Home Page of Paul Dalhoeven    

     

Tips for travelers.

 

Clothing

Daybag

Hygiene

Food

Special Tips

Paperwork

Money

Health

Medicines

Vaccinations

 

CLOTHING:

Generally speaking: donít take too much with you, but buy your clothes on the local market. Much lighter backpack, much cheaper, stimulate local commerce, and tuned for their climate. Furthermore, you wonít offend anyone if you wear local stuff, whilst your t-shirt or shorts may invoke local disapproval.

A plastic rain suit is advisable, as these things are lightweighted, and miniscule. Folded they easily fit in your daybag.

Mountaineering shoes are best bought in your home country, as well as strong sandals. When you wear mountaineering shoes, wear 2 pairs of socks, woolen socks over the light socks. Your feet will sweat a lot whilst mountaineering, crossing desserts (against scorpions) or crossing jungles (against leeches, snakes and all kinds of crawling keeps), but the two layers of socks absorb more sweat, thus avoiding blisters as well.

 

DAYBAG:

Walk as light as you can, try not to carry anything in your hands as your arms will feel twice as long. Take a daybag, like a small backpack. Fill this with

  • the travel book,
  • water,
  • snacks or food,
  • toilet paper,
  • medical emergency kit,
  • camera and batteries.

You might want to add compass, maps or whatever the circumstance requires.

It looks a bit funny, but when youíre walking with your backpack, you could wear the daybag in front. Looks alien, but the counterweight in your front does help to keep the balance.

 

HYGIENE

The most important thing whilst traveling is to wash your hands, and properly dry them, before every meal. Soap does nothing more than dispense the dirt and bacteria, you need a clean towel to actually get rid of them. Use your own towel if you donít trust it, or as you likely donít have a towel with you, use your toilet paper. For this and other more obvious reasons, always carry six sheets of toiletpaper in your back pocket. Fill up whenever you can. Toilet paper is often very expensive or even not available (muslims use their left hand instead), so it could be worth to occasionally visit a 5 star hotel and fill up. You might even consider dining in the 5 star hotel, as food prices are 2 or 3 times local prices which is still reasonable, whilst lodging is outrageously expensive.

Once every two weeks I take a hotel with at least two stars, so I can have a proper hot bath or a shower. After a physically exhausting trek, a nice hotel is bliss. A hamam (Turkish bath) is even better.

Donít drink the water of the shower. Use mineral water for brushing your teeth. In the desert, take 1 cup of water to wash and brush your teeth. Forget how your hair looks after not having it washed for weeks, forget shaving, but do wash your skin for as much as you can with just 1 cup.

I hate dirty beds, and always use my sleeping bag, together with its cotton inner sheet (which both have an extension for the head. Often itís way too hot to sleep inside the sleeping bag, so I place this on top of the bed, and sleep on top of my sleeping bag. I always sleep inside the cotton inner sheet (at least to minimize mosquito impact) and use the head part to cover the pillow as I hate the idea of exposing my cheeks to pillows where others drooled on it in their sleep. But thatís just my personal thing.

 

 

FOOD

Water is of utmost importance. Drink whenever you feel the slightest thirst, itís difficult to drink too much water. In deserts, youíll have to drink up to 7 liters a day, which you canít unless you take two tablespoons of pure table salt every day. Seven liters of water weights 7 kilo, so donít spoil it, itís gold. But drink enough !!!

Itís amazing how good mineral water is distributed throughout the world. It tastes much better than the chlorinated water, your only other alternative.

Drinks are only allowed when itís hot (like tea or coffee), or when you see them opening the bottle. Fresh fruit juices look so appealing, but they are diluted with unclean water, so I advice not to drink fresh fruit juices. Pity.

Same for food. It is not recommended to eat any food that can have traces of unclean water, or traces of dirt from people handling it:

Salads, how rich and appealing they may look, are cleaned in water of disputable quality. Five star hotels have a better reputation, but I only go there once a week or two, because 15 euros for a great buffet is cheap (and a good place to get free toilet paper) but not according my daily budget. (Residence is completely out of the question, the 5 star rates are quite similar to Europe or US standards). But again: no 5 stars, no salad, at least for the first month of stay.

Fruits have to be peeled or sterilized. On local markets you can find the richest, cheapest delicacies youíve ever seen. Fruits with a peelable skin, like bananas and oranges, have this natural protection in shape of the skin, and with it you remove the bad water and human bacteria on its skin. Of course you clean your hands prior to eating the orange, so youíre in full control of the bacteria level. Fruits which you eat including the skin, like grapes, must be washed with your own water (either mineral water from bottles, or chlorinated tap water).

