Djibouti

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Djibouti
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Environmental Health Risks

• The greatest short-term health risks are
  associated with water contaminated with raw
  sewage, runoff containing fecal pathogens, or
  industrial waste.
• The physical environment posses additional risk
  from extreme heat
• Greatest long-term risks associated with air
  contamination and chemical contamination of
  food/water

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Environmental Issues

• Air Quality Contamination
• Low Risk- Minimal health effects
• Localized air contamination may occur near
  specific industrial facilities or urban areas
• Sandstorms can result in particulate
  concentrations in localized areas that may reach
  levels that cause acute respiratory symptoms in
  sensitive persons

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Environmental Issues

• Soil Contamination
• Low Risk
• Soil contamination is usually localized to
  specific areas surrounding industrial facilities
  and waste disposal sites.
• Even in such areas, significant exposure to
  contaminants in soil is unlikely in the absence
  of windblown dust, active digging, or migration
  of contaminants from soil into groundwater
• Saline soils occur within Djibouti, primarily
  near inland lakes and depressions. During dust
  storms, the salts in the soil can be carried by
  the wind and deposited elsewhere. Airborne salts
  can be highly irritating to humans

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Environmental Issues

• Drinking Water Contamination
• Intermediate Risk
• Drinking water and surface waters in Djibouti are
  likely to be contaminated with untreated sewage
• The persistent discharge of untreated sewage into
  surface waters and coastal areas is a serious
  environmental contamination problem in Djibouti
• Consumption of water contaminated with raw sewage
  or runoff containing fecal pathogens may cause a
  variety of acute enteric infections

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Infectious Disease Risk

• High Risk for infectious diseases
• Inadequate Force Health Protection (FHP)
  measures, will place service members at risk and
  seriously jeopardize mission effectiveness

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Infectious Diseases

• Foodborne and Waterborne Diseases
• High Risk Diarrhea (bacterial), Hepatitis A
  Diarrhea (protozoal), Typhoid/Paratyphoid,
  Hepatitis E
• Intermediate Risk Cholera, Brucellosis
• FHP Priorities
• Consume food, water, ice only from US-approved
  sources
• Wash your hands after using latrines and before
  eating (hand washing stations should be near
  latrines and dining facilities)

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Infectious Diseases

• Vector-borne Disease
• High Risk Malaria
• Intermediate Risk West Nile virus, Rift Valley
  fever, Chikungunya, dengue fever, sand fly fever,
  leishmaniasis, Crimean-Congo fever, yellow fever,
  rickettsioses
• FHP Priorities
• Take malaria chemoprophylaxsis
• Use DEET on all exposed skin
• Treat field uniforms with permethrin
• Practice proper uniform discipline
• Use bed nets in field conditions, treat with
  permethrin

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Infectious Diseases

• Animal-contact Diseases
• Intermediate Risk Q-fever, Rabies
• FHP Priorities
• Avoid animal contact, especially if the animal
  exhibits strange behavior
• No mascots (GENERAL ORDER 1)
• Report all animal bites and scratches

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Infectious Diseases

• Sexually Transmitted Diseases
• High Risk Hepatitis B
• Intermediate Risk Gonorrhea, Chlamydia, HIV
• FHP Priorities
• Refrain from any sexual activity while on
  deployment (Adhere to General Order regarding
  this issue)

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Infectious Diseases

• Respiratory Diseases
• Intermediate Risk Tuberculosis, meningococcal
  meningitis
• FHP Priorities
• Tuberculin skin test before and after deployment
• 72 sq ft/person and head-to-toe sleeping
  arrangement
• Cough or sneeze into your upper sleeve instead of
  your hands
• Wash hands at every opportunity
• Avoid close contact with local population

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Hazardous Animals

• Animals
• Rabid dogs, poisonous snakes, scorpions, spiders
• FHP Priorities
• Do not handle or feed animals
• Shake out boots, clothing, bedding

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Summary

• Physical Environment
• Infectious Diseases HIGH RISK
• Hazardous Animals
• FHP measures are simple and effective
• Use and Enforce
• Will conserve the fighting strength
• Help ensure mission success
• COME HOME HEALTHY!!!