Practical Information

Health

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IMG_6677Staying Healthy

The information contained within this article is purely for information purposes only. I am not a health care professional and I write purely based on my own experiences and research. I urge anyone who is looking to travel to seek the advice from a qualified health care professional prior to departure.

That said, the following information should give you a good idea of the potential health issues you may encounter whilst traveling.

They are not listed in any particular order, though the risks of certain illnesses/ailments vary considerably throughout different countries and climates. A health care professional will be able to give you tailored advice according to where/when you are travelling.

The NHS provides travel information here: Travel Health

The World Health Organization provides travel information here

I strongly advise anyone looking to go travelling, no matter where to or for how long to obtain comprehensive travel insurance. Prices may surprise you with my recent 7 week trip costing just £40 for the four of us.

The standards of medical care vary greatly, with recent reports saying up to 50% of all doctors in India are dodgy, it goes without saying that a visit to the quack poses many potential issues.

Firstly, you don’t know for sure you are getting the correct diagnosis or that the doctor is competent and genuine. Secondly, there is the age old doctor scam where you are charged for things you don’t need or face a hugely inflated medical fee for a plaster. Add into that fake drugs, cleanliness issues and dirty syringes and a visit to the doctor might give you more than you bargained for.

It therefore goes without saying that you should attempt to deal with as many health/first aid issues as possible yourself. Of course, matters of a serious nature should be referred to a reputable health practitioner but a simple self-diagnosis of minor problems can be the difference between a complex array of issues and getting back on track in no time.

It is also worth pointing out that health care might not be available. Not only that, but health care might be specialized, for instance – Not every hospital is equipped to deal with tropical diseases and travel may be required. Find out where to go in an emergency, but also make yourself aware of the nearest tropical disease clinic.

A comprehensive medical checklist:

Antibacterial Cream

Contraceptives

Steroid Cream

Antibiotics for skin infection

Decongestant Scissors

Antibiotics for diarrhoea treatment & oral re-hydration solution

Thermometer

Anti-fungal cream

Indigestion medication

Throat Lozenges

Antihistamine

Iodine tablets for water purification

Thrush Treatment

Anti-Inflammatory

Laxative

Urine infection treatment

Antiseptic

Paracetamol  

Antispasmodic plasters, bandages & safety pins   

The medical checklist should of course be tailored to your own needs. If you are taking medication it is important to carry this in its packaging and with proof from your doctor or pharmacist. Be aware that not all drugs taken in the EU are permitted in other countries, this includes but is not limited to some types of – Strong painkillers, sleeping tablets, anti-depressants and anti-psychotic drugs.

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Backpacking Health

Vaccinations prior to travel

The World Health Organization recommend the following:

Routine Vaccination Selective – Specific areas/duration of travel Required (country list here)

Diphtheria, Tetanus, Pertussis Cholera Yellow fever

Hepatitis B Hepatitis A Meningococcal (A, C, Y & W135)

Haemophilus influenza type b Japanese encephalitis Polio 

Human papillomavirus Meningococcal  

Influenza Rabies  

Measles, Mumps & Rubella  Tick-borne encephalitis  

Pneumococcal Typhoid fever  

Polio Yellow fever  

Rotavirus    

Tuberculosis    

Varicella    

What you might catch:

Listed below are some of the types of illnesses you may encounter whilst travelling. Though some are exceptionally rare others aren’t. With a bit of common sense though most (if not all) can be avoided. To put it into perspective we have never caught any of the following illnesses.

The symptoms listed are general symptoms, and these differ greatly between patients and not all patients get the same or all symptoms. Each infectious disease links directly to the NHS or WHO where further, comprehensive advice is given.

At the foot of this page is the emergency numbers for popular countries and the local word for hospital.

Symptoms, How it is caught & How to avoid

Cutaneous Larva Migrans: Linear rash that is very itchy.

– Contaminated sand and soil and contact with the skin.

– Be careful where you lay on the beach, don’t eat sand.

Dengue Fever: Severe headache and aching bones, high fever and rash similar to that of measles. 

– Mosquitos carrying the dengue virus.

– Use DEET and take precautions such as long trousers and sleeves. Particularly at night.

Hepatitis A: Jaundice, nausea and lethargy.

– Contaminated food and water.

– Get the Hep A Vaccination prior to travel.

Hepatitis B: Flu like symptoms, jaundice, nausea.

– Bodily fluid & sex.

– Men should wrap up, women should make men wrap up and both should choose their sexual partners carefully.

Hepatitis E: Gastrointestinal upset, flu like symptoms, jaundice, aches and pains.

