Thursday, 28 August 2014

How to cope with illness when travelling

It's everybody's worst nightmare; stranded in the middle of nowhere, with little knowledge of the language, and suddenly you fall ill.

When you travel, you have to accept that a certain amount of illness is part and parcel of the experience. You're subjecting your body to things you've never been near before, you'll probably be exhausting it (whether through hours on a bus or plane, or nights of partying) and you'll find that the standards of hygiene don't quite meet those back home. 

Wherever you go, you'll likely have an upset stomach of some kind. You'll be eating new food, drinking different water, and your body takes a while to adjust.

Top tips:

  • Stay hydrated. Massive cliche, I know, but it's so important! Being dehydrated makes you feel so much worse! Don't just rely on water, you need to replace salt and sugar as well. Rehydration salts are vile, but do the job, and a doctor actually recommended Coca Cola to me. Make sure it's flat (fizzy is not good on a poorly tummy) and it replaces any sugar you've lost.
  • Avoid it in the first place. When travelling in Africa, I steer clear of mayonnaise (no fridges/unreliable electricity) and fruit/veg without a skin unless it's been cooked and is piping hot. Not foolproof but it's better than nothing.
  • Don't use Imodium unless you have to. It's very handy for long journeys etc., but usually when you have an upset stomach, your body is trying to get rid of stuff. It's unpleasant, but usually best to just let it. 
  • Antibacterial gel! I swear by it when travelling, and use it whenever I feel the need. I have a pretty hardy immune system, but this helps avoid any unnecessary germs.

I've had the misfortune of health issues pretty much every time I've been away! In the UK, I'm generally very healthy; I'll have probably one cold a year, and apart from regular headaches, have no other maladies. Both times I've visited Africa however, I've had more serious problems. 

The first one was my trip to Tanzania. I suffered pretty badly from altitude sickness when climbing Kilimanjaro; I didn't eat for around 4 days and pretty much exhausted myself from the effort. This by itself wasn't serious; the guides were keeping an eye on me, and as soon as I descended from the high altitude, I'd be absolutely fine. They'd stop me from climbing if it was going to make me seriously ill, so I wasn't particularly worried.

It did have some side effects however. On the day before the summit attempt, I was really quite ill. My body was running on empty, and I was suffering from exhaustion and AMS. I went to sleep as soon as I reached camp, and woke up just as everyone was about to set off to climb (they'd missed my tent in the darkness and so I'd missed breakfast). In the rush to get ready (bear in mind it was midnight, pitch black, and around -20C) sun cream didn't even occur to me. I originally had my buff (scarf) covering my nose and mouth, but I couldn't breathe anyway, so the guides pulled it off my face.

The long and short of it is, that the day after I summitted, I woke up feeling a bit strange. It was confirmed by the look on my tent-mates' faces that my face was very swollen and covered in pus. I didn't get a good look until later on that day, but I'd given myself second-degree burns from the sun and the wind!

After-sun wasn't really going to cut it, so I headed to the pharmacy to see what they recommended. After they tried to sell me sun-cream, however, I had to accept that they probably didn't have anything that could help so I treated it myself with anti-histamines, antiseptic, moisturiser, and by keeping out of the sun as much as possible. Fortunately, I was very lucky and it healed relatively quickly with no scarring. I'm now very careful about my face in the sun, as I'm sure it will have done some long-lasting damage, but it turned out ok in the end. 

I swear by Lifesystems First Aid Kits, but you can easily make your own instead

I was fortunate to be travelling with a group that had plenty of antiseptic wipes and antihistamines they could lend me, as I hadn't brought enough for myself. I'm sure I could have gotten them somewhere in Tanzania, but it wouldn't have been the easiest, and so now whenever I travel I make sure I'm stocked up on as much as possible. I always carry a first-aid kit with painkillers, bandages, antiseptic, anti-histamines, plasters, safety pins, Imodium and anything else I can squeeze in. It's come in handy several times (not just for me) and guarantees you'll never have to panic about finding somewhere. I try and carry a few clean syringes with me as well - I've never had to use them *touch wood* but don't ever be afraid to ask a doctor to use your syringes instead of theirs if you're concerned. Better to be safe than sorry!

