Most people do get sick on the road at one point in their travels. If you are lucky, your illness will require a quick trip to the doctor and some antibiotics or anti-parasite medication. If you are me, your illnesses will straddle several continents, a multitude of body parts and an exploration of Eastern and Western medicine – all in the span of one year.
Long-term readers of the blog know that I used to have a ‘days of sickness’ counter in the righthand column, but removed it because the sick days quickly outnumbered the healthy days and I stopped counting altogether. I started the trip with a cold and had I not been so stubborn about ignoring it, I would have been able to avoid a lot of doctor’s visits and insurance claims. But then I wouldn’t have all this information about free hospitals in Argentina (who knew?), terrifyingly long wait times in Port Elizabeth or an incredible Tibetan medicine doctor in Siberia.
What started in April 2008 as a classic cold in bone-chillingly damp Punta Arenas blossomed into bronchitis, and then (because I refused to admit how sick I really was) went downhill from there. I worked for years to save up for my trip, and did not want to let some cold get in the way of my travels. So, I kept climbing mountains in South America despite the fact that I could not breathe, and then the cold turned into bronchitis, then all the resultant coughing bruised my ribs, then the illness moved to my sinuses, then I lost all hearing in my left ear and then I ended up on a flight home from Johannesburg in July of 2008, shaking with 104 fever and delirious.
After recovering back home, I took off for Russia in the fall of 2008, determined to not get sick again. This desire turned out to be laughable. Somehow, I ended up with an uncontrollable, dry cough the second I arrived in Moscow. After several days of coughing through Siberia, I decided to approach my guide Andre about a doctor’s visit when we were in Verkhnyaya Ivolga, a tiny Buddhist village in the semi-autonomous Buriyat Republic. Tucked into the Eastern shores of Siberia’s cold, windy Lake Baikal, the village did not seem like an ideal place to find a one, but when I discussed the matter with Andre, he felt otherwise. Andre was one of the more knowledgeable guides I’ve ever had, with a wealth of information about the intricacies of Buriyat life (explaining that the houses in the Buriyat villages were scattered haphazardly about because the the local Lama was the one who divined where the house wanted to live, and thus actual town planning was nonexistent) and a healthy dose of sarcasm (when someone asked why Buddhists in Siberia eat meat, the response was “We’re in Siberia. What do you suggest we eat instead?”). When I talked to him about potentially needing some antibiotics, he suggested that we go to the Tibetan Clinic instead.
The clinic was a squat, chalky building right in the empty husk of town, and once the doctor ushered me into her office I had Andre run through the laundry list of my prior respiratory issues, ending with the dry cough that had plagued me for weeks. Other than my nationality and the coughing, she had no information about me or my medical history.
Her examination started with the basics (blood pressure, heartbeat, breathing) and then I held onto a solid brass tube connected to a pulse-measuring meter with my writing hand, while she took another 5-inch brass tube and touched the reflexology points in my other hand. After taking out several plastic cartons, each with 10 small holes the size of a pencil tip across and 5 holes down, she used a different tool – baton at one end, exposed wire at the other – to prod my non-writing hand with the baton and poke the exposed wire into an algorithm of the holes in the plastic sheets. The meter danced or remained immobile, depending on what holes the wire touched. She then put small sachets, one at a time, between the brass pole and my hand, and continued her examination.
Translated through Andre, she started asking me questions about prior ailments and they were dead on. Did I have parasites recently? Yes, thanks to the llama empañada. Did I have a prior problem with wheat or flour? Yes, they diagnosed me with a gluten intolerance years ago. And then she ran through my entire family’s history – on both sides. Remember: I hadn’t told her a thing about them or any of my medical history either, save for the coughing and bronchitis. The fact that she was able to tell me what illnesses my grandparents had suffered during their lifetimes truly blew me away.
