Vaccinations Then and Now

Vaccination

Okay so I am Australian and I want to travel the world.  I live on, what is basically a large island we are well protected from the rest of the world’s diseases. We have very strict quarantine laws, we have safe drinking water and strong food safety laws. In recent years we have had some Ross River Fever and our Bats have a rabies/lyssaviruses, but on the whole we are a very safe country to travel in. Oh except for the venomous snakes (Australia has about 140 different land snake, and 32 water snakes. Around 100 are venomous, but the number that could actually kill you is only 12). Let’s not forget the spiders, giant crocodiles and perhaps the drop bears, but that is a whole different topic, today we are talking about vaccinations. Before I started to travel overseas in 2005 I went to the local travel Doctor and asked what I needed for Africa and this is what he said.

1. Hepatitis A
   1. Hepatitis A vaccination is thought to provide lifelong immunity. Hepatitis A vaccination can be given alone or as a combination with Hepatitis B or Typhoid.
2. Hepatitis B
   1. A completed course of vaccination is thought to confer life-long immunity.
3. Cholera
   1. The oral cholera vaccine also provides some protection against one of the more common forms of traveler’s diarrhea. Normally the vaccine is taken in two doses 1-6 weeks apart.
4. Typhoid Fever
   1.  A completed course of typhoid vaccination provides protection for up to three years.
5. Yellow Fever
   1. The vaccination for yellow fever provides a high level of immunity for a period of ten years. The vaccination is usually quite safe but is unsuitable for a small number of individuals.
6. Rabies
   1. Normally the vaccine is used before departure to provide immunity in the event of an animal bite.  Rabies vaccination provides effective protection against this serious illness. Normally the course requires three visits to our clinic within about one month.
7. Influenza
   1. Although the vaccine only provides immunity for about one year it normally has very few side effects.
8. Malaria –
   1. Malaria is an infection it is passed on via the bite of an infected mosquito. Travellers to tropical regions of Asia, Africa, and Central or South America are at risk. In malarial areas, avoid mosquito bites by wearing long, loose clothing, using insect repellents and avoiding outdoors at dusk and dawn. Anti-malaria tablets.
9. Tetanus
   1. Protection against tetanus should be considered for all travelers and normally lasts about ten years.
10. Meningococcal Meningitis
    1. The vaccine most commonly used for travelers protects against multiple strains of Meningitis and provides immunity for up to three years.
11. HIV/AIDS
    1. The human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS). There is no vaccine or cure for HIV or AIDS, but medication can manage HIV-related illnesses and AIDS.
12. Japanese encephalitis vaccine
    1. This should be considered for travelers to affected regions of Asia.
13. Bilharzia
    1. Bilharzia is a parasitic disease caused by worms that enter a person through the skin when they come into contact with contaminated fresh water. The parasites enter the skin, migrates through the body to the blood vessels of the lungs and liver. It advances to the veins around the bowel or bladder, lays eggs which can either be passed in the urine or faeces, or remain in the tissues in the human host in the liver or bladder.
14. Giardia infection (Giardiasis)
    1. Giardiasis also known as gastro. It is caused by the parasite Giardia Lamblia. Giardiasis can be spread by contaminated drinking water. It can also be spread by faecal contamination of public water. Giardiasis can be treated with medications.
15. Varicella (chicken pox)
    1. Vaccination of children against chickenpox not only prevents serious disease in childhood, but also ensures immunity in adolescence and adulthood, when complications from the disease can have severe outcomes.
16. Dengue Fever
    1. Dengue fever is a viral disease spread by mosquitoes in tropical and subtropical regions. There is no specific medical treatment and no vaccine. The best way to protect against dengue fever is to avoid mosquito bites when in affected areas.
17. Polio
    1. A single booster during adulthood is thought to result in lifelong immunity. Polio can be given alone or as part of a combination with other vaccines.
18. Measles mumps and rubella
    1. An effective combination of these vaccines can be given as a single dose and it provides long-lasting immunity.
19. Diphtheria
    1. Boosters are normally given as a combination with other vaccines in a single needle formulation.

Oh my God is he kidding, I know right, there is no way I am going to do all of that, but luckily for me here in Australia a lot of that has already been done in childhood or through work related vaccines. So we can tick off a possible 10 (the ones in bold) off that list straight away and some may not be relevant to the destination you are going to travel to for example my first trip away was Africa so I am not going to need Japanese encephalitis.

