- Wednesday, 21 February 2007
This page is subject to further revision and update.
Firstly, I must say that I am not a Doctor, and the advice on this page is distilled from experience, from reading travel guides to India, and the web sites of the US Centers for Disease Control and New Zealand's DermNet. This information does not claim to be exhaustive. Links are provided for more info on each topic.
It is not uncommon to fall ill for a short time during a visit to India (or shortly after returning home). With appropriate medical attention, these problems can be quickly cured and should not deter anyone who is in reasonable health from attending the parikrama. There are always doctors available during our parikrama.
Persons with chronic health problems, pregnant women, or parents of small children should consult a physician before attending the parikrama.
Many times over-the-counter remedies will suffice, but for any severe illness always seek medical attention. With a little extra caution and common sense maintaining good health in India is no harder than anywhere else.Sections:
Hydration and Water
Got a Bad Back?
Flu, Colds, and Parikrama
There is a section on Travel Insurance which includes health coverage. Since that is part of planning your journey, you will find it on that page.
If you visit a travel clinic, they will try to scare you into so many inoculations, for rabies, and many for diseases that you've never heard of (and which you have very little chance of contracting) like Japanese encephalitis.
There are a few diseases that are common in India that are worth considering immunizations.
Tetanus is a real possibility in India especially for anyone walking barefoot. Cuts on the feet are quite common. If you have not had a tetanus booster in the last ten years, it is definitely worthwhile getting one. Tetanus is difficult to treat and potentially fatal if you are unlucky enough to get it. The Tetanus booster also protects against diphtheria.
Typhoid fever is a VERY heavy illness and potentially life-threatening. There is a injection or a live oral vaccine, which gives you immunity (but can't give you the disease) and is effective for five years. You take home the vaccine and keep it in the fridge and take four doses at two day intervals. "Yeah prabhu, I'm going to India, and you'll never guess what I've got in the fridge..."
Boosters for measles and polio are optional. In 2003, for the first time on the Vraja Mandala parikrama, there was a measles outbreak. About 20 devotees (mostly un-vaccinated children, but some young adults) fell ill.
Malaria is found everywhere in India, and is not unknown in Navadipa Parikrama. There are several malaria prevention medications which can be taken to prevent illness. All require a prescription and none are without side effects. The most common drug, Mefloquine (AKA Lariam) should not be used by persons with a history of depression. Such persons should seek a doctors advice on alternatives.
Indians and long-staying westerners never use these drugs, they exercise caution during times when mosquitoes are most active (early morning and evening) and use a mosquito net (and sometimes mosquito mats and coils, etc) at night.
There are some daytime biting mosquitoes that are capable of carrying dengue, which is even more serious than malaria. Though generally found in Delhi they can also be found in Vraja mandala or Navadwip. For the first time ever there was one case of Dengue during the 2003 Vraja Mandala Parikrama. It is unknown where he contracted the ailment.
Be sure to bring mosquito repellant, but some mosquitoes bites are inevitable, and very few mosquitoes carry these diseases, so it's not worth being super-paranoid about it.
Street vendors selling food or juice should be avoided. Their hygiene standards are non-existent. One time I was on the roof of the Mathura math and saw a boy peeling pomegranates into a basket for the juice vendor outside the math. He accidentally spilled the basket onto the street, then looked around (but not up!) to see if anybody saw what happened. He then quickly put the dirty spilled seeds BACK into the basket and covered them over with new seeds. Ack!
Whole uncut fruits and vegetables can be made safe by washing in pure water and/or peeling it.
The devotees at the Mathura math used to bike a mile to a pump at Bengali Ghat, next to the Jamuna river, to fill big plastic jerry cans with drinking water from what was supposed to be a pure source. I brought back a sample of that water to the USA to have it tested, and they said that it was basically pure sewer water.
Ice is always made with local water and is therefore dangerous and should be avoided. That means lassis was well, as they are made with ice.
Because of mainly non-existent sanitary sewers, practically all of the well water in India is contaminated with e.coli and h.pylori which causes stomach ulcers and viruses such as hepatitis which can make you sick. Don't even brush your teeth with local water. Just bathe in it, wash clothes in it. That's all. Bottled water is relatively cheap and widely available, so it just isn't worth the risk. An average person needs to drink one and a half to two liters of water a day. You need to drink more if you are active, if the weather is hot, or if you have diarrhoea.
Dysentery is a disease involving the inflammation of the lining of the large intestines and is the most common disease in India. The inflammation causes stomach pains and diarrhoea. Some cases involve vomiting and fever.
