Vaccine advice for going to West Africa?

[Bibliomommy]

My three children, husband, and I are going to spend about 9 months in West Africa (in Niger). Is anyone on this list living in Niger?! That would be too amazing. In any case, we have chosen--until now--not to vaccinate and I am wondering if anyone has advice for me about what to do about vaccines. I was hoping to get away with the barest minimum. It does seem that polio is necessary, and yellow fever (without which we cannot get visas), and perhaps tetnus. Are there any others that you would absolutely recommend? I was going to forgo measles as it is a common childhood illness that my children should get and I heard about a white man who started an epidemic in a rural African area, because he had just vaccinated his son. Any advice, thoughts, comments most welcome!

[tbean]

Hi, my family and I may be moving to Ghana in August to live and teach in Accra. I have two unvacc'd daughters (2 and 4) and am just beginning to seriously consider all of these issues. Did you learn anything new? I'd be very interested in talking to you about Yellow Fever and Malaria....
T.

[maxmama]

I was in Peace Corps in Central Africa (Gabon) and had my vaccinations updated for polio and MMR, which were both required by Peace Corps, and got typhoid, yellow fever and rabies as new vaccinations. None of them gave me much of a reaction except the rabies series, and for most people living in the countries but not working with animals it's not necessary.

I did not tolerate mefloquine for malaria prophylaxis, and it's why I came home early (you cannot stay in country in PC if you can't prophylax). Mefloquine was tested on men, who have approx a 10% risk of psych side effects. With women, it's closer to 30%, mostly depression/anxiety. Doxycycline is a good alternative, but is daily instead of weekly, and can't be used by children under eight due to effects on permanent teeth. If you choose not to prophylax, have Fansidar handy and treat pretty much all fevers as if they're malaria.

Is West Africa a meningococcal-endemic area? Gabon's not, so I wasn't vaccinated for that.

[tbean]

Thanks for replying, we are definitely going to be moving to Ghana in August and so I will be researching this stuff like crazy. Good info on the malaria, it seems like a trip to the doctor for every fever may be the way to go. That will be a change for us since we don't usually fuss much over a fever. We already have a good connection for a doctor there.
T.

[lyd84]

I travelled west africa last year, and was at university in Legon, just outside Accra. (tbean where abouts are you moving? i love Accra and have much to share about the city if you're at all interested)

i got yellow fever vaccine, they checked my certificate upon entry and Kotoko airport and when i crossed into Togo, and when i crossed from Benin to Niger, but nowhere else i don't think.

i also vaccinated against tetanus, hep B (i was working in a clinic but might reconsider for a child, this jag was nasty) and i took anti malarials. i grew up in cape town so didn't bother with TB and polio, i was around them a lot as a youngster. i also didn't do rabies which was recommended (too expensive).

i got typhoid from a chop cafe in Ghana (in Akosombo i *think* and recovered pretty well after only 2 weeks).

in Accra, i would be as bold as to say anti malarials are a waste of time unless you are awake a lot in the early mornings and plan on sleeping without a net.

this is my first post here, i'm Lyd, 21, and i live in the UK. if you want photos etc of Accra i'll happily share access to my photobucket

[tbean]

Hi,
That sounds very cool. We would love to see your photos. The vaccination thing had been hard mentally, but I think we are working things out. I think the bottom line is that we will get everyone Hep A and Yellow Fever (maybe typhoid) before we go and then any others we will take care of with a doctor/clinic in Accra. My biggest worry was that we waited to vacc and then we suddenly did a bunch all in one short summer.

I've still barely had time to read about where we are going. I have only heard good things though. We will be in Accra and teaching at an international school. Definitely tell me what your favourite things were. Any favourite beach or restaurant?

Tracey

[lyd84]

you MUST head to Kokrobite. you can get a taxi from Accra for roughly 100,000 cedi (£10 US? i'm useless converting to canadian but $13-14?) from Kaneshie station (which you will find very quickly - it is the best place to pick up a tro tro to go anywhere outside Accra) you can get on a tro tro to Winneba or anything heading west (ie. Cape coast but will be less likely to stop, Apam, Mumford, etc) and then get a shared taxi from the big barrier at the Kokrobite sign and head on down to the beach. there is a backpacker resort (big millie's back yard) which is awesome, lots of families, a good white/black mix, live music at weekends, cute-as local children on the beach who might make good companions for your own little ones. the accomodation is basic but comfortable - a few huts have the flushing toilets, then there are communal facilities, a sleeping deck which is very basic (matress, net) for around 10,000 cedi a night ($1?) or a room with a fan will be more like 60,000cedi, and probably worth every last penny! once there we did nothing but slob on the beach (beware, badi - beach in Twi, is the same as the word for toilet for a reason! although Kokrobite isn't too bad at all) and sing and dance at night. the restaurant in big millie's does decent food, jollof and banku which you'll get used to quickly, as well as seafood. there is also a cheap italian place close by which is delicious, my best friend celebrated her 21st birthday there. beware the apateshie (distilled palm wine alcohol, 3x stronger than gin) it is lethal.