Interestingly the varicella vaccine is fairly recent to Australia so therefore I did not get vaccinated in childhood. This was one that my Doctor pushed quiet strongly and I argued with him that I was immune to it, as I had nursed all three of my children and not been infected. He insisted that I be tested and I was right I had a natural immunity.

I did not get the Rabies vaccination for my first two African visits but by the third time I was going overseas, this time to the Middle East I thought I had pushed my luck too far. Rabies if contracted WILL KILL YOU there is no cure once you show the first signs and symptoms.

My Doctor did not insist on the cholera vaccine so I did not question his judgment and Meningococcal vaccine is also fairly new and was not offered as strongly as others.

Malaria tablets are started as a course two weeks prior to your departure so you have an existing immunity and continued for two weeks after leaving the affected areas. I was taking Doxycycline which is the cheapest and most common daily administered medication for Malaria. On the second day in Africa when we are heading out of South Africa and into Mozambique I noticed this rash and I was scratching my skin off my arms and torso. I discuss my options with the driver of the truck, he offered to drop me at a Doctor clinic before we crossed the border (South Africa has a much more reliable medical system than Mozambique). I was quiet nervous when they dropped me on the side of the road in front of this building that looked more like a shack than a GP office, and then they drove away. I went inside as I had few other options, once inside it more or less looked like your typical doctors surgery. People waiting around reading magazines, children coughing and sneezing and the general look of impatience people get when they have been waiting for a long time.  The GP gave me some cream for the rash and some tablets for the itch and a new medication for the Malaria. He had all the require medications in his office so he was the Doctor and Pharmacist in one convenient location. That night we were heading to a beach party in a town called Vilankulo on the coast of Mozambique. All I will say at this point is you should always read the labels on your medication, especially the bit about mixing medication with alcohol, I was sick for days.

So when it came done to it I only really needed a couple of injections and some basic hygiene and mosquito protection oh and if I met that certain special person to practice safe sex.

So now here we are 10 years later and I need to revisit this list and see what is still current and which ones I will need to have done again. Oh joy wish me luck !

 

South Luangwa National Park Zambia Africa – (the need to pee!)

We started in Zimbabwe in Victoria Falls, we stayed at a fenced in camp site in traditional round houses. Helena my niece and I shared a room and my son Jono had a room to himself.  On our first day I watched my son jump off a bridge and survive (bungy jumping 111 metres to the river/rocks below). At this point I want to point out, if you have never been to Africa, they have absolutely no concept of “work place health and safety”.  Prior to Jono jumping off Victoria Bridge they marched us off into the bush, and as we came around a bend in the path we saw a tent hidden away from the road. At first we are wondering what the hell was going on. You know thoughts of being marched off to your death runs through your mind, and then when we get there they make Jono sign an ‘indemnity waiver’. Jono gets back to the bridge and gets out on the ledge, the guy running the show asks Jono “do you trusts me” Ha. They tie his feet together and tell him to hop forward to the very edge of the ledge. He tells him to be brave and look out at the horizon and enjoy the ride down. Then he counts 5 -4- 3- 2- 1 BUNGIEEEE. Jono dives out into the abyss, I can hear him yelling out as he goes down, and it is the ride of his life.

The next day we go white water rafting on one of the most dangerous rivers in the world, see my previous blog for that ride, here we go we have started our adventure. We are leaving Zim and are heading to Zambia in a huge truck that has only 5 passengers.  Due to the political situation in Zimbabwe at this time there are only 5 people brave enough to go on this tour, governments have recommended to limit travel in this country at this time.    We are heading to South Luangwa National Park in Zambia, as we drive into the blazing African sun, the horizon encompasses the full front window of the truck.  We are travelling along  red dirt roads that are totally corrugated. It is jarring and ends up being painful after hours of driving, Africans call this a massage.

We arrive at our campsite its called “Flatdogs” that is the term for crocodile in Africa. All the tent sites are built up in the trees away from the wild life. However there is a flaw in this plan, our tents are too big for the platforms. So they give us the option we can sleep in the truck or we can pitch our tents on the ground like you would normally. We just pitch our tents like normal people do, I mean what can go wrong right. The other two people travelling with us opted for to sleep in the truck. Our guides have cabins to sleep in although they are greeted by a snake when they first go in.

We take a bit of a tour around camp to see where everything is. Amenities building, bar, swimming pool and the river. We go kill some time at the swimming pool with a few cold drinks, check out the internet access the usual stuff. That night we go to the bar for dinner and a few more drinks, the meal is nice the company is great. I decide to leave early as I am tired, I head to bed in the tent I am sharing with Helena. Later that night I hear Helena come in and I go back to sleep, then in the early hours of the morning those beers I had with dinner came back and tell me I needed to go to the bathroom.

