While you are reading books, watching videos and looking at pictures from peoples travels around the world, it can be easy to assume that everything is easy and your days are filled with nothing but adventure. But the truth is you can get some rather nasty illnesses in some of the most interesting places that you might visit. Here is some information about the illnesses and injuries I have experienced on my journey.
Getting a sunburn seems like a pretty common occurrence and I thought I had experienced sunburn before, but on the trip there have been two or three times when I have got a really bad sunburn. The worst was in Romania when I went hiking in the Fagaras Mountains. I don’t use much sun cream, generally I like to build up a tan so that my skin doesn’t burn so easily, but this was the first time I had been in the sun on the for a while. It wasn’t a particularly hot or sunny day, but we were up above the clouds and after hiking for a few hours I got pretty badly burned. My legs got swollen and it felt like my whole of my legs were cramping. It took about a week for me to recover, after spending the first few days laying in bed applying moisturiser/aftersun lotion to the burnt skin and drinking plenty of fluids. After a week it looked like I had the top layer of skin removed from my legs. This is when I went for a swim in the sea. After a few minutes my legs started to feel strange, so I decided to get out of the water. When I got to the beach my legs looked like they were covered in blisters, but the blisters were just sea water which had been trapped under the layer of dead skin covering my legs.
Now I generally try to carry a long sleeved shirt and some thin trousers so that I can cover up and still stay as cool as possible in the heat. After a couple of weeks of covering up less each day I don’t see the need to use suncream. However this is because I tend not to spend all of the day stood in the sun. When riding a bicycle you can sometimes be stuck out in the sun so I definitely think carrying light clothes to cover up is the best idea.
I have been luckier than most people I have travelled with when it comes to food poisoning and other stomach issues. But it is possible to get pretty bad diarrhoea from under cooked food, dirty water or even just drinking water that your body isn’t used to. There are lots of different medicines that you can buy that can help, and I do try to keep a couple of strong stomach antibiotics with me just incase. But generally I just try to keep hydrated and eat bland foods like plain rice, while I wait it out. Obviously the best thing to do is avoid the illness all together.
Even clean water can make you sick if it has different bacteria than your body is used to. So when I am arrive in a new continent I drink bottled water, while slowly adding more of the local water to my daily intake. Maybe by using the water to brush my teeth and rinse out my mouth one day, then take a few sips the next. After a week I feel confident enough to just refill my water bottles from the local water, however I do carry a SteriPEN with me. There are a whole range of SteriPENs which have solar chargers or USB charges, but mine just runs on rechargeable batteries. It is basically a light which kills all the bacteria in the water using ultra-violet radiation. You can use this to clean any water which is clear, but water with big floating bits inside is no good, the light can’t penetrate through the bits and wont kill the bacteria that might be inside.
As for food, while generally people advise you to avoid street food and only eat in restaurants, this isn’t always safe. I have travelled with people who have gotten sick in restaurants from dirty water which was used to wash their salad. I like to eat street food because it is cheap and tends to give you a more cultural experience. To try to avoid getting sick I try to get food that is hot and fresh. There is no sure way of judging this though so I try to keep my stomach health by eating fruit and drinking yoghurt when I can find it.
Polluted Shower Water
This is a strange one, because I never actually found out what the problem was. While I was staying in a cheap hotel in Mwanza, a town in the north of Tanzania on the edge of Lake Victoria. I took a shower in the evening and when I woke up in the morning I had some swelling on my face, the next day it had spread and I was noticing marks on my back and shoulders. The swelling got worse and started to burn and itch. I got different creams from a pharmacy and even went to see a doctor in a small hospital in Kashasha, near Bukoba on the other side of lake Victoria. The swelling just kept getting worse and worse until the point that I sat up all night with a bucket of cold water and a piece of cloth. Dipping the cloth into the water and dabbing it against the burning skin. Eventually I fell asleep and in the morning the swelling had improved. It took a few days to clear up fully and the only explanation I have is that there must have been some kind of bacteria or chemical in the shower water which reacted badly with my skin. As I don’t actually know the specific cause there is nothing I can suggest to avoid it. Whatever caused it, it wasn’t fun.
When you are in a hot, humid climate a small cut can quickly get infected, if you don’t treat it early then it gets bigger and eventually starts to spread. The picture shown above, was taken in Tanzania in 2006. I had got the initial infection (the big one that looks like a figure 8) for a couple of months, trying to treat it myself by cleaning the wound and applying antiseptic and antibiotic creams. It all started from a mosquito bite which I scratched and broke the skin. The wound would heal up, but after a couple of days I had a sharp pain that felt like a worm or something was trying to crawl out. This was actually puss building up inside. After a couple of months every mosquito bite I got started to turn into a sore. I only actually treated this infection after I went to the pharmacy for a skin irritation, that I got from the polluted shower water. I picked up the medicine for my skin and as I was walking out I stopped and said “Do you have anything for this?” and pointed to my feet. The guy looked and then gave me a course of wide spectrum antibiotics which cleared the infection up without any problems.
