Tag Archive | research

Peru – Anna Kirsch (2012)

Anna Kirsch

Anna Kirschis a medical student at Georgia Health Sciences University.  Anna (Mariah) worked in Peru during the summer of 2012, leading a research team that is assessing the impact of cancer initiatives by a local clinic in the Andes.  Mariah received a $1500 scholarship from Sara’s Wish Foundation.

Here are Anna’s travel safety tips:

Peru has become a popular destination for many travelers of all ages.  Although relatively safe, when traveling to anywhere in the world, I would advise taking certain precautions in the unlikely event something unexpected happens while abroad.  In addition, it is important to remember basic awareness and common sense to keep you safe while traveling to ensure your health and safety.  Based on my recent travels to the Andean region of Peru, I have written out a few guidelines below to help ensure health and safety while enjoying your trip to Peru.

I.             Before you leave your home country:

A.             Vaccinations and Health Consideration

If you will not be traveling to the jungle on your own, yellow fever vaccination will not be necessary.  Antimalarial prophylaxis is also not necessary if you remain in the Andes Mountains (Cusco) or Lima.  However, if you will travel to Iquitos in the jungle region, malaria prophylaxis will be required.  Hepatitis A vaccination is suggested.  It is given in 2 doses spaced 6 months apart. It may be a good idea to bring:

  • Diamox (acetazolamide)- Altitude sickness: You may choose to take Diamox (acetazolamide) to help prevent acute high altitude sickness.  Diamox 125- 250mg every 12 hours should be started at least 24 hours prior to departure for Cusco.  This medication causes an increase in urination and respiratory rate.  The side effects include numbness, tingling, or vibrating sensations in your hands, feet, and lips, also an alteration in taste and a ringing in your ears.  Diamox should be continued until the second or third night at altitude.  If you are concerned with acclimatizing, talk to your doctor before you leave.
  • Ibuprofen: An anti-inflammatory and pain reliever wonderful for the first few days when adjusting to altitude!
  • A decongestant: High altitude and dry air make it very easy to get a respiratory infection (a cold) that is hard to kick.  A decongestant combined with hot, steamy showers is a wonderful relief in case you happen to catch a cold while on the trip.
  • Ciprofloxacin: Common anti-biotic for traveler’s diarrhea… something unfortunately not too uncommon while bouncing around developing countries and adjusting to the local cuisine.
  • Sunscreen/repellant: Peruvian sun, especially at altitude, is intense and sunscreen can be expensive in some touristy destinations.  Repellant is also great for Manchu Picchu, although other highland areas do not have many biting insects.  Both can be purchased in country, but may be more expensive than simply bringing a bit from home.
  • And any medications you normally take, including extra contacts/glasses.

Bring your medications in your carry on luggage.  Although most medications can be purchased in Peru, it is always better to be prepared.  You may access the CDC website (www.CDC.gov) for further information about precautions for Peru and South America.

B.             Travel and Health Insurance

MEDICAL EVACUATION INSURANCE: Call your medical insurance and ensure what is covered while traveling abroad.  In some cases, your medical insurance may not be valid outside of the US.  Consequently, it is smart to purchase short-term medical insurance from an external source, such as

  • Cultural Insurance Services (CISI) (800) 303-8120 or (203) 399-5132

Although accidents are unlikely to happen, medical evacuation insurance is strongly suggested just in case.  Short term plans are easy to sign up for and can be purchased on a trip-by-trip basis by a variety of services, such as:

Medical evacuation from Peru could cost more than $50,000 without evacuation insurance.  Although it is not something many of us like to dwell on before traveling, having insurance is a good safe guard against much hardship if an emergency does unfortunately occur.

Bring all insurance information with you, and leave another copy with someone you trust at home in case of an emergency!

C.             Political Security

Before traveling to any foreign country, it is good to know a bit about the current political security of where you are headed.  Check any news reports, upcoming election dates, and any US Dept. of State warnings, which for Peru, can be found at: http://www.state.gov/p/wha/ci/pe/

D.             Personal Documentation

  1. PassportAll travelers are required to have a valid passport (http: //travel.state.gov/passport).  If you do not have a passport, get one quickly. Check the expiration date to make sure your passport is valid at least 6 months beyond your return date to the US and that there are blank pages available for entry/departure stamps.  Be sure to have your passport with you during travel to and from Peru, although a Visa is not necessary.  Extra copies of your passport should be made prior to leaving and stored either electronically, and/or in an area separate from where your actual passport will be stored while traveling.
  2. MoneyCredit cards and ATM cards are also good to have access to funds while traveling.  Make sure you notify your bank of travels before you leave, and make a copy of all your cards to store with your passport copy while traveling.  Also, include any international numbers for the appropriate banks with this documentation in case of theft or loss of a card.  Bring an extra ATM card!  I’ve had an ATM eat my card more than once while traveling, and in many small shops/towns, credit cards are a bit harder to use and will be harder to use as a primary means of currency.Also, it is a good idea to leave copies of such important documents with someone you trust at home in case of emergency.

