General tips and advises: 

This page contains: What to bring for your trip; Some general health issues; Altitude (sickness); Safety tips and Respect for different cultures

What to bring for your trip?

One of the important things to keep in mind if you start paking is that most places where a lot of tourists come are prepared for this. They often sell T-shirts on places where it is warm and woolen sweaters, hats, scarf's, gloves when the temperature is cold. These things you don´t really have to bring and will make good souvenirs as well.

In general:

I would recommend you to bring not to much thick clothes with you. It is often better just to dress yourself in layers of thinner clothes and if it is really cold, you can use your windproof jacket on top. Even in busses it is better to dress in layers. For example, a bus ride of 7 hours in Ecuador can start with a normal temperature inside the bus of about 17 degrees  Celsius, halfway in the mountains it lowers until maybe 12 degrees, but at the end, on the coast, it can change again to 25 degrees. In luxury busses you sometimes need to be prepared for a freezing airco.Things which are often not so easy to get are: good outdoor equipment, shoes and clothes. Good backpacks, good wind/water proof jackets and outdoor pants for example, you can often better buy at home. Another small advice, to keep your clothes fresh smelling, is to put  them in small amounts into plastic bags with small (hotel) soaps inbetween.  Before you bring a sleeping bag try to make sure where you want to use it. In hostels (in Latin America) there are usually enough blankets and for trekkings of a few days it is usually not so difficult or expensive to rent sleeping gear.

Don´t take too many books with you, because a lot of places where often backpackers come, have their own book exchange. You can also just swop your books with other travelers, which will be easier if you take English books with you.

Money:

About money I can only speak for sure within Latin America. In these countries you now find in most big city´s ATM´s. However not all of them accept banking cards from all over the world, they do all accept Master Card and Visa. Only in Cuba it is still really difficult to find cashmachines for tourists, here you better take enough Euro´s with. Don´t take traveler cheques with you to Latin America, except maybe for real emergancies. It is better to take two banking/credit cards and some cash dollars with you, spreath out over differnt places in your backpacks. 

Some general health issues: 

Visiting new places means that your body has to get used to new surroundings, colder, warmer (stronger sunshine), higher altitude and different food than it is used to. For everyone this can mean something different. Some people adapt quick, others need more time, but in the end almost everyone gets used to their new surroundings. The most important thing is that you listen to your body. Take it easy the first few days and let your body slowly adapt to the new things you eat and the new surrounding you are.

Be also careful with the use of strong medication against diarrhea, like Lopromide. Having diarrhea means often that you ate something wrong. If you don´t really have to travel, it is better to get rid off the wrong food instead of closing your body and let the bacteria do more damage inside.

One of the things you have to be prepared for while you travel to higher altitudes is altitude sickness or soroche. It is a strange kind of disease that everyone can get, but doesn´t always has the same effects for everyone. Some people already feel weak at an altitude of a 1000m, others only above the 2500m. In general most people feel the symptomes of altitude sickness when they are above 2500m and/or ascend more than 300m a day and sleep on this higher altitude. If you ascend to an higher altitude, but descend again, this usually gives less problems. More information about altitude sickness you can find at the Dutch site of Han Willems www.hoogteziekte.info/  Most of my info about altitude sickness comes also from his site and some of my own experiences.

How to recognize (high) altitude sickness? For this you need to know that there are three important forms of altitude sickness:

Other symptoms on high altitude can be: a bit short of breath, the feeling that you get less air and also dihydratacion.

These are the symptoms: Usually you first get some of the symptoms from AMS and next to these you get: mental problems, trouble with thinking, calculating, talking, hallucinating and not being able to walk in a strait line. Some people can get HACE without getting first AMS.

If you have these symptoms you need to go down immediately (at least more than 300m) and it is preferable to seek medical attention! 

The third and most dangerous form is when you get liquid in your lungs, called: High Altitude Pulmonary Edema (HAPE).  These are the symptoms according to a congress about this subject in Lake Louise: Usually, but not always, it starts with the symptoms of AMS followed by at least two of the next symptoms: coughing very strong, total loss of strength, real short of breath and pressure on the chest. In combination with two of the following symptoms: un-usual sound coming from your lungs, get to less oxygen, your heartbeat rises a lot (mostly above 110 beats a minute in rest), you start to breath faster (mostly above 25 breaths a minute), your lips, nose, and nails are getting purple/blue! If you have these symptoms you need to go down immediately (at least more than 500m), you need oxygen and it is preferable to seek medical attention, they may give you nifedipine (Adalat).

