Volunteer Travel Guide Vietnam

Verdant patchworks of rice paddies, pointed lampshade-style hats, a country ravaged by war, and economic repression - these are the international images of Vietnam, seen on worldwide television and read about in the newspapers. But there are other scenes to be found, ones of natural beauty, ethnic culture, and imperial history, of timeless traditional villages, idyllic sea resorts and dynamic cities.

Shaped like an elongated 'S', Vietnam stretches along the east coast of the Indochinese Peninsula and is likened by its people to a long bamboo pole hung with two baskets of rice, represented by the two fertile regions at either end of the country. Between the lush Red River Delta and the highlands in the north, known for their magnificent scenery and colourful hill tribes, and the agricultural plains and floating markets of the Mekong Delta in the south, lie miles of white sandy beaches, towering mountains, rivers and dense forests, and the thousands of bizarre rock and cave formations on the islands of Halong Bay.

The impact of Japanese and Chinese trade, French occupation and American intervention has left its stain on Vietnam, smeared over a period of more than two thousand years of recorded history. However, the country has also been left with a vivid legacy from different cultures evident in the character of its towns, as well as in the architecture and food.

The quaint town of Hoi An, once a major trading port, boasts the perfectly preserved architectural influences of the Asian merchants from the north, while the broad leafy boulevards of the capital Hanoi and Ho Chi Minh City are reminiscent of France. Menus offer Chinese variations of spring rolls, steamed dumplings and noodles. Hué is the old imperial capital of Vietnam with its royal palaces and palatial mausoleums, and nearby the battle sites of the Demilitarised Zone (DMZ) are reminders of the brutality of war.

Ancient temples and colourful pagodas are scattered throughout the urban centres, while among them stand hotels of modern luxury, and the development of tourism infrastructure is a booming business. Vietnam is a perfect balance between ancient times and the here and now, a country that reveres its past heroes, a nation that has collectively put the woes of war behind it, and people who welcome visitors to their country with open arms and friendly smiles.

The Basics

Time:

GMT +7.

Electricity:

220 volts, 50Hz. Plugs are either the two flat-pin or the two round-pin type. Three rectangular blade plugs can be found in some of the newer hotels.

Language:

The official language is Vietnamese. Some Chinese, English and French are spoken. Tour guides can also speak Russian and Japanese. Numerous ethnic languages are also spoken in parts.

Health:

An outbreak of bird flu in 2004 claimed numerous human lives; recent outbreaks have also resulted in human fatalities. Avian flu in poultry has now spread to numerous provinces and cities across Vietnam. All care should be taken to avoid contact with live poultry and visitors are advised to exercise caution when eating poultry dishes, particularly raw or undercooked poultry products. Other health risks in the country include Hepatitis A and E, typhoid, Japanese encephalitis, bilharzia, plague, cholera, diarrhoea and HIV/AIDS. Malaria prophylaxis is recommended for travel outside the main cities and towns, the Red River delta and north of Nha Trang. There has been an increase in the amount of deaths relating to dengue fever over the past year, and visitors should take care to protect themselves from mosquito bites during the day, especially just after dawn and just before dusk, particularly in the southern Mekong Delta region. Travellers should seek medical advice about vaccinations at least three weeks before leaving for Vietnam and ensure they have adequate insect protection. Typhoid can be a problem in the Mekong Delta. Those arriving from an infected area require a yellow fever vaccination certificate. Water is potable, but visitors usually prefer to drink bottled water. Decent health care is available in Hanoi and Ho Chi Minh City (Saigon) with English-speaking doctors, and there is a surgical clinic in Da Nang, but more complicated treatment may require medical evacuation. Pharmacies throughout the country are adequate, but check expiry dates of medicines carefully. Health insurance is essential.

Tipping:

Most restaurants and hotels now add a 5 to 10% service charge to their bills. In top hotels porters expect a small tip. Hired drivers and guides are usually tipped, and it is customary to round up the bill for taxi drivers in the cities. Tipping is not generally expected, but some small change for most services is appreciated.