Donít underestimate this, but also donít exaggerate. After a month or so, you should start to slowly expose yourself to the local micro-environment, to build some resistance.

Icecream. Only enjoy packed icecream. Fresh icecream may have lingered on the bottom of the can for months.

Uncooked meat is lethal. For commercial reasons, some cooks are too much in a rush to have the chicken well done. Before you eat it, please check if the meat inside is also well cooked on the inside. Besides, if the food is cold, you should reject it.

Spicy food can burn 3 times, in your mouth, in your intestines, and further. If itís too hot, just order something else. If your mouth is on fire, donít use water (or beer ;-), as this just spreads the capsaicin throughout. Plain rice works much better.

Alcohol is a dangerous substance. It induces excessive sweating when itís hot, so you will loose too much water, and it undermines your strength. When mountaineering or crossing a desert, donít even think about it.

 

 

SPECIAL TIPS:

Jungle: very wet, loads of mosquitoes, leaches and giant toxic centipedes with a big sting. Cover your complete body: long trousers/sleeves, sunhat (against spiders), mountaineering boots, pull socks over your trousers, big handkerchief around your neck (against leeches). Take an experienced guide, and a compass. Never scatch any bite, as this can get seriously infected.

Desert: very hot, very dry. Cover your complete body: long trousers/sleeves against sunburn, sunhat, mountaineering boots (sand is too hot for sandals), big handkerchief around your neck (against sunburn). When itís above 37 degrees centigrade, itís cooler to have more clothes on, than less. Only wear cotton, as this absorbs sweat. Drink plenty, take 2 spoons of salt every day. When dressing, check your boots as scorpions like warm, sweaty dark places for sleeping. Use suntan oil all over your body, as cotton clothes have a protection factor of less than 5, so you can burn trough your clothes. Try to continue to eat normal, even if you donít feel like it. Nights can be pretty cold. Never go alone. For long tracks, upon arrival, go to the police station first, to announce your arrival and alert them on your next destination. Donít give phony names, as this is not so much for their records, but more for rescue operations. Always drive in convoys, never with 1 car alone. If possible, buy a shortwave radioset. Take at least 10 ltr of water per person per day, and consider the car itself as an additional person. Take two metal sand mats in case you go over loose sand. Follow the markers, return to the previous in case you miss one. Take a compass. Always stop for other people, convoys etc., to check local conditions. No alcohol at all. Donít swim in still water in oases, as this might contain some really nasty bugs, causing things like schistosomiasis and hepatitis.

Mountains: take rain suit with you, wear clothes in layers, so you can easily add more heath if needed. Rely on good mountaineering boots. Read the book, tracking instructions, make sure to have a very detailed map and take an experienced guide and a compass. Never go alone. Plan everything carefully. Donít go anywhere you need special climbing tools, in case you donít have these. Donít take risks, beware that fatigue and high altitude makes you take stupid risks. Take a walking stick for long descends, as this really is an attack on your knees. Slow does it, walk in the rhythm of your heart, smaller steps in case of steep ascent, Donít walk on glaciers. Take a small blowing whistle, to alert others in case of need, and a torch. Boil melting water thoroughly or add chlorine, (unless you are very sure thereís no cattle on the slopes above you). Donít eat ice. Use a gasoline heater, as spiritus (alcohol-based) heaters take way to long to boil water. Mild alcohol usage at night against the cold ;-). Lots of sunblocker, donít forget your ears and nose. Sunhat, sunglasses and warm gloves. When you see small black spots moving around, together with a headache, go down now. Under an avalanche: pee, if needed in your trousers. Dogs can smell your pee. Never fall asleep unless youíre in a safe place, stay awake. Go around obstacles, rather than over.

Sea: mind your step, try plastic shoes in case the seabottom is covered with sharp rocks or sea urchins. Donít touch the beautiful anemones, as they may give a serious sting. Donít eat fish you caught in coral, as most are toxic, or at least eat toxic coral or coral fish. Leave coral fishing to experts. Use antihistamine in case you got a jellyfish kiss. Donít remove remaining tentacles with your hands, as youíll only get more stings. Use weed, or sand. Big waves + rocks = death. Never enter the water when the tide is getting low and you get strong currents towards the sea, at bottom level. Make sure your raft isnít caught in an offshore current. Donít fall asleep on the boat. Use plenty, plenty of waterproof sunblocker (only available in Ďmoderní cities). Always check with locals if itís save to swim. Reefs may contain cone shells, which produce one of the most toxic poisons on earth. About all water snakes are toxic.

