São Tomé Safety Guide
Health, security, and travel safety information
Emergency Numbers
Save these numbers before your trip.
Healthcare
What to know about medical care in São Tomé.
Healthcare System
São Tomé has a basic public healthcare system with limited resources and facilities. The main hospital, Hospital Ayres de Menezes in São Tomé city, provides basic medical care but lacks advanced equipment and specialist services. Medical facilities on Príncipe island are even more limited.
Hospitals
Hospital Ayres de Menezes is the main facility for tourists. There are small health centers (centros de saúde) in larger towns, but these offer only basic care. Príncipe has a small hospital with very limited capabilities. For anything beyond minor ailments, medical evacuation is often necessary.
Pharmacies
Pharmacies (farmácias) are available in São Tomé city and some larger towns, but stock is limited and inconsistent. Common medications like painkillers, antibiotics, and anti-malarials may not always be available. Bring a comprehensive medical kit with all medications you might need, including prescription drugs in their original packaging.
Insurance
Comprehensive travel insurance with medical evacuation coverage is absolutely essential. Medical evacuation to Portugal or South Africa can cost $50,000-100,000 USD or more. Ensure your policy covers helicopter evacuation and repatriation.
Healthcare Tips
- Bring a complete first aid kit and all necessary medications from home, including extras in case of travel delays
- Carry a copy of your prescriptions and medical records, including blood type and allergies
- Consider bringing oral rehydration salts, anti-diarrheal medication, and broad-spectrum antibiotics
- Verify that your insurance company has 24/7 emergency assistance and can arrange medical evacuation
- Keep emergency contact numbers for your insurance provider and embassy readily accessible
- For serious medical issues, request evacuation rather than relying on local treatment
Common Risks
Be aware of these potential issues.
Pickpocketing and bag snatching occur occasionally, particularly targeting tourists. Theft from hotel rooms and beaches also happens but is relatively uncommon compared to many destinations.
Malaria is endemic throughout São Tomé and Príncipe year-round, with transmission occurring in all areas including urban zones. This is one of the most serious health risks for travelers.
Roads are often in poor condition with potholes, limited lighting, and inadequate signage. Driving standards vary, and livestock and pedestrians frequently use roadways. Accidents are common, especially during rainy season.
Tap water is not safe to drink and can cause traveler's diarrhea, typhoid, hepatitis A, and other illnesses. Contaminated food and water are common sources of illness.
Strong currents, riptides, and unpredictable waves affect many beaches. There are no lifeguards, and rescue services are virtually non-existent. Drowning incidents occur periodically.
Dengue fever occurs sporadically in São Tomé, with occasional outbreaks. The mosquitoes that carry dengue bite during daytime hours.
Scams to Avoid
Watch out for these common tourist scams.
Individuals approach tourists offering guide services at inflated prices or demand payment after providing unsolicited information or assistance. Some may become aggressive if refused payment.
Unofficial money changers offer better rates than banks but may use sleight of hand, give counterfeit notes, or shortchange tourists during the exchange process.
Taxi drivers quote inflated prices to tourists or take unnecessarily long routes. Meters are rarely used, making it easy to overcharge unfamiliar visitors.
Vendors selling crafts, tours, or services on beaches can be persistent and may employ guilt tactics or become pushy when refused.
Safety Tips
Practical advice to stay safe.