Mmmmmm yes the bathroom, now where was that again, we had been told if we wanted to go anywhere during the night that there were guards with guns that would escort us. During the day the toilet block seemed like it was just there beside the tent, but now in the middle of the night I realised it was a long way away. Where were, those guards anyway, how was I supposed to find them in the dark if I wasn’t allowed to leave my tent. Then I remembered a temporary toilet that was just a hole in the ground with a tarp strung around four posts. It was literally just 5 metres from our tent. I decided that was where I was going to go, I would sneak out and pee and be back before you could say “lion attack”.

So very quietly I rummage around and find the toilet paper and I unzip the tent, I stand up and wait for my eyes to adjust. It is very dark in the African bush, then I see these silver glowing disks, my heart stops, I have no idea what it is. My heart starts pounding painfully in my chest I can hear it in my ears, it is roaring. I look to the left and there are more silver disks, my right is also blocked with these horrible silver glowing disks.

After about 30 seconds I realise what I am looking at, hippo’s I am surrounded by hippopotami there must be at least a dozen maybe more. I realise they have come up from the river during the night to feed on the flowers that are dropping from the trees. The trees we should have been sleeping in, not under this is why the tent are up in the trees. I slowly edge my way backwards into the tent, I know how dangerous these animals are. I am then squatting in my tent thinking to myself “I need to pee, I need to pee, I need to pee”. Well I thought I was thinking it, I was actually talking in a whisper and Helena pipes up with a ‘so do I’.  I filled her in on the situation, she stuck her head out and agrees that the toilet was out of the question. This did not solve the immediate problem however, so I decided we had to risk it. It took a little bit to convince her but what else was there I was not going to pee in the tent.

So we unzipped the tent and edged our way down the side of our tent. When we got to the back of the tent I told her to face one way and I would face the other this was not for privacy but for safety. She was to watch for hippos in that direction and I would watch for them in this direction. It was the fastest I have ever peed in my entire life. We snuck back into the tent and then we sat and watched the hippos for a while through the window in the side of our tent. I mean this was an up close and personal encounter with the most dangerous animal in Africa, later we could hear them brushing up against the side of our tent. TIA (this is Africa).

You never feel more alive than when you are scared to death!

 

 

White Water Rafting

White Water Rafting

What is white water rafting you ask?  Well that is when a group of people climb into an inflatable raft and try to navigate a raging river and live to tell the tale. This raging river will have varying degrees of rapids that will challenge the occupants of the raft to greater or lesser degrees of risk and skill. The only way to get to the end of this challenge is to work as a team. White water rafting is considered to be an extreme sport and can have fatal consequences. If you are travelling you should always remember to check your insurance covers this kind of activity, if it doesn’t get extra cover.

The first time I went white water rafting was in Cairns Queensland on the Barron River in 2003, this was a half day adventure with a company called ‘Raging Thunder Adventures” http://www.cairnsrafting.com.au/barron-river-rafting/  The Barron River Gorge rapids are classed as grade 2-3 (see list below for grading) this is relatively easy learning curve and probably a good place to start. We got there mid-morning and they gave us the usual safety instructions. You are asked to fill in a liability and medical waiver and you and seven other excited inexperienced people get into the raft. Your equipment consists of an 80kg, 3 metre rubber raft, a double bladed paddle, a safety helmet and vest, you also have one experienced guide with a single bladed steering paddle at the stern of the raft. Once in the raft you are taught a few basic paddling techniques (about 5 minutes practice) and you are also told what to do in the event of a boat capsizing or if you are thrown out.

 

What is that you ask, well that’s simple lay on your back, point your feet down river, cross your arms over your chest, and Pray. Oh and if you get sucked under the surface, start counting if your down for more than 20 seconds you may be in trouble.

The second time I rafted was in 2005 and the third time in 2007. I went rafting on the Zambezi River below Victoria Falls in Africa with a company called ‘Shearwater’, http://www.shearwatervictoriafalls.com.  This time we were serious, the Zambezi is graded a 5 extremely difficult  with violent long rapids that have big drops and pressure areas with steep gradients, there is no higher grading for the novice rafter.

