Leaving the comforts of your familiar healthcare can be one of the biggest concerns for those considering travelling. I started travelling when I was in my teens and such things didn’t really bother me at that age. I thought I was invincible and took things in my stride. As the years have passed, I’ve become more of a worrier and can see why concerns about health prevent some people them from ever stepping beyond their comfort zone. However, in reality, your health is under threat everywhere, even within that comfort zone. There’s no panacea for perfect health. When you travel, you will encounter new risks, but, for me, those risks are outweighed by the joys I get from travel. I do, however, take lots of precautions to minimize those risks.
This post outlines some of those steps, and my tips for staying healthy while travelling. Of course, don’t use it in place of actual medical advice. Neither of us are experts! We also recommend you get some good travel insurance.
It’s advisable to book an appointment with your nurse a few months before you travel to find out what vaccinations you need. It can take time to order the vaccinations in, and sometimes you need to wait a certain period of time in-between treatments (for example with rabies vaccinations). If you’re running late and your doctors’ surgery is unable to get the vaccinations in time, private clinics such as the STA Travel Clinic can sometimes do things quicker. For example, there’s currently a national shortage of Typhoid vaccinations in the UK, but I was able to get my most recent one on the same day that I booked my appointment at STA in Bristol. I had to pay £30 (it would have been free on the NHS). For a full list of vaccinations that are free on the NHS, and ones you have to pay for, see this list.
Your nurse will tell you what vaccinations you need but you can also check yourself on the Fit for Travel website. This is an incredibly useful NHS Scotland website that provides a wealth of easy-to-understand health advice for individual countries. The vaccinations section is divided into those that are strongly advised, and those that can be considered. For example, when I went to Indonesia, I was only advised to get the Japanese Encephalitis vaccination if I planned to go to remote village areas. The choice (and risk) is up to you.
Before Steve and I went to South America, we chose to get the rabies injections as we’d heard a lot of stories about travellers being bitten/scratched by animals and have had a few close encounters ourselves. It was quite expensive at around £150 for a course of three, but we considered it worth it. Some people choose not to get the rabies vaccination if travelling to an area with good healthcare because the vaccine also works when administered a short time after coming into contact with the virus. Also note that even if you do get the vaccine in advance, you still need to get two further treatments if you come into contact with the virus (that increases to five if you didn’t get the vaccination in advance).
Steve and I have received the following vaccinations:
- Tetanus, Diptheria and Polio
- Hepatitis A
- Hepatitis B
- Yellow Fever
The Fit for Travel website is also a great resource for checking the risk of malaria in a country. It provides colour-coded maps that show which areas are high-risk, and which are low-to-no-risk. If you’re travelling to an area that is high-risk, your nurse/doctor will likely suggest you take antimalarials. The type of antimalarial recommended will depend on which ones are effective in the area you’re travelling to, as well as your budget.
In the past two years, we haven’t travelled anywhere where anti-malarials are advised, but we have both taken them in the past. I took Mefloquine (Lariam) when I went to Tanzania in 1999, Chloroquine and Proguanil during my gap year in 2002, and Malarone on a trip to Peru in 2009. These all varied in how often I had to take the tablets and for how long before/after the trip. Malarone was by far my favourite as it was the most convenient and had the least side effects (the others tended to give me crazy dreams). The problem with Malarone is that it is expensive so not such a good option for longer stays. Doxycycline is also a popular option. Whatever you do, make sure to get advice from your doctor/nurse.
We know there is a lot of controversy around whether or not it’s worth taking antimalarials, some arguing that the side effects are worse than the disease. Of course it’s a personal choice, but for us, considering the disease can be fatal, we’d rather take the pills.
Unfortunately, there is no vaccination against dengue fever. It’s transmitted by mosquitoes and is prevalent in a lot of South East Asia and other countries. The Fit for Travel site will again give you information on whether or not it’s a risk where you’re going. The risk varies depending on the time of year. I’ve known some people who got it and recovered quickly, and others who took a long time to recover. Jodi at Legal Nomads had it and didn’t realise it until months later. She’s written a good post on how and why it’s important to get treated early.
The most important thing is to try not to get bitten. Cover up during the times of day that mosquitoes will be biting and use a good mosquito repellant. Also use a mosquito net in high-risk areas.