The cause of this symptoms is because on higher altitude there is less oxygen in the air around us and usually the air is more dry. Our body needs to make more red blood cells to compensate this less amount of oxygen. For most people this process only takes a few days, but for some it takes longer and sometimes it doesn´t work out at all.

Unfortunately there is still nothing that can really help to prevent altitude sickness! If you have to much trouble with the altitude the best thing you can do is to descend at least 300m or to a lower altitude where you didn´t feel sick before.

There are some things you can do to help your body getting used to the altitude, but be informed that I´m not a dokter and before you use any medication it is always best to verify with your own dokter. For questions in Dutch or English you can also send an e-mail to Han Willems: This e-mail address is being protected from spambots, you need JavaScript enabled to view it

-          The most important advise if you go to higher altitude is that you keep yourself calm, especially during the first days. Again listen to your body, take your time and don´t rush things.

-          Drink enough and eat a bit more salty. Drink more than you usually do, because on altitude you not always notice that you drink to less. Two things that can indicate that you drink to less are; when your urine is darker than usual and your lips get dry. Drink about one liter more a day for each 1000m you ascend, depending on your ddepending on the exercises you are doing. Do not drink only water, especially when you go often to the toilet, this indicates that your body doesn´t absorb the water well enough. In this case you can put a bit of salt and sugar in your water, or drink some fruit juices. I have the experience that one of my group members drunk about 4 liters of water from 7:30 am until 15:30 pm and at 15:45 pm she was laying in hospital, dehydratated... Of course this doesn´t happen often, but it is better to be informed. 

-          You can use Paracetamol against a small headache (aspirine has usually more side-effects, but can be used if you prever). If the headache is to strong for Paracetamol, than you have to descend and/or find medical attencion.

-          Avoid eating meat just before you go to higher altitude, especially when you don´t know how you will react on this. It takes your stomach more energy to digest meat on altitude, which gives a bigger change of getting problems with your stomach

-          Be more careful with alcohol, the effect is stronger on higher altitude, it also dehydratates and has invluences on your capability in making decisions.

-          If you smoke, try to smoke less. Smoking will cost you oxygen.

-          Sun; avoid too much sun. Especially on high altitude the ultra violet light is much stronger. The strong sun light in combination with dry air gives a bigger possibility to get dehydratated.

-          Dextrose tablets or Coromida, a stronger version of dextrose tablets (in Peru). These are no medicine and they do work a bit against headaches.

-          Try to eat more iron rich food, like spinach and other green vegetables (only worth it is you are really going to do some exercises.  

-          There is a medicine that´s called acetazolamide (Diamox) This medicine can prevent the first symptoms of altitude sickness for example with lowering the sour level of your blood and it also work slightly positive on your breathing rhythem. Make sure you drink enough if you use this medications, because it will make you urinate more often. Ask your dokter about other side-effects before you use this medication. The general recommondation if you decide to use this medication is to take 2 times a day 250mg, starting only one day before you ascend and to stop if you are one day at the highest altitude of your destination without problems.

If you have to much trouble with the altitude, the only real medicine is to go back to lower altitude.  

Safety tips:  

Don´t worry too much, but be careful, this can already prevent a lot of problems. Some small advices that might help you are:  

Respect for other cultures! 

Traveling means that you not only see new places, but also get in contact with other cultures. These cultures can be very different from ours and maybe they look even crazy in our eyes. But I´m sure some of them will think the same about us, especially when dozens of tourists daily pass their ugly mud-houses to take pictures of it...Talking about taking pictures I would really like to ask you to do this with respect! Treat the nature, animals, but especially the people you take pictures off with respect. If they don´t want that you take their picture, then don´t take it; if the want money for it, then pay them, or don´t take the picture. Keep in mind that you are not the only tourist who asks them to take a picture. Some people will get this question maybe more than 10 times a day, 7 days a week, how would you react to this???

Ask people before you take their picture, smile at them and maybe even talk a few words with them. They are no objects, but persons like you and me.

Other info:

Two handy internet sites to verify your flights: www.flightview.com and in Peru: www.lap.com.pe