World Country Guide

1
A yellow fever vaccination certificate is required from travellers arriving from infected areas. Travellers arriving from non-endemic zones should note that vaccination is strongly recommended for travel outside the urban areas, even if an outbreak of the disease has not been reported and they would normally not require a vaccination certificate to enter the country.

2
Following WHO guidelines issued in 1973, a cholera vaccination certificate is not a condition of entry to Somalia. However, at the beginning of 2000, an outbreak of cholera was reported, and precautions are recommended for those likely to be at risk. Up-to-date advice should be sought before deciding whether these precautions should include vaccination, as medical opinion is divided over its effectiveness; see the Health appendix.

3
Vaccination against typhoid is advised.

4
Malaria risk, predominantly in the malignant falciparum form, exists all year throughout the country. Resistance to chloroquine and sulfadoxine-pyrimethamine has been reported. The recommended prophylaxis is mefloquine.

Food & drink
Mains water is normally chlorinated and, whilst relatively safe, may cause mild abdominal upsets. Bottled water is available and is advised for the first few weeks of stay. Drinking water outside main cities and towns is likely to be contaminated and sterilisation is considered essential. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled.

Other risks
Bilharzia (schistosomiasis) is present. Avoid swimming and paddling in fresh water; swimming pools which are well chlorinated and maintained are safe. Hepatitis A and E are widespread; hepatitis B is hyperendemic. Meningococcal meningitis may occur.
Rabies is present. For those at high risk, vaccination before arrival should be considered. If you are bitten, seek medical advice without delay. For more information, see the Health appendix.

Health care
Medical facilities are very limited and visitors are advised to take their own medicines with them. Health insurance is essential. Medical treatment at government-run hospitals and dispensaries is free for Somalians and may sometimes be free for visitors.