Common problems that travellers encounter, such as stomach upsets and those from insect bites, can be prevented by taking . . . → Read More: Preventing Medical Problems]]>

Common problems that travellers encounter, such as stomach upsets and those from insect bites, can be prevented by taking simple precautions.

These include such things as good hygiene and safe food preparation practices, drinking (and using) only treated or clean water, avoiding being bitten by various insects and worms, and getting vaccinated and taking pills to prevent diseases.

Clean water and water treatment

Everyone needs a minimum of about two and a half litres or just over half a gallon of clean water a day. In hot climates while doing things like carrying a backpack, hiking or just walking around in the sun, you will need even more, maybe around 4 litres or about a gallon a day, mainly because of loss from sweating.

It is extremely easy to become dehydrated while travelling in hot and unfamiliar climates. It is recommended to take a water bottle with you each day.



Public water in all of the USA, western Europe and some parts of eastern Europe is safe to drink. A lot of countries around the world, however, are not so stringent about the cleanliness of their water supply, which can mean health risks for travellers.

Drinking water can be contaminated with all sorts of infectious agents, ice (for example, in drinks (even in alcoholic ones)) is a major problem, as is finding safe water to use when brushing your teeth, washing (and swimming).

Salads, vegetables and fruits washed in local water should also be avoided, as well as and water-based products such as ice cream.

Check destination information on the Internet to find out in which countries you are at risk from inadequate sanitation and contaminated water.

Sites such as www.tripprep.com and www.cdc.gov are good sources of information. However, the main danger areas are:

- The Indian subcontinent

- Africa

- Mexico, Central and South America

- Russia and the former USSR countries

- Asia

There are five basic ways to get clean water. Buying bottled water, and either boiling, distilling, filtering or purifying water from local supplies.

Robert Sangster’s book here is a good place to find more information.

Bottled Water

Generally easy to find and sold in various sized plastic bottles. Other bottled drinks are somewhat safe and routinely drunk by travellers.

Bottled water can be expensive, but the main problem, though, is availability. It can’t always be found everywhere you go (or when you want or need it), and even if do find it you can’t be sure that it is really safe. Anyone can fill an old bottle with tap water, reseal it and sell it to you.

The worst thing about bottled water, however, is the hundreds of unrecycled plastic bottles that get dumped or left behind.

Boiling

Boiling water for a minute or two is the best method for eliminating infectious agents. Also the best method to use when making tea, coffee, and soups.

While boiled water is safe, it should not be relied upon as the sole source of drinking water as you won’t always have access to a stove or pan.

Distillation

Distillation involves a unit that boils water and then condenses the steam into a clean container, leaving nearly all of the solid contaminants behind.

This will kill and remove bacteria, viruses, cysts, heavy metals, and other particulates, more so in fact than any other system.

Useful if you can’t tolerate or don’t like the taste of iodine, or for long-term travellers (where using iodine for extended periods may cause problems. See below).

Most systems do need electricity to work, however, although there are some non-electric systems out there. They are also quite slow to produce clean water, as well as being heavy and bulky.

They also leave scale behind, which means that the distillation apparatus be frequently cleaned.

Filtration

Water filtration devices work by forcing water through materials which screen out particles. What gets filtered out depends on the size of the pores in the material used.

Filters of about 0.2 microns will remove dirt, bacteria and parasites, but waterborne viruses, such as hepatitis and polio, are 0.04 microns or smaller so may not be removed, and the water will need subsequent boiling or chemical treatment.

Filtering doesn’t change the taste of the water, however, and there is no need to wait. You can clean and reuse filters so it is also cheap.

Again this is a good solution if you are sensitive to iodine or where viruses might not be a problem, such as for backcountry use in the U.S. and Canada. Also can be used where the user has had all the vaccination for local viruses.

Mechanical filters can, however, be bulky, heavy, and hard to use for less experienced travellers. Filters can become clogged and if further chemical treatment is needed the cost per gallon increases.

Purification

Water can be purified with one of a number of chemical additives. The most popular is iodine, either in tablet or liquid form. Chlorine and silver are alternatives.

Iodine is used by putting 2-3 drops or a couple of tablets in water and letting it stand for about 30 minutes.

The dosage must be doubled for very cold water (e.g. from mountain streams).

