Staying Healthy While Traveling in the Developing World

You’re taking a trip to the developing world, and maybe you’re even taking your kids.  Congratulations!  There are so many amazing things to see.  However, you’ll need to take a few extra precautions to ensure you are staying healthy during your trip.

Don’t drink the water

Seriously, not even a little bit.  There are some nasty critters in there: E. coli, Salmonella (including the kind that causes typhoid fever), cholera, parasites and more.  Some of these can be deadly, and others may take up residence and cause lifelong issues with your digestion.  Avoiding these is worth the hassle!

Buy bottled water (which is plentiful in developing countries, because the locals have to deal with this issue, too).  Alternatively (or in addition), you can use a personal water filtration or purification system, like those designed for use by hikers.  Buy this at home (you can find them at an outdoor gear store) and bring it with you, since it will be difficult to find locally.  There are several alternatives; look for one that at least removes nearly all protozoans (parasites) and bacteria.  (Some also remove viruses; most viruses don’t survive for very long in water, so this isn’t absolutely necessary, but would be a good idea nonetheless.)  You should open the system and try it out at home first, to make sure that it works and that you know how to use it when it counts.

Watch out for ice cubes; assume they’re made of tap water.  Alcoholic beverages are safe, because the alcohol kills the germs, but don’t drink anything else unless you saw the container being opened.  Don’t brush your teeth with the tap water (use bottled), and keep your mouth closed in the shower.

If your kids are with you, do your best to keep the tap water away from their mouths; you may want to wash their little faces with bottled water, so they don’t swallow some tap water during bath time.  Rather than frequent baths, you can get by with wiping the kids’ bodies down with wet wipes, or giving a quick wipe with a wet washcloth.  (They’re traveling; they’re allowed to be a little grimy.)

You may feel like you’re being overly paranoid about the water.  It’s worth it to stay healthy.  Include the cost of bottled water in your trip budget, so you don’t have to include the cost of illness.  It really doesn’t take that much water to brush your teeth.

Watch what you eat

This is related to the first tip.  Fresh fruits and vegetables are out, because they’ve been grown and washed in the possibly-contaminated tap water.  Don’t assume that high-end restaurants are safe in this regard; they generally buy the same produce as any other restaurant, and though they may do an excellent job of washing it, they also may not.  Always look for your vegetables and fruits to be cooked, dried, or canned.  On the plus side, this means that salads will taste absolutely heavenly when you return home!

A fruit with a peel (e.g. oranges, mangoes, passionfruit) will be safe on the inside, so you can have those as long as you peel them yourself and are careful not to contaminate the inside with what’s on the outside.  To be cautious, you could rub hand sanitizer on the outside of the peel, and wait for it to dry before peeling.  That’s what I did with some fresh passionfruit that I picked in a Peruvian rainforest and simply HAD to eat.  (The taste, by the way, was so wonderful that I swooned over it for 10 minutes.  Yes, fresh fruit is amazing; just eat it safely.)

Eating raw or undercooked meat or seafood isn’t inherently more dangerous in the developing world than it is at home, except that you may not have good medical care available to you if you get an illness.  When I’m in the developing world, I’m more cautious than usual to eat only fully-cooked animal products, but the main food group I focus on is the produce.

Keep your hands clean

Because the tap water isn’t clean, washing your hands with it won’t exactly result in them being clean.  After your hands have dried for a  few minutes, most of the microbes that were in the water will be killed, but you’ll want to be very careful in that period not to touch your face or your food.  To avoid this situation, bring along some small bottles of hand sanitizer (or buy it when you get there; it’s generally readily available, because the locals deal with this all the time) and use them often.  In the developing world, I always use hand sanitizer after using the restroom; after washing my hands in the sink, if they have dirt on them and I need soap and water; and immediately before eating anything (even a snack, even if I’m only planning on touching the wrapper).

If you get a gastrointestinal illness, hydration is your priority

The biggest danger from a GI illness (read: vomiting and/or diarrhea) is getting dehydrated.  So if you (or one of your kids) end up with one of these illnesses, your main goal is to replace the fluids you’re losing, by drinking more than enough to do so.

