Suggestions for Veterinarians Working in Central Africa
American Association of Zoo Veterinarians Conference 2005
Michael R. Loomis, DVM, MA, DACZM
Hanes Veterinary Medical Center, North Carolina Zoological Park, Asheboro, NC, USA

Abstract

From a geopolitical standpoint, Central Africa is composed of the countries of Angola, Cameroon, Central African Republic, Chad, Democratic Republic of Congo, Equatorial Guinea, Gabon, Republic of Congo, Sudan and Zambia. The remarks in this paper will be limited to the Central African countries of the Congo Basin: Cameroon, Central African Republic, Democratic Republic of Congo, Equatorial Guinea, Gabon and Republic of Congo. These countries are among the most biologically diverse countries in the world. All or parts of all of these countries are francophone and most have a legal system based on the French civil law system.

It is important to look at all of these countries from a historic perspective. All were colonized by European countries. The colonial period has had lasting effects, both overtly and subtly. Colonization was, for the most part, an exploitive activity. Some of the undesirable practices employed by the colonizers have been institutionalized in some countries. Pakenham provides an excellent overview of colonization across Africa.5

Much of Africa, excluding Northern Africa, South Africa and parts of the Horn of Africa, function differently than the majority of the rest of the world. Most relationships are oriented vertically, creating in essence a number of “silos,” with wealth at the top and poverty at the bottom of each silo. Those lower in the vertical stratification expect those above them to benefit them in some way. From the perception of the local population, an expatriate working with them is inserted at some level into their “silo.” With that insertion comes the obligation to benefit those below. These vertical relationships at times seem to result in chaos.2 Understanding how one’s position in one or multiple “silos” is perceived is important in defining relationships with others.

In addition to being biologically diverse, the countries of the Congo Basin are also culturally diverse. Field teams may be composed of individuals from several different cultures. Cultural differences can lead to strife in a team. An example is the relationship between the Bantu and the Baka. The relationship is centuries old and can simplistically be described as a dependence of the Baka on the Bantu. A Bantu will not take an order from a Baka. It is extremely important to be aware of and respectful of cultural and tribal differences.

Witchcraft is common throughout Central Africa. Witchcraft can lead to conflict within a team and can be blamed for an unsuccessful mission. For those who believe in witchcraft, it is real and must be dealt with from the perspective of the believers. Geschiere provides an excellent overview of modern witchcraft.3

Several layers of bureaucracy must be dealt with. At the national level, permits to work with wildlife must be obtained from the ministry in charge of wildlife or protected areas. Travel plans may need to be filed with the national police (gendarmerie). Permits for importation of narcotics and other drugs must be obtained from the ministry of health. In sensitive areas or in areas near conflict, permission from the military may be required prior to entry into the area. Clearing customs with large amounts of equipment can be challenging. Having a detailed list of all equipment available for the customs agent can speed the process. Having an invitation letter from a local partner can also help.

The bureaucracy tends to filter down through provinces to districts to sub-districts to villages. Paying courtesy calls to officials at all levels is recommended if time permits. At the village level, depending on the size of the village, one may be required to deal with a sous-prefet (highest-ranking federal official), police chief, commandant of the gendarmerie, the mayor and the tribal chief. In general, the sous-prefet is the point of contact. The local situation can sometimes change the power dynamics, which can be a pitfall if one is not aware of the situation. Tribal chiefs can be very helpful because of their wealth of knowledge of the geography and biology of the local area.

Corruption is institutionalized in many African countries.2 Dealing with corruption can be very time-consuming and expensive. The World Bank estimates that US $1,000 billion are paid in bribes worldwide. Paying bribes can be avoided with preplanning: have all permits in order prior to entering the country, and have an in-country partner to assist with customs. Be familiar with local laws and regulations, and do not break laws. In one study, the most common cause of expatriate arrest was associated with motor vehicles (79.5%), followed by drug/alcohol violations (7.7%), sexual assault (5.1%) satellite phone use (5.1%), and property damage (2.6%).

The infrastructure in all Central African countries is underdeveloped. Roads are often poorly maintained. Public transportation in the form of buses and bush taxis are readily available, but dangerous. Four-wheel drive vehicles are available for hire in most large cities. Boats for navigating waterways are generally readily available for hire. Fixed-wing aircraft can be very difficult to find and helicopters are extremely difficult to find. In general, medical equipment and narcotic anesthetic agents are unavailable. Basic camping equipment is available in some of the major cities. The electrical grid is unreliable and seldom extends far from moderately-sized towns. Communications are also unreliable. Telephone and internet connections are available in most large cities. Cellular telephones are becoming more common with increasing coverage, but vast areas remain outside coverage. In remote areas, satellite telephones may be the only means of communication.