Tablets and liquids are very compact and are good for short-term use or with filters.

Regular iodine stains badly (if it leaks in your bag) but you can find uncoloured (as well as regular) iodine in some places, for example, in pharmacies around the world.

With iodine the water has a chemical taste (as it does with chlorine) which some find objectionable, and is coloured, although both the colour and taste can be removed by adding vitamin C (orange juice, for example) to the water, but only after the waiting period is over, otherwise the iodine will be neutralised.

There is some debate over the safety of iodine for long-term use and what is a safe maximum dose to ingest over and above the recommended daily amount. Reports of serious side-effects are few and far between, however. A 1998 study published in the Lancet described thyroid problems in a group of Peace Corps workers in Africa which was linked to their use of two-stage iodine-resin filters as their only water purification method for over two years. Then again a study in the 1960′s of Florida prison inmates who were given iodinated water for up to 15 years showed no such problems. Those with thyroid problems, pregnant women, or those with a sensitivity to iodine, might want to consider alternative solutions, however.

Read more about it here, especially the ‘Recommendations for Iodine Use in Water Treatment’ section.

Other approaches

A combination of methods works well. Some travellers (including myself) carry personal water purifiers which both purify and filter the water at the same time, and generally does it a lot quicker than with iodine alone.

Most purifiers use iodine as the active ingredient as part of a filter cartridge. The filtration process removes the larger, hard-shelled creatures such as Giardia and Cryptosporidium, then the water passes through an iodised resin bed, where bacteria and viruses are deactivated. Some systems incorporate a carbon filter at the final stage of purification. These filters absorb traces of residual iodine and greatly improve the flavour of the water.

The most convenient method I have found so far, and one which I thoroughly recommend, is the Aquapure Traveller Water Bottle. You can fill the bottle from ANY water source, streams, ponds, rainwater barrels, and obtain safe, palatable, clear, odourless drinking water. It kills viruses and bacteria and removes parasites such as Cryptosporidium and Giardia. Read more about it here, or watch the video:

As a backup I also carry a Steripen (the Adventurer model). This is an amazing product, it is an ultra-light UV water purifier that destroys 99.99% of the bacteria, viruses and Giardia in water. It emits UV light which purifies 16 ounces of water from any source in under 1 minute (32 ounces in 90 seconds). You can use regular camera batteries to power it but I bought the optional solar charger which means I can go anywhere in the world and not worry about drinking the water. I bought both the Steripen and the solar charger in the US but you can also buy them in the UK.

Another device (used by the US military), is MSR’s MIOX Purifier which creates a dose of mixed oxidants (MIOX) that is then added to the water to inactivate bacteria, Giardia and Cryptosporidium, (which iodine won’t kill). It runs on common camera batteries and uses regular salt to operate, and needs no maintenance.

Facilities for keeping clean while travelling vary greatly. Guesthouses and hotels may (or may not) have showers, sometimes you . . . → Read More: Keeping Clean]]>

Facilities for keeping clean while travelling vary greatly. Guesthouses and hotels may (or may not) have showers, sometimes you may get hot and cold running water, sometimes it may be just a tap and bucket of hot water. There is no guarantee that the water you use is clean either.

Keeping your hands clean is probably the easiest way to keep healthy in some countries, although this can be hard to do if you aren’t close to fresh water and soap for most of the day. Keeping your hands away from your mouth and eyes will help (especially after handling well-thumbed bills), as well as stopping any nail-biting habit.

Some countries don’t use toilet paper in the toilets, they just aren’t designed to handle it. If you use it you are supposed to put it in the bin provided. Locals use a tap, a bucket, and their left hand. Whichever method you use, it pays to keep a bar of soap handy wherever you go.



A better way to keep clean is to keep a bottle of hand sanitizer gel with you (and use it) at all times. If you use gel you don’t need soap or water so is really useful where both of these are scarce (you can also use hand wipes but you will go through these quite quickly which can get expensive).

Sanitizing gel should be used before eating and drinking (or after touching suspect surfaces). To be effective gels require a 60% minimum alcohol concentration to kill most harmful bacteria and viruses.

You can carry a small bottle around with you (they come in travel sizes), either in your pocket or clipped to your belt or bag. These clips can be bought anywhere, for example, here.

