Tennet's Travels: illness

I've just moved on from Quito after spending my first week in Ecuador's capital city. For the duration of that period I was attending a Spanish school and living with a local family to brush up on la lingua. Apart from a few wanderings around the Centro Historico, a visit to an indigenous market and a cable-car jolly 4100m up the side of a volcano, there's not a huge amount to relate. Instead, I'm going to write about the three things that have been at the forefront of my mind this past week: Crime, Illness and Getting High (i.e. high altitude). Namely, the attempted avoidance of all three. Tennet's Travel's first set of How-To Guides, if you will. Or more accurately How-Not-To.

Quito from Above

These three challenges pop-up throughout Latin America, but they are never so prevalent and combined than in Ecuador, and particularly Quito. Sitting at 2800m above sea level with exotic-bacteria aplenty and one of the worst reputations in South America when it comes to tourist-focused crime. Quite an intimidating place to encounter at any point on a travel itinerary, but even more so when you're fresh off the sky-boat (some people call these aeroplanes) from low-altitude, friendly, easy-living Inglaterre. Doubly so if you're on your poor little lonesome.

I was lucky enough to encounter issues with only two of these obstacles during my time in Quito, but my weak foreign-body was still a mess from the thin air that high altitude creates and the stomach-testers that the local eateries serve up.

Yanapuma Spanish School

First though, a little look at the more serious and scary ingredient in the Quito cocktail: Crime. In late 2009, the Ecuadorian government released a State of Emergency warning in respect to the crime levels in major cities, particularly Quito & Guayaquil (the start and end points of my upcoming Ecuador Tour Leader job - yay!). Things have undoubtedly improved since then, with a very obvious increase in police presence around Quito Old Town. I was here two years ago and it definitely feels safer this time round. Still, the horror stories continue to circulate and there's no doubt the New Town (or 'Gringolandia' as it's referred to by the locals) can be a risky place to wander, especially after dark. So, with a focus on the solo traveller in a dodgy city, how can you make yourself safer? Here's the first guide:

Crime: How-Not-To be a Mug(ging)...

Speak to locals
Even before guidebooks are published, taking into consideration the time between research and publication, they are out of date. Therefore, regardless of what the guidebook says, as soon as you arrive in a new town chat to the locals; hotel staff, restaurants, taxi drivers. These people actually live here and will have the up-to-the-minute, on-the-ground information regarding crime and safety.
Appearance
Try to decrease your tourist look. Shorts, sandals, luminescent t-shirts, cameras bigger than your face,

Looking like a nutter

guide book in one hand, giant map in the other. All of these combine to create a big tourist arrow pointing down above your head. Not necessarily a problem in some cities in the world, but in Quito I've purposefully been wearing long-trousers, shoes and generally cheap/dirty looking clothing (not a huge challenge with my wardrobe). If I need to look at a map or guide-book, I'll pop into a nearby shop rather than appear disorientated on the street. Sure, I'm still obviously a tourist, but hopefully one who looks a little more like they belong. And one who doesn't have any money.
Walk everywhere quickly and with purpose, avoid dawdling and looking lost. It can also help to appear a bit pissed-off and a little crazy (I've found bizarre facial hair can help achieve this). If you look like a nutter you'll likely be left alone.
Belongings
Always carry the least possible 'stuff' around with you. I absolutely hate having to hump all my belongings around and the feeling of vulnerability that comes with this, so I'll only do so when absolutely necessary. When you do need to carry valuables, split them up - in your bag, on your person, the majority of money concealed somewhere (money belt, sock, inside hem of trousers) and smaller denominations in various pockets. When sitting in restaurants, on buses etc. keep one limb looped through your bag strap.
Taxis
ONLY EVER use official taxis, making a note of the registration or licence number beforehand if you can. Booking over then phone is preferable to hailing on the street and obviously never share a ride with a stranger. I always try and joke with the driver before jumping in, to get an impression of his character. Continuing a friendly chat during the journey, showing an interest in his life and culture. Developing some sort of mutual understanding and therefore hopefully reducing chances of murder and rape.
Power in Numbers
Your vulnerability is always reduced when you are in a big group. This is something I often have trouble with as I'm usually travelling alone. Whenever possible, though, tag onto a group and move around together.
After Dark
The night is not your friend. Situations and places can change greatly once darkness falls so always find out exactly what the deal is, the latest information, before venturing out en la noche. Only carry the absolute minimum with you, so if the worst happens you won't lose much. A personal pet hate of mine is arriving in an unknown city after dark, so try to schedule your travel to avoid this.
Be Aware
Finally, be aware and trust your instincts. Keep monitoring your surroundings for anyone or anything unusual and don't second guess yourself if something doesn't feel right - get outta there!

