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Environmental Hazards
Altitude Sickness
Areas of northern India from part of the Himalaya, therefore lack of oxygen at high altitudes (over 2500m) may affect some people. The effect may be mild or severe and occurs because less oxygen reaches the muscles and brain at high altitudes, requiring the heart and lungs to compensate by working harder.
Symptoms of acute mountain sickness (AMS) usually develop during the first 24 hours at altitude but may be delayed by up to three weeks. Mild symptoms include headache, lethargy, dizziness, difficulty sleeping and loss of appetite. AMS may become more severe without warning and c an be fatal. Severe symptoms include breathlessness, a dry, irritative chough (which may progress to the production of pink, frothy sputum, severe headache, lack of coordination and balance, confusion, irrational behaviour, vomiting, drowsiness and unconsciousness. There is no hard-and-fast rule to what is too high: AMS has been fatal at 3000m, although 3500m to 4500m is the usual range.
Treat mild symptoms by resting at the same altitude until recovery, usually a day or two. Paracetamol or asprin can be taken for headaches. If symptoms persist or become worse, however, immediate descent is necessary; even 500m can help. Drug treatments should never be used to avoid descent or to enable further ascent.
The drugs acetazolamide (Diamox) and dexmethesone are recommended by some doctors for the prevention of AMS, however their use is controversial. They can reduce the symptoms, but they may also mask warnings signs; severe and fatal AMS has occurred in people taking these drugs. In general we do not recommend them for travellers.
To prevent acute mountain sickness:
Ascend slowly - have frequent rest days, spending two to three nights at each rise of 1000m. if you reach a high altitude by trekking, acclimatisation takes place gradually and you are less likely to be affected than if you fly directly to high altitude.
It is always wise to sleep at a lower attitude than the greatest height reached during the day if possible. Also, once above 300m, care should be taken not to increase the sleeping altitude by more than 300m per day
Drink extra fluids. The mountain air is dry and cold and moisture is lost as you breathe. Evaporation of sweat may occur unnoticed and result in dehydration.
Eat light, high-carbohydrate meals for more energy.
Avoid alcohol as it may increase the risk of dehydration.
Avoid sedatives
Heat Exhaustion
Dehydration and salt deficiency can cause heat exhaustion. Take time to acclimatise to high temperatures, drink sufficient liquids and do not do any thing too physically demanding.
Salt deficiency is characterised by fatigue, lethargy, headaches, giddiness and muscle cramps; salt tablets may help, but adding extra salt to your food is better.
Anhydrotic heat exhaustion is a rare form of heat exhaustion that is caused by an inability to sweat. It tends to affect people who have been in a hot climate for some time, rather than newcomers. I can progress to heatstroke. Treatment involves removal to a cooler climate.
Heatstroke
The serious, occasionally fatal, condition can occur if the body's heat-regulating mechanism breaks down and the body temperature rises to dangerous levels. Long, continuous periods of exposure to high temperatures and insufficient fluids can leave you vulnerable to heat stroke.
The symptoms are feeling unwell, not sweating very much (or at all) and a high body temperature (39°C to 41°C or 102°F to 106°F). Where sweating has ceased the skin becomes flushed and red. Severe, throbbing headaches and lack of coordination will also occur, and the sufferer may be confused or aggressive. Eventually the victim will become delirious or convulse. Hospitalisation is essential, but ibn the interim get victims out of the sun, remove their clothing, cover them with a sheet or towel and then fan continually. Give fluids if they are conscious.
Hypothermia
Too much cold can be just dangerous as too much heat. If you are trekking at high altitudes or simply taking a long bus trip over mountains, particularly at night, be prepared. In some areas you should always be prepared for the cold, wet or windy conditions even if you're just out walking or hitching.
Hypothermia occurs when the body loses heat faster than it can produce it and the core temperature of the body falls. It is surprisingly easy to progress from very cold to dangerously cold due to combination of wind wet clothing, fatigue and hunger, even if the air temperature is above freezing. It is best to dress in layers; silk, wool and some of the new artificial fibres are all good insulating materials. A hat is important, as a lot of heat is lost through the head. A strong waterproof outer layer (and a 'space' blanket for emergencies) are essential. Carry basic supplies including food containing simple sugars to generate heat quickly and fluid to drink.
Symptoms of hypothermia are exhaustion, numb skin (particularly toes and fingers), shivering, slurred speech, irrational or violent behaviour, lethargy, stumbling, dizzy spells, muscle cramps and violent bursts of energy. Irrationality may take the form of sufferers claiming they are warm and trying to take off their clothes.
