Personal Travel Advice
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Traveler's First-Aid Kit

By Rick Steves

You can buy virtually anything you need in Europe. (You might not find "Sudafed," but you can get the European generic equivalent, pseudoephedrine.) But if you're accustomed to a very specific, name-brand medication, it's easier to bring it from home.

It's also handy to bring along the following:

  • Band-Aids
  • soap or alcohol preps (antiseptic Handi-Wipes or Purell-type hand sanitizer)
  • antibiotic cream (in Europe, you may need a prescription to buy skin ointments with antibiotics)
  • moleskin (to cover blisters)
  • tweezers
  • thermometer
  • non-aspirin pain reliever (your US brand of preference: Advil, Tylenol, etc.)
  • medication for colds and diarrhea
  • prescriptions and medications (in labeled, original containers)
Particularly if you'll be hiking in isolated areas, bring a first-aid booklet, Ace bandage, space blanket, and tape and bandages.

For eye care: Those with corrected vision should carry the lens prescription as well as extra glasses in a solid protective case. Contact lenses are used all over Europe, and the required solutions for their care are easy to find.

Basic First Aid

Travel is much more fun when you're healthy. Be proactive to stay well. If you do get sick, take action to regain your health.

Headaches and other aches: Tylenol (or any other non-aspirin pain reliever) soothes headaches, sore feet, sprains, bruises, Italian traffic, hangovers, and many other minor problems. If you're buying it overseas, Europeans may be more familiar with the term "paracetamol" (pare-ah-SEET-ah-mall).

Abrasions: Clean abrasions thoroughly with soap to prevent or control infection. Bandages help keep wounds clean but are not a substitute for cleaning. A piece of clean cloth can be sterilized by boiling for 10 minutes or by scorching with a match.

Blisters: Moleskin, bandages, tape, or two pairs of socks can prevent or retard problems with your feet. Cover any irritated area before it blisters. Many walkers swear by Body Glide, a solid anti-chafing stick sold in running shops and sporting-goods stores.

Motion sickness: To be effective, medication for motion sickness (Dramamine or Marezine) should be taken one hour before you think you'll need it. These medications can also serve as a mild sleep aid. Bonine also treats motion sickness but causes less drowsiness.

Swelling: Often accompanying a physical injury, swelling is painful and delays healing. Ice and elevate any sprain periodically for 48 hours. A package of frozen veggies works as a cheap ice pack. If your foot or leg is swollen, buy or borrow a bucket and soak the affected area in cold water, or sit on the edge of a cool swimming pool. Take an anti-inflammatory drug like ibuprofen (Advil, Motrin). Use an Ace bandage to immobilize, reduce swelling, and provide support. It is not helpful to "work out" a sprain — instead, cut back on activities that could aggravate the injury.

Fever: A high fever merits medical attention. A normal temperature of 98.6° Fahrenheit equals 37° Celsius. If your thermometer reads 40°C, you're boiling at 104°F.

Colds: It's tempting to go, go, go while you're in Europe — but if you push yourself to the point of getting sick, you've accomplished nothing. Keep yourself healthy and hygienic. If you're feeling run-down, check into a good hotel, sleep well, and force fluids. (My trick during the hectic scramble of TV production is to suck on vitamin C tablets.) Stock each place you stay with boxes of juice upon arrival. Sudafed (pseudoephedrine) and other cold capsules are usually available, but may not come in as many varieties.

Diarrhea: Get used to the fact that you might have diarrhea for a day. (Practice that thought in front of the mirror tonight.) If you get the runs, take it in stride. It's simply not worth taking eight Pepto-Bismol tablets a day or brushing your teeth in Coca-Cola all summer long to avoid a day of the trots. I take my health seriously, and, for me, traveling in India or Mexico is a major health concern. But I find Europe no more threatening to my health than the US.

I've routinely taken groups of 24 Americans through Turkey for two weeks. With adequate discretion, we eat everything in sight. At the end of the trip, my loose-stool survey typically shows that five or six travelers coped with a day of the Big D and one person was stuck with an extended weeklong bout.

To avoid getting diarrhea, eat yogurt. Its helpful enzymes ease your system into the country's cuisine.

If you get diarrhea, it will run its course. Revise your diet, don't panic, and take it easy for a day. Make your diet as bland and boring as possible for a day or so (bread, rice, applesauce, boiled potatoes, clear soup, toast, weak tea). Keep telling yourself that tomorrow you'll feel much better. You will. Most conditions are self-limiting.

If loose stools persist, drink lots of water to replenish lost liquids and minerals. Bananas are effective in replacing potassium, which is lost during a bout with diarrhea.

Don't take antidiarrheals if you have blood in your stools or a fever greater than 101ºF (38ºC). You need a doctor's exam and antibiotics. A child (especially an infant) who suffers a prolonged case of diarrhea also needs prompt medical attention.

I visited the Red Cross in Athens after a miserable three-week tour of the toilets of Syria, Jordan, and Israel. My intestinal commotion was finally stilled by a recommended strict diet of boiled rice and plain tea. As a matter of fact, after five days on that dull diet, I was constipated.

Constipation: With all the bread you'll be eating, constipation, the other side of the intestinal pendulum, is (according to my surveys) as prevalent as diarrhea. Get exercise, eat lots of roughage (raw fruits, leafy vegetables, prunes, or bran tablets from home), and everything will come out all right in the end.



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Staying Healthy
By Rick Steves

Europe Goes Smoke-Free

One out of every three Europeans smokes, but new legislation across Europe is trying to change things.

The following countries prohibit smoking in any enclosed public space — Cyprus, Denmark, Estonia, Finland, France, the Republic of Ireland, Italy, Latvia, Lithuania, the Netherlands, Norway, Portugal, Slovenia, Spain, and the United Kingdom — although some countries allow for sealed-off and well-ventilated smoking rooms in restaurants and bars.

