Our health is very important to us.
As we are travelling through many different countries with their own unique circumstances, we need to be aware of the risks and preventative actions that we can take to ensure we stay healthy, fit and safe.
Fortunately, before she retired, Karen was employed as a practice nurse, travel being one of her special interests, so we are in a fortunate position. Here she gives you the benefit of that experience.
Anyone who is undertaking any form of adventure travel will, most likely, already consider themselves pretty fit and healthy. So much so that they may think all they require is to get their vaccinations and malaria tablets and get on a plane. This approach is sometimes reinforced by the variation in quality of advice available from professionals and other information sources.
There are many web sites that can help in planning your needs for foreign trips. These sites are the ones used by healthcare professionals to provide travel advice and are constantly updated:
You can also get health advice from pharmacists, practice nurses, GPs or travel clinics. The knowledge and expertise of GPs and practice nurses will vary considerably depending upon how frequently they consult on the subject, their interest level and specialist training. If possible try to determine the relevance of their expertise to you particular type of travel and your chosen destinations. This applies particularly to adventure trips in exotic places.
Most people will consider the obvious things like vaccinations and malaria risk, but may not provide full advice on wider ranging aspects of your continuing good health and safety. e.g. for remote destinations, your first aid kit will need to be larger and you should consider taking standby medication, such as an antibiotic.
There are many other things that can and do go wrong. What we have tried to provide through these pages is the health tips that we have found useful before and during our travels. Whether or not you care to use the knowledge that is written here is up to you, but at the very least we can give you an awareness that will help when you meet with your healthcare professional.
Although it is a broad subject we have tried to split the subject into a number of categories:
Planning a long term trip, cycling through many different countries
means that you are exposed to a variety of health and disease risks. Probably the
easiest ones to consider first are those that are preventable through
vaccination. The web sites already suggested give information on what
vaccinations are required for which countries and you do need to allow
at least 2 months (preferably 6 months if you want Hepatitis B
protection) as a course of 2-3 injections is needed for some vaccines to
give long term protection.
Traveling on a bike means that you are more exposed to certain health risks e.g. rabies from animal bites, Japanese encephalitis from mosquito bites, Tick borne encephalitis from tick bites.
Another consideration for long term travel is that for continued protection booster vaccinations may be needed during the journey or you may need to have new vaccines if you decide to change your route. The cost of these vaccinations may seem high if you are on a tight budget but all of these diseases are serious, possibly fatal and will certainly spoil your travel plans.
In the UK, you can get vaccinations either at a private travel clinic or at your own GP practice. The quality of the service can vary greatly and it helps to be as well informed as possible by using the web sites. Generally private travel clinic practitioners are more knowledgeable and up to date, especially for unusual destinations. However, although some of the vaccines that you may need such as Hepatitis A and Typhoid are free within the NHS, you will be charged for them at a private clinic.
Malaria protection is another important consideration if your plans involve travel to tropical areas. The best way to avoid malaria is to avoid getting bitten but this is not so easy if you are on a bike. Malaria mosquitoes mainly bite at night but can still enjoy an afternoon snack. Malaria is a serious, sometimes fatal, problem and even if you take anti-malarials religiously there is still a risk of developing it. Because of the way the parasite develops once in you body, it is usually 2-4 weeks after being bitten that symptoms arise. For most package holiday travelers this means that they have returned home before they get ill. For long term travel it is wise to make sure you know what the symptoms are and if you suspect you have them to seek help as quickly as possible. The treatment is safe and effective, no treatment can be fatal. One of the symptoms is a high temperature so a digital thermometer in the first aid kit is useful. Normal body temperature is 36.5-37.5C so any reading above this is called fever. The characteristic symptom of malaria is that the body temperature keeps rising and falling at intervals.
Where malaria is a risk there will be recommendations for the tablets to take to prevent malaria. These vary from country to country and so a long trip could involve countries with different recommended medication. It is better to choose an anti-malarial that will cover for all the countries that you will travel through rather than swapping from one to another.
