There are always risks involved when going to a foreign place, take precautions to preserve your health in South America.
South America is one of the world’s most beautiful continents, with an abundance of flourishing countries and wildlife. That said, there are always risks involved when going to a foreign place, and it’s always best to take precautions to preserve your health. Here’s everything you need to know about healthcare in South America.
The quality of healthcare you receive will vary greatly from location to location but the best facilities can typically be found in larger cities. It’s also important to keep in mind that some hospitals and even doctors may require payments in cash, regardless of the fact that you have travel insurance. It may not be fair but you should be prepared for this situation if it arises. For life-threatening injuries or illnesses make sure your travel insurance covers medevac services, operations or overnight stays at medical facilities, as these services can easily cost tens of thousands of dollars or more.
Dengue fever is a viral infection transmitted by Aedes mosquitoes, and is found throughout the continent. Contraction of the disease occurs mostly in the daytime when bites are most frequent. These mosquitoes can be found close to human habitations, and most often indoors. The mosquitoes like to breed in artificial water containers, such as in jars, barrels, plastic bottles and old discarded tires. Symptoms include, fever, muscle and joint aches, headaches, nausea and vomiting. Typically an episode of Dengue fever will pass in a few days. There is no treatment or vaccine for Dengue fever except for taking analgesics such as acetaminophen/paracetamol (Tylenol) and drinking plenty of fluids. Severe, though very rare cases may require hospitalization. The best prevention is protection against insect bites, which includes using insect repellent, wearing long sleeve shirts, pants and high socks, especially when walking through tropical areas.
Another common disease is Malaria, which occurs in every South American country except for Chile, Uruguay and the Falkland Islands. Mosquitoes are the primary carriers of the disease, with the greatest risk of bites occurring between dusk and dawn. Symptoms include high fever, chills, sweats, headache, body aches, weakness, vomiting or diarrhea. Severe cases have been known to attack the central nervous system, leading to seizures, coma or even death.
Obviously you should speak with a doctor before choosing any of the following options but there are three pills most travelers use to prevent the infection of Malaria:
- Mefloquine (Lariam) is a 250mg pill taken 1-2 weeks prior to your departure and once every week until 4 weeks after you come home. There are, however, a number of people who report mild to severe neuropsychiatric side effects.
- Atovaquone/proguanil (Malarone) is newly approved drug that can be taken daily beginning two days before arrival and throughout your trip until seven days after you come home. Side effects are said to be mild.
- Doxycycline is another alternative but can cause severe sunburn when exposed to sunlight for long periods of time (which I can personally vouch for). It also happens to be a common acne medication.
It’s important to note that symptoms of Malaria can occur months after the initial infection, so visit a doctor right away if you feel any of the aforementioned symptoms once you return home.
Rabies, a viral infection that affects the brain and spinal cord, transmitted by the saliva of infected animals, typically through animal bites and, if left untreated, is almost always fatal. Though most travelers will not need a rabies vaccine, animal handlers, spelunkers (cave explorers) and others who plan to be in constant contact with animals should definitely get the vaccine. Vaccines are safe but expensive. Any bites or scratches from animals should be immediately cleaned with plenty of water and soap, and seek medical attention to determine further treatment options.
Salmonella typhi, or typhoid fever, is caused by the ingestion of contaminated food or water. Fever is the most common symptom, along with headache, malaise (weakness), muscle aches, dizziness, nausea, abdominal pain, constipation and diarrhea and loss of appetite. Eating well-prepared food is key to prevention but, unless you plan to have all your meals professionally catered and served, a typhoid vaccine is highly recommended. Self-treatment of typhoid fever is possible with quinolone antibiotics such as ciprofloxacin (Cipro) or levofloxacin (Levaquin), though symptoms of both malaria and typhoid are very similar, so seeing a doctor should be a priority.
Perhaps the most dangerous of all infections in South America, Yellow fever is a potentially fatal infection transmitted by mosquitoes in forested areas. Symptoms include fever, chills, headache, muscle and backaches, vomiting, nausea and loss of appetite. Though the symptoms usually subside in a few days, there are others (one in every six infected people) who will develop more severe symptoms including a spiking fever, listlessness, jaundice, kidney failure and hemorrhage, which results in death for half of such cases. There is no treatment, which is why the vaccine is absolutely vital. Vaccines can only be given at approved vaccination centers and don’t forget to get your International Certificates of Vaccination booklet.
