Your Health Abroad

• Should you choose to have consensual sexual activity in Kenya, know your partner’s HIV status before you choose to proceed. Always use condoms regardless of their HIV status. Condoms and abstinence are the ONLY ways to protect against STDs of all varieties.
• There are support and resources available for sexual assault and nonconsensual sexual encounters. IU has a victim-supportive stance. See section on Safety and Sexual Assault Information for more information.
• Zika virus: See the CDC site for more information.  Pregnant women should not travel to Kenya. Women and men should avoid pregnancy for six months after traveling as even asymptomatic Zika is sexually transmitted.

HIV Post-Exposure Prophylaxis 

HIV post-exposure prophylaxis is available no matter how the exposure occurred (bodily fluid exposure in the hospital/clinic, consensual or nonconsensual sexual contact, etc.). See HIV exposure section for more details.

Malaria Prophylaxis 

• Use BUG SPRAY. Any DEET-containing product is effective. Picardin is an odorless, effective, and safe non-DEET alternative.
• Bed nets are available in every room at IU House and the hostel and we recommend using them.
• The CDC recommends malaria prophylaxis for travel to all areas of Kenya. Drug options for prophylaxis include:

Atovaquone-proguanil (Malarone): This is usually the preferred choice.

• • Dosing: Daily
  • NOT for use in pregnancy
  • Adverse effects: GI upset, insomnia, HA, rash, mouth ulcers

Doxycycline

• • Dosing: Daily
  • NOT for use in pregnancy
  • Adverse effects: esophagitis

Mefloquine 

• • Dosing: Weekly
  • Adverse effects: GI upset, lightheadedness, HA, difficulty concentrating, mood swings, strange dreams, neuropsychiatric effects (5%)
  • Contraindications: seizures, depression, anxiety, QT prolongation, bradycardia
  • Prescription for whichever medicine you choose may be written by Campus Health or your primary care doctor, who is welcome to contact Jenny Baenziger, MD, for questions. Alternatively, you may schedule an appointment with Dr. Baenziger’s office at Eskenazi Health North Arlington (317-554-5200); both in-person and phone visits are available.
  • FILL YOUR PRESCRIPTION EARLY. Most insurance companies will only fill a 30-day supply unless you call and request preauthorization for a greater supply. You will need enough for your entire travel time.

Immunizations 

See the CDC webpage for the most up to date recommendations. Currently recommended are: Hepatitis A, Hepatitis B, Typhoid, Yellow Fever, Meningitis, and Tdap if you have not had a Td or other tetanus shot within the past 10 years. Immunizations are available at Campus Health, Marion County Health Department, or travel clinics such as Community Travel Medicine and Riley Travel Medicine.

Chronic Medical Conditions 

If you have a medical issue, especially any chronic medical conditions and/or immunocompromising health issues, it is important that you discuss your condition and travel to this resource-limited country with your doctor prior to travel to make appropriate preparations. Healthcare facilities, access to specialty and emergency care, and drug supplies are very limited in Eldoret. Please be aware that it may be impossible to obtain certain medications in Eldoret, even if they are common in the United States. Some medications are available for purchase at local pharmacies, but none are guaranteed to be available. YOU ARE RESPONSIBLE FOR YOUR OWN HEALTH WHILE IN KENYA.

CASE EXAMPLES:

• A student has asthma but hasn’t used an inhaler in over a year. However, after a week of the high altitude, dust, and air pollution in Kenya, he is wheezing throughout the day and waking up every night coughing. BRING ALBUTEROL if you have ever had a reactive airway disease.
• A resident with chronic hypothyroidism comes to Kenya with only 30 days’ worth of levothyroxine, a critical medication. There is no guarantee she will be able to refill her levothyroxine in Kenya.
• A medical student with lupus is on chronic steroids and another immunosuppressant medication. She needs weekly lab checks (CBC, BMP) but SHOULD NOT EXPECT to be able to get these in Kenya. Her risk of contracting TB in the community is high; wearing a mask on the wards is insufficient to mitigate her risk as most exposures will happen in the community. She should RECONSIDER TRAVEL.
• A faculty member is 26 weeks pregnant at the time of her planned Kenya trip. She should RECONSIDER TRAVEL. There is not reliable access to blood products in case of an emergency C-section, nor reliable ventilator or other necessary support for the infant if delivered. International travel is prohibited by airlines beyond 32 weeks gestation and travel medical insurance is severely restricted in the second and third trimesters.
• A resident, her husband, and their 3-year-old with severe food allergies come to Kenya. They should bring sufficient Epi Pens to sustain their child’s life on their own should the child become exposed to the allergen.
• A resident has a medication that requires refrigeration. The resident should CONTACT THE TEAM LEADER at least two months in advance to establish a plan for the medication storage.