Why do travelers have to take medical precautions before going to South East Asia? Answer to this question is directly connected to the knowledge why there are so many diseases in Third World Countries that are not (or hardly) present in Western civilizations. The reasons for it include favorable conditions for disease growth in this type of tropics which then can be transmitted to humans by insects, not as closely regulated as in Western World sanitary conditions which contributes not only to easier spread of diseases but also to the creation of another source of harmful bacteria which are present in contaminated food and water. The last major way of catching a disease is physical contact with infected person, through exchange of body fluids (can be through sex but also e.g. having done a tattoo with previously used needle).
I started my preparations around 8 weeks before my planned departure with vaccinations. If you have not had your injections done recently (and most of us have not had one since childhood or for this particular diseases never have done at all) it is advised to have them done at least 6 weeks before going. Depending on where you going, for South East Asia recommended vaccinations include Typhoid Fever, Hepatitis A and B, Polio, Diphtheria and Tetanus, Tuberculosis, Rabies and Japanese encephalitis. Because I am not planning to go to rural areas and work with animals like pigs, I ruled out vaccination against Rabies and Japanese encephalitis. I have already had done my Tuberculosis shoot when I was a kid and I am not planning to have any physical contact with anybody therefore Hepatitis B also was out of my list. Finally, I had done 3 injections: one for Typhoid Fever, one for Hepatitis A (both spreading through uncooked/contaminated water or food) and one (thankfully) containing all three Polio (spreading through contaminated food), Diphtheria (air and skin to skin contact) and Tetanus (bacteria present in soil entering your cut or scrape). Injections itself didn't hurt but around half an hour later they started bruising, swelling and be very painful when touched. As I have them in both of my arms, because of the pain I had trouble sleeping comfortably for next 3 nights.
While taking vaccinations, the doctor prescribed me malaria tablets. There are few types of them, the most popular and available only with doctor prescription are:
1. Atovaquone plus proguanil (commonly known as Malarone), they are the most expensive ones
2. Doxycycline, slightly less expensive but common side effect is sensitivity to light
3. Mefloquine or Lariam, the cheapest ones but with the most side effects
The doctor basically told me that the more expensive ones you take once a day (I am talking about £70/two weeks supply!), and the cheaper ones you take once a week (£14/6 tablets or so) and that they generally can make you feel a little bit sick, dizzy and drowsy. That was pretty much all the information I was given and based on that I purchased the cheaper ones, not only because they were cheaper, but also because I prefer to take them once a week rather than ever day. As I was suppose to start taking them 3 weeks before going, just before taking my first tablet I was reading about them online. And I couldn't believe what I found out. They basically are very controversial psychotropic (!) drugs, in a long run affecting your brain and mood, very commonly making you to have nightmares and severe depression. And if there is any family history of depression/psychological problems, you should never come close to them. That discovery was pretty scary and I am so happy I read about it before I took my first tablet. My brain is the most treasured part of my body and I never ever want to mess with it. I also am quite disappointed if not angry with this stupid GP who have not even mentioned this type of risk while prescribing me this tablets.
Here is a link to the youtube video which summarizes well what I read about the Lariam tablets:
Overall, although some rural areas of South East Asia are considered malaria risky, majority of where tourists go is malaria free (as I am going to travel on my own, I don't really want to go somewhere far away from where other people are). Also, because of severe side effects, many travelers start taking the pills and drop them after few weeks and they ere perfectly fine, just as my boyfriend and his friend were when they went traveling together to the same region, refusing to take anti malaria medications. After a careful thought, I decided not to take the malaria tablets at all (although I already bought my psychotropic tablets for £50); the risk of taking them and having side effects is much higher for me than catching a malaria which in fact is a treatable disease.
The final precautions I am taking, is to stock up with charcoal (which naturally absorbs and neutralizes poisons, in case of food poisoning), diarrhea tablets, familiar to me painkillers, maybe some lemsip and lots of good insect repellant spray/gel (50 DEET or more) and repellant plug ins.
At the end of the day, I hope that I will not need to worry abut any of what I just wrote and without any problems I will be enjoying my trip. It is so soon now! In three weeks from today I will be landing in hot Bangkok :)
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