Healthcare System in Guinea-Bissau: Available Care, Emergencies, Evacuation and Vaccinations

The official sources read describe a healthcare system with constrained resources. The WHO reports health spending of about 80 dollars per inhabitant, or less than 9% of GDP. Life expectancy at birth is about 58 years for men and 64 years for women, healthy life expectancy about 53 years, and mortality of children under five about 52 per 1,000 live births. For adults (ages 15-60), the WHO records about 415 deaths per 1,000 men and 300 per 1,000 women.

The WHO mentions the existence of a national ophthalmology service, given equipment, and of a national HIV treatment protocol: these elements show a system organised by programmes, but they do not mean that specialist care is accessible everywhere. The list of health establishments should be requested from the Ministry of Health or from the French embassy on the spot.

France Diplomatie cites no hospital or clinic in Guinea-Bissau in its health page. A French resident therefore plans first-contact consultations in Bissau and, for any serious condition, an evacuation to a country with a technical facility, Dakar being the nearest point. The French embassy in Bissau keeps a list of French-speaking professionals on its website.

Guinea-Bissau has a national social security institute, the INSS, intended for affiliated workers. The official sources read give no details of its contribution rates, its in-kind benefits, or the access of a foreign resident without local employment: this information should be requested directly from the institute and your employer. No bilateral agreement coordinates the French and Guinea-Bissau schemes, and the country does not appear in the CLEISS list of agreements (the French centre for international social security liaison).

For a French resident, health protection therefore rests on the French scheme maintained (secondment outside a treaty), the CFE (the Caisse des Français de l’Étranger, the French expatriate social security fund) or international health insurance. Reimbursement details are presented on the reimbursement page.

France Diplomatie gives no national emergency number for Guinea-Bissau. The useful numbers are those of the French embassy in Bissau (+245 955 393 280, office hours) and, outside hours, of the French consulate general in Dakar (+221 33 839 52 62), competent for Guinea-Bissau, Gambia and Cape Verde.

The decisive point is evacuation: there is no air ambulance in Bissau, the nearest is in Dakar, about 1 h 30 of flight away, subject to flights and available seats; the overland journey Bissau-Dakar takes at least 12 hours, provided an ambulance or vehicle can be found. Medical evacuation, at the expense of the patient and their family, is preferable to local hospitalisation. Without an assistance contract, the French embassy cannot under any circumstances cover these costs; see assistance and repatriation.

Check that your contract covers evacuation from Bissau, that it specifies the place of arrival (Dakar, Lisbon, France) and that it arranges payment without upfront costs. Flight availability and the rainy season (July to September) may lengthen the delays.

France Diplomatie recommends bringing a suitable personal medicine kit, limited to strictly necessary medicines, in their original packaging with labels and a prescription giving the names as international nonproprietary names (INN). Check that the medicines are authorised in the country: importing them beyond personal use requires authorisation from the Ministry of Health. Never take medicines bought in the street, because of the risk of counterfeits.

In case of dengue, avoid anti-inflammatory drugs. The rabies vaccine can be very hard to obtain quickly after a risky exposure: preventive vaccination is recommended for young children and for stays in rural areas. For a chronic treatment, build up a reserve of several months before departure.

Yellow fever is the compulsory vaccination: to be done at an approved centre, preferably at least ten days before departure, the disease being fatal in 20 to 60% of severe forms. The French vaccination schedule must be up to date (diphtheria, tetanus, polio, whooping cough, measles). Depending on the length and conditions of the stay, France Diplomatie also recommends hepatitis A, typhoid fever, hepatitis B for frequent or prolonged stays, ACWY meningitis in the dry season or in case of an epidemic, tuberculosis for children under 15, rabies, as well as chikungunya, dengue and mpox in case of risky exposure.

The diseases cited are chikungunya, dengue, yellow fever, malaria and Zika, transmitted by mosquitoes, as well as cholera (endemic in Guinea-Bissau), typhoid fever, hepatitis A, meningococcal meningitis, rabies and tuberculosis. Meningitis causes regular epidemics during the dry season, from November to June; France Diplomatie advises against taking very young children to this area at that time.

Prevention relies on repellents, covering clothing, treated mosquito nets, bottled or treated water and hand hygiene. Consult a doctor or an international vaccination centre sufficiently early before departure.

• Routine care: consult in Bissau a doctor recommended by the embassy or your employer, and keep all paid invoices for your insurer, the CFE or your fund if you are seconded.
• Emergency or worsening: immediately call the assistance platform of your contract, which arranges transport and evacuation; without a contract, delays and costs fall on the family.
• Animal bite or scratch: consult without delay, because the rabies vaccine can be very hard to obtain quickly after a risky exposure.
• Fever on return or during the stay: consult quickly, as malaria can appear several weeks after exposure.
• Consular steps: in case of serious difficulty, contact the French embassy in Bissau during office hours, or the consulate general in Dakar for emergencies outside hours.

Compare contracts on the ceiling, the coverage zone, evacuation and the handling of pre-existing conditions (medical questionnaire), then declare your current treatments. For a stay of more than six months, register on the register of French nationals living abroad and on Fil d’Ariane (the French foreign ministry’s traveller registration service). See expat health insurance; Expavy helps you compare options according to your status.