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Zambia

Risk Ratings

HIGH MEDICAL RISK for Zambia LOW TRAVEL RISK for Zambia Know My Risks

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Please see our:

Medical and Security Alerts for Zambia

COVID-19 information for Zambia

Dedicated COVID-19 website

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National crime rates are low, but levels are higher in Lusaka and the Copperbelt. Business visitors are most vulnerable to petty and opportunistic theft, though violent crime, including armed robbery and carjacking, is increasing. Business travellers and resident expatriates are perceived as comparatively wealthier, and may be considered prospective targets.

Unruly protests occur periodically in the vicinity of parliament, Lusaka's central business district, and on and around university campuses. Checkpoints are sometimes erected prior to demonstrations, which rarely entail any direct security threat to foreigners. Social unrest may nonetheless pose incidental risks to travellers. The political situation is stable and poses minimal risk to foreign travel, though election periods may witness a temporary uptick in political unrest.

This information is intended as a summary of the travel security environment; however, the risks can change at short notice during a crisis or evolving situation. Please check our travel security alerts to ensure you are informed of the most recent developments.

STANDING TRAVEL ADVICE Alerts

COVID-19: Abide by country-specific advice as pandemic, associated consequences move into new phases

View All Alerts Alerts

COVID-19: Abide by country-specific advice as pandemic, associated consequences move into new phases

Created and/or Modified: Friday, July 10, 2020 00:31:24 GMT

Level: Advisory Location: Angola; Benin; Botswana; Burkina Faso; Burundi; Cameroon; Cape Verde; Central African Republic; Chad; Comoros; Congo; Congo (DRC); Côte d'Ivoire; Djibouti; Equatorial Guinea; Eritrea; Eswatini; Ethiopia; Gabon; Gambia; Ghana; Guinea; Guinea-Bissau; Kenya; Lesotho; Liberia; Madagascar; Malawi; Mali; Mauritania; Mauritius; Mayotte (France); Mozambique; Namibia; Niger; Nigeria; Réunion (France); Rwanda; São Tomé and Príncipe; Senegal; Seychelles; Sierra Leone; Somalia; South Africa; Tanzania; Togo; Uganda; Zambia; Zimbabwe Category: Travel restriction, COVID-19

A number of countries have relaxed some restrictions that aimed to contain the spread of COVID-19. This includes the relaxation of restrictions on internal movement, reopening of businesses and a resumption of some domestic and international travel. Nevertheless, strict measures remain in place, or are being re-imposed, in some locations where there is increasing case activity. https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 1 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

International SOS is issuing this global alert for all countries and territories. In some locations all travel should continue to be deferred, while for others essential travel can resume after undertaking an individual risk assessment of the COVID-19 situation and entry restrictions, including the potential for sudden changes. Please refer to our dedicated country pages and alerts for details and location-specific advice.

Advice

Managers

Closely monitor official advice and the extent of COVID-19 transmission and related developments for impacts on staff mobility or associated security risks. Review operational requirements such as: Whether it is practical for any relocated staff to return to certain locations Whether it is best for your staff and dependents to remain certain locations or to relocate The viability of contingency plans for a deterioration in the logistical, security and/or medical environment and impact of a re-imposition of local measures on business operations and the workforce in-country with minimal forewarning. Ensure country-specific Business Continuity Plans are regularly reviewed and focused on next steps. These include mobility management, site operations and return to work. Ensure the strict compliance of your staff with local government containment efforts. Check the COVID-19 Travel Restrictions Page or contact International SOS for quarantine measures in place or transportation status for specific locations prior to approving a trip. Consult our country pages for country-specific advice.

In-country members

Closely follow all official directives and abide by them. This includes any requirements to wear masks in public places, and self-isolation or quarantine obligations. Regularly re-evaluate whether it is best for you and your family to remain in-country or to relocate. Consider the circumstances that influence your ability to remain in-country. These include: Closely monitor reliable sources for the extent of transmission in your location and information relating to security incidents or changes to internal mobility, including the International SOS country-specific alerts. Understand your company’s medical and security triggers for changes to in-country posture. Prepare for an outbreak in your location: Reduce the spread of infection: Social Distancing: Some people have COVID-19 without noticeable symptoms. Follow these measures: Consider staying home as much as practical. In public, try to maintain a distance of 1-2 meters (3-6 feet) from others. Use private vehicles if possible. Keep face-to-face interactions brief. Choose outdoor activities rather than indoor. Consider whether gatherings with friends and family should be minimised. For those who are sick: Stay at home and call for medical advice. Follow the local procedure for your area.

For further health information and advice, see the current International SOS medical alerts and the COVID-19 information within the Pandemic Information Site.

Inbound travellers

Defer either all or non-essential travel (depending on our country-specific advice). Understand your company's business-specific pandemic and business continuity plans and triggers for changes to in-country operations. Discuss all travel with management in accordance with your organisation's travel approval process. Review with your management the necessity of travelling against the potential risks. Consider the following factors: Reconfirm flights prior to departure. We do not hold information on specific flights or other modes of transport; contact the relevant service provider or your travel agent. Plan flexible itineraries taking into account any residual travel restrictions. Account for additional time required for likely health and temperature screening at airports and other transport hubs. Be mindful of any quarantine and isolation procedures being implemented at point of departure and destination.

More detail

An outbreak or resurgence of COVID-19 cases could occur at any time and location, and could escalate rapidly. This could lead to the re-imposition of border closures and localised restrictions, including lockdowns and business closures. Healthcare facilities may become strained or overloaded, limiting the ability to treat all illnesses, including COVID-19. Medical evacuations may be further constrained. From a security perspective, the socio-economic impact of COVID-19 will continue to resonate for some time. Ramifications will be distinct to local context but will likely exacerbate existing security challenges in the location.

International SOS continues to monitor related developments. Our risk assessment is made jointly by medical and security professionals, and accounts for current risk levels, as well as the likely evolution of risk in the coming weeks and months. Daily updated information on COVID-19-related restrictions worldwide is accessible on the COVID-19 Travel restrictions page of our International SOS Pandemic Information site. We will also continue to provide any necessary updates to significant mobility, logistical, medical and security implications, with corresponding advice, in dedicated country-specific alerts.

Vaccinations For Zambia

Cholera Oral vaccination is recommended for travellers Read more

Hepatitis A Recommended for all travellers and expatriates, Read more

Hepatitis B Recommended for all travellers and expatriates. https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 2 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

Read more Polio All travellers are recommended to be fully Read more Rabies Consider for certain travellers, especially: For Read more Typhoid fever Recommended for all travellers and expatriates. Read more Yellow fever Zambia has a low risk of yellow fever Read more Routine Vaccinations

All routine vaccinations should be current: these include Measles-Mumps-Rubella, Polio, Tetanus-Diphtheria-Pertussis, and Varicella. Annual influenza vaccination.

Other Medical Precautions

Before you go - See your doctor and dentist and ensure you are in the best health before you leave. Other preparations: Malaria Zika Virus Health Threats Alerts

COVID-19: Abide by country-specific advice as pandemic, associated consequences move into new phases

View All Alerts

Summary

TRAVEL RISK SUMMARY

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Please see our:

Medical and Security Alerts for Zambia

COVID-19 information for Zambia

Dedicated COVID-19 website

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STANDING TRAVEL ADVICE

Advice amid COVID-19-related restrictions

Defer non-essential travel due to restrictions related to COVID-19. See country page for latest developments and advice.

Other advice

Zambia (LOW)

Travel to Zambia can continue with basic security precautions. Avoid overt displays of wealth and minimise time spent in low-income areas to mitigate potential exposure to crime. Avoid pedestrian travel after dark and conduct https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 3 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

road journeys in a locked vehicle with the windows closed. Maintain a low profile at all times. Avoid all protests due to the risk of localised unrest. Vacate an area if demonstrators or security force personnel begin to congregate. Do not stop to watch or photograph demonstrators. Pre-arrange a trustworthy meet-and-greet upon arrival through local contacts or your hotel. Regular taxis, which are usually painted sky blue or a light grey, are an acceptable alternative. Travellers should insist that the driver does not pick up additional passengers en route. Only self-drive if familiar with the local traffic conditions as road infrastructure and driving standards are poor and traffic accidents are common. If self-driving, keep to main thoroughfares, drive defensively and avoid travel outside cities after dark. Remain on the principal routes where possible and plan journeys carefully, identifying locations for refuelling and replenishing supplies. Do not use combi (minibus) taxis, public buses or trains. Exercise considerable caution while taking photographs; do not take photos of the security forces, key infrastructure and government buildings. Respect local customs and legislation. Personal Risk

CRIME

Crime for financial gain

Most crimes carried out in the country are petty and opportunistic, such as bag-snatching, pickpocketing and theft from parked vehicles; these can take place at restaurants, internet cafés, near bus and railway stations and in crowded markets. Violent crime against foreigners is less frequent in Zambia than in neighbouring Angola and Mozambique, and the majority of business travellers will face a very low threat level.

