Living in Angola

Medical Information

This section serves as an introduction to and overview of the medical situation, as well as suggestions for how to keep healthy and safe in Luanda, including tips and guidelines for domestic help:

Overview

The civil war took a large toll on the Angolan population, leaving many women widowed and many children orphaned. Luanda has a very large population of street children, who are either orphans or abandoned by families who cannot support them. Angola has one of the largest amputee populations in the world, mainly due to the severe landmine problem outside of Luanda. There is widespread malnutrition and infant mortality is high. HIV infection is spreading rapidly. Because of poor living and general health conditions within Luanda's neighborhoods, disease, illness, and malnutrition are commonplace among the majority of Luanda's population.

Prevention

Health depends largely on pre-departure preparations, day-to-day attention to health-related matters and a high standard of personal hygiene. You will be exposed to different environmental factors, foods and sanitation standards. However, aside from routine gastro-intestinal troubles, you should have no major problems if you receive the recommended vaccinations and faithfully take your anti-malarial medication.

HIV/AIDS

AIDS is still a fatal disease despite recent advances in therapy. The incidence of HIV is between 10-20% in the general Angolan population, and likely to grow now that the war is over and people can move more freely throughout the country.

Malaria

Angola is a high risk area for malaria and many people get it. Estimates are that 80% of the Angolan population has been infected with malaria. The best advice is to avoid being bitten by mosquitoes, particularly at dawn and dusk. Cover bare skin with clothing, use mosquito repellant and sleep under a mosquito net. Should you suffer from flu-like symptoms, have a blood test and get treatment immediately. Because Angola is in a chloroquine-resistant area of Africa, much stronger medicines need to be used to combat malaria. Malaria prevention is very important and requires use of medication (mefloquine or doxycycline, check with your physician as to which one to use), as well as sprays/creams and mosquito nets. Mosquito repellant should contain 30% DEET, preferably in a slow release form, i.e. Hour Guard cream from AMWAY, U.S.A.

Medical Risks

The most common health problem for expatriates is intestinal illness related to food and water contamination, and is mostly avoidable. Malaria and auto accidents are the most prevalent of the serious health risks, and either can be fatal. In addition, auto accident injuries may lead to hospitalization and the risk of exposure to blood and needles contaminated with AIDS or hepatitis. Yellow fever exists but vaccination prevents illness. Cholera epidemics occur but expatriates rarely become infected, if following normal food and water precautions. EBOLA, like most of the contents of the tropical medicine textbooks, is of no real threat to official Americans.

Medication

All necessary medication should be brought with you.

Preparations before arrival

Medical and dental evaluations should be completed before departure from the U.S. Start to get all immunizations. Some require a series of shots over a period of time.

Immunizations

The only immunization required by the Angolan authorities is for yellow fever. Recommended additional immunizations are hepatitis A and B, polio, rabies, typhoid, tetanus, and meningitis. Routine immunizations must be up to date before arrival in Angola.

Intestinal problems

To counteract intestinal problems, bring Pepto-Bismol and/or Immodium; antibiotics are available to help with serious attacks.

Medical Care Available

Angola is a tropical African country with an inadequate medical and public health system by Western standards. Tropical precautions (i.e. food, water, and malaria) are advised. Primary care for simple conditions should be obtained from the recommended resources. All serious cases should be stabilized locally, and then evacuated to Johannesburg, South Africa or Europe.

Clinics

The following list of hospitals, clinics, and providers was compiled by the U.S. Embassy's Health Unit after review by the Regional Medical Officer. The majority of practitioners in these clinics have had training overseas and are familiar with American levels of medical care. They have been utilized by the American community in the past. Only a few have any command of English. The list is not meant to be exhaustive or definitive, nor does a clinic's placement on this list constitute a recommendation by the U.S. Embassy. There are many private clinics and hospitals, which can provide consultations, administer first aid and treat common ailments. These clinics are all open 24 hours:

CLIDOPA - Rua Rainha Jinga #128, Tel. 390-198/248, Fax 391-031
Climed - Rua de São Tome #56 (close to the Embassy), Tel. 340-074
Clinica Alvalade - Tel. 323-540
Clinica Sagrada Esperança - Ilha de Luanda, Tel. 391-080/334-442/334-498
Elf Aquitaine Clinic - Rua Dr. Tome Agostinho das Neves, Tel. 352-633/354-511
Fisiomed - Sportsmedicine and Physiotherapy, Rua Eduardo Mondlaine #41-43, Tel. 334-862
French Medical Cabinet - French Embassy Clinic (good lab facilities), Tel. 395-207
Medical Rescue International (MRI) - Angola, Rua Eduardo Mondlaine #41-3, Tel. 336-555/391-946/337-939. Provides emergency response for many expatriate organizations in Luanda.
Medigroup/Clinica da Mutamba - Rua Felix Machado (Mutamba), Tel. 393-783/395-283

Dentists:

Anglodente Centro Medico - Rua 28 de Maio, Maianga, Tel. 337-919
BIO DENTE - Largo Che Guevara, 4-R/C, Tel. 396-095
Clinica Sagrada Esperança - Ilha de Luanda, Tel. 391-080/334-442/334-498
Medigroup - "Mutamba clinic" also offers dental services (see above for contact information).

Pharmacies:

Farmacia Tropicale - Rua Pedro Felix Machado #16 (Mutamba), Tel. 334-962

General Precautions

Eating and Drinking in Luanda - The following are a few things to remember, especially when eating out:

Do Not Drink -

Tap water, not even to rinse your mouth or for brushing your teeth.
Eat frozen confections prepared with unpurified water or non-pasteurized milk.
Water served in hotels or restaurants unless you are sure the bottle was sealed. Open it yourself to make sure.
From a glass that is wet from washing.

Do Not Eat -

Raw fruits and vegetables that you cannot peel yourself, or that have broken skins (salads especially).
Foods likely to have been prepared far in advance of serving, especially chicken, eggs, or dishes containing mayonnaise.
Custards and cream-filled pastries or other desserts.
Raw or rare meats, poultry, fish, or shellfish.

Other Guidelines -

Always sterilize fruit and vegetables for at least 10 minutes before storing.
Eat well-cooked foods while still hot.
Carry anti-diarrhea medications, preparations when traveling.
When going on a trip to the provinces take along at least 1 liter or more of bottled water.
Do not swim, bathe, or wash in contaminated fresh water. Avoid fresh water streams, rivers, or lakes where schistosomiasis (bilharzia) is a potential hazard.
Follow malaria precautions carefully, i.e. well screened house; wear long sleeves and pants from dusk to dawn if outside; take precautions against biting insects and apply a spray or cream containing DEET to exposed skin. Take malaria prophylaxis medication.
The sun in Angola is very strong, so it is important to protect from sunburn with clothing, wide-brimmed hats, good sun block, lip balm, and UV coated sunglasses.

Precautions for Domestic Help

Domestic help is readily available at reasonable rates; however, they must be trained to achieve Western standards and most speak only Portuguese. The source of many family illnesses can be traced to an untreated member of staff. When domestic help is hired, they should have a complete medical, including stool exam for parasites, culture for typhoid, a complete blood count, and a chest x-ray for tuberculosis. The following checklist for kitchen staff can help maintain proper standards of hygiene for those involved in food preparation:

If your help is ill with a fever, vomiting, diarrhea, or a bad cold, they should tell you before they start the day's work. It is best to release them to go to the clinic.
Teach your help to wash their hands in hot soapy water when they first enter the kitchen, and before they begin preparing food or drink. Hands and fingernails should be cleaned with hot soapy water every time after going to the toilet.
Only bottled water must be used for drinking and for filling ice trays.
Have a supply of boiling water on hand to be used for rinsing dishes. Wash dishes in hot soapy water and rinse with boiling water. Be sure all surfaces of dishes and cutlery come in contact with the boiling water. The dishes will dry in a few minutes and must be promptly stored in the cupboard.
Food must be stored in the refrigerator or other storage area and should not be allowed to sit around the kitchen or dining table. Do not store open tin cans of food or beverages in the refrigerator. Put the food into glass, plastic, or stainless steel containers.
Handle food with bare hands as little as possible. Use kitchen utensils. Use tongs when putting ice cubes into drinks. Uncovered cooked or raw food should not be allowed to sit around the kitchen before being served.
Garbage must be kept covered and should be emptied at least once daily. Never allow garbage to remain in the kitchen overnight.