Dear Dr. Camardi,

I save all your articles, but I can’t find the one you wrote about how you got sick in the jungle. I’m interested in that one because we’re going to take a missionary trip to countries in Central America and I recall the advice you gave about traveling to foreign places and some of the things you should do to protect yourself from getting sick.

Alexandria, Virginia

Yeah, well, thanks for reminding me of that. All kidding aside, if I was as careful for myself as I was for others, I probably would not have contracted the diseases I did. And therein lies the moral: You don’t have to get sick if you establish a routine, adjust to your new surroundings and don’t take your environment for granted.

About 50 years ago, a very wise Master Sergeant said to me before we deployed in the field to “adapt or die,” which is as true now as it was then. None of this is intended to talk you out of your trip and the good you will do, but you are going into a new reality where simple things like drinking from a faucet, having ice in your drink, trying the local street vendor for a snack or going to sleep without a net over your cot are not the wisest things to do.

An excellent resource is the Center for Disease Control’s “Yellow Book on International Travel,” which is available free online and has country-specific advice and precautions you’ll need. I’d like to reinforce some crucial points. Make sure your vaccinations are all up to date. With all the press about vaccination concerns, some folks may decide not to take advantage of the protection vaccinations provide for them. If you fall into this camp, please reconsider because from my side of the sickbed, you’ll save yourself a lot of misery from suffering a disease that the local health care providers may not know a lot about.

To be frank, do you really expect a physician in a developing country to have the experience and resources to care for a disease they have never seen or have little experience with because vaccines have practically eradicated its spread? The cost of transport to other hospitals, possibly out of country, and the delays in treatment can result in untold complications. Having “been there and seen that” consider this seriously if you chose not to vaccinate.

A word about trying the local cuisine: Don’t. I know I’m no fun, but right after you appreciate that momentary flash of flavor, think about what the next 72 hours could be like if you swallow. Overly dramatic? Not really. You are in control of what you ingest and given local hygiene factors, and water sources, you really don’t want that salad and glass of ice water if the result is misery. Bottled beverages are the rule and drinking tap water and using ice cubes are out of the question.

Don’t even use the dishes, glasses and utensils that may have been rinsed in local tap water. Food should come from sealed packages, all dairy products from pasteurized sources and only produce that can be peeled — such as bananas, carrots and potatoes — should be eaten. Meals should be very well-cooked food and served hot. If I pressed the “easy button,” the military’s meal-ready-to-eat would be the answer. This packaged food source and bottled water allay many travel concerns.

Traffic accidents are something else you might not have considered. Please fight the temptation of renting that motor scooter to get around the city or village. You’re going into a country where the roads are poorly maintained, and traffic laws are not respected and rarely enforced. Motor vehicle accidents are the leading cause of deaths for Americans traveling abroad. Medical transport back to an American hospital facility can cost over $80,000 for an orthopedic injury.

From my experience, I know that most missionary sponsors provide their volunteers with transport, so take advantage of that service. Since the last time I wrote about this topic, the Zika virus from mosquitoes has become a serious risk, in addition to malaria, yellow fever, dengue and a catalog of others. Depending on your sponsor’s ability to provide air conditioning, window screens or mosquito nets, a safe living environment may not be guaranteed, so you will be responsible for avoiding mosquitoes. The Environmental Protection Agency’s website lists registered insect repellant products, which you should use as directed for the duration of your stay.

This advice might seem overwhelming, but it is not intended to talk you out of the good work you will do on your voluntary missionary trip. It is meant to make you understand that your health is your responsibility — just more so outside of the United States. Start with what I’ve advised and you’ll return with stories of how you helped people and not of how sick you were. God bless.

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