Staying healthy in the less developed countries

I am a month into a seven month stay in Asia, primarily India. As I am settling in to my routine here, I am repeating some practices I have learned over the years in order to protect my health. Since I have friends and family coming to India later this year (and I will also be leading a workshop in India early next year,) I thought I would share my particular approach to staying healthy in the developing world. This really is one of those examples of “your mileage may vary.”

First, a couple rules. I am not a doctor. I don’t play one on T.V. This is not medical advice. It is what I have learned works for me. Nothing more. The smart way to read this is to follow it up with reading a dozen other such pieces by veteran travelers then to formulate your own approach to “staying healthy in the developing world.”

Figuring out what works for you entails finding trustworthy advice to use as a starting point and then experimenting to see how closely or loosely you need to follow a given strategy. I work with people who have iron stomachs and others who make my approach look haphazard.

I am a big fan of Melatonin tablets for mitigating the impact of jet lag. Melatonin is a hormone that regulates sleep and wake cycles. What works for me is to start taking Melatonin tablets three to five days before I am changing time zones. The trick is to take the pills based on the time you will be going to sleep in the time zone where you are going to be. For me that means taking Melatonin (and experiencing its accompanying drowsiness) in the early afternoons at home on the days that precede my flight to India.

I mention Melatonin (and sleep regulation) because we all know that getting a good night’s sleep as fast as possible after arriving in a new time zone is one way to make sure you stay healthy. Another basic strategy for maintaining good health is simply wearing a hat and drinking lots of safe water since so much of the developing world (at least where I work) is hot, hot, hot.

International travelers have probably heard the rule about not eating salads or anything raw. I stick to that. I follow the rule that usually follows that first one, which says only eat things that you see cooked in front of you or that you peel yourself. The good news about this is that it means I can (and do) enjoy lots of street food, especially things like grilled meats, which are cooked right before my eyes. Bananas are also an ideal choice since, I control when they are peeled, they are good for the digestion, they are cheap and they are very tasty, especially the smaller ones that are omnipresent here in India.

Most travelers know that you should only drink boiled/bottled water. I have a sensitive stomach, so I practice a fairly paranoid approach to water. I avoid the purified/filtered water that I am regularly offered here. The reason is that in the 17 years I have been coming here I have never, ever seen anyone change the filters in of the any of the many water purifying devices that I see all around me. Yes, that means I am limited to more expensive bottled water, from water bottling plants where I hope (assume) they change the filters periodically. I rinse my mouth out with safe water after a shower and I use bottled water when brushing my teeth. I follow this rule so diligently that I have been known to drink soft drinks or even beer rather than take a risk with water that was suspect.

The other thing that I do is take pro-biotics, such as Acidophillus, twice a day to give my system lots of healthy microbes to eat up the “bad guys.” The next step up my particular medicine chain is an antio-biotic commonly known as Ciproflaxin. Many people use Imodium as an intermediate step but it has never worked for me.

My routine, and again, your mileage may vary, is as follows. Every day I take pro-biotics, in the morning and evening. If I have a less than stellar stomach, I will try to simplify my diet for a day and often have some bananas. Then of course, more pro-biotics. If the upset persists, I move up to taking a course of Cipoflaxin, over a few days. The way that particular medicine works is to “kill” everything in your stomach and then you rebuild the culture therein. More probiotics are needed at that point.

Though I have only resorted to them once, every traveller should also know about oral rehydration salts which are a last resort for people like me (and severely ill people across the globe who are threatened with death because of the dehydration that is the result of sever diarrhea.) Oral rehydration salts are available almost everywhere since they are commonly used throughout the developing world.

Always bring all your own usual travel medications. The irony is that many important medicines are available in much of the third world as cheap knock offs, especially in India where they have mastered reverse engineering drugs. Figuring out which drug is which is another challenge altogether.

In the two weeks that I have been in India, I have had two bad days and mostly good ones. That may seem like “too much information” but the real point is that a regular discipline/process focused on staying healthy in the developing world is as much a part of my photography as my camera and laptop computer.