The following health information is a general text that applies to all our travellers in South America. Those who pay some attention to hygiene and skincare do not usually run into health problems.
Food and drink: Temperatures in Peru and Bolivia can be extremely high and if you do not drink enough you run the risk of getting dehydrated. This effect is magnified at high altitude. Tap water is unsuitable for human consumption. Generally, mineral water is available. When ordering a drink, ask the staff not add ice cubes, as these are usually made of unboiled tap water and may contain germs. In small eating-places, it is better not to eat fruit or salads that have been skinned beforehand. Preferably, take your meals in busy restaurants. They are busy for good reason and the food is fresh. Clean your hands thoroughly before eating and keep your fingernails short.
Sunshine and heat :Sunburn, particularly at high altitudes, is a frequent cause of health problems. Sunburn and heat strokes are easier caught than you may think. You should therefore avoid the sun during the hottest hours of the day, always wear a hat (or carry an umbrella) and good sunglasses when you are walking, and use the recommended factor of suntan lotion. These are best brought from home. At high temperatures, the body’s need for water increases very rapidly, as does its need for salt. Make sure you drink enough. Take it easy during the hottest hours of the day. Treat small scratches, wounds and insect bites before they become infected.
Diarrhoea: Next to sunburn, the most common health problem is diarrhoea. Travellers are often hit by it after they have been on holiday for only a few days. In most cases it is innocuous and caused by the change of diet, the heat or harmless bacteria, against which the body will soon develop its defences. The main risk is dehydration, especially in children. It occurs when the body loses more fluid, salt and sugars than it receives. The result is a feeling of listlessness and weakness. It can be prevented by drinking a solution of water and ORS (Oral Rehydration Solution). It is sold in bags at the pharmacies and contains all the minerals and sugars that are lost with diarrhoea. Instead of this solution you can also take noncarbonated soft drinks or heavily salted broth. For many people, Coca Cola has a constipating effect in the first stages of diarrhoea. When the diarrhoea is accompanied by high fever and/or bloody defecation it is sensible to consult a physician. When the diarrhoea lasts for more than a few days without the above-mentioned symptoms or when you have to travel, you may take Imodium (or Diacure) a couple of times. It is an opium-like preparation that prevents bowel movement for a number of hours.
Insect bites: Mosquitoes are not a big problem in these countries, however, they are found in some places. Insect repellents are effective, but do not expect miracles.
Physicians, pharmacies and medication: If you want to consult a physician, ask advice from the guesthouse/hotel staff or the travel guide.
First-Aid Kit: A good first-aid kit would consist of plasters, bandages, cotton wool, scissors, a thermometer, iodine, painkillers, malaria tablets, Oral Rehydration Solution bags, Imodium, sun cream, earplugs, and tweezers, insect repellent and an anti-itch cream or lotion. If you must regularly use prescription medicine, bring with you an exact description of the medicine in English (no brand names, just the essential ingredients, composition and dosage), bring twice the dosage necessary for the duration of the holiday and store in two separate places, so you always have a back-up.
Altitude sickness: About half of the people who stay at heights above 3500 metres will suffer from altitude sickness to some degree. It is a reaction of the body to the decreasing oxygen content in the air. The danger is in the accumulation of fluid in the lungs or brain. Altitude sickness is potentially deadly. Be sure to be alert to the symptoms. Before giving a description of the symptoms, note that contracting the illness is not dependent on your physical fitness or routine when walking at altitude. Practised mountain hikers and even our bearers in Nepal can contract it even after long exposure. People under thirty, those who have had altitude sickness before and people with a pulmonary or heart condition are at a greater risk. There is a wide range of symptoms with altitude sickness. The French Alpine Association works with a scoring system in order to assess the seriousness of the situation. Symptoms with one point are nausea, headache, insomnia, dizziness. Two points: vomiting, headache that does not react to aspirin. Three points: excessive fatigue, shortness of breath or tightness of chest without exertion, little or no urination. If you do not score more than three points you can keep on going up slowly, but it is better to go on climbing when the symptoms have disappeared completely. Between four and six points, must be careful and wait until the symptoms have disappeared, or even better descend a couple of hundred metres. More than six points means: there is a life-threatening situation at hand, descend immediately, the patient cannot stay at this altitude and certainly not sleep here. During this journey, we will reach a height of 4900 metres at most. This is not an altitude where one can expect great difficulties but it is necessary to be alert. Most travellers will experience a difference when exerting themselves. At a height of 4000 metres, climbing two flights of stairs can even be a difficult task. The best thing is to take it easy and drink a cup of Coca Tea now and then.
Vaccinations: Below is the recommendation of the Health Authorities when this edition went to press. This information may change. Furthermore it depends on your personal needs if you have had previous vaccinations, possible sensitivity for certain medicines, pregnancy, age etc. ALWAYS contact your General Practitioner or the Practice Nurse for advice. To obtain the most recent general information you can call The National Travel Health Network and Centre (NaTHNaC) Tel: +44 (0) 845 155 5000 ext 5943 and visit their website http://www.nathnac.org/travel and http://www.fitfortravel.nhs.uk/ . We at Shoestring cannot provide any further information by telephone. The complete overview for this journey is: DTP, hepatitis A, Typhoid and yellow fever. Plan ahead, some inoculations need time to achieve the desired effect.
A yellow fever vaccination is compulsory in Peru. Recently, for travellers booking a time extension in the jungle in Peru a vaccination against yellow fever was made compulsory. You have to be able to prove this on arrival by showing a certificate or stamp.
Further advice to make you journey more pleasant
Allow your body and mind the time to steadily adjust to the new time zone and location. Avoid tension, do not draw up a plan immediately. In any event take it easy on the first day. Getting up early is a good habit; in warm countries, the morning temperature is usually the most agreeable. The people in these countries are used to getting up early. If you adapt to their rhythm, you will make the most of your time.