I remember when I went off on my gap year, aged 18, I went equipped with a mini hospital in my bag. I had everything! Nowadays, I’ve cut down those supplies a little, but I still tend to go with the idea that it’s better to be safe than sorry. Other people choose to go with a much smaller load. It depends what you’re comfortable with.
I adjust my kit depending on where I’m going. For example, it’s currently very small as I’m in Berlin for a few months where medical treatment is good and readily available. I barely need anything here, but as we’re settled for a few months I like to have the same kind of supplies I’d have in my house at home. The kit gets bigger if I’m going somewhere where I know it will be harder to get medical help / supplies will be in short supply (for example in the jungle or on a hiking trip)
My basic medical kit
- Antihistamine tablets – I need these for my hayfever and allergies
- Antihistamine cream – good for bites, stings, and rashes
- Probiotics – these are a good preventive against stomach problems (but you can eat live yoghurt instead)
- Second skin blister plasters – so useful if you’re hiking, or even if you get some new shoes that rub.
- Travel sickness pills – I really need these on boats
- Antiseptic wipes
- Tweezers – I seem to get a lot of splinters
- Canestan – for thrush
- Cystitis-relief sachets – just in case
- Levonelle (morning after pill) – just in case
Extras for trips that are further afield
- Batroban – an antibiotic cream, good if you cut yourself whilst somewhere remote
- Ciprofloxacin antibiotics – good for food poisoning / stomach infections
- Oral rehydration salts – for recovery after diarrhea
- Large and medium wound dressings
- Medical gloves
- Burn gel
- Immodium – it’s best to avoid using this as it can exacerbate the problem, but is useful for emergencies (e.g long bus journeys).
- Wound closure strips
- Sterile syringes
Bar the sterile syringes, the wound closure strips, and the Levonelle, we’ve used all of these things at least once on our trip, and have sometimes needed them to help others out – for example when a friend had a terrible stomach bug in San Pancho, we could give him some Ciprofloxacin.
I also recommend the Red Cross First Aid app, which is useful for advice in emergency situations. I’m biased as I was part of the team who made the app back in my days at the charity (I wrote all the content), but it really is useful. Steve and I used it when he burnt himself in Argentina!
A lot of the health problems that travellers face are the result of the food/drinks they’ve consumed – but that doesn’t mean you can’t eat street food. It’s often perfectly safe. Steve and I only got food poisoning once during our trip around South America and Mexico, but we did get a bout in Berlin! It’s not always about how developed a country is.
A headline tip is to eat at the places that are busy and popular with locals. Also go for food that is fresh and hot as lukewarm food can harbor bacteria. My most recommended resource for tips on food safety is The Food Traveler’s Handbook by Jodi at Legal Nomads.
Water is of prime concern. Always find out if the tap water is safe in the country you’re visiting. Even in some more developed countries, it’s still not safe to drink. Also bear in mind that unclean water may have been used to wash salads or make ice. If in doubt, porous fruit / veg (for example lettuce, tomatoes, grapes and apples) are the main things to avoid
One gadget that we wish we’d taken to South America is the SteriPEN, which sterilizes tap water using ultraviolet light. This would have saved an awful lot of plastic as we had to buy a lot of bottled water. We’ll definitely get one next time we’re heading somewhere with unsafe water. In Bali, we rented a house for five months, which came with a very useful ceramic water filer, which essentially looked like two plastic buckets on top of one another with a lump of ceramic in the top one, which filtered out impurities. These are an awesome (and cheap) solution for long-term stays.
Be aware that tampons are not always readily available around the world so you may want to consider an alternative. I use the Mooncup (AKA the Diva Cup). It’s super easy to use AND good for the environment. It’s a definite win-win. Shannon at A Little Adrift has written a great review.
Wear it! I spent a lot of my teens sunbathing and getting burnt. After a little cancer scare in Ecuador, I’m now much more careful about my skin. The key thing is to stay out of the sun / cover up during the hours when it’s strongest. Wear a sunscreen that’s at least SPF15 and wear a hat to cover your face. I did try using the Riemann once-a-day sunscreen and it did prevent me from getting burnt but I also really hated the way it felt on my skin. I’m now on the hunt for an effective eco-friendly sunscreen (I’ll update you as soon as I find it!). I have found that coconut oil works only when the sun is very weak.