 

 

PAPERWORK

Make multiple copies of your passport, including the pages with the visa, and travel documents, and store them in your backpack as well as your daybag, as well as leaving some copies at home.

Take a worldwide health insurance, and insure your luggage for about the real price. Take copies and treat these as above.

Write down all the numbers of your travelers checks, and include the phone support number in case of theft. Make copies, etc.

Make a list of people at home, to contact in case of serious issues, make copies etc.

For every country you go, find the phone nr of the embassy (or consulate). Make copies etc.

On longer trips, check where you can get visa for the next countries (many visa have a limited lifetime, like Ďívalid the next three monthsí, way to short to be useful. Plan your visa.

Set up a hotmail account, and a place to ftp your digital photos. Many big cities have got internet cafes.

 

 

MONEY

Read the book what kind of travelers checks are most common in that country.

Take sandwich bags to cover all your documents / travelers checks etc. prior to putting them in your money belt. I always use a belt hanging over one shoulder, leaving the bag under my other arm pit. Also to be used for credit cards, emergency phone nr, etc.

Use a Ďhollowíbelt, like the one you use to keep up your trousers, but then with a zipper in it, and a space for money. Good sports shops have them. Fold cash US dollars in three, put them in sandwich bags and fold them into the belt. Take some hundreds of dollars, as this money is not only for traveling from any place to the nearest embassy, but also for those remote villages whene they donít accept travelers checks.

Wallet: buy a good one, and attach it toy your belt with a chain of iron. Whenever you cash money, take small notes only, as no remote shopkeeper will have change for 25 US. Put the excess in your money belt under your pit. Besides, never accept notes which are torn. In many countries, people have the believe that these are invalid, and you wonít be able to change them back.

Write down the number of the travelers check, the date and the place where you cashed them.

Donít use your credit card unless really needed. Itís very simple for the shopkeeper to make internet purchases based on the creditcard nr and expire date, which he can capture using carbon copy paper in just seconds.

Never use any money belt which is visible when you fall asleep. Foreign razorblades are very fast and very silent.

Check here if you want to find the latest exchange rates (from rss feed).

 

HEALTH

In case of diarrhea, make sure to drink a lot of water. When you pinch yourself and the skin doesnít return swiftly, you are dehydrating. Donít only drink pure water, add lots of Oral Rehydration Salt (ORS) to it, to compensate the salts youíre losing. I puke on the normal ORS, and I always carry ORS-for-kids, as it tastes much better. Keep on drinking, a constant flow of tea. In case a diarrhea takes more than 4 days, consult a doctor. In case you also have a big flew, or blood in the toilet, consult a doctor immediately.

Doctors normally accept only cash, so use your emergency money, and make sure you get an understandable receipt to claim on the insurance as well. In hospitals you should show your insurance papers prior to contacting the physician, so they can claim it directly to the insurance.

When you go to the doctor, put the plastic syringes in your daybag which you always carry. In case of injections, ask the doctor to use these. (I donít like glass syringes, as Iím completely dependent on the local discipline on how to sterilize them)

 

 

MEDICINES

Immodium: stops intestinal activities (without curing them). useful when traveling whilst having diarrhea.

Clorine: used to disinfect water.

Plasters, cotton wool, bandages: used to cover wounds. Also take scissors with you.

Betadine: iodine based lotion to disinfect wounds.

Pure alcohol: also used to disinfect wounds, but also good to remove ticks

Razor blade. Always useful

Pincet

Antihistamines. against itches from mosquitoes, flees etc. etc. Locally available.

Activated carbon (Norit): used against diarrhea. Donít combine with other medicines, like paracetamol or anticonception pills, as this really absorbs everything.

Paracetamol: used against pains

Strong pain killer: (maybe youíve got some left from the dentist?)

Antibiotics. impossible to get here without prescription, but available locally

ORS (oral rehydration salt). buy the one used for kids, it tastes much better.

Knife

 

 

VACCINATIONS

Minimal 6 weeks before departure, you should check your doctor (GGD) for the essential vaccinations, check the validity of the ones you had before, and update your vaccination passport.

Do not rely on my small list below, but, depending on the countries you're going to visit, you should consider at least the following vaccinations:

 

 

Hepatitis A

You need 2 shots (used to be 3 shots) at 0 and 6 months, although if you can it's even better to postpone the second shot till after 12 months. Best is to get your first shot 2 weeks before departure, but a "last-minute shot" is always possible. They are expensive, but they protect you for 10 years.

