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Advice for backpackers

Backpacking refers to self-organised trips, which usually involve travelling on foot or public transport and staying in simple cheap accommodation. This can expose travellers to additional health risks. The term 'backpacker' is now not very specific since traditional 'backpack' or rucksack is now often used by other groups of travellers including those on organised holidays and expeditions.


Adequate health insurance to cover medical treatment is essential.It is important to consider repatriation particularly when visiting areas with inadequate medical facilities.

Beware of the risk of accidents

Accidents, mostly minor skin injuries and sprains but occasionally fractures, are common when trekking but also when travellers undertake more adventurous activities than they are used to at home. Sometimes hire cars are poorly maintained and this combined with poorly maintained roads can be very hazardous, even more so for motorcyclists.

Contamination of food and water

This is a major cause of illness in travellers in particular travellers' diarrhoea.Unless certain of the purity of the local water supply, stick to boiled or bottled water and avoid ice in drinks. Alternatively, water can be sterilised with iodine drops/tablets or with a quality filter. Dishes and cutlery should ideally be washed with sterilised water.Hot tea, coffee, beer and wine are usually safe. Ensure that milk has been pasteurised and that cheese, cream and ice cream are made from milk that has been pasteurised Peel all fruit, eat only cooked vegetables and avoid salads. Ensure that seafood, fish and meat are thoroughly cooked and eaten hot whenever possible. Avoid leftovers. Wash hands before eating or handling food and always after using the toilet.

Mosquito, other insect and animal bites

Insect bites can be minimised by wearing loose fitting clothing that covers as much of the body as possible, using insect repellents for remaining exposed skin and a mosquito net if accommodation will not be effectively screened or air-conditioned. Stray dogs should not be approached in countries where rabies is present, not just to avoid definitely rabid bites, but also to avoid concern if you are bitten by an angry dog which then runs away and possibly may have rabies.

Unsafe sex

Casual sexual relationships are always risky, although sex with commercial sex workers (prostitutes) provides the highest risk of infection transmission. It is important to realise that where the opportunity to come in contact with commercial sex workers increases, for example in cultures where commercial sex work is condoned, so the risk of receiving an STI infection increases.

A comprehensive first aid kit is important

Travellers should consider carrying a first aid kit containing dressings, plasters, antiseptics for cleaning wounds, pain killers, anti-diarrhoeal medication. Carrying simple antibiotics can sometimes be helpful but education as to how to use these is important. It may also be appropriare to carry emergency malarial treatment if going to areas remote from medical facilities. Sufficient anti-malarial tablets for prevention should be carried as necessary. Sometimes larger groups may carry additional equipment when there is someone trained in first aid in the party.

Culture shock

Culture shock has been described as the anxiety that can result from losing all the familiar signs and symbols of social intercourse giving rise to rejection of the new environment and regression in which the home environment is glorified or in simple terms the shock of the new Possible problems include adjusting to a different climate, unusual food, religious and cultural differences, separation from family, changes in living standards, different social amenities, language differences, coming to terms with poverty, begging, and compulsory movement restrictions for safety or political reasons. Cultural change is a serious and severe test of emotional stability Language difficulties can lead to serious difficulties particularly in times of stress or illness Sometimes people feel that travel is a release from difficulties at home, it rarely is. Separation can lead to unresolved relationship problems which will resurface later. Time differences between continents might increase isolation when it is difficult to maintain contact with friends and relatives . A situation that is exciting and welcome to one person can be daunting to another. Being open to new and different cultures and being patient, rather than critical, will help the traveller adapt to new and challenging adventures.


Vaccinations take time to become effective. See a doctor or nurse well before departure ideally 6-8 weeks in advance especially if a similar trip has not been undertaken before. Boosting childhood vaccines may be necessary - for example tetanus, diphtheria and poliomyelitis. There is an risk of tuberculosis for those visiting high-risk areas and mixing closely with the local population. Remember protection from BCG vaccine is only achieved after about 4-6 weeks. Meningococcal type A,C W135 and Y vaccine is often advised for backpackers visiting risk areas in sub-Saharan Africa. Hepatitis A and typhoid vaccines are important for those who are unable to be scrupulously careful about their food and water hygiene. Hepatitis B vaccine can be useful for those staying for longer periods in high risk areas or if sexual risk taking is anticipated. Japanese B encephalitis is spread by mosquitoes and is sometimes advised for those travelling in Asia (India and beyond) especially in rural areas. Rabies vaccination can be important if going to countries where rabies is present and where the traveller is likely to be more than a day or two from good medical facilities in a situation where a bite has occurred. Yellow fever is a mosquito borne disease and occurs most commonly in jungle areas. It is therefore more likely in travellers going to remote areas. A yellow fever vaccination certificate may be necessary if visiting these areas or if going from them to countries that ask for a certificate as a condition of entry.The disease is not present in Europe, Asia or North America.

Malaria prevention

In addition to avoiding mosquito bites (as above) , when anti malaria tablets are recommended it is important that they are taken correctly. Some backpackers travel a long way from medical facilities - in these circumstances carrying an emergency supply of malaria treatment may be important.
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