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Practical Suggestions on Health Care
Edited from a compilation by Marianne Rev, M.D.

Many foreigners experience some stomach upset and diarrhea when traveling - particularly when visiting tropical, less developed, or rural areas. The reason for this is not completely understood, but it is thought to be secondary to a change in the type and quantity of the bacteria that normally inhabit our gastrointestinal system. The change in climate, types of food, stresses of traveling, as well as being in a strange environment, are probably all contributing factors.

How You Can Minimize Getting Significant Diarrhea

  • Drink purified water (bottled, boiled, or treated with "Halazone") if in an area where tap water is questionable.
  • Make sure you ask for drinks without ice (may not be made from purified water).
  • Use iodine tables or "Iodo" for soaking vegetables and fruits that cannot be peeled, for at least fifteen minutes. (Liquid "Iodo" is better than tablets - no dissolving time.) Purified water does not alone kill microorganisms on fruits, vegetables, etc. (Don't drink water with high "Iodo" content!)
  • Avoid, at all cost, ready-made custards and foods made with mayonnaise (e.g. potato and chicken salads, cream cheese, etc.) as they are the most common transmitters of food poisoning (salmonella, staphylococcus). Avoid eating from stands where meats and dairy products are kept in the open in the heat of the sun for long periods of time.

When You Have Diarrhea

  • Stop eating! Give your body a rest! You can live for a couple of months without solid food, but you can only live 24-36 hours without water (or fluids of some sort). When you have diarrhea, your body is losing lots of water and certain salts--the chief one being potassium. Try the following feeding suggestions for at least 3 days:
  • First day: Clear fluids alone. Examples: water, clear soup, weak lemon or plain tea, flat ginger ale, Coca Cola or Pepsi. Pop is especially good because of its salt content (sodium, chloride, and potassium). Allow the gas to escape before drinking, it's easier for the body to handle. NO MILK!
  • Second day: You may add dry toast, mashed potatoes (without milk or butter), baby foods (e.g. mashed bananas, etc.).
  • Third day: You may add boiled meats, cooked vegetables, and cooked fruit. Milk, other dairy products, fresh fruit, fresh vegetables, and fried foods should be the last foods to be added.

When You Should See a Qualified Doctor/Paramedic? When you have:

  • Severe abdominal pain (especially if localized in one area).
  • Repeated vomiting, along with diarrhea.
  • Severe diarrhea that is blood stained, or passing of blood and mucus.
  • Accompaniment of fever for more than 24 hours.
  • Diarrhea that doesn't subside after 4-5 days of the above-mentioned conservative treatment.
  • Don't run to your local pharmacy for all sorts of constipating agents and antibiotics that may mask your real problem and expose you to further and possible more serious illness!

Health Care Hints for Home & Away

  • Avoid "Entero-Vioform" and "chloramphenicol." Entero-vioform is a constipating agent that has been removed from the North American market several years ago because it has been proven to have potentially dangerous neurological side effects.
  • If you need injections, request that a disposable syringe be used.
  • Avoid blood transfusions unless critically necessary. Plasma or glucose are less likely to be contaminated.
  • Wear shoes or sandals at all times! Many protozoa, fungi, and worms enter the body through the skin. These parasitic organisms are common in most areas of the world. Don't go barefoot!

Colds and sore throats are common. When should you be concerned?

  • When you have accompanying fever lasting more than 24 hours.
  • When you have swollen glands around your jaws, ears, and/or neck.
  • When you have severe sore throat lasting more than a few days.
  • When you have accompanying earache, loss or diminution of hearing, or discharge from ear(s).
  • When you have accompanying painful and very tender sinus(es), and/or redness over sinus(es).
  • When you have accompanying moderate to severe muscular and joint pains.
  • When you have an accompanying red rash that is worse in body creases (e.g., at the elbow or back of the knees).
  • When you have accompanying cough with increased and abnormal colored sputum.

If you have any of the above reasons for being concerned, you should see a qualified doctor or paramedic as you will require a physical examination, some lab tests (throat culture and possibly a blood test), and antibiotics. Different antibiotics are required depending on location and clinical picture of the infection as well as on any individual drug allergies.

Sun Heat

If you're in the mountains (or close to the equator) you may be closer to the sun than in many parts of the U .S. and Canada. Your body will feel the effects of the sun more and with in a shorter time.