A far better solution is to buy a purpose-built hand sanitizer gel dispenser (shown right). These are the ones used in hospitals and contain 50ml of 70% ethyl-alcohol gel and are refillable so you can use your own gel if you prefer.

They are light and compact, are easy to carry and use, and are always on hand. You can carry them on a lanyard or clipped to waistbands, belts, bags or pockets.

They can be very hard to get hold of, however, and can be expensive if you want to buy just one. If you can’t find one then email me as I can get hold of them in the US or the UK.

You use them as illustrated below. Just flip the dispenser and push, and a small, measured dose of gel comes out, then rub your hands together for a few seconds and the gel evaporates and that’s it.

Inadequate sanitation and contaminated water are the leading cause of stomach upsets in travellers.

Unfamiliar foods, changes in routine, . . . → Read More: Problems With Digestion]]>

Inadequate sanitation and contaminated water are the leading cause of stomach upsets in travellers.

Unfamiliar foods, changes in routine, diet, all can cause digestive problems.

While some are are not life threatening, they are still annoying and can make you feel sick for several days.

Traveller’s diarrhea

Found – common amongst visitors to the developing world.

Cause – usually caused by unfamiliar bacteria and sometimes even anxiety. Generally, lasts a few days and no great problem.

Treatment – best to let normal diarrhea run its course, drink plenty of liquids, eat no solid foods on the first day. On the second day eat bland foods (toast, soup, rice, bananas).

Recent research has shown that one dose of an appropriate antibiotic such as Cipro or Noroxin, combined with two Immodium AD tablets, will effectively treat more than 90% of cases of traveller’s diarrhoea. If you do get symptoms of traveller’s diarrhoea, which may include watery or loose stools, fever, nausea, and malaise, immediately take the appropriate antibiotic with Immodium. It can limit the period of being sick to an hour or two, instead of being sick two to three days longer.

Prevention – good hygiene.

Food poisoning

Found – worldwide. (I got it in Spain. I passed out at the main railway station in Barcelona and woke up in the emergency room).

Cause – unknown or undiscovered agents cause most cases. Known causes are infective agents such as viruses, bacteria, and parasites, or toxic agents such as poisonous mushrooms, improperly prepared foods, or pesticides on fruits and vegetables. Poor sanitation when preparing food, improperly packaged or stored food.

Symptoms – depend on what was ingested. Nausea, vomiting, abdominal cramping, and diarrhea within 48 hours. Then fever and chills, bloody stools and dehydration possibly to follow.

Treatment – do not eat solid food while nauseous or vomiting but drink plenty of (clear) fluids (not caffeinated or alcohol). Then bland solid foods when liquids are tolerated. Seek medical advice if in a developing country.

Prevention – safe shopping, storage, thawing, handling, preparation and cooking of food. Good hygiene.

Rehydration therapy

In case of dehydration due to severe diarrhea and vomiting, rehydration therapy is recommended. The two types of rehydration therapy are intravenous, performed with a salt/sugar/water solution in the hospital, and oral, which can be done anywhere.

Oral rehydration solution consists of:

water: 1 quart or 1 liter

salt: 1/2 level teaspoon

sugar: 8 level teaspoons

sodium bicarbonate (baking soda): 1/4 teaspoon

The sugar aids absorption of the water and salt. Sodium bicarbonate isn’t necessary if unavailable. Be careful with measurements as too much salt can increase dehydration. Dispose of unused solutions after twenty-four hours since bacteria may multiply. Patients should drink more solution as able. A gallon or more may be needed. Commercially prepared solutions to which you just add clean water are available from pharmacies.

Constipation

Found – worldwide. Common amongst all travellers.

Cause – usually a change in routine and diet.

Prevention – drink plenty of fluids, and eat lots of fibre or roughage.

The sun is very intense in the tropics and at higher elevation. For every 5000 feet (1500 meters) in . . . → Read More: Problems With The Sun]]>

The sun is very intense in the tropics and at higher elevation. For every 5000 feet (1500 meters) in altitude gain, UVB radiation increases by twenty percent.

Travellers should wear a hat with at least a three-inch brim all around, and use sunblock with a sun protection factor of at least fifteen.

Wear sunglasses with ninety-nine percent UVA/UVB protection, and protective goggles are a must for preventing snowblindness at altitude.

