A Guide to South-east Asia: Part Three! In which I attempt to answer general health questions and provide advice based on my personal experiences.
Sun Safety is not to be downplayed. “Melanoma is the least common but the most deadly skin cancer, accounting for only about 1% of all cases, but the vast majority of skin cancer death.” (https://www.aimatmelanoma.org/about-melanoma/melanoma-stats-facts-and-figures/)
Put on sunscreen, wear a hat, and be especially cautious if you’re on antibiotics or anti-malaria medication. And as I’ll cover in part four always check for skin lightening agents in your sunscreen lotion. Keep hydrated and keep a bottle of water on hand whenever possible. If you become dizzy, disoriented, or otherwise symptomatic of heat stroke get out of the sun asap. That’s about it folks.
If you are not up to date I highly recommend speaking with your primary care physician months before your trip as vaccines sometimes require multiple doses months apart. I did not have that option as the U.S. Healthcare system absolutely sucks which is why I researched the Thai Travel Clinic at the Hospital for Tropical Diseases and made an appointment within a week of arriving in Bangkok. There I received a one dose shot for Japanese Encephalitis. To be honest I wouldn’t stress too much about vaccinations unless you’re planning on living in South East Asia for an extended amount of time, but that’s just my two cents. For example the rates of Hepatitis B may be higher than the country you are departing from but generally you should have most of the vaccines you need already (cue angry anti-vaxxers).
Dengue Fever can be a concern but according to the doctors at the Thai Travel Clinic you have a higher risk of serious infection if you are a native or a frequent visitor as the fever develops somewhat cumulatively.
Anti-Malaria pills suck and you probably don’t need them. Mosquitoes or mozzies if you’re reading this from Oceania can be deadly but are usually just annoying. Unless you’re going to be spending a good amount of time in higher risk Malaria regions such as parts of Myanmar and Laos you’re probably wasting money and making yourself feel sick. Again, I’m not a doctor. Your health is your own, consult your primary.
If you are advised to take preventatives make sure to read the directions in advance. Most require a week or so before they become effective. It might be worth it to splurge in this department. I’ve heard from other travelers that Malarone will not make you feel as shitty as something like Doxycycline will.
As for mosquito repellent I was astonished to find sprays that contained up to 90% deet. Although the CDC recommends using products that contain more than 20% deet anything over 50% is astronomical and in my opinion complete overkill. My favorite mozzie spray was a jungle formula I picked up in Cambodia that had 35% deet and a mix of of natural repellents such as eucalyptus oil and citronella. Similar to this one. Eating food that contains lots of garlic can also be beneficial.
As far as food safety is concerned common sense is half the battle. The other half can’t be seen. Traveler’s Sickness if you’re being coi and Traveler’s Diarrhea if you want to be scientific affects many men and women who visit South East Asia every year.
Two of the best things you can do to avoid travelers sickness are to examine your food and take it slow. That food cart looks and usually is quite tasty but be wary if it looks vacant or if the food appears to have been sitting out for a while. The more frequent the visitors, the fresher the food. My first experience getting ill was likely because I ate an entire dish of a new dish (a fried oyster combo) that my stomach wasn’t familiar with. If I had tried a smaller portion the first time around I probably wouldn’t have ended up sick for several days. The key is often moderation.
So what happens if you do become ill? Travelers diarrhea should go away after a couple of days but is sometimes more persistent. Keep hydrated and supplement your water with electrolyte packets if possible. You don’t need a prescription for antibiotics in most parts of SEA so if it doesn’t go away in a couple of days go to a pharmacy. If you become sick again or the antibiotics don’t work then see a doctor. Hepatitis A, Typhoid, and Diphtheria are invisible diseases that are more common in SEA than some parts of the western world. Remember when I said “you should have most of the vaccines you need already,” these are three that fall into that category.
Whether or not it’s okay to drink the water can be a controversial subject. In most major cities the drinking water will not make you sick. Restaurants often use purified water and ice made from purified water when serving tourists. I am stressing the major part there for good reason. For instance I was told never to use the water to brush my teeth in Cambodia. I violated that within hours of arriving Phnom Penh, Cambodia and was fine. In fact I don’t think I saw one person use bottled water to brush their teeth while I was there. However if I had made that mistake a couple towns over I likely would have found myself telling a very different tale. When in doubt politely decline and use your own bottled water. Don’t fret there are 711s everywhere. And if you’re going somewhere more remote, stock up. Clean water is an issue but it’s much more of an issue for the people that actually have to deal with it on a daily basis. Consider donating your money or time to a charity that is fighting to make clean water a privilege for everybody.