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| Home Page of Paul Dalhoeven |
Generally speaking: don’t 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 won’t
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.
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
You might want to add compass, maps or whatever the
circumstance requires.
It looks a bit funny, but when you’re 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.
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 don’t trust it, or
as you likely don’t 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.
Don’t 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 it’s 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 that’s just my personal thing.
Water
is of utmost importance. Drink whenever you feel the slightest thirst, it’s
difficult to drink too much water. In deserts, you’ll have to drink up to 7
liters a day, which you can’t unless you take two tablespoons of pure table
salt every day. Seven liters of water weights 7 kilo, so don’t spoil it, it’s gold. But drink enough !!!
It’s 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 it’s 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
Fruits
have to be peeled or sterilized. On local markets you can find the richest,
cheapest delicacies you’ve 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 you’re 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).
Don’t underestimate this, but also don’t 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 it’s too
hot, just order something else. If your mouth is on fire, don’t 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 it’s hot, so you
will loose too much water, and it undermines your strength. When
mountaineering or crossing a desert, don’t even think about it.
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 it’s above 37 degrees
centigrade, it’s 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 don’t 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. Don’t 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. Don’t 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. Don’t go
anywhere you need special climbing tools, in case you don’t have these. Don’t
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, Don’t 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 there’s
no cattle on the slopes above you). Don’t 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, don’t 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
you’re 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. Don’t
touch the beautiful anemones, as they may give a serious sting. Don’t 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. Don’t remove remaining tentacles with your hands, as you’ll
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 isn’t caught in an offshore current.
Don’t fall asleep on the boat. Use plenty, plenty of waterproof sunblocker (only available in ‘modern’ cities). Always
check with locals if it’s save to swim. Reefs may contain cone shells, which
produce one of the most toxic poisons on earth. About all water snakes are
toxic.
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 ‘’valid the next three
months’, 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.
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 ‘hollow’belt, 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 don’t
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 won’t be able to change them back.
Write down the number of the travelers check, the date
and the place where you cashed them.
Don’t use your credit card unless really needed. It’s
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).
In case of diarrhea, make sure to drink a lot of
water. When you pinch yourself and the skin doesn’t return swiftly, you are
dehydrating. Don’t only drink pure water, add lots of
Oral Rehydration Salt (ORS) to it, to compensate the
salts you’re 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 don’t like glass syringes, as I’m
completely dependent on the local discipline on how to sterilize them)
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.
Don’t combine with other medicines, like paracetamol
or anticonception pills, as this really absorbs
everything.
Paracetamol:
used against pains
Strong pain killer: (maybe you’ve 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
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
Meningitis
Meningitis vaccine is recommended for travellers to areas where the disease is endemic such as
most of Sub-Saharan Africa.
Japanese B
encephalitis
Japanese B encephalitis is a rare but serious insect
borne disease that occurs in most of the
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 of Mycobacterium 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
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 measures and Chloroquine
in case of infection
Parts of
No risk in the big cities
Very low risk in the tourist areas
of Java,
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
The jungle areas of
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 measures Chloroquine
+ Proguanil
Trip > 2 weeks: General measures Chloroquine
+ 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.
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
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
Diphtheria
Low dose boosters of diphtheria vaccine are advised
for travellers to countries of the former
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 you’re 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 you’ll gain, in terms of fun but also in terms of security. The
same is true for your home town. So open up and relax. Don’t expect anything,
be absorbed by the life around the corner. When you accept the occasional
hazard and stay alert, you’ll be fine, I guess.