Customs:

Shorts should be avoided away from the beaches if possible. Shoes must be removed on entering religious sites and a donation is expected when visiting a temple or pagoda. Photography is restricted at ports, harbours and airports, and it is polite to ask permission before taking photographs of people, especially of ethnic minorities. Never leave chopsticks sticking upright in a bowl of rice as it has strong death connotations.

Business:

Business practices in Vietnam are conducted in a similar fashion to those of China, Japan and Korea rather than their Southeast Asian counterparts. Pride and tact are important to bear in mind, as practices tend to be formalised more so than in Western countries. Often it is best to be introduced rather than approach the person with whom business is intended for fear of suspicion. Negotiations and settlements may take longer as the Vietnamese like to examine contracts thoroughly. Formal dress is common but in summer months the dress tends to be more casual. It is important to be on time for business appointments as the Vietnamese consider lateness rude. The person is always addressed as Mr., Mrs., and Ms., followed by their personal name (not family name), unless otherwise referred. It is worth finding out in advance. Shaking hands with both hands is the most respectful greeting although bowing is still popular among the older population, and meetings always begin with the exchange of business cards, which should be given and received with both hands; each person expects to receive one, so be sure to bring a vast supply. Business hours are typically 8am to 5pm Monday to Friday with an hour taken at lunch, and 8am to 11.30am on Saturdays.

Communications:

The international country code is +84. The outgoing code is 00, followed by the relevant country code (e.g. 001 for the United States or Canada). City/area codes are in use, e.g. Hanoi is (0)4 and Ho Chi Minh City is (0)8. GSM 900 mobile networks cover the major urban areas. Internet cafes are available in Hanoi, Ho Chi Minh City and Internet access is often available at post offices in rural areas.

Duty Free:

Travellers to Vietnam over 18 years do not have to pay duty on the following items: 400 cigarettes, 100 cigars or 500g tobacco; 1.5 litres alcohol with alcohol content higher than 22% and 2 litres below 22%; up to 5kg tea and 3kg coffee; perfume and items for personal consumption within reasonable amounts; other goods to the value of five million Vietnamese dong.

Health

View information on diseases: Typhoid fever, Schistosomiasis (bilharzia), Plague, Malaria, Japanese encephalitis, HIV/AIDS and Sexually Transmitted Diseases, Hepatitis E, Hepatitis A, Dengue Fever, Cholera

Typhoid fever

Cause:
Salmonella typhi, the typhoid bacillus, which infects only humans. Similar paratyphoid and enteric fevers are caused by other species of Salmonella, which infect domestic animals as well as humans.

Transmission:
Infection with typhoid fever is transmitted by consumption of contaminated food or water. Occasionally direct faecal-oral transmission may occur. Shellfish taken from sewage-polluted beds are an important source of infection. Infection occurs through eating fruit and vegetables fertilized by night soil and eaten raw, and milk and milk products that have been contaminated by those in contact with them. Flies may transfer infection to foods, resulting in contamination that may be sufficient to cause human infection. Pollution of water sources may produce epidemics of typhoid fever, when large numbers of people use the same source of drinking water.

Nature of the disease:
Typhoid fever is a systemic disease of varying severity. Severe cases are characterized by gradual onset of fever, headache, malaise, anorexia and insomnia. Constipation is more common than diarrhoea in adults and older children. Without treatment, the disease progresses with sustained fever, bradycardia, hepatosplenomegaly, abdominal symptoms and, in some cases, pneumonia. In white-skinned patients, pink spots (papules), which fade on pressure, appear on the skin of the trunk in up to 50% of cases. In the third week, untreated cases develop additional gastrointestinal and other complications, which may prove fatal. Around 2-5% of those who contract typhoid fever become chronic carriers, as bacteria persist in the biliary tract after symptoms have resolved.