There is a significant pool of well-educated biologists in the region. There are few veterinarians in the area and very few veterinarians with experience in wildlife medicine. A primary focus of any expatriate veterinarian working in the area should be to build the capacity of local veterinarians to ultimately take over the veterinary aspects of the project. There are a number of universities in the region that can form the basis of partnerships. A large number of NGOs operate in the region, including WWF, WCS and ECOFAC. Major governmental agencies that operate in the region include CARPE (USA), EU, GTZ (German), SNV (Dutch) and CF (French). Guides, porters and trackers are readily available.

Table 1 lists the major infectious diseases endemic to Central Africa. Many are preventable by vaccination or by modifying personal behaviors. Plasmodium falciparum infection is particularly dangerous because it often leads to cerebral malaria. Antimalarial drugs, insect repellants and appropriate clothing should be employed to limit exposure. HIV infection rates are high in many of the Central African countries.

Table 1. Major human infectious diseases endemic to Central Africa

Parasites

Viruses

Bacteria

Malaria (P. falciparum)

HIV

Meningitis

Onchocerciasis

Yellow fever

Tuberculosis

Trypanosomiasis

Hepatitis A

Cholera

Filariasis

Hepatitis B

Typhus

Myiasis

Hepatitis C

Other rickettsial

Schistosomiasis

Rabies

Typhoid

Numerous GI parasites

Dengue

Relapsing fever

Leishmaniasis

Poliomyelitis

 

Dracunculiasis

 

Loa loa

Scabies

Tungiasis

 

Drinking bottled water and drinks or drinking treated water (boiling, iodination) is highly advisable. Eating well-cooked foods served hot and avoiding fresh fruits and vegetables unless prepared properly is also advised. Two good references for health considerations are Jong and Auerbach.1,4

The greatest threat to health is trauma, and the greatest cause of trauma is vehicular accidents. Driving is dangerous; driving at night and on holidays is very dangerous. Hiring both a skilled driver and a well-maintained vehicle is wise.

There are a few medical facilities which would meet minimal standards in the West. Because medical evacuation can be very expensive, it is suggested that people working in the region have emergency medical evacuation insurance.

Many of the countries in Central Africa have legislation which, if enforced, would provide adequate protection for animals and their habitats. Unfortunately, there is, in general, a lack of both human and financial capacity to effectively manage protected areas and enforce wildlife laws.

Legal and illegal extractive activities cause both habitat destruction and directly threaten animal populations. Logging and mining not only destroy habitat but also open remote areas with roads making illegal hunting much easier. Logging trucks often provide transportation for poachers into areas and for transporting bushmeat out of the area. The single most important threat to many species of animals in the Congo Basin is the commercial bushmeat trade. Each year, millions of tons of meat from illegally killed animals are sold both locally in Africa, Europe, the USA and Asia. Legal trophy hunting, if done sustainably, and if the local community benefits, can have positive effects by helping to reduce poaching.

Intrusion of people and livestock into protected areas can have significant degradative effects. This is a very complicated issue since local populations are often translocated out of their traditional homelands when protected areas are formed. The rights of indigenous peoples must be taken into account when protected areas are formed.

Armed conflict causes a breakdown in management of protected areas. Many animals in conflict areas are shot for sport or for food. This can locally decimate animal populations.

Emerging diseases in the region include Ebola virus and anthrax. Both have had significant impacts on great ape populations. It is yet to be seen if the recent outbreak of Marburg disease in Angola will have a major impact on animal populations.

Literature Cited

1.  Auerbach, P.S., H.J. Donner, and E.A. Weiss. 2003. Field Guide to Wilderness Medicine. (2nd ed.) Mosby.

2.  Chabal, P., and J-P. Dolaz. 1999. Africa Works: Disorder as Political Instrument. Indiana University Press, Bloomington.

3.  Geschiere, P. 1997. The Modernity of Witchcraft. University Press of Virginia, Charlottesville.

4.  Jong, E.C., and R. McMullen. 2003. The Travel and Tropical Medicine Manual. (3rd ed.) Saunders, Philadelphia.

5.  Pakenham, T. 1991. The Scramble for Africa. Avon Books, New York.

 

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Michael R. Loomis, DVM, MA, DACZM
Hanes Veterinary Medical Center
North Carolina Zoological Park
Asheboro, NC, USA


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