Top tips:

  • Wear suncream! I'm usually pretty good at this, and preventative is better than cure! 
  • Take a fully stocked first aid kit with you
  • I now take aloe vera gel wherever I go. The Banana Boat stuff is pretty good, and it's so soothing on sunburn
  • Stay out of the sun. This was quite hard as I was on safari, then heading to Zanzibar, but I covered up as much as possible, and it definitely helped it heal quicker.

My next major mishap occurred when I was living in Mali. I'd made it through almost the full three months - I had just 2 weeks left - with no major illness apart from a couple of bouts of food poisoning. Not bad for one of the poorest countries in the world! I'd been looking forward to 1st December for ages; I love Christmas, and to me that's the day to begin celebrating! I was looking forward to sharing stories with the Malians (most of them Muslim) and to begin listening to Christmas music! I woke up that morning feeling a bit lousy, but that's kind of normal over there. You're usually fighting off some kind of malaise, so not being hungry wasn't overly unusual.

I headed out to work, still feeling ok (although not brilliant) but as the day went on, I started getting goosebumps, and felt a bit run down and cold (it was about 35C so definitely not cold!). I headed back from work early, and took my temperature (I ALWAYS keep a thermometer in my first aid kit when I'm travelling to Africa) and it was quite high at around 38C. I took some paracetamol to bring it down, and tried to sleep, though still felt a bit iffy. I Googled my symptoms, and I had 7/10 of the symptoms of malaria (headache, chills, high temperature, muscle aches, sore stomach, generally feeling unwell, fatigue...) - general flu-like symptoms, but something to keep an eye on.

We had a rule amongst the volunteers that, if you had a fever, you had to go to the hospital to get checked out. As mine was fluctuating around the 37-38C mark, and wasn't overly high (probably due to the paracetamol) and I felt ok, I was very reluctant to go to the hospital, sure that everyone was making a fuss about nothing. I agreed to check however, and headed to the 'Clinique Pasteur' - the best hospital in town, and the place that few Malians could afford to be covered by. 

I was seen quickly by a doctor, sent for a blood test (just a pin-prick on my finger) and was sent back to wait for the doctor again with the results in my hand. I couldn't resist a quick peek, and sure enough, I had tested positive for malaria. 

Very fortunately, and due to everyone persuading me to go to the hospital that night rather than wait for the next morning, they had caught it very early, and as long as I took some very strong drugs, I didn't have to stay in hospital. There are several different strains of malaria; one that doesn't kill you very often, but does stay in your system and re-infect you years later, and one that is fatal if not treated very promptly. I'd tested positive for falciparum - that lethal type - so had I waited overnight, I could have become very poorly, very quickly. 

The most galling thing for me was that I'd taken my malarone (anti-malarials) without fail (apart from puking one up near the very beginning), used a mosquito net every night, and used insect repellent; some of my group weren't even taking their anti-malarials. Nothing is fool-proof with malaria, unfortunately, but I will always take anti-malarials. As well as protecting against the disease, they massively reduce the symptoms, so had I not taken them, I would have felt a great deal more poorly than I did!

Top tips:

  • Always trust your instincts. Don't be a hypochondriac, but I felt off from the first thing that morning, and I was right. Trust your body and listen to it.
  • If you have a temperature when travelling, get it checked out. All kinds of bugs and diseases cause a fever, and it's better to be overly cautious and potentially catch something early, than to leave it and become ill.
  • Take precautions. I will always, always use anti-malarials and mosquito nets. Malaria is not fun, and not something I'd wish on anyone, so anything you can do to avoid it, do. 
  • Make sure you know where the nearest hospital is. Had I been further away, or not known where the hospital was, I could have become more ill than I did. Make sure you have travel insurance, and that you have your documents to hand, as some places won't treat you until they have proof that you're covered

Please don't let the possibility of becoming ill stop you travelling! If you let it become a barrier, you'll never go anywhere, and the risks are really quite small. If you're careful, you'll be absolutely fine, and if you become ill, get treated as soon as possible. Both mine have now become great stories, and it's just another thing that happened on my travels!

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