Geographical distribution:
Worldwide. The disease occurs most commonly in association with poor standards of hygiene in food preparation and handling and where sanitary disposal of sewage is lacking.

Risk for travellers:
Generally low risk for travellers, except in parts of north and west Africa, in south Asia and in Peru. Elsewhere, travellers are usually at risk only when exposed to low standards of hygiene with respect to food handling, control of drinking water quality, and sewage disposal.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Observe all precautions against exposure to foodborne and waterborne infections. Source: WHO.

Schistosomiasis (bilharzia)

Cause:
Several species of parasitic blood flukes (trematodes), of which the most important are Schistosoma mansoni, S. japonicum and S. haematobium.

Transmission:
Infection with bilharzia occurs in fresh water containing larval forms (cercariae) of schistosomes, which develop in snails. The free-swimming larvae penetrate the skin of individuals swimming or wading in water. Snails become infected as a result of excretion of eggs in human urine or faeces.

Nature of the disease:
Chronic conditions in which adult flukes live for many years in the veins (mesenteric or vesical) of the host where they produce eggs, which cause damage to the organs in which they are deposited. The symptoms of bilharzias depend on the main target organs affected by the different species, with S. mansoni and S. japonicum causing hepatic and intestinal signs and S. haematobium causing urinary dysfunction. The larvae of some schistosomes of birds and other animals may penetrate human skin and cause a self-limiting dermatitis, "swimmers itch". These larvae are unable to develop in humans.

Geographical distribution:
S. mansoni occurs in many countries of sub-Saharan Africa, in the Arabian peninsula, and in Brazil, Suriname and Venezuela. S. japonicum is found in China, in parts of Indonesia, and in the Philippines (but no longer in Japan). S. haematobium is present in sub-Saharan Africa and in eastern Mediterranean areas.
Risk for travellers:
In endemic areas, travellers are at risk to bilharzias while swimming or wading in fresh water.

Prophylaxis (protective treatment):
None.

Precautions:
Avoid direct contact (swimming or wading) with potentially contaminated fresh water in endemic areas. In case of accidental exposure, dry the skin vigorously to reduce penetration by cercariae. Avoid drinking, washing, or washing clothing in water that may contain cercariae. Water can be treated to remove or inactivate cercariae by paper filtering or use of iodine or chlorine. Source: WHO.

Plague

Cause:
The plague bacillus, Yersinia pestis.

Transmission:
Plague is a zoonotic disease affecting rodents and transmitted by fleas from rodents to other animals and to humans. Direct person-to-person transmission does not occur except in the case of pneumonic plague, when respiratory droplets may transfer the infection from the patient to others in close contact.

Nature of the disease:
Plague occurs in three main clinical forms: Bubonic plague is the form that usually results from the bite of infected fleas. Lymphadenitis develops in the drainage lymph nodes, with the regional lymph nodes most commonly affected. Swelling, pain and suppuration of the lymph nodes produces the characteristic plague buboes. Septicaemic plague may develop from bubonic plague or occur in the absence of lymphadenitis. Dissemination of the infection in the bloodstream results in meningitis, endotoxic shock and disseminated intravascular coagulation. Pneumonic plague may result from secondary infection of the lungs following dissemination of plague bacilli from other body sites. It produces severe pneumonia. Direct infection of others may result from transfer of infection by respiratory droplets, causing primary pulmonary plague in the recipients. Without prompt and effective treatment, 50-60% of cases of bubonic plague are fatal, while untreated septicaemic and pneumonic plague are invariably fatal.

Geographical distribution:
There are natural foci of plague infection of rodents in many parts of the world. Wild rodent plague is present in central, eastern and southern Africa, south America, the western part of north America and in large areas of Asia. In some areas, contact between wild and domestic rats is common, resulting in sporadic cases of human plague and occasional outbreaks.

Risk for travellers:
Generally low. However, travellers in rural areas of plague-endemic regions may be at risk, particularly if camping or hunting or if contact with rodents takes place.

