Mosquito Connected Diseases
This has to be the single most greatest concern of travellers to Thailand. Especially those who intend to travel around the Eastern national boundary with Burma / Myanmar, near Three Pagodas Pass. And around the coastal region where Thailand borders Cambodia (i.e. Trat / Ko Chang area). These particular areas are known to be malarial. And it is a fact, with global warming, efforts to maintain malaria free areas are becoming increasingly tougher (let alone reduce malarial areas). Not only this, a lot of doctors now seem to be recommending against the use of anti-malarial Prophylactics drugs, see here for details.
A useful source of information on malaria is malaria.org. However, when we authored this page, the detailed malarial maps they said existed on their site did not exist! The best map we could find of the main risk areas in Thailand was here, but it is not in English. The Thailand Department of Public Health have this information page on malaria, but no maps! In most cases, malarial mortality is generally greatest amongst children. Although risks exist for all people, especially pregnant mothers.
Malaria tends to be carried by a species of mosquito that are prevalent at dawn and dusk. Also, mosquitos breed most when it rains. So monsoon / rainy seasons will see an increase in their numbers. Part of the problem is lack of public awareness. Where locals (and tourists) throw litter on the ground for example, this often becomes stagnant water traps - ideally for mosquito larvae. Even the coconut shell rubber sap collectors used in plantations cause problems if not inverted during the rainy / rubber nonproductive season as they are meant to be.
Unfortunately, malaria is not the only mosquito born disease risk. And outbreaks of Dengue Fever in Bangkok and the deep south of Thailand have been reported in July 2001. What is even more unfortunate, is that this disease is born by another species of mosquito, which happily flies during the day. The Thai government do, to their credit, meet such outbreaks with major sprayings to kill the larvae. For these reasons, it is important to seek up to the minute advice from your local doctor / health organization for treatment advice and infected areas.
All this having been said, the best form of cure is prevention. Which means using a 40% + deet (N-Diethyl-M-Toluamide) content insect repellent. Especially around vulnerable areas like exposed feet, ankles, legs, elbow and neck areas. It is probably better not to wash before eating breakfast (but to apply repellent). As mosquitos do seem to like clean skin! Wearing long trousers and socks definitely helps. As does a mosquito net at night (although be careful about touching the netting as mosquitos then have access to that area of your body).
Mosquitos also like still air. So a fan is a great idea, even if you are using air conditioning. In fact, as air conditioners dry the air out and make the heat of the day even harder to tolerate. Using an aircon unit in combination with a fan, not only has anti-mosquito and acclimatization benefits, but is also considered by many as much more pleasant. Also, mosquitos do seem to be attracted to dark colours, especially blue. So wear light browns and greens. One other useful reference site on this subject is TravelHealth OnLine.
This will typically be no more than your stomach's reaction to a sudden massive increase in having to digest fresh and unprocessed foods, especially fruits. A little story! One of the defining moments in humankind's development was the time, through the use of having hands (as opposed to 4 feet) and making tools (spears etc.), we were able to "progress" from being herbivores (early vegans) to meat and veggie eaters. The availability of meat, which is a more processed form of food and requires less digestion, meant our stomachs could become smaller. Because our stomachs became smaller, we had more blood supply for other organs including, for some, the brain. This allowed us to increase the size and power of our brains so that we could invent television and neighbours!
The point is, the more the unrefined the food, that the more your poor stomach has to do to digest it. When you do not recognise this fact, it can suffer and you with it. So, a useful practice is to start eating much, much more salad and fresh fruit around 2 weeks before you set off for Thailand.
Having said that, there are a lot more pitfalls waiting to trip you up with a real, even very nasty case of a bad tummy. Now, and completely unlike my normal practice! A lot of what I am now going to tell you is my personal beliefs on this subject. Having suffered horribly with it myself and wondering why those around me, who ate the same dishes, why they were not suffering so. I am going to tell you in order of probability where I believe the greatest risks come from.