Heat and humidity

Unacclimated travellers run a risk of heat exhaustion or heat stroke if they try to do too much, too soon. Also, pricky heat may be a problem.

If you are AC-addicted or from a cool climate, use caution and allow time. Soon the hot environment will seem cooler. Knowing your body is adjusting should be a comfort. In one to three weeks the body gradually acclimates to heat through a physiological process.

Prickly heat is a red rash which occurs under clothing. It has a moderate prickly feeling, and goes away after a day or two.

Prevention – travellers may be able to partially acclimate themselves to a hot environment like Egypt by taking daily saunas for a week or two before departure, gradually building exposure levels.

Treatment – high humidity is the worst aspect of the tropics for many travellers. Wear loose cotton clothing and drink lots of clean water. A wet bandanna around your neck or forehead provides good cooling. Prickly heat is assuaged by cool showers, cold water sponging, calamine lotion, and loose-fitting, breathable clothing. In my case clothing should also be well-rinsed of detergent, which is harsh in developing countries.

Heat exhaustion

Cause – overexposure to heat by a non-acclimated person, or insufficient water or salt intake by any person.

Symptoms – fatigue, dizziness, nausea, headache, and possibly muscle cramps.

Treatment – rest, shade, and drinking water at a slow but steady rate, including water with a weak salt solution of approximately 1/4 teaspoon per eight-ounce (1/4 liter) glass. Cool the body with water, wet towels, and a fan, if possible. If the victim becomes unconscious, feet should be raised twelve inches above the head.

Heat stroke

Cause – untreated heat exhaustion. It often results in rapid death due to a breakdown of the body’s heat regulating mechanisms. Body temperatures can reach soaring levels.

Symptoms – a cessation of sweating, shallow breathing, hot, dry, and flushed skin, unconsciousness, and if conscious, disorientation or stupor.

Treatment – should be immediate. The victim should be placed in shade and his body cooled as quickly as possible. Remove all clothing and wrap him in wet towels, or sponge the body continuously with cool water. Direct a fan at the victim. If unconscious, raise feet twelve inches. If conscious, give the victim water, preferably with 1/4 teaspoon salt per eight-ounce (1/4 liter) glass. Medical help must be summoned.

Some problems with the cold aren’t necessarily associated with cold temperatures, for example, hypothermia.

Hypothermia

Cause – a life-threatening . . . → Read More: Problems With The Cold]]>

Some problems with the cold aren’t necessarily associated with cold temperatures, for example, hypothermia.

Hypothermia

Cause – a life-threatening condition defined as body temperature below 95 F (35 C).

Temperatures do not have to be extreme to cause hypothermia, since water and wind can combine to rapidly chill a person. Most deaths from hypothermia occur in well-above freezing temperatures.

Symptoms – a pale, drowsy, confused, and cold victim. She may become unconscious.

Treatment – consists of seeking immediate medical help and warming the victim. Warm drinks are effective, as well as hats, blankets, emergency aluminum blankets which reflect body heat, and, of course, warm shelter. Remove wet clothing.

Prevention – wear warm clothing in insulating layers, a windproof/waterproof shell, and a hat. An aluminum reflective space blanket should be in every traveler’s pack. Avoid cotton clothing in cold, wet conditions.

Frostbite

Treatment – must be immediate. Warming affected areas. Massage is not helpful, but placing feet and hands under armpits is. If warm water is available, place the affected areas in it. The water should not be hotter than 110 F (43 C). Remove constricting clothing, rings, and watches. Don’t warm affected areas with direct heat, such as from a lighter. Don’t allow someone to walk on a frostbitten foot, unless it’s necessary for survival.

Infected wounds

Cuts, blisters, and other wounds can become infected very fast in the tropics due to the rich . . . → Read More: Other Medical Problems]]>

Infected wounds

Cuts, blisters, and other wounds can become infected very fast in the tropics due to the rich microbial environment.

Treatment – thoroughly clean wounds, and to treat with an antiseptic such as tincture of iodine, which also kills viruses. Keep wounds covered with a clean bandage and recheck. Double-strength triple antibiotic ointments such as Neosporin are also helpful.

Rashes

To combat itching from stings and plants in the tropics, be sure to have antihistamine pills and a tube of 1% hydrocortisone anti-itch cream.

Prevention – a layer of clothing and shoe leather.

