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Niamey, Niger

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Secondment[edit]

Since TeachBeyond does not have an office in Niger, our missionaries there are seconded to SIM Niger. This means while you are in the country you are subject to their rules and authority, but also to their office and in-country services. The SIM office will find your housing, pay your rent and utilities (your payment for these will go from your paycheck to the office automatically), and help you with any logistical items including mail, visas, or other government related items. They will be your go-to for most of your in-country questions. 

Transportation[edit]

Driving can be challenging in Niger. The SIM office can help you purchase a car and get a driver's license if you wish. However, taxis also work and are a fairly cheap way to travel around the city.

Banking[edit]

Your paycheck will be sent to Sahel Academy business office. Instead of going to the ATM for money, you will go to the office. The ATMs around the city do not always work, might not have cash in them, and have a host of other issues including transportation to and from the ATM. This system also eliminates any ATM fees your bank may have. 

If you find your salary is more than you are spending in the country, you can opt to have TeachBeyond send only part of your salary to Sahel and deposit the extra in your US/Canada bank account. 

Malaria Prophylaxis and Information  [edit]

While in the US or Canada, get a prescription for prophylaxis that will last each member of the family one month in country (note, look at the usage because generally you need to start taking your phrophylaxis a week or so before entering the country). This will give you time to enter the country and adjust, before having to attain these drugs. Unless you plan to use Malerone for you prophylaxis, DO NOT purchase a year's worth of medicine because Mephloquine and Doxycyline (Doxy) are much cheaper to purchase in Niger. Only about $1 for a month of medicine!

Both Doxy and Mefloquine are very cheap when purchased through Galmi hospital (affiliated with SIM) in Niger. Mefloquine is 500 cfa per pill, and you take it every ten days. Doxy is generally cheaper.

Mefloquine doesn't make you sensitive to sunlight and only has to be taken once every 10 days to 2 weeks. However, there is a 50/50 chance that it will cause psychological issues. If anyone has ever been treated for depression or anxiety, they should not use Mefloquine. 

Doxy is taken every day and makes you sensitive to sunlight and a few other side affects (see chart below). However, it shouldn't have psycological affects

Malerone supposidly has fewer side affects but is very expensive and cannot be found in country. If your medical insurance covers it, and you can buy a year's worth before coming, this treatment is recommended. However, if it is not covered, this regimen is not possible.

'PRESCRIPTION 'DRUGS USED IN THE PROPHYLAXIS OF MALARIA

Drug

Usage

Adult Dosage

Child Dosage

Comments

Mefloquine
(Lariam®)

 

Take on a

full stomach

 

Do not take

On an empty

stomach

In areas with chloroquine- resistant Plasmodium falciparum

228 mg base (250 mg salt) orally, once/week

 

1 tablet weekly

 

Start 2 weeks before arrival, continue once weekly, and continue 4 weeks after departure.

<9 kg: 4.6 mg/kg base

(5 mg/kg salt) orally, once/week

10-19 kg/22-42#: 1/4 tab/week

20-30 kg/43-66#: 1/2 tab/week

31-45 kg/67-100#: 3/4 tab/week

>46 kg/>100#: 1 tab/week

Update: Mefloquine can now be used for very young children, including newborns.   Since it does not come as a liquid, one has to be very careful in measuring out the proportion of the crushed tables that is appropriate for a young child.

Contraindicated in persons allergic to mefloquine. Not recommended for persons with history of depression, epilepsy, seizures; generalized anxiety, schizophrenia, psychiatric disorders; cardiac conduction abnormalities, taking a Beta blocker medication. Not for use by pilots.

Common side effects: nausea, vivid dreams headache, sleep disturbances.

Mefloquine is acceptable during pregnancy and for breast-feeding.

Doxycycline

(Vibramycin)

(a  tetracycline)

 

Take with full stomach and full glass of liquid. Do not lie down for 1 hour after taking

An
alternative
to mefloquine

 

Start 2 days before arrival, continue once daily, continue for 4 weeks after

100 mg orally, once/day

 

1 tablet daily

 

 

>8 years of age: 2 mg/kg of body weight orally/day up to adult dose of 100 mg/day

Contraindicated in children <8 years of age, pregnant or breast-feeding women.

Use supplemental protection in addition to birth control pills.

Not to be taken with Oral Typhoid Vaccine

May cause sun sensitivity, vaginal yeast infections, and benign intercranial hypertension. Consult healthcare provider if experiencing persistent headache or change in vision.

