Stay healthy

Whether you have a "staycation" or travel to the farthest corners of the Earth, you will be able to enjoy your travels more if you stay healthy. This article presents an introduction to good practices: how to live healthy, minimize risks to your health, and deal with injuries and ill health if you encounter them while you are away from home. There is something very unsettling about being unwell overseas so it's good to be prepared.

Before you go
"The first wealth is health"

- Ralph Waldo Emerson

Living a healthy lifestyle
Regardless of where you plan on travelling, you are more likely to stay healthy if you are already living a healthy lifestyle. Getting regular aerobic exercise increases your endurance, enabling you to do more walking, hiking, swimming, skiing, or other more or less strenuous activities you may want to partake in on your trip, and making it less likely that a tough climb will result in a heart attack, dizziness, or shortness of breath.

Vaccinations
Get any required or recommended vaccinations, starting 8 weeks before travelling, especially when travelling abroad to tropical or developing countries. If you are travelling to a particularly disease prone area, you may want to discuss immunoglobulin injections, which will make you immune to a host of diseases for several months. Consult a doctor to identify exact needs, as it depends on the case and the individual. For info about specific vaccines, see the article on infectious diseases.

Don't wait till the last minute, as some vaccinations take weeks to produce immunity and if you need multiple vaccinations, chances are good that some of them require a few weeks (usually 2 to 4) before the next vaccination. It really could be the difference between life and death. Also be aware that some countries require immunizations for travellers entering the country, particularly in areas where yellow fever is a risk. The internationally recognized "Carte Jaune" (yellow card) is a document created by the World Health Organization that is valid proof of immunization for yellow fever. Your doctor can either provide you with a Carte Jaune or update your existing card when you receive an immunization. Customs agents may check this record before allowing entry into a country.

Yellow fever vaccination is not the only potential required vaccination. For instance, travelers are not permitted to visit Mecca during Hajj without a meningococcal meningitis vaccine due to previous outbreaks that have occurred during that pilgrimage.

Medication
If you have a pre-existing health condition, consult your healthcare provider beforehand. You may need to take special precautions when traveling.

If you use prescription medication, make sure to bring it with you, especially if it would be hard to find where you're going. If you will be away for more than the number of days remaining of the medication, talk to your pharmacist about getting an extra supply for your vacation. Also take non-prescription medication with you: some medications that are over the counter in one country require a prescription in another. Some drugs may be difficult or impossible to find in some countries.

However, make sure that by taking such medications on your trip, you won't run afoul of local drug laws and get in trouble. If crossing an international border, confirm in advance that you can convey your medications. What's legal in your home country may be illegal in another. In particular, always check for: Pay particular attention to medications if you are traveling to, or could be diverted to or involuntarily delayed in, United Arab Emirates. They restrict or ban a wide variety of medications, such as anti-diarrhea drugs, antidepressants, cough medicines, and hormone therapy (including estrogen and testosterone) and painkillers, and the mandatory prison sentence for even trace amounts of a banned substance is four years. The UAE also treats common foods that contain poppy seeds with the same harsh sentence as smuggling pure heroin.
 * narcotics, such as codeine-based cough syrup and medications for treating pain, such as Vicodin, Percocet, and oxycodone;
 * benzodiazepines, barbiturates and other psychotropic drugs, such as phenobarbital for epilepsy, dronabinol for nausea, and some sleeping pills; and
 * amphetamines, such as the anti-ADHD drugs Adderall and Ritalin (methylphenidate), especially when going to Japan.

Singapore is also notorious for its strict anti-drug policies and for executing drug users. Unlike the UAE, they provide a comprehensive list of prescription medications that you must seek permission to possess for personal use, and a lengthy list of drugs that are illegal under all circumstances, including nicotine gum and any chewing gum that claims to promote dental health. Note that the presence of cannabis in a urine test has been counted as "possession" in Singapore, even if it's certain that the traveler used the drug in another country.

Take copies of your prescriptions in case you lose or run out of medications or to prove the medication is for your personal use.

If you are traveling within your own country or another country that has an agreement with yours, you may be able to have a prescription temporarily transferred to a local pharmacy. Ask your pharmacist if this is possible in your case.

Also, there are some diseases that can be prevented with prophylactic medications, including malaria. As with vaccinations, it can take weeks for immunity to build up, so find out well in advance of your trip which medication(s) you need and when you should start taking them. To be effective malaria medicines must be taken for a period of time after exiting area at risk, which can range from days to weeks, so it is important to keep that in mind as well.

