Malaria in Honiara

Hi,

I have a job offer in Honiara and I plan to go there with my filipino partner and my 15 months old baby. I am desperate to know the current situation for malaria. I heard is better than it used to be but actually what does it mean? Is it reasonably safe if with use mosquito net and repellent? What about the hospital facility to deal with Malaria? We are also looking at contacts there, Filipino and other? Please contact me. thanks

I think I outlined answers to much of this in my reply to your previous question. I lived in Honiara for 11 months in 2004, and did not get malaria. I got it 11 times living in rural Guadalcanal for 4 years from 1991 to 1994, but we were in a very malaria prone area, and we had to be on duty outdoors around sunrise and sunset, when the mosquitos are out. Malaria is much less prevalent now in the whole country than it was in 1994.
On shorter visits, which I do regularly, I use doxycycline as a prophylaxis, but if I am there for longer periods of time, I don't.
Be careful with repellants with your baby, as some are not recommended. Otherwise, use treated nets (available through the Malaria Centre in Honiara), and make sure your house has screens. If you need to be outdoors for about an hour before and after sunrise and sunset, cover your legs, arms etc with thick clothing (eg jeans) as mosquitos can bite through thin cotton fabric.
There is a good hospital in Honiara, as well as several clinics, and treatment is heavily subsidised for residents. However, with my private Australian Health Insurance, I use a local private doctor, who is very good at understanding malaria and other tropical diseases. (He is much cheaper than Australian doctors, his office is downstairs at Panatina Plaza). If you have travel insurance, you can get evacuated to Australia if necessary, but I find the local medical treatment more than adequate. The Malaria Centre at Kukum also does very professional malaria tests. (I find Solomon Islands medical personnel are much more knowledgable about malaria than the average Australian Health Worker, as they are dealing with it all the time.)
The best Filipino contact I know are the owners of Ning's bakery, in the street behind Mendana Avenue. Otherwise, go to Holy Cross Cathedral, as many Filipinos are Catholic. Honiara is a comapritively small place so you will find it easy to meet people. If you let me know your home country, I may even know someone from there. Many expats visit the Lime Lounge, around the corner from the ANZ bank, on the road to the wharf. Also, contact the Embassy or High Commission for your country.

Hi there. Congratulations on your job offer - you're guaranteed to love your time in the Solomons, it's an amazing place.

I was placed in the Solomons as a volunteer a few years back and am now married to a Solomon Islander. We now balance our time between Australia and the Sols.

Despite the fact that the Sols is a fairly healthy place, Malaria is a considerable problem and does need to be considered. I'm not sure that the situation has improved, despite what you have heard, as the rate of malaria cases can fluctuate considerably depending on a range of factors such as environmental conditions etc.

Unfortunately, to local people, Malaria is simply a way of life. Much of the population experiences malaria almost as often as the western world experience a cold or flu.

Despite this, don't be concerned. There are plenty of people that spend long periods of time in the Solomons without contracting malaria and there are some simple precautions you can take.

There are a range of prophylactic (anti malarial) options available for you and your partner (but not your child) which doctors are likely to tell you are mandatory. Doxycycline seems to be the most popular, probably due to its relatively low cost and mild side-effects, but there are many other choices.

Regardless of medical advice and the initial good intentions to take prophylactic medicine throughout their time in country, many expats in the Sols seem to discontinue this shortly after arrival. This is usually put down to side effects (sensitivity to light, slight tiredness, nausea etc) or the perceived low threat of mosquito bite. This said, some people will continue to take their anti-malarial throughout their entire stay. It's an entirely personal choice.

Obviously, regardless if you are taking anti malarials or not, the stongest defence is to not get bitten. Repellents and mosquito netting are the most common defence. Mosquito coils are also known to be effective. Depending on what type of work you'll be doing, and where you'll be based, the vast majority of expat housing has mosquito netting surrounding the windows which allows you to sleep without a net (as they can get a little hot at night).

As malarial mosquitoes primarily bite at night (unless you find one in a dark place during the day) it's really only a consideration then.

Regarding the treatment / local medical ability to treat malaria - they are very well equipped. Malaria testing centres are throughout the Solomons and there are plenty of places where you can get tested (simple prick to the finger and a blood slide under a microscope) with an instant result. Medication is then supplied from the centre itself, the hospital, or a pharmisist.

My management of malaria was this:
1) Talked with doctor and discussed the best anti-malarial option for me
2) Took anti-malarial until I was settled and comfortable that my housing was appropriately screened and within my lifestyle I was able to manage the risks with the use of repellants, coils etc
3) Resumed anti-malarials if I was intending to visit a remote area or a provincial area where I was unsure of the malaria situation (or if my accommodation in these places would have mosquito netting)
4) Applied repellent regularly, particularly at dusk and covered with clothing.

This is what worked for me, but I'm not suggesting that this will work for everyone.

Regarding repellant, although there are mixed views on Deet, those repellants that contain Deet are significantly more effective. Dont bother with wrist bands or electronic repellants. Consider the use of permethrin.

For your child, many parents use dome tent type mosquito nets which are portable and can be located inside, on a balcony, garden etc and provide a safe play/sleep area in the evenings. I'd try to source one of these before you get to the Sols.

Although malaria exists, don't be scared by it. Once your lifestyle adapts, it's management will be routine and low impact... and the beauty and charm of the Sols is definately worth the effort.

Finally, there is a small Filipino community in the Solomons. You can find out contacts at the local Nings bakery in the centre of town which is run by a Filipino woman.

Hope this helps

Ben

Oops... sorry ozziegiraffe we had a power cut when I was writing this so I guess the page didn't update with your post until I posted response too. Oh well, similar message anyway.

So Honiara is still having power cuts! As we only had a part-time generator my first 4 years there, I became used to not having power the whole time - I get a bit cranky with the RAMSI people who insist on having their own generators on their homes to supplement town power.
When I was there 20 years ago, the incidence of malaria was significantly higher than it is now. However, I actually got my first case of malaria when I was taking the then recommended prophylaxis, and was advised to stop taking them, as it made it harder to diagnose. The slides are not easy to read - I was learning to do it while I was there.
I just thought of another warning - on no account drink Honiara tap water, either get a tank or boil tap water. I had a 3-month attack of "beli-run" (ie diarrhoea) when someone replaced my boiled water in the fridge with tap water accidentally.

Thank you, Ozzygiraffe and Uma. Your comments are very useful. Really, thanks. I have just received an email from my potential future employer. They are thinking about relocating me in Vanuatu. Maybe there are less mosquitos there! I looked at websites and Vanuatu seems in many ways quite similar to Solomons Islands. By the way Ozztgirrafe was asking my nationality. I am French.
Ok, now I have to consider the opportunity to go to Vanuatu. Any infos?

As Vanuatu was historically a French/English condominium, you will find a significant number of French speakers there.
However, if you haven't already, I suggest you post this request separately, as many of us have been to one country or the other, but not both.
However, the cultures and people are similar - I made quite a few ni_Vanuatu friends living in Solomon Islands.