Several years ago, I was hiking the Annapurna Circuit in Nepal. I’d forgone hiring a guide — a questionable decision. But it was the day after climbing Thorong-La, the circuit’s highest peak and, as I looked out across the vistas and plains with only a herd of wild goats to keep me company, I felt invincible.
A feeling that lasted all of twenty minutes after I’d eaten my lunch.
The story of how I made it through the next 15 miles, shaking and sick, is reserved for close company. But I learned two things that day: First, always pack tissues. And second, preparing for the worst while traveling means more than buying insurance. A smart traveler takes steps for prevention and preparedness, with each unique destination in mind.
In hopes that you never have to face the judgmental eyes of hundreds of wild goats, here are some smarter ways to deal with feeling sick or injured while traveling.
Prevention: Know What Should You Avoid
I’ve experienced some amazing (and inexpensive!) medical care while traveling internationally. However, those hours spent in a clinic weren’t preferable to the itinerary that had been planned. Preventing an illness or injury is sometimes as simple as a little research, and could save you, at best, several days of botched vacation.
Find Out If It’s Safe to Drink the Water
We all know the importance of staying well-hydrated when on the move. But with traveler’s diarrhea, hepatitis A, typhoid and cholera among the illnesses that can be transmitted by bad water, it pays to know where it’s safe to drink from the tap.
To help travelers, the CDC has developed this handy guide to show you where drinking from the tap is ok and where you’re better off carrying around a bottle that you’ve bought.
A couple important tips include warnings to check that natural bodies of water are safe before swimming and take care not to even brush your teeth or soak dentures in contaminated tap water.
Urgently Need Water Without Any Place to Buy?
The CDC says to leave a clear bottle of water on a reflective surface in intense sunlight for at least three hours. However, this technique won’t work on cloudy water.
You can also disinfect contaminated water with eight drops of unscented, household bleach per gallon. Stir well and wait 30 minutes before drinking.
Boil It, Cook It, Peel It or Forget It!
I’ve eaten some of my favorite meals from street food stands — and gotten sick from a local California burger joint. However, eating and drinking out in developing countries comes with extra risk. For those who would rather get an adrenaline rush outside of meal time, these are additional tips from the CDC on what not to eat.
What’s Okay To Eat
- Food that is cooked and served hot
- Hard-cooked eggs
- Fruits and vegetables you have washed in clean water or peeled yourself
- Pasteurized dairy products
- Dry foods, such as bread and crackers
- Beverages in a sealed bottle or can
What You Should Avoid
- Food served at room temperature
- Food from street vendors
- Raw or soft-cooked (runny) eggs
- Raw or undercooked (rare) meat or fish
- Unwashed or unpeeled raw fruits and vegetables
- Condiments (such as salsa) made with fresh ingredients
- Unpasteurized dairy products
- Bushmeat, including monkeys, bats, or other wild game
Stay Safe On the Road
Did you know that car accidents are the number one killer of healthy US citizens traveling abroad? Always looking out for your best interest, the CDC has also compiled this guide for international driving.
The infographic lists eight steps to minimize your risks of a car crash while traveling:
- Always wear your seatbelt and make sure children are secured in a car seat.
- When possible, avoid riding in a car in developing countries at night.
- Don’t ride motorcycles. And if you must? Wear a helmet!
- Know local traffic laws before you get behind the wheel.
- Don’t drink and drive.
- Ride only in marked taxis. Be sure that they have seatbelts.
- Be alert when crossing the street, especially in countries that drive on the left.
- Avoid overcrowded, overweight, or top-heavy buses and vans.
Prevent Bug Bites
Insects such as mosquitoes, fleas, and ticks can spread some pretty nasty diseases. To protect yourself against the illnesses they carry, including dengue fever, encephalitis, sleeping sickness, and yellow fever, follow these tips:
- Wear insect repellent with at least 20% DEET to protect against bites.
- Apply sunscreen first, let it dry, then apply your insect repellent.
- Wear long-sleeved shirts and pants as often as possible.
- Sleep in places that have screens to keep out insects.
- Sleep under a bed net if you are exposed to the outdoors.
Buy Travel Insurance Before You Leave Home
If you have insurance, call your provider before your trip to see what your plan will cover out of the country. If your plan doesn’t extend overseas, or you don’t have insurance to begin with, you still have options!
Make sure to purchase a travel insurance plan that covers the areas you’ll be visiting. To find out more, read our handy guide that breaks down travel insurance options.
Check out “Choosing Travel Insurance That Keeps You Covered.”
Always carry proof of your insurance coverage when traveling. Also, tell your travel agent, a friend or relative at home, or your travel companion how to contact your insurer, just in case.
Other Prevention Tips
The CDC offers travelers an easy tool to determine what extra steps, such as vaccinations, should be taken before traveling. Visit their Destination Guide and enter any additional information that’s relevant to your trip, including whether or not you’ll be traveling with children, are pregnant, or experience a chronic illness, for the most up-to-date and tailored prevention information.
Health Concerns While Traveling
By far, the most common complaint when traveling overseas is stomach problems. Called “traveler's diarrhea,” the ailment is caused by bacteria, viruses or parasites found in local water supplies used for drinking, washing and preparing food.