However, incidents affecting foreign nationals are occasionally reported and the threat of crime should not be deemed negligible. Thefts have also been reported from properties in the popular South Luangwa National Park. While serious attacks remain rare, the risk of muggings, assaults, residential break-ins and vehicle crimes may nonetheless increase after dark.

Members should be confident in the security measures at their accommodation, ensure staff are vetted and that they conduct vehicular travel with doors locked and windows closed to impair potential roadside attacks. While armed violence is rare, travellers should do nothing to antagonise assailants if accosted. Historically, travel to the northern border areas of Congo (DRC) carried a higher risk of exposure to violent crime, due to the activities of armed bandits.

Sexual assault

The country experiences a high rate of sexual assault and, though the majority of attacks occur domestically and in low-income areas, foreign travellers should be aware of the trend and adopt precautions to mitigate their exposure. Female travellers should not walk unattended in isolated areas and avoid all pedestrian travel after dark. Lone female drivers should remain vigilant at junctions and travel with the windows closed and doors locked at night. If returning to a parked car after dark, female travellers should check the back seats as a routine security precaution, as attackers may break into the vehicle, await the drivers' return and conduct an assault as the car travels through a remote area.

There have been several reports of the use of so-called ‘date rape' drugs against unsuspecting females in bars, nightclubs and restaurants. Travellers – females in particular – should never leave a drink unattended or accept drinks from strangers. Some common effects of such drugs include dizziness, drowsiness, nausea, vomiting, confusion, impaired muscle control, and memory loss (which can be transient or long-lasting depending on the drug). Members who suspect they may have been victims of a date rape attack should seek immediate professional medical advice and support.

Drugs

Fuelled by rapid urbanisation and economic hardship, drug trafficking has increased significantly in recent years. Cannabis is one of most common illicit drugs exported from the country, though the government has attempted to introduce a crop substitution program for peasant farmers that rely heavily on its production. The Drug Enforcement Commission (DEC) in July 2016 reported the arrest of 1,581 people for drug-related offences in the second quarter of 2016 - an 18% increase on the previous quarter. Foreigners should not accept packages from strangers or agree to carry parcels if they are unsure of the contents.

TERRORISM

There are no known terrorist groups operating in the country and the threat of a terrorist attack is negligible.

SOCIAL UNREST

The country has an adversarial political climate and incidents of political unrest - sometimes entailing rioting - occur regularly around sensitive political events and issues. Frequent incidents of election-related violence marred the run-up to the 2016 polls, and a ten-day campaign suspension was declared in July in the districts of Lusaka and Namwala (Southern province) after the killing of a UPND supporter during a protest. However, disturbances outside election periods are usually low-impact and the most violent episodes generally occur in high density, low-income areas. In April 2016, at least two people were killed during riots related to xenophobic tensions in low- income areas of Lusaka. Gatherings can quickly deteriorate, with the security forces liable to use heavy-handed measures, including live ammunition, to disperse crowds. Bystanders caught in the area are rarely targeted but can be exposed to the incidental risk of harm and opportunistic crimes such as looting, vandalism and mob violence.

Disturbances relating to industrial disputes as well as student protests are occasionally reported in Copperbelt province's principal cities of Kitwe, Ndola and Chingola, as well as in parts of Lusaka. In addition, communal grievances or local disputes have occasionally led to localised unrest in rural areas. Foreigners are very unlikely to be targeted during any such incidents, but should avoid any affected areas as a standard precaution.

BUSINESSWOMEN

While Southern Africa has a high incidence of sexual assault and rapes, the majority of cases are domestic and occur in low-income communities. Nonetheless, female travellers should be alert to the increased risks and adopt sensible security precautions as a routine measure.

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walking, be aware of your surroundings and occasionally check for any signs that you are being followed. Avoid giving away personal information to unfamiliar people, including full name, contact details and any address where you might be staying, visiting or working. Be particularly alert in restaurants, bars and nightclubs. Never leave a drink unattended or accept drinks from strangers. Some common effects of date rape drugs include dizziness, drowsiness, memory loss – which can be transient or long lasting depending on the drug –, nausea, vomiting, confusion and impaired muscle control. Personnel who suspect they may have been victim to a date rape attack should seek professional medical advice and support immediately. For further advice consult the ‘Additional Advice for Women' section of our General Security Advice in our travel security pages.

CONFLICT

Spill-over violence from the comparably less secure environment of Congo (DRC) has significantly reduced in recent years. However, the refugee situation has yet to normalise. In addition, Congolese rebel groups lay claim to portions of Zambian territory, though it is highly unlikely that they would stage a concerted campaign in the country. Small-scale sporadic clashes between militias and the security forces previously occurred, though none have been reported in recent years.

The ethnic-Lozi population in the western region of Barotseland has called for secession, claiming that the government has failed to abide by the terms of a 1964 Barotseland Agreement that entailed autonomy to the region. Tensions have revolved around the government's perceived lack of engagement on issues such as management of natural resources. The secessionist movement is, in principle, committed to a peaceful campaign, though there have been isolated occasions when related protests have degenerated into unrest. However, the issue is highly unlikely to trigger a deterioration of the political or security environment.

EMERGENCY NUMBERS Emergency Numbers Fire 993 Police 911

Ambulance services are not recommended. Contact International SOS for help with your medical situation. Country Stability

POLITICAL SITUATION

Zambia is a constitutional democracy with a president who is directly elected for a five-year term and is allowed a maximum of two consecutive terms. The legislature is the National Assembly, which contains 150 members who are directly elected, up to eight members nominated by the president, and a speaker, all with a five-year term.

Edgar Lungu of the Patriotic Front (PF) won the August 2016 presidential election by a narrow margin over Hakainde Hichilema of the UPND. The opposition leader accused the PF of fraud soon after the announcement of results and challenged the outcome before the constitutional court. The petition however, was dismissed, and Lungu was sworn in as president in September 2016. International election observers deemed the polls to have been fair, and while transitions of power following elections have generally been smooth, some low-level rioting was observed in southern parts of the country.

Although the country is more politically stable than many others in sub-Saharan Africa, tribal considerations and the adversarial character of the political system can trigger bitter intra- and inter-party feuding which can play out on the streets in the form of unrest. This is particularly true during election cycles, when political gatherings increase in frequency. Uncharacteristically for the region, recent elections were tightly fought, and no single party controls the political narrative. In the post-election period, Hichilema was charged with treason after vehicle vehicular altercation with the presidential motorcade, once again elevating tensions in the country for a number of months. He was subsequesntly released in August 2017 and the charges dropped, and the political situation has remained broadly stable since.

RULE OF LAW

The judicial system is underfunded, lacks infrastructure and is prone to political manipulation and corruption. The police lack adequate training and proper resources, rendering them inefficient in responding to and dealing with many types of incidents. Foreigners should avoid encounters with the police and military, who are frequently aggressive and heavy-handed. Suspects may be brutally beaten or released without charge (usually for a small sum). Keep passports and documentation close to hand in anticipation of police questioning.

CORRUPTION

Entrenched corruption among police officers is of particular concern to travellers; this can be attributed to low salaries and inadequate incentives, which makes officers susceptible to corruption. Street-level police officers may demand bribes (or seek to levy ‘instant fines' for spurious reasons) from foreign visitors, particularly drivers whom an officer can claim have committed a traffic infraction. If confronted by an individual making suspicious demands, be sure to show, but avoid handing over, the necessary documentation. Be prepared for potentially lengthy negotiations and maintain a consistent explanation of why it is not possible to pay the demanded ‘fine'. According to the latest Bribery Payers Index, compiled by the Anti-Corruption Commission, the demands for bribes increased by 6.7% in 2014.

NATURAL DISASTERS

Zambia experiences tropical storms between the months of November and April, as well as occasional droughts. Areas surrounding the Blue Lagoon National Park in Southern province and the northernmost parts of Copperbelt and North-Western provinces are vulnerable to flooding during prolonged or concentrated periods of rainfall.

RECENT HISTORY

Since gaining independence from the UK in 1964, Zambia has, for the most part, experienced broad political stability. From independence until 1991, the country was ruled by Kenneth Kaunda of the United National Independence Party (UNIP). During this period, the country suffered a serious economic crisis as copper prices declined. As a solution to the crisis, Kaunda amended the constitution and held elections in October 1991. Frederick Chiluba of the Movement for Multiparty Democracy (MMD) emerged as the winner and initiated the privatisation of state-owned enterprises and the streamlining of Zambia's burgeoning civil service. However, Chiluba's growing authoritarianism combined with perceived fraudulent electoral practices resulted in army officers staging an unsuccessful coup in 1997, forcing Chilubato impose a state of emergency.

