Djibouti
Travel Destination – Djibouti
Djibouti is a small country in the Horn of Africa with dramatic landscapes of deserts, volcanoes, salt lakes, and marine wildlife.
Lake Assal, Africa’s lowest point at 155 metres below sea level, is one of the saltiest lakes in the world, surrounded by striking white salt flats and turquoise water. Nearby Lake Abbe features towering limestone chimneys rising above a vast desert landscape, alongside flamingo-filled waters. Between November and January, the Gulf of Tadjoura becomes a renowned destination for swimming with whale sharks.
For a change of scenery, Day Forest National Park offers cooler mountain landscapes, ancient juniper forests, and rare birdlife. In Djibouti City, African, Arab, and French influences come together through its markets, architecture, and coastal atmosphere.
Healthcare facilities are limited, particularly outside the capital, so careful preparation, travel insurance, and access to emergency evacuation are important considerations before visiting.
Health Risks
Pre-travel preparation
Effective health preparation before visiting Djibouti can greatly reduce the risk of illness while travelling. A travel doctor appointment around six to eight weeks before departure allows time to review your vaccination history, arrange any recommended vaccines, and organise malaria prevention medication if needed. Advice can be tailored to your plans, as the risks for a short stay in Djibouti City differ from those associated with desert travel, hiking, or remote excursions.
Even if departure is soon, a consultation is still worthwhile, as some vaccines can be given on shorter schedules. Medical care in Djibouti is limited, especially outside the capital, and serious illnesses may require evacuation overseas. Comprehensive travel insurance that includes emergency medical evacuation is therefore essential.
Insect avoidance
Several insect-borne diseases are active in Djibouti, and protection needs to be in place throughout the day and into the night. Malaria is transmitted by Anopheles mosquitoes that feed most actively after dark. Dengue and chikungunya are spread by Aedes mosquitoes that bite mainly during daylight hours. Filariasis, a parasitic infection caused by worms transmitted through mosquito bites, is also present. Sandflies, which are small enough to pass through standard mosquito nets, are present across the region and can transmit leishmaniasis, a parasitic skin disease.
Apply insect repellent containing DEET or picaridin to uncovered skin throughout the day and evening, and reapply after swimming or sweating. Wearing long sleeves and trousers provides an additional physical barrier.
Stay in accommodation with screened windows or air conditioning wherever possible, and use a permethrin-treated bed net at night in any room without adequate screening. Fine-mesh permethrin-treated nets are more effective against sandflies than standard nets. Treating outer clothing with permethrin before travel adds further protection, which is particularly useful for travellers exploring rural or highland areas.
Food and water hygiene
Djiboutian food reflects the country's position between cultures, with Somali and Afar influences blending with Arab and French cooking traditions. To reduce the risk of gastroenteritis and hepatitis A, follow simple hygienic precautions and recommendations.
Tap water in Djibouti is not safe to drink. Bottled water should be used for drinking and brushing teeth throughout the entire stay. Ice should be avoided unless its origin from a purified source can be confirmed.
Wash hands thoroughly with soap before eating and after using the toilet, and use alcohol-based hand sanitiser when soap and water are not accessible. Eat food that has been freshly cooked and served hot, avoid anything that has been reheated or left out, and peel fruit yourself immediately before eating.
Rabies prevention
Rabies is present in Djibouti and is carried by dogs and other mammals, including bats. The disease is virtually always fatal once symptoms appear, which makes avoiding exposure the most critical step a traveller can take.
Avoid touching or approaching any animal during your visit, including stray dogs, cats, and bats. Pre-exposure rabies vaccination is worth discussing with your travel doctor, particularly if you are spending extended time in the country, travelling into rural or desert areas, or undertaking any activities that increase the likelihood of animal contact.
Any bite, scratch, or lick to broken skin from an animal requires the wound to be washed thoroughly with soap and running water immediately, followed by prompt medical assessment, regardless of whether pre-exposure vaccination has been given.
Our Travel Doctors
Our fully qualified doctors have an interest in travel medicine and immunisations. And they know travel. Their expert advice will be tailored for you, your travel companions and your trip.
Which shots do I need for Djibouti?
Hepatitis A
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Hepatitis A is a liver infection passed on through contaminated food or water, causing symptoms ranging from mild nausea and fatigue to weeks of jaundice and significant illness. Occasionally, it can lead to life-threatening liver failure. The infection is particularly serious in older adults and people with pre-existing liver conditions.