E.             Emergency Contacts and Itinerary

Always good to have at least one person expecting to hear from you and have a rough idea where you are, no matter where you are in the world.  Leave a rough itinerary with someone you trust at home, and keep in touch with them throughout your trip.  In addition, bring a list of emergency contacts names, phone numbers (with international calling code), emails, etc. in case someone needs to help you reach home in an emergency abroad.  Put this information in your day bag and an extra in your main pack at the start of the trip, that way it will be there if you need it.

II.             Arriving to PERU!!!

A.             Lima

Getting to Cusco can be difficult, and most travelers will first arrive in Lima, Peru in route to Cusco.  Due to flight schedules, it is likely you may spend a night, or at least several hours in this airport.  Hanging out here isn’t always fun, but Internet is available at Starbucks as well as the bar in the hotel across the street from the airport can help pass the time.  Some people chose to sleep waiting for their connection, but you are not allowed thru the security line until much closer to your flight time, so if you are solo, take care to be aware of your surroundings and keep your luggage close by.  Anyone, traveling or not, has full access to this area of the airport.

B.             Cusco and Sacred Valley

Many travel agents will be overly friendly offering tours and hotels upon arrival, sometimes rather aggressively.  Although I cannot say much for the deals they offer, know that it is extremely easy, and probably more relaxing and cheaper, to find tourists offices all around Cusco and in most tourists towns throughout Peru.  Collect your luggage and head into the parking lot to escape.  There, taxis will be waiting.  If you walk to the back of the lot, you will find bartering goes a bit further and you can get a decent price into town.  If you do not know where you are staying for the first night, the Plaza del Arms is the center of Cusco’s touristy area and an easy place to find a coffee shop with tourist’s maps that will mark several hostels and restaurants to help get you oriented for your first night.

