Category: Advice (that you probably shouldn’t follow)

Holidays and Exams

It’s been a busy week out here in training-land.  3 holidays in one week, and only one day off. July 1 is Rwandan Independence Day [but it’s not celebrated].  July 4 is both American Independence Day and Rwandan Liberation Day, and for us, our only day off.  My fellow trainees and I went to the local hotel,  had pizza, fajitas, cinnamon rolls, and Fanta [or beverage of  your choice].  For me it was a welcome day off from the onslaught of language classes that the week brought.

On Saturday, we had our a mid-training language exam.  The target at this stage is Novice-high, but I have a plan.  My plan is to score Novice-Mid, get put in remedial Kinyarwanda class, get extra speaking practice, and then WOW everyone at the final exam with my Kinyarwanda prowess. But here’s the real deal, I have performance anxiety, and I have had it for years.  I almost didn’t graduate from college with my Spanish degree because I had such anxiety for my final  oral exam.  And this was with my professor who I had known for three years, and was very familiar talking to him.  So while yes, I am older and wiser, but I still have so much anxiety concerning ‘public speaking.’


On Friday, I picked up my first tailor-made shirt.  It needed a few minor adjustments so I snapped this photo of my [15 year old] tailor making the adjustments.

On Saturday, after our mid-training language exam, I went to the talent show at my host sister’s school. There was singing. And traditional dancing.  And Drumming. There was a skit [in Kinyarwanda–I didn’t understand any of it], and some kid read the news.  And then there was ‘fashion’.  Fashion consists of about 10 couples of modelling different African fashions.  And these kids are stylish.  And they have real talent… unlike most of the talent shows I have been to  in the past.

We’re fancy. We met the US Ambassador to Rwanda.
Every so often, I see beautiful tropical flowers in unexpected places.

Every.Single.Thing. I Packed for Madagascar

More than 1500 coherent words on what I packed for two years in Madagascar from the kind of suitcase I had, and everything I put in said suitcase; don’t say I didn’t warn you

I found out in July 2017 that I’d been accepted into Peace Corps | Madagascar.  That left me with 7 months to pack and clean out my apartment, and seven months to obsess about what to pack.  And this from someone who hates to pack. And someone who hates to shop.  And then I went and bought a house in October 2017. And I had already planned vacation for December 2018.  So I packed for Madagascar as well as my vacation to Germany/France in December while I was packing up the apartment for the impending move. I scoured other PC blogs’ packing lists–for Madagascar, other African countries, even cold weather Eastern Europe/Asian countries… just to see what I was up against. I put effort into packing. I drudged through Amazon customer reviews. I wandered up and down REI’s aisles without buying a thing. I enjoyed crafting the spreadsheet more than the actual shopping.
Not related at all, but a somewhat ironic tangent: I was once in charge of logistics for planning my college’s fencing team flight from Greenville to Philadelphia and securing lodging while in Philadelphia. 13 college students, flying with sabres, foils, and  epees constantly reminding them not to say ‘weapons’ in an airport even though that is totally what they are called collectively.  Reminding people to pack clothing separately from fencing gear in case bags were confiscated, and yet I forgot socks.
Other journeys have similarly been fraught with packing mistakes and my most epic one to date is getting to the airport only to find out I’d brought my recently expired passport instead of the new, active one.  Thankfully it was about 1 in the afternoon, traffic was reasonable, and I lived 20 minutes away instead of an hour away like I do now.Before I start the list, here are the premises I’m working on:

  • Despite popular opinion, this is not a 2 year camping/backpacking trip. I will be living mostly in one place for 2 years. A place that most likely lacks indoor plumbing and electricity.
  • Madagascar is a poor country.  No need to have $200 hiking boots when most, if not all, of my neighbors will be barefoot. All the time.
  • I’ll forget something.   Hopefully, it won’t be my passport.  Or underwear.
A giant duffel bag–with wheels, a hiking backpack, a school backpack x2 and a messenger bag. Not all of these bags are going to Madagascar. At least not at first. One bag has the December vacation clothing in it.