Winneba was amazing, they have a deer festival in march which was slightly gruesome but an amazing party. easy to get to. etc

my favourite place was Cape Coast. totally beautiful town, friendliest people. they speak mainly ewe but i got along ok with my basic Twi. the further from accra you go, the less english will be spoken. the old slave forts are amazing. i would recommend the savoy hotel. it is a hostel and it is basic, but it is clean and the staff are friendly and they have the biggest beds i've ever seen! we comfortably slept 5 (we're students on a budget, but really, it was fine!) and spent something like 10,000cedi each. avoid the restaurant, but there are lots of chop stands nearby.

Kumasi is lovely, interesting for day trips. it seems much more 'city' like than Accra. i loved it. the ashantehene palace was a little disappointing, but still worth seeing.

Mole is animals. i grew up in south africa and can't get too excited by elephants, but they're there. such a long trip by bus from Accra though. worth seeing Tamale and Larabanga as the culture is much more Islamic and really interesting (the mosque at Larabanga is *amazing*) but from Larabanga you have to cycle (the road is impassable by vehicle) to the national park. and in 125* heat - man alive it was tough going.

In Accra, Osu is the place to go for restaurants. it is the tourist mecca i guess and it was the only place i was wary of crime. Frankie's hotel is on the main street and sells great ice cream (most ice cream is to be avoided, typhoid wise). just down from frankie's is a side street, and if you take a right then the first left there is an amazing restaurant, Mamma Mia's. owned by the friendliest guy - Pete - it is a standard Italian but can be very welcome for a little piece of home after days of rice. the pizza was just out of this world. amazing. oh man, i would go back just for a night at mamma mia's. the only club i went to was called Tantra. and it was a club. enough said.

I worked at an orphanage in Osu, Osu children's home. the mamas there were friendly and loved having people go in and play with the babies. i really think it is something worth doing. 2 little girls - Comfort and Jemima - stole my heart. i want to go back and bring them home with me. we took them to the beach (labadi in accra, near the culture centre) and to the really posh swimming pool at La Palm hotel (you *must* go here. it is 60,000c to use the pool for the day and it just IS paradise!) and they had so much fun. i have some lovely pictures of them.

as far as markets go, Makola is the main market, but i found it a little daunting. everyone yelling 'oboruni' (means white man, you'll here this often even if you're not white - they use it for all outsiders!) and i don't like the hissing. the women all hiss to get your attention. Madina, which is a fair way out of central accra out past the university (which is well worth a visit, it is gorgeous!) is smaller, more relaxed, and has lovely cloth and fresh fruits and food. i loved it, and made so many friends there.

Ghanaians are very friendly, they all want to ask you your day name (depending on which day of the week you were born you have a name in Ghana, i am friday born so called Afia) and talk about where you're from and touch your skin and hair. in the heat and with things to do this grates after a while, but generally was really nice. Yefre wo sen? (what is your name) and Ete sen? (how are you) are what they'll mainly shout, the answer to which is eye (ay-eh, i'm fine).

oh i am so jealous, as you can probably tell, i loved Ghana. I also loved Lome (well worth an overnight visit) and the southern part of Benin (Ouidah and Porto Novo, Cotonu is a dump!) which are really easy to get to on tro tros from Kaneshie.

The shangri-la hotel, close to the airport, has a nice pool and cheap food (houmous and pitta bread etc) and i spent far too much time there. drinks are pretty pricey though.

the restaurant opposite, La Chaumiere, is just mindblowingly amazing. total ex-pat haven. lobster dinner for $10! friendly but all white.

i had a hideous experience at Ridge clinic. avoid it at all costs. they didn't diagnose my typhoid, told me it was just heatstroke, and 12hrs later i was in bed unable to move and went to Nyaho hospital near shangri-la where i got better rapidly.

hope that helps some! this is fun, i miss my life there so much. you'll just love the place!

[tbean]

Wow Lyd!
That was such a cool post. I will definitely be putting a copy of it in my guide book to refer to once we are there. I can tell how much you loved your time there. It reminded me of when I was in my early twenties and I lived in Quito, Ecuador. We used to ride on top of buses along the coast and go to the best little beaches to hang out. Thanks for sharing. We would love to see your photos if you want to share. I think you can 'pm' me so that you don't have to post anything here.
Tracey

[lyd84]

hi Tracey,

sorry i forgot to put the link to pictures in my last post. i think the easiest way is through www.photobucket.com then if you log in as 'ghanapictures' then password 'siski' you can see the albums, i have 5 sub-albums on there. most of my people pictures are elsewhere, but i don't know they'd be of interest. i didn't get many pictures between jan-march. when the halmatans blow over the air is so filled with dust it was impossible to get a good picture, and you'll be constantly sweeping red dust. but once they go in march (the 'furnace' month) you'll miss the slight breeze there was as you cook in 100* heat with 100% humidity!

