Monday, March 15, 2010

Health Guide: Protect yourself while being in Nepal

Nepal is a popular destination for travelers across the world. Panoramic views of snow capped mountains, ten world heritage sites, the vivid symbols of traditional arts and cultures, and never endings festivals are the greatest attraction of this Himalayan country. Nations capital, Kathmandu, also known as the city of temples is a paradigm of cultural heritage.

Due to lack of infrastructures and proper management of health resources this country is still struggling with many diseases which are rare phenomenon in developed countries. Lack of awareness to this issue may make you prone to many diseases / disorders which you never know or imagined while being in your native country. Before embarking on your visit to Nepal, you must make yourself familiar with different diseases that are common in Nepalese climatic conditions. As the temperature of Nepal ranges from tropical to arctic, you should be acquainted not only with tropical diseases but also with altitude sickness. To make you an expert on health aspects of Nepal would not only be difficult but also troublesome. Some knowledge about proper lifestyle and precautions you have to take while being in Nepal can make your stay in Nepal pleasant and most memorable. This article aims to give glimpse of prevalent health situation, vaccination required and most and care you have to take to avoid most likely ailments.

Health Scenario of Nepal
Traveler’s diarrhea is the most common travel-related ailment for tourist visiting any developing countries including Nepal. Diarrhea, dysentery, typhoid and other gastrointestinal disease are other potential diseases that you can acquire while being in Nepal. Kathmandu, the city of temples, a paradigm of cultural heritage, is one of the most polluted cities. Water and sanitation are also poor in Kathmandu. The prevalence of Malaria and Japanese encephalitis is greatest in the Terai plains along the southern border with India. Transmission is from July to December, with a peak during the monsoon season from mid-August to early November. Risk of Malaria exists in Chitwan National Park and Lumbini, the birth place of Lord Buddha, from June to August but is negligible during the rest of the year. There is no malaria risk in Kathmandu and Pokhara or on typical Himalayan treks. The prevalence of rabies is high in Nepal. The chief risk is from stray dogs, followed by monkeys.

Recommended vaccination
Before visiting Nepal, you may need to get vaccinations and medications for vaccine-preventable diseases and other diseases you might be at risk for at your destination. Hepatitis A, Hepatitis B and typhoid vaccine is recommended for all travelers. Revaccination is recommended in every 10 years for Diphtheria and Tetanus. One-time booster of Polio is recommended for any adult traveler who completed the childhood series but never had polio vaccine as an adult. Japanese encephalitis vaccine is recommended only for travelers who may spend a month or more in rural areas and for short-term travelers who may spend substantial time outdoors in rural areas, especially after dusk. For travelers spending a lot of time outdoors, or at high risk for animal bites, or involved in any activities that might bring them into direct contact with bats, rabies vaccine is necessary. Two doses of Measles mumps and rubella is recommended for all travelers born after 1956, if not previously given. Yellow fever vaccination is required for all travelers arriving from a yellow-fever-infected area in Africa or the Americas.

Prevention, the Best Medicine
Care in what you eat and drink is the most important health rule. The cornerstone of prevention of most travel related ailments is food and water precautions. The number one rule is, do not drink tap water unless it has been boiled, filtered or chemically disinfected. Use only bottled water of good brands for drinking purpose. The Water of Bagmati and all other rivers, water from wells and public taps are grossly contaminated so don’t use them for any purposes. Reputable brands of bottled Water or soft drinks are generally fine. Salads and fruit should be washed with purified water or peeled where possible. Wash your hands frequently, as it's quite easy to contaminate your own food. You should clean your teeth with purified water rather than straight from the tap. Visitors should only eat thoroughly cooked food and fruits they have peeled themselves.

You can get worm infections through bare feet. Wear long sleeves, long pants, hats and shoes instead of sandal. For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Try to avoid insect bites by using full sleeves clothes and by using insect repellents to exposed skins (but not to the eyes, mouth, or open wounds). If you are planning to go trekking monsoon season, leech are the most noxious creatures troubling you. They are not harmful, but sure make a bloody mess of your socks, boots, and any parts where they do penetrate. Wearing durable cotton leech-proof sock and boots can make your trekking adventurous and exciting, but do care while walking as leech don’t only enter the body from foots, they can enter from any where. Use of full sleeves clothes not only reduce the bite of insects and mosquitoes but also protect you from leeches to some extents.

Air pollution is the number one area in Kathmandu valley where improvement is needed. You can never be convinced with the air quality of Kathmandu so wear good masks if you are taking the tour of cultural heritages around the city. Use good quality masks can save you from respiratory problems. Avoid contact with stray dogs and other animals. Altitude sickness is the most area to be concerned with if you are planning trips and treks in Himalayan regions. It occurs in travelers ascending altitudes greater than 2500m. Do read about it and do understand it before you leave and while trekking and mountaineering in Nepal.
Bring adequate supplies of all essential medications in their original containers, clearly labeled. All travelers should bring along an antibiotic and an anti-diarrheal drug to be started promptly if significant diarrhea occurs. Most cases of travelers diarrhea are mild and do not require either antibiotics or anti-diarrheal drugs. Adequate fluid intake is essential. If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought. If acquired animal bites, clean the area with soap and bottled water and contact the local health authorities immediately for possible post-exposure treatment.
ByTankeshwar Acharya(The writer has passed M.Sc in Medical Microbiology)

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