PRACTICE AN OUNCE OF PREVENTION

Last time, I wrote about A FEW OF THE VACCINATIONS AND MEDICAL PRECAUTIONS TRAVELERS SHOULD CONSIDER BEFORE THEY HEAD OVERSEAS. BUT FOREIGN TRAVEL ALWAYS ENTAILS OTHER HEALTH QUANDARIES, ESPECIALLY ONCE YOU ARRIVE WHERE YOU'RE GOING.  Food, for example. Exotic eats and unfamiliar tastes are tempting to some travelers and turn-offs for others. But taste preferences aside, it is always crucial to find food that won't make you sick.  By one estimate, half of all travelers to developing countries, which includes many tempting beaches and tropical islands, suffer trip-changing, gastrointestinal distresses. They range from diarrhea and dysentery to internal parasites, hepatitis, cholera and typhoid fever.  Sadly, many if not most of these cases are avoidable. For while the specific ailment may vary from destination to destination, the underlying cause is often the same. The water is not hygienic. Foods are contaminated with micro-organisms because their storage and preparation are unhygienic or the water used to clean them is unsafe.  At home, a healthy diet means eating lots of green salads, raw vegetables and fresh fruit. Some places, these same foods carry the highest risks of illness. And normal no-no's like french fries, packaged snacks, candies and processed foods are often safer choices. The general rule with fruit and vegetables is to peel it yourself, watch it being cooked or forget it. Avoid raw fruits and vegetables, especially salads.  Fresh foods thoroughly cooked to order and quickly served are usually a safe option, but never be dazzled by a hotel's star rating. It may be safer to eat simple food cooked in plain sight at a street market stall than prepared behind the closed doors of a fancy restaurant.  As a last resort, if there are no reliable food options, you may get away with eating a small quantity, but do it on an empty stomach, since many ailments are dose-related and stomach acids offer a measure of protection.  Finding pure water can be a challenge across broad areas of Africa, Asia, Eastern Europe, as well as South and Central America. Whenever water is questionable, stick to known brands of bottled water or soft drinks. Carbonated drinks are generally more reliable than fresh juices and non-carbonated bottled water. Hot beverages such as coffee or tea made with boiled water are good, as are wine and beer.  Forgo ice in your drink, unless you're sure the cubes are made from boiled, bottled or disinfected water. If you can't do without that icy chill, take along some plastic, sealable sandwich bags. Put the ice in a bag and the bag in your drink. In places where water is contaminated, don't even brush your teeth with the liquid that comes from the tap. In a pinch, water can usually be purified for drinking by boiling it for at least 20 minutes or by adding several drops of chlorine bleach or one iodine disinfectant tablet per liter and letting it stand for up to an hour. Common water disinfectant tablets include Gloabaline and Potable-Aqua. A variety of small, inexpensive, hand-powered, microfilter pumps are on the market, and they can filter out most contaminants and make water potable. PUR is one of the primary manufacturers.  But even cautious travelers occasionally get a bug. If that happens, plan to lie low and drink fluids to avoid dehydration. Commonly prescribed cures are Lomatil or Imodium, but they can cause complications for anyone who has a high fever or blood in their stool.  Oral rehydration salts may provide faster relief. Commercial brands are available, but here's a simple recipe whose ingredients can be found almost anywhere: Add 1/ 2 teaspoon salt, 1/ 2 teaspoon baking soda and 4 tablespoons sugar to 1 quart boiled or carbonated water and drink 8 ounces after each episode of diarrhea.  The unavoidable reality is, however, that there are no absolute health travel guarantees, especially in tropical places.  A traveler can do everything right and get sick, or everything wrong and stay well. Health depends on common sense, luck and ability to resist infection. But health experts have devised what they call the Ten Commandments for Tropical Travel.  1. Check with your doctor well ahead of departure to get advice about your present health conditions, and get any regular immunizations or special vaccines required for places you'll visit.  2. Acclimatize yourself. That means things like getting lots of fluids and rest en route. Take steps to combat jet lag. Use sunscreen.  3. Protect yourself from insects. La Nina has doubled the risk of malaria in some places. Use mosquito nets and repellents with DEET.  4. Drink only purified water, in cluding ice cubes.  5. Eat only well-cooked food and freshly-peeled fruits and vegetables.  6. Bring self-treatments for traveler's diarrhea.  7. Since HIV is prevalent everywhere, take and use prophylactics.  8: Avoid walking barefoot or swimming in fresh water.  9. Think about personal security. Keep a low profile, don't flash money, and use alcohol in moderation.  10. Be careful about your conveyance. All of the preceding medical concerns notwithstanding, motor vehicle accidents are still the leading cause of injury and death to travelers.

In the final analysis, however, medical precautions always pay. After all, avoiding illness is essential for enjoyable travel. Not only that, some simple ailments can still have fatal consequences. The life you save or discomfort you avoid may be your own.


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