The full range of vaccinations that you have completed are a huge step forward in defending against many of the most awful endemic diseases.
2020 update. Now that pretty much every Jane and Joe is an expert on viral infection (or conspiracy theories) this may be redundant.
As a guard against bacterial infection I use a ‘clean hand, dirty hand’ protocol. I use my right hand to interact with the world – door handles, shaking hands, carrying things. My left hand is reserved exclusively for eating (left hand eating annoys some people of certain religions in the world, but lots of what I enjoy offends them). Additionally I try to only touch my face through a layer of fabric (bandanna or shirt).
I am not a fan of handiwipes (litter) or hand sanitizer (liquid) or anti-bacterial soap (soap is soap). I take the little soap bars from the hotels and use those as I move on – light and compact and non liquid.
A nail clipper and file are essential. Really look after your feet – days quickly become miserable if you do not.
Before launching be sure to take a good first aid course – it may prepare you to someday help yourself or someone else. Additionally, download and read a solid wilderness first aid guide, as practices for remote locations with limited resources can be dramatically different from urban first aid (honey as anti bacterial?).
I do not carry a first aid kit (just a few bandaids) because I have almost never had need of one, and there are pharmacies all over the world. I use soap and water as a sanitizer if I cut myself, then back that up with vodka if I am within walking distance of a bar (a good excuse).
A small stash of folded toilet paper in a ziplock bag provides insurance for when you have to ‘unpack’ in rough places. If all else fails sacrifice a sock to the toilet gods (Kilimanjaro high altitude dump).
I carry a tiny container of Vicks vapor rub. When jammed on a bus among people (besides me) who have limited access to washing facilities a small smear under the nostrils dramatically improves the odiferous experience.
After a sweaty day or three it is nice to get some stink out of my clothes. I wear my clothes into the shower and soap up under then on top of them. I find that this is much more thorough than scrubbing them in a sink. The clothes line of nylon string I carry really help get the drying done faster. If the clothes are damp in the morning I put them on anyway – they dry much more quickly on my body.
Before I launched I went ‘poo free’, which is a disgusting way of saying ‘do not use shampoo’. My hair has never been happier, and a quick rinse is all it needs for weeks on end.
I do not, but you might want to, bring along some azithromycin, prednisone, ibuprofen, acetaminophen. I have just never really needed them. I do carry four tabs of diphenhydramine – I had an insane allergic reaction after biking through a cloud of tiny bugs.
Having survived to the age where prescription medications are a part of daily life, I had to learn some new things. While my physician may prescribe a six month course of medication, insurance companies typically only permit a thirty day course to be dispensed at a time. There is a workaround, called a vacation exemption. Call or visit your pharmacy with your real or imagined travel dates (hint – over, not underestimate, the duration of your next lap). The pharmacist (or worst case, you) calls for approval to dispense a regimen longer than thirty days. It will work some times. Failing that just pay for the prescriptions. There are a number of online ‘vouchers’ for medications that you can download and show the pharmacist, and the net costs were very reasonable.
I try to be pretty careful about Drinking water cleanliness. I use a couple of tabs of denture cleaners (like Polident) to give my water bottle a scouring once a month, and use my toothbrush with soap to really clean the threads of the cap.
Well intentioned admonishments about never eating salads or street food, or drinking fruit juices or drinks with ice on holiday are good ideas, but do not reflect the reality of full time travel. You cannot leave Rio de Janeiro or Marrakech without having glasses of juice, or depart Kyoto without trying some of whatever they cook. Very occasionally I get a squirrelly belly (probably not more often than post-sushi in Europe) but it is a small price to pay for actively engaging the world and people.
I would not recommend loperamide to ‘treat’ diarrhea, except in extreme, remote locations, or when stuck on a bus. I reckon that nature should take it’s course as quickly as possible.
With so much free time to ponder, I occasionally (though hopefully not obsessively) engage in the ‘what if’ health thought experiments: break my ankle up on Mount Cook; Dengue in Belize; butt-bit by a Komodo Dragon (I’m dead). Why not spend some time thinking about what you would (will) do when a tooth, an ankle, a heart, breaks. I believe that it is useful rumination, thinking about options and internalizing a considered set of response steps.