Following elections in 2001, Levy Mwanawasa, Chiluba's chosen successor, became the next president and received credit for restoring political stability and for initiating an anti-corruption campaign. Mwanawasa won a second term in October 2006, but died of a stroke in August 2008; the post was subsequently assumed by Rupiah Banda of the MMD in a tightly-fought presidential by-election. Despite overseeing a period of sustained economic growth, Banda was unable to secure the popular vote at the September 2011 polls and was defeated by Michael Sata of the Patriotic Front (PF). https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 5 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

The outspoken and charismatic Sata oversaw a period of marked economic growth but was criticised for his role in what was popularly dubbed the ‘cartel', a group of high ranking PF figures and business and media tycoons perceived to be embroiled in corruption. Sata died in office on 28 October 2014 of an undisclosed illness and the presidency was assumed by Vice-president Guy Scott on an interim basis.

After months of internal wrangling within the PF, the presidential by-election of January 2015 was won by PF candidate and former Minister of Defense, Edgar Lungu in a tightly-fought contest with Hakainde Hichilema of the opposition United Party for National Development (UPND). In August 2016, Lungu was re-elected following an equally close race with Hichilema. Alerts

SPECIAL ADVISORY: COVID-19 outbreak impacting health care

View All Alerts

Before You Go

See your doctor and dentist and ensure you are in the best health before you leave. Other preparations:

Check your routine vaccinations Check your measles and other routine vaccinations are up to date (polio; varicella; mumps and rubella; tetanus, diphtheria and pertussis, seasonal influenza). See a travel health practitioner 6 to 8 weeks before departure for destination-specific health preparations. You may need additional vaccinations, some of which require several doses, or be recommended malaria medication which may need to be started a week or more before arriving in the malarial country.

Documentation: Arrange a copy of your personal health record to carry with you when you travel. Include a letter from your doctor explaining your need for all medications you are carrying, including any over-the-counter medications, in English and the language of your destination(s). Make sure you have copies of your prescriptions.

Medication: Check the regulations of your destination country regarding importation of your medication, as some drugs may be strictly prohibited (especially narcotics and psychotropics) and may result in severe penalties. Some restrictions are published on the International Narcotics Control Board. Take any medicines you require in their original packaging, including any information leaflets, with them clearly labelled with your name (matching your passport name), and your doctor's name. Have enough to cover the trip, and extra in case of delays, however note that many destinations limit quantities of certain drugs to a 30-day supply. Carry medication in your hand luggage, with copies of your prescriptions.

Vaccinations for Zambia

Recommendations may vary for short-term visitors. Always consult your travel health advisor or contact International SOS to discuss your specific needs.

Oral vaccination is recommended for travellers and relief workers who are likely to encounter unsanitary conditions, or will have Cholera limited access to safe water.

Recommended for all travellers and expatriates, especially groups at higher risk including:

long-term and frequent visitors. Hepatitis A adventurous travellers who travel to more remote locations or stay in areas with poor sanitation. gay, bisexual, and other men who have sex with men see (see US CDC). people who use illicit drugs. those with liver disease.

Hepatitis B Recommended for all travellers and expatriates.

All travellers are recommended to be fully immunised against polio (including a booster, if available) before they arrive in the country.

WHO recommends that all residents and visitors who have been in the country for more than 4 weeks receive a dose of polio vaccine (IPV) within 4 weeks to 12 months of travel.

Travellers should carry the document on which their polio vaccination status is recorded. They may be asked to show proof of Polio polio vaccination at departure or while entering other countries.

(The above-mentioned recommendations/requirements are as stated by the World Health Organization or the Ministry of Health. However national authorities may differ in how they implement these recommendations. Consult your travel health practitioner for individualised vaccination recommendation 6-8 weeks before your trip and check with the embassy or consulate

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of your destination if proof of vaccination is required in your itinerary.)

Consider for certain travellers, especially:

For expatriates and long-term visitors. For children who tend to play with animals and may not admit to being bitten or scratched. If you are travelling to a location where quality medical care may not be available immediately after being Rabies bitten/scratched by an animal. (Unvaccinated people need immunoglobulin within 24 hours of an animal injury, and this medication is scarce in some countries. If you are pre-vaccinated, you do not need this immunoglobulin after an injury.) If contact with dogs, monkeys or other potentially rabies-carrying animals is likely. Jogging increases your risk of dog bite.

Typhoid fever Recommended for all travellers and expatriates.

Zambia has a low risk of yellow fever transmission in some parts of the country.

A yellow fever vaccination certificate is required for entry for anyone > one year of age arriving from a country with a risk of yellow fever transmission, including people who were in transit for more than 12 hours in an airport located in a risk country.

Vaccination is generally not recommended for travellers going to Zambia. However, vaccination may be recommended for some travellers visiting certain areas (North West and Western provinces) who are at higher risk for infection due to the duration of their trip, planned activities, or other individual circumstances.

See the map of vaccination recommendations. Yellow fever For onward travel: your next destination, including your home country, may require a vaccination certificate for entry. Travellers going to Costa Rica or Egypt will be required to show proof of vaccination to enter.

NOTE: The Zambian embassy in Washington DC, USA, states on its website: "all travelers to and from Zambia are required to be in possession of either a Yellow Fever Vaccination Certificate or a valid waiver certificate."

(Discuss vaccination with your travel health professional well in advance of your trip. The certificate becomes valid 10 days after vaccination and is valid for the life of the traveller. Note that vaccination requirements may change at any time; check with the relevant embassy or consulate for your destination. Occasionally border authorities request a valid vaccination certificate although it may not be required under the official policy.)

More on diseases in Zambia Malaria

Threat from: Bites and Stings

Malaria is present year-round in all of Zambia.

Prevention:

mosquito bite avoidance medication: consult your travel health doctor for an individual recommendation. Some authorities recommend preventive medication.

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Malaria is transmitted by mosquitoes that usually bite from dusk to dawn. Symptoms can develop as early as seven days or as late as several months after exposure. Early malaria symptoms are flu-like and can include fever, sweats/chills, head and body aches, and generally feeling tired and unwell. People also sometimes feel nauseous and vomit or have diarrhoea. Untreated, malaria can cause serious complications like anaemia, seizures, mental confusion, kidney failure and coma. It can be fatal.

Follow the ABCDEs to minimise malarial risk:

A: Awareness - Be Aware of the risk, the symptoms and malaria prevention. B: Bite Prevention - Avoid being Bitten by mosquitoes, especially between dusk and dawn. C: Chemoprophylaxis - If prescribed for you, use Chemoprophylaxis (antimalarial medication) to prevent infection and if infected reduce the risk of severe malaria. D: Diagnosis - Immediately seek Diagnosis and treatment if a fever develops one week or more after being in a malarial area (up to one year after departure). E: Emergency - Carry an Emergency Standby Treatment (EST) kit if available and recommended (this is the kit which contains malaria treatment).

Zika Virus

There is no Zika Virus in Zambia.

Standard of Care

Emergency Response

Always try to call International SOS whenever medical care or advice is required, especially in emergencies.

There is a private ground ambulance company called SES (Speciality Emergency Services). They are based in Lusaka, Kitwe and Livingstone, and are staffed by ALS Paramedics.

SES can assist with ground ambulance movement and stabilization of patients prior to international air ambulance evacuations.

SES in Zambia: +260 (0) 211 273 302/4/5

Emergency Numbers Fire 993 Police 911

Standard of Health Care

The overall standard of medical care in Zambia is well below international standards, especially in the government (public) facilities. https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 8 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

Private medical facilities in major cities may provide reasonable care, although the scope of medical specialities offered is very limited and healthcare may not be of an international standard. Basic medical care outside of major cities is extremely limited.

Only private facilities should be utilised if available, as these offer a better standard of care. In smaller towns, there is often no private healthcare available and public facilities would need to be utilised.

Complex medical conditions should not be treated locally. Those requiring international evacuation would be referred to either Johannesburg, South Africa or Nairobi, Kenya depending on location and medical requirements. The facilities in Zambia are only suitable for treatment of simple medical conditions or for stabilisation of patients prior to medical evacuation.

OutPatient Care

Use only private facilities. Primary health care and some specialist care is available in Lusaka. Most specialists are only available for routine visits, not for emergencies. Generally, no specialist care is available outside of Lusaka.

The facilities in Zambia are only suitable for treatment of simple medical conditions or for stabilisation of patients prior to medical evacuation. Complex medical conditions should not be treated locally.

Paying for Health Care

Most doctors and medical facilities will require immediate cash or credit card payment. Primary and specialist care can be arranged in the major cities.

Do not defer medical treatment because of financial concerns. Contact International SOS, and if our terms allow, we will make financial arrangements on your behalf.

Dental Care

Although basic dental care is available, it is not up to western standards. Quality of care is not reliable. Facilities in Lusaka can provide basic dentistry in case of an emergency. Only the minimum treatment should be performed and more extensive dental work postponed/delayed until you reach a center of medical excellence.