Another thing you need to consider is that medication does not travel well on a bike. As well as mechanical damage from all the bumps and ruts, most medication deteriorates quickly in humid conditions. Also there is not much room in panniers for large amounts of tablets. It is probably better to take 3-4 months supply and buy further supplies whenever possible.
When you’re working hard on a bike it’s important to have enough clean safe drinking water to keep you healthy and adequately hydrated.
This is no problem in more populated areas with safe water supplies and bottled water or canned soft drinks for sale, but can be difficult in remote country.
Carrying large amounts of water on the bike weighs you down, but there is nothing worse than running out of supplies in the middle of nowhere with a raging thirst.
We carry iodine and neutralizing tablets with us in case we’re unsure of the water safety. We are also thinking about buying a water filter, but have to consider whether it is worth carrying all this extra weight.
Wherever we are in the World the biggest consideration every day is can we get enough to eat and also avoid traveler’s diarrhoea. There is lots of advice about what foods to eat and what not to eat, but on the bike you don’t always have a choice if you’re miles from anywhere and the only place with food looks at least questionable. We have eaten curries at a roadside shack in Sri Lanka with no running water and a generous coating of flies on everything with no problems, but got food poisoning in a ‘good’ hotel in England.
Food that is freshly and thoroughly cooked is less likely to cause health problems, and frying, because of the high temperatures reached, is the safest cooking method.
Bacteria and viruses can be picked up from surfaces on the hands and transferred to the mouth during eating. For this reason it is important to always wash hands before eating, but sometimes difficult to achieve. We always try to carry wet-wipes and/or hand sanitizing gel.
Despite vigorous attempts to prevent it, diarrhoea is an almost inevitable consequence of travel. It is inconvenient but will usually improve without treatment in 3-4 days. You can make your own re-hydration drinks from sugar, salt and water (1 litre of water; 1tsp salt; 8tsp sugar) or buy ready mixed sachets and take a drug such as loperamide to reduce trips to the toilet. You need medical help if there is blood in the motions or you have a temperature.
Your travel health advisor may suggest taking a stand-by antibiotic if you are planning a trip to a remote area. These can be obtained on a private prescription and you pay a fee to the prescription provider (this will usually be higher than the NHS prescription charge) as well as paying a dispensing fee to the chemist and the cost of the medication.
On a bike you are always fair game for all the local wildlife and if you are camping as well your exposure is even greater.
The most apparent risk is dogs. You’re cycling innocently along a beautiful quiet country road and suddenly you’re surrounded by a pack of vicious barking dogs. There seems to be no global agreement for how to cope with this. Do you try to outrun them with a superhuman burst of speed or is it better to go slowly and try to not overexcite them? We have an (as yet not required) ultrasonic dog dazer. Some people carry stones and rocks to throw at threatening dogs. Shouting and waving a stick (we have our flag poles on our rear rack) can sometimes deter them, but then you risk loosing control of the bike while you’re busy waving!
The biggest problem with dogs is that if they bite you there is a risk of rabies and of infection from bacteria on their teeth. Rabies can also be the result of bites from other animals such as monkeys and bats. The virus that causes rabies is present in the animal’s saliva so one of the most important first aid measures is to immediately wash any bite with copious amounts of water to remove the saliva, and then apply iodine or alcohol to the wound to kill the virus. Drinkable spirits (more than 40% by vol e.g. whiskey) are effective.
Even if you have been vaccinated against rabies you still need to get treatment after an animal bite, but you have more time and it is much simpler. If you have not been vaccinated before being bitten you need to get medical help within 24 hours and the treatment injection, called immunoglobulin, is not easily available in remote areas.
Insects are the other most likely source of problems. In northern countries midges can be a nightmare in summer. We have found the Avon ‘skin so soft’ oil to be very effective.
Further south mosquitoes are just bigger midges but with more risk. They spread many diseases. Malaria is obviously the most well known but there are others that are increasing as global travel becomes more common. Dengue fever, West Nile fever, Japanese Encephalitis are less well known but becoming more widespread. Different types of mosquitoes carry different diseases and bite at different times of day so the important thing is to avoid getting bitten 24/7. The most effective protection is to keep as much skin covered as possible and use DEET sprays to repel attack. It is also a good idea if you’re touring in a malaria risk country to carry your own mosquito net if you are staying in budget accommodation. Just one small hole is all a mossie needs.