  1. High Altitude:If you choose to fly into Cusco from Lima, the first thing most travelers will notice is the effect of the high altitude.  Cusco is situated at 11,151 feet above sea level.  High altitude sickness is characterized by a headache with associated loss of appetite, nausea or vomiting, fatigue or weakness, dizziness or light-headedness, and difficulty sleeping.  The best treatment of acute high altitude sickness is rest, fluids, and mild analgesics such as acetominophen or ibuprofen.  Symptoms will usually resolve in 1-2 days.In consideration of the effects of high altitude, please remember to take it easy, rest, and drink plenty of fluids.  It will be difficult to exercise at this altitude until you acclimate.  Normal physiologic changes in every one who goes to high altitude are hyperventilation, shortness of breath during exertion, changed breathing pattern at night, awakening frequently at night, and increased urination.  Avoid alcohol and sleeping pills (Diamox can be used as a sleeping pill, take upon arrival).Medication Options:   Diamox (acetazolamide)- Altitude sickness, Avoid alcohol and sleeping pills (Diamox can be used as a sleeping pill, take upon arrival). Coca tea or leaves: It is said that the drink helps reduce symptoms of high altitude illness.  However, please remember coca leaves are also used to make cocaine.  Ibuprofen –anti-inflammatory: Ibuprofen can be used to help reduce swelling of mucus membranes due to the altitude change.  In plane terms, it can help you regain your appetite and reduce any sinus pressure you may feel upon arrival.
  2. Food borne Illness and PrecautionsThere are many bacterial and parasitic food borne illnesses in Peru.  Please be very careful what and where you eat and drink.  DO NOT DRINK WATER FROM THE FAUCET OR SHOWER.  ONLY DRINK WATER FROM A SEALED BOTTLE OF PURIFIED/TREATED WATER.  Do not eat ice cubes.  Take precaution when brushing your teeth to not drink tap water.  The Peruvian tap water is not purified.  Keep your mouth closed when you take a shower.   Only eat food that has been cooked or boiled.  Do not eat food prepared on the street.  Also avoid vegetable and fruit salads and cold vegetables as they may have been washed in the local water.  Fruit that can be peeled is safe to eat.  Be extremely careful when eating at buffet type restaurants.  Do not eat raw seafood such as ceviche.Medications: Ciproflaxacin 500mg (#14) In case of acute gastroenteritis (fever, vomiting and diarrhea), you may want to bring a 7 day supply of Ciprofloxacin 500mg tablets #14, 1 tab orally twice daily) with you.
  3. Attire:Cusco is in the mountains and the average temperature during the daytime is 60° F and 40° F during the nighttime.  You can check www.weather.com for an idea of Cusco temperatures before leaving. We suggest that you bring a warm jacket or sweater for the evening.  A raincoat may be a good idea, particularly if you are there during the rainy season (November-March). If you will travel to Machu Picchu, consider bringing a short sleeve shirt and shorts or jeans.  The temperature will be warmer than Cusco with considerable humidity.   Because this region is known for warm alpaca clothes, you may want to purchase these items while in Peru.Hiking in Peru is amazing, but good quality hiking boots/clothes are a bit harder to come by if you are looking for normal US prices.  If you enjoy hiking, make sure you bring sturdy shoes and a few very warm layers in your pack along with you.
  4. Pickpockets:Although Cusco is a relatively safe part of Peru, common sense and awareness always helps keep you safe.  Be particularly cautious for theft of money, cell phones, laptops, cameras and documents.  Do not wear expensive jewelry or watches.  Be especially cautious if visiting local markets or downtown Lima.  A hidden money belt or pouch worn beneath your shirt may help prevent theft, and be sure to keep all zippers on bags securely closed, especially in crowded streets. Pickpockets: Walking around the tourist areas are rather safe during both day and night.  However, always be aware of pickpockets, especially during festivals.  Keep your bags/purses zipped up and if in crowds, in front of you so somebody cannot reach in and remove any of your valuables.San Blas: funky little artsy part of Cusco that is well worth a trip.  However, this area can get rather quiet and is known to be a bit more notorious for muggings and pickpockets.  Don’t walk around this area at night solo, and just be aware of your surroundings.
  5. Electricity:Because Peru uses 220 volts instead of 110 volts and a different electrical plug, an electrical adapter and voltage converter (transformer) will be required in Peru if you bring an electrical device from the US.  Some electrical devices, such as your laptop, have this built in and will not need an electrical adapter.
  6. Transportation:Taxis are relatively inexpensive in Cusco.  However, if traveling independently, always take secure taxis or call one if late at night.  Settle on a price to your destination before leaving or entering the taxi, most are slightly negotiable.  Locals generally are willing to tell you the appropriate price.  If taking a taxi from a hostel, ask the front desk owner to point out a secure taxi if it is late at night, and if possible, travel with a friend.  Carry bags with you instead of in the trunk if possible, a friend of mine had a taxi driver drive off before she was able to unload!If traveling to a more remote hostel/club/whatever at night, take a taxi in place of walking.  Don’t be a target for muggings, and if you talk to those that have lived in the area for a while, a traveler walking around in a quiet part of town at night is a great way to make yourself a target!Buses/collectivos: Vans and buses frequently make loops around the city.  Each one has a name on the top, and follows a set route.  Overall, they are pretty safe and cheap.  However, finding out the routes is sometimes a process of trial and error, or simply asking the locals.  Many are happy to help.If taking a bus or van to a near-by town, such as Pisac, try to find one in good repair, as these roads are rather full of twists and turns.  I often asked if I could sit in the front to avoid motion sickness and have the rare opportunity to buckle up for the journey.  However, I warn you that this is not the seat for the faint of heart- sometimes seeing the narrow mountain road can be rather, well, thrilling, by itself.  I recommend scheduling plenty of daylight on either end of the car journey to not only be safe on the road, but also allow you not to arrive in a strange new town or drop off location at night.
  7. Alcohol:Remember you are at altitude in a dry climate: this means not only will you become dehydrated quicker (think hangover), the alcohol will actually absorb faster into your bloodstream than at lower altitudes (think drunk faster).  If your choose to drink, which many do due to the wide array of nightlife offered here, go slower than you normally would at home and try to find purified water to sip in between beverages.Girls: some bars/bartenders, like in any location, are known to slip drugs in girls drinks out at clubs.  Try to always go out in groups, watch your drink being made, and never leave it unattended while you go off to dance or socialize.
  8. Drugs:Any street drugs such as cocaine and pot are offered fairly frequently on the streets of Cusco.  Remember that these drugs are illegal and penalties for foreigners can be harsh.  Use your head, and remember that staying in a foreign jail probably isn’t on the top of your to-do list.
  9. Money:You may exchange money in Peru, but it is easiest in larger cities like Lima and Cusco.  Bank ATM’s offer the best rates.  Hotels can exchange money, but the rates are generally not as good.  Credit cards can also be used in the major cities, but beware you may have to pay a fee or percentage for using the card abroad.  If traveling to rural settings, be sure to have some cash in local currency (nuevos soles).  Do not carry a large amount of cash.  Avoid changing money on the street, as there is a chance of receiving false currency.  Have CLEAN, NEW bills ($20s) for exchange only!!!!  Ripped or crumbled bills will not be accepted for exchange.
  10. Phone:Your cell phone may operate in Peru; however check with your service plan to assess charges.  Otherwise, calling cards or Skype (if you have internet) may used to call home.   Local cell phones can be purchased quite cheaply in most markets in Peru, and you simply purchase minutes, as you need them.  If staying in the country for a few weeks, this may be a great option not only for safety (sketch cab? Get lost? Dark sooner than expected? GREAT to have a phone at those moments), but also to keep in touch with friends along the way!

