Togo

Togo is a country with a simple clinical geometry: a manageable south, a Level 4 north, and a checklist defined by two non-negotiables. Yellow fever vaccination is required at entry — the certificate gets checked — and malaria prophylaxis is mandatory for every itinerary, because P. falciparum transmits year-round everywhere including Lomé; there is no malaria-free zone at any altitude in the country. The vaccine I emphasize for Togo that short-trip travelers skip is meningococcal ACWY: the country straddles the meningitis belt's southern edge, and dry-season outbreaks move fast. Add hepatitis A, typhoid, an MMR check — Togo is named on the measles notice — and rabies pre-exposure for mission or rural work, where post-exposure options thin out quickly.

The geography rules are firm: nothing north of Kandé, and the Savanes region requires advance written authorization for foreigners under its state of emergency — mission teams should plan south of Kandé, full stop. Never swim in fresh water anywhere (schistosomiasis lives in the Volta and Oti basins), and teach the one-year rule: any fever up to twelve months after return is malaria until proven otherwise. CHU Sylvanus Olympio is the national referral center and Dogta-Lafiè is Lomé's modern newcomer, but the real plan for anything serious is Accra — thirty to forty-five minutes by air — which is what the medevac policy exists to fund.