Packing is certainly one of the most stressful aspects of preparing for service, because you think, “how the hell am I going to fit 2 years’ worth of stuff in 2 bags?”  Just so you know now, the Peace Corps country handbook is of absolutely no use. So I put together my own list of what I thought would be helpful. This will hopefully take care of a lot of your potential questions up front, but please feel free to message me or comment if you have a specific question, or if you don’t see something on this list and wonder if you should take it. [Caveat: I am the proud owner of 2 X chromosomes so this is aimed at fellow XX-ers more than guys, but most of these suggestions also apply to men… except, you know, the parts about bringing skirts, bras, and tampons.]

The first thing to keep in mind is that no amount of stuff will make it easy, and no one item will make the difference between having a great experience and a terrible one. The second thing is to keep in mind that even though 2 bags doesn’t sound like a lot, you will still have way more stuff than any of your neighbors have. Having 3 pairs of shoes to carry you for the next 2 years might not sound like a lot, but remember that most people you’ll be living near are lucky if they have one pair of shoes. It is very humbling.  Hopefully my suggestions and advice below will help you avoid packing stress as much as possible but help you arrive to Madagascar well-equipped and excited to serve.

So with that being said…


To get the goods to a location, I’ll need bags. I’m allowed 4; 2 checked, one carry-on and one personal item. The checked bags must weigh less than 50# each. Since I usually try to do carry-on only, I did not have a large duffel or suitcase so I bought one from ebags. It’s my go to site for things luggage related.  So my four bags are:

    1. A suitcase. A duffel bag. Something big. Something sturdy. It’s going to get abused. It may fall apart; it may surprise me and last my full service.  I’ll probably use it as storage once I have a home.
    2. A hiking backpack. I have an old REI one. I’ll probably take the REI one; it’s no longer bright and shiny, and has already proven itself, has a cover, and I know I can pack a lot of stuff in it
    3. A school-type backpack. Can be stuffed to capacity and carry a weeks’ worth of clothing.
    4. A messenger bag. Good for books, notebooks, official documents, plane snacks, travel pillow, ect.

Inside the bags, things will be organized with packing cubes.  If you’ve never used packing cubes, they will change your life.  I also have two plastic storage boxes, 1 small and one medium. And inside those containers, I’ll have:

Outfits: 10 tops + 10 bottoms + 1 cold weather base layer

  • 1 nice outfit: 1 nice top + 1 skirt (mainly to be worn ‘out’ or for important events like swearing in)
  • 2 cardigan/blazer things to be worn over regular T-shirts when the occasion calls for it
  • 2 work outfits: 4 T-shirts + 2 skirts
  • 2 casual outfits: 1 T-shirt + 1 pair of casual pants, and 1 long-sleeve shirt + 1 pair of yoga pants
  • 2 pairs of scrub pants
  • 3 pairs of capri pants/knee length shorts

Additional Clothing

  • Jackets: 1 rain jacket, 1 zip-up jacket, 1 light jacket
  • Bras: 5 sports bras, 5 regular bra
  • Underwear: as many as I can fit into one packing cube [estimated 20-30 pairs]
  • Socks: 6 pairs cotton, 6 pair lightweight wool
  • 2 pairs of leggings

Accessories

  • 1 belt: a few years ago I bough a durable leather belt from the men’s section of REI.  I’ve never gone back.
  • 1 baseball cap
  • 1 bathing suit:
  • 2 pairs of sunglasses

Shoes

  • 1 pair of Tevas sandals–these are fancy dress-up Tevas
  • 1 pair of Keen sandals
  • 1 pair of hiking shoes
  • 1 pair of flip-flops for showering and around the house

Sleeping Kit

  • Sleeping bag: It’s down, but lightweight REI brand.
  • Sleeping liner:  really just a large king sized sheet sewed together to be used when it’s too hot for the bag or in sketchy travel hotels
  • Sleeping pad: REI brand. On past travel, I opted not to use one, but this time around is different.
  • Tent: REI-brand… two-person, simple setup, easy storage.
  • 1 medium compressible Thermarest pillow

