Djibouti, Africa

1. Djibouti, Africa

2. Facts

3. Environmental Hazards

4. SNAKES

5. Adult length usually 2.5 to 3.0 meters, maximum of 4.3 meters; relatively slender snake. Background color may be brown, olive brown, dark olive, greenish brown or dark blackish gray. Interior of mouth blue-gray to blackish. Black Mamba Most dreaded African venomous snake; few people survive its bite unless antivenom administered promptly. Vemon very potent neurotoxin. Adult length usually 1.2 to 1.5 meters; relatively slender snake. Background color varies from almost black to almost uniform green; no blotches or distinct spots. Short stubby head and enormous emerald green eyes. Scales strongly keeled and overlapping. Boom Slang Potently hemotoxic; can cause severe bleeding internally and from mucous surfaces. Deaths reported.

6. Adult length usually less than 0.9 meters; relatively slender snake. Background color varies; usually uniform dark purplish brown to black above. Short, conical head, not distinct from the neck; snout broad, flattened, often pointed. Fangs well developed and comparatively large in relation to size of head. Tail short, ending in distinct spine. Venom primarily hemotoxic. Victims may experience intense local pain, swelling, and, in some instances, necrosis. Burrowing ASP Adult length usually 0.3 to 0.6 meters; relatively stout snake. Background color variable, usually yellowish, brown, gray, or reddish; may have series of oblique pale crossbars, interspersed with dark spaces, along back. Usually has row of triangular or circular markings with pale or white edging along each side. Some specimens with very faded or almost invisible markings. Belly pale, usually with brown or reddish spots. Head pear-shaped. No known antivenom produced Egyptian Carpet Viper

7. Adult length usually 1.5 to 2.0 meters, maximum of 3.0 meters. Background color usually yellow-gray to brown or blue-black, but extremely variable. Belly yellowish with dark blotches. Most specimens have dark brown or black band across the throat. Egyptian Cobra Venom primarily neurotoxic, acting largely on nerves controlling respiratory muscles. Untreated cases may culminate in respiratory failure and death Adult length usually 0.6 to 1.0 meters, maximum of 1.5 meters; thick, heavily built snake. Background color varies from bright yellow to light yellow, yellow-brown, orange-brown, light brown, or gray. Belly yellowish white to gray with black blotches. Rough-scaled appearance and alternating pattern of dark and light chevron-shaped markings are characteristic. Puff Adder Many serious bites reported; only a small portion prove fatal. Venom potent cytotoxin, attacking tissue and blood cells. Symptoms include extreme pain with swelling and large blisters in region of the bite.

10. Scorpions Envenomations are usually categorized into two or three levels of severity: 1) localized effects, 2) systemic effects, and 3) systemic effects with central nervous system involvement. Localized effects are common to nearly all scorpion stings regardless of the toxicity of the venom. These symptoms are restricted to the site of sting and include intense pain, minor swelling, redness or induration, numbness, tenderness, and tingling. Intense pain normally subsides within one hour, giving way to numbeness, tenderness, and tingling at the site of the sting. This normally results in the favoring of an affected limb. These symptoms normally fade after 24 hours. Systemic signs and symptoms are often reported following scorpion envenomation: intense pain that radiates towards the body and is especially acute at the armpits and groin areas, aggitation or anxiety, increased body temperature, sweating, chills, a feeling of numbness or swelling of the face, tongue and throat, pain or tightness in the chest or back, and occasionally slightly increased heart rate and blood pressure.

21. Malaria(mah-LARE-ee-ah) What is malaria? Malaria is a serious, sometimes fatal, disease caused by a parasite. There are four kinds of malaria that can infect humans: How do you get malaria? Humans get malaria from the bite of a malaria-infected mosquito.. The parasites then travel to the person’s liver, enter the liver’s cells, grow and multiply. The parasites leave the liver and enter red blood cells; this may take as little as 8 days or as many as several months. Once inside the red blood cells, the parasites grow and multiply. The red blood cells burst, freeing the parasites to attack other red blood cells. Toxins from the parasite are also released into the blood, making the person feel sick. If a mosquito bites this person while the parasites are in his or her blood, it will ingest the tiny parasites. After a week or more, the mosquito can infect another person. What are the signs and symptoms of malaria? Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Infection with one type of malaria, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.