Prophylaxis (protective treatment):
A vaccine effective against bubonic plague is available exclusively for persons with a high occupational exposure to plague; it is not commercially available in most countries.

Precautions:
Avoid any contact with live or dead rodents. Source: WHO.

Malaria

General considerations:
Malaria is a common and life-threatening disease in many tropical and subtropical areas. It is currently endemic in over 100 countries, which are visited by more than 125 million international travellers every year. Each year many international travellers fall ill with malaria while visiting countries where the disease is endemic, and well over 10,000 fall ill after returning home. Fever occurring in a traveller within three months of leaving a malaria-endemic area is a medical emergency and should be investigated urgently.

Cause:
Human malaria is caused by four different species of the protozoan parasite Plasmodium: Plasmodium falciparum, P. vivax, P. ovale and P. malariae.

Transmission:
The malaria parasite is transmitted by various species of Anopheles mosquitoes, which bite mainly between sunset and sunrise.

Nature of the disease:
Malaria is an acute febrile illness with an incubation period of 7 days or longer. Thus, a febrile illness developing less than one week after the first possible exposure is not malaria. The most severe form is caused by P. falciparum, in which variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain; other symptoms related to organ failure may supervene, such as: acute renal failure, generalized convulsions, circulatory collapse, followed by coma and death. It is estimated that about 1% of patients with P. falciparum infection die of the disease. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria. It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between the seventh day of first possible exposure to malaria and three months (or, rarely, later) after the last possible exposure, and any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment. Early diagnosis and appropriate treatment can be life-saving. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours. A blood sample should be examined for malaria parasites. If no parasites are found in the first blood film but symptoms persist, a series of blood samples should be taken and examined at 6-12-hour intervals. Pregnant women, young children and elderly travellers are particularly at risk. Malaria in pregnant travellers increases the risk of maternal death, miscarriage, stillbirth and neonatal death. The forms of malaria caused by other Plasmodium species are less severe and rarely life-threatening. Prevention and treatment of falciparum malaria are becoming more difficult because P. falciparum is increasingly resistant to various antimalarial drugs. Of the other malaria species, drug resistance has to date been reported for P. vivax, mainly from Indonesia (Irian Jaya) and Papua New Guinea, with more sporadic cases reported from Guyana. P. vivax with declining sensitivity has been reported for Brazil, Colombia, Guatemala, India, Myanmar, the Republic of Korea, and Thailand. P. malariae resistant to chloroquine has been reported from Indonesia.

Geographical distribution:
The risk for travellers of contracting malaria is highly variable from country to country and even between areas in a country. In many endemic countries of Latin America and the Caribbean, Asia and the Mediterranean region, the main urban areas, but not necessarily the outskirts of towns, are free of malaria transmission. However, malaria can occur in main urban areas in Africa and India. There is usually less risk of the disease at altitudes above 1,500 metres, but in favourable climatic conditions it can occur at altitudes up to almost 3,000 metres. The risk of infection may also vary according to the season, being highest at the end of the rainy season. There is no risk of malaria in many tourist destinations in South-East Asia, Latin America and the Caribbean. Source: WHO.

Japanese encephalitis

Cause:
Japanese encephalitis (JE) virus, which is a flavivirus.

Transmission:
The Japanese encephalitis virus is transmitted by various mosquitoes of the genus Culex. It infects pigs and various wild birds as well as humans. Mosquitoes become infective after feeding on viraemic pigs or birds.

Nature of the disease:
Most infections are asymptomatic (e.g. cause no symptoms). In symptomatic cases, severity varies; mild infections are characterized by febrile headache or aseptic meningitis. Severe cases have a rapid onset and progression, with headache, high fever and meningeal signs. Permanent neurological sequelae are common among survivors. Approximately 50% of severe clinical cases have a fatal outcome.

Geographical distribution:
Japanese encephalitis occurs in a number of countries in Asia and occasionally in northern Queensland, Australia.