First aid kit
Especially if you are going to be doing hard hiking in remote areas, make sure you bring a first aid kit with you, including a tourniquet. You don't want to be caught without in an extreme situation.

Take a health kit of medications and first aid items. Ensure that the quantity of prescription medications, and other items that may be difficult to obtain while travelling, will last for the entire trip. If you're taking it as hand luggage on a flight, be sure to leave the scissors out though.

Condoms
If there is any chance you might have sex on your trip, buy the condoms of your choice and take them with you. If you don't, there's a risk that you could get carried away by the moment and catch something you can never get rid of, get pregnant or get someone pregnant. Also, condoms sold in some places may be the wrong size for you or may be poorly quality-controlled and liable to break. And while it has become extremely rare, there are some places in the world where condoms are hard to get, if not impossible.

Being of a very durable, cheap and lightweight material, condoms can in a pinch also serve purposes other than the one for which they were designed. In fact, some military units regularly carry condoms for non-sexual uses. Condoms can serve as makeshift waterproofing or as containers for up to a liter of liquids or some solid substances. Do keep in mind that condoms will not survive contact with any sharp objects and are liable to break under UV radiation or extreme temperatures; use things that were actually designed to do the job instead of condoms if they are available.

Travel insurance
Verify what your regular or credit card insurance will cover while away from home, and consider taking out travel insurance to cover any difference. Although travel insurance for lost luggage and delays will save some small costs or inconvenience, the cost of medical treatment or medical evacuation can be crippling if not covered by insurance. In some countries, an inability to show you are insured or can otherwise pay may lead to your being refused treatment altogether. Some countries will not allow entry into the country without proof of medical insurance, such as Cuba. Worst case scenario, you pay for it and never use it. So you cost yourself a few bucks. But if you need it and don't have it, the downside is massive.

Guarding against injuries in accidents
Whether you are in a car or a plane, you are well-advised to use a seatbelt and to check everybody else is. You don't want your child from the back seat to hit you in 70 km/h, neither do you want to crash through the windshield. Also anything borderline hard or heavy should be packed so that it stays where it is in case of an accident; you don't want a bag or flashlight in the back of your head.

If you are on any kind of bike, make sure to wear a good helmet, and if you are going somewhere where helmets are hard to find, consider bringing one from home. You do not want to have your vacation spoiled by an easily preventable brain injury.

Precautions against disease
Keeping clean is usually easy if you stay and eat at a business hotel. In a low-income country or in outdoor life, it is more of a challenge. Toilets are a risk factor.

Water contamination
Make sure you know whether the tap water of the places you're visiting is safe to drink. In many instances, it is not safe to use tap water even to rinse your toothbrush, unless the water is boiled. Similarly, be careful about drinks with ice. If the water is not safe to drink at room temperature, freezing it will not kill pathogens that can make you very sick. In some cities like Shanghai, there are restaurants that use reverse osmosis that filters out pathogens from tap water, and use that tap water to make their ice. If that's the case, the ice is safe, but when in doubt, look out!

Food contamination
Food poisoning can happen anywhere, but the risk is greater in hot climates where food can go bad more quickly. Be careful about food that has been or could have been left out for hours, especially in hot weather that's conducive to microbe reproduction. Travellers' diarrhea is particularly common when people from developed countries travel to developing ones, where sanitation standards tend to leave much to be desired.

In addition, in countries where nightsoil (human excrement) is used for fertilizer (such as China), it is dangerous to eat raw fruits or vegetables unless they have hard peel that can be discarded. Also fresh vegetables washed in possibly dirty water are a risk. In many countries, raw fruits and vegetables are usually quite safe, but if you are in doubt about the safety of raw, unpeeled fruits or vegetables anywhere, don't eat them. Also, even if you are purchasing a slice of melon, if you know whether the vendor used a dirty machete to chop it or it was cut cleanly, you can gauge the possible danger from eating it.

Finally, there are diseases and parasites you can get by eating meat, poultry, or fish that has not been cooked to a sufficient temperature to kill them. This does not mean that sushi and sashimi restaurants are all unsafe to patronize, nor that the steak tartare at your local French restaurant will definitely make you ill: part of what you need to do when patronizing an eatery is to make a judgment about how much you trust their quality control.

