HEALTH AND MEDICAL INFORMATION IN BOLIVIA

Prevention will be a very important issue before your trip to Bolivia, one of the poorest countries in South America, is not necessarily an unhealthy country, but sanitation and hygiene are limited especially out of the main cities (La Paz, Cochabamba and Santa Cruz).

Food: The most common ailment for visitors in Bolivia is diarrhea caused by contaminated food or water. Symptoms usually last a couple days to a week. If symptoms are beyond two weeks, with blood or pain, you should seek medical attention.

It is important that you should be careful about eating food purchased from street vendors, if possible eat only thoroughly cooked food and drink bottled or boiled water.

Of course eating local foods it is a fantastic experience in Bolivia, but be careful to visit clean and recommended restaurants, a huge attraction is the trout of the Lake Titicaca, also traditional dishes such as "salteñas" (meat pies), "fricasé" (pork soup), "chuño" (dried potato), "chairo" (chuño soup) among the most representative.

Health: Make sure you are healthy before you travel, it is a good idea to get a thorough check-up before you leave, get all the necessary vaccinations, and a good travel insurance that covers medical care costs in Bolivia, just for a precaution if serious health problems arise. A traveller going abroad with a pre-existing medical problem should carry a letter from the attending doctor, describing the medical condition and any prescription medications, including the generic names of prescribed drugs.

Eastern Bolivia and the Bolivian Amazon are tropical, so travelers that are visiting the area are often bitten by mosquitoes, so it is very important to have the yellow fever shot which should be 10-14 days prior to traveling. When you get this vaccine you also get a certificate showing the date you got the shot (International Yellow Fever Vaccination Certificate) and you must carry it with you when you travel in Bolivia.

Using mosquito repellent on your skin and clothes, wearing long sleeves and pants, tucking your pant cuffs into boots, hanging mosquito netting over your bed at night, placing screens on your windows and doors, and staying away from known infected areas are other ways to ensure you don't get any disease transmitted by mosquito.

On the rainy season (November to April) is important to keep informed about any increasing dengue fever in Bolivia, transmitted by mosquito bites, also in the eastern region.

Western Bolivia is in the Andes Mountains, and it is mostly insect-free, the most important issue must be altitude sickness (locally known as "sorojchi"), ultraviolet radiation is stronger because of the higher altitude, which increases risk of getting sunburn, sun screen should be worn as a protective measure.

The altitude of La Paz ranges from 3,600 meters (11,811 feet) to 4050 meters (13,287 feet) above sea level, the similar case in Lake Titicaca, Uyuni Salt Flat and Potosi.

Altitude Sickness: Altitude sickness can be a problem especially for those arriving from at or near sea level, sometimes could be serious risk of illness and hospitalization. Shortness of breath and lack of oxygen at these heights are normal, some people may experience headaches, loss of appetite, fatigue and nausea. Most symptoms develop during the first 2 days and then will go away.

The symptoms include: headache, not feeling like eating, nausea, feeling sick to your stomach, feeling weak and lazy, fatigue, and feeling dizzy. Many people say altitude sickness feels like having a hangover; obesity and the habit of smoking increase the risk and strength of altitude sickness, as well as high blood pressure; genetics may also put some people at increased risk, so it is important to get a thorough check-up before your trip to Bolivia; watch carefully for symptoms when you perceive you are at an increased risk because altitude sickness can be life threatening in some cases. There is also altitude sickness medicine that can be prescribed by a doctor.

Especially when you are planning to make adventure activities during tour visit to Bolivia, will be imperative to take care of this contraindications:

- Vascular insufficiency
- History of respiratory compromise
- Epileptic seizures and previous neuro-surgery
- Illnesses necessitating repeated injections such as insulin - dependent diabetes
- Unstable heart diseases
- Some blood disease and high blood pressure
- Acute mountain sickness, cerebral or pulmonary edema during a previous trip

The best advice is to get to high altitude cities gradually (to increase your elevation gradually), would be very good option to stay at least 3 days in cities like Cusco, Santa Cruz, Cochabamba or Sucre before arriving to La Paz, Lake Titicaca, Uyuni Salt Flat or Potosi. When you are planning to do strenuous activities like mountain climbing, trekking or mountain biking is imperative to stay at least 4 days before the activity in La Paz or other higher city.