Vaccination is recommended for all previously unvaccinated travellers to Djibouti, given the elevated risk of foodborne and waterborne illness across the country. The vaccine is given as two doses and provides long-lasting protection. Many Australians have not yet completed the full course.
Typhoid
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Typhoid fever is a bacterial illness caused by Salmonella Typhi, spread through food or water contaminated with the bacteria. It causes a persistent high fever, headache, fatigue, and abdominal pain that can lead to serious complications without treatment.
Vaccination is recommended for most travellers to Djibouti, particularly those eating outside of strictly controlled hotel environments, sampling street or market food, or spending extended time in the country. The vaccine reduces but does not completely eliminate risk, so careful food and water habits throughout the trip remain important.
Rabies
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Rabies is present in Djibouti and is carried by dogs and other mammals, including bats. The disease is virtually always fatal once symptoms appear, which makes avoiding exposure the most critical step a traveller can take.
Avoid touching or approaching any animal during your visit, including stray dogs, cats, and bats. Pre-exposure rabies vaccination is worth discussing with your travel doctor, particularly if you are spending extended time in the country, travelling into rural or desert areas, or undertaking any activities that increase the likelihood of animal contact.
Any bite, scratch, or lick to broken skin from an animal requires the wound to be washed thoroughly with soap and running water immediately, followed by prompt medical assessment, regardless of whether pre-exposure vaccination has been given.
Measles
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Measles is an airborne viral illness that spreads through the air with remarkable ease, causing fever, a distinctive spreading rash, and in some cases serious complications including pneumonia and brain inflammation.
Cases are rising across many countries globally, and all Australian travellers heading overseas should be vaccinated with the measles-mumps-rubella (MMR) vaccine before departure. Australians born in 1966 or later need two documented doses. Your travel doctor can check whether your vaccination record is complete.
Polio
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Polio spreads mainly through the faecal oral route by contaminated food and water. In a small proportion of cases, it can cause irreversible paralysis.
Ensuring polio vaccination is up to date is recommended before international travel, including to Djibouti. Adults who completed the childhood vaccination series may be advised to receive a single adult booster depending on their vaccination history and travel plans, and a travel doctor can provide personalised advice.
Hepatitis B
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Hepatitis B is a bloodborne viral liver infection transmitted through contact with infected blood or other body fluids, including through unprotected sex, non-sterile medical or dental instruments, and tattooing or piercing. The limited capacity of Djiboutian healthcare facilities to guarantee sterile equipment in all circumstances makes vaccination particularly relevant for any traveller who might need medical care during their trip.
Many Australians received hepatitis B vaccine as children but some adults have not, and vaccination status is worth confirming with a travel doctor before departure.
Yellow Fever
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Yellow fever does not occur in Djibouti itself, so vaccination is not needed for personal protection within the country. However, a valid yellow fever vaccination certificate is required for travellers arriving from countries where yellow fever is present. If any part of your journey to Djibouti passes through a yellow fever risk country in sub-Saharan Africa or South America, you must carry documented proof of vaccination. Entry requirements can change, and your routing should be confirmed with a travel doctor before departure to ensure you have the right documentation.
Routine vaccinations
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When preparing for a trip to Djibouti, take the opportunity to make sure all standard immunisations are current. This includes tetanus, diphtheria, and pertussis, with a booster recommended for anyone whose last dose was more than ten years ago, particularly relevant for travellers planning outdoor activities such as desert hiking and wildlife excursions where minor injuries are more common. Other key vaccinations include measles-mumps-rubella (MMR), hepatitis B, and polio.
Annual influenza vaccination is worthwhile, as influenza circulates year-round with risk increasing due to international travel. COVID-19 vaccination should be up to date in line with current Australian guidance, including booster doses for those aged 65 and over or with relevant underlying health conditions.
Djibouti
Other health risks in Djibouti
Malaria
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Malaria risk due predominantly to Plasmodium falciparum, the most fatal species, exists throughout the year across the entire country. The parasite is transmitted by mosquitoes that are most active from dusk to dawn, infecting red blood cells and causing high fever, chills, headache, nausea, and muscle aching. Without treatment, falciparum malaria can deteriorate rapidly into a life-threatening illness.
Prescription antimalarial medication, which must be started before arriving in Djibouti, is essential for all travellers. The full medication supply must be obtained in Australia before you leave, as supply is uncertain overseas.
Any fever developing during your trip or in the weeks and months after returning home should be assessed by a doctor promptly, with your travel history clearly communicated.
