Staying healthy abroad

1. Acclimatize

• What ever kind of medicine you take, do keep in mind that for hundreds and hundreds of years people still get ‘tropical frenzy’ (due to food, climate, tiredness, new impressions etc). Take into account that some people just cannot stand tropical conditions. This is something you don’t have to be ashamed about.
• On your arrival take it easy for a few days, so that you can adjust to the new conditions. Do not start doing heavy duties, make sure that you have a relaxed program.

2. Travel sickness

• Anti-motion sickness pills are usually indispensable in every medical box, even though you think that you might never get nauseous. A bus ride through the mountains of Nepal, a boat ride in a tropical storm or a flight during rough weather can even break the toughest guys.
• Also the fact that you will be able to read a book on an eight hour bus ride on a winding road will make anti-motion sickness worth carrying with you.

3. Sun, heat and dehydration

• A basic rule for travelers who are going to travel to the tropics is that you need to drink a lot of water, this way you will avoid a lot of problems.
• Make sure that you urinate enough. This is the best indicator for dehydration. Diarrhea is an important cause for dehydration. A package of Oral Rehydration System (ORS) can create miracles. If you suffer from dry eyes during your flight, bring some cucumber slices and put them on your eyes, or you can buy sleeping glasses/eye mask.

4. Sun allergies & Sunburns

• In countries near the equator, such as Australia and Indonesia, there are very big chances of getting your skin burned. Every skin gets burned if it is exposed too much to the sun. How long it takes for this to happen depends on what kind of skin you have and where you are (in the mountains and around the equator the sun is much stronger).
• The sun protection factor (SPF) of sunscreen indicates how long you can stay in the sun. You can extend your exposure by applying more sunscreen. For the first few days, your skin will burn within 5 minutes without sunscreen. With SPF 15 sunscreen, you can stay in the sun for about 75 minutes without burning too much. Don't take unnecessary risks while traveling; for your own health, make sure you've applied enough sunscreen. Carrying a backpack isn't pleasant when you're sunburned.

5. Sunstroke

• Heatstroke occurs when your body is overheated by the sun's heat. Heatstroke usually occurs from being active in the sun on a hot day, leaving your head and/or body unprotected from the sun.
• Symptoms: Headaches, dehydration, Nauseous / throwing up
• Treatment: Get the person out of the sun, cool them dow, drink a lot, or use ORS.

6. Food

• Do not eat vegetables or fruits that are not washed. You might come across it during your journey.
• You might consider the possibility of becoming a vegetarian or being very selective with where, when and what kind of meat you eat.
• Make sure that you always have enough food when you are traveling (it can happen that during a slow bus ride, slow boot ride, closed shops or restaurants you find yourself short of food or drinks).

7. Drinking water and water purification

• Purifying water has become less and less necessary. Even in the most remote areas, you can buy bottled water. They might not be cheap but water is some that you do not economize, especially in tropical areas, drinking water is very essential.
• Are you going to the jungle or to mountainous areas, climbing a volcano or are you going to an island where they have limited water supplies, a water purification equipment is the best way to purify tap water.

How can you purify water?

• Chlorine based drops or tablets are the easiest way to purify water, but it will make the taste different from normal water. Chlorine purifies water from viruses and bacteria’s, but not from (all) parasites. Micro infiltration can be used as well to purify water.

8. Infections, accidents, Wounds

• If you are going on a trip to a remote and primitive area it is very convenient to have a variety of antibiotics with you. Discuss with your doctor which ones are the best to take with you.
• Small skin wounds can grow into bad infections in the tropics. Treat every wound that you might get very well. Protect infected wounds well from any type of bacteria. If the wound is still there after a couple of days it is best to take antibiotics.

9. Ticks

• When traveling, be aware of ticks. Ticks can be found in forests, gardens and parcs and can bite into your skin. If a tick is long enough on your skin, you can obtain diseases such as the Lyme disease, CEE or RSSE encephalitis, Ehrlichiose and Fièvre boutonneuse.
• You can protect yourself from ticks by wearing long sleeves and pants and by using anti-tick spray on non-covered body parts. Always check yourself after spending a day in the forest or on the beach, as young ticks can only be 1 mm.
• In case you find a tick on your body, remove it with a special tick picker or a tick spoon. Make sure to not damage the tick, as the tick can still inject its poison into your skin

When to get vaccinations for yellow fever when you go abroad?

• Yellow fever is a potentially fatal disease carried by certain mosquitoes in parts of South America and Africa. If traveling to these areas you should check with your travel clinic or doctor whether a vaccine is required. Yellow fever vaccine is only available from approved medical practitioners and must be given at least 10 days before traveling to infected areas.
• Yellow fever is contagious and can be spread by infected travelers, so if you are traveling to a country where yellow fever is a risk, you may need a certificate showing proof of yellow fever vaccination. Without this certificate you may be refused entry to some countries, or required to be vaccinated upon arrival.
• If you have stayed overnight or longer in a declared yellow fever infected country in Africa or South America, within six days prior to your arrival, you will require a valid international yellow fever vaccination certificate.
• The World Health Organization closely monitors reports of yellow fever infection and periodically publishes a list of countries where the disease occurs.

When to get vaccinations for diphtheria, tetanus and polio when you go abroad?