Risk for travellers:
Low for most travellers. Visitors to rural and agricultural areas in endemic countries may be at risk, particularly during epidemics of JE.

Prophylaxis (protective treatment):
Vaccination, if justified by likelihood of exposure.

Precautions:
Avoid mosquito bites. Source: WHO.

HIV/AIDS and Sexually Transmitted Diseases

The most important sexually transmitted diseases and infectious agents are HIV/AIDS, hepatitis B, syphilis, gonorrhoea, chlamydia infections, trichomoniasis, chancroid, genital herpes and genital warts.

Transmission:
Infection occurs during unprotected sexual intercourse. Hepatitis B, HIV and syphilis may also be transmitted in contaminated blood and blood products, by contaminated syringes and needles used for injection, and potentially by unsterilized instruments used for acupuncture, piercing and tattooing.

Nature of the diseases:
Most of the clinical manifestations are included in the following syndromes: genital ulcer, pelvic inflammatory disease, urethral discharge and vaginal discharge. However, many infections are asymptomatic. Sexually transmitted infections are a major cause of acute illness, infertility, long-term disability and death, with severe medical and psychological consequences for millions of men, women and children. Apart from being serious diseases in their own right, sexually transmitted infections increase the risk of HIV infection. The presence of an untreated disease (ulcerative or non-ulcerative) can increase by a factor of up to 10 the risk of becoming infected with HIV and transmitting the infection. On the other hand, early diagnosis and improved management of other sexually transmitted infections can reduce the incidence of HIV infection by up to 40%. Prevention and treatment of all sexually transmitted infections are therefore important for the prevention of HIV infection.

Geographical distribution:
Worldwide. Sexually transmitted infections have been known since ancient times; they remain a major public health problem, which was compounded by the appearance of HIV/AIDS around 1980. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year. Viral infections, which are more difficult to treat, are also very common in many populations. Genital herpes is becoming a major cause of genital ulcer, and subtypes of the human papillomavirus are associated with cervical cancer.

Risk for travellers:
For some travellers there may be an increased risk of infection. Lack of information about risk and preventive measures and the fact that travel and tourism enhance the probability of having sex with casual partners increase the risk of exposure to sexually transmitted infections. In some developed countries, a large proportion of sexually transmitted infections now occur as a result of unprotected sexual intercourse during international travel. In addition to transmission through sexual intercourse (both heterosexual and homosexual-anal, vaginal or oral), most of these infections can be passed on from an infected mother to her unborn or newborn baby. Hepatitis B, HIV and syphilis are also transmitted through transfusion of contaminated blood or blood products and the use of contaminated needles. There is no risk of acquiring any sexually transmitted infection from casual day-to-day contact at home, at work or socially. People run no risk of infection when sharing any means of communal transport (e.g. aircraft, boat, bus, car, train) with infected individuals. There is no evidence that HIV or other sexually transmitted infections can be acquired from insect bites.

Prophylaxis:
There is a vaccination against hepatitis B. No prophylaxis is available for any of the other sexually transmitted diseases.

Precautions:
Male or female condoms, when properly used, have proved to be effective in preventing the transmission of HIV and other sexually transmitted infections, and for reducing the risk of unwanted pregnancy. Latex rubber condoms are relatively inexpensive, are highly reliable and have virtually no side-effects. The transmission of HIV and other infections during sexual intercourse can be effectively prevented when high-quality condoms are used correctly and consistently. Studies on serodiscordant couples (only one of whom is HIV-positive) have shown that, with regular sexual intercourse over a period of two years, partners who consistently use condoms have a near-zero risk of HIV infection. A man should always use a condom during sexual intercourse, each time, from start to finish, and a woman should make sure that her partner uses one. A woman can also protect herself from sexually transmitted infections by using a female condom - essentially, a vaginal pouch, which is now commercially available in some countries. It is essential to avoid injecting drugs for non-medical purposes, and particularly to avoid any type of needle-sharing to reduce the risk of acquiring hepatitis, HIV, syphilis and other infections from contaminated needles and blood. Medical injections using unsterilized equipment are also a possible source of infection. If an injection is essential, the traveller should try to ensure that the needles and syringes come from a sterile package or have been sterilized properly by steam or boiling water for 20 minutes. Patients under medical care who require frequent injections, e.g. diabetics, should carry sufficient sterile needles and syringes for the duration of their trip and a doctor's authorization for their use. Unsterile dental and surgical instruments, needles used in acupuncture and tattooing, ear-piercing devices, and other skin-piercing instruments can likewise transmit infection and should be avoided.

