Health

Safety



Health

With Dr Felicity Nicholson. For up-to-date information on health issues across Africa, click here.

Nigeria’s poor infrastructure, colossal population, poverty, terrible roads and high crime rate combine to create what can only be described as not a very healthy or safe place to visit. Travelling in tropical Africa exposes us to diseases caused by parasites, bacteria and viruses, some so bizarre we may never have heard of them before. Illnesses are passed around in food and water, or by insects and bugs, and can even be contracted from passing an infected person on the street. Added to this is the high crime rate and manic, highly publicised congestion on the roads.

However, remember that with the right precautions and a sensible attitude, the following events or illnesses are unlikely to trouble you. Getting fully acquainted with them in the first place, and knowing what to do if something goes wrong when you get there, can minimise all Nigeria’s health and safety risks. Prevention is the best way to stay healthy and safe. To put things in perspective, after malaria, which can be prevented by taking the right precautions, the biggest danger for a traveller in Nigeria is being involved in a road accident

Immunisations

Immunisation against yellow fever is essential and proof may be required on entry, and always if you are coming from another yellow fever infected area. There is a real risk of contracting yellow fever so the vaccine would be recommended unless there is a contraindication against having this live vaccine. Most travel clinic experts would then advise against travelling, as the risk of disease is high. Cholera is a risk in high-density urban areas, so if you have time then consider having the oral cholera vaccine (Dukoral), now available in the UK, especially if you have any underlying medical condition or are planning to work in unsanitary conditions.

This palatable berry-flavoured drink is said to offer about 75% protection against the more common strains of cholera. For adults and children six years and over, two doses are needed, taken at least one week but no more than six weeks apart. Ideally the second dose should be taken at least one week before entering an infected area. Two doses of vaccine will provide cover for two years. For children aged two to five, three doses are needed for the same efficacy, but protection lasts only for six months.

Typhoid and hepatitis A and B are present in Nigeria and immunisations are highly recommended. Meningitis and rabies immunisations should also be seriously considered. Routine immunisations, such as for tetanus, diphtheria and polio, should be reviewed and updated. If you do decide to have an armful of jabs, start organising them at least six weeks before departure, and remember that a yellow fever certificate becomes valid only ten days after you’ve had the vaccination.

Travel clinics and health information



A full list of current travel clinic websites worldwide is available on www.istm.org. For other journey preparation information, consult www.travelhealthpro.org.uk (UK) or http://wwwnc.cdc.gov/travel/ (US). Information about various medications may be found on www.netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.

Safety

Road accidents



Bugs, bowel movements and tropical diseases aside, your safety during any trip to Nigeria is most likely to be endangered by getting around by road. Traffic everywhere, and most infamously in Lagos, is one big aggressive snarl-up. The city roads are choked and congested beyond belief, while the highways and expressways between the cities are poorly maintained, and used by manic drivers who have no respect for oncoming traffic.

Road accidents are common, as attested to by the millions of battered vehicles in the country, and by the thousands of mangled buses and cars on the sides of the road. If you are travelling around in a chauffeur-driven car, by overland vehicle or by overcrowded public transport, always exercise caution on the roads. Always be aware of your driver’s road sense as soon as you get in a vehicle – which you should be able to judge pretty quickly. If you are very uncomfortable with his method of driving then stop him, get out of the vehicle and find an alternative one.

Always avoid driving, or being driven, after dark. There are very few street lights, many vehicles do not have headlights, and there’s the added problem of pedestrians and domestic animals on the road. Additionally, though there are countless police roadblocks during the day, there are far fewer at night on the roads and this is when armed robberies of vehicles tend to take place. If you are taking public transport over quite some distance, set off early in the day as you will inevitably have to wait for some time in the motor park for a vehicle that goes-when-full, and you will want to ensure that you reach your destination before dark. I would also not advise you to travel on the so-called ‘luxury’ buses simply because they nearly always travel at night.

Crime and corruption



Nigeria has a reputation for crime and corruption and has more than its fair share of challenges to safety and security – it is advisable always to be security conscious. Things do happen – armed robberies and carjackings are prevalent in Lagos and there is a threat of mugging. More disturbing are the huge numbers of guns in private possession and in the police and armed forces; all are susceptible to bribery and corruption, and thus could provide arms to civilians at the right price. There have also been incidents when the police themselves have been the perpetrators of crime.

Some of the more outlandish crime that occurs in Nigeria is piracy, or armed robbery on ships anchored in Nigerian waters, or the illegal ‘bunkering’ of oil onto ships belonging to other nationalities. It’s also not uncommon for gangs to hijack oilrigs off the coast to extort money from the oil companies. Also be aware that there have been many recent incidents of hostage-taking for ransom, particularly in the Niger Delta, because of local community problems with the oil companies. People working in Nigeria for these companies should be especially vigilant and follow their employer’s security guidelines.

Although it doesn’t produce any drugs of its own, Nigeria is known as a major drug-trafficking country for Asian heroin smuggled to Europe and the USA, and for South American cocaine trafficked to Europe. Nigerian drug organisations are also heavily involved in other criminal activities such as document fabrication, illegal immigration and financial fraud. But Nigerians in Nigeria are generally not drug users.

