Local Health Conditions
sunburn
You can get sunburned quickly and seriously, even through clouds. Use a strong sunscreen, hat and barrier cream for your nose and lips. Calamine lotion and aloe vera are good for mild sunburn. Protect your eyes with good-quality sunglasses.
prickly heat
This is an itchy rash caused by excessive perspiration trapped under the skin. Prickly heat usually strikes people who have just arrived in a hot climate. Keeping cool, bathing often, drying the skin and using a mild talcum or prickly-heat powder will help. Or splurge on an air-conditioned hotel.
dehydration
This can be caused by any condition that leads to an excessive loss of body fluids, including heat, fever, diarrhoea, vomiting and strenuous physical activity. Signs of dehydration include nausea and dizziness, headache, dry eyes and mouth, weakness and muscle cramps, passing small quantities of dark urine, and raised temperature. The treatment is to drink lots of fluids: take oral re-hydration salts if available, otherwise any fluid will do.
heat exhaustion
Caused by heavy and prolonged sweating with inadequate fluid replacement and insufficient time for acclimatisation. Symptoms to look out for are headache, dizziness, nausea, feeling weak and exhausted, only passing small quantities of dark urine and possibly muscle aches or cramps. At this stage your temperature may be normal. Treatment is aimed at cooling down and replacing fluids by resting in a cool environment (fanning and cool water sprays may help) and drinking lots of fluids (water, oral re-hydration salts or diluted fruit juice).
heat stroke
If untreated, heat exhaustion can progress to heat stroke. Signs include confusion, headache, lack of sweating and flushed and red appearance. The skin feels hot to touch and the person's temperature is raised. In addition, they may show lack of coordination, fits and finally coma (unconsciousness). Heat stroke can be rapidly fatal, so you need to take immediate action to lower the person's temperature and to get medical help. Move the person into the shade or a cool environment (get a fan going or use a room with air-con), give them cool water to sip intravenous fluid replacement may be needed once you get medical help, ice packs, sponging or spraying with cold water and fanning will all help; ice packs are most effective if you put them over the groin and under the arms, but wrap them up first.
fungal infections
Sweating liberally, probably washing less than usual and going longer without a change of clothes mean that long-distance walkers risk picking up a fungal infection, which, while an unpleasant irritant, presents no danger. Fungal infections are encouraged by moisture, so wear loose, comfortable clothes, wash when you can and dry yourself thoroughly. Try to expose the infected area to air or sunlight as much as possible (without causing offence) and apply an antifungal cream or powder.
diarrhoea
To prevent diarrhoea, avoid tap water unless it has been boiled, filtered, or chemically disinfected (e.g. with iodine tablets); only eat fresh fruits and vegetables if cooked or peeled; be wary of dairy products that might contain unpasteurised milk, and be highly selective when eating food from street vendors. If you develop diarrhoea, be sure to drink plenty of fluids, preferably an oral re-hydration solution containing lots of salt and sugar. A few loose stools don't require treatment but, if you start experiencing more than four or five stools a day, you should start taking an antibiotic (usually a quinolone drug) and an antidiarrhoeal agent (such as loperamide). If diarrhoea is bloody, or persists for more than 72 hours, or is accompanied by fever, shaking chills or severe abdominal pain you should seek medical attention.
Giardiasis
This travellers favourite is caused by a parasite, Giardia lamblia, which you acquire by ingesting food or water contaminated by the hardy cysts of the parasite. Giardia can also infect animals, and may be found in streams and other water sources in rural areas, especially on trekking routes. The illness usually appears about a week after you have been exposed to the parasite, but it can appear several weeks after. It may cause a short-lived episode of typical 'travellers diarrhoea', but it can cause persistent diarrhoea. You often notice weight loss with giardiasis, as it can prevent food from being absorbed properly in the upper part of your gut.
Giardiasis can start quite suddenly, with explosive, watery diarrhoea, without blood. More often you get loose, bulky, foul-smelling faeces that are hard to flush away (assuming you have the luxury of flushing, of course), with lots of gas, bloating, stomach gurgling and cramps. You can sometimes get a mild fever and often feel nauseated, with little or no appetite, 'indigestion' (heartburn) and rotten-egg burps. Although all these symptoms commonly occur in giardiasis, note that they are nonspecific symptoms and can occur in other types of diarrhoea too - eg you can't assume you've got giardiasis just because you've got rotten-egg burps.
You should ideally have a laboratory test to diagnose your illness before starting a course of antibiotics, but if you are in a remote area away from medical help, you could take either metronidazole (250mg three times daily for five to 10 days) OR tinidazole (2g single dose -tinidazole is not currently available in the USA).
HIV/AIDS
HIV (Human Immuno-deficiency Virus) develops into AIDS (Acquired Immune Deficiency Syndrome), which is a fatal disease. Any exposure to blood, blood products or body fluids may put the individual at risk. The disease is often transmitted through sexual contact or dirty needles - body piercing, acupuncture, tattooing and vaccinations can be potentially as dangerous as intravenous drug use. HIV and AIDS can also be spread via infected blood transfusions, but blood supplies in most reputable hospitals are now screened, so the risk from transfusions is low. If you do need an injection, ask to see the syringe unwrapped in front of you, or take a needle and syringe pack with you. Fear of HIV infection should not preclude treatment for any serious medical conditions. Most countries have organisations and services for HIV-positive folk and people with AIDS. For a list of organizations divided by country, plus descriptions of their services, see www.aidsmap.com.
tetanus
This infection is caused by a germ that lives in soil and in the faeces of horses and other animals. It enters the body via breaks in the skin, so the best prevention is to clean all wounds promptly and thoroughly with an antiseptic. Use antibiotics if the wound becomes hot or pus-filled, or throbs. The first symptom may be discomfort in swallowing, or stiffening of the jaw and neck; this is followed by painful convulsions of the jaw and whole body. The disease can be fatal, but is preventable with vaccination. |