Blood Supplies

Blood supplies in Zambia are UNSAFE. Any patient requiring blood should be evacuated to Johannesburg, South Africa. In Zambia, there is a high incidence of HIV and hepatitis, and blood is not screened according to international standards.

Even in areas where the blood supply is considered safe, it's best to avoid blood transfusions if possible. Screening cannot detect every blood-borne disease, and immune reactions can vary from minor to life-threatening. If a blood transfusion is recommended and circumstances permit, seek a second opinion from International SOS or your health advisor.

Medication Availability

All medications are imported. They are often in short supply and availability cannot be guaranteed. Use pharmacies at private facilities if available.

Since brand names vary, know the generic (chemical) names of your medications. It is always advisable to bring an adequate supply of prescription and other medications from your home country. However ensure you check the regulations of your destination regarding importation of your medication, as some drugs may be strictly prohibited (especially narcotics and psychotropics) and may result in severe penalties. Some restrictions are published on the International Narcotics Control Board. Clinics & Hospitals

Medical Providers No matter where you are, contact International SOS first if you are sick, injured or need medical advice.

Our medical staff will advise you, help you select the correct doctor, hospital or clinic, and make any necessary appointments on your behalf. If our terms allow, we will also make financial arrangements for you.

It is recommended that you contact International SOS before accessing medical care in Zambia Food & Water

Food and Water Precautions

Travellers have a small risk of developing diarrhoea in any country. It may be advisable to drink bottled water only, especially on short trips. Always wash your hands with soap before eating, or use an alcohol-based hand sanitizer. See the following country-specific recommendations:

Water and Beverages

Tap water is unsafe. Drink only boiled or bottled water or carbonated drinks. Some hotels have their own water purification plants.

Food Risk

In major cities, food in hotels and well-known restaurants is generally safe. In other areas, canned foods and well-cooked fresh meat should be safe. Avoid street vendor food and pre-peeled fruit. Wash fruit and vegetables before eating. https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 9 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

More on food and water safety Health Threats Summary

Health threats present include:

Animals: Anthrax, Rabies

Bites and Stings: African Sleeping Sickness, Dengue fever, Filariasis, Leishmaniasis, Malaria, Plague, Yellow fever

Coughing/sneezing: *COVID-19, Plague, Tuberculosis (TB)

Food and/or water: Cholera, Hepatitis A, Polio, Travellers' diarrhoea, Typhoid fever

Sex/blood/needles: HIV, Hepatitis B and C, & STIs

Swimming/bathing: Schistosomiasis

Health Threats

*COVID-19 | Threat from : Coughing/sneezing

This is a rapidly evolving situation. International SOS is monitoring closely - please see the MEDICAL ALERT on the "View All Alerts" section of this location guide, and the COVID-19 pages of the Pandemic Information website.

Towards the end of December 2019, authorities in Wuhan, Hubei province, announced a cluster of cases of pneumonia associated with the Huanan / South China Seafood Wholesale Market, for which a cause had not yet been identified. By January, a new coronavirus was identified as the cause of the illness. Initially called 2019- novel coronavirus (2019-nCoV), the virus was renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease it causes is called Coronavirus Disease 2019 (COVID-19). The situation is now a pandemic, and every location is expected to eventually be affected.

Transmission of the virus is from human to human. Although the exact way this happens with COVID-19 is still being investigated, it is probably occurring in the same way as other respiratory infections - through infected respiratory droplets. The infected person expels these when they cough, sneeze, or talk. Others can get the disease via contact (direct or indirect) with these contaminated droplets. Symptoms include fever, cough, sore throat, shortness of breath and breathing difficulty. Less common symptoms include headache, muscle aches and diarrhoea. Around 15% of cases have been severe and some will die. Older people, and people with underlying health conditions appear to be at higher risk for severe disease. There is no specific treatment - "non-steroidal anti-inflammatory drugs (NSAIDS)", such as ibuprofen, which are often available over the counter without prescription, should NOT be used to treat symptoms. They might make the illness worse. Paracetamol / acetaminophen can be used.

There is no vaccine yet, however research and development has commenced. Prevention is through avoiding potential exposure (keeping 1-2 metres away from other people) and employing general hygiene measures (washing hands, not touching your face, keeping surfaces clean).

Zambia

The first imported COVID-19 case was reported on 18 March 2020 and local transmission was detected by the end of the month. See the Ministry of Health COVID-19 website, the MOH Zambia Facebook page or Twitter account.

The national toll-free COVID-19 hotline is 909.

African Sleeping Sickness | Threat from : Bites and Stings

African sleeping sickness (sometimes called African trypanosomiasis or human African trypanosomiasis) is a parasitic disease that can be fatal if left untreated. It is spread by the bite of the tsetse fly, which is about the size of a honeybee and gray-brown in color.

Early symptoms include fever, skin lesions and a rash. The lymph nodes in the neck often become enlarged and swollen. Early diagnosis and treatment can minimize the risk of developing more serious symptoms. Untreated, the disease progresses to affect the patient's brain. This can cause confusion, personality changes and disturbed sleep cycles, with excessive daytime fatigue and nighttime insomnia. Coma and death can occur.

No vaccine is available. Prevent infection by avoiding Tsetse fly bites. Ask local inhabitants which areas are infected, and avoid these areas. Tsetse flies are attracted to moving vehicles and dark, contrasting colors. They are not affected by insect repellent and can bite through light-weight clothing. If you must visit an affected area, wear medium-weight clothes with long sleeves, long pants and socks. Choose neutral colors that blend with the background environment.

Zambia

Cases have been recorded in travellers who are diagnosed after return to their home countries. The risk is present in game parks and rural areas, including in South Luangwa National Park.

Anthrax | Threat from : Animals

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Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. It most commonly occurs in hoofed mammals, though humans can also become infected. The serious forms of human anthrax are cutaneous anthrax, inhalation anthrax and intestinal anthrax.

Symptoms of anthrax are different depending on the mode of infection. Generally, symptoms develop within seven days of exposure.

Cutaneous anthrax is a skin infection and accounts for 95% of all naturally-occurring anthrax infections. The main risk factor is contact with animal hides or hair, bone products, and wool. The disease can also be spread through contact with infected animals. Hence, the populations most at risk for anthrax include farm workers, veterinarians, and tannery and wool workers.

Bacteria infects a person through cuts or abrasions on their skin. An itchy skin lesion, similar to an insect bite, then develops - usually within two weeks of exposure. This lesion may later blister and then break down, resulting in a black ulcer. The ulcer is frequently painless but surrounded by significant swelling. Sometimes painful lymph nodes may develop. Often, a scab forms, then dries and falls off within two weeks. In 20 percent of untreated individuals, the infection may spread through the bloodstream and become fatal. However, death is extremely rare among individuals who receive appropriate treatment.

Initial symptoms of inhalation anthrax infection may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is often fatal.

Intestinal anthrax may follow the consumption of contaminated food and is characterized by acute inflammation of the intestinal tract. Initial signs of this disease are nausea, loss of appetite, vomiting and fever. These are followed by abdominal pain, vomiting of blood and severe diarrhea.

Direct person-to-person spread of anthrax is extremely unlikely; it may not even be possible. Therefore, there is no need to immunize or treat people who have been in contact with infected people unless they also were also exposed to the same source of infection (usually, a sick animal).

People who have been exposed to anthrax can take antibiotics to prevent infection. It is necessary to treat anthrax infections early; a delay lessens chances for survival. Anthrax usually is susceptible to penicillin, doxycycline and fluoroquinolones.

An anthrax vaccine can also prevent infection. Vaccination against anthrax is not recommended for the general public and is not available.

Cholera | Threat from : Food and/or water

Cholera is a diarrhoeal disease. People get sick when they consume food or water that has been contaminated by the faeces of an infected person. The most common symptom is severe diarrhoea. It is painless and watery (often called "rice-water" stools). Vomiting is also common.

Most cholera infections are relatively mild. People recover on their own by keeping well-hydrated. About 10-20 percent of all infected people will suffer severe illness, which can cause life-threatening dehydration. These cases are treated with oral and/or intravenous fluid replacement and antibiotics.

Most travellers have a low risk of cholera, as following food and water precautions is usually sufficient to prevent the disease.

Healthcare and relief workers who travel to areas of cholera outbreaks and have limited access to safe water are at higher risk. They should consider vaccination against cholera.

ZambiaOutbreaks occur in both rural and urban areas.

Dengue fever | Threat from : Bites and Stings

Dengue, or "break-bone" fever, is a viral disease of the tropics and sub-tropics. It is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes that bite during the daytime and are found in and around human habitation. Sexual transmission can occur but is rare. Transmission from mother to child is possible during pregnancy or birth. Symptoms include high fever, severe headaches, joint and muscle pain, nausea and vomiting. A rash often follows. The acute illness can last up to ten days, but complete recovery can take two to four weeks.

