Travel to Developing Countries- First Aid Kit Travel Series

Are you contemplating a trip or a hike outside the country where medical means are less accessible than in the US?  Preparing for even minor scrapes and inconvenient stomach bugs can become more difficult in these circumstances and it is always better to travel prepared.  If you are also hiking in a developing country- check out my blog on hiking in the mountains.

First Steps in Preparation

Your first step in preparation is to contact your local travel clinic to verify which immunizations you will need in addition to what you already have.  Immunization is your first and most important step before traveling to a developing world.  These countries do not have the resources to vaccinate all of their citizens, which allows certain pathogens to circulate, that you will not encounter at home.  As much as vaccinations have become a political issue in the last decade or so, they have been an integral part of most developed countries’ infrastructures since the mid-20th century.  How many of us know someone who was diagnosed recently with pertussis, diphtheria, or polio?  The prevalence of vaccines has made the answer to that question likely nobody. If you have concerns the travel clinic is also there to educate you on any vaccines they are recommending to you.

Water Sanitation

Next up on the priority list is water sanitation.  When packing for a trip to a less developed world I include a small handheld water filter.  I own an MSR water filter that I purchased more than a decade ago, and it still works like a champ as long as I clean and maintain it with use.  I have utilized the filter in India, not just when I was hiking the Himalayas, but when I couldn’t purchase drinking water, and I have purified water with it throughout Western Africa.  Iodine tablets work too… but they make the water taste unappetizing, and I don’t fancy drinking extra iodine regularly.  I do carry a bottle of these for emergency reasons including if I think my filter isn’t working correctly, or you don’t have the time to filter the water.   

Managing Stomach Bugs

One of the biggest issues when traveling is stomach trouble or upset.  I always purchase Loperamide (Imodium) for diarrhea troubles.  As a side tip most, medical professionals will go generic, because it is the same medicine at a fraction of the price.  Loperamide will help you stop your diarrhea, but use with caution, it can stop ALL activity for several days.  Determine if you are having true diarrhea, or just stomach irritation/soft stools, if it is the latter, hold off on taking the loperamide, and be sure to hydrate as much as possible. 

Throw in a thermometer as well.  When you are experiencing any gastro-intestinal symptoms, check to see if you have a fever- this helps determine if it is bacterial in origin and if you would need to see a doctor for antibiotic treatment.  Origin can come from infection, food, medication and disease.  I also bring shelf-stable pro-biotics.  If you have a bout of diarrhea, nausea and or vomiting- having probiotics can help you keep your good bacteria and promote a healthy gut biome.  Also, make sure to take electrolytes if you do have vomiting or diarrhea and plenty of water.  If nausea, vomiting, and diarrhea persist you should see a medical professional if possible and trustworthy. 

Who Should I See and How Do I Get Good Medical Care?

Depending on the country and location of the country, you will have different levels of care.  Educate yourself on where you are traveling, and medical options in the area.  

You also have the option of getting advice and treating prolonged bouts by calling International “SOS at +1 (617) 998-0000 or connect through the Assistance App. Case managers can take your call 24/7, connect you with a medical professional, and direct you to the nearest pharmacy, clinic, or hospital for appropriate treatment.”

The travel clinic you visit before your trip will often prescribe prophylactic antibiotics and anti-nausea medications. I recommend getting these filled and bringing them with you. If you don't need them, that means you had a great trip. If you did need them, you will be grateful you had them and didn't completely ruin your trip being sick the entire time.

Good Hygiene Goes a REALLY Long Way

Hygiene in less developed worlds can vary and won’t always be up to standard.  An easy solution is to bring hand sanitizer to kill germs on your hands quickly and when water is not available.  I also carry a bar of soap in plastic bag or container along with a microfiber towel/wash cloth and have it will me at all times.  If you can find water, wash your hands throughout the day, specifically before eating and when your hands are visibly soiled.  This is an inexpensive, uncomplicated way to keep yourself safe and healthy while traveling abroad. 

Microfiber is amazing at capturing germs on your hands and is low maintenance. As long as you clean the cloth with soap every day and dry it in the sun the cloth is clean, sanitized, and ready to be used again.  I use Norwex because it is silver infused.  This adds another layer of discouragement for microbial life to take up dwelling on the cloth, without any added chemical element.  Silver is used in some medical grade dressings for certain wounds for its antimicrobial qualities.  I purchased these cloths for home and travel over a decade ago, and they are still going strong.  The price tag is substantial on the front end, but they look the same as the day I bought them… Well, they might be a little sun bleached.  Wet wipes are also a good idea if you don’t have access to water to remove soiling that is visible on your hands.