Gastroenteritis
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Gastroenteritis is the most common illness affecting travellers in Djibouti, causing diarrhoea, nausea, vomiting, and stomach cramping, typically appearing within one to three days of exposure. It is usually caused by bacteria or viruses in contaminated food or water.
A high risk of gastrointestinal illness exists throughout the country, including in some higher-end accommodation. Staying well hydrated with oral rehydration solutions is the most important self-treatment measure for mild cases, and most episodes resolve within a few days. If symptoms are severe, persistent, contain blood, or are accompanied by a high fever, seek medical attention without delay, noting that medical facilities outside Djibouti City are extremely limited.
Dengue and chikungunya
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Dengue is a viral infection transmitted by mosquitoes that bite mainly during daylight hours, causing a sudden high fever, severe headache, intense joint and muscle pain, and fatigue. In a small proportion of travellers it can progress to more serious illness.
Chikungunya is caused by the same type of daytime-biting mosquito and presents similarly, with the addition of joint pain that can persist for weeks or months after the initial infection has resolved. Djibouti is considered a higher-risk region for chikungunya.
No specific treatment exists for either dengue or chikungunya, and prevention through consistent mosquito bite protection throughout the day is the most reliable defence available.
Schistosomiasis
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Avoid swimming, wading, bathing, or washing in rivers, lakes, and other freshwater bodies in Djibouti, as these can harbour the parasite that causes schistosomiasis (otherwise called bilharzia).
Infection occurs when microscopic larvae released by freshwater snails penetrate intact skin. There is no vaccine or preventive medication, so avoiding freshwater exposure is the only reliable way to prevent infection. Seawater and properly chlorinated swimming pools are considered safe. If you have had any freshwater exposure during your trip, arrange testing after returning to Australia, as effective treatment is available.
Tuberculosis
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For most short-term travellers, the risk of Tuberculosis (TB) in Djibouti is low. However, the risk increases for those spending extended periods in the country, working in healthcare or community settings, or living in close contact with local communities.
TB is a bacterial infection that spreads through the air when someone with active disease coughs, speaks, or sings, most commonly affecting the lungs. Symptoms include a persistent cough, fever, night sweats, and unexplained weight loss.
If you fall into a higher-risk group, discuss TB screening with your doctor before and after travel. Any persistent cough or fever after returning home should be assessed promptly, with your travel history clearly communicated.
Non-infectious conditions
Crime and unrest
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The security situation in Djibouti can be changeable. Petty crime, including pickpocketing, can occur, particularly after dark, while security risks are higher outside Djibouti City. Avoid unnecessary travel at night and remain alert in isolated areas.
Demonstrations can become unpredictable and should be avoided. Travellers arriving by private vessel should also be aware of piracy risks in the Gulf of Aden and surrounding waters.
Travellers should check the Australian Government's Smartraveller website before and during their trip and ensure they have appropriate travel insurance.
Heat related illness
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Djibouti's climate is extremely hot. Between May and October temperatures regularly exceed 40 degrees Celsius and can reach 50 degrees or higher inland, with high humidity adding to the physical burden.
These conditions create a genuine risk of heat exhaustion and heat stroke, particularly for visitors who are physically active outdoors.
Drink water consistently throughout the day rather than waiting until you feel thirsty, limit strenuous outdoor activity to the cooler early morning and evening hours, wear lightweight and light-coloured clothing, and apply broad-spectrum sunscreen when outdoors. Be aware that essential services including food and water availability can be affected during periods of extreme heat.
Safety on the roads and elsewhere
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Road conditions outside Djibouti City can be poor, and many attractions require four-wheel drive vehicles and experienced local operators. Avoid driving at night, carry plenty of water, and be prepared for extreme heat when travelling in remote areas.
When swimming, diving, or joining whale shark tours, use reputable operators and follow local safety advice, as sea conditions and currents can change quickly.
Deep vein thrombosis
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Long-haul flights to Djibouti can increase the risk of deep vein thrombosis (DVT), where a blood clot forms in the deep veins of the leg due to prolonged sitting.
To reduce the risk, get up and walk regularly, perform simple seated leg exercises such as ankle circles and calf raises, and stay well hydrated throughout the journey. Travellers with additional risk factors, including a previous blood clot, recent surgery, pregnancy, oral contraceptive use, or significant overweight, should speak with a travel doctor before departure, as compression stockings may be recommended.