|Landing in Kumasi, Ghana.|
As part of my international anesthesia education work I have found myself in some interesting and out-of-the-way places. Consequently I have picked up some tips that may avoid wheel-reinvention. I figure this is a good place to share them.
- On these trips there is often much equipment to take. Consequently, personal luggage usually consists of carry-on only. OneBag.com is an excellent site offering exhaustive detail on the art and science of travelling light.
- Bath wipes are very handy for a long, sweaty, smelly journey at the end of which you will have to interact with non-smelly people.
- Gelsan / alcohol lotion - tap water in the developing world is often not clean, so after you 'wash' your hands this completes the job.
- Business cards - the people you will work with love to be able to communicate with you afterwards. Do not give them to everyone because some will abuse the relationship and request money / sponsorship etc.
- Sleep sack - spray with permethrin for clothing to insulate you from insects in your bed / room.
- Phone - most cell-phones that will work in most 3rd world countries are GSM system vs CDMA (the latter being predominant in the USA). Not only are these handy for in-country communication amongst a team, but they can be used quite cheaply to call home or enable your family to call you.
- Money - cash is recommended for accommodation, in-country travel, food, drink, gifts, tips. Most places will not accept credit cards, and you shouldn't use them even if they do. There are ATMs in most big cities where you can withdraw more cash should the need arise. Before you leave the US, advise your bank that you may be withdrawing cash in Africa, otherwise they might block your card.
- Insect repellant - before you leave the US spray any clothes that you might wear at dawn / dusk (everything but underwear) with permethrin for clothing. Keep a bottle of serious DEET-containing spray with you if there's a possibility you will be outside early morning / nighttime (including the dawn / dusk you arrive).
- Toiletries - consider not carrying any toiletries with you, and purchasing them at your destination. Not only do you save yourself the transportation hassle but you will contribute to the local economy.
- Pepto-Bismol caplets - useful for prophylaxis (2 tabs 4 times per day), or symptomatic relief.
- Jet lag - "For jet lag, circadian adaptation is suggested only for travel greater than 48 h, with travel east more challenging than travel west. Although advancing sleep and wake times and circadian timing for eastward travel with evening melatonin and morning bright light several days prior to departure can help avoid jet lag at the new destination, this approach may be impractical for many people, Therefore, strategies for treatment at the destination, such as avoidance of early morning light and exposure to late-morning and afternoon light alone or in conjunction with bedtime melatonin, can accelerate re-entrainment following eastward travel. For westward travel, a circadian delay can be achieved after arrival with afternoon and early-evening light with bedtime melatonin." Zee and Goldstein. Treatment of shift work disorder and jet lag. Curr Treat Options Neurol (2010) vol. 12 (5) pp. 396-411
- There is nice clinical review of jet lag here.