Your doctor will recommend one of three main options:

Atovaquone-Proguanil (Malarone): Daily. Well-tolerated, few side effects. Start 1–2 days before entering a malaria zone, take daily throughout, continue 7 days after leaving. Expensive for long trips — discuss cost with your doctor. Generic versions are cheaper.

Doxycycline: Daily. Effective and inexpensive. Start 1–2 days before, continue 28 days after leaving the zone. Side effects: sun sensitivity (significant in Africa — wear sunscreen and a hat), possible stomach upset, yeast infections in women. Take with food and a full glass of water. Do not lie down for 30 minutes after taking.

Mefloquine (Lariam): Weekly. Convenient for long trips (one tablet per week). Start 2 weeks before. Side effects can include vivid dreams, anxiety, dizziness, and mood changes — not tolerated by everyone. Discuss with your doctor. Not suitable if you have a history of depression or anxiety.

Water: Never drink untreated water from any natural source. Use your multi-barrier treatment system (cross-reference R12 for full detail). Treated water for drinking, cooking, and teeth brushing. Ice in drinks is risky unless you made it yourself from treated water.

Food from local sources: Eat cooked food served hot. Avoid raw salads and unpeeled fruit from roadside vendors (you don't know what water was used to wash them). Peel your own fruit. Avoid raw or undercooked meat and seafood. Street food that's cooked fresh in front of you (high heat, visible preparation) is generally safer than food from a buffet that's been sitting out.

Your own cooking: Wash hands before food preparation. Wash all fresh produce in treated water. Cook meat thoroughly. Refrigerate leftovers promptly (your fridge is your food safety tool — cross-reference R5 for fridge power management). Discard any food left at ambient temperature for more than 2 hours in hot conditions.

Hand hygiene: Wash hands with soap and water (or alcohol-based sanitiser) before eating, before cooking, after using the toilet, and after handling money. This single habit prevents more illness than any other.

Shower daily — even a bucket wash with 5 L of water is sufficient. Pay attention to armpits, groin, and feet. In hot, humid conditions, fungal infections (jock itch, athlete's foot) develop rapidly if these areas stay damp. Dry thoroughly and apply antifungal powder if needed. Carry biodegradable soap for bush washing — never use soap directly in rivers or lakes.

Dental: Brush twice daily, floss daily. A dental abscess in rural Tanzania is a serious problem. See a dentist for a full check-up before departure. Carry a dental emergency kit (temporary filling material like Cavit, oil of cloves for pain relief, antibiotics for dental infection).

Feet: Inspect daily. Wear dry socks, change them if wet. Treat any cuts or blisters immediately with antiseptic and plasters. In wet/humid environments, air your boots overnight. Fungal infections between toes are common — carry clotrimazole cream.

Wounds: Clean every cut, scrape, and insect bite immediately with clean water and antiseptic (povidone-iodine or chlorhexidine). In the African bush, even minor wounds can become infected rapidly in the heat and humidity. Cover with a clean dressing. Watch for signs of infection: redness spreading from the wound, increasing pain, pus, fever. An infected wound that doesn't improve in 24–48 hours with cleaning and topical antiseptic may need oral antibiotics.

Laundry: Wash clothing regularly. In areas where the tumbu (putzi) fly is present (mainly Central/East Africa), either tumble dry clothing, iron all clothing (including underwear), or dry in direct sunlight in a sealed vehicle. The tumbu fly lays eggs on damp clothing; larvae burrow into skin when worn.

Sun protection: Southern and East Africa have extreme UV levels. Apply SPF 50+ sunscreen to all exposed skin every morning, reapply every 2 hours and after sweating. Wear a wide-brimmed hat, UV-rated sunglasses, and light long-sleeved shirts. Sunburn is cumulative — two years of African sun without protection causes real skin damage. If taking Doxycycline for malaria, sun sensitivity is significantly increased.

Heat exhaustion: Symptoms: heavy sweating, weakness, nausea, dizziness, cool/clammy skin. Move to shade, lie down, sip water with ORS, cool the skin with wet cloths. It resolves with rest and rehydration.

Heat stroke: Symptoms: hot/dry skin (sweating may stop), confusion, rapid pulse, body temperature above 40°C. This is a medical emergency. Cool the person aggressively (wet cloths, fanning, ice if available), give fluids if conscious, and evacuate immediately. Cross-reference R10.

Hydration: Minimum 3–4 litres per person per day in hot conditions. More if active (setting up camp, recovery work, hiking). Cross-reference R12 (Water Management) for your daily water budget.

Altitude: Relevant if visiting highlands (Ethiopia, Rwanda, Lesotho highlands, Ngorongoro, Kilimanjaro approaches). Symptoms of altitude sickness: headache, nausea, fatigue, shortness of breath. Ascend gradually. If symptoms worsen, descend immediately. The treatment for altitude sickness is always descent.

Supply: Carry at least 6 months of all prescription medications. Replenish at pharmacies in major cities (Windhoek, Gaborone, Harare, Lusaka, Dar es Salaam, Nairobi, Kampala, Kigali). Some medications are unavailable in smaller African countries — do not rely on finding specific brands. Carry copies of all prescriptions (generic names, not brand names — brand names vary by country).

Border crossings: Large quantities of medication can attract attention at borders. Carry a typed letter from your doctor on letterhead listing all medications, their generic names, dosages, and the medical reason. This prevents delays and accusations of drug trafficking. Keep medications in their original pharmacy-labelled packaging where possible.

Storage: Heat degrades most medications. Store below 25°C where possible — the fridge is acceptable for some (not all) medications. Ask your pharmacist which medications are heat-sensitive. Avoid storing medication in the glove compartment or on the dashboard — temperatures can exceed 60°C.

Malaria prophylaxis resupply: Doxycycline is widely available at African pharmacies and much cheaper than in SA. If using Doxycycline for a two-year trip, carry 3–6 months and resupply as you go. Malarone is harder to find and more expensive — carry your full supply from SA.