Malarone

250mg/100mg atovaquone/

proguanil hydrochloride

 

Take with food or milk

Alternative to Mefloquine

 

In the event of vomiting, a repeat dose should be taken within 1 hour.

1 tab daily

 

Start 2 days before arrival in malaria area

Continue once daily

Continue 7 days after departure

Pediatric tablet=62.5mg/25mg

Atovaquone/Proquanil HCL

5-8 kg/11-18 lbs – ½ pedi tab

8-10 kg/18-23 lbs – ¾  tab

10-20 kg/23-45 lbs- 1 pedi tab

20-30kg/45-67 lbs - 2 pedi tabs

30-40kg/67-88 lbs - 3 pedi tabs

>40kg/>88 lbs - 1 adult tab

Not recommended for those with severe renal impairment, pregnancy, breast-feeding or for use in infants weighing less than 5 kg/11 lbs.

 

Adverse Reactions: Rare- abdominal pain, nausea, vomiting and headache.

Hydroxy-Chloroquine sulfate (Plaquenil®)

 

Best taken with food and water

 

 

 

For use only in Mexico, Central America, Haiti, Dominican Republic, Middle East, Eastern Europe.

 

Tablet size

200 mg
(155 mg base)

400 mg (salt)

(310 base)

orally, once/week

 

Start 2 weeks before arrival, continue weekly, continue for 4 weeks after departure

 

 

5 mg/kg base (6.5 mg/kg salt) orally, once/week, up to maximum adult dose of 310 mg base

Pediatric Dose

For 400 mg (310 base) tablets:

<1 yr: ¼ tab= 37.5 mg base

1-3 yrs: ½ tab=75 mg base

4-6 yrs: ¾ tab=100 mg base

7-10 yrs: 1 tab=150 mg base

11-16 yrs: 1 ½ tab=225 mg base

>17 yrs: 2 tabs=300 mg base

Side Effects:

 

Rare:  Nausea, vomiting, headache, dizziness, blurred vision, itching.  May worsen symptoms of psoriasis.  Nail and mucous membrane discoloration, intolerance of light

 

 

Primaquine

as

Prophylaxis

Nausea and abdominal pain reduced when administered with food.

Prophylaxis

2 (15 mg base tabs/ 26.3 mg salt)

(30mg base or 52.6 mg salt)

once  daily

Start 2 days prior to travel and continue 7 days after leaving malarial area

0.6mg/kg. base or 1.0mg/kg salt up to adult dose once daily

 

Start 2 days prior to travel

 

Continue 7 days after leaving malarial area

Must be tested for G6PD deficiency testing prior to use. May cause nausea or vomiting. Let your Health Care provider know if you have anemia or other blood disorders. Contraindicated in persons with G6PD (1) deficiency.

Not recommended for use if pregnant, trying to get pregnant, or breast-feeding.

Primaquine

to

Decrease relapses of

P. vivax/ovale

Nausea and abdominal pain reduced when administered with food.

Decreases relapses of

P. vivax/ovale

Adult: 30 mg base or 52.6mg salt

Once daily for 14 days

To decrease relapse

of P. vivax andP. ovale.

Pediatric:0.6 mg/kg base or

1.0 mg/kg salt up to adult dose orally, once daily for 14 days.

Contraindicated in persons with G6PD (1) deficiency.Must have G6PD deficiency testing prior to administration.

Not recommended for use if pregnant, trying to get pregnant, or breast-feeding.


  • Chart used from SIM NIger

Packing[edit]

Real vanilla, craisins, chocolate chips, sage, cumin, marjoram (for making sausage), nutmeg (lots of pumpkin all year round), shortening (only expensive butter here).

Bring: a battery powered fan for sleeping with no electricity. A few flashlights to place around the house. Good smelling candles. Thermometer and ibuprofen (most common sickness). Cortisone cream and baby powder (sweating all the time). Favorite board games and some playing cards are great. Get malaria meds from Galmi pharmacy here--only $1 for a month of doxy! Good quality face wash and deoderant. Dry mix packets for any sauces or seasonings (taco, chili, etc) you like.

Be prepared to be very dependent. Driving is hard (crazy hpeople that have no rules), and you might not get a car. 

Memorize French things to say to the taxi drivers and money stuff (numbers, hundred, thousand)