Home

  • Cookbook
  • 2 water bottles: a 1L Nagalene and a 24oz stainless steel one
  • Wall decor:  USA map, SC flag, and UT flag
  • Umbrella
  • Clothesline. Braided rubber from REI.
  • Housewares:  measuring cups, cutting board, knives, vegetable peelers, bottle opener, can opener, ect
  • Drink packets / spices
  • Mug + stainless steel water bottles
  • ziploc bags, plastic storage containers
  • Towels: 1 large quick-dry, 1 small quick-dry
  • flat sheets
  • Gorilla tape roll

Tech

  • Kindle, USB cord, and case
  • Phone, USB cord, and case
  • Mini speaker, USB cord
  • 2 headlamps, one to stay at home; one to stay in the bag
  • USB hub, for all the above
  • Laptop, charger, and case
  • 2 sets of headphones* (nothing fancy, not blue tooth)
  • 2 flash drive
  • Shortwave radio
  • Travel alarm clock
  • Rechargeable AA and AAA batteries.  Not sure if I’ll need D or not so I’m waiting before I purchase them
  • A non- electronic alarm clock

Travel, Study & Fun

  • 4 packs of blank index cards
  • 2 decks of playing cards
  • 2 shopping tote bags
  • Travel purse
  • Earplugs
  • Gifts for host families
  • Pens and pencils
  • Notebooks
  • Blank journals
  • Photo albums of friends and family
  • Snacks
  • small umbrella
  • sunglasses
  • canvas tote bags
  • cards

Toiletries

  • Small bottle of your favorite perfume
  • Hand wipes/hand sanitizer
  • Multivitamins
  • Makeup: foundation, eye shadow, lipstick, face wipes, face lotion
  • Hair: comb + brush, shampoo + conditioner, bobby pins, hair ties, scissors, dry shampoo
  • Tools: tweezers, nail clippers, razor + blades, make-up brush, Q-tips
  • Dental: toothbrush, toothpaste, floss
  • Body: bar soap, lotion, razor + blades, pumice stone, deodorant, menstrual cup + tampons
  • Eyedrops
  • Mini first aid kit

And that’s it.

Note: At training I’ll be provided with a Peace Corps’ first aid kit. Again, this is my pre-service packing list. Overall I feel pretty good about it, but that’ll change: Things will break; I’ll send things home, and hopefully I will have some awesome friends who will send me things while I’m here.

Poop, pills, and parasites…oh my

Disclaimer #1:  I am not a doctor, but I do work in a hospital in the USA; I have graduated nursing school [just last week!], have examined my fair share of poop and snot, and have volunteered/visited several health clinics in my travels.  I DO consider myself an expert on all things related to green snot.

Disclaimer #2:   I do not advocate unyielding doctor avoidance or rampant self-medication. Sometimes,  there can be something seriously wrong that you can’t fix on your own, but quite often, there are simple ways to treat what ails you without spending piles cash on tons of medicine either at home or abroad.

Without further ado:  an around-the-world traveler’s guide to poop, parasites, pulmonary related issues, pokes, motion sickness, headaches, birth control and women’s health, cuts, breaks, sprains, scrapes, burns, and all things snot related.

At home, I am a healthy, but clumsy individual.  I attribute it to all the time spent around snot-nosed kids who happen to be sick and in the hospital.  My immune system is in overdrive.  All the time.  Flu-schmu.  I almost never get sick beyond a simple sore throat and cough.  But when I travel, it’s a difficult story.

Evidence #1:  Every time I change environments, this guy sets up in my chest [or more accurately, my nose].  I don’t freak out, run to the nearest pharmacy, or anything out of the ordinary.  He just has to run his course.