Treatment – take immediate action by washing the affected area with water, beer, or spit. Run water over it for ten or more minutes if possible. Then disinfect with soap or alcohol. In the tropics you risk infection by scratching severe itches. Benadryl antihistamine pills and 1% hydrocortisone cream works well.
Blisters

Treatment – at the first sign of a “hot spot,” take action. The sooner the healing process begins the better. A piece of Compeed works, as well as Duct tape, Moleskin, and a liquid product called NuSkin also work.

Prevention – keep a thick pair of socks (such as Thorlo) in your pack in case blisters develop. Can become easily infected in the tropics, so be extra careful to avoid them, and keep them clean and disinfected when they develop. If you decide to pop a blister, use a sterilized needle and apply antiseptic. Cover and check regularly.

Foot infections

Treatment – Lotrimin AF (clotrimazole) antifungal solution can be used to treat athlete’s foot, ringworm, and other unusual skin infections which may crop-up during extended tropical travels.

Links to the suppliers of the travel gear I use and recommend can be found through out this site. . . . → Read More: Suppliers]]>

Links to the suppliers of the travel gear I use and recommend can be found through out this site. Here is a list of those suppliers on one page.

I don’t work for any of the companies listed, neither do I receive any money from them to list them here. The list changes all the time as I add new suppliers and test out new gear.

I buy my equipment from companies on both sides of the Atlantic (I am both British and American). US-based companies and website links are preceded by and those in the UK by

For example, most of the things I buy I get from Amazon US or Amazon UK.

When I am in the States I frequently shop at REI (Recreational Equipment Inc.), and have bought equipment from them online too. All the products have been high quality, including their own brand. You can also become a member of their cooperative by paying a small joining fee which entitles you to an annual dividend (about 10% of what you spent with them the previous year).

I have bought equipment online from Magellan’s International Travel Inc (based in California). They have a US website and a UK website. I order mostly from the UK website as if they don’t have what you want they can get it quite quickly (I assume from the US).

Another supplier with websites for both the US and the UK is Tilley Endurables. I have bought hats and travel underwear from this company and am very happy with both. Everything is very good quality and worth the little extra it may cost.



I bought my main travel pack, the MEI Voyageur, directly from the manufacturer, you can read about them here. The website has their email address but you can also contact them by clicking here: mei-legacy@netscape.com

I bought one of Kiva Design’s lightweight backpacks for carrying small amounts of shopping and sometimes laundry. It packs away really small in its own stuff sack and fits in a pocket or clips to a belt.

A good clothing store where I shop in London is Rohan. They also sell travel accessories and have an online store.

As well as being a travel equipment supplier both in their stores and online, Nomad have a travel clinic which gives advice on travel health and can give vaccinations and supply you with malaria pills.

Craghoppers don’t have their own store but many stores stock their excellent gear. They also have an online store from which I have bought equipment before.

Other US suppliers I have used are Campmor for camping equipment, and Sierra Trading Post, an online outlet mall for clothing and equipment.

All my hammock requirements are met by Hennessy Hammocks, I have the Ultralite Backpacker model.

You can find Eagle Creek gear in a lot of other stores and websites but they also have their own online store. I like their money belts and pouches (I have two).

For water purification I use products like the Aquapure Traveller water bottle and the Steripen handheld, pocket-sized water purifier.

The MIOX water purifier is supplied by Mountain Safety Research. They also make some great stoves, tents and other gear.

Good knives and other tools are supplied by Leatherman and Victorinox (Swiss Army knives) and can be bought anywhere.

If you need to buy gear, get it from the classifieds, craigslist, ebay, buy it used, or borrow it . . . → Read More: Tips for Saving Money]]>

If you need to buy gear, get it from the classifieds, craigslist, ebay, buy it used, or borrow it from friends.

Stay in hostels, rather than hotels. Stay in a tent, rather than a hostel.

Take a train instead of a plane. Walk or get the bus instead of taking a taxi. Hitchhike instead of taking a train or bus.

Don’t buy water, use a plastic bottle filled and topped up with tap water.

Don’t eat out in restaurants every day, especially in Europe. Supermarkets and bakeries are so much cheaper and the food is often better (than McDonalds, for sure).

You can cook for yourself in hostels, and, if camping, you can use a stove to make some great meals.