The airport in La Paz is 400m higher than the downtown and the South zone of the city is 400m below the downtown so it would be a good idea to book a hotel at this part of the city.

When you arrive to a high altitude place and start feeling the symptoms (because not all of tourists suffer of altitude sickness, many do not feel anything at all) rest on your first day, drink plenty of liquids, eat only the necessary and avoid alcohol. Also, many hotels and some travel agencies in Bolivia offer oxygen for those affected with severe headaches. If symptoms become more severe seek medical attention.

Medical Assistance: Medical assistance in large cities is good for most purposes, but quality decrease when you get out from the larger cities, and in rural areas health facilities can be poor or non-existent. Some English speaking doctors can be found in La Paz and Santa Cruz.

Drugstores or Pharmacies in Bolivia can be easily found in the larger cities and also found in some smaller towns, but not many open 24 hours a day; standard drugs and medicines are available, but labels and instructions will be in Spanish.

Health Insurance: If your health insurance does not cover you for medical expenses abroad will be very important to consider a supplementary insurance. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures, credit cards are usually not accepted for medical services in Bolivia.

SAFETY AND SECURITY INFORMATION IN BOLIVIA

Bolivia is undoubtedly one of the most secure countries in South America, but since it is one of the poorest, protests, strikes, marches and demonstrations might appear; as possible avoid them because some could become violent.

Violent crimes in Bolivia are rare compared to other neighboring countries, so it is important to be vigilant and cautious about surroundings, railway and bus stations, restaurants and in general all public places visited by tourists and isolated areas especially at night, also when traveling on public or regular transport. Certain events as robberies, people posing as policemen happen so we recommend you to travel in groups, to not leave your valuables and photographic equipment without supervision, and also to keep your cash or traveler`s checks, airplane tickets and your passport on your person and not to carry them in your backpack.

Some other important recommendations are: when using ATMs don't withdraw large sums and hide your card well, don't wear flashy jewelry and expensive watches, don't carry large amounts of cash, put your money and documents in your hotel safes; carry a photocopy of your documents instead of originals.

When taking taxis avoid the ones that are unmarked, look for taxis with signs on their vehicles, and try to arrive into a city during the day.

Travel Insurance: We also advise you to take out travel insurance for "loss of baggage" and for "interruption of stay" before traveling. Check for any exclusions to your travel insurance policy to ensure that your policy covers you for all the activities you want to undertake.

WHEATHER IN BOLIVIA

Summer (November to April) is the rainy season when overland transportation becomes difficult if not impossible in some yungmejorregions, the season for exploring the whole country is during winter (May to October). Bolivia’s two most extreme climatic towns are Puerto Suórez (in Santa Cruz) with its overwhelming heat and Uyuni (in Potosí) for its icy and cold winds, but weather could change drastically any palce and any season.

Winter in the Altiplano means extreme heat during the day, and freezing winds and subzero temperatures at night. The highland valleys are refuges, having a comfortable climate with little rain year round.

The high tourist season runs from June to September, which coincides with European and North American summer holidays. This can be an advantage if you are looking for people to form a travel group, but prices are generally higher than during the rest of the year.

ADDITIONAL PRACTICAL INFORMATION IN BOLIVIA FOR TOURISTS

The local currency is the Boliviano, the rate of exchange varies, now it is 1USD = 7 Bs. Our advice is to bring cash and credit card.

The voltage in most cities of Bolivia is 110V, however, there are many areas where it is 220V and the use of this voltage is increasing.

About internet, the easiest way to get online is at an internet café, which can easily be found in the larger cities of La Paz, Santa Cruz, Cochabamba, and Sucre; smaller towns have at least a couple. Most of hotels have internet access in some form, usually in a business center with a high-speed connection or a wi-fi connection for your laptop.

Mobile phones are widely used in the major cities and towns in Bolivia; coverage is good in the larger cities, but can be poor to non-existent in rural areas. If you plan on bringing your own cell phone from home to Bolivia, check with your service provider about international plans and coverage areas. Cell phones on the GSM technology will usually work in the larger cities of Bolivia, such as La Paz, Santa Cruz and Cochabamba. If you have an existing phone that uses a SIM card, you may be able to purchase a compatible SIM card in Bolivia and use one of Bolivia’s cell phone companies, before leaving home make sure your phone is unlocked so that it works.

Source: Dr. Jaime Ordóñez B.