i was thinking also, the best beach was at a place - KoSa was the 'resort' just outside Cape Coast. it was beautiful and quiet, the sand was like sugar and the few people were so friendly, but the place to stay at KoSa was so full of spiders i was terrified, our net had holes in it and i was just so sure Nina or i would wake up dead. spent the whole night in a cold sweat listening to those 8-legged demons rustling in the roof. gah the memory is almost too much!

please ask any questions you might have, and just because i found it the other day, the orphanage i worked at is at www.osuchildrenshome.org. if you're bored of a saturday morning go and play with the babies, they are so cute and you'll have so much fun! (wear old old old clothes!) there is also a huge refugee camp just outside the city to the west, mainly for Liberians, and it is a pretty cool place to hang out but it was difficult to get to and i can't remember the name of the area (Billa Borra?) although if you want to volunteer i'd investigate.

i only remember seeing one international school in Accra. It was called 'Christ is King' or something and was on the route from Legon into Accra. is that where you're headed? i'm sure there are more but don't remember seeing any. as a non-christian who has spent her whole life at international schools i didn't go near the place but it did look nice from the road!

let me know if i can help with anything else. when do you leave?

[tbean]

Awesome photos thanks for sharing! We are leaving in a month. The school we will be teaching at is in Accra. It is called Lincoln Community School (non-profit, non-denominational) and they teach an IB program. I'm really glad you sent the link to the orphanage. When I lived in Shanghai we took our middle school students every Saturday to play with the babies at an orphanage. It was difficult but incredibly rewarding. I really miss those kids, and there were many I wanted to bring home with me.

Again, I'll be rereading your posts once I arrive and settle in. I think the names and places will have more meaning to me once I'm there. I'll also think of more questions I might have.

Tracey

[Jael]

I vaccinated on my first trip, but on my last trips to both East and South Africa I didn't vaccinate at all. I also didn't take malaria pills and I survived. Even though I did it, in good conscience I can't recommend anyone else try it, however, as another friend tried the same thing and became very, very, VERY ill with a bout of malaria in Ethiopia. While visiting the YWCA in Kenya, I heard a story of an American girl who'd stayed at the hostel and contracted malaria and lost something like 30 pounds in 2 days. They said she lived, but it was touch and go for her.

[Bibliomommy]

I had a terrible time with a doctor yesterday who started lecturing me about how I was endangering my children and the world when I scheduled an appt to take to him again about vaccines. But one thing he said, and he was ULTRA CONSERVATIVE, was that Hep A is not dangerous for children but is pretty bad for adults. He is a vaccine-happy doctor and even so seemed to not be recommending Hep A.

I know for sure we will not do MMR or chicken pox but I'm having trouble sorting out the rest. Yellow Fever is required for our visas so we all got that vaccine. I read that the Typhoid vaccine is only 70% effective, if that, and something like 95% of Thyphoid cases manifest as bad diarrhea and fever. So I'm pretty sure we'll skip that as well.

Have you found out anything else? Any other wisdom welcome. I'm on the computer a lot for work so I forget to check this board. Anyone going to Africa, living in Africa, or interested in vaccine questions is more than welcome to email me at: properzioprose@jeffnet.org

[lyd84]

biblio i had the typhoid injection and still got it. it was grim for sure but in 14 days i was fighting fit again. the injection was absolutely nasty, almost as bad as Hep B, i wouldn't get it again and didn't get the booster. i think with all things it is about being aware of what to look for. if child starts breaking out in fever, check for malaria etc.

[ochoco]

Hi,

I also was in the Peace Corps (Senegal, though), and I just want to pop in and give my two cents about malaria. Mefloquine is scary, scary stuff, and if it can be avoided, I'd do it. Lots of PCV's have had issues with it - worth investigating online. However, Fanzidar (the anti-malaria medication) is also heavy-duty, and I wouldn't give that lightly, or wait for the children to develop fevers. Some kinds of malaria are very fast-acting and can be fatal quickly (My DH got this kind - luckily he happened to be in the capital and was diagnosed/treated quickly). Doxycycline may not be the best thing, but having had firsthand experience with malaria, it might be the least of all the evils, you know?

Not to scare you - sounds like you might not be in such a bad area - but definitely some kind of prophylaxis is a good idea...

Your trip sounds fun - I'd love to get back to visit our 'family' in Senegal...!

[wagamama]

We've been in Nairobi for the past two years and will be moving to Abuja, Nigeria in November. I have a 13-month-old and am also worried about the vax situation. Unfortunately I only recently found out that vaccinations are damaging to the immune system, so he has received all of them up to now. :( He hasn't had the MMR yet, and if we were living in Europe or NA, i would definitely stop vaxing now. But Nigeria ... I really don't know what to do.

I'm pretty sure we won't be taking anti-malaria meds, though. It's just not safe longterm, I could never give that to my baby. So we'll be living under mosquito nets I guess.

[george3]

Need email address either for Wendy or Big Millies. Have 400+, people, 7 villiages (100's) signing up for Mercy Ship Unite for Sight screening. Need a place for screening team to stay.

New to Mothering. please advise of any better place for my query.

thanks

george.