Staying hydrated is vital (Lora Rajah)
Article Words : Dr Jane Wilson-Howarth | 01 August

How to beat the little niggles

Sore throats, cuts and grazes, a bout of piles – all can hit you on your trip. Dr Jane Howarth-Wilson tells you what to do about them

Mention health problems abroad and most people think about malaria and other ‘tropical diseases’. In reality, the commonest ailments are the familiar complaints that pester us at home too. Sore throats and colds are common in the tropics so pack some favourite remedies. But if something new goes wrong while you’re travelling, how will you find a cure?

Pharmacies often sell simple treatments – if you think the symptoms are trivial, this is a good place to start. If a pharmacist can’t help (and do speak to the pharmacist rather than the shop assistant), then your hotel or hostel should be able to tell you where the nearest/cheapest/ best clinics are. Go to the best, since – except in northern Europe and the USA – healthcare overseas is inexpensive, and paying more usually gets you safer treatment.

Here, we look at some of the trivial but tedious health problems you may encounter while travelling, and advise you what to do about them.

1. Cuts and scrapes

Problem: You’ve sustained minor grazes and lacerations after trying an adventurous activity  – or from a protuberant bit of ancient taxi.

Diagnosis: Cuts and grazes, which can become infected and lead to nasty, septic wounds.

Cure: If you’re in hot and/or unhygienic surroundings, wash the wound properly, apply an antiseptic and cover it with a dressing. Even a mosquito bite that you’ve scratched can lead to a troublesome infection.

2. Scabby sores

Problem: You’ve developed a scabby, oozing sore where your clothes have rubbed against your skin in the hot and sticky holiday weather.

Diagnosis: Impetigo, a common, golden-crusting, superficial infection of the skin, frequent in hot, steamy climates.

Cure: Antibiotic ointments or neomycin powder work well unless there are lots of sores, when a course of flucloxacillin, cloxacillin or erythromycin capsules needs to be taken by mouth.

3. Black toes

Problem: You’ve stubbed your toes on a piece of hotel-room furniture, resulting in a lot of pain and a black toenail.

Diagnosis: A build-up of blood behind the toenail. If the toe looks a normal shape, it probably isn’t broken.

Cure: Uncurl a paperclip, heat the end of it until it’s red-hot, then push it through the nail. After sizzling briefly, a large drop of blood should come through the hole; the pain relief is almost instantaneous.  

4. Pain in the bum

Problem: You’ve got a sore bottom – with a painful lump close to the anus – after a bout of Delhi Belly while trekking with a heavy backpack.

Diagnosis: Haemorrhoids, common after constipation or diarrhoea and also when there is increased strain on the abdomen – as happens if you’re carrying a heavy backpack. They can bleed – frighteningly – and are uncomfortable and inconvenient.

Cure: Wash your bum after each bowel action, which keeps you clean and cools the throbbing haemorrhoid. Rest until the ‘pile’ is less painful. Greasy creams and ointments are soothing; pack some in your medical kit.

5. Dehydration

Problem: You’ve developed a pounding headache while sightseeing on a baking-hot day.  

Diagnosis: Dehydration, caused by hot temperatures and not drinking enough water. It might seem convenient not to have to go to the toilet when you’re unsure about the local loos and drinks, but it can make you feel unwell.

Cure: Down plenty – more than a litre – of oral rehydration salts. Aim to produce a minimum of three good-volume urinations a day.

6. Blisters

Problem: You find fluid-filled bubbles under your skin after a hard day’s walking or severe sunburn.

Diagnosis: Blisters, which cushion you from further friction damage.  

Cure: Rest from the activity that caused the blisters and, if possible, pad the area with moleskin or similar dressings. Whatever the cause of a blister, it shouldn’t be punctured.

7. Pink-eye

Problem: You wake up in a cheerless hotel room to find that your eyes are stuck closed and feel like they’re on fire.

Diagnosis: Conjunctivitis or contagious ‘pink-eye’, common in hot climates.

Cure: Splash lots of water on your eyes, which should get them open, and head to the nearest pharmacy to buy some eye-drops. 

8. Nosebleeds

Problem: There’s blood dripping out of your nose while you’re trekking.

Diagnosis: A nosebleed, resulting from the inside of the nose getting dried out by mountain air.

Cure: Cool down – a hot head will encourage blood-flow. Put a cold, wet cloths on the back of your neck and your nose and lie down – activity increases blood loss. Don’t blow your nose or remove any clots as the bleeding will restart. Don’t pick any scabs. In arid conditions, anointing the inside of the nose with grease (or even butter) will stop it happening again. If the problem becomes recurrent, the area that bleeds can be cauterised by a doctor.

Occasionally nosebleeds can be a sign of high blood pressure, so consider getting that checked when you get home if the climate isn’t the obvious culprit.

9. Flu

Problem: You’re in an exotic new country and you feel so awful – feverish, with aching joints and bones – that you can’t get out of your hotel bed.

Diagnosis: Real influenza – as opposed to a heavy cold that many mistakenly call flu.
Cure: Medicines that get the fever down, namely paracetamol (called acetaminophen in the USA) and ibuprofen, make you feel a lot better and can be taken at the same time. Gargling with soluble paracetamol soothes sore throats, too.

In the tropics there are several serious diseases that cause flu-like symptoms, so consult a local doctor who will know which diseases are circulating and in which season malaria is rife.

Whatever symptoms you suffer on your travels, go and see a local doctor if you are worried, and check their prescription against advice in your health guide. Be reassured that most symptoms will get better.

For 11 years Dr Jane Wilson-Howarth acted as GP to trekkers and expats in Pakistan, Indonesia and Nepal. Her health guides are 'Your Child Abroad' (Bradt) and 'Bugs, Bites & Bowels' (Cadogan).

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