NEW YORK • On a recent trip to Tanzania with four grandsons, my most important task (beside protecting them from the jaws of a lion or leopard) was to keep them and myself in good health.
It would not have been much fun to be stuck in a tent next to the commode or flattened on a cot while the rest of the gang viewed a dazzling array of wild animals from the safety of a Land Rover.
Although I went prepared for the worst, I did everything I could to make our trip the best. I am happy to report, no one got sick and we all had a great time.
When I described the steps I took to friends and physicians, they urged me to write about them. Here are some tips:
1 KEEP YOUR MOUTH SHUT
I reminded my grandsons daily, any water you drink or use to brush your teeth must come from a sealed bottle that you open. Ice was not an issue in the bush, but that too should be prepared from bottled water. When you take a shower or swim in a pool, keep your mouth shut.
2 POP PILLS BEFORE MEALS
Before every meal, we each chewed one pink tablet of bismuth subsalicylate (sold as Pepto-Bismol and various store brands).
A study published in The Journal of the American Medical Association described how two tablets chewed four times a day reduced the risk of developing diarrhoea by 65 per cent. (Each tablet contained the standard dose, 262 milligrams of bismuth subsalicylate.)
I have relied on these tablets on trips to Vietnam, Thailand, Peru, Indonesia, India and Nepal, and never got sick despite eating salads and peeled fruit, which one is warned to avoid.
However, if you choose to try this preventive, I suggest you check first with your doctor.Without a preventive, which is no guarantee against food-borne illness, stick to food that is cooked and served hot, and fruits and vegetables you have washed in bottled water and peeled yourself. Never eat undercooked foods - eggs, meat, fish or poultry - or any food sold by street vendors.
Reduce your exposure to germs by washing your hands often and always before eating. A hand sanitiser with at least 60 per cent alcohol can be used if soap and water are unavailable.
I also had an emergency supply of Lomotil (for digestive problems) and azithromycin (Zithromax Z-pak, for infections).
3 DON'T MISS THE SHOTS
I made sure we were up-to-date on routine vaccines - measles, mumps, rubella, varicella (chickenpox); diphtheria, tetanus, pertussis; polio and an annual flu shot - and added two (for hepatitis A and typhoid) that the Centers for Disease Control and Prevention recommends for travellers to Tanzania.
You can check recommendations for destinations on cdc.gov/travel. We also each filled prescriptions for generic Malarone (atovaquone proguanil) to prevent malaria and I checked daily to be sure the boys remembered to take it.
4 PACK A FIRST-AID KIT
I packed an ample supply of sunscreen, insect repellent with 20 per cent or more of Deet, and a first-aid kit of hydrocortisone cream, antibiotic ointment and a variety of bandages.
For one grandson prone to motion sickness, I took some meclizine as well.
5 FLEX THOSE LEGS AND ANKLES
As the oldest traveller in the group, I am acutely aware of the risk of blood clots when flying long distances. I always book an aisle seat so I can get up every hour or so and walk around for a minute.
It also helps to move your legs and flex your ankles frequently.
You can wear graduated compression stockings on long trips. Similar precautions apply to long car or train trips.
Although the risk of clots is generally very small, they can be life-threatening. At greatest risk are people over 40, those who are obese or pregnant or have limited mobility (for example, because of a leg cast) or who have a personal or family history of clots.
6 GET INSURED
I always buy travel health and medical evacuation insurance because, well, you never know.
7 CARRY A PRESCRIPTION CARD
Consider carrying a card that lists your blood type, any chronic illnesses or serious allergies and the generic names of prescription medicines you take. Bring extra doses in case of travel delays.
8 AVOID WADING IN WATER
To avoid parasitic diseases such as schistosomiasis, do not swim or wade in fresh water in developing countries or wherever the sanitation is poor. Pools should be chlorinated.
9 DON'T GET CLOSE TO ANIMALS
However adorable an animal (domestic or wild) may be, keep your distance. Do not touch or feed any animal you do not know. Some carry rabies. Should you get bitten or scratched by an animal, wash the wound immediately with soap and clean water and, if at all possible, get to a doctor quickly.
10 PREPARE FOR THE HIGHS
If you expect to be at a high altitude, consult your doctor about medicine to prevent altitude sickness. The recommended preventive is acetazolamide (generic version of Diamox).
NEW YORK TIMES