Worlds in Rwanda are medical mega-puzzle, but Belgian team doctor fears one thing above all else: "That’s when we evacuate"

“We started preparing for these World Championships a year ago,” Van der Mieren begins. The process began with the proper vaccinations. A quick look at the GGD (Public Health Service) website shows that vaccines such as Yellow Fever, DTP (diphtheria, tetanus, polio), and Hepatitis A are recommended, along with others like Mumps, Measles, and Rubella, which are typically already covered.

“Vaccination is not mandatory, but it is strongly recommended,” says the Belgian team doctor. “There was very little discussion; there are no anti-vaxxers in the group.” Potential side effects were also taken into account. “I can speak for the whole group: everyone started on time.”

Due to the high risk of malaria in Kigali, vaccinations alone won’t be enough. The riders must take a daily pill to reduce that risk. An infection could have lasting consequences. “Everyone has been briefed on that too,” Van der Mieren adds.

No worries for anyone who forgets their pills, because Van der Mieren is bringing spares himself. Double-checked, of course. “Last week, I spent a morning checking all expiration dates. I also compared the list with what I brought to Wollongong, Australia, in 2022: there’s barely any difference.”

What is different from Wollongong, however, is the abundance of mosquito sprays and nets. Those are absolutely essential, Van der Mieren emphasizes. “Most tropical diseases are spread by mosquitoes. Prevention is key. We’ll be spraying and applying repellent 24/7. I’ll also recommend everyone wear light-colored clothing, which tends to repel mosquitoes more than dark clothes.”

Next issue: Rwanda’s tap water isn’t safe to drink everywhere. The Belgian delegation will take zero risks. “The quality isn’t guaranteed. So we’re not taking chances. Washing is fine, but for everything else we’ll use bottled water or boil it first.”

Even vegetables will be rinsed with pre-heated water, as salmonella must be avoided at all costs. “Our cooking team has a very important job. They’ll have a lot of extra work. It’s entirely possible that by the end of the World Championships, they’ll have burned more calories than our riders,” says Van der Mieren.

The riders will also have to return, in a way, to COVID-era protocols: the Belgians want to minimize handshakes. “Because through water, things can enter the body that can then be passed on through physical contact. The local population has some resistance, but we Europeans, with our extreme focus on hygiene, are not resistant.”

Still, there’s one thing Van der Mieren fears above all: rabies. “That’s my biggest fear,” the doctor admits. “Actually, it’s my only real fear. The chance of being bitten by a rabid dog is tiny, but if it happens, and it’s a serious bite, then it’s full emergency mode.”

In such a case, every alarm would go off. “That is when we evacuate. An infection that’s not treated is always fatal. But if you act fast and treat it intensively with the right medication and wound care, it doesn’t have to be. But that’s a job for specialists.”

Should that scenario become reality, Van der Mieren is already in close contact with other doctors. “I know exactly which hospitals we can go to over there. That was my very first question when Rwanda was announced as the World Championships host. We also have a WhatsApp group with all the team doctors from participating nations and the UCI’s head doctor.”