Occasionally, a potentially fatal form of dengue called severe dengue (previously known as dengue hemorrhagic fever or DHF) occurs. Severe dengue is more likely in infants and pregnant women, as well as for people who have been infected in the past and are infected again with a different strain of dengue. When a pregnant woman is infected there is a risk of pre-term birth, low birth weight and foetal distress. About 2 to 3 out of 100 severe dengue cases are likely to be fatal.

Prevention is through avoiding mosquito bites. Prevention of sexual transmission is through abstinence or using condoms when infected with dengue. A dengue vaccine, Dengvaxia, is available in several countries however it is not recommended for people who have never had dengue infection. It should only be used in people who have previously been infected with dengue. Hence, travellers who have already had the disease or are seropositive and planning to visit areas with high transmission can consider vaccination in consultation with a travel health specialist.

Filariasis | Threat from : Bites and Stings

Filariasis is a parasitic disease, also sometimes called "elephantiasis". It is caused by microscopic, thread-like worms that are spread via mosquito bites. Larvae enter the skin when a person is bitten, then travel to the lymph nodes, where they develop into adult worms. The adult worms reproduce (creating microfilaria) then migrate further in the tissues and circulate in the blood causing a variety of symptoms.

Initial symptoms include skin redness and swollen lymph nodes in the arms and legs. Headache, weakness, muscles pain, coughing, wheezing and fever are also common.

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Hepatitis A | Threat from : Food and/or water

Hepatitis A is a viral disease that causes liver inflammation. The virus is present in the faeces of an infected person. It spreads through contaminated food and water, and is common in areas with poor sanitation. Person-to-person spread also occurs, when the virus is inadvertently transferred into the mouth, including during sexual activity. People at higher risk of infection include men who have sex with men, illicit drug users and people with liver disease.

Symptoms begin on average 28 days after exposure (range 2 to 8 weeks), and include fever, chills, fatigue, abdominal pain, nausea, vomiting, dark urine and jaundice (yellow colour of the skin and eyes). Many infected people suffer only a mild illness. Most cases recover fully after four or more weeks. However for some, the disease can be severe, and occasionally is fatal. There is no specific treatment and cases are managed through supportive therapy.

Prevention is through vaccination, attention to hygiene, and access to safe food and water.

HIV, Hepatitis B and C, & STIs | Threat from : Sex/blood/needles

HIV/AIDS, hepatitis B, and hepatitis C are spread by contact with bodily fluids (especially blood and semen).

unprotected sex, needle sharing during IV drug use, or unsafe blood or medical/dental instruments.

Genital herpes (HSV), genital warts (HPV), gonorrhoea, chlamydia, syphilis and most other sexually transmitted diseases are spread by genital contact.

Prevention:

In many countries, hepatitis B is now a routine childhood immunisation and need not be repeated. All non-immune travellers should consider vaccination. Always use new condoms (preferably brought from your home country). IV drug users should not share needles. Avoid having tattoos or piercings done. In healthcare settings, make sure that needles and syringes sterile and not shared between patients. Call International SOS or your corporate medical department if you are hospitalised. Be aware of your risk when assisting anyone with an injury. Protect yourself from contact with bodily fluids. Seek medical attention within 24 hours if you accidentally come into contact with someone else's bodily fluids.

ZambiaThere is a high incidence of HIV and Hepatitis B infection.

Leishmaniasis | Threat from : Bites and Stings

Leishmaniasis is a disease caused by a parasite that can infect humans, dogs, rodents and other small animals. It is transmitted by sandflies that bite mainly between dusk and dawn and can occur in both rural and urban environments. Sandflies breed quickly in unsanitary conditions, and the spread of the disease is exacerbated by war, chronic food shortages and urbanisation activities like deforestation and building of dams and irrigation systems, changes in temperature, heavy rainfall and population movement. The disease can manifest in one of the three forms, cutaneous (is the most common form and causes skin ulcers), mucocutaneous (is a rare form which affects the inner parts of the nose and mouth) or visceral (which is the more severe form and can lead to death).There is no vaccine or drug to prevent leishmaniasis.

Prevention The only way to avoid leishmaniasis is to prevent sandfly bites.

Minimise outdoor activities from dusk to dawn--this is when sand flies are most active. Use protective clothing and insect repellent. Consider using an insecticide treated bed net with fine mesh if there are sandflies in your living quarters. The standard bed nets used to prevent malaria are not effective, as sandflies are about one-third the size of mosquitoes and can fly through the malaria nets. Note that sandflies are small and do not make noise while flying. This makes it difficult to determine whether they are in your environment. Their bites cause mild symptoms and might not be noticed.

Malaria | Threat from : Bites and Stings

Follow the ABCDEs to minimise malarial risk:

A: Awareness - Be Aware of the risk, the symptoms and malaria prevention. B: Bite Prevention - Avoid being Bitten by mosquitoes, especially between dusk and dawn.

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C: Chemoprophylaxis - If prescribed for you, use Chemoprophylaxis (antimalarial medication) to prevent infection and if infected reduce the risk of severe malaria. D: Diagnosis - Immediately seek Diagnosis and treatment if a fever develops one week or more after being in a malarial area (up to one year after departure). E: Emergency - Carry an Emergency Standby Treatment (EST) kit if available and recommended (this is the kit which contains malaria treatment).

Zambia

Malaria is present year-round in all of Zambia.

Prevention:

mosquito bite avoidance medication: consult your travel health doctor for an individual recommendation. Some authorities recommend preventive medication.

Plague | Threat from : Bites and Stings

Plague is found in many areas of the world. Caused by the bacterium Y. Pestis, plague mainly affects rodents but is occasionally transmitted to humans by fleabites. There are three main forms of plague in humans: bubonic, septicemic and pneumonic.

Bubonic plague is the more common form and occurs as the result of a fleabite. The plague bacillus travels through the lymphatic system to the nearest lymph node. The lymph node becomes enlarged and inflamed - a "bubo".

The septicemic form of plague occurs when infection spreads directly through the bloodstream. Without antibiotic treatment, this form of plague is usually fatal.

Pneumonic plague occurs when Y. Pestis infects the lungs. The first signs of illness in pneumonic plague are fever, headache, weakness and cough that produces bloody or watery sputum. The pneumonia progresses over two to four days and may cause septic shock and, without early treatment, death.

Plague vaccine is no longer commercially available.

Zambia

Sporadic outbreaks in humans have been reported in Eastern and Southern provinces.

Plague | Threat from : Coughing/sneezing

Bubonic plague is the more common form and occurs as the result of a fleabite. The plague bacillus travels through the lymphatic system to the nearest lymph node. The https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 13 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

lymph node becomes enlarged and inflamed - a "bubo".

The septicemic form of plague occurs when infection spreads directly through the bloodstream. Without antibiotic treatment, this form of plague is usually fatal.

Plague vaccine is no longer commercially available.

Zambia

Sporadic outbreaks in humans have been reported in Eastern and Southern provinces.

Polio | Threat from : Food and/or water

Polio is highly infectious, and is spread from person-to-person. People can be infected with polio if they eat or drink something that has been contaminated with faeces, particularly in countries with less-developed sanitation systems. It may also spread through the oral and nasal secretions of an infected person. In countries with higher levels of sanitation, respiratory droplets coughed by an infected person are an important means of transmission.

Most infected people show no symptoms, or have only mild ones including fever, headache, nausea and vomiting. In about one in 100 cases, the virus reaches the central nervous system and causes some form of paralysis.

Polio prevention involves selecting safe food and water, as well as vaccination. Many countries give a primary vaccination against polio during childhood. It entails several doses of oral (OPV) or injected (IPV) vaccine. Unvaccinated people, or those whose vaccination status is unknown, should receive IPV before travel to areas where polio is a risk.

Zambia

In October 2019, polio was reported in Luapula province. Prior to this, polio was detected in the country in 2002 among refugees from Angola.

Rabies | Threat from : Animals

Rabies is a viral disease contracted when bitten or scratched by an infected (rabid) animal, often a dog. Once it enters the body, the virus travels along nerves and causes paralysis. As it reaches important organs like the spinal cord and the brain, it causes coma and death.

In countries where rabies is present in animals or bats, ALL animal / bat bites, scratches and licks to broken skin must be treated seriously. Rabies vaccination is very effective in preventing rabies, even after a bite/scratch by a rabid animal.

Rabies vaccination Pre-exposure vaccination is often recommended for expatriates and long-term visitors to destinations where rabies is present. It's especially recommended if quality medical care may not be available after being bitten or scratched by an animal. Pre-exposure treatment can be especially useful for children, since they may not tell their parents that they have been bitten/scratched.