What to do:

  • Cover your head.
  • Wear sunglasses if your eyes are in direct sunlight or are exposed to reflections of the sun on sand and water for a long time.
  • Get used to direct sunlight gradually. If you are keen on tanning, but have sensitive and fair skin, use a total sunscreen initially. Any agent with 5% para-aminobenzoic acid in 50% ethyl alcohol is a good sunscreen agent (e.g., "PRE SUN "). Another good one is any agent with 10% sulisobenzone (e.g., "UVAL"). Lie in the sun for 10-15 minutes per day, initially, and increase by 10-15 minutes every couple of days. Too much sun is not good for your skin! As well as drying the skin, chronic overexposure greatly increases your risk of developing skin cancer.

Problems You May Encounter and What To About Them

  • Sunburn (suggestions for relief):
    • Cool water and cool soaks applied to the affected areas
    • Baking soda (soda bicarbonate): 8 tsp. to a liter of water; apply paste to affected areas; may be repeated as needed
    • "Solarcaine" lotion (0.5% benzocaine), a mild topical (skin) anesthetic. Note skin sensitivity to benzocaine may occur.
    • Ultraviolet burns to the cornea of the eye may be caused by overexposure to direct sunlight. About 12 hours after the injurious exposure, there are symptoms of extreme pain in the eye, especially in well-lit areas. See a doctor immediately! Until then, take some pain reliever by mouth (e.g. aspirin, Tylenol, etc.) and rest in a darkened room with eyes closed.
  • Heat Exhaustion or Prostration: Symptoms: weakness, dizziness, confusion, headache, with or without muscle cramps. Underlying Problem: salt depletion and dehydration. Treatment: cool environment, elevate feet, massage legs, drink 1-2 liters of water with 2 grams of salt in it. ( 1 oz. = 30 cc. = 28 gms.)
  • Heat Stroke (Sunstroke): Symptoms: sudden loss of consciousness, high fever, cessation of sweating, signs of shock, hot and dry skin (may be preceded by headache, dizziness, nausea, convulsions, visual disturbances). Underlying Problem: failure of heat regulating mechanisms of body. Emergency treatment-- MUST REDUCE HIGH TEMPERATURE! Place in a shady cool place, remove clothing, sprinkle with water, then fan as soon as possible, immerse in cold water or use ice packs, massage extremities (legs and arms) vigorously to maintain circulation, may require oxygen. Get a doctor immediately, or, even better, take the person to the nearest hospital emergency room! After a heat stroke, one must avoid immediate re-exposure to heat. Hypersensitivity to high temperatures may remain for a considerable time.
  • Heat Cramps: Symptoms: painful spasm of muscles of abdomen and extremities, with possible twitching. Underlying problem: salt depletion. Treatment: 1 gm. salt every 1/2 to 1 hour with large amounts of water by mouth usually relieves attacks promptly. Mace patient in a cool place and massage sore muscles. Rest should be continued for 1-3 days depending on the severity of the attack.
  • Acclimatization: You will find that in the initial weeks of your stay in places of high altitude you will tire more easily, require more sleep and become short of breath more easily. This will pass after a few weeks, once your body has made adjustments to the lower oxygen tensions.
  • Vaccinations: It is strongly suggested that you check with your physician or public health service before traveling. Consider areas you may visit on side trips as well as your primary destination. Tetanus vaccinations are always recommended (even at home). Check with health authorities well in advance before you go, as you may need to take preventatives starting weeks before you set out.
  • Good personal hygiene is a prerequisite to good health. Few public bathrooms have toilet paper. Carry some with you during your travels.

A Final Note:

  • Most people don't get sick when traveling - and many who do get sick induce it upon themselves. Exercise restraint.
  • Get plenty of rest (more than you get at home as you'll probably be more active).
  • Drink liquids. If you can take the bottle top off or peel it, you can drink or eat it most anywhere in the world. Dehydration is no fun.
  • Avoid excesses of alcohol and food, at least until your body starts to adjust to its new environment.
  • Plan ahead and build flexibility into your travel itinerary. Reducing emotional stress as well as physical stress will enable you to adjust more quickly to your new surroundings - and maximize the probabilities for a healthy, enjoyable trip.
 




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