One of the scariest obstacles to international travel is often the health question. In my planning stages for my own round the world trip I fretted over the health side of the equation because it was the big unknown. Beyond vaccinating myself, stocking my medical kit, and buying really good travel insurance, the rest was out of my control, and I really like maintaining control. Alongside the common questions I’ve covered these past few months in my ongoing series about facing fears and obstacles to travel, the health topic is a big one. It crops up in many reader emails as pre-planning questions, but I have also wrestled with guilt from time to time because there is no promise of health. Over the years, several long-time readers emailed me about their health battles after setting out on their big trip overseas.While my travel planning resource page tackles a lot of the basic questions, it doesn’t factor in the emotional toll that health can take on you while traveling. I discussed fears of physical dangers earlier this summer, but the health topic is one I have thought about how to approach for many months. At the most basic level, it’s more dangerous on your health to travel than stay home. And in the other fears I discussed, that was either not the case, or the risks were relatively equal. But with the type of travel I undertake, it’s often to remote areas without medical access and with serious diseases—areas where I willingly put myself at more of a health risk than staying put in a place with quick and easy hospital access.
I state this so clearly out of respect for the adventurous travelers who have ventured out on trips and faced their own obstacles and stumbles. For the woman who emailed me for advice after she took off on her first trip to India, only to fly home weeks later with a persistent and lasting battle with giardia for more than ten months (she ended each email with the assertion she would resume her trip once better though!). And for others who emailed me saying they felt like they did something wrong because they got sick right away, or robbed on the first day of travel, or lonely on day two.
Travel is not always glamorous and though I believe it’s worth the trade-off, it’s best to have a healthy respect for the issues so you take the right precautions. First let’s look at a rundown of what I’ve faced since I left in 2008, perspectives on the long-term effect on my health, and then a long list of tips and resources to keep you safe and healthy on the road.
The Sickness Rundown
Leaving to travel I knew I had general health on my side—I ate a healthy vegetarian diet, hiked reluctantly but often, and rarely faced serious illness. My only Achilles heel is a bizarre and varied list of allergies to things that bite/sting. Not too bad, and so, let’s look at the serious and not-so-serious things my immune system was up to over the past five years:
- Laryngitis: It was November 2008, mere weeks into my round the world trip, and my Florida-girl sensibilities couldn’t handle the biting cold of Australia’s south coast. I completely lost my voice for five days after losing my week-long battle with a hellacious cold.
- Head lice: Not sickness per se, but not ideal thanks to a very suspect hostel in Melbourne, Australia.
- Dysentery: My most severe illness in my life; I likely acquired it from the fresh fruit smoothies rampant in Luang Prabang, Laos or from the fresh veggies I ate there as well. I described it in more depth here, but suffice to say it worsened so rapidly because of the nonexistent healthcare infrastructure in the country, and the fact that I was in a remote region when I realized it wasn’t just a casual bout of traveler’s diarrhea. The key here was hydration, and it’s the only reason I lived through it (hydration and charcoal tablets to be precise).
- Food poisoning: Complements of a lukewarm plate of vegetables from a street stall in McLeod Ganj, India in 2009. The illness struck hours later and lasted throughout my overnight train; I spent the dark dawn hours balanced over the open hole in the train bathroom depositing my dinner onto the whooshing train-tracks as we sped toward Rishikesh. It was awesome.
- Allergic reaction: After hiking around Croatia’s national parks and sustaining a tick bite, I found myself with hives and bumps that would not respond to Benadryl—after pantomiming with a pharmacist in Bosnia who spoke no English, she gave me an amazing wonder-cream I still use to this day.
- Allergic reaction: I don’t know what caused my severe allergic reaction in Belize in 2010, but I found myself covered in hives and my throat started closing. The local doctor then poked my arms/hands so many times trying to find a vein for the shot that I passed out; when I woke up he had managed it with a jab to the buttocks. 12+ hours later, with my symptoms still serious and since I didn’t know what was causing the allergic reaction, I left Belize and all returned to normal.
