Southern Asia is a region where more diseases are rife then in Europe. The situation is comparable to that in our parts before the Second World War. All dangerous diseases that are common in India or Nepal (to a lesser degree in Sri Lanka and the Maldives) almost exclusively affect the poor. Besides, with a timely treatment they can almost always be checked, for those that can afford it. If you pay sufficient attention to hygiene, insect repellents and skin care in South Asia, you will most probably stay healthy, apart maybe from some harmless intestinal problems.
Food and hygiene: Intestinal problems are much more common in India and Nepal (and to a lesser degree in Sri Lanka and the Maldives) than in Western Europe, and food can be a major source of contamination. Visitors to this country are advised to eat meat and chicken only in reputed restaurants and otherwise stick to vegetarian food. Eat in good restaurants or, if you do go to cheap eating places, look for the busiest ones. Here, the turn-around of the food is highest and hence the freshest. Fried vegetarian snacks can hardly go wrong, although the quality of the frying oil can go down after frequent use, and sit heavy on the stomach. In expensive restaurants, you should be able to trust all the food, including meat, ice creams and salads, but in case of doubt, put it aside. It is best not to eat salads in simple establishments, and the same applies to fruit salads and fruit juices. If you peel the fruit yourself, it is safe. Wash your hands often and check if cutlery and plates are washed properly. Keep your fingernails short.
Sun and heat: Sunburn is a common phenomenon which can be prevented in a very simple way. In the bright tropical sun, people risk sunstroke or sunburn. To prevent this, try not to expose your body to direct sunshine, especially during the hottest hours of day. Wear a hat or cap or an umbrella and a pair of sunglasses when walking in the sun, and use a good sun tan lotion when sunbathing. Buy these articles prior to the journey.The key for good skin care is to treat each little wound with a disinfectant, however small.
Insects: Mosquitoes are most active just after sundown or just before sunrise. So take your measures right then, and during the entire night. Covering up the skin with clothing does help, just as an insect repellent like DDT. Besides, you can request mosquito coils from your hotel desk or the restaurant where you eat. These green spirals can be burnt underneath your table or chair, detaining the mosquitoes. Electric coils are better suited to closed-off spaces. You may also consider bringing a mosquito net.
Animals: Don’t stroke animals. Rabies and scabies occur widely in India. Should you be bitten, call on a doctor immediately. In case of a bite by a monkey or a dog, you should be flown home immediately; and seek medical care straight away. Rabies that has not been treated in an early stage will be deadly without exception. Bites by snakes and scorpions are rare and as a rule are not deadly. However, do not walk in high grass and other vegetation with open shoes. Keep your travel bags closed, in particular at night, and do not put on your shoes in the morning before you have checked if they are uninhabited.
Diarrhoea: The most common complaints are intestinal disorders, in particular diarrhoea. Diarrhoea is a natural defence mechanism of the intestines to quickly dispose of anything damaging or irritating in the digestive tract. In most cases it is a completely innocuous phenomenon caused by a sudden change in diet, the heat or harmless bacteria, against which your body will quickly gain resistance (traveller’s diarrhoea). The main risk is dehydration. Dehydration occurs when the body continues to emit moisture and salts, while the intestines no longer absorb those from their contents. The symptoms are a feeling of listlessness, a dry mouth and lips and a low urine production. Test for advanced dehydration by taking some skin on the top of your hand between your thumb and index finger, and release it. If the skin does not smooth itself straight away, you are dehydrated. In elderly people, this test does not work well. Serious dehydration often leads to a confused state of mind. Drinking lots of water, soft drinks and soup can prevent dehydration. In case of dehydration, it is best to drink water mixed with an ORS solution. This powder, which is available from chemists’ in sachets both in India and at home, contains all minerals which the body loses as a result of diarrhoea. Sugar has been added to improve the uptake of salts and water. The amount to be taken is shown on the sachet. If the diarrhoea comes with a high fever, vomiting, blood in the faeces or vehement retching, call on a doctor immediately. It is probable that you have dysentery, which is caused by bacteria that may require a medicine to fight it. There are excellent medicines to stop diarrhoea, but they do not remove the cause. Medicines containing loperamide, such as the branded medicines Diacura and Immodium, call a complete halt to the bowel activity. It makes sense when you have to travel. However, never take them when the diarrhoea comes with one of the symptoms mentioned and can have the form of dysentery.
Prickly heat: Prickly heat is an inflammation of the pores which comes about as a consequence of excessive sweating. It is common and innocuous, but unpleasant. The skin becomes red and irritated. Places where skin touches skin are extra susceptible, such as armpits and thighs. The symptoms will become less if you shower several times a day (cold, no soap), and dry off well. Applying talcum powder at the sore points may help, too. In moist heat, sleep in a cotton shirt, rather than under a sheet. If you suffer badly, it is best to take a room with air-conditioning for a few nights.
Doctors, dispensaries and medicines: Doctors and dispensary staff are generally well-educated and trustworthy. The medical infrastructure and clinics are of rather poor quality. All medicines can be purchased over the counter, without prescription. When buying medicine, note the date of packaging. A small travel first-aid kit could contain the following items: plasters, bandages, cotton wool, a small pair of scissors, a thermometer, iodine, pain-killers, malaria tablets, ORS sachets, Immodium or Diacure, insect repellent such as DDT and itch-alleviating ointment or stick. In case of an injury, you need an elastic bandage and tiger balm.
Vaccinations: For India, Sri Lanka and Nepal there are no obligatory vaccinations, except if you have visited a region with yellow fever or cholera less than a fortnight before you arrive. To be sure of the best protection, always contact your GP at least four weeks before you travel, to find out what measures to take. Usually, vaccinations again DTP are administered, as well as hepatitis-A, typhoid and malaria pills. The latter are to be taken during the trip until four weeks after your return. Some people get bitten dramatically less by mosquitoes if they start taking vitamin B complex pills two weeks before their journey, but unfortunately this trick does not work for everybody. In Nepal, malaria occurs only in the low-lying Terai, so near Chitwan National Park.
Some more bits of advice for a pleasant stay
Take time to allow your body and mind to adjust to the new time zone and location. Avoid stress; do not draw up a busy schedule. In any case, take it easy the first day. It is a good idea to get up early; in hot countries the morning temperature is often the most pleasant. Besides, the people in the country you are visiting are also used to getting up early. If you adjust to the local rhythm, you will take in most. If you are well rested, you can handle all new impressions best and you will have enough energy to do a lot.