Ecuadorian Surrogate Family

The aim here isn't to be overly paranoid and spend all the time worrying. These steps obviously apply more when you are in a 'dodgy' location and if you can make them second-nature you'll be a lot safer without really having to think about it. Also, accept that you may still become an unlucky victim and the most important thing to remember is don't try to resist an aggravated robbery. Despite following all my own advice I was still mugged on the last trip in Costa Rica (see this ol' blog).

Moving onto the two ailments I've fallen victim to in this first week: La Comida y La Altitud. Both unavoidable and potentially debilitating, but certainly manageable if the right steps are taken. Let's start with intestinal issues, in this second guide:

Food: How-Not-To Say 'Uh-Oh Estomago' (catchy titles, right?)

Speak to locals
As before, the best source of up-to-date information. Where is good to eat? Locals within the tourist industry are the best option as they are also aware of weak Western stomachs.
Check the customers
If one restaurant is heaving and next door is empty, pick the busy one. There's a reason people are in there. It's also a good sign if other tourists and young children are present. As much as this goes against pleasurable dining rules, children's tummies are almost as delicate as your pathetic foreign belly.
Wash your hands
You filthy animal.
Food preparation
Look for somewhere with a high turnover of meals (again, back to the busy rule). You don't want a pre-prepared meal heated up after being sat on a counter for hours.
Take it easy
One step at a time. Try the local chicken dish first, before the deep-fried dog's colon.
Watch out for the water
You're probably more likely to get ill from el aqua than la comida. Most people know to avoid drinking from the tap, but remember there are other sources - ice in drinks, washed fruit/veg, watered-down juices, non-boiled tea/coffee, even teeth-brushing. Any one of these has the potential to make you a permanent Baño-dweller for the next little while.
Accept it
I'm often a hypocrite where the above rules are concerned - venturing into a dodgy local eatery at the beginning of a long trip, spending a couple of days attached to a toilet and then moving on with an increased level of intestinal immunity. At least that's the plan. You're going to get ill and when it's happened once it's less likely to again. So get stuck in. Take it on the chin (or bowels).

Finally, the most specialised of the three guides here. Something you'll only encounter in a minority of locations. High altitude.

I was obsessed with getting high during my previous South America trip - constantly climbing higher and higher until finally reaching the 6000+m peak of Huayna Potosi in Bolivia (you can read all about it here, if you have nothing else to do with your life). By then my body was very well acclimatised as I'd spent many months floating around and above 4000m. Quito's height of 2800m wouldn't have warranted a second thought. Which should still be the case now, two years on, right? Wrong. So very wrong.

Otavalo Market

I've had real problems with the altitude this time round. Constant headaches, disturbed sleep, tiredness, breathlessness and just generally feeling shit. This probably wasn't helped by the cocksure-manner in which I arrived, "I've been above 6000m, don't you know". On more than one occasion I found myself internally scolding my pathetic body, "You know you're better than this!", developing a deep competitiveness with my past self, "If he could do it then, why can't you do it now? I will not be beaten by past-James!". An insight into my inflated ego there. Having manliness issues with other men is perhaps understandable, but with yourself from a different time period? We may have gone through the looking glass and into a douchebag worm-hole here. Anyway, my top tips:

Altitude: How-Not-To Get so High it Knocks You Back Down

Drink water
And lots of it. The only thing I've always found to help. Dehydration plays a big role in altitude sickness, so gulp it down.
Take it easy
Don't push yourself. Give your body time to adapt.
Avoid unnatural rapid ascent
Always try to ascend gradually and manage symptoms as they occur. Flying from sea level to La Paz at 3650m is never going to end well.
Ascend higher before you sleep
Another measure that's usually effective for me. Head up high during the day and come back down to sleep. Increase both levels gradually but always sleep lower than where you spent the day's activities.
Descend
If your body really isn't acclimatising, don't ignore the symptoms (headache, lack of appetite, trouble sleeping, low energy, dizziness). You could be developing much more serious lung and brain disorders - AMS (Acute Mountain Sickness) and HACE (High Altitude Cerebral Edema). You don't want these. The only sure-fire antidote is to descend. You can always give it another go later.

There you have it! My three How-Not-To guides. A little insight into my travelling mind and the main issues I've faced this week. Quite possibly an astoundingly-boring blog but who knows, someone may find it useful one day, perhaps even interesting.

The last thing to say is no te preocupes, I've now left Quito with a more durable gut and moved onto the town of Baños at a gentle 1800m and with tourist-friendly crime stats.

Just remember: Be aware, wash your hands and ascend slowly.

View over Quito

Volcano Llama

Otavalo Market

Quito Street Volleyball Game

It´s happened! It took a whole ten days, but then it happened.... I got ill.

On the day that Ollie left (last Saturday) I ate some very dodgy street food in Cancun, and while I´m feeling a lot better now, the intervening days have been.... interesting.