Here’s the trick. Your body can’t absorb plain water by itself; if you just throw back bottles of water, it will pass straight through you, taking some of your minerals with it.  You need a little salt and a little sugar to absorb the fluid.  One good idea is to bring powdered Pedialyte or other rehydration solutions along with you, so you can make it if you need it. These solutions also contain trace minerals such as zinc, which will help you replace what you’re losing.  If you don’t have any of these, you can drink coconut water, juice or broth, or just throw a handful of salt and two handfuls of sugar into a gallon of (clean!) water.  The precise ratio isn’t important, so don’t get hung up on the exact amount.  Take frequent sips of fluid as tolerated.  Most kids love Pedialyte, so if your kid is the one who’s sick, getting them to drink it shouldn’t be a problem.

You’ll know you’re hydrated if your lips and mouth feel moist and you’re urinating at least once every few hours; if this isn’t the case, increase your fluid intake gradually until it is.  (This is true whether you’re sick or not.)

Bring some medications with you

When you’re in the developing world, you can’t trust a drugstore or even a pharmacy to have the medications you need.  Pharmacies are often unregulated or poorly regulated, so even if you know what medication you need, you often can’t be sure that what’s in the pill is what’s written on the package.  It’s a good idea to bring with you anything you might need.  Of course, this includes prescriptions you normally take at home; bring at least a few extra days’ worth of meds with you, in case a travel delay causes you to get home later than you expected. 

It’s generally recommended to bring the meds in their original prescription bottles, which prevents you from being harassed by airport security and also makes sure that you remember which pills are which.

You may also want to bring a course or two of antibiotics with you; if you get sick, you won’t have to deal with foreign medical offices and unregulated pharmacies.  Of course, you’ll probably stay healthy and discard these when you get home, but most antibiotics are cheap, and it’s worth a few dollars to know that you have them.  Think of it as health insurance.  These can be prescribed by your regular family physician, or you can make a visit to a travel health clinic.  The advantage of the travel clinic is that they’ll have vaccines on hand that aren’t normally given to non-travelers, and they’re familiar with what’s necessary at various destinations.

Additionally, consider the altitude you’ll be traveling to; if you’ll be at high altitude, bring some altitude sickness medication.  Sure, you don’t think you’ll need it; you’re young and fit, and you can handle it.  You probably can, but altitude sickness isn’t a sign of weakness or lack of fitness.  It’s a simple matter of body chemistry, which isn’t under your control.  So bring those pills along.  If you need them, you’ll know you have the pure stuff; if you don’t, once again, they were dirt cheap.

Get your vaccinations

I know how controversial this one is in certain circles, but please consider the environment you’ll be traveling in.  Measles, for example, is endemic in many parts of the world, and can rapidly lead to brain damage or death.  Typhoid, hepatitis A, yellow fever, and other diseases are also common in the developing world.  Taking vaccinations before you go reduces your risk of ending up in a very serious situation.  This is even more important if you’re taking your kids on your trip with you; leaving them unvaccinated at home is one thing, but taking them to a developing country unvaccinated is a whole new level of risk.  Whatever the dangers of preservatives in vaccines may be, the dangers of these diseases are much greater.

You can visit a travel health clinic to get the vaccines you need.  If you’re so inclined, you can also check out the CDC’s Travel Health.  It contains information for many destinations around the globe, and is updated frequently.  Checking it ahead of time can help you decide whether you need to visit a travel clinic, or your regular physician can take care of prescribing what you need.  Make sure you do this well ahead of time; some vaccines take a few weeks to reach peak effectiveness.  Six weeks in advance is a good idea.

Enjoy your trip!

With the constant thinking about water, produce, and hand sanitizer, you could definitely stress yourself out about illness.  Don’t get stressed!  Just do what you need to do as part of your travel routine (buying lots of bottled water, ordering the steamed veggies rather than the salad), and then enjoy your trip.  You’re somewhere amazing, after all – somewhere with natural wonders, cultural treasures, historical artifacts, or (almost always) all of these.  You’re mitigating the risks of being there, and the risk that’s left is worth it.  So travel on, without letting fear stop you.  The world is big and amazing.  Don’t miss out!