Last of all, have fun!  Staying safe while traveling mostly involves common sense, and building a few routines (extra document copies, making sure you have medical/evacuation insurance, keeping someone posted on your whereabouts, etc.) into your travel routine to keep you safe in case of the unexpected.

Venezuela – Azita Jacobson (2006)

Azita Jacobson is a graduate student in Public Health at New York Medical College. Azita received a scholarship of $1500 from Sara’s Wish Foundation in order to support her study of the effects of harmful household environmental pollutants on pregnant women in Marcibo, Venezuela.

Here are Azita’s travel safety tips:

Maraciabo is blistering year round, so plan to take hot weather appropriate clothing. Most of my long distance travel in Maraciabo was by car. If you are the type to get out and see as much as you can, then I strongly suggest using registered taxis as opposed to unmarked taxi services. There are phone numbers for registered taxis published everywhere. Usually from public places, like a shopping district or tourist attractions, there are always registered taxis waiting. From other areas like residential areas and areas less traveled, you can call up a taxi. Registered taxis have clear published fares and radio their assignments to their headquarters.

Local bus travel can be particularly dangerous. This is not because of theft or violence, but instead due to the extreme over crowding. In the mornings I had to ride the bus from my home to the clinic in which I worked. People literally would hang on to the open windows panes from the outside of the bus (formally a school bus) because there were so many people squashed in the seats and aisle.

Most of my case studies and house visits were during my study were reached by walking.

By caring a calling card you can ensure a way to make a phone call in emergencies at the payphone booths. You can buy them online for a fraction of the cost that they are sold for on the streets. You can also access international calling from any of the numerous convenient phone kiosks/news stands around the city. These kiosks have multiple cell phones chained to a table, you can call anywhere locally for an extremely reasonable price.

During my time in Maraciabo, the metro train system was not up in running in my area. So I have no experience with this mode of transportation. However, I rode the Metro train in Caracas. There are subway maps around each train station and the individuals at the information desk are very helpful. In Caracas, most of the taxis in the city center are registered. So I highly recommend taking a taxi, indefinitely, during late, dark hours. I would strongly recommend investing in ground transportation, such as a shuttle or a taxi service to get to and from the airport as soon as you land in Caracas. This will ensure a return trip to the airport. I failed to do this and when the major bridge connecting Caracas to the airport (approximately a 30-45 minute drive) fell due to the rain waters, I had no way to return to the airport. Unregistered taxis will solicit their services for ridiculous amounts of money. What they fail to tell you is that their “alternate” route is though the extremely sketchy neighborhoods along the “Caretera Vieja” or the “Old Highway.” This is an area that not even the military will go without being highly armed. So try to confirm your way to and from the airport in advance if possible.

If you plan on traveling outside of Maraciabo via airplane, plan on paying with cash or with a credit card of a resident from Maraciabo. Most travel has to be arranged by a travel agent and they usually do not accept US credit cards. In my experience, travel agencies that were more lenient with accepting more forms of payment were more stringent in travel restrictions.

Most importantly, make sure that even though you may think as a pedestrian that you have the right away…think again, pay close attention, and be ready to run when crossing streets by foot.

Ghana – Rachael Bonawitz (2006)

Rachael Bonawitz is a graduate of Mount Holyoke College. Rachael received a $1300 scholarship from Sara’s Wish Foundation to support her work as a laboratory researcher in Kumasi, Ghana.