To treat mild hypothermia, first get the person out of the wind and/or rain, remove their clothing if it's wet and replace it with dry, warm clothing. Give them hot liquids - not alcohol - and some high-kilojoule, easily digestible food. Do not rub victims, instead allow them to slowly warm themselves. This should be enough to treat the early stages of hypothermia. The early recognition and treatment of mild hypothermia is the only way to prevent severe hypothermia, which is a critical condition.
Jet Lag
Jet Lag is experienced when a person travels by air across more than three time zones (each time zone usually represents a one-hour time difference). It occurs because many of the functions of the human body (such as temperature, pulse rate and emptying of the gallbladder and bowels) are regulated by internal 24 hour cycles. When we travel long distances rapidly, our bodies take time to adjust to the 'new time' of our destination, and we may experience disorientation, insomnia, fatigue, impaired concentrations, anxiety, and loss of appetite.
These effects will usually be gone within three days of arrival, but to minimise the impact of jet lag:
Rest for a couple of days prior to departure
Try to select flight schedules that minimise sleep deprivation; arriving late in the day means you can go to sleep soon after you arrive. For very long flights, try to organise a stopover.
Avoid excessive eating (which bloats the stomach) and alcohol (which causes dehydration) during the flight. Instead drink plenty of non-carbonated, non-alcoholic drinks such as fruit juice or water.
Avoid smoking.
Make yourself comfortable by wearing loose fitting clothes and perhaps bringing an eye mask and ear plugs to help you sleep.
Try to sleep at the appropriate time for the time zone you are travelling.
Motion sickness
Eating lightly before and during a trip will reduce the chances of motion sickness. If you are prone to motion sickness try to find a place that minimises movement - near the wing on aircraft, close to midships on boats, near the centre on buses. Fresh air usually helps; reading and cigarette smoke don't. Commercial motion sickness preparations, which can cause drowsiness, have to be taken before the trip commences. Ginger (available in capsule form) and peppermint (including mint flavoured sweets) are natural preventives.
Prickly Heat
Prickly heat is an itchy rash caused by excessive perspiration trapped under the skin. It usually strikes people who have just arrived in a hot climate. Keeping cool, bathing often, drying the skin on resorting to air-conditioning may help.
Sunburn
In the tropics, the desert or at high altitude you can get sunburnt surprisingly quickly, even through cloud. Use a sunscreen, hat, and barrier cream for your nose and lips. Calamine lotion or a sting relief spray are good for mild sunburn. Protect your eyes with good-quality sunglasses, particularly if you will be near water, sand or snow.
Bites & Stings
Bee and wasp stings are usually painful rather than dangerous. However in people who are allergic to them severe breathing difficulties may occur and require urgent medical care. Calamine lotion or a sting relief spray will ease the discomfort and ice packs will reduce the pain and swelling. There are some spiders with dangerous bites but antivenenes are usually available. Scorpion stings are notoriously painful and can actually be fatal. Scorpions often shelter in shoes or clothing.
There are various fish and other sea creatures which can sting or bite dangerously or which are dangerous too eat. Again, local advice is the best suggestion.
Cuts & Scratches
Wash well and treat any cut with antiseptic such as povidone-iodine. Where possible avoid bandages and Band-Aids, which can keep wounds wet. Coral cuts are notoriously slow to heal and if they are not adequately cleaned, small pieces of coral become embedded in the wound.
Jelly Fish
Local advice is the best wey of avoiding contact wit these sea creatures which have stinging tentacles. Dousing in vinegar will deactivate any stingers which have not 'fired'.
Calamine lotion, antihistamines and analgesics may reduce the reaction and relieve the pain.
Leeches & Ticks
Leeches may be present in damp rainforests; they attach themselves to your skin to suck your blood. Trekkers often get them on their legs or their boots. Salt or a lighted cigarette end will make them fall off. Do not pull them off, as the bite is then more likely to become infected. Clean and apply pressure if the point of attachment is bleeding. An insect repellent may keep them away.
You should always check all over your body if you have been walking through a potentially tick-infested area as ticks can cause skin infections and other more serious diseases. If a tick is found attached., press down around the tick's head with tweezers, grab the head and gently pull upwards. Avoid pulling the rear of the body as this may squeeze the tick's gut contents through the attached mouthparts into the skin, increasing the risk of infection an disease. Smearing chemicals on the tick will not make it let go and is not recommended.
Snakes
To minimise your chances of being bitten always wear boots, socks and long trousers when walking through under-growth where snakes may be present. Don't put your hands into holes and crevices, and be careful when collecting firewood.
Snake bites do not cause instantaneous death and antivencenes are usually available. Immediately wrap the bitten limb tightly, as you would for a sprained ankle, and then attach a splint to immobilise it. Keep the victim still and seek medical help, if possible with the dead snake for identification. Don't attempt to catch the snake if there is a possibility of being bitten again. Tourniquets and sucking out the poison are now comprehensively discredited.
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