View Full Version : India - Getting sick - precautions
01-07-2004, 10:20 PM
I'm just curious, how many of you have come down with stomach problems in India or Asia? Obviously I intend to take basic precautions (like drink as much beer as possible ;) but the guidebooks sure make it sound like Russian roulette.
So I was wondering about your real-world experiences. Also wondering if it's worth taking preventative medication.
I've been to Thailand, Malaysia, and Indonesia with no problems but India seems more risky due to its population density.
01-07-2004, 11:38 PM
I've been to India/Nepal/Bangladesh/SEA more than a dozen times, long trips, usually 2-3 months per.
I've been sick several times. Only three times enough to be memorable. Once in Bali and twice in India.
I have no idea what happened in Bali, the first time in India was while staying on a houseboat in Kashmir. We had omelets for breakfast and they had a strange taste, sort of like the taste that I got when I would change the water in one of my aquariums - you know, suck on the hose to get the flow started. I think they had washed the dishes in lake water. And the lake is the sewer system.
The second time in India was my fault. I saw a tray of custard being brought out from the kitchen. We had been eating this most excellent custard in Mysore that a local shop had been making especially for us. I figured that this stuff was coming fresh from the kitchen and took a chance. Bad idea.
I'd advise picking up some cipro (cipro-floxacin). The first pill knocked the attack of the custard to its knees.
I'm more careful in India than in, say, Thailand where I drink the tap water in major cities. Just follow the standard rule. Heat kills nasty things. Eat food that has been recently cooked. Treat your water or use bottled water. Eat only fruit that you peel. Wash your hands before eating.
Don't sweat the trots. It's just your body trying to get rid of stuff it doesn't like. Could be chili or the local bugs that you aren't yet used to. Don't stop yourself up with meds (unless you MUST get on the bus/plane). Drink lots of water. Eat bananas. Get some salt and sugar into your system.
Go. Don't worry too much. Life is a crap shoot.
01-07-2004, 11:58 PM
Excellent advice from Bob, I'd say. Especially his last three paragraphs. Eating food from the scruffiest street stalls is not a problem if you can see the stuff coming straight out of boiling oil - not many bugs are going to survive that! Don't bother eating meat in India, the vegetarian food is better and much less likely to upset you. I firmly believe that taking preventative medicine and being obsessive about hygiene can be counterproductive, let your system acclimatise itself. You might get unlucky, but what's the alternative - stay at home and watch TV? Have a great trip.
01-08-2004, 04:30 AM
Just remember, by the time a glass of water reaches Calcutta, it's been through 700 million greater intestines...
01-08-2004, 07:24 AM
I have a weaker stomach than the average person but I always go crazy in Asia regarding food. The only thing that I watch out for is water. I always bring from bottle, whether it is water, coke or beer :).
Let's see, I have been OK in Singapore, Nepal, Malaysia and Japan. I have most of my problems in VN where I eat almost anything and anywhere. The worst time is when I ate some lettuce in the countryside then thrown in some home-made yogourt just for fun. It was a very bad idea. I spent the next three days in argony, used up all my Advance Immodium without getting any better. Then my sister who is working for a pharmacy gave me some sort of a power medicine. It was the most effective drug I have ever used, in a span of half a day, my problem was gone. Actually, it was so effective that I have to take some ExLax two days laters because it really just stop.
In HK, I was fine eating like a real local, on the stalls in the street without a problem untill I have the bright idea to go for an expensive 5 stars hotel buffet costing as much as my room only to scream for blood the next day. It is Russian Roulette :D
01-08-2004, 08:31 PM
Thanks everybody. I guess I won't spend too much time worrying about it. Just try to be careful and bring some medication just in case. Is the ciprofloxacin that you mention otc or by prescription?
01-08-2004, 09:55 PM
In the US I think it's prescription (certainly was a couple of years ago).
In most of SEA/India you can generally buy it over the counter. For a small fraction of what you'd pay here.