Pre-exposure vaccination makes it easier to treat a bite or scratch. That's important because some types of rabies treatment can be in short supply in many countries, even in cities.

If bitten, scratched or licked (on broken skin) by an animal:

Immediately cleanse the wound with soap and water and a povidone-iodine solution if available. Seek medical advice from a qualified source or your assistance company. Notify local health authorities immediately. You may need post-exposure vaccination, even if you have had pre-exposure vaccination. (THIS CAN BE LIFE SAVING.)

ZambiaPresent in rural areas.

Schistosomiasis | Threat from : Swimming/bathing

Schistosomiasis, also known as bilharzia, is a disease caused by parasitic worms that live in freshwater lakes, rivers and rice paddies. It can penetrate the skin of persons who are wading, swimming, bathing or washing in contaminated water. There is no vaccine.

To prevent infection:

Avoid swimming or wading in fresh water in countries where schistosomiasis occurs. Using soap during bathing reduces the risk of infection, as does a vigorous rubdown with a towel immediately after contact with contaminated water. Do not rely on these methods to prevent schistosomiasis. Heat bath water for five minutes at 50°C (122°F). Water held in a storage tank for at least 48 hours should be safe.

ZambiaPresent in all areas of Zambia.

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Travellers' diarrhoea | Threat from : Food and/or water

Travellers' diarrhoea is the most common travel-related illness. It usually occurs within the first week away from home. It is spread through contaminated food and water.

Prevention is through choosing safe food and water, and paying attention to hygiene. Select food that is thoroughly cooked while fresh and served hot. Avoid undercooked or raw meat, fish or shellfish. Avoid salad and raw vegetables unless you can wash them with clean (treated) water and you peel them yourself.

Unless you are certain that the tap water is drinkable - choose bottled water and beverages, avoid ice.

Tuberculosis (TB) | Threat from : Coughing/sneezing

Tuberculosis (TB) is a serious bacterial disease. The bacteria can be coughed or sneezed into the air by an infected person. Most people who contract TB have had prolonged, close, exposure to an infected person. This means they have spent days or weeks – not just a few hours – sharing the same air space with an infected person (e.g. living in the same house). People who work or live in institutions such as nursing homes or correctional facilities are also at higher risk.

Active TB causes a variety of symptoms that are sometimes vague, but often include cough, fever, night sweats, unintended weight loss and lethargy. Latent (inactive) TB causes no symptoms. Most strains of TB can be treated with antimicrobial drugs. Up to four different types of medicines may be used together to treat a patient. If left untreated, active TB can be life-threatening.

Some forms of TB have become resistant to drugs (MDR TB), and some forms are extensively resistant to drugs (XDR TB). These diseases are hard to treat. People sometimes contract MDR or XDR TB through direct contact with a person who is already infected. Or, in other cases, people with more traditional TB infections develop a drug-resistant strains. This can happen if anti-TB medication is used inappropriately or stopped too soon.

Many countries where TB is common will routinely give the Bacillus Calmette-Guerin (BCG) vaccine against tuberculosis to babies or children. The BCG vaccine protects these children against severe TB. If you live in an area with higher rates of TB infection, you may also consider vaccinating children up to 16 years old if you plan to live there for 3 months or more.

Travellers and expatriates may be able to reduce their chance of contracting TB by limiting the amount of time they spend in crowded places. Avoiding people who are coughing also minimises risk. Consider TB screening of local staff who live with you – especially if you have young children in your household.

Zambia

The World Health Organization (WHO) has designated Zambia a "high burden country" for tuberculosis. The country falls in the "high incidence" range as per WHO. High incidence range is greater than 300 new cases each year per 100,000 population. BCG vaccination is given at birth and is included in the country's immunisation schedule.

Expatriates or frequent travellers should consider consulting their doctor as TB screening may be offered.

Typhoid fever | Threat from : Food and/or water

Typhoid fever is a serious infection caused by Salmonella Typhi bacteria. People are infected through ingesting contaminated food or water. Choosing safe food and water and vaccination reduces the risk of developing the disease.

Symptoms usually begin one to three weeks after exposure. Although typhoid fever is often called a diarrhoeal disease, some patients do not have diarrhoea. Persistent, high fever is typical. Other early symptoms are flu-like: body aches and pains, weakness, loss of appetite and a continuous dull headache. A rash with pink spots may appear on the chest and abdomen of some patients. In severe cases, perforation of the bowel can cause severe bleeding or infection in the abdomen, which can be fatal.

Typhoid is treated with antibiotics. However there is a growing problem of antibiotic resistance. "Extensively drug-resistant' (XDR) typhoid is present in some locations and does not respond to many of the antibiotics which are usually used against typhoid, making preventive measures even more important.

Yellow fever | Threat from : Bites and Stings

Yellow fever is caused by a virus spread through mosquito bites. The symptoms range from a mild flu-like illness to a severe haemorrhagic fever with organ failure. It is prevented through vaccination and preventing mosquito bites.

Vaccination provides life-long protection. It is only available through designated yellow fever vaccination clinics. They will issue a signed and stamped International Certificate of Vaccination or Prophylaxis (ICVP) which becomes valid 10 days after the vaccination, and is valid for the lifetime of the person vaccinated.

Many countries require proof of vaccination for entry. If proof is not available, authorities may deny entry, mandate vaccination or may monitor your health. Some countries require proof of vaccination when departing. Always check the relevant location guide, or ask the consulate or embassy for the requirements, several weeks prior to your trip.

Zambia

Some areas of Zambia have a risk of yellow fever, however the potential for exposure is low, and vaccination is generally not recommended. The areas are:

North West province

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Western province

Elsewhere in Zambia there is no risk of yellow fever.

The country has not reported any cases since 1971.

Getting There

METHOD OF ARRIVAL

By air

Kenneth Kaunda International Airport (LUN), previously known as Lusaka International Airport, is Zambia's main international air hub; it is a basic facility with limited services and amenities. Harry Mwaanga Nkumbula International Airport (LVI, formerly known as Livingstone International Airport) in Livingstone handles a limited amount of regional traffic. Mfuwe International Airport (MFU), located in South Luangwa National Park, connects Mfuwe with several destinations in the region. Simon Mwansa Kapwepwe International Airport (NLA), located around two miles (3km) from Ndola city centre, also offers some international connections.

Baggage reclaim procedures are secure and security at the international airport is adequate. All baggage is scanned through a metal detector in the Arrivals and Departures areas.

Airlines have variable security standards. You may wish to consult the European Commission's website for a list of airlines banned within the EU and the US Federal Aviation Administration's website for a database of aviation accidents and statistics.

By land

Overland entry into the country is possible from Zimbabwe, Botswana, Malawi, Congo (DRC), Mozambique and Tanzania. The main border crossing points from Zimbabwe are at Kariba, Chirundu and Victoria Falls Bridge. From Malawi, the entry points are the Mchinga/Chipata border, Nyika plateau and Chitipa in the north. Zambia can be accessed from Mozambique via the Chimefusa border post, Tanzania via the Tanduma/Nakonde border post, while the crossing point from Congo (DRC) is through the Lubumbashi-Chingola road. However, banditry and landmines pose a risk on the route with Congo (DRC). Travellers can enter Zambia from Botswana via Kasane and Kazungula. A Temporary Import Permit (TIP) is required to bring a vehicle into the country. However, travellers should bear in mind that despite the widespread network, road conditions are poor in many areas. Opening hours for border crossings are from 06.00 to 18.00, except for Victoria Falls, which closes at 20.00. Visit the Zambia Tourism website for requirements needed for entry at border crossings.

Buses operate to and from Dar es Salaam and Mbeya in Tanzania, Lilongwe in Malawi, as well as Botswana and South Africa. While using a hire car, third-party insurance of the vehicle is necessary, and can be bought at the border post with a validity of one month. International express trains connect Zambia to South Africa, Zimbabwe and Tanzania.

By sea

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Entry & Departure Requirements Passport and visa requirements are subject to change and vary depending on the length of stay and visa type (business or tourist). Check with your travel advisor, embassy or consulate in your home country. Passports must be valid for at least six months from the date of entry. Passport Required? Visa Required? Return Ticket Required Australia Yes Yes Yes United Kingdom Yes Yes Yes Canada Yes Yes Yes Europe Yes Yes/1/2 Yes United States Yes Yes Yes

Visas

Required by nationals referred to in the chart above for stays of up to 30 days, except the following: 1. Nationals of Cyprus, Ireland, Malta and Romania are allowed free entry at the airport (all other EU nationals require a visa); 2. Nationals of Croatia, Czech Republic and Greece must obtain their visa before travel. All other EU nationals requiring a visa may buy it at their port of entry.