Now I am much more careful about wounds when I am in tropical climates. It is important to carry a decent first aid kit, and know how to use it, so that you can clean and cover any injuries you get and avoid getting an infection in the first place. I carry a strong antibiotic cream and a bottle of Betadine. Betadine is good for tropical climates because it dries quickly, whereas the creams will stay wet and attract dirt and keep the infection alive.
Bilharzia is a parasite which passes through humans and the water supply. You can catch this in water which has come into contact with urine from a person who has the parasite. I heard that it is less likely to be in fast moving water and also stays close to the origin in the water. So basically close to villages around lakes and rivers. I had already heard that there was Bilharzia in some parts of Lake Malawi, but the advice is for anyone who goes into the lake to have a course of praziquantel 6-8 weeks after the last time you swim in the lake, this is to male sure that any ‘eggs’ have hatched so that the pills can kill them, if you take it too early then the medicine has cleared from your system before the ‘eggs’ hatch. People who actually live in the area or advised to take the pills every 12 months. The parasite starts off in the water, where it attaches to snails and reproduces. It then infects humans who swim in the water and have a weakness in their skin, like a wound or even a mosquito bite. It then travels through your bloodstream to your lungs, then liver and kidneys and intestines where it develops further until it passes out of the body. Hopefully not back into the lake.
People don’t usually realise that they have the parasite until they start to see blood in their urine, which can be accompanied by some pain, but some people experience stomach pains earlier than this. I started to have a fever and feel stomach pains about 8 weeks after the last time I had been in the lake, although I could have got the parasite the first time I swam. I went to a local hospital as I thought the fever could be from Malaria. I had a Malaria test which was clear so the doctor advised me to take the pills, in two days I was fine. To avoid Bilharzia you can try to ask about the presence of Bilharzia in the water before swimming and not swim there. I couldn’t resist swimming in the beautiful waters on Lake Malawi so I decided to just buy some pills. The parasite is harmless anyway, so why not?
Scabies is another kind of parasite, this one burrows into your skin to lay eggs which then hatch and burrow into your skin again. You commonly find small blister-like growths between your fingers and a rash under your arm pits and around your groin. The rash itches a lot, but scratching can lead to infection. You get scabies from being in close contact with another person who has scabies, this is usually prolonged skin to skin contact, like sharing a bed, but can come from borrowing their clothes or a blanket. I got scabies while staying with some people in Australia. I borrowed a blanket and about a week later I noticed the itching. Scabies is easy to clear up, you just need to buy some permethrin based cream. You should be make sure your skin is clean and then cover all of your skin, from the neck down, with the cream and leave it on for at least 8 hours. Scabies can also survive in your clothing and bedding for about a week, so you need to wash everything that you can in a hot wash. Anything you can’t wash should be wrapped in plastic and not used for a week or so.
Malaria is a potentially deadly infectious disease which is transmitted by mosquitos who are carrying the disease. There are a few different strains of Malaria, some worse than others, and it is common in many areas around the world. I got Malaria the second time I was in Malawi(Click to read the original Blog post for more details.). There are some preventative medicines that you can take which will increase your protection against Malaria, but it is not good to take these medicines for an extended period of time. I decided not to take the preventative medicine and bought a treatment instead. I was recommended to buy a treatment which contains Artemisinin, as this is a very effective treatment being used in areas where Malaria is common. I kept an eye on my temperature because I knew that Malaria causes a fever and planned to get tested when I had a fever so that I could take the medicine. As long as you are healthy, have a good diet and get treatment straight away, then serious risk from Malaria is relatively small.
A broken bone can stop you travelling and can take a long time to heal. I was lucky that I only broke a bone in my hand and fractured some ribs when I crashed the bike in Namibia. I was driving on a gravel road when I lost control of the bike and fell(Click to read the original Blog post for more details.). I rested for a couple of days and then decided I was well enough to carry on, but the next couple of weeks were pretty bad. I was in pain with my ribs and that had a negative effect on my mood and motivation. Luckily Charlie, who I was travelling with at the time, put up with me during that time. I have friends who have had much more serious accidents and broken bones much more seriously. In those cases it is very helpful if you have medical insurance, as they will arrange for you to be flown back home to a hospital there. Personally, I have been travelling without any insurance.
Other useful links:
Sunscreen advice from the World Health Organisation
Bilharzia information from the World Health Organisation
Scabies information from the World Health Organisation
Malaria information from the World Health Organisation