This was the most scary and most amazing thing I have ever done in my life and I will do it again whenever the opportunity arises even at 52 years of age. I have done both the ‘low water’ run rapids 1-18 and the ‘high water’ run 11-23 of the Zambezi. I have never been in a boat that capsized, I have however been thrown out, but it was in a relatively safe area and had no problems getting back into the raft. My travel companion was not so lucky he did fall out, kicking another rafter in the face on his way out. We started counting as soon as he hit the water, and by the time he came up we were starting to get very worried. He was down for a long time, way more than 20 seconds. So what can you do? The answer is nothing all we could do was wait and watch to see if he surfaced, which he did eventually. The whole day was thrilling and scary and stunningly beautiful, it made you feel alive and free.  Anything that brings you close to death or scares you seems to makes you appreciate your life that much more.

Okay,  so you have rafted the most amazing river in the world, you have survived. Now time to relax, have some lunch and a drink and recharge. Wait, you are at the bottom of a gorge, that’s right- think about that for a moment. You’re tired and battered and bruised and now you have to climb out of this gorge. This is a very steep climb of about 250 metres almost straight up (or feels like it) do not be fooled this is the hardest part of the day. You will need a reasonable level of fitness to achieve this climb. When you finally make it to the top your guides who ran up the 350 metres, are there waiting with lunch and plenty of cold drinks and beers.

Interesting facts about the Zambezi rafting trip:

• The climb down into the gorge is on a ladder that is missing not only rungs but most if not all of the rails it is straight down in most places.
• The river has crocodiles in it just to spice up the day, and if you want you can take a boogie board down the rapids.
• Two young boys who help with the gear carry the 80kg rafts down to the bottom and back up again in record time and don’t even break a sweat.
• The trip home in the back of the truck goes past a cemetery that is exclusively for victims of AIDS, it is a very large cemetery.
• When I was there a group behind us ran rapid # 9 ‘Commercial Suicide’ class 6, it capsized of course and one man was down way too long and eventually came out way down river. It pays to go with a reputable company.
• A Class six is commonly known in the industry as a ‘commercial suicide’, because people will die and your business will be shut down if you take clients down them.
• The canyon has steep walls and there is no game within the gorge.
• Due to the fast flowing water there is no risk of Bilharzia a disease you can get swimming in Africa.

The rapid names and grades:

1. “…against the wall” # 1: Class 4/5: The Boiling Pot. From here the river hits a wall forming a wild cushion wave and eddy.
2. “…the bridge” # 2: Class 3: A wild mixture of waves clearly visible to bungee jumpers and spectators on the Victoria Falls bridge.
3. Rapid # 3: Class 4: A steep and radically fast wave with an easily avoidable hole.
4. “Morning Glory” # 4: Class 4/5: The first major rapid with an almost river wide hole at the top and a big hole at the bottom.
5. “Stairway to Heaven” # 5: Class 5: with an 8m drop over 10m, very steep and powerful. Avoid the waterfalls and a hole on the left called the “catcher’s mitt” plus a large pour-over on the right.
6. “Devil’s Toilet Bowl” # 6: Class 4: A Short rapid with a deceptively steep and powerful hole.
7. “Gulliver’s Travels” # 7: Class 5: A very respectful 700m of class 5 with high volume of white water. The run consists of a 4 channels called the “Temple of Doom”, “The Crease”, “Patella Gap” and “Land of the Giants”.
8. “Midnight Diner” # 8: Class 3/5: This rapid has 3 runs. The left is “Star Trek” with a hole about 5m reserved for the brave. The “Muncher Run” in the centre takes you through a window of “Star Trek”. On the right is the “Chicken Run” this is self-explanatory.
9. “Commercial Suicide” # 9: Class 5/6: The Zambezi’s most infamous. This is a river-wide pour-over with a very narrow slot of less than a metre on the right – commercial portage!
10. “Gnashing Jaws of Death” #10: Class 4: An easy run the name is deceptive
11. “Overland Truck Eater” # 11: Class 5: Watch out for the hole, eddy line and whirlpool.
12. “Three Sisters” #12A, B, C: Class 3/4: Rafters prefer the term “three little pigs”.
13. “The Mother” # 13: Class 4/5: A massive wave train at its best, first 3 waves are super-fast.
14. Rapid # 14: Class 3: Big S-bend in the river. Center chute to be avoided at lower water levels.
15. “Washing Machine” # 15: Class 5: Simple wave train but un-runnable in the middle because of a huge crashing hole
16. “The Terminators I and II” # 16: Class 4: A massive wave train and trough at higher levels.
17. “Double Trouble” # 17: Class 5: A simple wave train but un-runnable because of 2 large holes – also known as “The Bitch”.
18. “Oblivion” # 18: Class 5: Three waves make up the rapid on the Zambezi. The 3rd crashing wave is responsible for more raft flips than any other in the world
19. Rapids #19 to #25: Class 2/3: Easy runs.