Treatment:
Travellers with signs or symptoms of a sexually transmitted disease should cease all sexual activity and seek medical care immediately. The absence of symptoms does not guarantee absence of infection, and travellers exposed to unprotected sex should be tested for infection on returning home. HIV testing should always be voluntary and with counselling. The sexually transmitted infections caused by bacteria, e.g. chancroid, chlamydia, gonorrhoea and syphilis, can be treated successfully, but there is no single antimicrobial that is effective against more than one or two of them. Moreover, throughout the world, many of these bacteria are showing increased resistance to penicillin and other antimicrobials. Treatment for sexually transmitted viral infections, e.g. hepatitis B, genital herpes and genital warts, is unsatisfactory due to lack of specific medication, and cure is difficult to achieve. The same is true of HIV infection, which in its late stage causes AIDS and is thought to be invariably fatal. Antiretroviral drugs cannot completely eradicate the HIV virus; treatment is expensive and complex and most countries have only a few centres that are able to provide it. Source: WHO.

Hepatitis E

Cause:
Hepatitis E virus, which has not yet been definitively classified (formerly classified as Caliciviridae).

Transmission:
Hepatitis E is a waterborne disease usually acquired from contaminated drinking water. Direct faecal-oral transmission from person to person is also possible. There is no insect vector. It is suspected, but not proved, that hepatitis E may have a domestic animal reservoir host, such as pigs.

Nature of the disease:
The clinical features and course of the disease are generally similar to those of hepatitis A. As with hepatitis A, there is no chronic phase. Young adults are most commonly affected. In pregnant women there is an important difference between hepatitis E and hepatitis A: during the third trimester of pregnancy, hepatitis E takes a much more severe form with a case-fatality rate reaching 20%.

Geographical distribution:
Worldwide. Most cases, both sporadic and epidemic, occur in countries with poor standards of hygiene and sanitation.

Risk for travellers:
Travellers to developing countries may be at risk of hepatitis E when exposed to poor conditions of sanitation and drinking water control.

Prophylaxis (protective treatment):
None.

Precautions:
Travellers should follow the general conditions for avoiding potentially contaminated food and drinking-water. Source: WHO.

Hepatitis A

Cause:
Hepatitis A virus, a member of the picornavirus family.

Transmission:
The virus is acquired directly from infected persons by the faecal-oral route or by close contact, or by consumption of contaminated food or drinking water. There is no insect vector or animal reservoir (although some non-human primates are sometimes infected).

Nature of the disease:
An acute viral hepatitis with abrupt onset of fever, malaise, nausea and abdominal discomfort, followed by the development of jaundice a few days later. Infection in very young children is usually mild or asymptomatic (e.g. causes no symptoms); older children are at risk of symptomatic disease. The disease is more severe in adults, with illness lasting several weeks and recovery taking several months; case-fatality is greater than 2% for those over 40 years of age and 4% for those over 60.

Geographical distribution:
Worldwide, but most common where sanitary conditions are poor and the safety of drinking water is not well controlled.

Risk for travellers:
Non-immune travellers to developing countries are at significant risk of infection. The risk is particularly high for travellers exposed to poor conditions of hygiene, sanitation and drinking water control.

Prophylaxis (protective treatment):
Vaccination.

Precautions:
Travellers who are non-immune to hepatitis A (i.e. have never had the disease and have not been vaccinated) should take particular care to avoid potentially contaminated food and water. Source: WHO.

