English only article – Slovak version coming soon | Článok je iba v angličtine, preklad pribudne čoskoro.
When going on a long term overlanding expedition, staying healthy can be challenging – but the better you’re prepared, the better are your chances – and your whole journey. Again, there will be some Latin America specific advice, but most of this can be applied generally.
Let’s start with some tips how you can avoid unnecessary risks:
Do your research, period. Depending on which countries are you going to, check what possible diseases and dangers you might encounter there. A great place to check this is Center for disease control and prevention – look through the website, open the countries you’re planning to visit and read what’s what. The first thing you’ll probably find and it’s a good place to start is…
Being properly vaccinated is one of the easiest ways how to minimize the risk of some nasty diseases – some countries won’t even let you into the country if you don’t have some of them – so check that CDC and WikiOverland sites.
We did all the vaccinations necessary + some optional ones. For Latin America, the only mandatory vaccine you must have is Yellow Fever – without a certificate of vaccination they may deny your entry to Brasil and some other countries. All of the others are optional, some of them highly recommended – Hepatitis A and B, Typhoid, Rabies. In the end, we decided to do all of these, including rabies – this one isn’t by no means necessary and has only limited usefulness, but it was not expensive, so why not.
Probably the most infamous disease is Malaria – there is no vaccine against it, but you can protect yourself with antimalarials. The way these work is you still can get Malaria – but if you do, the symptoms are way, way easier for you and you can be on your way quite quickly.
Thing is, you have to start taking them before going to risky areas and continue taking them during and after your stay – the duration vary depending on the type of the antimalarial. Note that none of them are 100% effective and you have to be a bit cautious and use other forms of protection as well (clothing, mosquito net, repelent). They can have quite nasty countereffects, or can be very expensive (or both). In the end, we opted not to use these and be very careful in potentially dangerous zones, using repellents with high concentration of DEET and long sleeves.
This is very important, as there is also Dengue, Chikunguya and the infamous Zika fever – with no safe vaccination, prophylaxis or cure available as well. All three of these are contracted by the same type of mosquito – you can distinguish it by its black and white legs (we got quite good at it). (note on Dengue – there is a vaccine called Dengvaxia, but due to this controversy I will leave it to your judgment if you’ll want it – and it’s almost impossible to get to.)
In the affected areas, you can and you should protect yourself – it’s not that hard and most likely you’ll be just fine. Wear long sleeved clothes, avoid staying out shortly after sunset / before sunrise when they are most active (or protect yourself), and use repellent with DEET or Picaridin. Don’t use the “natural” citrussy things, or other similar natural-but-definitely-work repellents. Yes, DEET is nasty, you have to be carful when using it and don’t touch colourful things, sunbathe or put it on the clothes, but it is one of the only things that actually work. I only found about Picaridin while travelling, and it looks like it might be the best option – it was proven to work in some studies and seems to have less negative effects. Stock up at home before flying into these areas – surprisingly, good repellents can be hard to get here (sometimes due to higher risk of the mosquitoes developing resistance)
You can also “impregnate” your clothing with repellent made for clothing, that contain Permethrin.
A note on Zika: as far as I know, it is still not conclusive if it can cause microcephaly (undeveloped brains in newborn babies). Since you can contract Zika and have no symptoms at all, and still have the virus in you for even a year – I would stay clear from affected countries if you plan on having a baby in the next year or two. Other than that, you should be OK – dengue is far more common and has worse symptoms than Zika and people are not so afraid of it 🙂 (not a great consolation, I know)
Next is travel insurance. Do not go for an overland expedition without one – the risk might be low, but you take the insurance to avoid potentially life changing outcomes – getting in a hospital in the US can leave you indebted for years, or even decades, if you don’t have one.
A good tip is to check, if you can opt out of your insurance you have back home. In my country (Slovakia), health insurance is mandatory and if you’re unemployed by choice, you have to pay on your own. But if you declare that you’ll stay outside the country for more than 6 months, you can cancel it – with some proof of leaving the country like a flight ticket. This is what we did – and funnily enough, the travel insurance was actually cheaper and covered more…
A few things to note:
So you’re vaccinated, bought your repellents and long sleeved clothing to protect you from the mosquitoes and on your adventure already. What more can you do to stay safe?
Again, this will be just some general advice, most of it might be very obvious but it never hurt anyone to read it again.