1. Avoiding diarrhoea: sizzling street-snacks are almost invariably safer than lukewarm foods served at buffets, even in the best hotels.
2. Malaria: if taking antimalarial tablets remember that the parasites don’t stay behind at immigration. Be sure to continue the tablets as directed after you get home.
3. Women travellers: dressing modestly – if that is the local custom – reduces hassle, unwanted advances, and risk of rape.
4. Biters and stingers: wearing shoes and long, loose trousers will help protect you from snake bites as well as an assortment of animal hazards.
5. Blood-suckers: insect repellents not only deter six-legged assailants but they also repel leeches, ticks and chiggers. The best repellents are based on DEET (diethyltoluamide).
6. Sex: there are more than 25 known sexually transmitted infections. Think about the risks and arrange a check-up promptly if you have exposed yourself to possible infection.
7. Plague paranoia: the risks of epidemics abroad are frequently exaggerated in the media. Check up on the facts before travelling. Knowledge is power.
8. Solar power: shirts with collars (rather than T-shirts) best protect the skin at the back of the neck – one common site for sunburn and skin cancer.
9. Sun protection: the Australian campaign to protect people from skin cancer has this ditty to help remember precautions: Slip, slap, slop (Slip on a shirt. Slap on a hat. Slop on some sun screen.)
10. Avoiding cystitis: Bladder infections are common in travelling women, especially those who don’t drink enough water in hot climates. Antibiotic treatment is sometimes needed, but bicarbonate of soda in water, followed by lots of plain water can help mild symptoms.
11. Responsible tourism: purple potassium permanganate crystals are excellent for cleaning and sterilising wounds and breaks in the skin. They are a good traveller’s cure and are cheap so lots can be given away to locals. Carrying locally bought medicines shows that these are useful, and have a Westerner’s approval.
12. Motion sickness: this can be well controlled with tablets. Hyoscine preparations start to work fastest but are only really good for shorter journeys. Antihistamine preparations are excellent for long journeys or voyages but you need to take the first dose three to four hours before travel.
13. Camping accidents: never sleep with anything burning in your tent, however cold it is. You risk being burned alive or succumbing to poisonous fumes.
14. Mountain sickness: when at an altitude over 3,000m assume any deteriorating illness is mountain sickness and descend before it is too late.
15. Bilharzia or schistosomiasis: this is acquired from bathing, paddling or showering in tropical fresh water that infected people have excreted into. It occurs mainly in Africa. It should be safe to bathe if you plunge in at least 200m from where other water-users might have ‘been’.
16. Diarrhoea: peel it, boil it, cook it or forget it... then you’ll avoid it.
17. Itchy bites: it is easier to prevent bites than cure the itch afterwards. Travel with long loose clothes and a stick of some good insect repellent in your pocket.
18. Leeches: covering your shoes with insect repellent will stop leeches climbing over your shoes to feed on the skin of your ankles.
19. Beach hazards: wearing jellies or old trainers on the beach will give protection from razorshell cuts, sharp coral, sea urchin spines, weever fish and other unpleasant assailants.
20. Dangers of the deep: if attacked by a venomous fish (or you tread on one), immersing the stung limb in hot but not scalding water (around 45°C) should relieve the pain immediately.
21. Snake bites: firm crepe bandaging of a limb that has received a snake bite will slow distribution of the venom while avoiding the dangers of tourniquets.
22. Meat matters: if you are concerned about the risks of traveller’s diarrhoea, become vegetarian. Meat dishes present a higher risk than vegetables.
23. Malaria prevention: people intending to take mefloquine (Lariam) tablets for the first time should try two or three doses before travel to see if it makes them feel weird, then find an alternative before travel if necessary.
24. Expats: those living or staying longish-term in regions with restricted access to good medical care, ambulances and rescue services should plan for evacuation in case of an emergency.
25. Jet lag: avoid alcohol and caffeine on the flight, take plenty of non-fizzy water or juice and plan your trip carefully to allow for time-zone adjustment.