Visas can be obtained on arrival, though nationals of certain countries must apply in advance and need to refer their applications to the Zambian Immigration department. In addition, nationals of certain countries do not require visas for stays for up to 90 days. Visitors from Zimbabwe can use the Kaza visa to travel under the new UNIVISA system. The visa will cost $50 and will be valid for 30 days. The UNIVISA system is operational at the Livingstone, Lusaka, Harare and Victoria Falls airports, as well as at the Victoria Falls and Kazungula border posts. It is, however, liable to be periodically suspended; therefore travellers should liaise with the nearest consulate or embassy regarding the status of the system.

The cost of single and double entry visa is $50 and $80 respectively, while multiple entry visas cost $80 and the fee for transit visa is $50. Single entry visas can be obtained at most ports of entry; however, multi-entry visas should be applied for prior to travel. A day-trip visa which costs $20 is available at border crossings for those visiting for a single day from a neighbouring country. Business visas can also be obtained on arrival for free and allow for a stay up to a maximum of 30 days; those intending to stay longer than 30 days should apply for a temporary employment permit. Applicants for business visas require a letter confirming the purpose of their visit from a Zambian host; tourist visa applicants require only proof of onward travel.

Transit passengers do not require a visa – which is valid for seven days – if they continue their journey by the same or first connecting aircraft within 24 hours, hold valid onward or return documentation and do not leave the airport. Visa validity for US nationals is three years from the date of issue, while it is six months for British nationals. For nationals of all other countries, visas are valid for three months.

Visitors intending to stay for more than three months should apply for a visiting permit; the application for the permit must be made within 30 days before the expiry of the initial 90 days.

Entry/exit requirements

Visitors need a valid passport, with at least six months validity, a return air ticket (or evidence of an onward journey) and sufficient funds to support themselves for the duration of their visit. Travellers should ensure that their passport has at least two blank pages.

The immigration authorities usually permit travellers to stay for a maximum of 30 days. Visitors are also allowed 30-day extensions only twice, with a maximum duration of 90 days. Visitors planning to prolong their stay beyond the allowed duration are required to obtain an extension from the immigration office; the service is free of charge. Foreigners should be cautious of ‘consultants' who could offer false documents and charge fees for this service.

There are no restrictions on the import of foreign currency, provided a declaration is made on arrival. Visitors should be aware of specific medications that may be on the government's controlled substances list (such as certain antihistamines), as foreigners have previously been jailed for unknowingly bringing such banned materials into the country.

Amid an increase in reported cases of the coronavirus disease 2019 (‘COVID-19') worldwide, the local authorities have introduced screening measures involving temperature checks at all ports of entry.

Procedures

Business visitors usually go through immigration speedily. The immigration officers scan the fingerprint of visitors at the time of entry and stamp the passport with the authorised stay.

Departure Tax

The departure tax is US$25 for international flights and US$8 for domestic flights, and is usually included in airline ticket price.

Getting Around

BY AIR

Distances are considerable and domestic air travel is the most efficient means of transport. Several airlines operate internal flights, though the small number of aircraft owned by these carrier's means that even a minor technical fault can lead to long delays. Several air charter services operate out of Lusaka.

Former national carrier Zambian Airways suspended operations in 2009, citing high fuel costs. In late 2011, Zambezi Airlines lost its operating licence due to safety concerns. Following a safety review, its licence was restored and the airline resumed limited operations in June 2012. Travellers should be confident of the quality and https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 17 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

standard of the provider that they select for their journey before setting out.

BY ROAD

Visitors should not self-drive unless familiar with local conditions. Accidents are common, particularly on the Great East Road in Lusaka, and most roads are poorly lit at night. Travellers should hire a vehicle with a trusted local driver. Travel in rural areas can be hazardous, as wild animals often wander onto roads, many vehicles lack tail lights and driving while inebriated is common practice. Travel to remote areas, including near many border crossings, is not possible without four-wheel drive (4WD) vehicles, particularly during the rainy season between November and April.

Foreigners intending to self-drive require an international driving permit. The police often set up roadblocks to inspect vehicle conditions. Motorists should ensure that their headlights and indicator lights are working and that their vehicle has two metallic emergency triangles, reflectors with white stickers for the front and red at the back, a fire extinguisher and a spare tyre; those failing to comply are liable to heavy fines. In the event of being fined, motorists must ensure to either collect an official receipt or visit the nearest police station to pay the fine.

The police can also examine the headlights and brakes. The use of seatbelt is mandatory and using cellular phones while driving carries a fine. Traffic drives on the left. There are strict penalties for driving while intoxicated. The speed limit is 62 miles per hour (100kph) on national highways and 40 mph (65kph) in built-up areas, but these limits are often violated. It is unlawful to take a left turn on a red light and splatter water on pedestrians while driving.

Motorists should keep to main thoroughfares, and drive slowly and defensively. Visitors should avoid travelling after dark. Broken-down cars and trucks are often left standing in the middle of the road with little or no hazard warning. Motorists should slow down if branches or bushes are placed on the road, as this usually indicates that there is a broken-down truck or heavy vehicle ahead. Most main roads are tarred, but surfaces are often rough. Major throughways connecting provincial capitals are well maintained. The weather affects driving conditions and heavy rainfall can make some roads impassable. Given that emergency service or roadside assistance is limited in Zambia, travellers should carry a mobile phone with them. Temporary imports permit (TIP) and third-party insurance must be obtained to take a vehicle into Zambia. If the driver is not the owner, a letter authorising the use of the vehicle will be required.

Due to the country's overdependence on a single fuel refinery in Ndola (Copperbelt province), closures or scheduled repairs at the facility can occasionally bring about nationwide fuel shortages. During such times, motorists should anticipate queues at petrol stations and be sure to refill their tank whenever possible. An announcement that fuel prices will be raised can also trigger significant queues as motorists refill their tanks before the new prices are put into effect. When undertaking longer journeys or when visiting the worst-affected areas, drivers may wish to consider bringing a spare jerry can of fuel. In addition, fuel scarcity may trigger protests by public transport operators and other drivers that depend on road travel for their livelihoods.

Landmines and unexploded ordnance (UXOs) pose a risk in remote areas near the borders with Angola, Mozambique and Congo (DRC). Travellers should keep to established de-mined routes at all times.

BY TAXI

Regular taxis, which are usually painted sky blue or a light grey, are an acceptable mode of transport for short distances, though the maintenance of most vehicles is poor and shared taxis should be avoided. Taxis are rarely metered so fares should be agreed upon in advance. Most taxi drivers are members of a trade organisation and are strictly controlled. Taxis are expensive and there is little difference between the cost of hiring a car and a taxi's day rate; fares should be paid in local currency.

BY TRAIN

Rail services are limited and not suitable for business travellers.

BY OTHER MEANS

By bus

Local bus services are unsuitable for foreign business visitors. Luxury buses from Lusaka to Livingstone are designed to meet tourists' needs rather than those of business travellers. Buses rarely adhere to schedule and are only likely to leave when the maximum number of seats has been filled. Shared minibus taxis should be avoided for safety and security reasons.

By ferry

Local boat services are also unsuitable for foreign business travellers. Language & Money

LANGUAGE

English is the official language, and most Zambians speak it fairly well. Bemba and Njanja are the other most commonly understood languages. Other commonly spoken languages in Zambia are Tonga, Lozi, Tumbuka, Nsenga, Lunda and Luvale.

MONEY

The Zambian Kwacha (ZMK) is the official currency. The use of foreign currencies during transactions is unlawful. Most leading hotels and shops accept credit cards, though travellers should be aware of possible credit card fraud. Banks and bureau de change will not accept US dollars issued before 2000. Shops occasionally use carbon paper to process card payments; visitors should ensure that these are destroyed after the transaction has been made to prevent any fraud.

Visa and MasterCard are widely accepted at major stores, markets, restaurants and hotels in Lusaka and Livingstone. ATMs compatible with international cash withdrawal cards are available, though most of these accept only Visa and not MasterCard; traveller's cheques are not widely accepted and cashing them is difficult. Currency should be exchanged at known banks and bureaux de change as counterfeit US$100 and 50,000 Kwacha bills are in circulation. Cultural Tips

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General Tips

Handshaking is the typical form of greeting in Zambia, and the left hand should support the right elbow to demonstrate respect. Avoid making direct eye contact, touching someone of the opposite sex and finger pointing since these are all signs of disrespect. Friendliness and warmth are hallmarks of Zambians, who expect the same from visitors. Personal appearance should be neat and clean, especially in public. Giving gifts is important in Zambian society and signifies friendship and gratitude. When giving or receiving a gift, both hands are used. Photographing military facilities, airports, bridges, mines, railways, the Ndola Oil refinery, electrical power supply buildings and other facilities deemed to be of security relevance is prohibited. Police officers occasionally seize camera memory cards, film or cameras if these areas are photographed. It is best to seek permission before taking photographs of anything other than tourist attractions. Pornography is illegal; those found in possession of any such material may face imprisonment or deportation. Homosexuality is illegal and conviction may result in long-term imprisonment.

