Your health vaccinations | kit

I went to Nepal expecting the worst, and returned having had no major problems. However, there's no doubt that stomach bugs and other infections are too common to dismiss, and it's therefore well worth thinking about this before you go. Remember that prevention is by far better than cure, and much of this is through simple and persistent adherence to the basic guidelines of handwashing and where to buy food/water. It really ain't pleasant to suffer for several days with the Nepal equivalent of "Delhi Belly".

If there's one thing to remember: keep your fluid levels up. It's amazing how quickly you can become dehydrated, and this is the most common reason for people to end up seriously unwell... in hospital, requiring intravenous drips and not a good situation to be in at all.

Vaccinations

What you need will depend on where you're going, where you're coming from and how long you plan to stay. Your home country will have different guidance about what to get immunised against. However, it's worth ensuring that your travel adviser is aware that you'll be working in a hospital.

In Glasgow, the Brownlea Centre based at Gartnavel Hospital is absolutely fantastic. Just phone to book an appointment to discuss what you need. The travel advisers are all well-travelled themselves... the one I saw had just returned from an African safari with a doctor from Nepal, and was able to give loads of good local advice!

Note that most of these vaccinations will cost money - allow around £100 to cover it, although there may be arrangements to fund it via university or hospital occupational health. This varies each year and between departments.

The CIWEC Clinic in Kathmandu has a superb website that gives loads of information for visitors to Nepal, and good, practical advice for dealing with diarrhoea and other problems.

In the end I received:

• Diptheria/Hepatitis A combination
• Japanese Encephalitis (because my stay was longer than 4 weeks, and I was visiting during the monsoon season)
• Meningitis A+C (especially because I'd be working in a children's hospital)
• Rabies (only required if you'll be 24 hours away from a main hospital. I wasn't sure if this would be the case during my travels)

Consider malaria prophylaxis if you plan to visit the Terai region. The rest of Nepal is too high for malaria-carrying mosquitos (but you do still get mosquitos so remember the net!). Also there's a Meningitis W135 and Y vaccine which might be worth getting, depending on the local situation at the time.

Personal Medical Kit

It's worth taking a few moments to plan this and think about what might be needed. Many drugs can be easily bought over the counter, but I think it's really worth getting things like antibiotics before you go - you don't want to be touring Kathmandu pharmacies when you're suffering from stomach bugs or other illnesses.

Have a look at the CIWEC Clinic website for up-to-date information on antibiotic treatments for diarrhoea and other conditions which are prevalent in travellers at the time. It's an excellent website. My GP was good in giving me a 2 week supply of Cipro in case I required it. I also took immodium and rehydration sachets - again if you're suffering then you don't want to have to track these down whilst in KTM. Paracetamol was only used for a few hungover mornings.

Thankfully, I didn't suffer any problems, probably because I was over-prepared in the event of being ill! Fellow students weren't all so lucky however. Immodium can be very useful for unavoidable long bus journeys when suffering diarrhoea. Beware sunburn, something which I did suffer from in Pokhara due to my Celtic genes (and admittedly some laziness in using suncream). If you wear glasses, a spare pair is invaluable, and also take some of those retainers in case bungee jumping or rafting go on your agenda.

In KTM and major towns, clean water is very easy and cheap to buy (15 rupees, about 10 pence for one litre). However, note that there is currently an increasing drive to do something about the massive waste problem of not recycling the bottles. Further afield it is useful to have some form of water filtration. If it's in case of the occasional reassurance, iodine droplets (with neutralising tablets... they work amazingly well, even though they're just vitamin C/ascorbic acid!) are fine. If you need something more heavy duty (for trekking etc.) there's some very compact and good-quality purification systems on the market.

As for multivitamins they were a precaution as I wasn't sure where I would be eating - however because I was staying with a family there was no need for them whatsoever. I don't normally take them anyway, but sometimes it's a good idea if you're away for more than one month and you can't be certain about keeping a balanced diet.

antihistamine tablets ciprofloxacin (or equivalent) antibiotics immodium multivitamin tablets rehydration mix glucose tablets iodine drops/water filtration and neutralising tablets paracetamol

tubigrip ibuprofen spare glasses sunglasses glasses "retainers" suncream after sun mosquito spray