If, despite taking precautions, you’ve come down with a bad stomach, the most important treatment is to get water back into your body. Drink plenty of safe fluids, including bottled water, diluted juices, and sports drinks, as soon as the problem starts.
Most cases of traveler's diarrhea will clear up in a few days. However, if symptoms persist for more than two or three days, it’s important to seek medical care.
If you’d like more information on the topic, Lonely Planet has the most comprehensive article on traveler’s diarrhea the internet has ever seen. Read it at your own discretion here.
Travelers seeking fun times are often game to try local spirits without realizing that alcohol strengths vary widely. Some drinks may even contain harmful substances.
When visiting Bali, Indonesia, I was warned to always order beers — and be sure to check the seal. Reason being, less reputable tourist bars in Kuta Beach had started diluting their shelved spirits with methanol to save money. The chemical is difficult for already-inebriated tourists to detect and had already resulted in the death of one young man.
Travelers should be aware that the contents of any bottle, even brand-name ones, may have been altered. Use your judgment when out drinking and be sure to switch to water before caution flies out the window.
Thinking of hiking up to the top of Kilimanjaro? Travelers who ascend rapidly to altitudes greater than 2500m are at risk for altitude sickness. Symptoms may include headache, nausea, vomiting, dizziness, malaise, insomnia and loss of appetite, and severe cases can even lead to death.
To lessen your chances of altitude sickness, it’s important to ascend gradually to higher altitudes, avoid overexertion, eat light meals and avoid alcohol. The recommended pace of ascension for inexperienced hikers is 500m to 1000m per day. If you, or someone you’re with, starts to exhibit trouble breathing or mental confusion, descend immediately and seek medical attention.
If you’re traveling somewhere hot, try to minimize sun exposure, especially between 12pm and 2pm. Keep kids covered up and slathered in high factor sunscreen. If they do get sunburned, apply an aftersun lotion and give ibuprofen to ease pain. If you suspect dehydration, seek medical attention.
Extra Precautions For Ladies
There are few things worse than having a yeast infection or UTI when you’re in the middle of nowhere, and a pharmacy full of Monistat or cranberry pills is nowhere in sight. Uncomfortable and embarrassing to describe to someone with limited English, you’d be surprised how often these problems crop up after long hours on hot busses, infrequent changing of clothes while backpacking, and limited (or gross) shower facilities.
Even worse, less-experienced female travelers are often surprised to learn that in certain regions, such as Asia, lady-problems aren’t particularly common thanks to local foods, like kimchi, which are rich in healthy bacteria.
Your best bet is to prepare by packing a few extra medications. However, if you’re in desperate need of assistance, visit the largest local hospital in the area and request a female physician.
If Things Go Wrong and You Need Help
If you become ill or injured and require medical assistance while abroad, be aware that standards of medical care vary greatly from country to country and even within countries. More choices are generally available in urban rather than rural or remote areas. However, options for specialized treatment may be nonexistent or inadequate in some countries.
Who To Ask For Assistance
Especially at upscale lodgings, ask the hotel concierge for physician recommendations. Some doctors will make "house calls" to your hotel. Alternatively, your best bet may be to contact the nearest medical school where you will often find English-speaking doctors and students.
The U.S. State Department provides a list of doctors and hospitals abroad. The nearest embassy or consulate in your destination should also have recommendations.
If you travel frequently, you may wish to look into becoming a member of the International Association for Medical Assistance to Travelers (IAMAT). Membership is free and grants you access to a database of English-speaking doctors and clinics around the world.
When To Seek Medical Help
Going to the doctor in your home country is enough of a pain. Trying to do so while traveling? Most of us will avoid it at any cost.
However, it’s vital to know under which circumstances you should seek medical attention. While this list is by no means comprehensive, seek medical attention as soon as possible if you:
- Have diarrhea AND a high fever (above 102° F)
- Have bloody diarrhea
- Are visiting a malaria-risk area and become sick with a fever or flu-like illness
- Are bitten or scratched by an animal
- Have been in a car accident
- Have been seriously injured
- Are sexually assaulted
Consult Your Guidebook For Local Recommendations
Since standards of care and available resources vary widely from each location to the next, travel guidebooks (my favorite is Lonely Planet) are your best resource for location-relevant information.
Didn’t purchase one ahead of time? Don’t worry! Performing a simple internet search for “Health in (your location),” will yield pertinent results.
Bottom Line, Being Sick Is No Fun
But, getting sick or injured while traveling can be even worse! Alone and away from home, dealing with discomfort while abroad is no one’s idea of a fun vacation.
Remember that, when traveling, keep emergency numbers close. If you need medical help, seek treatment urgently — it’s better to be safe than sorry. Be sure to keep a list of your important allergies and other medical information in your wallet or purse. And don’t forget to inform yourself about any bugs, viruses, diseases and other nasties you may encounter.
Finally, keep in mind that travel insurance isn’t just peace of mind. It’s real assistance when things get rough! Look at where you’re traveling, what could potentially happen, and get adequate coverage lest you end up kicking yourself that you didn’t sign up.
Have you ever had to seek medical help while traveling? Share your tips and stories in the comments below!