Business Tips

Day-to-day business conduct differs little from that in the West. Meetings are formal and suits should be worn, though smart casual wear will be acceptable in most day-to-day business settings. As Zambian business personnel tend to wear suits for evening meetings, it is advisable to do the same. Business cards are appreciated. The pace of business can be slower than what many business travellers are used to, especially when meeting with civil servants or government officials. Exercise patience and always be polite if a meeting or appointment is delayed. Travellers should reconfirm all appointments beforehand and plan for potential delays. Business is conducted in English, the official language of Zambia. Zambian law provides for full equality of women in the workplace.

Businesswomen

The majority of attacks are conducted at night against lone female travellers in dark streets, unauthorised taxis or in the vicinity of nightlife areas. Remain vigilant in such areas and endeavour to book taxis through the hotel or a trusted local third party. Female travellers are advised to prioritise security concerns when selecting accommodation. Lone females relocating for the medium-to-long term should reside in a secure complex where possible. Adopt sensible pedestrian security measures; avoid walking unattended in isolated areas and desist from walking outside of secure locations after dark. When walking, be aware of your surroundings and occasionally check for any signs that you are being followed. Avoid giving away personal information to unfamiliar people, including full name, contact details and any address where you might be staying, visiting or working. Be particularly alert in restaurants, bars and nightclubs. Never leave a drink unattended or accept drinks from strangers. Some common effects of date rape drugs include dizziness, drowsiness, memory loss – which can be transient or long lasting depending on the drug –, nausea, vomiting, confusion and impaired muscle control. Personnel who suspect they may have been victim to a date rape attack should seek professional medical advice and support immediately. For further advice consult the ‘Additional Advice for Women' section of our General Security Advice in our travel security pages.

Tipping

Tipping is not customary in Zambia, but tips are appreciated when given. The normal tip is 10% of the bill. Some hotels and restaurants may add this charge to the bill.

Working Week

Working week: Monday to Friday Office hours: 08.00-17.00 Banking hours: vary from bank to bank; in general, 08.15-15.30 Monday to Friday; 08.15-11.30 on Saturdays. Phone & Power

Zambia Telecommunications

Emergency Numbers Fire 993 Police 911

Dialing Codes Country Code 260 IDD Prefix (International Direct Dialing) 00 NDD Prefix (National Direct Dialing) 0

Telephone Information

The telephone system is adequate but overburdened: patience and repeat dialling may be required when attempting to reach both fixed-line and mobile numbers. Major GSM mobile network providers include Zamtel, MTN and Airtel. International calls are expensive and sometimes take a long time to connect. The local mobile telephone network is widely used, though coverage is limited to the major towns, the Copperbelt and highways in between.

Postal services are available and fairly reliable. However, valuables should be sent through courier. International couriers such as DHL and FedEx offer services in the https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 19 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

country.

Zambia Electricity

Voltage and Frequency

Additional Electrical Information

Voltage: 230 volts Frequency: 50 Hz

These are the most common plug types used:

Geography & Weather

Weather data provided by weather.com

Climate

Most of Zambia is at a high altitude and there is little of the humidity associated with Africa's east or west coast countries. Zambia has three distinct seasons: hot and dry summer in October-November, hotter rainy season from December to April and cool and dry winters in May-September. The rainy season is typified by electrical storms towards the evening, some of which can last for days, particularly in Copperbelt province. This exacerbates difficult driving conditions in the region and makes some areas impassable. Although May-September is the main tourist season, business visitors are unlikely to have problems booking hotels in Lusaka because most tourists spend little time there. October is the hottest month of the year. Zambian hotels and offices are not normally air-conditioned.

GEOGRAPHY

Zambia is a landlocked country in southern Africa. It draws its name from the Zambezi river, which demarcates the country's southern border with Zimbabwe. Zambia is flanked by Angola to the west and Mozambique to the east; it also shares borders with Congo (DRC), Tanzania, Malawi, Botswana and Namibia.

The majority of the country's terrain consists of savannah bush veld plains with hills and mountains in the areas bordering Congo (DRC) and Tanzania. Zambia's topographical features also include the famous Victoria Falls waterfall, as well as lakes and wetlands. The country's major urban centres in addition to Lusaka are Ndola, Kitwe, Chingola, Mufulira and Luanshya, located in Copperbelt, as well as Kabwe in central Zambia. Embassies & Consulates

Embassies Canada High Commission Lusaka 5199 United Nations Avenue, PO Box 31313; Lusaka

Lusaka Zambia Telephone: +260 211 250833 Fascimilie: +260 211 254176 Email: [email protected] website: http://www.zambia.gc.ca China Embassy Lusaka United Nations Avenue; Lusaka

Lusaka 10101 Zambia Telephone: +260 211 252410 https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 20 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

Fascimilie: +260 211 251157 Email: [email protected] website: http://zm.chineseembassy.org Finland Embassy Lusaka Haile Selasie Ave, Opposite Ndeke house Longacres; Lusaka

Lusaka Zambia Telephone: +260 211 251988 Fascimilie: +260 211 253783

Email: [email protected] website: http://www.finland.org.zm/Public/Default.aspx France Embassy Lusaka 74 Independence Avenue, 4th Floor, Mpile Building, PO Box 30062; Lusaka

Lusaka 10101 Zambia Telephone: +260 211 251322 Fascimilie: +260 211 254475 Email: [email protected]

website: http://www.ambafrance-zm.org/-Francais- Germany Embassy Lusaka 5209 United Nations Avenue, PO Box 50120, Ridgeway; Lusaka

Lusaka Zambia Telephone: +260 211 250644/2512 Fascimilie: +260 211 254014 Email: [email protected] website: http://www.lusaka.diplo.de/ Italy Embassy Lusaka P.O. Box 50497, Plot No 5211, Embassy Park, Diplomatic Triangle; Lusaka

Lusaka Zambia Telephone: +260 211 250 755

Fascimilie: +260 211 254929 Email: [email protected] website: http://www.amblusaka.esteri.it Japan Embassy Lusaka 5218 Haile Salassie Avenue, PO Box: 34190; Lusaka

Lusaka Zambia Telephone: +260 211 251555 Fascimilie: +260 211 254425/2534

Email: [email protected] website: http://www.zm.emb-japan.go.jp/en/topic/2015.03.11.ZATULET.E.htm Norway Embassy https://www.internationalsos.com/MasterPortal/PrintDisplayPR.aspx Page 21 of 23 International SOS Member Site - - Country Report 7/21/20, 3:53 PM

Lusaka Corner: Birdcage Walk/Haile Selassie Avenue Plot: 245/61, Longacres; Lusaka

Lusaka Zambia Telephone: +260 211 389 000 Fascimilie: +260 211 389 001 Email: [email protected]

website: http://www.norway.org.zm/Embassy/ Saudi Arabia Embassy Lusaka 27BC Leopord Hill Street, Kabulonga; Lusaka

Lusaka 34411 Zambia Telephone: +260 211266861 Fascimilie: +260 211266863 Email: [email protected] website: http://embassies.mofa.gov.sa/sites/Zambia/EN/Pages/default.aspx South Africa High Commission Lusaka Cheetah Road 26D, Kabulonga; Lusaka

Lusaka Zambia Telephone: +260 211 260999 Fascimilie: +260 211 262723

Email: [email protected] Sweden Embassy Lusaka Haile Selassie Avenue Opposite Ndeke House Longacres; Lusaka

Lusaka Zambia Telephone: +260 211 251711 Fascimilie: +260 211 254049 Email: [email protected]; [email protected] website: http://www.swedenabroad.com/sv-SE/Ambassader/Lusaka/ United Kingdom High Commission Lusaka 5210 Independence Ave. 15101 Ridgeway, PO Box 50050; Lusaka

Lusaka Zambia Telephone: +260 211 423200

Fascimilie: +260 211 423291/4232 Email: [email protected] website: https://www.gov.uk/government/world/organisations/british-high-commission-l United States Embassy Lusaka Ibex Hill Road; Lusaka

Lusaka Zambia Telephone: +260 211 357000

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Fascimilie: +260 211 252225

Email: [email protected] website: http://zambia.usembassy.gov/ Calendar

2020

24 Oct Independence Day

25 Dec Christmas Day In some countries, if this holiday falls on a Saturday or Sunday, a public holiday is declared for the following Monday.

2021

01 Jan New Year's Day In many countries, if this holiday falls on a Saturday or Sunday, a public holiday is declared for the following Monday.

12 Mar Youth Day

25 May Africa Day

DISCLAIMER PRIVACY Travel security advice provided in this report represents the best judgment of AEA International Holdings Pte. Ltd. Medical and health advice provided in this report represents the best judgment of AEA International Holdings Pte. Ltd. Advice in this report does not however provide a warranty of future results nor a guarantee against risk.

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