If you do a round of antibiotics eat some yogurt, drink a lassi a day or two after you stop. The antibiotics are going to knock out not only the bad bugs in your stomach but also the good ones you need to help digest your food. Yogurt will replace some of the good ones you lost and compete (and probably win due to superior numbers) with any bad guys that get left behind.
OK, here's something else for volunteer guinea pigs....
While trekking in Nepal a few years back I got a mild case of the trots. We were carrying iodine tabs for times that we ran out of boiled water from the tea houses. I treated some water from a clear stream with the tabs and drank it. My trots stopped.
Hummm.... Iodine kills bad stuff in water. Why not in your gut?
I've tried it a couple more times. Even a couple of months ago when I ate at a local fast food place and woke up at two in the morning. Worked within a couple hours both times. Followed with some yogurt.
Is it a cure? Heck I don't know. I'm trained as a scientist and I know better than to get carried away with anecdotal data from a sample of one.
But you might want to give it a try. Moderate intake of iodine isn't a problem from the data I've read.
For projectile vomiting and pooping I'd go straight to the cipro....
01-08-2004, 10:24 PM
> Hummm.... Iodine kills bad stuff in water. Why not in your gut?
Interesting. In any case, I'm sure it'll be good to have some tablets in my kit. Thanks for the idea.
01-09-2004, 12:55 AM
<b>I may as well continue this thread with a different subject.
As I read various accounts like those below, I wonder how this corresponds with your own experiences.
<i>Unfortunately Jaipur will always be connected for me with the memory of being hassled most of the day. The Indian men are a pest in Jaipur. They wanted to talk to me and did not accept a "No". One or two even touched my breasts, when they passed me. And I definitely was dressed in a modest way!
One morning, when I was walking around, a young man was following me. I tried to ignore him, but he talked and talked and I just wanted to walk alone in the not so hot morning air. I told him to leave me alone. He insisted on talking to me. He ignored my wishes and did not respect my decision to be alone. Nothing helped. He just talked and talked and asked me about my life. I told him to f* off. As an answer he asked me, how I like India. I was so angry about him, that I answered: "I hate India!". Surprised he looked at me and askedd: "Why?" "Because of people like you!" I answered. That made him finally leave me.
I hated myself for being that rude. Experiences like this made me want to leave India immediately.</i>
<b>and, from another writer, </b>
<i>That's when it started. Indians! At first, it was just people walking by, stopping and of course staring. No big deal. Then some younger ones walked over and moved my hand away to look at my drawing, without so much as a by-your-leave! Assholes. Then, groups of teenage boys started sitting around me, not talking, just staring. Getting annoyed, I told to go away. They didn't. I moved to another spot, they followed. They continued to pester until one guy got too close, so like the wild animal (they seemed to think I was) that has had enough, I clubbed him across the shoulder with my stick. He just went back, sat with others, and started staring again. Staring back made no difference, they just looked you in the eye for long minutes, with no hesitation. Very rude. I finally went and sat on the stairs in the corner of the mock (right hand side) mosque where they had nowhere they could sit out of the sun, and they gave up and went away.
That's when the flies started. Like flies to sh*t (me being the sh*t) they came across the grounds just to stand and stare. As soon as one group of Indians left, another came. For four hours! I think maybe they didn't come here to see the Taj. Instead, they were here to gawk at pale foreigners. I was very annoyed and rude and wouldn't talk to any of them, refused to shake literally hundreds of hands. I just wanted to sit and draw - alone! It was very annoying. I think I like India so far, but I am growing to hate all Indians, especially the men, if you can understand the difference. Like little boys, who never grew up.
01-09-2004, 01:19 AM
I think these are extreme cases and most likely to happen to younger solo females. If you fall into this category and get touched/hassled just start screaming. Locals will come to your aid in almost every circumstance.
It seems to me that India males have gotten more sexually aggressive in the last few years. Perhaps too many Italians have been traveling there? ;o)
For most of us the major problem will be the persistent salesman. Think used car dealer, insurance salesman, religious fanatic, ....