- Scabies: A delightful gift from what I thought was a nice guesthouse in Guatemala. Words can not express how awful and itchy scabies is. On the funny side, I baffled the pharmacist when I asked, in Spanish, for scabicide. Our animated argument lasted at least five minutes, it included all locals passing by, and all insisted that there was no way I had scabies. I did. She finally handed over the bottle, at which point I spent two days dealing with the fun process of washing every single thing I own and coating myself in poison from neck-to-toe.
- Motorbike accident: I crashed my motorbike on a bridge in Laos and sustained a good deal of road-rash as well as a serious muffler burn on my ankle that sent me into shock. Luang Prabang has a very basic hospital now that bandaged me up and sent me on my way. I wrote a bit here more about the danger of traffic accidents and travel.
- Giardia: My second most severe illness and this one was also contracted in Laos; it took effect on my birthday in 2011. I thought I had food poisoning at my birthday dinner with friends in Thailand, but weeks later as Ana and I traveled through Myanmar I realized I had some hallmark symptoms of giardia, which include really lovely sulfur burps. I could not find the medicine for giardia, metronidazole, while in Myanmar so I waited it out for three more weeks until I returned to Thailand. At that point the Thai doctors had a conniption fit over my weight loss and ran heaps of tests and heaps of medicine before they would call me “fixed.”
- Worms: There is every chance that I carried worms for a year before I figured out why I couldn’t gain the weight back from my bout with giardia. It was my friends Bessie and Kyle, who had lived in Myanmar, who pointed out in February of this year that I sounded like I was still carrying worms/parasites. Good call, I was.
And now, after that last bout with de-worming and antibiotics, which I took while I was in Mexico earlier this year, I am finally feeling really good. I am healthy in a way I haven’t been for years. I am fairly positive that I am parasite-free, and I am so good, in fact, that my best friend convinced me to train for a marathon in January. :)
The Toll on My Health
I haven’t come out of these past five years unscathed, but this varied list of ailments doesn’t make me fear travel. Quite the opposite, most of these I listed I forgot about until I made this list because once the illness passes I am back to enjoying being on the road, hearing new stories, and meeting new people. I am pretty big on being prepared, and then accepting that you can’t do much in life beyond that.
I am a planner and a preparer, I carry a well-stocked medical kit—double stocked when my niece Ana traveled with me—and my kit has helped me and dozens of other travelers I met along the way who needed help. And that’s a biggie, I ask for help and have played the pantomime game with pharmacists all over the world to find the medicine I needed.
Before traveling, my only known allergies were mild reactions to stinging/biting things (as I child I was very allergic to fleas), and a mild cat allergy. Over the years all my allergies worsened, with the most notable change after dysentery, when I took a huge course of strong antibiotics and I was underweight and undernourished for months after it. On the other side of that illness I have much more severe allergies to the mundane things like seasonal allergies and hay-fever—and I’ll know within seconds if you have a cat in your house.And as much as past health helps, it’s as much about luck, experience, and preparedness to stay healthy on the road. And I’ll note time and again that I come out smiling and grateful for the travels and life I’ve led these past five years. Though there is little chance I would have contracted some of these illnesses if I wasn’t on the road, there surely would have been something else cropping up instead.
10 Practical Tips to Avoid Travel Sickness & Stay Healthy
- Get your vaccines: Vaccinations are an important part of off-the-beaten path travel and all new travelers should visit their local health clinic for the recommended vaccines. A full list of tips and resources is here.
- Carry a medical kit: While you can easily buy a travel medical kit to get you started, I recommend customizing it to meet your needs and adding a few things that are often lacking. I noted that oral rehydration salts were a life-saver several times, as was a general antibiotic, and heaps of antihistamines.
- Buy travel insurance: I have never used my travel insurance but I highly recommend having it just in case, especially if you’re traveling long-term. I use World Nomads or IMG Patriot and generally think one of these two are the best options I have found; my review is here.
- Read and research: Read up on the places you’re traveling, ask other travelers what precautions they took for the region, and learn what you need about your own health to keep you safe. Read How to Shit Around the World, which wins for the best title ever, and it also unapologetically discusses everything you might need to know when sick on the road, never shying from “eww” topics, instead dispensing advice and life-saving information.
- Take physical precautions: Your research should tell you the reasonable precautions to take; in many tropical regions mosquito bite prevention is important; consider Deet, malaria medicines, and/or a mosquito net as needed for your specific trip. Wash your hands a lot—more than you ever would back home.