Money and Valuables
- Carry only small amounts of cash and keep the rest secured in your hotel safe
- Use ATMs during daylight hours at banks or secure locations, preferably with someone accompanying you
- Keep a photocopy of your passport and important documents separate from the originals
- Consider using a money belt or hidden pouch for important documents and emergency cash
- Credit cards are rarely accepted outside major hotels; bring sufficient cash
- Divide money and cards between different locations so you're not left with nothing if robbed
Transportation
- Arrange airport transfers through your hotel rather than accepting offers from strangers
- If renting a car, inspect it thoroughly and photograph any existing damage
- Avoid driving after dark due to poor road conditions, limited lighting, and increased accident risk
- Use only clearly marked taxis or arrange transport through your accommodation
- Shared taxis (candongueiros) are cheap but crowded and may not meet safety standards
- Always wear a seatbelt and ensure child safety seats are available if traveling with children
Accommodation Security
- Choose accommodations with good security reviews and secure locks on doors and windows
- Use the hotel safe for passports, extra cash, and valuables
- Don't leave valuables visible in your room or on the beach
- Keep your room locked even when inside, and use door chains or additional locks if available
- Be cautious about who you allow into your room, including staff you haven't requested
- Check that windows and balcony doors are secure, especially on ground floors
Health Precautions
- Start antimalarial medication before arrival and continue as directed after leaving
- Apply insect repellent regularly, especially at dawn and dusk
- Ensure all vaccinations are up to date, including yellow fever (required), hepatitis A and B, typhoid, and tetanus
- Wash hands frequently with soap or use hand sanitizer, especially before eating
- Avoid contact with animals, including dogs, as rabies is present
- Seek medical attention immediately if you develop fever, as this could indicate malaria
Food and Water Safety
- Drink only bottled water and check that seals are intact
- Avoid ice in drinks unless you're certain it's made from purified water
- Choose restaurants that appear clean and are busy with locals
- Eat food that is thoroughly cooked and served hot
- Peel your own fruit and avoid pre-cut fruit salads
- Avoid raw or undercooked seafood, despite the temptation in this island nation
- Brush teeth with bottled water and keep your mouth closed while showering
Communication
- Learn basic Portuguese phrases, as English is not widely spoken
- Keep your embassy or consulate contact information readily available
- Register with your embassy's travel registration system before arrival
- Keep your accommodation address written in Portuguese to show taxi drivers
- Consider purchasing a local SIM card for emergencies (coverage is limited outside main towns)
- Share your itinerary with someone back home and check in regularly
Beach and Water Safety
- Never leave belongings unattended on the beach
- Don't swim alone or after consuming alcohol
- Be extremely cautious of riptides and strong currents
- Ask locals about safe swimming areas before entering the water
- Wear water shoes to protect against sharp rocks, coral, and sea urchins
- Avoid swimming at dusk or dawn when visibility is poor
Information for Specific Travelers
Safety considerations for different traveler groups.
Women Travelers
São Tomé is generally safe for women travelers, including solo female travelers. The local culture is relatively conservative but welcoming, and serious incidents targeting women are rare. However, women may experience some unwanted attention, catcalling, or persistent approaches from men, particularly in tourist areas. Solo women travelers should take standard precautions.
- Dress modestly, especially outside beach areas, to minimize unwanted attention and show cultural respect
- Avoid walking alone in isolated areas or after dark; use taxis for evening transportation
- Be firm but polite when declining unwanted advances; don't feel obligated to be overly friendly
- Consider wearing a fake wedding ring to discourage persistent suitors
- Stay in reputable accommodations with good security and female-friendly reviews
- Be cautious about accepting drinks from strangers or leaving drinks unattended
- Trust your instincts; if a situation feels uncomfortable, remove yourself promptly
- Connect with other travelers or join group tours for activities in remote areas
- Keep your accommodation address private from casual acquaintances
- Have your phone charged and emergency numbers accessible at all times
LGBTQ+ Travelers
Homosexuality is legal in São Tomé and Príncipe with no specific laws criminalizing same-sex relationships. However, there are no legal protections against discrimination based on sexual orientation or gender identity, and same-sex marriage is not recognized.
- Exercise discretion with public displays of affection, as this may attract negative attention
- Be aware that local attitudes toward LGBTQ+ individuals are generally conservative
- Research accommodations in advance; international hotels may be more welcoming
- Avoid discussing sexual orientation with casual acquaintances or in public settings
- Connect with LGBTQ+ travel communities online for current information and support
- Be prepared for limited or no LGBTQ+ scene or dedicated venues
- Consider booking private accommodations rather than shared spaces for greater privacy
- If traveling as a couple, you may choose to book rooms with two beds to avoid questions
Travel Insurance
Comprehensive travel insurance with robust medical evacuation coverage is absolutely essential for São Tomé. The limited medical facilities mean that serious illness or injury will require expensive evacuation to Portugal, South Africa, or another country with advanced medical care. Evacuations can easily cost $50,000-150,000 USD. Additionally, the country's remote location and limited infrastructure mean that trip interruptions, delays, and lost luggage are more common than in more developed destinations.
Planning your trip? Make sure you have the right travel insurance for São Tomé Safety Guide before you go.