Dengue Fever

Cause:
The dengue virus - a flavivirus of which there are four serotypes.

Transmission:
Dengue fever is transmitted by the Aedes aegypti mosquito, which bites during daylight hours. There is no direct person-to-person transmission. Monkeys act as a reservoir host in south-east Asia and west Africa.

Nature of the disease:
Dengue occurs in three main clinical forms: Dengue fever is an acute febrile illness with sudden onset of fever, followed by development of generalized symptoms and sometimes a macular skin rash. It is known as "breakbone fever" because of severe muscular pains. The fever may be biphasic (i.e. two separate episodes or waves of fever). Most patients recover after a few days; Dengue haemorrhagic fever has an acute onset of fever followed by other symptoms resulting from thrombocytopenia, increased vascular permeability and haemorrhagic manifestations; Dengue shock syndrome supervenes in a small proportion of cases. Severe hypotension develops, requiring urgent medical treatment to correct hypovolaemia. Without appropriate treatment, 40-50% of cases are fatal; with timely therapy, the mortality rate is 1% or less.

Geographical distribution:
Dengue fever is widespread in tropical and subtropical regions of central and south America and south and south-east Asia and also occurs in Africa; in these regions, dengue is limited to altitudes below 600 metres (2,000 feet).

Risk for travellers:
There is a significant risk for travellers in areas where dengue fever is endemic and in areas affected by epidemics of dengue.

Prophylaxis (protective treatment):
None.

Precautions:
Travellers should take precautions to avoid mosquito bites both during the day and at night in areas where dengue occurs. Source: WHO.

Cholera

Cause:
Vibrio cholerae bacteria, serogroups O1 and O139.

Transmission:
Infection occurs through ingestion of food or water contaminated directly or indirectly by faeces or vomit of infected persons. Cholera affects only humans; there is no insect vector or animal reservoir host.

Nature of the disease:
An acute enteric (intestine) disease varying in severity. Most infections are asymptomatic (i.e. do not cause any illness). In mild cases, diarrhoea occurs without other symptoms. In severe cases, there is sudden onset of profuse watery diarrhoea with nausea and vomiting and rapid development of dehydration. In severe untreated cases, death may occur within a few hours due to dehydration leading to circulatory collapse.

Geographical distribution:
Cholera occurs mainly in poor countries with inadequate sanitation and lack of clean drinking water and in war-torn countries where the infrastructure may have broken down. Many developing countries are affected, particularly those in Africa and Asia, and to a lesser extent those in central and south America.

Risk for travellers:
The risk of cholera is very low for most travellers, even in countries where cholera epidemics occur. Humanitarian relief workers in disaster areas and refugee camps are at risk.

Prophylaxis (protective treatment):
Oral cholera vaccines for use by travellers and those in occupational risk groups are available in some countries.

Precautions:
As for other diarrhoeal diseases. All precautions should be taken to avoid consumption of potentially contaminated food, drink and drinking water. Oral rehydration salts should be carried to combat dehydration in case of severe diarrhoea. Source: WHO.

Contacts

Visa Agencies
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Tourism
Vietnam Tourist Office: +84 (0)4 942 3998 (Hanoi) or www.vietnamtourism.com

Vietnam Embassies
Embassy of Vietnam, Washington DC, United States: +1 202 861 0737.

Embassy of Vietnam, London, United Kingdom (also responsible for Ireland): +44 (0)20 7937 1912.
Embassy of Vietnam, Ottawa, Canada: +1 613 236 0772.
Embassy of Vietnam, Canberra, Australia: +61 (0)2 6290 1549.
Embassy of Vietnam, Pretoria, South Africa: +27 (0)12 362 8119.
Embassy of Vietnam, Wellington, New Zealand: +64 (0)4 473 5912.

Foreign Embassies in Vietnam
United States Embassy, Hanoi: +84 (0)4 831 4590.