26. Kids: the greatest health risk to travelling children is from accidents and falls. Probably the most common example is when they swallow something noxious, mistaking it for sweets or Coke.
27. Accidents: of all travellers’ deaths abroad, about half are due to accidents. Very few travellers die from infectious diseases.
28. Walking hazards: get fit for whatever you plan to do on your travels. Unfit adventurers are far more likely to have accidents, and will have less fun.
29. Dehydration: when you are in a very hot climate and need to drink litres a day, adding oral rehydration salts to some of your drinks will enhance your body’s absorption of water.
30. Coming home: malaria is the most dangerous disease that is commonly imported into Britain by returning travellers; the serious kind will announce itself within three months of return.
31. Diarrhoea: avoid lettuce, watercress, strawberries, ice-cream and drinks that contain added ice and have been messed-about with and you should avoid the Kathmandu quickstep.
32. Ticks: if you find a tick feeding on you, grasp it as close to your skin as possible and pull steadily away. Douse the wound liberally with gin, iodine or surgical spirit.
33. Economy Class Syndrome: to reduce the chances of a blood clot on a long-haul flight (more than five hours), move around the aircraft every hour or so and if you have room, do some calf-tensing exercises in your seat.
34. Malaria: symptoms may, misleadingly, start with nausea, diarrhoea or a cough. It is important to get any fever properly diagnosed.
35. Air rage: reduced oxygen and low air humidity makes everyone on long flights a little uncomfortable and irritable but it’s not yet understood what turns this discomfort to air rage.
36. Ailments: it’s not weird tropical diseases that will get you on your travels but queasy stomachs, grazes and sore throats. Pack a simple first aid kit, and a travel health guide.
37. Mosquito-borne diseases: both day- and night-biting mosquitoes spread diseases, and both are active around dusk and dawn. Watch out for the double shift at twilight.
38. The Big Trip: take out adequate medical insurance (£2 million worth of cover) for your trip and declare any current or previous health conditions.
39. Sun and skin: the sun is more damaging closer to the equator and at altitude, and reflective surfaces like snow, water and the beach increase your chance of getting sunburn, which can lead to skin cancer. Malignant melanoma kills about 1,500 people a year in Britain.
40. Peruvian sand flies: a painless skin ulcer that crusts and fails to heal within a couple of months needs medical attention. It could be leishmania – or skin cancer.
41. Water treatment: the best method of killing all microbes that are likely to be in your drinking water is to bring the water to a good rolling boil. Chemicals don’t get all bugs.
42. Responsible relief: in the absence of flush facilities, bury your excreta under 15-20cm of soil. Don’t just dump and run.
43. Altitude: acetazolamide (Diamox) tablets can be used for both prevention and treatment of mild high-altitude symptoms.
44. Economy Class Syndrome: those most likely to suffer from a blood clot after a long flight are those who’ve had a clot in the past. A single low dose (75mg) of aspirin taken before the flight will help reduce the risk (though is not for those with asthma or stomach problems).
45. Sex: travel with condoms. (They’re also useful emergency water carriers!)
46. Grey travellers: limber up for the squat loo or travel with a Whizzy.
47 Malaria: in sweaty climates it may be necessary to reapply repellent every couple of hours. If used with sunscreen, apply repellent 30 minutes to one hour after sunscreen.
48. Water: A tincture of iodine is probably the most portable means of rendering drinking water safe when you fancy a drink of cold water.
49. African hazards: the most dangerous wildlife in Africa is the drunk behind the wheel. Check your bush taxi-driver is sober and has functioning limbs and eyes.
50. Diving and snorkelling: take local advice about where it’s safe to snorkel or swim – there may be estuarine crocodiles, a risk of shark attacks or rip tides.
Dr Jane Wilson-Howarth was Wanderlust’s first contributor, having impressed us with her knowledge of travellers’ bowel movements. Since then, she has contributed to almost every issue and has always met her deadlines, even when cut off from civilisation in the wilds of Nepal during the monsoon.
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