Vaccinations-You knew there would be some

To make sure that we had all the correct vaccinations we went to the Ottawa West Travel Medicine Clinic run by Dr. John Lee. We met with Hasana Birk. She spent about an hour with us discussing all of our current medications, vaccinations needed, drug interactions and options. The one hour visit for two people was $80. Hasana was extremely knowledgeable about prescription drugs and the country of Tanzania. The visit was well worth the cost.

Address: 2nd Floor,760 Eagleson Road
Ottawa, Ontario, K2M 0A7
Phone: (613) 592-9081

--------------------------------------------------------------------------
Tetanus, Diphtheria, Polio
Adults in Canada generally have a booster shot every 10 years.
Apparently 1 shot of polio in your adult life is generally sufficient,
Tetanus and diphtheria every 10. If you can't remember precisely when your last booster shot was, be prepared to roll up your sleeve. You will be given a shot as a precaution.

Health Coverage: is covered by OHIP

--------------------------------------------------------------------------
Rabies
If you check some travel and health web sites, rabies shot are recommended but not mandatory. If you get bit and haven't had your pre-exposure rabies shot (what you get before you get bit) you will need a series of 6 rabies shots. Pre-exposure rabies shots come in a series of 3 shots. If you have these shots and then get bit, you still will need to have another 3 rabies shots (to complete the series of 6).
Since our clinic did not feel that rabies was necessary, our decision to have them was based on whether or not our health plan covered the cost of the shots. Not covered so no shots.

Name of the vaccine: RabAvert
DIN#: 02267667
Cost: per shot is ~$60 CND (~$180 for the 3 shots)
Health Coverage: not covered by OHIP, may be covered by private health plans.

--------------------------------------------------------------------------
Yellow Fever
Apparently only needed in Tanzania IF you are traveling into Tanzania from a country that is currently recognized as a yellow fever endemic zone. Since yellow fever is not endemic in Canada, the shot wasn't necessary. As a precaution we were given an official exemption certificate.

Cost: $100 for the single dose

--------------------------------------------------------------------------
Hepatitis A
Recommended but not necessary. We had received HepA shots a few years ago in preparation for a trip to Mexico, so we were still protected. Cost for the shots (at that time) were covered under our private health plan.

The inoculation consists of 2 injectable doses, taken six months apart. When we picked up the HepA prescription we were each given two "kits" each containing a glass syringe plus separate vaccine. We had to bring the kit to the doctor's office to get the injection. This protection lasts for about 10 years.

Name of the vaccine: Havrix
DIN#: 02187078
Cost: per shot is ~$60 CND (~$120 for the 2 doses)
Health Coverage: not covered by OHIP, may be covered by private health plans.

--------------------------------------------------------------------------
Hepatitis B
Hep B is usually contacted through contact with an infected person's blood, semen, or other body fluid. Since we are going to be working in a medical enviroment, we decided that getting vacinated would be a good idea. Innoculation consisted of 3 shots, second shot is 1 month after the first shot; the third (and last shot) is 6 months after your first shot.

--------------------------------------------------------------------------
Typhoid
This vaccination was recommended for us to get. When getting this you have two choices: a single dose, injectable vaccine (good for 2-3 years) or a live, oral version which consists of 4 pills to be taken over 8 days (good for 5-7 years). Since the live vaccine offers slightly longer lasting protection, we opted for that. It was not covered under our health plan.

Name of the oral vaccine: Vivotif
DIN#: 00885975
Cost: 4 pills is $40 CND
Health Coverage: not covered by OHIP, may be covered by private health plans.

--------------------------------------------------------------------------
Malaria
Unfortunately daily doses of gin and tonics will not be a sufficient preventative (and yes I asked :-). The clinic mentioned that there were three possible brands- Mefloquine, Doxycycline, and Malarone.

Mefloquine was not even considered due to its potentially severe side effects including bad nightmares, depression and suicidal tendencies. (GEEZE why even offer this one)
I can`t really remember the difference between Doxycycline and Malarone. I think that Doxycycline costs less but you need to take the drug longer than the Malorone. We decided to go with the Malorone since it meant less doses and it turned out to be covered by our health plan. You take one pill per day. You start 1 day before you arrive in the area and continue to take them for 7 days after you leave.

Name of the oral vaccine: Malorone
Cost:
DIN#: 02238151
Health Coverage: not covered by OHIP, may be covered by private health plans.
---------------------------------------------------------------------
Traveler's Diarrhea
We were given pills that we could take in case of moderate or severe diarrhea or bladder infection. Good to have just in case! The pills were covered by our health plan. The single prescription contained only 3 (very large) pills.

Name of the oral vaccine: Cipro XL
Cost:
DIN#: 02247916 (500mg) OR 02251787 (100mg)
Health Coverage: not covered by OHIP, may be covered by private health plans.
--------------------------------------------------------------------------
Cholera
Necessary vaccination against Cholera was abolished in 1973 by International Health Regulations. Apparently some corrupt border guards will, on occasion, demand proof of vaccination. The travel clinic can provide an official exemption certificate. This was not something that was necessary for Tanzania. Apparently Dukoral can be used as an oral vaccine against Cholera.

