Water, water, everywhere and not safe to drink!

I’ve been rather fortunate in my travels around the world. I’ve only been sick twice. Once was after a dinner in Uzhhorod, Ukraine. I was the only one in the group to get sick and can only possibly blame it on some uncooked tomatoes. The other time was in Nepal. I know what cause that episode. Taking a shower!

Call it what you want but diarrhea is likely the biggest health concern you are likely to face on any adventure travel. But, with a little common sense and some precautions the likelihood can be greatly reduced.

Drinking water: Bottled water is now available almost everyplace. Just because it is in a bottle doesn’t mean it absolutely safe. Here in the US our regulatory control of the bottled water industry is minimal. In the developing world there may be very few if any controls. So what are we to do?

Bottled water purchased in a major city from a major retailer is likely going to be OK. Often it will be bottled by a multi-national company. In the country side from a small store the quality might be questionable unless it is the city available brand. So, what to do?

For short excursions into the country side an easy way is to carry a couple of liters of bottled water with you. If you are going to be on a multiple day excursion, that may not be practical.

On our STEAM SIDE ADVENTURES guide trip we meet the clean water challenge in two ways. First, each guide starts out with a liter bottle of water. A liter will generally provide sufficient water in the morning for our clients. Lunch and the afternoon is a different story. We carry one of the currently available portable micro-filters. These products purify water from the river by passing the water through a course filter to remove suspended materials, a ceramic micro-filter, often impregnated with iodine to remove and neutralized bacteria and an activated carbon filter to remove organic/pesticide contaminants. Most of these products are sufficient to last for over a 100 liters.

In the developing world relying on a micro-filter system alone is not a wise choice. What are you going to do if the pump breaks? As a fall back, carry a bottle of 2%Tincture of Iodine in alcohol. Purchase it at the drug store before you leave home. Here is how to use it.
1) Fill your water bottle from the cleanest source you can find. If possible fill the bottle from a spigot to keep the outside of the bottle dry and uncontaminated.
2) Add 5 drops of tincture per liter if the water is clear. Add 10 drops per liter if the water is cloudy. Replace the top and agitate gently.
3) After five minutes, you need to purify the mouth and rim of the bottle (which touched the original water source and which will touch your mouth). To do this, you need to "un-thread" the bottle. Turn the bottle upside down and slowly unscrew the top until you can see a ring of water appear around the inner rim and flow along the neck. Re-tread the top and allow to stand for 30 minutes.
4) Much of the iodine taste and color can be removed by crushing a vitamin C tablet and adding it to your treated water.


Food: If fruits or vegetables are not peeled or cooked, don’t eat them. And, don’t use ice!

Personal hygiene: My experience in Nepal with “intestinal upset” in all likelihood came from taking a shower. Likely I inadvertently swallowed some water. Keep you mouth closed and don’t sing! If you think you may have taken in some water during your shower, immediately rinse your mouth out with your safe water and spit it out. Along with that, be sure and brush your teeth with either your bottle water or treated water.

OK, so you have done all these things and you still get sick. What to do? Always carry an over the counter anti-diarrhea medication such as Imodium. At the first sign of a problem take the medicine and keep yourself hydrated with “safe” water.

As a precaution, before you head out on your trip, make a visit to your primary care physician and ask for a prescription for a broad spectrum antibiotic like Cipro. Most physicians will write a prescription for you if you tell them you will be traveling in the developing world. These can be taken as prescribed for severe gastrointestinal problems caused by microorganisms in contaminated water, should you be unfortunate enough to experience this problem and Imodium doesn’t work.