BootsnAll Travel Community

The recent tragic loss of Kinga leads me to create this thread, and to reiterate some points I have made before.

I have often read posts on BNA that were along the lines of "I never got all my shots and was just fine" or "don't worry about malaria, just use bug juice." I know these perspectives are the exceptions, but for someone looking for an excuse not to immunize, they work well.

People who tell you not to worry about malaria have never had it: I have. More to point, it can be fatal, and you don't have to be in Africa for it to be terminal. If you are going to malarial climates (and that includes Central America) deal with it! I have doctored untold numbers of backpackers/travelers with malaria, Dengue fever, dysentery and other avoidable ailments (and many that aren't' like broken bones, septic infections and antifalactic shock) and the comment "I never thought this could happen to me" is oft repeated.

Newflash: Skin so Soft will NOT protect you from malarial moquitoes or from biters that carry Dengue (another wonderful illness I have experienced). Deet is the ONLY thing that will protect you, long pants and shirts or not. Water is suspect EVERYWHERE in the developing world, and in spite of what I have seen posted here, bottled water is NOT available everywhere (at least not where I travel). Take tablets or a quality micro-pump to clean water.

Finally, if you travel in complex and dangerous ecosystems, you MUST be able to take care of yourself and those who did not have your good sense. That means a serious medical kit, with serious drugs. It can be a real pain in the ass--my kit weights nearly 3 pounds, and when the weight limit on luggage is 11 pounds as it was in the outer Cook atolls last spring--it is really a pain. BUT... I took a really bad tumble and cut the hell out myself on Manihiki, and without antibiotics, stitching material and pain meds I would have been in deep shit. And the drugs I left behind in the local "clinic" were most appreciated.

Diplomatico Hiyo de Playa out.

Thanks for putting this out there, Salmo Dipolmatico Hiyo de Playa. I just want to holler amen to every word you said. I've read some (probably well-intentioned) misinformation on the net to the effect that malaria drugs are a conspiracy conceived by the pharmaceutical companies to bilk money out of fear-driven travelers. I'm skeptical of fear-mongers wherever I find them, and I am no defender of pharmaceutical companies, but like you, I have seen malaria up close. I have lost friends who couldn't afford the malaria preventives, and I know that malaria is not to be taken lightly. That is not to say that Kinga or anyone else who gets malaria was NOT being careful. Even the best drugs out there aren't completely reliable because malaria keeps mutating; drug-resistant strains keep cropping up. Take the preventives (if you can; and stay out of malaria-ridden areas if you can't), cover up, use DEET, and trust what Salmo says on this.

Absolutely right Salmo. Thanks for posting this.

Also, Americans should be aware that, just because CDC doesn't recommend preventive treatments for disease, that it's not a good idea. I travel in a part of the world where tick-borne encephalitis is a major concern. This is a very nasty disease which carries risk of permanent neurological damage or death. If you travel to countries of the former Soviet Union, or northern Asia (including China), you should get immunized.

It's not present in the US, and physicians typically don't carry the vaccine, so it's not as easy to get immunized. Major US metropolitan areas with clinics that specialize in immunizations for world travelers might have it. Canadians can get immunized for TBE much more easily at any clinic.

It's also a good idea to travel with a few disposable sterile syringes. If you need an inoculation while abroad, and you suspect for whatever reason that things like syringes are not sterile, have the clinicians use your own syringes. Or, insist on having the syringe package opened in front of you. MAKE SURE you secure a signed prescription for the syringes from your physician to carry with you in case there's any question as to why you're traveling with them.

A leading cause of HIV infection in the Russian Federation is use of improperly-sterilized surgical instruments, and re-use of syringes.

Thanks to you experienced travellers for posting this.
I'm heading to South/Central America in a few months and I've had a hard time figuring out if the anti-malarial pills are really worth it. I guess so.
So, for myself and any other green travellers who will need this info,
What is Deet?
What are the best options for malaria medications? Do you stop taking them when out of an area where it's not a concern? How do you really know if an area is dangerous for malaria or not?
Many thanks.

I have received an admonishment from someone within BNA who feels I was inferring that Kinga died of malaria because she was unprepared, and perhaps had not taken the appropriate precautions. (That person also thinks I am giving out professional medical advice on a soapbox, which I certainly am not. Careful, Sputnik-you could be next.) I happen to believe that first person experience trumps a web link on malaria, BUT....

I meant no disrespect to Kinga, or to question her preparedness. I have no idea if she had taken malarial drugs or not. Based on her extensive travels, it is hard to believe she didn't, but as Grannygold pointed out, even if you do take them, there is no 100% guarantee. But let me be clear, please: It was not my intent--in any way--to blame her, diminish her passing or the tragic nature of her loss. If anyone else thought I was blaming Kinga, I apologize for any misunderstanding and hope this clears it up.

Salmo's post seems to me to be another form of tribute. Given Kinga's compassion, how could she not support the distribution of information that could possibly save the lives of other adventurers, travelers, and brave souls. I did not see any blaming in Salmo's post, and for burbledunken, here is a CDC site that explains more (though not enough, as Sputnik points out): CDC
and here is the World Health Association on the same topic: WHO

I am not a licensed medical practitioner, I haven't played one on TV, and I didn't sleep in a Holiday Inn last night. But with the stakes as high as one's LIFE, I don't think either Salmo or myself are hyperventilating on this issue.