Usually a polite 'no' is enough. Sometimes I will look the 'offender' straight in the eye and say in a firm, quite voice "NO". Just show resolve.
You are going to be an object of curiosity if you get off the beaten path. Just go with the flow. Think of yourself as a traveling side-show that's just come into town. Use your attractiveness as a way to get some great pictures. (Digital Rules!)
With some luck you'll get to play Pied Pipper and be followed by a bunch of young kids down the path. Shoot 'em.
If you want attention go to Bangladesh.
Just one more suggestion -- taking Pepto-Bismal tabs on a daily basis before you eat. Although I haven't done it (luckily, I tend to have a cast-iron stomach), I know people who swear by it.
01-09-2004, 02:56 AM
What kind of a person are you in everyday life? That's what makes the difference. The people who wrote these accounts sound like they might lose their tempers a bit too easily, fly into a rage if they get stuck in traffic even though they aren't in a rush, that kind of thing. You need to accept that India is different to back home, try not to keep to too rigid a schedule (you won't be able to) relax a bit. It's all an adventure whatever happens. People will be interested in you, they'll stare. They'll ask to have their photo taken with you, and they'll ask as many questions as they can think of. Which means you'll be answering the same questions every day. Smile! Crack a joke! You'll be fine. Bear in mind that people aren't being rude, they have a different outlook entirely and different standards apply. To Indian people, being rude is paying for something with your left hand.
01-09-2004, 03:45 AM
I've heard this one as well. Can't figure it out. As far as I know pepto is just an anti-acid. Don't think it's an antibiotic.
If it's not an antibiotic then most likely it's just buffering the spices that people are not used to. Again, spice/grease are likely the cause of a lot of trots.
Or it could be like tearing up pieces of paper to keep the elephants away....
01-09-2004, 03:49 AM
"Bear in mind that people aren't being rude, they have a different outlook entirely and different standards apply. To Indian people, being rude is paying for something with your left hand."
Excellent point. Big difference between US folks and others (say Mexico) in terms of personal space. We tend to get uncomfortable when someone stands too close, others don't.
The Chinese stare like crazy, which tends to offend us. The Thai rarely seem to make eye contact. We must bother the heck out of them with our polite eye contact.
01-09-2004, 05:23 AM
Of course I see your point and believe I can go with the flow and not let these things get to me in the short time we will be there. And I don't intend to hang around at a public place like the Taj Mahal for four hours drawing. On the other hand if I catch somebody grabbing my wife's chest, I will attempt to "teach" him that that is not a proper thing to do. It's not like they do that to their own country-women so you can't say that this is a "custom."
01-09-2004, 06:27 AM
"It's not like they do that to their own country-women so you can't say that this is a "custom.""
Last February I was walking through Old Delhi. A few paces in front of me was a well dressed local man, about 45 years old. Nice slacks, dress shirt. Could have been a doctor, nicer dressed than most office workers. A one point he reached out and patted a young Indian woman on the butt. Very deliberately.
I stopped quickly, didn't want to be suspected.
The Indians have a term for it - "Eve teasing". They have separate women's train cars, buses, and ticket lines to reduce the abuse opportunities.
My suggestion would be to make a lot of noise, don't actually assault. Public embarrassment seems to work best. People very rarely come to blows. Let the locals do the hitting for you if it's necessary. Someone of a higher caste will whack the heck out of him.
01-15-2004, 08:13 PM
Just thought I'd post here for posterity, for people who might stumble across this thread in the future.
A good source for India info is the forums at <a href="http://www.indiamike.com/" target=_blank>http://www.indiamike.com/</a>.
01-16-2004, 07:19 AM
I've been sick while traveling quite a bit. Preventive medication no. But when you arrive in India, I'd recommend picking up Amoxicillian and Tinidazole. You can buy them for pennies.