At a Clinic in Haiti - after the 2010 earthquake

Food Safety

Food safety is another preventative measure to keep you healthy on your trip.  I recommend packing protein bars with you.  These bars are a quick way to get nutrition wherever you are, in all situations.  I worked in a field hospital in Haiti after the earthquake of 2010 and the bars I brought really saved my life.  We were fed twice a day, and we ate more than most.  I am allergic to milk, and the majority of our meals at our remote clinics had cheese since it has protein and packs easily.  The protein bars gave me the nutrition I needed to keep working without any fuss. 

If possible, preparing your own food is ideal.  Any fruits or vegetables that are cooked just need to be rinsed of visible debris and the cooking process will eliminate bacteria, viruses and parasites.  If you are going to eat raw fruits, be safe and only consume those with a “thick covering” (i.e. citrus fruits, banana, pineapples and melons).  Sadly, it is safer to avoid salads and raw vegetables. ... Check out my blog on Food Safety for more in depth tips.

Mosquito Safety and Other Creepy Crawlies

Last but certainly not least is mosquito and insect safety.  Your trip to the travel clinic will give you recommendations on malaria prevention medication.  I have been prescribed quinines for some trips and antibiotics for others.  The two have their down and up-sides and only you and your provider can decide what treatment is best for you.  One of the quinines I took for a trip to South Africa and Zimbabwe was later taken off the market from people literally going crazy on it.  I never had that reaction (thank goodness) – but this demonstrates that everyone is different and there is no across the board prescription for malaria.  For a more in depth discussion on this go to my article for MedReport in the Projects section on keeping yourself safe from mosquitos.

In Cameroon I awoke one morning to white spot just below my left knee.  Over the next week it grew in size, became painful, red and inflamed and I noticed an abscess had formed.  I visited the local hospital and obtained steroids and antibiotics, which helped, but the area continued to be swollen, red and painful.  The friend I was traveling with at the time was also a nurse, and she was originally from Cameroon.  She voiced concerns of me having a procedure at the local hospital and we decided it was best for her to purchase the supplies needed to perform the incision and drainage, and to sterilize them and perforated the abscess at home.  She had been trained to perform this procedure and understood how to implement the procedure safely (I don’t recommend this to non-medical professionals!) I was glad we did, because we discovered what appeared to be an egg sac imbedded in my leg.  Once she removed it, my leg was able to drain.  She performed dressing changes on me and after 1 week I was as good as new.  

At that time I always slept with a mosquito netting loosely hanging over my bed, but after this event changed my insect control at night.  I purchased a Sans Bug tent.  They are a packable pop-up tent that do not allow anything but air into your sleeping environment.  They are far easier to set up and move than the netting, more durable, and I have never had another intruder decide to use my leg as a nursery after purchasing one. 

Bug deterrent spray is also important when you are out and about.  I won’t get into what kind you want to buy since some want all natural, and others are using deet.  Decide what is best for you and use it daily. 

Education is Key

Foremost when deciding to travel beyond the borders of the United States, be sure to educate and familiarize yourself with health and safety issues in the region you are visiting.  You may be wondering if it is worth all the time and effort you must exert.  I can assure you that experiencing diverse cultures, tasting remarkable food, and meeting intriguing people will be an experience you can savor your entire life.

p.s. I haven’t received any endorsements for the products I mention here.  They are just what I have found to be reliable and work for me.

Maroua, Cameroon- Digging dip to do laundry

List of suggested supplies

Loperamide

Bandages

Bandaids

Prophylactic medications your travel clinic prescribed- this may include Ondasteron for nausea and antibiotics for possible stomach infection.

Iodine pills

Water purifier

Insect protection- repellent and net

Malaria prevention

Acetaminophen

Ibuprofen

Electrolyte mixture

Thermometer

References

Affairs, O. of R. (n.d.). Chapter 4 travel guide. U.S. Food and Drug Administration. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/foreign-inspections/chapter-4-travel-guide

SUBCHAPTER 400 - GENERAL; 401 HEALTH CARE

Freedman, D. O., & Leder, K. (2024, March 26). Immunizations for travel. UpToDate. https://www.uptodate.com/contents/immunizations-for-travel?search=third+world+travel&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

Literature review current through: Apr 2024. This topic last updated: Mar 26, 2024.

Travel to developing countries. Mount Sinai Health System. (2020, January 9). https://www.mountsinai.org/health-library/report/travel-to-developing-countries