Mr. Mucus likes to travel too

Evidence #2:  While living in a low-malarial risk area [and on prophylaxis]  I inexplicably caught malaria.  Even though mosquitoes rarely bother me at home.  I thought I might die.  It was really that bad.

Evidence #3:  This little guy must live on my passport.  He’s responsible for all things related to excessive poop.  He always follows me out of the country.  Even to Canada.  Even though I carry a supply of metronidazole with me at all times.

[a member of the Giradia family]

Evidence #4:  I have had stitches and broken bones in five separate countries [USA included, but also Mexico, Peru, England, and Russia.]

Evidence #5:  A particularly nasty little bout of excessive poop acquired in Mexico robbed me of my will to live.

All of these incidents occurred outside the friendly confines of my home state.  So I know a thing or two about travel related maladies.  For #5, I called my boss [who was a Mexican doctor] and he called a friend of his who lived in the city I was visiting who brought me some oral re-hydration solution.  That saved my ass — quite literally.  It’s no fun pooping mucus.  Take it from someone who knows.

So after you have traveled all over creation, battled a few bugs, completed two health care degrees, got accepted into a health graduate program, worked in a hospital for a few years, worked and volunteered in hospitals and clinics all over creation, you come to know a few things. Or at least you think you do.   Or at least your friends and family think you do.  And they ask questions.

So here goes–a list of common travel illness scenarios, where they are likely to occur based on my limited experience, how you might want to treat what is going on, and some secrets on how to acquire drugs inexpensively.

Problem #1:  My snot is lime-jello green.

green snot

 

  • What it is:  More than likely it is a sinus infection.
  • Where it often happens:    In public places, touching stuff and not washing hands afterward.  In large, heavily polluted cities.  Anywhere air quality is poor.
  • What to do: After 7-10 days with no improvement, go for a round of an antibiotic like Amoxicillin. Amoxicillin [for sinus infection] is currently out of fashion in the US, but it is cheap and easy to get in most of the world. [Do not take if you are allergic to any of the -cillin family of drugs]

My disclaimer about antibiotics: I try to avoid taking antibiotics if at all possible because they kill all the bacteria in your body [not just the bad bugs]. Additionally, over-prescription of antibiotics in recent years has helped lead to drug-resistant strains of bacteria such as MRSA and VRE.

Problem #2. I’m pooping all the time! (and it brings its friend–vomit)

  • What it is:  More than likely it is traveler’s diarrhea. [or vomiting]
  • Where it comes from:  Most cases come from an intestinal bacteria or viral infection.  It could come from food, water, dirty glasses, pretty much anything.
  • Where and when it happens: Countries throughout Latin America, South America, Asia, and Africa.
  • What to do: Avoid getting sick, but if you do get sick, try the following:  Treat the emergent: You are about to board a night bus for _____.  You have a queasy tummy.  You know bathroom breaks will be few and far between.  Take loperamide [Immodium] or diphenoxylate/atropine [Lomotil].  But not both.  Or your intestines will turn to cement.  Crisis averted for the next few hours.
  • Address the cause: If you have bad traveler’s diarrhea doesn’t go away in a day or two, it’s likely you’ve got a bacterial or viral infection.   I always carry a supply of Ciprofloxacin [Cipro] or Azithromycin [Z-pak] — an antibiotic easily found almost anywhere in the world cheaply — as my first line of treatment. Often, you’ll see your body recovering in 24-36 hours. However, once you begin taking an antibiotic, you MUST take the full course. Never stop after you feel good.  This also contributes the the multi-drug resistant bacteria  surge.
  • If you can’t keep anything down, including medications–hydrate, hydrate, hydrate:  Don’t drink plain [bottled or boiled] water, but find yourself some packets of hydration salts, make your own using this formula, or buy some Gatorade and cut it with water. This will help replenish your system with salts, sugar, and minerals that your body has violently kicked out.  It’s all too easy to end up in the hospital from dehydration.  [I would have–twice–if I didn’t know how to start my own IV and carry a saline bag with me.  I don’t always do this, just to remote places]
  • If you have a virus, antibiotics will not help you. Period. If it lasts more than a couple of days without improvement, suck it up and go see a doctor.  They are almost always cheaper than in the US.  Especially if you have travel insurance.