Another problem insect is the tick. These can cause problems including another type of encephalitis and Lyme disease. They are found further north, in Northern Europe and Russia. Their main hosts are deer and sheep but they’re not choosy and will feed on humans. Again, the best protection is to keep skin covered, especially the lower leg and feet and to check regularly for ticks which may be attached so that you can remove them as soon as possible. The tick will usually not begin to feed until it has been attached for several hours, and it is only then that there is a risk of transferring infection to you.
On the bike there is a very fine line between too hot and too cold. You
toil for hours up a steep hill in full sun sweating buckets then
suddenly you go over the col onto the shaded downhill slope and freeze
in seconds. Obviously layered clothing and windproof layers help. The
trick is to stop before the problem gets bad. Put on or take off layers
according to whether you’re going uphill or down.
We value our windproof gloves and skull caps that go under the helmet for long cold descents.
"Sealskin" socks are also good for preventing cold feet. However, once they are wet they do not seem so good at heat insulation.
In high temperatures and strong sunshine heat exhaustion can come on very quickly even though you think you are drinking plenty. It is very important to reduce the body heat and soaking the head and neck with water can help.
It is important to have a good first aid kit. You can buy an off the
shelf kit but it is easy to put your own together so that you can adapt
it for your own needs. Although the trip may be long you still only need
enough supplies for ‘first aid’ i.e. to deal with the immediate problem
and then get the injured person to further help if necessary. You can
restock the kit as you use it (subject to available supplies).
A good thing to include in your kit, which isn’t often provided in off the shelf ones, is a few latex or vinyl gloves. These protect you from the body fluids of the injured person (when you don’t know them) and also protect the injured person from your dirty hands which may be covered in mud and oil from mending the last puncture. They are also very useful for dealing with messy bike chains when there’s nowhere to wash your hands.
Obviously it is no use having a good first aid kit if you don’t know how to use it so some basic first aid training is very valuable. Even if you are traveling alone you never know what you might come across on the road.
Also knowing the emergency number for an ambulance in the country you are in (if there is an emergency service) is useful (see personal safety for web page.
One of the key pieces of advice given to travellers abroad is to avoid
conspicuous clothing, blend in and try not to draw attention to
The one thing you can be sure of on a long bike tour is that you will certainly get plenty of attention wherever you go. This can work to your advantage as it means you get plenty of offers of help and advice from complete strangers, often in an incomprehensible dialect. It also makes you more vulnerable to petty crime as everything you own is virtually on display.
For our personal safety when riding we try to always wear a helmet (although I admit not all the time), wear reflective clothing when the visibility is poor and use lights if by some misfortune we’re still on the road after sunset. We try to avoid this and aim to be at our destination by 16.00 hrs.
It is difficult to know quite where to keep your money on the bike. We find money belts uncomfortable and sweaty and you want to be able to get at your money easily. We try to only carry small amounts of cash and have a spare wallet with expired cards and a little cash to try to appease a determined thief.
It is important to be familiar with any local cycling laws e.g. in Spain it is now compulsory to wear a cycle helmet when on a road. This doesn’t mean you have to abide by these rules but it helps to know when you are breaking the law.
We have scanned copies of all our important documents such as passport, insurance certificate and driving license on our laptop and also on a secure server in case the laptop gets stolen also. We can therefore access them from anywhere in the World. We also have scanned copies of our NHS medical notes, repeat prescription list, optical prescription and vaccination records. We do not carry any paper copies as we find they add weight and deteriorate quickly from being crammed into panniers.
We have a mobile phone on ‘pay-as-you-go’ which could be used for emergencies. It is important to know the emergency services phone numbers for the country you are traveling through. The web page below gives a useful list.
It is also advisable to know how to contact the local consulate for the country in which you are travelling, just in case.
Link Back From Our Health Page to Our Planning Page
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