The
traveller's
commonest
health
complaint
is a
stomach
upset,
usually
caused
by
contaminated
food or
water
. Tap
water is
unsafe
to drink
in
Ecuador;
bottled
water
(so long
as the
seal is
intact)
and soft
drinks,
widely
available
in all
but the
remotest
places,
are safe
alternatives.
Wash
your
hands
before
meals
and use
bottled
or
boiled
water to
clean
your
teeth.
Avoid
ice
cubes;
fruit
juices
with
water
added;
raw
vegetables,
shellfish
(including
most
ceviche)
and
eggs;
salads;
undercooked,
partly
cooked
or
reheated
fish,
meat or
eggs;
dairy
products
and ice
cream
made
from
unpasteurized
milk;
and food
that's
been
lying
around
uncovered
where
flies
can get
at it.
Food
that's
freshly
prepared
and hot,
and
fruit
and
vegetables
that you
can peel
yourself
rarely
cause
any
harm.
You can
also
pick up
stomach
upsets
from
swimming
in
unclean
water;
only use
chlorinated
swimming
pools
and
avoid
beaches
near
large
population
centres
or
sewage
outlets.
If
you plan
to visit
remote
areas,
you may
have to
purify
your
water
.
Boiling
water
for at
least
ten
minutes
(longer
if
you're
at
altitude)
is
effective,
though
chemical
purification
is
simpler.
Chemical
and
iodine
tablets
are
small,
light
and easy
to use,
and
iodine
tincture
is
particularly
effective
against
amoebas
and
giardia,
even if
the
resulting
liquid
doesn't
taste
very
pleasant
(note
that
iodine
is
unsafe
for
pregnant
women,
babies
and
people
with
thyroid
complaints).
Portable
water
purifiers
give the
most
complete
treatment
but are
expensive,
fiddly
to use
and
relatively
heavy to
carry.
A
bout of
diarrhoea
(sometimes
accompanied
with
vomiting
and
stomach
cramps)
is an
annoyance
that
most
travellers
have to
suffer
at one
time or
another.
In most
cases it
passes
within a
couple
of days
and is
best
remedied
by
resting
and
taking
plenty
of
fluids
(avoid
milk,
alcohol
and
caffeine-based
drinks;
still
drinks
are
preferable
to
fizzy).
Rehydration
salts
are
widely
available
in
Ecuadorian
pharmacies
and are
very
helpful
in
replenishing
lost
salts.
Alternatively
you can
make
your own
solution
by
adding a
generous
pinch of
salt and
three to
four
tablespoons
of sugar
to a
litre of
clean
water -
aim to
drink at
least
three
litres a
day if
you're
unwell,
or a
couple
of
glasses
for
every
loose
movement.
Current
medical
opinion
is that
you
should
continue
to eat
normally
as
opposed
to
fasting,
though
you'll
probably
find
only
blander
foods
palatable.
Anti-diarrhoeal
drugs,
such as
Imodium,
only
suppress
symptoms
rather
than
solving
the
underlying
problem,
but can
be
useful
when
you're
on the
move and
out of
range of
a
toilet.
In
more
serious
cases,
such as
bacterial
dysentery
,
following
a course
of
antibiotics
(Ciprofloxacin)
can be
effective,
though
it's
best to
get
medical
advice
first.
Most
towns
have
facilities
for
testing
stool
samples;
tests
often
only
take a
matter
of
hours,
cost a
few
dollars
and are
invaluable
for
diagnosis.
You'll
usually
have to
buy your
own
sample
pot
(caja de
muestra)
from a
pharmacy.
Ciprofloxacin
does not
work
against
giardia
, a
parasitic
infection
that
induces
sudden,
watery
and
bad-smelling
diarrhoea,
bloating,
fatigue
and
excessive
wind.
Symptoms
wax and
wane but
can last
for
weeks if
left
untreated
with a
course
of
Flagyl
or
Fasigyn
(metronidazole
or
tinidazole).
Amoebic
dysentery
, often
indicated
by
bloody
stools
and
fever,
requires
similar
medication,
but you
should
always
consult
a doctor
first.
Cholera
-
transmitted
through
contaminated
water -
occasionally
breaks
out in
rural
areas,
but
tends to
be very
localized
and
restricted
to poor
communities
with
inadequate
sanitation.
As a
tourist,
it's
unlikely
you'll
go
anywhere
near
these
places,
but if
you
suspect
you're
infected
(symptoms
include
profuse
watery
diarrhoea,
explosive
vomiting
and
fever)
it's
easy to
treat,
provided
you get
to a
doctor
immediately
and keep
rehydrating
by
drinking
large
quantities
of
bottled
or
boiled
water.
There's
no point
getting
a
cholera
inoculation
as the
cholera
germ has
become
resistant
to the
vaccine,
which is
generally
acknowledged
to be
worthless.
