in cold water, filtration of water is advised with a pore size of at least 1 micron. Boil all water regardless of how pristine it looks for at least three minutes at altitude. Metronidazole is the recognised first line treatment, diagnosis is through a stool specimen where the cysts are usually found, sometimes several are required. General advice Bring adequate supplies of all medications in their original containers, clearly labelled. Carry a signed and dated letter from your doctor listing all medications and if carrying syringes and needles ensure the doctor mentions their medical necessity. Ensure that you have a personalised medical kit for your trip. Any unused medication would be gratefully received by the medical team based in kipkut, they provide a mobile service for 28 villages within the Wakhan Corridor. If flying via Dubai please take note of the restrictions on medications. Make sure that your health Insurance covers you for medical expences abroad and possible evacuation should it be needed. Security Security - Badakhshan, the province in which the Wakhan Corridor is situated, was the only province to repel both Soviet and Taliban incursions, due to the mountainous terrain and resilience of the population. Although many governments advise against unessential travel to Afghanistan an increasing number of adventurous travellers are visiting the Wakhan Corridor and Pamirs for climbing and trekking holidays. The Wakhan Corridor is entirely peaceful with no incidents recorded in the last few years. Further west towards Faizabad away from the Wakhan Corridor incidents have occured. If you are planning a trip to this area you must take responsibility for your own security and do your own research into the risks. From our information we understand there are only two minefields in the Wakhan Corridor both on the approach to Noshaq (Afghanistan's highest mountain). Local guides and porters can provide a safe route past to basecamp. You can keep updated from the Afghanistan NGO Security Office www.afgnso.org. There have been recent problems with the website but you can try contacting them by e-mail: coordinator@afgnso.org There has not been any tribal warfare between the Ismaili Wakhis and the Kirghiz nomads, and we have not yet felt tension from locals due to us being here. A team from Mountain Unity held meetings with village elders to discuss tourism and mountaineering, all were very supportive. It was discussed with the elders and they are keen for us to be their link to you. We will hold regular meetings and keep you informed with anything that comes up. |
The Wakhan Corridor, NE Afghanistan |