If the alternative to these kinds of cautionary posts on the boards is either silence or insistence that all advice come only from certified, licensed authorities, then I predict a lot less (useful) interaction on BnA.

I didn't infer any accusation or disrespect in Salmo's post, and certainly intended none myself.

I personally did not infer any accusation or disrespect in Salmo's post. Maybe his previous posts on these boards might have clouded somebody's judgement on this particular post and what he was trying to say.

I don't think you need to apologise Salmo.

I personally am glad for the post as it made me think twice and also highlighted how unpredictable life is.

Maybe this is the first time on these boards that we here have heard about the loss of somebody we read about, knew through her words ..so it might have been very personal to many and seemed the timing was wrong for such a post.

I don;t think any of us meant any disrepect to Kinga..if a tragic loss can highlight the seriousness of an issue then its sad realityThis could be another way of paying tribute..our own small way.

I can understand how somebody could read more into Salmos starting of this thread.

But I would think that Kinga would rest comfortable in knowing that her passing has brought some of the pitfalls of life and travelling to the attention of others.

In my view Salmo, no apology is needed.

Kinga's death has been a bit of a wake-up call for all of us. Tradgedy has presented this community with a teachable moment and Salmo, Sputnik, Grannygold etc, have taken the opportunity to share their knowledge with the rest of us. They are not medical experts, but like Kinga, experienced travelers. They are dealing with this loss by helping the rest of us. There are no judgements against Kinga. None us can ever know why she became infected. What we do know is that she was a great spirit that will be missed.

Thank you for this great advice. Less experienced travelers will take this information to heart.

Jet

Along the lines of being medically prepared, I heard on NPR last night that the sale of fake malarial medication in Africa and SEA is becoming quite a problem.

quote:

I travel in a part of the world where tick-borne encephalitis is a major concern. This is a very nasty disease which carries risk of permanent neurological damage or death. If you travel to countries of the former Soviet Union, or northern Asia (including China), you should get immunized.

I would like to second this, and point out that the disease is endemic in many parts of Europe as well. In Austria the vaccines against it are a standard part of the vaccination plan and schools make sure all students get vaccinated. Encephalitis is no joke, if not vaccinated and a tick bites you, you have to go to hospital IMMEDIATELY for shots. But people often don't see them soon enough. And they live in the cities as well, anywhere with trees or foliage.

I appreciate the concerns shared here. I have thought about this a lot over the years, and always thought I'd just take my chances if I traveled someplace that required something more than a jab before the trip. After Kinga's death, I have re-thought this idea .... and I for one am glad you folks are here sharing your experiences.

Bead-thanks for the post. It validates the thread.

I thought you folks might need to 'hear' that ... Kinga meant a lot to me, and I will miss her loads. But if I, and others, can learn not only from her life view and travels - well we can also learn from her death.

So again, thank you.

Of all the posts I have made over the years, I think this one has triggered the most private e-mails. Only one was negative, the rest were appreciative, introspective and enlightened. Part of honoring the memory of people we lose is to find what we can that is positive in the loss of a great spirit, and to use it help others. This all of you have done....and speaking just for myself, I think that someone up there is smiling.

Has anyone here read "To Engineer is Human" by Henry Petroski? I won't bore you with a detailed description, but his point is this: it's the basic nature of technology to push the limits. Things that are bigger / better / faster keep getting designed and put into use, and inevitably, someone somewhere pushes some limit over the line. Think Coconut Grove, think KC Hyatt Regency, think Challenger, Titanic, any number of disasters.

I think world travel is subject to the same phenomenom. More people can get more places more easily than ever before, and that means more exposure to risks that we aren't aware of or don't completely understand.

It's really important to recognize that you are treading unknown territory, and that the assumptions you've carried around all your life may be a liability now. This goes way beyond just straight up medical stuff to people being hit by vehicles because they didn't understand traffic laws, people who experienced anaphalactic shock because not every nation has peanut labeling laws and people who get frostbite because they assumed their Kansas city coat was good enough for anywhere.

I won't even open the topic of people who think their limited introduction to sports like sailing, climbing, hiking or diving fits them for action anywhere in the world.

I wholeheartedly agree with all of the experienced travellers on this thread about the importance of medical preparedness, but I want to add that readiness goes beyond medicine as well.

La

Good information salmo, thanks for putting it together.

quote:

I won't even open the topic of people who think their limited introduction to sports like sailing, climbing, hiking or diving fits them for action anywhere in the world.

I agree. I see this in diving all the time. The basic open water course isn't enough to cover all types of diving....that is why the recompression chambers are used so much. I have been shocked at some of the statistics in certain locations.

Thanks Salmo for reminding me why I make room for the first aid kit.....it is so tempting to leave it behind when you have weight and space limitations.

Thank you Salmo - you really brought home just what is at stake when it comes to malaria. Thanks for the dose of reality, and the necessary preventative measures for this disease.