(originally posted in 2013)

I have managed to disappear for couple of weeks from my office cubicle to Thailand. Trip was half medical tourism (no, it wasn’t because of plastic surgery ;-).  And half just sightseeing completed by eating large quantities of beautiful local food. This time me and my wife we went to Chiang Mai and now I am sitting in the cafe organising my thoughts. All is great, cheap and excellent 4 stars hotel, awesome food and nice people.

Yesterday we walked to one temple which was out from city center. Small part of the walk was through bit dodgy area with lots of weed, mess and dilapidated houses. My sandal needed to be fixed as something was scratching my toe. There was a concrete wall with some glass on the top of it about 5 feet tall. I have leaned on it with my shoulder and bent to my sandal to fix it. Then I felt sudden pain in my left shoulder and noticed dog biting it and running away. It was not that painful and don’t have problem with animals but getting bitten by the stray dog in Thailand was NOT an my to do list.

What to do after getting bitten by a stray dog?

So now I have to go through 5 injections against rabies within 30 days because rabies is so fatal that once the disease is developed there is no cure. It is actually quite common. Nurse in Chiang Mai said that they are having foreigners with bites every day.  You can get it from any animal like dog, cat, fox, bat, etc. While in the hotel I read Lonely Planet Health section and it looked quite scary. I did not get any travel vaccination while I never travel without travel insurance at least.

It looked like I have missed a bit. For the starter my Hepatitis A,B,C vaccination expired as it was done more than 10 years ago, same as Tetanus. Obviously I did not have rabies vaccination which would make the treatment easier. Then I read about Malaria where is no vaccination but just some tablets which will make possible contagion less dangerous.  Though you will still get it. Japanese encephalitis looked quite scary. In Thailand about 50k Thais get infected annually with 1/3 fatal and 1/3 permanent brain damage if I understood it correctly. Luckily not many visitors get it so recommendation is to get vaccinated only if you stay in the area more than a month.

Dengui fever

Then there is Dengui fever with few different strains out of one is possibly fatal when you basically bleed into your own body. I and my wife we actually got Dengui couple of years ago in Bali (Lombok) with the disease developing immediately after our arrival home to Sydney. 41 degrees temperature, red rash on the body, extreme muscle and joints pain lasted for about 3 weeks and my wife even spent 3 days in the hospital on drips as she was severally dehydrated. Unfortunately there is no vaccination or cure for Dengui fever. We got only Panadol.

While reading all this in the Lonely Planed and remembering my brush Dengui I have realised that though I thought I was ok traveller, I have to be better prepared. My travel experience was mostly in the first world where biggest dangers are accidents and pick pocketing. I will be now going through detailed vaccination program as I wish to do more travel especially in the Asia and as I am realising how much is in stake. If you are not healthy you cannot enjoy your travel at all plus your health and even life are seriously threatened.

I have actually learned a bit about mosquitos bite prevention. I used to bring special creams and sprays from home. It actually did not work AT ALL! In Thailand I have acquired local antimosquito spray and it worked perfectly. Reapplied couple of times a day and I did not get a bite. There was recommendation that DEET as active ingredient of the mosquito repellent should be 20-30% in the cities and 90% if you get to the jungle. I haven’t tried jungle conditions but in the cities it worked incredibly well.

Clean food and water

Second serious travel health threat comes from food and water. Sanitation is not greatest in many third world countries. Just to name some of my experiences from my Thailand travel (I have been there 3 times 2 weeks in last 6 months) for to me unknown reason Thais leave garbage in plastic bags on the streets overnight and it is picked up in the morning by the cleaners. At night it is just crawling with huge rats. Untreated sewage runs into little streams and then directly into ocean or river. Every stream, river, beach or roadside are full of piles of rubbish.

This was same in Bangkok, Phuket, Chiang Mai or Hua Hin. I am not sure how locals deal with it but it is serious health risk for foreigners. Couple of times while dining outside some restaurants I saw rats running around. So my way of minimising stomach issues from food and water are few rules which worked (so far). Except hotel (3-4stars) I don’t drink any non bottled water or have any ice (so no ice cream or smoothies), I do eat often in cheaper places (in Thailand it can be $1 per meal) I pick only busy or recommended ones. We limit meat and check sea food if it is fresh. At home I almost don’t eat fried food but in some iffy places it makes sense. So I have enjoyed quite a few deep fried chickens or fish.

Ice

Outside the hotel I don’t have salads or vegetables (cooked is ok) and I quite like soups. They seem to be usually safe as these are boiled for the long time. I know that my list looks quite limiting but so far it works and I met many people complaining about belly problems while I am generally ok. Couple of times I couldn’t resist and I had smoothie and I had minor stomach ache afterwards. Maybe ice could be culprit. These rules allow me to reasonably safe eating in local places. Generally it is not because these are cheaper but the food is genuine. We are used to spicy meals and generally I can take as much as locals. There are some exceptions like some curries or tom yams which were past my chilli threshold. I noticed that hotel and tourist places cook quite bland versions of local meals which I don’t appreciate.

Hope these few points might help you to better enjoy your travel. It worked for me. I met many other travelers who said they were fine whatever they ate. Some of them went across whole south east Asia or Africa. Countries like Nepal, India or Egypt were often named as quite problematic.