I live in Cape Town and at the end of my road is a large Nigerian community (a reported one million Nigerians live in South Africa, and three million in the USA, with other large communities in Europe and elsewhere in the world). Some of Cape Town’s Nigerian community, as well as many Capetonians, sell drugs on the street for a living. We never once got offered drugs on the street by a Nigerian in Nigeria.

Many Nigerians complain that the illegal activities of the offending minority have damaged the whole nation’s image. It was also explained to me that most of Nigeria’s criminals were not in Nigeria at all, and made up the huge populations of Nigerians living overseas. These were the people who were capable of forging, stealing or bribing to get passports and visas, and, as illegal immigrants in other countries, resorting to criminal activity to make a living. Despite all this, Nigeria’s awful reputation for crime is largely exaggerated, especially outside Lagos where you will rarely feel threatened or be a victim of crime. Even in Lagos, long-term visitors may never see an ‘Area Boy’ (hoodlum, thief) or someone out of uniform carrying a gun. But always remember that there is a criminal element in Nigeria and keep up your guard.

Petty theft

The culture of cheating is alive and kicking in Nigeria and you are more likely to be cheated out of something than having it simply stolen off you. This was one of the biggest surprises I had in Nigeria. As a seasoned traveller in eastern and southern Africa, where you guard your bags and possessions fiercely, I didn’t feel the need to do this so attentively in Nigeria. Not once did we have anything stolen out of a hotel room, and after the first few outings on public transport when we crouched over our bags jealously, we would quite willingly throw them into the open back of a vehicle surrounded by hundreds of people and go for a wander around a motor park while waiting for the vehicle to go-when-full.

Political risks

There is no doubt that political and religious tensions in Nigeria are high, and there has been a catalogue of riots and violent incidents since the country gained independence in 1960. There is no real science of assessing political risk, though it’s a good idea to check your nationality’s foreign office advice before you leave home and keep a close eye on Nigerian news. Outbreaks of localised civil unrest and violence can occur all over Nigeria without warning. If something does occur while you are in Nigeria, it is unlikely that a traveller will be targeted or involved, and most violent eruptions are based on local ethnic or religious spats.

Potential trouble spots are in the northern cities, and in the Niger Delta where the local communities resent the presence of the multi-national oil companies. Here is the one place where foreigners could be specifically targeted if they are identified (mistakenly or not) as oil employees and at the time of writing the region was pretty much off-limits to foreigners because of a continual spate of kidnappings.

Women travellers



Nigerian women all over the country travel on their own, be it on long journeys by bus or for a short hop on the back of an okada. Every time I jumped on the back of an okada, however, everyone stopped and stared incredulously. But the attention you get stops there, and you will soon get used to having a million pairs of eyes on you. The most prevalent attitude you are going to meet is complete bemusement. Nigerian society is conducted on the street and Nigerians are by character great socialisers and talkers, and they’ll often approach you for a chat.

Almost all of the time it is just out of inquisitiveness and simply just to say ‘Welcome’. Not once did I receive any rude or suggestive comments, and (only!) once was I approached in a bar environment to ask if I wanted company – as happens anywhere in the world. The guy in question left when I declined. But remember to turn down unwanted attention very politely – pride is important for Nigerian men.

One word of advice for women travellers (at least for anyone over the age of 21!) is to say that you are married even if you’re not. This is not for any practical reason; you certainly won’t be asked if you are married to get a hotel room, even in the Muslim north. But if you are over 21 and not married, Nigerians – male and female – will not get it, and you’ll be embroiled in a lengthy and analytical conversation about why you’re not married. Believe me, it’s just easier to say you are. Although there have been occasions in Nigerian history where rape and sexual assault have been prevalent, they have only really occurred during war times when the army has used rape as a weapon against women. Other than that, sexual crime is not common in Nigerian society. Hopefully this is because it doesn’t happen rather than because it’s not being reported.

The most important thing for a woman to consider is to dress modestly, especially in the Muslim north, though despite the strict sharia code, Western women are not expected to cover their hair. This is because many Christians live in the northern cities and wear what they like, though as a visitor it’s always sensible to respect the local customs.

There are other Islamic considerations to take into account: women are generally not welcome at mosques, particularly at prayer times, and as prayers often happen outside mosques or in open prayer compounds at the side of the road or in markets, it is a good idea not to get too close, and under no circumstances should you stop and stare. In the northern cities, my male fellow traveller went to the main Friday prayers to see several thousand men praying in and around the main mosque. It wasn’t appropriate for me to go and he says that all the women in the area simply melted away during prayer time.

Travellers with a disability



Nigeria, like many other African countries, does not cater for the needs of disabled travellers – or even those of its own disabled population. Unfortunately, few establishments, except perhaps the international hotels in larger cities (about three or four at most), have made any considerations for wheelchair users. Even an able-bodied person would have difficulty finding any space at all on public transport, never mind an actual seat, and getting around the congested streets is virtually impossible.

Gay travellers



In early 2007, the national assembly deemed homosexual activity illegal in Nigeria. It’s now punishable by up to five years in prison in the south and, under sharia law in the north, possibly by death.

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