lonely-planet-myanmar-burma-11-edition

DRINKING WATER» Never drink tap water.» Check bottled water seals are intact at purchase.» Avoid ice.» Avoid fresh juices – they may have been watereddown.» Boiling water is the most efficient method of purifyingit.» Iodine, the best chemical purifier, should not beused by pregnant women or those who suffer withthyroid problems.» Ensure your water filter has a chemical barrier, suchas iodine, and a pore size of less than four microns.problems, such as sinusitis,dry throat and irritated eyes.If troubled by the pollution,leave the city for a few daysand get some fresh air.DivingDivers and surfers shouldseek specialised advicebefore they travel to ensuretheir medical kit containstreatment for coral cuts andtropical ear infections, as wellas the standard problems.Divers should ensure theirinsurance covers them fordecompression illness – getspecialised dive insurancethrough an organisation suchas Divers Alert Network(DAN; www.danseap.org). Havea dive medical examinationbefore you leave your homecountry – there are certainmedical conditions that areincompatible with diving, andeconomic considerationsmay override health considerationsfor some dive operatorsthat operate in Myanmar.FoodRather than being overly concernedat street stalls, wherefood is freshly cooked toorder, note that eating in restaurantsis the biggest riskfactor for contracting traveller’sdiarrhoea. Avoid shellfish,and food that has beensitting around in buffets. Peelall fruit, cook vegetables andsoak salads in iodine waterfor at least 20 minutes. Eat inbusy restaurants with a highturnover of customers.HeatMany parts of Myanmar arehot and humid throughoutthe year. It can take up to twoweeks to adapt to the hotclimate. Swelling of the feetand ankles is common, as aremuscle cramps caused byexcessive sweating. Preventthese by avoiding dehydrationand excessive activity inthe heat.Dehydration is the maincontributor to heat exhaustion.Symptoms includefeeling weak; headache;irritability; nausea or vomiting;sweaty skin; a fast, weakpulse; and a normal or slightlyelevated body temperature.Treat by getting out of theheat, applying cool wet clothsto the skin, lying flat with legsraised and rehydrating withwater containing a quarter ofa teaspoon of salt per litre.Heatstroke is a seriousmedical emergency. Symptomscome on suddenly andinclude weakness, nausea,a hot dry body with a bodytemperature of over 41°C,dizziness, confusion, lossof coordination, fits andeventual collapse and loss ofconsciousness. Seek medicalhelp and commence coolingby getting the person outof the heat, removing theirclothes, and applying coolwet cloths or ice to theirbody, especially to the groinand armpits.Prickly heat –an itchy rashof tiny lumps –is caused bysweat being trapped underthe skin. Treat by movingout of the heat and into anair-conditioned area for afew hours and by having coolshowers. Creams and ointmentsclog the skin so theyshould be avoided.Insect Bites & StingsBedbugs Don’t carry diseasebut their bites are very itchy.They live in the cracks offurniture and walls and thenmigrate to the bed at night tofeed on you. You can treat theitch with an antihistamine.Bees or wasps If allergic totheir stings, carry an injectionof adrenaline (eg an EpiPen®)for emergency treatment.Jellyfish In Myanmar watersmost are not dangerous.If stung, pour vinegar ontothe affected area to neutralisethe poison. Take painkillersand seek medical adviceif your condition worsens.Leeches Found in humidrainforest areas. Don’t transmitany disease but theirbites can be itchy for weeksafterwards and can easilybecome infected. Apply aniodine-based antiseptic toany leech bite to help preventinfection.Lice Most commonly inhabityour head and pubic area.Transmission is via close contactwith an infected person.Treat with numerous applicationsof an antilice shampoo,such as Permethrin.Ticks Contracted after walkingin rural areas. If you arebitten and experience symptomssuch as a rash at thesite of the bite or elsewhere,fever, or muscle aches, see adoctor. Doxycycline preventstick-borne diseases.Skin ProblemsFungal rashes are commonin humid climates. There aretwo common fungal rashesthat affect travellers. Thefirst occurs in moist areas385HEALTH ENVIRONMENTAL HAZARDS