British Embassy, Hanoi: +84 (0)4 936 0500.
Canadian Embassy, Hanoi: +84 (0)4 734 5000.
Australian Embassy, Hanoi: +84 (0)4 831 7755.
South African Embassy, Hanoi: +84 (0)4 936 2000.
Irish Embassy, Hanoi: +84 (0)4 974 3291.
New Zealand Embassy, Hanoi: +84 (0)4 824 1481.

Vietnam Emergency Numbers
Emergencies: 13 (Police); 15 (Ambulance)

Airports

Tan Son Nhat International Airport (SGN)

Location: The airport is situated four miles (7km) from Ho Chi Minh City (Saigon).
Time: GMT +7.
Contacts: Tel: +84 (0)8 845 6654.
Transfer to the city: Minibuses and metered taxis are available for transport to the city centre. Make sure the driver is wearing an official name badge and that the meter is on. Most hotels can arrange transport for arriving passengers, but visitors should organise this in advance.
Car rental: There are no car hire rentals at the airport.
Facilities: The airport is small and overcrowded and patience is often required, however the facilities are perfectly adequate. The tourist information desk at the international arrivals exit can help with hotel reservations. Foreign exchange kiosks are available outside both international arrivals and departures. A post office is outside the arrivals terminal.
Parking:
Departure Tax: US$14 for international flights.

Noi Bai International Airport (HAN)

Location: The airport is situated 28 miles (45km) north of Hanoi.
Time: GMT +7.
Contacts: Tel: +84 (0)4 827 1513, (0)4 826 8522, or (0)4 886 5060.
Transfer to the city: Airport minibuses and metered taxis are available outside arrivals for transport to the city centre. Use an official taxi, it should be indicated on the driver's name badge and check that the meter is on.
Facilities: The airport has a bureau de change and basic facilities.
Parking:
Departure Tax: US$14 for international flights.

Climate

Hanoi has a humid tropical climate, characterised by monsoons, like most of northern Vietnam. Summers, between May and September, are very hot with plenty of rain, while winters, from November to March, are cold and relatively dry. During the transition months of April and October anything is possible, and spring often brings light rain. The hottest month of the year is June. January is the coolest month, usually beset with a cold north-easterly wind.

Passport & Visa

Visa Agencies:

Avoid the stress and queues, get a visa agency to arrange your visa.
Travel Visa Pro, San Francisco, USA. 1-888-470-8472 or www.TravelVisaPro.com
Global Visas, London, UK. 0207 190 3903 or www.globalvisas.com

Entry requirements for Americans: US passport holders must have a valid passport and a visa is required.

Entry requirements for UK nationals: UK passport holders must have a valid passport and a visa is required.

Entry requirements for Canadians: Canadian passport holders must have a valid passport and a visa is required.

Entry requirements for Australians: Australian passport holders must have a valid passport and a visa is required.

Entry requirements for South Africans: South Africans require a valid passport and a visa.

Entry requirements for New Zealanders: New Zealand nationals require a visa and a valid passport.

Entry requirements for Irish nationals: Irish nationals require a valid passport and a visa.

Passport/Visa Note: Passport must be valid for at least one month after expiry date of visa. Otherwise passports should have six months validity for visa-free nationals, except for nationals of Denmark, Finland, Japan, Korea (Rep.), Norway and Sweden, who require three months validity. All visitors must have sufficient funds for the duration of their stay, onward or return tickets (if no visa is required) and all documents needed for next destination. Visitors should hold a spare passport photograph on arrival in Vietnam for use on the immigration form that must be filled out. You should retain the yellow portion of your immigration Arrival-Departure card on entry to Vietnam, as this is required for exit. Visitors coming from countries with no Vietnamese diplomatic representation will be issued a visa on arrival, provided the visitor is holding a letter from Vietnamese Immigration confirming this.

Note: Passport and visa requirements are liable to change at short notice. Travellers are advised to check their entry requirements with their embassy or consulate.