Isla Mujeres - perfect blue sea

As much as I´d like to place the blame elsewhere, I have to admit this was largely my own doing. I missed breakfast because we had to leave early for Ollie´s flight and by the time I got back to the city centre it was past 1pm and I was starving. The first food stand I came to was manned by a wrinkly, old woman and offered a choice of random meat baguettes or cheese and sour cream empanadas. I had two of each. I watched my chef prepare the food: no obvious cleansing to speak of before preparation, and rather grimy hands digging out the mystery meat from it's uncovered container. Disconcerting. Still, I thought, this is authentic Mexico - I have to get into the ´real´ street food sooner rather than later, and the grassroots local stuff always tastes the best. It didn´t. It tasted awful. I´m not sure if ´soggy´ qualifies as a flavour, but that´s all my tastebuds were getting. If I hadn´t been so ravenously hungry, and if there had been other food options in sight, I would have discreetly dumped it and gone elsewhere to eat. But there wasn´t. So I ate it (or half of it - as much as I could bear).

More beautiful blue sea!

I pretty much accepted whilst eating that I would get a little bit ill from this culinary adventure, but convinced myself that this could actually be a good thing: It's not a bad idea to get your gut used to the proper local cuisine early on in the trip; if you´re ill at the start you´re less likely to get ill further down the road. This is exactly what happened on my last trip: I was appallingly sick for the first few days in Nepal, but then never again for the next seven months - my iron stomach could take anything!

I was less convinced by my own foolish logic two days later, stuck in the toilet on Isla Mujeres. While I wasn´t as elaborately ill as in Nepal, I still had very painful stomach cramps and decided a quick trip to the pharmacy would be a good idea. The guy behind the counter could speak reasonable English and was very helpful, but he couldn´t really help me until I´d had a consultation with the resident doctor. So, I waited upstairs until the very young medical consultant called me in:

"Hablas ingles?", I asked hopefully. "No", she replied. "No hay problema. Hablo espanol!" I said confidently (while not-so-confidently rummaging for my Spanish language bible and quickly searching for the ´health´chapter).

My lengthy prescription note

I was in the consultation for a good 1/2 hour, using my phrasebook-assisted pigeon Spanish to stammer out various symptoms, accompanied by extravagant miming. It was during one of these elaborate dramatisations (I think with a reference to ´diarrea´ - which doesn´t need translating...) that I noticed the following wording on the back cover of my phrasebook: "Chat with the locals and discover their culture - a guaranteed way to enrich your travel experience". Amongst the chaos this struck me as very funny - I don´t think this was the kind of ´enrichment´ the publishers had in mind!

During the moments that the doctor wasn´t laughing at me, she said a few things I understood, a lot of things I didn´t, measured my weight, height and temperature (through a thermometer clamped inelegantly beneath my armpit) and asked my age (one of the few questions I understood first time!)

My prescribed drugs

At the end of our extended exchange, she started to write a prescription... and kept writing... and kept writing... until the whole A5 sheet of paper was filled with a list of various medications and detailed instructions on how to take them (all different and all in Spanish). It's highly possible that I got into the whole illness translation and elaborate symptom charades thing a bit too much and the consultant came to the conclusion that I was at death´s door. Either way, when I presented the list to the pharmacist, he looked a little shocked at first and then spent five minutes gathering together a vast selection of drugs - 1 antibiotic, 1 painkiller, 1 long-term stomach protection thing, 1 rehydration drink, and 2 others I´m still not really sure of their function - all in vivid, pretty colours. I´ve been feeling remarkably better since taking them all (sometimes much, much better and sometimes a bit ´floaty´).

Lots of pretty colours

I was initially disappointed that I´d no longer be able to indulge at the beach bar - a fear that was confirmed when the doctor said, "No alcohol. No tequila, no rum, no whisky, no vodka, no mescal". Fair enough, I thought, I have to prioritise my health.... But then she finished: "Cervaza (beer) es OK!" :-)
(I have to admit this victory was shortlived, though - I followed the doctors orders and indulged on plenty of cervazas during my first drugged-up night: a unique drunken experience, but I felt so rough the next day that I´ve decided to abstain until I´ve finished the course of medication).

My ´office´ for the week (red building)

With all this excitement, I´ve not achieved a great deal else since the last blog. I have returned to, and remained on, the beautiful Isla Mujeres and have established a fairly productive daily routine: get up in time for breakfast at 10.30am, 2 hours proofreading work at a nearby internet cafe (note - this is the only productive part), back to the hostel for a quick workout, cheap lunch from the supermarket, and then to the beach until sunset, after which I fit in a couple of hours volleyball before dinner, and then head down to the (now sober) beach bar until the early hours. I could easily live like this for a very long time, but I am forcing myself to leave tomorrow (Friday) and get on with the ´proper travelling´. Next stop is Merida, and then I´ll continue heading inland across Mexico before dropping down into Guatemala.

Until the next (hopefully fully healthy) entry.....

(more pictures below)