Rapids are graded according to the degree of difficulty of the rapids.

Class 1: Very small rough areas, might require slight maneuvering.

Class 2: Some rough water, maybe some rocks, might require some maneuvering.

Class 3: Whitewater, small waves, maybe a small drop, but no considerable danger. May require significant maneuvering.

Class 4: Whitewater, medium waves, maybe rocks, maybe a considerable drop, and sharp maneuvers may be needed.

Class 5: Whitewater, large waves, large volume, possibility of large rocks and hazards, possibility of a large drop, requires precise maneuvering.

Class 6: Class 6 rapids are considered to be so dangerous that they are effectively unnavigable on a reliably safe basis. Traversing a Class 6 rapid has a dramatically increased likelihood of ending in serious injury or death compared to lesser classes.

Africa 2005

I thought I might give you a bit of a look at what kind of travel I have been doing over the past ten years. This next two years are going to be a bit lean on holidays and a bit heavy on learning curves. So I though instead of boring you totally with just the technical and menial stuff we could also look back at my past adventures.

AFRICA

I flew into JOBURG airport and through my window I saw the most amazing sunrise I had ever seen in my entire life.

Sunrise in Africa

I believed coming here was Fate.

I had organised a transport to my backpacker accommodation, they drove me about 45 min through town to the outskirts. On the drive I noticed the busy city, the opulent mansions with massive fences, I also noticed the electrified wire around the fences. As we got farther out of the city the houses got smaller and the fences got shorter and now they were topped with glass. Farther still the houses were shacks and the fences were barbed wire. Oh and there was a dead guy in the gutter.

“Culture shock!”

When I got to the backpackers the van drove away, I buzzed at the gate and they opened it from inside. I was let into a section with another gate, basically I was now in a cage. While I stood there waiting for the next gate to open, I noticed someone looking out the window to see who was at the gate, then they let me in.

“Security system”

First stop was Kruger National Park that’s right probably one of the most famous wild life parks in the world and I WAS THERE. Everything about Africa is bigger, brighter, shinier and more dangerous. When we left Joburg we had an issue with the truck its alternator was playing up so we couldn’t stop it or it wouldn’t restart without being pushed. We are in the middle of Kruger NP with signs everywhere stating ‘you are not allowed out of your vehicle’ because of the lions. Makes sense its a wildlife park. Our driver forgot about the alternator and stopped the truck!

So we are all there looking at each other thinking to ourselves “I’m not going out there to push the damn thing”. So the tour guide climbs up into the back of the truck and says, okay all the guys need to get out of the truck and push, while the girls stay in the truck and keep watch for any movement in the bush. That was the fastest push start in history.

We did see what we came for though “The Big Five” in case you don’t know what that is:

Elephant

Lion

Rhino

Cape Buffalo

Leopard

The Leopard however escaped our eyes this time, and actually to this day I have still not seen a leopard in the wild. It is still on my list and when I go back again (and I will) I will see a leopard.

The Hippo, Gorilla, Giraffe and the Cheetah did not make it to the list and this is because, this list was originally made by the Big Game Hunters, it was a kill list.

I spent three weeks in Africa with an overlands tour company, we started in Johannesburg South Africa up through Mozambique across into Zimbabwe and then Zambia and Botswana and back to Joburg.  Every night you put up your tent and  every morning you took it down, you slept on a self inflating mattress on the ground. The truck had a driver/cook and a guide they were great, very knowledgeable and looked after us. We had some long drive days and I swear every road in Mozambique was one big pot hole, but it was an amazing experience. I was in love I never wanted to travel anywhere else. I just wanted to come back again and again.

Island off the coast of Mozambique

Chobe National Park

Okavango Delta

I will continue this story if your interested over the next couple of years, after all we haven’t even left South Africa yet.

 

Highlights of the tour

• Botswana • Okavango Delta • Canoeing and Game Walks • Maun • Chobe National Park • Chobe River Cruise and Game Drive Zimbabwe • Victoria Falls Town • Bulawayo • Matobos National Park • Antelope Park • Lion Walk Mozambique • Vilanculos • Dhow Safari • Bazaruto Archipelago • Inhambane • Ponta da Barra Beaches • Maputo South Africa • Kruger National Park • Johannesburg