Pests
If you are going to be traveling in a region where diseases spread by mosquitoes, ticks, flies, or other vectors are endemic, make sure to take preventive measures. To avoid mosquito bites, consider using a repellent such as citronella and sleeping under a mosquito netting. To reduce the risk of tick bites, also tuck your long pants into your socks, and search your body for ticks when back at home or making camp for the day.

Body care
Services such as spas, public bathing and hairdressing are usually relatively cheap in low-income countries. They can be a good compensation for long travel without proper sanitation.

Dangerous animals
We have a separate article on this topic, but the watchword really is to respect animals, listen to what local people say about them, and use common sense.

In the event that you have potentially been exposed to rabies, prompt treatment is critical. Treatment only works prior to development of symptoms and rabies is nearly always fatal once symptoms develop. More on rabies can be found under the article for infectious diseases.

Swimming and diving risks
Some beaches are extremely dangerous. If you ask some locals where the beach is, and they point you in its direction but tell you not to swim there because there are evil spirits in the water, don't ignore their advice. Whether you call it evil spirits or undertow, it will kill you just as dead. A word to the wise is, if you are considering swimming at a remote ocean beach with no lifeguard, make sure it is partially enclosed by a cape, because that is likely to cut off some of the riptide. Of course, it's much safer not to swim unless a lifeguard is on duty.

Also be careful in places where dangerous jellyfish are endemic. Jellyfish attacks are much more frequent than shark attacks, and from some species, more likely to be fatal.

There is no reason to be paranoid about risks involved with swimming; just know what the risks are in each place you visit and make a judgment about them.

In terms of diving risks, scuba diving can easily be fatal if you are not properly trained. Fortunately, you generally cannot scuba dive unless you are properly trained and certified, which minimizes the risks greatly.

If you would prefer to stay closer to the surface of the water, snorkeling can be a good alternative. It contains its own risks, but in many places, you can stay in shallow water, where you can swim back to shore more quickly and may even be able to stand up if you have to (though it is bad to stand on fragile coral reefs and should be avoided whenever possible).

At some beaches algal bloom is a recurring problem. If the water has a layer with an odd colour, check whether this is normal or may be harmful.

Swimming or wading in fresh water, in some warmer climate countries, may lead to parasitic infection. For instance, around 200 million people are infected worldwide with schistosomiasis, a parasitic worm found in fresh water. Where this is a risk, the effective protection is to not enter the water. Consult a travel medicine specialist for advice for where this is a risk.

What to do if you get sick or injured
If there is a reliable emergency number for ambulances in the country you are visiting, make sure you have it memorized or take it with you. For GSM phones 112 should connect you to the local emergency number (but better safe than sorry). You can try 112 or 911 with any phone and hope they are forwarded to the right place. Your insurance company may also have a helpline – you have also that number handy, don't you?

If you are dealing with a situation that is not an emergency, but you are nevertheless really ill, don't be a hero: Get a recommendation for a good doctor (preferably one who speaks your language, but some of the content of our phrasebooks may help you in extremes), and go and see them. If you are traveling in a remote area where either there are no doctors or your condition is too serious for you to be able to travel to a doctor, find out who the reputable local traditional medical practitioner is, and see them. The herbs they prescribe for you could be just the thing you need. Also consider medical evacuation (by helicopter or whatnot).

Private healthcare can be very expensive. Also some European countries that have a state-backed healthcare system are notoriously expensive for foreigners. To cover the costs you really want to have an travel insurance that cover them. In the UK for instance, the cost of seeing a private doctor can be upwards of £150 for a face-to-face consultation.

In addition to the worry of the treatment itself and its costs, you might have to change your plans. You don't want to sit in a bus for your next destination, and you might not be allowed on your homebound flight. You need to extend your hotel stay or find somewhere else to stay, you need to cancel transport and accommodation you cannot use, and you might need to get somebody to take care of you, at least in getting you fed and checking up on you. Will you overstay your visa? Lastly you need to get new transport to get home, and you might want to get home while you still aren't able to travel by the normal transports.

Your insurance might cover all or parts of this, but there may be loopholes. Can your travel company stay with you? You might need a doctors statement on your being ill – can you get to a doctor? What if you aren't ill, but are put in quarantine (such as having been on a flight with somebody testing positive for COVID-19)?