Name of oral vaccine: Dukoral
DIN#: 02247208
--------------------------------------------------------------------------

One thing that we never discussed was whether or not we would need a dose of anti parasite pills—Mebendazade (Vermox)—used to treat infestations by worms including pinworms, roundworms, tapeworms, hookworms, and whipworms. Once dose is usually taken once you arrive back home, from Africa.

UGH...Paper Work

Besides a valid passport, CACHA requires that you fill in and submit the following:

1. Mission Sign-up form (available online through CACHA's web site)
   You first need to be accepted into the mission by CACHA. Filling out and submitting this form is the first step. If you are approved, then you'll probably be contacted by email. All necessary documents will either be included with the emaiL or contain instructions on how to get them.


2. Membership form
   If you are not a CACHA member already, you will need to purchase a membership $40 CND per person for one year.


3. CACHA Waiver form and Code of Conduct
   Obviously you are representing CACHA when you are in Africa so there are some waiver and conduct items that need to be understood and acknowledged.


4. Mission Volunteer Agreement form


5. Photocopy of your passport


6. Photocopy of your Travel Health Insurance


7. Copies of any professional licenses


8. Working Permit/Exemption form
   This is a work permit that will allow you to volunteer in Tanzania. You need to fill this out and submit to CACHA who will the handle the submission process for all the mission members.
   
   You need to submit 3 copies of this form to CACHA along with 5 passport size photos that have a blue background, plus photocopies of any professional certifications/licenses/diplomas for reference.
   NOTE: This form is different form the Tanzanian Visa which you, yourself are responsible for attaining. Submit your application at least one month before departure. The working permit must be processed before you can apply for your visa.


9. Entry Visa (obtain from the Tanzanian embassy in Ottawa)
   You will need to submit a passport picture with this application. The cost for a visa is $75 Canadian; cash only (no credit card or cheques). As well you will need a "letter of Invitation" showing that you have permission to be working in the country. The letter of invitation will be sent directly to the embassy by CACHA, who will inform you as soon as the letter is sent.
   
   About the visa application process:
   
   -the embassy requires that you leave your password with them! They have it for about a week (kinda stressful) and they "add a page" with your visa info.
   
   - when filling out the visa form, item #11-Purpose of Visit, should be checked off as Mission. If you are staying for travel afterward, also check off Travel, Leisure, Holiday. Be prepared to include all addresses of the places that you will be staying at during your visit (for both mission and travel).

A couple of notes regarding the pictures: The 5 passport size photos with the blue background are used by CACHA to accompany your paperwork. They don't need to be passport quality. You can get them taken at a photo booth as long as a blue background is available. We tried that route but found that the blue background came out grey, so we threw a blue sheet on a door, took some digital pics and printed them out ourselves.

There are tons of places for you to get your Visa passport picture.
A few we checked out in Ottawa...
for a set of two pics:
Blacks Photography (Bayshore S.C.) ~$23
Shopper's Drug mart ~$10
Costco $6.99 (if you can wait the 30 minutes without buying anything else in the store!)

Canada-Africa Community Health Alliance (CACHA)

Our plan is to volunteer with an organization called Canada-Africa Community Health Alliance (CACHA). We will be participating in CACHA's medical caravan mission in the Kilema district of Tanzania. This is a well established mission therefore a lot of the "kinks" of the mission have been worked out over time, so we are expecting smooth sailing (for the most part). 

Neither of us have a medical background so we will be participating as logistic members. What does that mean? Well for now what we believe it to be is: packing, unpacking, pharmacy inventory, counting pills, talking to residents, logging some of their personal information for medical stats, setting up reception areas, and generally entertaining the locals while they wait to see the doctors. More to come on what we actually do in later blogs. 

This particular mission lasts for 14 days. During that time we will staying at the Kilema Hospital which is built on the slopes of Mount Kilimanjaro. 

According to the web site InterCare-Medical Aid for Africa Kilema Hospital http://www.intercare.org.uk/health-centre/tanzania/kilema-hospital 

"...is run by the Sisters of Our Lady of Kilimanjaro and has a catchment of around 228,000. This was the very first hospital in this area to be set up by the European missionaries. They chose this site – high up on a hill – because the place was too high for the mosquitoes so there is virtually no malaria caught in the area. The place is beautiful, and pine trees (planted by the missionaries to remind them of home) grow alongside lemon and orange trees. To reach the hospital it is necessary to travel on very poor roads up the slope of the mountain and in the rainy season this is virtually but not quite impossible. " 

 Every day we will be driving out to the surrounding villages with our "caravan" of supplies and people. Hope the rainy season is over by the time we get there.

We're going to Africa!!!

With that realization comes tons of questions, worries, planning and excitement. In an effort to get all our plans in order (and to possibly help any other people who are planning a trip to Tanzania) this blog will be a running commentary of "stuff that happens" and info that we need to know.