Here are Rachael’s travel safety tips:

– Try to arrive in daylight – the airport is not necessarily near downtown Accra and trying to charter a taxi/get transportation might be difficult unless you’ve made arrangements prior to your arrival

– If you will be in the country for a while, try and purchase a cell phone/buy a card for your own cell phone. Most systems (such as Areeba) are pay-as-you-go, so it’s not a huge financial commitment and it may be useful to have a means of communication.

– When traveling by taxi, set the fare before getting into the taxi.

– When eating out, clearly specify that you want drinks without ice, as ice is often not made with bottled/boiled water.

– Prior to leaving, make sure you have a travel health consultation- bring malaria prophylaxis, bring some antibiotics as prophylaxis if your physician will fill a script, and bring some over the counter medications (ibuprofen, immodium). In large cities you can find pharmacies where most medications can be dispensed (and it’s unclear to me what meds require a prescription in Ghana), but always better to come with some.

– Bring a mosquito net, even if you think where you will be staying will have one. Also bring some mosquito/insect repellent, and be conscious of what you’re wearing – long sleeves and long pants help keep bugs off.

Nicaragua – Hilary Robbins (2011)

Hilary Robbins is a graduate of Duke University. Hilary spent six months in Nicaragua, performing a research study in an impoverished community to determine health needs, developing a program design for a free clinic, and then applying for monetary grants and medical supply donations to make the clinic a reality. Hilary received a $1500 scholarship from Sara’s Wish Foundation.

Here are Hilary’s travel safety tips:

The following bullet points are pieces of advice that I have about staying safe in Managua and around Nicaragua. Some of them may apply broadly to developing countries, and others may be specific to my experience.

  • First, know your site. While I do think it is useful to learn generic travel safety tips if it is your first traveling experience, be aware that most pieces of advice don’t apply everywhere. Make a point to talk extensively with someone who grew up in the area and has high standards of safety about the best way to stay safe.
  • Take the time to learn the language as much as possible. Do not go to a new place where you do not speak the language and expect others to take care of you, especially if you are going to be there for an extended period of time. I have found that the better your language skills and knowledge of the area, the less likely you are to become a victim of any sort of crime.
  • In Managua, it is usually best to use nicer-looking taxis as opposed to the more dilapidated ones. The number on the license plate should match the number on the side of the taxi, and the driver should have official taxi registration.
  • Get contact information for taxi drivers who are known to be safe and reliable, and use them whenever possible.
  • Though city buses in Managua don’t always feel safe, the reality is that the drivers know what they’re doing and accidents are quite rare. The real danger is at night, as the robberies sometimes occur on the buses at gunpoint or knifepoint. Riding buses is a fine idea during the day, but something I did not do as a rule at night.

The great part about traveling in Nicaragua is that buses are cheap and run frequently all over the country. The troubling part is that the buses don’t always appear to be in great shape and some roads are much less safe than others. That said, I did not hear of any bus accidents while I was there and I am told they are extremely rare. While I did take public buses around the country quite often, I avoided traveling in or through the mountains as much as possible. During one trip I did this by mistake, and was frightened by the speed at which the bus traveled around corners lacking guardrails of any sort. I also avoided traveling at night, as any road is less safe in the dark.

It almost goes without saying that in Managua, one should not walk with any bags or purses and especially not at night. Many of us are accustomed to talking or texting on our cell phones as we walk, but in Managua it is important to keep your cell phone completely hidden if you are carrying it with you. Whether it is safe to walk at night is very dependent upon the area, but as a rule it is not a good idea to walk alone in the dark anywhere.

Perhaps the most important piece of advice I have for people in similar situations to mine – i.e. traveling as an individual volunteer to work with a new organization – is to have a frank discussion about safety before arriving in the country. Each organization has its own standards of safety, and it is important that your organization agree to uphold your standards before you arrive. For instance, in Managua it is extremely common to ride around in the back of a pickup truck – but Managua is a place where traffic laws are often ignored and accidents occur frequently. The members of my organization, including one American, made a habit of riding in the back of the pickup truck as that was the only vehicle they had to transport everyone. This created an awkward situation, as usually the most “important” people took the seats in the front and I did not want to act presumptuously. However, when I made it clear that I wasn’t comfortable riding in the back of the truck because of safety, the organization made every effort to accommodate this. However, I think it’s best that this sort of understanding occur before a volunteer commits to a long-term stay – not after.