Over the last 5 years I have travelled to Cambodia for 4-5 weeks annually to do medical volunteer work. Back in my home country of New Zealand I am a registered medical practitioner. When I’m in South-East Asia I enjoy the wonderful tropical fruits and local street foods but I try to be sensible so as to reduce my chances of getting sick. The following are my tips for staying well and for what to take if you get a tummy bug or a minor allergic reation. You may have heard some of these tips before but they are worth repeating.
– in most developing countries you can’t drink the local water. It’s usually OK to clean your teeth with but always spit it out. Buy bottled water and make sure the seal on the bottle is good.
– preferably eat fruit that you can peel yourself. If you buy pre-peeled and chopped fruit from a street stall you are taking a risk, especially if they are handling money as well as the fruit.
– carry some hand disinfectant with you. When travelling you’re sure to have to use some bathrooms that are less than hygienic.
– when eating at a local restaurant or from a street stall choose one that is obviously popular with the local people. If they’re busy it shows that the people have eaten there at least once before and haven’t got sick.
During your trip you’re likely to get a touch of “gastro” despite your best efforts to be hygienic so the following are some VERY useful medications to get from your doctor before you leave home.
– Loperamide tablets to stop/settle diarrhoea. It’s fantastic stuff and it’s literally saved my butt multiple times! If you get diarrhoea with blood mixed in with it then you likely have a more serious infection and you need to see a doctor.
– Electrolyte powder (though you can always buy this from a local pharmacy) to mix with bottled water to replace fluids you have lost through diarrhoea and/or vomiting. Coconut water is also an excellent natural electrolyte replacement.
– An Anti-emetic (preferably the one that is absorbed from under the top lip like Buccastem rather than swallowed) for nausea/vomiting. Once vomiting has started it may be impossible to keep an oral tablet down, so that is why the “buccal”(meaning cheek) tab is more useful. They usually cost a bit more but I always get them.
– On my latest trip to Cambodia I did have one nasty bout of diarrhoea and vomiting which lasted about 8 hours. I was travelling alone and I felt extremely weak and unwell during this episode. It made me realise the importance of having a local cell phone Sim card so I could let my friends know I was unwell and vulnerable. You really don’t want to be alone when the shit is literally hitting the fan!!
– Non sedating Antihistamine Tablets. They help to settle down reactions to mosquito and other insect bites,as well as mild allergic rashes. It is possible that you could have an allergic reaction to a new food or plant that you don’t have at home, so having anti-histamine tablets with you is really a good idea. N.B Any shortness of breath or swelling in and around the mouth (Angioedema) indicates a more serious allergic reaction and you would need medical attention immediately.
– I also like to have some anti-inflammatory cream (e.g Locoid Lipocream) with me as I find it helpful in settling down my reactions to mosquito bites. Also good for settling inflamed skin due to chaffing in the heat, and the odd haemarrhoid!! It may be my imagination but I do believe it helps my sunburn too.
– Take some Paracetamol or Tylenol for the odd headache or random pain. You could buy it locally and probably a lot cheaper but there is always the concern in developing countries as to whether drugs are genuine or knock-offs.
– Generally it is not the best idea to take an antibiotic because it may not be specific enough for a particular infection. Broad-spectrum antibiotics promote bacterial resistance. If you have a chesty cough with shortness of breath, or a wound that is getting hot and red, it is best to go to an international medical clinic if you can. Which leads me to the next point….
– never travel overseas without travel Insurance. N.B many credit card companies offer free travel insurance when you purchase the bulk of your travel expenses i.e flights, with their card.
The photograph above is the food court at the Russian Market in Phnom Penh, Cambodia where I ate lunch most days.