It's important to have the two of these in your pack in case you get sick. Sometimes you may not be near a pharmacy or the pharmacy may be closed. Also, if you're sick enough then traveling a few miles in a taxi will be difficult. After an amoxicillian or two you should be much more able to comfortably travel to a doctor.
01-18-2004, 01:25 AM
Your doctor should be able to refer you to a tropical/travel medicine specialist or specialized registered nurse who can advise you on what precautions to take, and to take with you. You should definitely have something like Imodium with you. Also iodine tablets for cases where you can't get bottled water. And some antibiotics that will work for you--which is why you should check with a health professional. Many people have developed a resistance to various antibiotics, and being in the middle of nowhere with serious gut problems is not the right place and time to find out that you're one of them. Also, remember the basic rule of antibiotics--you have to do a complete course, even if you get better after one or two doses, otherwise you run a very high risk of building resistance and they won't work the next time.
No woman in our group was ever left alone the entire three weeks were in India!
Any travel guide will warn women not to travel alone to almost any destination, but in India I wouldn't go anywhere alone as a man. This is especially true for women in Muslim areas, where your daily Western dress, even your assertiveness and freedom can be offensive to the local males.
We did malaria pills, plague shots, hepatitis shots, tetanus shots and Cipro for your stomach. We ate only in hotels and better restaurants and drank bottled water...a must.
And I still got sick as a dog...stomach trouble. But, then, I get that everywhere.
India is not just any trip.
01-18-2004, 03:03 AM
Bart - I think your advice is a little strong. I've been traveling a number of years in India, quite a bit of time alone, never in a group, sometimes with one other person. Other that a few 'bad parts of town' there aren't any places that I hesitate going. (OK, haven't been to Kashmir for a while.)
I know many women who travel by themselves in India quite regularly. In fact, one friend is scheduled to land sometime today in Mumbai. She first traveled India on her own in 1965.
Women do sometimes get a bit of bad treatment. Something along the lines of that provided by New York construction workers and the stereotyped Italian butt-pincher. Modest dress seems to help quite a bit, especially if one adapts the salwar kameez.
01-18-2004, 03:09 AM
I've got some strong feelings about this drug.
You body is trying to expel the bad bugs. Imodium plugs you up and keeps them inside (keeps in the substances that they secrete/excrete that your body finds poisonous).
If you've got a mild case it will most likely take care of itself in a day or two. If it's a bad case then resort to antibiotics.
In either case keep the liquids and electrolytes going in the proper end to stay even with what is coming out the other.
Imodium is a 'chemical cork' that you might choose to use if you must fly.
01-19-2004, 01:50 PM
The first time I went to India in 1984 i got sick because I had to drink bad water being in the mountains. At the time I was using a stupid drug called Micropur, that's supposed to kill everything. But no... I got Giardia. Not too bad, just have to run fast!!!
Then I have been there 7 times.
In the past 3 years I did spend 13 months there. NOTHING happened to me. I eat everything loving Indian food. I make sure not to eat salads, fruits without skin, and I drink Bottled water.
You don't really need any medication. Be careful with fresh milk unboiled.. I never expereinced any trouble with yoghourt..
I have to say that I like the southern Indian cooking a lot better. I go mad for those thalis and dosas..
If you want to know more , please ask me..
02-02-2004, 04:52 PM
Been to India several times, never was sick.
I did in fact eat according to the common rule (cook it, peel it or forget it) and as few as possible - which is quite simple in this hot, smelly and dirty country. Weight-loss is a nice side-effect, not so bad for many Westeners.
07-26-2004, 02:43 PM
I would definitely stay away from the water, eat vegetarian food as much as possible, but other than that...I was in India for 2 months last year, did not take many precautions apart from the above and never got sick at all
It's really uneasy to get adapted on a few days only to a new circumstance, especially of our dietary habit. Such cultural shocks perhaps are any causes of such problems. My advise: open mind to any society and culture where we want to visit it.
09-28-2004, 03:43 PM
Even though I took all the precautions I ended up getting giardia. It's not from cultural shocks, it's from unsanitary conditions. :-/
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