The Combined Joint Task Force - Horn of Africa Surgeon Cell Newsletter, distributed around Camp Lemonnier, Djibouti, is chock-full of pertinent information about things that can harm you, whether on camp or out in the field. Those things include snakes, malaria-ridden mosquitoes, rabid animals, disease-carrying ticks and fleas, and rats and mice which infest areas throughout the Horn of Africa.



Herman Grant, Camp Lemonnier vector control supervisor, said that one threat to the health of personnel working in the Horn of Africa is snakes. Whether on the camp running trail, in Djibouti, Ethiopia, Tanzania, Uganda, underneath tents or living quarters, they can be almost anywhere, he said.



U.S. Navy Lt. Cmdr. Mary Graves, CJTF-HOA Surgeon Cell environmental health officer, said there are 25 different species of snakes in the Horn of Africa alone. Djibouti has the Puff Adder, Africa's most common snake, which sometimes warns with a loud hiss and bites when approached.



The Boomslang, a type of tree snake, can be either brown or green and is known to be timid, but it will bite when harassed, Graves added. In addition, there's the East African Carpet Viper, which emits a rasping sound with its scales. It's a relatively small snake, very aggressive and not afraid to strike. It's also responsible for many snake bites and deaths in Africa and is among the most venomous.



Other snakes in the Djibouti area include the False Burrowing Asp and the Red Spitting Cobra, which are not as venomous or aggressive as the others mentioned but just as dangerous, said Graves. Fortunately, she, added, there have been no reports of snake bites at Camp Lemonnier.



"If you are bitten, stay calm," Graves advised. "If you've got a buddy with you, get him to notify the Expeditionary Medical Facility, the fire department, or somebody. It is best if the person lies down and just waits for EMF to arrive."



To avoid snakebites, Grant advised people to minimize clutter in their work and living areas and to avoid blindly reaching into places with limited visibility. He also recommended people wear gloves when picking up boxes and shake out their shoes if left outside at night.



While no snake bites have been reported at Camp Lemonnier, mosquito bites are plentiful, said Grant.



There were over 6,000 cases of malaria in Djibouti last year, Graves wrote in the October 2011 CJTF-HOA Surgeon Cell Newsletter. The culprit for the spread of malaria is the female mosquito, which feed mostly at night. Grant said wearing mosquito repellent can reduce the chances of people getting bit.



"[Some warning signs for malaria] are similar to the flu," said U.S. Navy Petty Officer 3rd Class Robin Lloyd, CJTF-HOA Surgeon Cell hospital corpsman. "They include headaches, difficulty breathing, joint pain and fever."



Alongside mosquitoes, keep in mind that rats, mice and feral animals are all carriers of fleas and ticks, and that some may have rabies, said Graves. She advised people to stay away from the animals and leave them alone if they are in traps.



When going out in a wooded and brushy area, Graves said people should check themselves for ticks once they return to their tents or living quarters. She wrote in the March 2012 CJTF-HOA Surgeon Cell Newsletter that the proper way to remove a tick is to grab it with tweezers as close to the skin as possible and pull straight up until it releases. Attempts to burn, freeze or drown the tick will only cause it to regurgitate blood back into the host's system, along with any disease it may be carrying. Graves advised to notify EMF if bitten.



Fleas prefer to feed from animals, but Graves said they aren't choosy about a blood source when hungry. Their bites usually appear in a group of three or four and may be itchy and soreeâ?more so than a mosquito bite.



Feral animals, such as hyenas, mongooses, honey badgers, cats and dogs, as well as rodents here on base, are carriers of both ticks and fleas, Grant added.



While the feral animals are displaced by construction around camp, they are attracted to clutter, garbage and foul odors, said Grant. If these factors are eliminated, their number on base would greatly diminish.



"We have things out there than can make you have a bad day," said Grant. "I'm more afraid of someone getting malaria from mosquitoessâ?they are at the top of my list."



"Next to the mosquitoes are rodents," Grant continued. "They create issues and all kinds of other things that I'm concerned with. Third would be the feral animal population." He then advised it's best to simply leave these animals alone.



Grant mentioned one of the best lines of defense against these and other critters was situational awareness. "We are in a different environment," he said. "Be more aware of the things that we can't see. The different culture, different sanitation--be cognizant of what is around you."