The diagnosis was scratched out on a piece of paper and translated through Andre that night, with help from his Russian-English dictionary. I was allergic to wormwood and goosefoot (both plants), down and dust mites. I’ve never suffered from allergies before, and was dumbfounded, but since the woman had accurately and immediately provided me with my entire family medical history I believed her. She instructed me to take a spoonful of Tibetan powder for the next ten days, once at morning and once at night, from two small sachets that she prepared. She promised that I would have no cough on the tenth day. The morning involved a shot of powder followed by a shot of water, and then at night a different powder had to be boiled for five minutes and drunk like tea. The scent of the powders was strong, earthy, pungent and fairly indescribable. They tasted awful.
I got back on the trains, bound for Mongolia. Luckily, samovars abound on the Trans-Siberian and Trans-Mongolian lines, so free hot water was plentiful and taking my medicine was easy enough. Five days on: still coughing. I moved onto the Gobi, with my friend Bryce (who travelled the trains with me). No free hot water anymore, but Bryce had packed a camping stove and he generously boiled me water each night to take my earth medicine.
Eight days in, still coughing. And then, on the tenth and last day, my cough completely stopped. In the heart of the Gobi desert, living in a ger with no running water and with a family of nomads, I felt healthier than I had in months. Lesson learned: I will be much more open to Eastern medicine in the future, and will never underestimate the power of disgusting-tasting medicine.
* * *
I am obviously not a medical professional, but below I’ve listed some of the Dos and Don’ts that I have cobbled together from my time on the road:
● Do try and bring a friend who speaks the local language. If that fails, bring a Point-It Dictionary and a lot of patience.
● Do keep sterile syringes on you. They take up very little room and are indispensable the one time the hospital or doctor has run out of clean needles. These are much cheaper to purchase on the road – I bought mine in Chile.
● Do invest in travel medical insurance. I took mine out as a Canadian national, meaning I am covered everywhere in the world except Canada. Check the riders for activities such as scuba diving, skydiving, jumping off random bridges or high altitude climbing if you’ve a bit of an adrenaline addiction, like I do. A good resource is BootsnAll’s travel insurance page.
● Do eat street food, often. The reality is, street food is a great way to explore local culture and cuisine, will earn you props with the locals and is usually a safer option than whatever fancy restaurant is in town. So long as you stick to street carts that have lineups or a good turnover, and make sure your food is cooked through, you are less likely to get food poisoning than a quiet touristy spot.
● Do read How to Shit Around the World: The Art of Staying Clean and Healthy While Traveling (Travelers’ Tales Guides) before taking off. If possible, try to read this book in public places, with the cover in plain view. You will make new friends.
● Do bring some acidophilus or probiotics tablets with you (the ones that do not need to be refrigerated, e.g. Pearls), to take after a cycle of antibiotics. These will help build up the good bacteria that your antibiotics cycle has destroyed. For the ladies, these will also help with some of the nastier antibiotics side effects.
● Do try and let traveller’s diarrhea take its course without resorting to Immodium. the Immodium will just trap the bad bacteria in your intestines and potentially make you sicker in the long run. Instead, try and stick to oral rehydration salts and lots of water – unless, of course, you are taking an 18-hour overnight bus ride through the Andes from Cusco to Ica. In that case, go nuts with the Immodium. And then hope that the bus doesn’t break down.
● Don’t fall asleep in the hospital waiting room. You will wake up to a small child trying to tie you to your chair. Despite having 104 fever and a serious desire to crawl under the chair and sleep, you will muster up enough rage to push said small child away.
● Don’t climb above 5000m (16,000 feet), for three weeks in a row when you have severe bronchitis. Similarly, do not climb a mountain requiring you to hoist yourself up steep ladders or ropes when you have several bruised ribs.
● Don’t get food poisoning when you are about to embark upon a 3-day jeep tour through the Bolivian Antiplano. It will not be pleasant.
● Don’t be as enthusiastic about antibiotics as your local doctor. Though they are important for certain types of ailments, the dosages and frequency will be higher than you are used to and it is equally important to be cautious about consuming so many – they take their toll on your body, believe me.