Staying Healthy in Thailand – Some Things to Think About

Staying healthy while on the trip is a very high priority for students, faculty, family, friends …… really everyone. Being ill on a trip like this really is not very fun. So far, we have had few illnesses on this trip. And there are several things we can do to stay as healthy as we can, although sometimes, stuff happens.

Before you leave…..

There are a few things you can do before even getting on the plane to help keep you healthy. The most important thing you can do is make sure you have all your vaccinations. This was covered in another post in detail. Make sure you have the standard vaccinations (DTP, MMR, hepatitis A, hepatitis B, etc.), as well as typhoid. As recent measles outbreaks have shown, even standard vaccinations like MMR are important when traveling abroad.

You should also make sure you have everything you need in terms of medications and other personal items that you rely on to stay healthy. Make sure you have enough prescription medications to last the trip, as well as any other personal items that you are used to having. Also bring a supply of over-the-counter (OTC) pain medication that you usually use (ibuprofen, acetaminophen, etc.), some Pepto-Bismo tablets or other anti-diarrheals, a small first-aid kit with some bandages and topical anti-bacterial lotion, some Benadryl or other allergy medication (especially if you have allergies), and anything else you tend to use frequently. As I mentioned before, most of the OTC medications are readily available in Thailand, but if you’re particular, please bring your own.

Finally, if you have particular health issues, make sure you talk to your clinician about traveling for three-to-four weeks in Thailand, and what you need to do to manage your health. For those with motion sickness issues, make sure you bring any medication that you usually use, and make sure you bring enough. I have another post about managing motion sickness.

While there…..how to stay safe eating and drinking

There are several things you need to do while we are traveling to minimize the risk of illness. The first concern many of us have while traveling is gastrointestinal discomfort. We’ve all heard about “Montezuma’s Revenge” for those traveling south of the border, and the same issues apply when traveling to Thailand. It’s almost a guarantee that you will have some minor diarrhea when we’re in Thailand (or any other location). In most cases, it’s very minor and lasts only a day or two. Usually, this isn’t because you’ve ingested a nasty pathogen; it’s because your diet has changed. The food we’re eating in Thailand is very different than what most of you eat here. Your system isn’t used to it, thus you have some gastrointestinal distress. So make sure you have some Pepto-Bismo (which works very quickly), preferably in tablet form, so when it strikes, usually at the most inopportune time (say, in a van, stuck in traffic), you can deal with it. This may not be as much of a problem for those of you who have traveled extensively, especially through Asia and Africa. However, if you haven’t traveled to the developing world, you may have it a little worse.

Of course, you can get a nasty gastrointestinal pathogen if you’re not careful. Giardia, dysentery, cryptosporidium, etc. are not fun. But if you’re careful, we can avoid these as well. First, don’t drink tap water! Drink only bottled water. Even when you’re brushing your teeth, use the bottled water provided for you. And if you’re getting drinks or shaved ice on the street, make sure the ice is from drinking water! Sometimes, they are not. Ice served in restaurants is safe, as is ice and ice cream purchased in stores. But be careful with stuff bought from street vendors. When in doubt, ask us!

Next, wash your hands! Washing your hands thoroughly, with soap, for 30+ seconds, does wonders. If you don’t have access to soap and water, use hand sanitizer, which you should bring plenty of. Wash after using the bathroom, and before eating.

Finally, be safe when eating. The food served to you will be as safe as possible. But if you’re on your own, and want to purchase street food, please be careful. Street food is absolutely yummy, and usually very cheap. And it is perfectly safe as long as you take precautions. First, eat street food that is prepared in front of you. If it’s been sitting out, it may not be safe. Second, look at the vender and cart. If it’s dirty, with insects flying around, go to another vendor. Third, go where the crowds are. If a vendor is crowded, it’s usually because it’s particularly tasty, and it’s also because it’s safe. Thais won’t go to a vendor that has issues with food safety. Fourth, be careful of drinks or ice bought from street vendors. If it’s a bottled product, you’re fine. But if it’s a drink made right there, be very mindful of where the water or ice came from. Finally, when buying fruits, buy whole fruits that can be peeled. That way, if they were washed with unsafe water, you can still peel the fruit.

When should you become concerned about your gastrointestinal symptoms? Please let us know if your diarrhea lasts more than two or three days, if the diarrhea is bloody or foul-smelling, or if you have other symptoms such as fever or body aches accompanying your gastrointestinal symptoms. Please don’t be shy about this. If you are not feeling well, please tell us.

Finally, make sure you drink enough if you have diarrhea. The biggest danger of diarrhea is dehydration.

Stay hydrated!

Most of us from Utah aren’t used to humidity. We’re used to high temperatures, but not high humidity. One misconception we have is that we don’t have to drink as much in humid conditions, since there is more moisture in the air. This belief can get you into a lot of trouble.

Sweating keeps us cool by evaporating on our skin. The process of evaporation removes heat from our body, thus making sure our body temperature stays constant even in high temperatures. In Utah, this works well, since sweat readily evaporates in the dry air. What drives movement of water is the difference in moisture between the air and your skin. The greater the difference in moisture levels, the greater the movement. However, in humid conditions, because of the high moisture content of the air, sweat does not evaporate as readily from our skin, and therefore doesn’t cool us as efficiently. This causes us to sweat even more, as the body attempts to regulate our temperature. This feedback loop causes us to lose more water, and we can quickly become dehydrated.

Severe dehydration can lead to heat exhaustion, heat stroke, and in severe cases, death. Avoiding this situation is easy: make sure you drink enough. The rule of thumb is that you should be urinating frequently. The color of your urine should be clear or slightly yellow. If you’re not urinating, or if your urine is very dark, you are dehydrated. Make sure you are constantly drinking enough, especially if you’re doing something strenuous, or if you’re sweating excessively.

Among women, there is another danger to being dehydrated: urinary tract infections. We’ve had some negative experiences with women getting UTIs on our trip. They are usually not serious, but they can make you miserable. One way to avoid this is to make sure you are well hydrated. Urinating frequently will help prevent conditions that lead to UTIs. This, and staying clean, can help prevent UTIs. You can find more information on UTIs here.

Sunscreen

We will be spending a lot of time outdoors, and the sun in Thailand can be intense. Please use sunscreen liberally, especially if you have fair skin. Use a water/sweat-proof sunscreen with SPF of greater than 30, that will protect you against UVA and UVB. And if you really want to protect yourself from the sun, wear a wide-brim hat and a light, long sleeve shirt.

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