Problem # 3  My burps smell/taste like rotten eggs.

  • What it is: When you’ve got a case of burps that smell and taste like rotten eggs or sulfur, there’s a good chance you are dealing with a water-borne protozoa like giardia.
  • Where and when it happens: Latin America/South America, Asia, Africa–any where that can’t purify the water system.
  • What to do: Take a full dose of  Metronidazole or Tinidazole (4 tablets at the same time). If you have this particular parasite, the burps will go away and you’ll feel better pretty quickly. If they don’t, get yourself to a doctor.  As a bonus, Metronidazole can be used to treat bacterial infections in the genitals. [should you need treatment for that sort of thing]

Problem #4  I can’t poop! [or my poop is really hard]

  • What it is: Constipation
  • Where and when it happens: USA/Canada… Pasta belt in Europe… Dumpling Belt of Central/Eastern Europe… anywhere where there is heavy food
  • What to do: Back off the pasta, dumplings, bread, and cheese. Eat as much fruit, greens, and water as you possibly can. If that doesn’t work, bring out the big guns and eat a bag of prunes (with another few liters of water).

Problem #5  Jackhammers are being used inside my skull.  

jackhammer

 

  • What it is: Depending upon the intensity and location of said jackhammer, you could be experiencing a garden-variety headache or a migraine.
  • Where and when it happens: After a series of overnight buses with blaring music and jerky stops. Sleeping in cheap hotels with giant pillows. People yelling outside your room ALL. NIGHT. LONG.
  • What to do: For regular headaches, Tylenol or Advil will usually do the trick.  For tension headache/migraines, try Tylenol with caffeine.   And quiet.  And darkness.  And not moving.

Problem #6  I don’t want to get malaria.

  • What it is:   A parasitic disease transmitted by the bites of infected mosquitoes
  • Where it happens: Africa, parts of Asia, select parts of Latin America, the Caribbean
  • What to do: Once you have an itinerary, consult the CDC malaria map to determine malaria risk for the regions where you are traveling. Two things will matter most: where you are going and in what season.  Not all malaria is created equal, so you’ll need different medication for different parts of the world.  [I contracted P. vivax  malaria in the Amazon even with Chloroquine–so take this advice with a grain of salt]
  • Doxycycline: Insanely cheap when purchased locally and fairly cheap in the USA. Two things to note: doxycycline tends to make people more sun-sensitive. It can also conflict with some birth control pills. It’s also an antibiotic.
  • Malarone: It’s insanely expensive, but its chemistry supposedly messes with your mind and body less than larium or mefloquin.
  • Chloroquine:   Not really cheap. Chloroquine tablets have an unpleasant metallic taste.
  • On the cutting edge of malaria remedies is the Chinese artemisia plant (or qing hao, “sweet wormwood” or “sweet annie”).  It appears to be commercially available from Novartis as the drug Coartem (Artemether 20 mg, lumefantrine 120 mg). It’s now on the WHO essential medical list. [2018 update:  Coartem is in in Peace Corps med kit for treatment of malaria so it is now a pretty standard drug].

Problem #7 I don’t want to catch Dengue fever/Typhoid fever.

  • What it is:  A viral infection transmitted by A. aegypti mosquito [dengue] or a bacterial infection caused by Salmonella typhi [typhoid].
  • Where it often occurs:  sub-tropic regions such as  Indonesian archipelago into northeastern Australia, South and Central America, Southeast Asia, Sub-Saharan Africa, and parts of the Caribbean [dengue] Most of the world except USA/Canada/Australia/ Western Europe. [typhoid]
  • What to do:  There is no prophylactic medicine for dengue. The best thing you can do is avoid being bitten.  These are the ones that come out during the day.  There is a vaccine available for typhoid, and it can be treated with good old Ciprofloxician. And wash your hands. Frequently.  Like become OCD obsessed with it.