Another possibility is to get an injection wth immunoglobulines. However, I advise against this because it's less effective (85%), and you need a new shot each time you go on holidays since it stops working after 3 to 6 months depending on the dose you've taken.

The risk of hepatitis B is almost non-existent if you don't involve in sexual activities or don't get transfusions of blood products or injections with unsterilized needles.

 

 

Typhoid

Original typhoid vaccine is given in two doses at intervals of four to six weeks and gives immunity for up to three years. 0.5ml is given by subcutaneous or intramuscular injection or 0.1ml by intradermal injection. This vaccine induces a mild form of the illness which can be very unpleasant in certain cases.

Typhim Vi is a single dose vaccine where 0.5ml is given by deep subcutaneous or intramuscular injection. Immunity lasts for approximately three years.

Vivotif is a live oral vaccine contained in an enteric coated capsule. The vaccine is taken as three doses of one capsule on alternate days. The capsules should be stored in a refrigerator between doses. Protection begins seven to ten days after the last dose.

 

Yellow Fever

This is given as a live vaccine (0.5ml subcutaneously) at designated yellow fever centres where an international certificate of vaccination will be issued and is valid for ten years, from ten days after vaccination. The certificate may be required for entry into certain countries particularly in East Africa. It is recommended that the traveller carries the certificate along with his or her passport when travelling to countries at risk.

 

 

Meningitis

Meningitis vaccine is recommended for travellers to areas where the disease is endemic such as most of Sub-Saharan Africa. Saudi Arabia requires vaccination of pilgrims to Mecca during the Hajj. 0.5ml of inactivated vaccine is given by deep subcutaneous or intramuscular injection. Immunity lasts up to three years.

 

 

Japanese B encephalitis

Japanese B encephalitis is a rare but serious insect borne disease that occurs in most of the Far East and South East Asia. Vaccination is recommended for stays of longer than one month in rural areas during and just after the rainy season. The vaccine is issued on a named patient basis and is given as 1ml subcutaneously for immunity up to four years.

 

 

Rabies

Prophylactic immunisation against rabies is recommended for travellers to endemic areas on long journeys to remote locations out of reach of immediate medical attention. For travellers who are not animal handlers, two 1ml doses given by deep subcutaneous injection 28 days apart is regarded as sufficient cover.

 

 

Tuberculosis

In many countries across the world, vaccination against tuberculosis is routinely practiced. Bacillus Calmette-Guerin (BCG) vaccine is a live, weakened strain ofMycobacterium bovis (cow tuberculosis), which was introduced in 1922.

The efficacy of BCG is unknown. Earlier European trials showed up to 80 percent protection, but recent Indian trials showed little value. Even though tuberculosis is becoming a problem again in this country, BCG is still recommended only in selected tuberculin-negative individuals with unavoidable intense exposure to tuberculosis, such as children of mothers with active tuberculosis.

BCG may be useful in travelers anticipating close contact with people infected with tuberculosis, but an alternative approach is tuberculin skin-testing before and after travel, with administration of isoniazid in the event of skin-test conversion.

For any individuals facing travel with their children to areas of high tuberculosis prevalence, for example missionaries, I would recommend consultation with a pediatric infectious disease specialist before considering the vaccine.

 

 

Tetanus

The Department of Health recommends administration of reinforcing (booster) doses at ten year intervals, with the administration of further doses in the event of injuries that may give rise to tetanus. 0.5ml is given by deep subcutaneous or intramuscular injection.

The Department of Health advised in 2002 that tetanus vaccine is to be replaced by the combined tetanus/low dose diphtheria vaccine for adults and adolescents for routine use and for travel vaccination. Stocks of single tetanus vaccine are now exhausted and companies are no longer supplying this product.

 

 

Malaria

Central America, a small part of Brazil, some areas in the Middle East and China

There's no risk in the cities, only in rural areas.

The risk is low and usually confined to rainy season.

Plasmodium Vivax is the predominant strain here.

Guidelines:When staying in cities at night with trips to rural areas: general measures, no pills.

When travelling adventurous with staying overnight in rural areas:

Either general measures + Chloroquine pills

Either general measuresand Chloroquine in case of infection

Parts of Yemen and Oman, Afghanistan, Pakistan, India, Sri Lanka, the lower parts of Nepal, most parts of Indonesia, Malaysia and the Philippines.

