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Practical mobile pharmacy - travel experiences
Tuesday, 05 June 2007
On long journeys it’s inevitable you’re becoming your own or someone else’s doctor at some stage. Professional medical advice is not always available and sometimes not necessary. In any case it means being prepared by having basic knowledge about  health, treatments and medicaments. In a year’s time of travelling we’ve learned quite a bit about being medically self sufficient. Also the internet is a valuable source, although it comes with a lot of misinformation.
In a year’s time we’ve seen our collection of medicaments and related knowledge grow rapidly. Not that we’re more sick than during our European life, but mainly because we started thinking about our health on the road a lot more. Health is a big thing, specially when travelling.

We now carry several medical books, a big case of medicaments and more practical health knowledge that we ever could have imagined. A valuable piece of information is a book called the BNF – the British National Formulary. Basically it’s a reference written in professional medical language about commercially available medicines. Having this enables us to read about a particular medicine and puts us in the position to know what it basically does (after some study). We didn’t know about this handy reference before till other travellers told us about this book. We bought the march 2006 edition in Islamabad. See for the bookshop.

When we left Europe our collection of medicaments was pretty basic. Pretty much the over the counter stuff you can buy in any pharmacy in Europe – usually for a big price and by default not covered by medical insurance. Now we have a wider spectrum of medicaments. Also over the counter and without any  doctors prescription. All this for very reasonable prices. We stocked up on malaria meds, painkillers, antibiotics and various kinds of Delhi Belly medicaments. In the Netherlands we would have paid a big price for all this. Not to mention the effort in persuading a doctor to write out preventive prescriptions – which is a big time No-No in the Netherlands.
To our experience pharmacies are never far away in Asia. We’ve seen whole pharmacy streets – many shops selling all sorts of medicaments only. Usually by the tablet, tablet strip and for the more wealthy the whole box with the standard folder. Pharmacies try to be your doctor too by asking for what you need the medicines. For locals this usually is a cheaper option than going to the doctor.  

We realise we’re not doctors and for many diseases we quickly admit we’re in way over our heads. However, for many common conditions it’s kind of liberating to not have to sit in a doctors waiting room (like in the Netherlands) – just to get antibiotics or anything else for something you’ve figured out yourself already. It stimulates (self) responsibility and awareness than just handing it all over to the doc.

The top 3 of what we got treated on in a year of travelling:

1st on all our travelling is the ole headache. Usually at the end of the day because of dehydration in combination with road stress. That’s usually an easy fix with lots of water, salt, a rest and something to eat. For the nastier headaches there is Aspirin, Paracetamol and Ibuprofen – which normally do quite well. However there’s a difference; Aspirin and ibuprofen do well for inflammations too. Paracetamol doesn’t.

2nd is the stuff to treat Delhi Belly’s when it doesn’t go away after 2-3 days. There’s a lot to be found on this subject and it gets complex quickly. In generally it’s not easy to select what to take based on the obvious symptom’s. So far we haven’t been in the situation where it simply doesn’t go away.
We do know that the broadspectrum antibiotic Ciprofloxacin deals with several causes of continuous Delhi Belly at once. To counter the after effects of antibiotics use we have Darmocare which is basically a bacteria culture which helps recover the balance of good bacteria in the stomach after they have been eradicated by antibiotics use. Anyhow, probably when it gets real serious after 2-3 days the need for a stool test is the best thing to start.  

3rd are nasty coughs which keep you awake and everyone around you during the night. Sometimes it comes with a normal cold but it can also be a reaction on severe air pollution. The worst part is not getting to sleep for days. Cough suppressors seem to be really popular in Asia. All pharmacy’s have a whole range of stuff there. The Paracetamol / Codeine tablets are great – at least there’s some sleep again! But with severe air pollution in cities like Ankara, Tehran, Islamabad, Kathmandu it’s just part of the deal.

The top 3 of things we found very useful :

1st Dettol – It’s disinfecting handsoap and toilet cleaner available in all kinds of different solutions. It’s great stuff to get rid of any germs pretty quick. It’s also works reasonable well as a smell absorber in a chemical toilet. 

2nd Certisil Combina – Kills most biological activity in water in about 30 minutes. Basically it contains mixture of silver ions and chlorine. The powder can be stored for about 2 years when kept under 25 degrees Celsius. Otherwise it expires slowly in about one tropical season (the chlorine decays quickly in the heat) – which is not a good thing when you rely on it for drinkwater treatment.

3rd Mosquito killers – We tried a whole bunch of stuff – The best we found is the electronic mosquito swatter, which jolts the bastards with a high voltage spike. A very very rewarding chase and without any chemical use. We found the static UV light based insect electrocutors not very effective, they kill insects but not the mosquito’s. Moreover they take too much power and the good ones are generally too bulky. We found them in the china bazaar in Kathmandu. See where.

One unsolved and ongoing issue related to health and specially Dehli Belly’s is what to use in the Porta Potty to disinfect and specially eradicate the smell. In Asia this stuff is hard to find, because the market for closed chemical toilets is pretty much non-existent. There is of course formaldahyde but that’s pretty hefty chemical to carry around. Dettol disinfects but doesn’t get rid of the smell, which keeps coming back after a few hours. A little research shows that Glutaraldehyde is popular ingredient of commercially available toilet sterilization liquids. (Aqua Kem Blue, Certisan, Flow Kem) Airliners use it in their toilets, so it must be available at the bigger airports. But imagine yourself at the airport asking for toilet flush? Yes sir? The new trend however is a biodegradable mixture – like adding a bacterial culture which deals with sterilization and smell. There are lots of bacterial cultures here but how to find the right one in Asia? Anyone who has the answer – drop us a note!

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