Altitude sickness occurs when travelers do not allow their bodies enough time to properly acclimate and ascend rapidly in elevation (typically above 2500m or 8200ft). Symptoms include headaches, nausea, vomiting, dizziness, malaise, insomnia and loss of appetite. It’s important to note that being physical fit will not prevent it, because the quicker the ascent the greater chance you have of developing symptoms. In severe cases fluid can build up in the lungs (high-altitude pulmonary edema) or swelling of the brain (high-altitude cerebral edema). Altitude sickness can be life threatening if not taken seriously. In order to avoid developing symptoms, it’s important to not overeat, avoid overexerting yourself, don’t drink alcohol and allow your body ample time to properly acclimate before ascending to a higher altitude. If you’re on a guided trek (e.g. Machu Pichu or Ciudad Perdida) make sure to alert your guide if you begin to develop any of the aforementioned symptoms.
Always clean any animal bite or scratch with liberal amounts of soap and water, followed by an antiseptic wipe (iodine or alcohol) to disinfect the wound. In case of snakebite, keep the bitten area immobilized and go to the nearest medical facility.
For those planning to hike in the Andes, cross the Salar de Uyuni (especially at night when temperatures can drop dramatically), or camp outdoors during the winter, cold exposure can be a significant problem. Always dress warm, drink plenty of water as well as eat plenty of food, and be sure to avoid any alcohol, caffeine, or tobacco.
Hypothermia occurs when your body loses heat faster than it can create it, which, as a result, drops your core body temperature to dangerous levels. Symptoms include exhaustion, numbness (or loss of sensation), shivering, slurred speech, irrational or violent behavior, lethargy, stumbling, mumbling, muscle cramps and violent bursts of behavior. If experiencing hypothermia it’s important to remove any wet clothing and dress in warm and dry clothes as soon as possible. Avoid drinking any alcohol and drink hot liquids and eat foods that are high in calories. Do not rub victims; allow them to do it, which should start by rubbing the chest and torso in order to maintain core temperature. Outdoors trekkers and travelers on long bus rides (particularly at night) through high-mountain passes stand a higher risk of developing hypothermia. It’s important to dress in layers, and always be prepared for cold, wet or windy conditions, regardless if it’s only for a few hours in outdoor conditions.
South America can get very hot and humid (in particular by the equator), so it’s important to always wear sunscreen (UVA & UVB with SPF higher than 15), sunglasses and a hat to protect you from the sun. Drink plenty of liquids and avoid strenuous exercise and activity to reduce your chance of developing heatstroke.
Insect bites & stings:
Avoiding mosquitoes bites will be difficult (if not impossible) so here are a few things you can do: wear long sleeves, high socks (to avoid bites on your ankles and lower legs, especially during jungle treks), mosquito net, and a good insect repellent that contains DEET. For the insect repellent it’s important that the DEET concentration is not greater than 10% when applied to children less than 12 years (and never on children less than 2); for adults and children over 12 years a 25%-35% concentration is fine to use. The repellent should only be applied to clothing and skin (avoid eyes, mouth, cuts, and wounds), used sparingly and is typically effective for up to three hours. DEET-containing products are effective for areas at high risk for malaria or yellow fever infection. Also, repellents that contain citronella are not as effective as those containing DEET.
Intestinal parasites can affect travelers anywhere on the South America continent. Common parasites include Cyclospora, amoebae, and Isospora. You can greatly reduce your chance of contracting parasites by exercising discretion in your food and drink choices. Always pick busy restaurants and food stalls because the chance of food sitting around for long periods of time is very unlikely.
At some point or another, every traveler will have to deal with diarrhea (unless you plan on eating from hotels and high quality restaurants for every meal). If you’re outdoors, always boil or filter water before drinking or use iodine tablets to purify water. Be careful with dairy products (especially unpasteurized milk) and be highly selective when picking fresh fruits and vegetables from food markets. If you have diarrhea, drink plenty of fluids (preferably a rehydration solution that contains sugars and salts, such as Gastrolyte) and take antibiotics such as Norfloxacin, Ciprofloxacin or Azithromycin to kill the bacteria. If you have symptoms such as fever, cramps, nausea or vomiting, visit your nearest pharmacy or clinic.
Tap water is generally not safe to drink so try to drink only bottled water, or water that has been purified with iodine tablets or properly filtered. It’s important to boil water for over a minute or, if at altitudes greater than 2000m (6,500ft), for more than three minutes.