MSG (monosodium glutamate)
Considered by many to be a poison, this flavour enhancer is used extensively throughout Asia and should be avoided at all costs as many, many cases of adverse reactions, including stomach problems are attributed to MSG. Most good restaurants will not use MSG and, in fact, advise you that only poor food retailers will use it as their food tastes so bland if they do not! How to ask the waiter not to have MSG? Simply but firmly state "My Sigh Ponch-er-luk" (without MSG) or "My Ow Ponch-er-luk" (I don't want MSG). It may also be worth repeating this (My Sigh / My Ow) with the brand names of MSG too ("Aginamoto" and a liquid MSG based sauce called "Aroma").
Additives (food colours and flavourings)
Be warned, many of the food additives that have been banned in Australasia, the European Union and North America are still legally in use in Asia. Many of the brightly coloured deserts, sweets and cakes you see in Thailand, may well have substances proven to cause cancer, etc. added. The best advice is, if it looks too pretty to be natural colouring, avoid it. You may find a delightful exception to this rule. The green candies / cakes you often see are made with colourings from leaves (but make sure!).
Food Stalls &
If cooked food has been allowed to get cold, and then simply re-heated, there is a substantial risk that you are eating a hole community of bacteria with it. It's that simple. If the locals (remember also, their stomachs may have become accustomed to certain bacteria) and seemingly knowledgeable / discerning / well travelled tourists avoid it, you should run a mile too. Recent government surveys into toxins found in food stall ingredients make frightening reading. And these are just the toxins recognized by the Thai Government.
Oh yes! I'm going to be careful not to say, if I am right, that the bottling plants are responsible (as they are owned by the big boys who might sue me). But I'm going to ask to you think about something here. What are the chances, when these drinks are bottled, that they are 100% free from germs / bacteria. Now bear in mind, the hard task of creating a sterile product, even in a less mass produced / tropical environment. Now, what are the principle ingredients of these soft drinks? That's right, water and sugar. If you were bacteria, what would you say to such an environment? Let me help you - "Yummy, yummy!". Now look how restaurants keep these drinks during the storage time BEFORE they go into the fridge. Yes, that's right. Outside in the lovely warm air. Do you catch my drift? Then think carefully about what you drink.
Tomato Ketchup etc.
Think about it. Most restaurants leave their sauce bottles out, never clean them, and simply top them up! Get a picture of bacteria breeding?! A good restaurant will serve you ketchup and others in a little dish.
If you ask a waiter(ess) if their salads are washed in safe water, what you expect them to say? If you are honest, aren't they going to automatically say the same thing as when you ask a market trader if that is their best price?! Restaurants can hardly afford to wash salads in bottled drinking water, can they?! So they have to boil / treat water and then let it cool to make it safe. Do they refuse to serve you salad if they run out of safe water? Do they keep safe water from one day to the next? Do they boil it for the prescribed time? If you must eat salad, only buy them from the more respectable restaurants.
What To Take / Buy
/ Do Regarding Upset Stomachs
The main thing to do, no matter how painful, is to keep hydrated. That means rehydration salts (to replenish minerals and salts) and plenty of water / weak tea. Do not drink fruit juice and make sure the bathroom is kept free and the door open!
Cuts & Infections
If you are going out of the tourist areas, and particularly if you are going swimming / snorkeling / diving. I can not advise you enough to take a sterile travellers first aid kit with you. Having fallen down a broken raised paving slab and grazed my leg. Having cut myself on coral (fortunately not poisonous) while on a snorkeling trip only to find the boat crews / guides do not carry first aid supplies. I can not express to you sufficiently the need to have disinfectant, sterile wipes, bandages and sticking plaster(s). Not only does it take even a small wound a long time to heal because of the climate, but there are general increased bacterial risks because of such tropical conditions. You would be absolutely amazed how many flies suddenly appear, intent on your wound, and how difficult it is to keep them off!
These kits come in handy little pouches that fit onto your belt. They are very light, comparatively inexpensive, and potentially the best investment you will ever make in your life - don't get caught out.
HIV / AIDS
For information, try this web site, the Asian Business Coalition on AIDS
All opinions stated here are the opinions only of travelforum.org and, although made in good faith, should not be relied upon without proper prior verification (don't sue us if our advise makes your trip go "pear-shaped"!).
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