- Learn about food safety: Carry your own utensils (I carry this spork), and research the ways to spot good street food stalls and restaurants. My friend Jodi wrote the Food Traveler’s Handbook and it’s a great guide that not only helps you delve deeper into a place’s food culture, but she offers heaps of practical tips for food and eating safety.
- Learn about water safety: Drinking water in developing countries is not always safe. But there are very effective precautions you can take. I used a SteriPen on the road (my full review here), and something like a LifeStraw could also be effective in ensuring that you’re never stuck without clean drinking water.
- Stay hydrated: Anything related to diarrhea and vomiting have severe dehydration side effects. Carry oral rehydration salts and drink electrolytes and minerals when you’re suffering from any bout of diarrhea or vomiting. Proper hydration may be the single thing that stops an illness from turning fatal before you can find medical help. Most outdoors stores (like REI, my favorite) sell oral rehydration salts to stock your medical kit before you leave. It’s also cheap to refill your supplies on the road in the more developed countries on your route (Thailand had them in every pharmacy, Laos did not).
- Take preventive measures: Antibiotics wreak havoc on your system and kill all the good bacteria in your body alongside the bad. Take probiotic pills and eat yogurt, kefir, or other foods with live cultures not only during your course of antibiotics, but throughout any region where you’re battling intestinal issues, they really help keep you healthy. Also get enough sleep and eat healthy, which is tricky on the road but helps your recovery time when you do get sick!
- Ask for help when you need it: This includes seeking medical help, asking locals to help when your condition is serious, and generally communicating. People are kind all over the world, and if you’re in a tough spot you need to let others know about your illness and let them help you find help. I’m not a doctor and so if I feel like things are out of control I have learned to immediately ask for help—between the humidity in tropical regions, risk of infection, and poor sanitation and healthcare, situations can deteriorate quickly. If you think you’re seriously ill, don’t just self-diagnose on WebMD, go get help.
- Bonus: Keep a positive attitude: I noted in the loneliness post that being sick on the road was the loneliest I have ever felt on the road, and maintaining a positive attitude after hugging a toilet for days is tough, but essential to helping you stay healthy and recover faster. You’re not alone and the rest of the traveler’s posting happy photos on Facebook don’t have a secret recipe for health; all long-term travelers have battled sickness on the road.
Next month I have a whole post coming about tackling toilet time on the road, mostly because it’s seems so infrequently discussed, but I suspect it’s one of those things readers Google while their browser is in incognito mode. It’s important to maintain honesty about travel, and health is one of those things. I’ll be the first to encourage someone to take the leap and travel asap, but with that leap comes the responsibility to stay informed.
With that in mind, is there anything I missed, tips you’ve found for staying healthy on the road or any resources that add to the topic of health and travel sickness for new or worried travelers?
This post is a part of my monthly series on overcoming fears to travel, check out all the posts here, new ones on the first Tuesday of every month.
Resources to Stay Healthy While You Travel
- How to Shit Around the World: The Art of Staying Clean and Healthy While Traveling:What happens when you travel in developing countries, for long periods of time, without a SteriPen? This book offers a frank and unapologetic discussion of everything from diarrhea to parasites, and other gastrointestinal nastiness. It doesn’t shy away from any topic that may impact your health—it should be a mandatory primer guide for all travelers.
- The Healthy Conscious Traveler: 8 Pathways to Smart and Effortless Travel: Written by a holistic healer and alternative medicine practitioner, this book offers a range of advice for staying healthy on the road, including self-assessment tests to discover travel sensitivities, as well as techniques for relieving stress, jetlag, and more. It’s great because it offers ideas that aren’t simply “find a doctor and get medicine.”
- SteriPen Adventurer Opti: Long-term travelers, or those spending a lot of time outdoor (camping, trekking, etc) should look into the SteriPen as an investment in their health, particularly for those traveling in developing countries.
- LifeStraw Personal Water Filter: Portable and effective, this straw can be used from a RTW trip to a camping trip—and everything in between. It’s an easy addition to any packing list because it’s both small and it’s fairly inexpensive.