There are two types of dysentery. The most common type is called Bacillary Dysentery and is caused by bacteria.
The bacteria enters the body through the mouth in food or water, and also by human stool and contact with infected people. The diarrhoea causes people suffering from dysentery to lose important salts and fluids from the body.
Fluid replacement is essential from the beginning of dysentery. Without drinking at least as much water as one is losing in diarrhoea, the body dehydrates, the heart has to work harder and a fever starts. A oral rehydration formula called Electral (available from chemists in India) can help.
In the west, stool samples are normally cultured to determine the cause of dysentery. In India, testing is only done if the normal course of medicine fails. The normal course of treatment is a "shotgun" of medicine which will clear up either type of dysentery.
The usual antibiotic prescribed is ciprofloxacin (Cipro) (500 mg) taken twice a day for five days.
The antiprotozoal medication used is a single 2mg dose of tinidazole or more often Metronidazole (Flagyl) 250mg three times a day for five to ten days.
All of these are heavy medicines, and should not be used for the common traveler's diarrhoea which is short-lived (less than three days) and trivial. That condition is best treated with over-the-counter medications such as Pepto-Bismol.
Doctors are widely available and in general it is not wise at all to self-treat, but in India is is perfectly possible to go to a chemist and say "I have loose motions since four days" and they will give you the above mentioned medicines without a prescription.
If you are one of the 25% of Americans without health insurance coverage, it might be prudent to do so on your way out of India even if you are feeling well, because the medicine will cost less than $1, and being treated for dysentery in an outpatient clinic or emergency room can cost from $400 to $1000 (as happened to me... twice).
Boils are skin infections caused by a bacteria called Staphylococcus aureus (Staph). The source of the infection is our own bodies. Many people are Staph carriers, but do not show symptoms until there is a break in the skin or a blocked hair follicle.
Boils can occur anywhere on the skin where there is a cut or graze but most often come from an infected hair follicle. Good hygiene can help prevent infection from Staph including washing the body well with an anti-bacterial body-wash or soap (containing the germ-killer Triclosan, found in many western soaps and "Dettol" soap in India) and a washcloth. Also, it is important not to pick your nose (this is one place where Staph lives). Other places include armpits, groin, and buttocks.
Though they are generally easily managed by increased hygiene and a Band-Aid (plaster) and antibiotic ointment, boils can occasionally become serious enough to require medical attention.
Diabetics are at a higher risk for these infections and should be very careful and seek medical treatment early if infection occurs.
Another tip sent in: "A boil developed on my leg. I had a red inflammation around it for 30cm or so. A devotee from Spain suggested I try applying Calendula gel to it twice a day. I followed her advice by applying the gel and covering it with a little cotton wadding and tape. Within 10 days it had reduced to a very small wound which then healed on its own. Calendula gel is sold as a Homeopathic medicine and is available from the local pharmacy here in Vrindavan, so should be readily available throughout India."
Got a Bad Back?
Sitting on the floor for class can be exquisitely painful for anyone with low back problems (like me). A lot of devotees have asked about a wedge-shaped cushion that I have had for the last year which helps a lot, and though it is a bit bulky, is reasonably light for travelling. Here is some more info on wedges.
Flu, Colds, and Parikrama
The Novel H1N1 Flu (swine flu) has made the news this year and is a concern for travelers. Please remember that Srila Gurudeva is personally inviting us to the holy dhama. In the past when devotees were reluctant to travel due to similar situations, Srila Gurudeva said that he would kick all such diseases out of Vraj, very far away. He has the power to do so.
At the same time, if you read this CDC page about the flu, there are some basic practices that I will recap here:
- Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based gels are also effective.
- Avoid touching your eyes, nose, and mouth. Germs spread that way.
- Stay back if you get sick.
- Avoid contact with ill persons
- Stay informed
Every year the Srila Gurudeva forms a health committee for the parikrama. This year is no exception. You can do your part by being careful on the feast days. If your constitution or immune system is not strong, then go light on sweets, pakoras and anything fried like puris and malpura.
As a precaution, bring your favorite vitamins and remedies for the common cold.
I would recommend avoiding any vaccines for the flu. The news also has reports of flu vaccine contamination. Relatives that work in the medical field have told me that even doctors have said the vaccine is more dangerous. For an eye openner, just google flu vaccine contamination, or a 6 minute YouTube video.
Their are a variety of dentist available in India with different training and equipment. Here is my recommendation and expereince.