Problem #8  I’m going to vomit on this bus/boat/plane/donkey cart/ect.

  • What it is: Motion sickness
  • Where and when it happens: On windy buses in the mountains of Ecuador, Bolivia, Peru.  In a donkey cart in Guatemala. On a research boat headed to the Galapagos Islands in a storm.
  • What to do:  Option #1– If you’re prone to motion sickness, keep a stash of Dramamine or my personal favorite Bonine  (aka Antivert, Meclizine) handy and take it 30 minutes before departure. If you take it once you’re on the road, it’s too late. As a side benefit, Dramamine will usually knock you out so you don’t have to watch the death defying acts of the bus driver.
  • Option #2:  Purchase a pair of pressure point wrist bands (usually go by the name of Sea Bands). Not sure if their effect is psychosomatic or real, but some people swear by them.

Problem #9 . I’ve gone too high. My head is going to explode.

  • What it is: Altitude sickness.
  • When and where it happens: Hiking or walking anywhere above 2500 meters, particularly if you’ve just arrived by air, train, or bus. The worst I have ever experienced was taking a bus from sea level in Ecuador up to Quito. I felt as if my head was going to blow right off.  La Paz, Bolivia and Bogota, Colombia were no picnic either.
  • What to do: If you can, take altitude slowly, acclimatize. Outside of that, try local remedies like coca leaves (recommended in the Andes, chewed or in served in coca tea) before resorting to traditional altitude sickness drugs like Diamox [which is a diuretic].

 Problem #10 .  I’ve got blood spurting from somewhere it shouldn’t.

  • What it is: Scrape, cut, gash, road rash.
  • Where it happens: Being smashed into rocks when trying to learn to surf in Peru.  Falling off the sand board in Chile.  Getting too close to the reef in the Caribbean.  Running into trees while skiing. Ect.
  • What to do: I always carry an assortment of band-aids, bio-occlusive dressings, gauze, steri-strips [for wound closing], ACE bandages, hydrogen peroxide, neosporin, saline, and iodine. And Cortisone cream–for rashes and bites.  I may be going overboard, but then again, I am pretty clumsy.

Problem #11. I do not want to get pregnant and/or a souvenir I can’t get rid of…

  • What it is and where it happens: Me hopes you should be able to figure this one out on your own.  But beaches, booze, and bathing suits are a heady combination.
  • What to do: Contraception options are many, but if you choose to take birth control pills, here’s some advice:  Before you leave home, ask your doctor to put you on a pill with a hormone formula that is more universally known.  Drugs are known by different names around the world, so write down the commercial name of the drug as well as its chemical and hormone structure.  Condoms are available [can be expensive], but especially if you need the non-latex variety, bring some from home.

In my experience, many countries outside of North America and Europe (and I assume Australia) will sell birth control pills without a prescription. Along your journey drop into pharmacies and ask if they carry your particular pill. Birth control pills are rather expensive (especially by local standards) and choices are limited in many Central and South American countries. However, they were relatively inexpensive and easy to find in Argentina. So, when you find yourself in a country that carries what you need for a good price, stock up.

How do you get all these drugs on the road?
Most pharmacies outside Europe, North America and Australia will sell you whatever you need without a prescription and at a much lower cost than you’ll find at home. My advice: if you’re going on a long journey, travel first to a country where prescriptions are not required for basic medications.

  • Prescriptions: not necessary.
  • Prices: much cheaper than back home
  • Medicines (at least based on my experience): the real deal

I have only had to buy medicine in countries where I speak the language, but knowing the generic name for a drug will help immensely.  Write down the chemicals (and percentages if you can find it) that go into the medication you need instead of just the commercial or generic name of it. The chemical names translate roughly the same in all languages even if the medication is called by another name in that country.

There it is.  My best advice for staying healthy on the road.  Take it or leave it knowing that I have had my fair share of sickness on the road, but it has kept me alive and mostly healthy.