Mission Preparation and Luggage

Question: My grandson is going to Ghana for 2 years on a mission for the Church of Jesus Christ of Latter-day Saints. His mother wants to send daily vitamins, probiotics, Zpack, ivermectin, etc., should he get sick. Can he have a separate medication bag that he can carry on the plane in addition to his carry-on luggage and personal item? For customs and security checks, would it be better to put these things in his large suitcases or carry them in a separate bag?

Answer: A separate "medical bag" is unlikely to be allowed as an extra free carry-on for these items, and carrying large quantities of prescription antibiotics and antiparasitics requires careful handling for international customs and airline travel.

LDS missionaries can travel with two large bags (50 lbs each), a carry-on, and a personal item (like an over-the-shoulder bag).

1. The "Extra Bag" Rule for Airlines

Airlines exempt medical bags from carry-on limits only for necessary medical equipment or life-sustaining daily supplies (such as CPAP machines, breast pumps, dialysis equipment, or daily insulin/epinephrine).

• Standard vitamins, supplements, and "just-in-case" prescription packs (like azithromycin or ivermectin) do not qualify for a third free carry-on bag.

• Gate agents will count that bag toward his standard allowance (one carry-on bag + one personal item).

• Everything he carries into the cabin must fit inside his standard carry-on suitcase and backpack/personal item.

2. Carry-On vs. Checked Baggage for Customs & Security

Category	Where to Pack	Why & Important Rules
Prescription Medications (Z-Pak, Ivermectin, Inhalers, etc.)	Carry-On / Personal Item	• Checked bags can get lost, delayed, or exposed to extreme cargo temperatures. • Crucial: Must remain in their original pharmacy-labeled bottles with his name printed on them matching his passport. Loose pills in baggies or pill planners invite immediate scrutiny or confiscation at customs. • Bring a printed doctor’s note listing the diagnosis, medication, and dosage.
Vitamins & Probiotics (Daily multivitamins, digestive aids)	Checked Luggage	• Two years' worth of vitamins takes up massive volume and weight. • Keep them sealed in factory bottles where possible. • Ghana's climate is hot and humid; gelatin capsules and heat-sensitive probiotics degrade quickly. Shelf-stable tablets or blister packs travel best.

3. Critical Considerations for Ghana & LDS Missions

• Mission Medical Advisors Handle Prescriptions: Every mission (including those in Ghana—Accra, Cape Coast, Kumasi, etc.) has assigned mission medical coordinators and Area Medical Advisors. They have established protocols and local clinics to diagnose and treat illnesses with local first-line medications (malaria treatments, antibiotics for travelers' diarrhea, etc.). Self-medicating with broad-spectrum antibiotics or antiparasitics without consulting the mission doctor is discouraged and can be dangerous if the actual illness is malaria or dengue.

• Malaria Prophylaxis: If he is going to Ghana, malaria prevention (such as Doxycycline, Atovaquone-Proguanil/Malarone) is mandatory and prescribed specifically through his pre-mission medical clearance. That should stay with him in his carry-on.

• Customs Restrictions: Arriving at Kotoka International Airport (Accra) with bulk quantities of loose prescription antibiotics or antiparasitics without a clear doctor's order can look like unauthorized importation. Carrying a personal 1-to-2 week supply with clear pharmacy labels is fine; carrying bulk emergency medications for two years is not recommended.

Recommendation: Pack any personal prescription medications and a small, basic travel first-aid kit (pepto, blister pads, pain reliever) in his personal backpack. Put a 3- to 6-month supply of daily vitamins into his large checked suitcases. For major illnesses in Ghana, he will coordinate directly with the mission medical team, who have direct access to local pharmacies and approved clinics.

Sources: 

Centers for Disease Control and Prevention. (2025, April 23). Malaria. In CDC yellow book: Health information for international travel. U.S. Department of Health and Human Services. https://www.cdc.gov/yellow-book/hcp/travel-associated-infections-diseases/malaria.html

The Church of Jesus Christ of Latter-day Saints. (n.d.). Dress and appearance: Missionary standards. The Church of Jesus Christ of Latter-day Saints. https://www.churchofjesuschrist.org/callings/missionary/dress-and-appearance

Transportation Security Administration. (n.d.). Liquid medications and special medical screening. U.S. Department of Homeland Security. https://www.tsa.gov/travel/security-screening/whatcanibring/items/liquid-medications

Universe Staff. (2016, April 26). Finding an alternative backpack for missionaries. The Daily Universe. https://universe.byu.edu/2016/04/26/finding-an-alternative-backpack-for-missionaries1/