No risk in the big cities

Very low risk in the tourist areas of Java, Bali, India, Malaysia and Venezuela.

Guidelines

Trip shorter then 14 days:Tourism or business: general measures, Adventure travel with nights in rural areas: general measures + Chloroquine + Proguanil

Trip longer then 14 days:Tourism or business: general measures + Chloroquine + Proguanil OR take treatment in case of infection with you

Adventure travel: General measures + Chloroquine + Proguanil and take treatment in case of infection with you. In certain areas of Indonesia, Malaysia and the Philippines, Lariam is indicated if no contra-indications.

The jungle areas of Brazil, Peru, Ecuador, Colombia, Venezuela, Suriname and French Guyana.

Trip less then 12 weeks: Lariam if no contra-indications. In selected cases, the term of 3 months may be prolonged.

In case of contra-indication:Trip < 2 weeks: General measuresChloroquine + Proguanil

Trip > 2 weeks: General measuresChloroquine + Proguanil and take treatment in case of infection with you.

General remarks:Exceptions to these rules are touristic or business trips in malaria free area with side trips to high risk area:f.i. Thailand with side trip to Burmese border, f.i. Brazil with side trip to Manaus,f.i. South Africa with side trip to KrŁger Park

AND on condition that avernight stay is in good hotels, adequate measures against bites are taken, good medical infrastructure is available

Cholera

The old type cholera vaccine which was given by injection offers poor protection against the disease and is no longer recommended for use by the Department of Health or the World Health Organisation.

However, in May 2004 a new vaccine (Dukoral) was licensed in the UK for immunisation against cholera for people travelling to highly endemic or epidemic areas, particularly emergency relief and health workers in refugee situations. The vaccine may be considered for the following:

††††††††††† People working in areas where there are known cholera outbreaks (e.g. aid workers).

††††††††††† Travellers staying for long periods in known high risk areas and/or where close contact with locals is likely, and who do not have access to medical care.

††††††††††† Travellers to risk areas who have an underlying gastro-intestinal disease or immune suppression.

The vaccine is taken as a raspberry flavoured drink and can be used in adults and children over 2 years. It is not currently licensed in the UK for travellers diarrhoea.

 

Diphtheria

Low dose boosters of diphtheria vaccine are advised for travellers to countries of the former USSR and for long stay expatriates in developing countries. A dose of 0.1ml of the childrens' monovalent diphtheria vaccine is given by subcutaneous injection on a named patient basis. Protection begins ten to fourteen days after administration.

 

Overview

Disease

No of Jabs

Interval Between 1st

Interval Between 2nd

Onset of

Duration of

 

(doses)

& 2nd Dose

& 3rd Dose

Protection

Protection

Yellow Fever

1

-

-

After 10 to 14 days

10 years

Hepatitis A

1 or 2

3 to 6 months

-

After 10 to 14 days

1 year or 10 years

Immunoglobulin (HepA)

1

-

-

Immediate

3 to 6 months

Typhoid

1

-

-

After 10 to 14 days

3 years

Typhoid (oral)

3

Alternate days

Alternate days

After 7 to 10 days

3 years

Tetanus

2

42 days

-

2 days after last dose

10 years

Polio (oral)

3 (oral)

28 days

28 days

2 days after last dose

10 years

Meningitis

1

-

-

After 10 to 14 days

3 to 5 years

Encephalitis

2

7 to 14 days

-

2 days after last dose

3 years

Diphtheria

3

28 days

6

2 days after last dose

10 years

Rabies

3

7 days

21 days

2 days after last dose

2 years

Hepatitis B

3

28 days

5 months

2 days after last dose

5 years

Cholera

2

7 days

-

7 days after last dose

3 months

 

 

Finally:

All of the above might give you the impression that your life is in great danger when traveling. In my opinion, this is NOT the case. Big western cities are potentially much more dangerous. Just use your common sense. In cities, avoid deserted roads as well as massive crowds. You would do the same in your home town, I guess. In rural parts, check out the locals. They know where to go, where to stay away from, and are generally speaking very friendly and helpful.

Never forget that youíre nothing more than a humble guest, and that you are one big mirror. When you smile, others will do the same. When you are friendly and helpful, so are others. The more you pretend to be, the less youíll gain, in terms of fun but also in terms of security. The same is true for your home town. So open up and relax. Donít expect anything, be absorbed by the life around the corner. When you accept the occasional hazard and stay alert, youíll be fine, I guess.


Also check Robert Young Pelton's site on Dangerous Places
Useful info (in dutch) available at LRC