Only two major European air carriers currently service Lungi Airport. The ferry service between the airport and Freetown is unreliable. In emergencies the overland route to the airport might be closed due to fighting. U.S. citizens are encouraged to be especially alert, to avoid large gatherings and to remain in contact with the U.S. Embassy. Persons with medical conditions that may require treatment or medications are discouraged from traveling to Sierra Leone.
Medicines are in short supply, sterility of equipment is questionable and treatment is unreliable.
Many primary health care workers, especially in rural areas, lack professional training. Instances of misdiagnosis, improper treatment and administration of improper drugs have been reported. International air carriers are reluctant to assist with medical evacuations from Sierra Leone. Private charter evacuations, costing thousands of dollars, may be necessary. Doctors and hospitals often require immediate payment for health services.