– Ingesting effected feces, usually in contaminated water.

– Drink bottled water.

HIV: Flu like illness.

– Sexually transmitted and contaminated needles.

– Never have sex with a local unless you take precautions, never let someone jab you unless you are 100% certain the needle is sterile.

Flu: Sudden high fever, dry cough, aches and pains, tiredness, chills, headache, sore throat, difficulty sleeping.

– Touching or breathing in contaminated droplets.

– Use hand wash and exercise vigilance when in the vicinity of serial sneezers.

Leptospirosis Flu like symptoms, may be mild or severe.

– By touching soil or water contaminated with the urine of infected animals.

– When canoeing/rafting go with reputable companies that know the area and don’t drink the water.

Measles: Cold like symptoms, sensitivity to light, grey white spots in the mouth, lethargy and then followed by a rash 2 – 3 days later.

– Touching or breathing in contaminated droplets.

– Most people are already vaccinated against measles, but check.

Rabies: High fever, tingling and itchiness at site of infection, hydrophobia, aggressiveness

– Bite, scratch or lick of an open wound by an infected animal.

– Stay away from dogs and monkeys and other animals. If you aren’t vaccinated and you think an animal may have infected you, head straight to hospital. Quickly.

Schistosomiasis: Skin rash, high temperature and muscle aches.

– By coming into contact with contaminated water.

– Swim in places that come recommended, not just any old pool of water.

Sexually Transmitted Diseases: Various symptoms

– Passed during sex and sexual contact.

– Men; don’t go bareback, women; Don’t let him. Both sexes should be careful.

Typhoid High fever, stomach pain, vomiting, dull headache at the front of the head, dry cough, rash. NB: Symptoms alter weekly so read up on typhoid. 

– Contaminated food and drink by someone that hasn’t washed their hands properly after using the toilet.

– Consider cleanliness where you eat, don’t eat food from someone that has just taken a dump and not washed their hands.

What you probably will catch:

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Travellers Diarrhoea

Up to half of all travellers will get some form of upset stomach, diarrhea and sickness. Even with the utmost vigilance it may become impossible to avoid and the severity varies greatly. Most bouts pass within 5 days but sting ring may linger a little longer.

For practical advice on what to eat, what not to eat and where to meet in the middle head to the food section of this website.

Symptoms:

Watery stools

Blood in faeces

Fever

Sickness

Nausea

Stomach cramps

Lethargy

How to cope:

The single most important thing you can do is drink water. Constantly. For young kids bring your own rehydration sachets containing essential minerals and salts. The stuff you buy abroad is nasty and I struggle to drink it, never mind kids.

Avoid taking immodium as this slows the parasite leaving the body and try to use soft toilet paper as you will cause serious irritation.

Appetite will normally be suppressed and I lost 5kg in 5 days, but it will pass. The most important thing is rehydration, aim to drink a minimum of 3 litres per day and take plenty of rest.

If you have the runs and your child doesn’t, ensure you wash your hands before touching them or things they might touch.

Antibiotics can be administered and medical help may be required for young patients. Select reputable medical professionals carefully.

Health when Backpacking

Potential issues:

Malaria

The problem with malaria is that mosquitos don’t fly around with a big banner around their neck saying ‘I carry Malaria’ and not only that, but malaria doesn’t always present itself immediately.

One of the major issues travellers face when heading to an area where Malaria is present is the anti-malarials. Side effects can be common and serious and many people opt to risk catching the disease rather than risk side effects of the medication. That is personal choice and one I think you should make on the basis of advice from a healthcare specialist.

We take anti malarials if there is anything other than a low risk. But if we are just nipping through an area where Malaria is present then we simply cover up and dose up on DEET as advised by our travel nurse. Some areas however carry very high risk and this would not be recommended. In short, you must visit your travel nurse for relevant and current advice on malarials, whether you need them and the type you should take, as not all types offer protection everywhere.

Malarone is our preferred anti-malarial due to the limited side effects. It is however very expensive, though generic versions are now available. Up until recently we were skinned £2.30 per adult tablet at Superdrug (with Boots charging £3.60!), but this has now reduced by about 20% if you choose the generic version. Having taken Malarone long term and multiple times, none of us have ever suffered any side effects whatsoever. I do recommend that whatever course you opt to take, that you try a tablet before you leave, if you have an allergic reaction you are likely much better placed in your home country to get the emergency care or alternative course of anti-malarial drugs that you require.

Symptoms:

High temperature

Vomiting

Sweats and chills

Muscle pains

Headache

Diarrhoea

How to cope – The ABCD approach courtesy of the NHS

Awareness of risk: find out whether you’re at risk of getting malaria before travelling.

