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As seen in Transitions Abroad Magazine November/December 2000

How to Travel and Stay Healthy in Developing Countries

When I first went to Central America on a study tour at the age of 19 I wasn’t afraid. I was invincible. Those stories of tourists getting held hostage were so sensational. Not eating street food or drinking tap water was paranoia. Traffic accidents? Those overloaded chicken buses always make it!

Or do they?

Death of a Friend

In May 1998 I faced the painful commonality of overseas tragedies when my childhood friend and fellow “global citizen” (who was 25 at the time) died in a bus accident in a mountain ravine in Bolivia. Her husband searched through the darkness calling out her name in vain. Both were experienced third world travelers who had made a commitment to a 3-year term of community volunteerism. I believe Krista made the right decision in going to Bolivia. She and Aaron were having the time of their lives.

Krista’s death came on the heels of my own plans to spend my second year of graduate school in Cuba and El Salvador, investigating social problems surrounding at-risk youth and urban violence. I began to wonder if my international travel choices were worth my life, but I couldn’t imagine life without travel and social outreach in the third world.

On the Internet, I came across the Sara’s Wish Foundation, a “safe travel” grant for women set up in memory of Sara Schewe, a Georgetown Univ. student who with two other students and a teacher were killed in a bus accident while studying in India with Semester At Sea in 1996. Their accident was similar to Krista’s—a bus plunged off a mountain road. Receiving the grant raised my awareness of travel dangers and at the same time affirmed my decision to go out into dangerous parts of the world and discover their beauty despite my fears.

Traffic Safety

Don’t travel on buses at night. Drivers may be tired or drunk and the roads are not lit.

Chat with the bus driver before getting on the bus to get a feel for whether or not he’s in condition to drive. If you feel that he is, tell the driver that you are confident in his abilities. A little flattery can go a long way toward making him consciencous. If at any time you feel unsafe, get off.


Many tourists believe that locals have built up an immunity to bacteria in the water and that they can do the same. In fact, everyone is susceptible. I know of a college president who died of malaria contracted from mosquito bites in China. My own bouts with amoebas, cholera, and food poisoning cause me to be more assertive when asking for bottled or at least boiled water. I respectfully explain to my local hosts that I have a very weak stomach.

Check on immunizations before traveling. Water must be boiled for at least 10 minutes in order to kill bacteria or parasites. Fresh produce can be eaten if it has been soaked in iodine or bleach.

I’m also careful to seek out good medical clinics. AIDS and other blood-born diseases spread rapidly in Africa, Asia, and Latin America where there is limited access to health education. Disposable hospital equipment is often re-used when there is little access to medical supplies. Be wary of dirty needles or IV tubes should you need to be hospitalized.


If you’re planning to travel in areas with a high crime rate, be street smart. If you go into a big city, ask about what areas are considered dangerous. When walking down the street at night, be wary of shrubs or other good hiding places for a potential attacker. In El Salvador I was saved from a serious mugging one night when I ran from an attacker by jumping into the street. A car’s headlights scared the robber off. If you are mugged, it’s usually best to cooperate. If someone is following you, why not pretend that you know that little old lady in the rocking chair on her porch? Sometimes you have to look to other strangers for protection.

Remember that your life is more important than your material possessions and even passports can be replaced. Carrying mace or a screamer device can be good deterrents in some attacks and they may save your life, but be careful if you think the attacker might have a gun.

Go with a Local

In some third world countries that have suffered years of political turmoil and economic destruction, war and violence has become a deep-seated psychology. A friend of mine was mugged at knife point while hiking by himself up a serene mountain in Mexico.

Countless other tourists I have met have been held up with machetes while hiking volcanoes in Guatemala and Nicaragua. If you want to hike in nature, don’t go alone; ask a local to take you. You don’t have to check with the Hilton for a pricey tour guide. In Guatemala, for example, I’ve made some wonderful friends by seeking out “ecotourism” guides. You’re bound to get a decent rate for such an excursion, plus you’ll develop a local social life while traveling.

Be Informed

The most important thing you can do is be aware and informed. Check statistics for crime, traffic fatalities, even diseases. Know the political and economic situation of a country. Have, as Martin Luther King Jr. said, “a tough mind and a tender heart.”

It also helps to get in contact with non-governmental organizations. International volunteers interact with the locals on a constant basis. They can offer you all kinds of insight into a country’s social situation, and they can also put you in contact with their local friends.

There are good and hospitable people wherever you go. The more connections you make with people in the country you’re going to before you leave, the better chance you’ll have of knowing who to contact and work with when you get there.

The beauty of low-budget travel is that you get to be more “at one” with the people. You don’t have to be one of those embarrassing tourists who pile off the tour bus to stand on the Mayan ruins with their cameras and point at the natives. Low-budget travel gets you down to the realities of life in the third world. Kudos to those who have a sense of adventure, just be aware and be educated.

According to ASIRT, 6,000 Americans die in accidents overseas each year. Third world citizens have no choice but to live and travel in dangerous conditions. but, as American travelers we make that choice, and can at least take preventative measures. No one wants their beloved adventurer arriving home in a coffin.

Helpful Contacts

Association for Safe International Road Travel (traffic fatalities statistics),

Peace Corps (local contacts and getting to know the community),,

U.S. State Department (travel warnings, crime statistics, medical concerns),

Related Topics
Independent Travel
Student to Student
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