22. Malaria(mah -LARE-ee-ah What is the treatment for malaria? Malaria can be cured with prescription drugs. The type of drugs and length of treatment depend on which kind of malaria is diagnosed, where the patient was infected, the age of the patient, and how severely ill the patient was at start of treatment • Take your antimalarial drug exactly on schedule without missing doses. • Prevent mosquito and other insect bites. Use DEET insect repellent on exposed skin and flying insect spray in the room where you sleep. • Wear uniforms rolled down, especially from dusk to dawn. This is the time when mosquitoes that spread malaria bite. • Sleep under a mosquito bednet that has been dipped in permethrin insecticide if you are not living in screened or air-conditioned housing How can malaria be prevented?

23. Djibouti Infectious Diseases Sandfly Fever : Dengue Fever Rift Valley Fever (RVF): Chikungunya Fever : Typhoid and Paratyphoid Fevers Meningococcal Meningitis Enterically Transmitted Viral Hepatitis A and E / Bloodborne Viral Hepatitis B,D, and C Leishmaniasis Schistosomiasis Tuberculosis Other diseases

24. STD's / HIV's STDs including gonorrheaand chlamydial cervicitis/urethritis are highly endemic. HIV/AIDS Predominantly heterosexual transmission. HIV transmission is much more widespread than official reporting indicates, and rates are likely to increase substantially. HIV-1 prevalence among high-risk and low-risk urban populations was estimated at 38 and 4 percent, respectively, as of early 1998. Prostitutes tested in 1994 and 1995 were found to have rates as high as 45 percent.

25. Heat-Related Illness

26. General • Vast majority of heat-related problems are a direct result of the environmental conditions in which the person has been exercising,

27. Factors Affecting Heat Injury/Illness • Temperature (ambient vs. body) • Wind • Illness • Hydration level • Acclimatization

28. Heat Index • Combined effects of temperature and humidity (what it feels like to the body)

29. Environmental Temperature (°F)

30. Flag conditions • White: WBGT<80, no restrictions • Green: WBGT 80-84.9, discretion in heavy exercise for unaclimatized people • Yellow: WBGT 85-87.9, no strenuous exercise for unaclimatized personnel during first three weeks of exposure

31. Flag conditions • Red: WBGT 88-89.9, strenuous exercise curtailed for all less than 12 weeks in hot climate • Black: WBGT 90 or greater, NO unnecessary or strenuous outdoor exertion

32. Hot environments • Desert • Jungle • Temperate • HOT WORK SPACES • Aircraft

33. Heat injuries • High humidity causes body to cool less efficiently • Increased body core temp leads to heat injuries

34. Dehydration • Dehydration is the major contributing factor to heat injures • High temperatures and exercise lead to the production of sweat • Normal conditions about 1 gallon a day

35. Dehydration • Weak, dizzy • Exhausted • Problems thinking clearly • Urine become darker • Thirst is not a good indicator

36. What to Do? • Replace fluids before they are lost • Hydrate with water approximately1 L hour • Drink slowly • Alcohol and caffeine cause faster water loss!

37. Heat injuries • Heat Cramps • Heat exhaustion • Heat stroke • Sunburn

38. Heat Cramps • Muscle spasm • Usually occur in the extremities or abdomen • Caused by • Heavy exertion/fatigue • Heavy sweating • Loss of water and electrolytes • lack of acclimatization

39. Heat Cramps • Treatment • Get to a cooler place • Replace water • Stretching better than massage • Rest

40. Heat Exhaustion • Headache • Nausea and vomiting • Rapid heartbeat and breathing • usually profuse sweating

41. Heat Exhaustion Treatment • Get out of the heat!!!! • Stay off concrete, asphalt, and hot aircraft • Cool off’ • Fans, keep clothing wet • Drink Fluids • Elevate legs • Rest

42. Heat Stroke • TRUE EMERGENCY • Up to 50% of cases are fatal even with treatment • MUST be prevented

43. Heat Stroke • Skin red, hot and dry • Confusion and loss of coordination • Body temp high (105°F) • Rapid heartbeat and breathing • May stop sweating

44. Heat Stroke Treatment • LIFE THREATENING EMERGENCY • Call EMS • Decrease body temperature • Move to a cooler place • Loosen/remove tight clothing • Cool with wet towels, apply ice to arm pit & groin areas • Elevate feet • Nothing to eat or drink!

45. Sunburn • 1st to third degree • preventable • Causes loss of fluids • Skin does not sweat normally • Best treatment is prevention

46. What can you do? • Hydrate , Hydrate, Hydrate (Water is life) • Know the flag conditions • Dress appropriately • Use Sunscreen

47. Questions?