Bite prevention: avoid mosquito bites by using insect repellent, covering your arms and legs and using an insecticide- treated mosquito net.

Check whether you need to take malaria prevention tablets: if you do, ensure you take the right antimalarial tablets, at the right dose and that you finish the course.

Diagnosis: seek immediate medical advice if you develop malaria-like symptoms, including up to a year after you return from travelling.

Health when Backpacking

Sunburn & Dehydration

Sunburn

When travelling with kids you will be surprised initially at just what an effect the sun will have on them. Some parts of India are 50 degrees and it gets to the point where you can barely cope. Exhaustion kicks in, you get dry mouth and your skin burns. This is your body telling you to drink water, and chill out.

Sunburn comes on quicker than you can imagine and factor 50 is an absolute must for children. Sun lotion is difficult and expensive to get hold of outside the main tourist areas and so come stocked up. I also make my children wear sun hats, they complain this makes them hotter and sweat and I counter this by telling them that we can control that by drinking more, but if they get sun stroke they will be ill and then we can’t control it.

With that in mind I never scrimp on sun lotion, apply it regularly and ensure it is reapplied prior to and following swimming in the sea.

If you do encounter sunburn, then apply hydrocortisone 1% and cover up. It may sound daft but sunburn, on sunburn is very painful.

In terms of dehydration thirst is a poor indicator of when the body needs water. Kids get bored of water but it is absolutely imperative they drink plenty. I buy my children their own bottle of water so I can monitor how much they drink. We have regular water breaks on hot days where we find shade, and I will make them drink up to 500mL of water. It is not uncommon for us to drink 3 Litres each per day minimum.

At night I ensure the kids have a 1.5L bottle of water before going to bed, I tell them they must drink this before we leave in the morning. I know how much they sweat at night and this needs replacing.

If we are spending extended times in the sun, say on a camel safari out in the desert or if I think we have exerted ourselves a lot and so sweated a lot I will add rehydration salts to the water. These bought abroad are nasty, awful tasting. They are a great bribe and the kids are fully aware that if they fail to keep up with the hydration requirements I give them, then they will have to have rehydration salts – Works every time!

Key things to look out for in kids is how often they go to the toilet. Also I will periodically check my children’s urine, if it is clear then this is an indication they are hydrated, the darker yellow it is the more it indicates they need to take in more water.

Look out for lethargy, tiredness, out of character behavior, dry mouths, dizziness and headaches. If they do complain of a headache, monitor if it reduces or goes with the intake of water.

Remember, dehydration in a hot country can occur very quickly, it is absolutely imperative you monitor your children’s hydration. A completely avoidable condition that should be taken seriously, if your child is too ill to take on fluids then you should seek medical help immediately.

Travel Health

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Where to get help

If it looks like a duck, walks like a duck and quacks like a duck – It’s probably a duck. We know that right?

Well the same can’t be said for doctors abroad. It would take 5 minutes to knock up a fake doctorate and stick it on the wall proclaiming to be a doctor and some don’t even put that much effort in. It’s a minefield of scams, rip offs and fake illnesses.

Hunting down a good doctor is as hard as hunting down a real one. Given your vulnerability I suggest you take a common sense approach. If it is some bloke a fortnight past a shower perched on a wooden stool outside a front door to a shop he is probably dodgy, but if it is a well signed, professional looking clinic he probably isn’t.

Most decent doctors will speak good English and actually look like they know what they’re doing.

Failing that, Lonely Planet and rough guide have recommendations of reputable medical centres where you can get a decent, though varied, standard of care.

Should you go in with a dodgy stomach expecting a course of antibiotics and you get diagnosed with a broken foot – Get a second opinion.

In an ideal world you will carry your own syringes, but if not – Don’t ever let any doctor inject you or your children unless you have watched the syringe be opened from a sterile packet with a date on it.

If you don’t have a guide book, ask your hostel/hotel or get in touch with your embassy or travel insurance provider.

If you are in a rural area and the condition is not immediately serious you might want to consider heading to the nearest large city. Healthcare is likely to be better and you may be referred there anyway, but this is a decision that should not be taken lightly and remember that conditions can deteriorate rapidly.

I also suggest that before you travel to a country you find out how to say “Call me a Doctor” in the local language, and also find out the emergency number for police and ambulance.

On a final note, remember, it is highly unlikely that you will catch any of the diseases listed here and with a bit of common sense and a practical approach it will be extremely unlikely!

Safe travels.

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