Advice for avoiding traveller’s diarrhoea is all over the internet so I won’t repeat it here. By and large we stick to it, except we do sometimes have salads; avoiding them completely for months or years at a time really isn’t feasible. But we are very choosy about where we have them, both the place in general and the specific establishment. It’s just down to whether we are reasonably certain about their hygiene standards so, for example, we would risk it in a place run by an Italian couple where they were actually in the kitchen, even in a relatively undeveloped town like Labuan Bajo in Flores. Or an Australian-packed tourist restaurant in Bali’s busy resorts. Or in an international chain restaurant in central Bangkok.
We have both had bouts of the runs, even though we were following the rules at the time – 4 times for me, once for Mr V. On one occasion I think it was because I had sat by the open window of an Indian train and ingested spray from the toilet (yuk). All you can do really is keep washing your hands before you touch food (after you’ve finished with the menu) and carry sanitizer in case you can’t. We are also scrupulous about not drinking or even brushing our teeth with tap water (except in places like Japan), and we also rinse fruit and salads with purified water.
We carry a fairly comprehensive first aid kit, but so far haven’t had to use most of it – just antiseptic cream, bite cream, a few plasters, painkillers, sore throat pastilles and immodium. The trouble with such kits is that you don’t usually have them with you when you need them, such as when I fell over and badly scraped my knee (luckily I was close to home and a pharmacy, so got some iodine to douse it with), or when Mr V had a too-close encounter with some coral.
Replenishing drug supplies can be tricky, so we stock up when we can. Common drugs are widely available but not necessarily the dosage you want. I normally take 200mg ibuprofen if my back hurts, but often I can only get 400g, and it can be expensive compared with the UK. Low dose (75mg) aspirin is hard to find, but we did find 82mg in Thailand. Doxycicline has always been available but the price varies a lot – Malaysia was surprisingly expensive. We do try to buy drugs from a reputable pharmacy chain as counterfeiting is an issue.
We’ve had no problem buying insect repellent, but the strongest concentration of DEET tends to be 12-15%, and was expensive in Laos and Myanmar. We failed to find anything with DEET in Malaysia except on Langkawi.
I took quite a lot of high factor sunscreen with me, then after lugging it around for more than a year threw it out when read about how it loses its effectiveness after a while (it wasn’t new to start with). I had no trouble finding more in Bangkok, but it cost the same as in the UK. I don’t use a huge amount as I try to keep out of the sun and almost always wear a hat.
If you do need medical attention in south or south-east Asia it’s quite cheap – for minor issues it won’t even exceed the excess on your insurance. I’ve had moles checked out by a dermatologist at a Bangkok international hospital (£25), and Mr V had an MRI scan in India (a follow-up check for an issue that arose just before we left the UK so it was just a scan) for £100. Other than those, our dealings have been with dentists. Apart from the problem that arose in Patnem and Mr V’s consequent decision to have dental implants (total price £1458 for 3, including one extraction) he’s seen dentists for fillings in Bali (£30) and Bangkok (£30), and in Bangkok again to have a chipped tooth filed smooth (£5). I had a check up and clean with Mr V’s dentist in Goa and had a porcelain crown replaced (£133).
I think it would have been virtually impossible to have maintained a special diet such as gluten-free – it’s hard enough just avoiding meat. In Thailand and Indonesia they seem to put sugar in everything, which I really dislike. At least in Indonesia I can check the ingredients for “gula” – in Thai script, I have no chance. In some ways our diet is probably less healthy than at home – the range of fruit available can be surprisingly limited, and the portions of veg served with restaurant meals are often tiny. I try to make up for it when we self-cater, and we don’t seem to suffer colds or mouth ulcers so are immune systems must be in reasonable shape. I guess the lack of stress helps!