• Vaccination and validity: always recommended for far away destinations and Eastern Europe (also in East Europe)
• Last minute travelers (=two weeks before departure) who have not received a standard vaccination before: 2 weeks before leaving there are 2 possible injections left. They protect you for a maximum period of 8 months.
• Last minute travelers who are not going to diphteria endemic areas: If the trip is shorter than two months it is not necessary to get a DTP vaccination, except for persons who have never received the vaccination before. If your trip is shorter than 8 months only persons who have received just one DTP vaccination need an extra one.
• Background information: Diphtheria is a common disease in certain countries. This bacteria can cause a seriously swollen throat that makes it more difficult to breathe. If this bacteria gets into the blood it can infect the heart and can lead to death. The bacteria can also cause serious skininfections, although this form of dipthteria is less serious. It is highly recommended get a vaccination against this disease.
• Tetanus is found everywhere around the world. You can get this disease through street dirt, soil, manure or dust getting in a wound. When this happens the poison substances can cause the muscles all over your body to cramp. It can even cause breathing problems leading to death. A vaccination again tetanus every 10 years is recommended.
• The polio virus is highly contagious. It is passed on through faeces, contaminated food or drinking water. Polio is very common in places of less hygienic places, such as certain areas in Asia and sub-Saharan Africa. Contamination with the polio virus can cause permanent paralysis of the muscles. If it has been more than ten years since you have had your last vaccination against polio you need another vaccination before you leave.

When to get vaccinations for hepatitis A when you go abroad?

• Vaccination and validity: Recommended when traveling to almost every far away destination. The gamma globulin injection is only effective for a few months and works passively. Nowadays you can also get a vaccination called Epaxal. It works actively for a minimum of 10 years and maybe longer. You can also get a vaccination of Hepatitis A+B (Twinrix) all at once.
• Background information: Hepatitis is a liver infection caused by bad hygiene or transmitted by infected water or food. It does not only exist in the tropics, but also in Turkey and East Europe.

When to get vaccinations for stomach typhus when you go abroad?

• Vaccination and validity: Often recommended for Asia and Latin America. There is a medicine that you can swallow and an injection.
• Background information: It is a life threatening disease of the gastro-enteric channel. This disease is caused by the Salmonella typhus bacteria. This is an infection related to bad hygienes. If you have had your vaccination, it will only protect you for about 70-90%. Therefore, you still need to be careful with what you take in.

When to get vaccinations for hepatitis B when you go abroad?

• Vaccination and Validity: a form of jaundice. Only high risk groups, (such as doctors, certain expats, and people who have intercourse with different partners) and travelers who are traveling longer than three months in an hepatitis B area need to get this vaccination. It is also possible to get the vaccination for Hepatitis A+B at once.
• Last minute: It is possible to get an accelerated injection, although this does not give similar protection.
• Background information: Hepatitis B is caused by a virus spread through blood to blood or through sexual contact. For example non sterile applied piercings, tattoos etc.

When to get vaccinations for Japanese encephalitis when you go abroad?

• Vaccination and validity: Recommended for people who are going to the countryside in the area between India and Japan.
• Background Information: Japanese encephalitis is a virus infection that is spread by by mosquitoes. People who are staying on the the countryside for a longer period during the season when the disease is spread run a higher risk.

When to get vaccinations for tuberculoses (TBC) when you go abroad?

• Vaccination and validity: sometimes recommended to people traveling for a long time to areas where TBC can reign.
• Details: The procedure is very complicated. Therefore, consult your personal doctor.

When to get vaccinations for rabies when you go abroad?

• Vaccination and validity: Only recommended to around the world travelers and expats.
• Details: expensive vaccine

When to get vaccinations for meningitis when you go abroad?

• Rarely given vaccination and hardly ever recommended

When to get vaccinations for cholera when you go abroad?

• This vaccination is very rarely given, but some countries do ask for a vaccination stamp. This stamp is available at any vaccination institute.

What is heatstroke, and is it dangerous?

• Heatstroke occurs when your body is overheated by the sun's heat. Your body temperature rises above 40 degrees Celsius during heatstroke.
• Heatstroke usually occurs from being active in the sun on a hot day when your head and/or body are unprotected from sunlight.
• The risk of heatstroke is higher if you don't drink enough. In dry conditions, you sometimes lose a lot of fluids without realizing it, and your body can no longer regulate your temperature.
• In high humidity, such as in the tropics, your body can also overheat more quickly.
• If the early signs of heatstroke, such as dizziness, confusion, and nausea, are ignored, heatstroke can be life-threatening.

What can you do to prevent heatstroke?

• Adapt your activities to the temperature and humidity. On hot, sunny days, it's best to avoid exercising or walking in the sun between 12 and 3 PM.
• Covering your head with a cap or hat significantly reduces the risk of heatstroke.
• Drink plenty of fluids. When you sweat a lot, you need extra salts in addition to water to maintain your fluid balance.
• During heatstroke, the person experiencing it is often not very sharp and alert, so it's important to take good care of each other.

How can you treat heatstroke?

• A person with heatstroke has a high body temperature, so the entire body needs to be cooled.
• Remove the person from the sun and remove excess clothing.
• Cool the body with water and/or moving air.
• Heatstroke is also dehydration: give them water, juice, or, if available, an ORS solution.