Countries that have some sort of smoking ban (generally covering workplaces, hospitals, schools, theaters, public transportation, and sometimes restaurants) are Austria, Belgium, Croatia, the Czech Republic, Germany, Greece, Montenegro, Poland, Slovakia, Sweden, Switzerland, and Turkey.

These countries are considering smoking bans: Hungary and Serbia.

It seems that it's only a matter of time before all of Europe — and its visitors — will breathe easier.


Just as you'd give your car a good checkup before a long journey, it's smart to meet with your doctor before your trip. Get a general checkup and ask for advice on maintaining your health on the road. Obtain recommended immunizations and discuss proper care for any preexisting medical conditions while traveling. Bring along a letter from your doctor describing any special health problems and a copy of pertinent prescriptions. If you have heart concerns, pack a copy of a recent EKG.

Travel-Medicine Specialists: While I consider Europe as safe as the US, those traveling to more exotic destinations should consult a travel-medicine physician. Only these specialists keep entirely up-to-date on health conditions for travelers around the world. Tell the doctor about every place you plan to visit and any place you may go. Then you can have the flexibility to take that impulsive swing through Turkey or Morocco knowing that you're prepared medically and have the required shots. Ask the doctor about vaccines against hepatitis A (food- or water-borne virus) and hepatitis B (virus transmitted by bodily fluids), antidiarrheal medicines, and any extra precautions. The Centers for Disease Control offers updated information on every country.

Dental Checkup: Get a dental checkup well before your trip. ( You don't want that crown you got right before you left to fall out as you munch your bag of airplane nuts, do you?) Emergency dental care during your trip consumes time and money, and can be hazardous and painful. I once had a tooth crowned by a German dentist who knew only one word in English, which he used in question form — "Pain?" The American Dental Association offers helpful advice on dental care away from home.

Traveling Healthy

Europe is generally safe. All the talk of treating water with purification tablets is applicable only south and east of Europe. Using discretion and common sense, I eat and drink whatever I like in Europe. As our world becomes more chemical, reasons for concern and caution will increase on both sides of the Atlantic.

I was able to stay healthy throughout a six-week trip traveling from Europe to India. By following these basic guidelines, I never once suffered from Tehran Tummy or Delhi Belly.

Eat nutritiously. The longer your trip, the more you'll be affected by an inadequate diet. Budget travelers often eat more carbohydrates and less protein to stretch their travel dollar. This is the root of many nutritional problems. Protein helps you resist infection and rebuilds muscles. Get the most nutritional mileage from your protein by eating it with the day's largest meal (in the presence of all those essential amino acids). Supplemental super-vitamins, taken regularly, help me to at least feel healthy. If you have a serious dietary restriction, have a multilingual friend write it in the native language on the back of a business card and use it to order in restaurants.

Use good judgment. Avoid unhealthy-looking restaurants. Meat should be well cooked and, in some places, avoided altogether. Have "well done" written on a piece of paper in the pertinent language and use it when ordering. Pre-prepared foods gather germs (a common cause of diarrhea). Outside of Europe, be especially cautious. When in serious doubt, eat only thick-skinned fruit...peeled.

Keep clean. Wash your hands often, keep your nails clean, and avoid touching your eyes, nose, and mouth. Hand sanitizers, such as Purell, are fine in a pinch. However, since they target bacteria, not viruses, they really should be used as an adjunct to, rather than a replacement for, hand washing with soap and warm water.

Practice safe sex. Sexually transmitted diseases are widespread. Obviously, the best way to prevent acquiring an STD is to avoid exposure. Condoms (readily available at pharmacies and from rest-room vending machines) are fairly effective in preventing transmission. HIV is also a risk, especially among prostitutes.

Exercise. Physically, travel is great living — healthy food, lots of activity, fresh air, and all those stairs! If you're a couch potato, try to get in shape before your trip by taking long walks. To keep in shape, you may want to work out during your trip. Running, while not as widespread in Europe as it is in the US, is not considered weird. Traveling runners can enjoy Europe from a special perspective — at dawn. Swimmers will find that Europe has plenty of good, inexpensive public swimming pools. Whatever your racket, if you want to badly enough, you'll find ways to keep in practice as you travel. Most big-city private tennis and swim clubs welcome foreign guests for a small fee, which is a good way to make friends as well as stay fit.

Get enough sleep. Know how much sleep you need to stay healthy (generally 7–8 hours per night). If I go more than two nights with fewer than six hours' sleep, I make it a priority to catch up — no matter how busy I am. Otherwise, I'm virtually guaranteed to get the sniffles.

Give yourself psychological pep talks. Europe can do to certain travelers what southern France did to Vincent van Gogh. Romantics can get the sensory bends, patriots can get their flags burned, and anyone can suffer from culture shock.

Europe is not particularly impressed by America or Americans. It will challenge givens that you always assumed were above the test of reason, and most of Europe on the street doesn't really care that much about what you, the historical and cultural pilgrim, have waited so long to see.

Take a break: a long, dark, air-conditioned trip back to California in a movie theater; a pleasant sit in an American embassy reading room surrounded by eagles, photos of presidents, Time magazines, and other Yankees; or a visit to the lobby of a world-class hotel, where any hint of the traditional culture has been lost under a big-business bucket of intercontinental whitewash. It can do wonders to refresh the struggling traveler's spirit.

European Water

I drink European tap water and any water served in restaurants. Read signs carefully, however: Some taps, including those on trains and airplanes, are not for drinking. If there's any hint of nonpotability — a decal showing a glass with a red "X" over it, or a skull and crossbones — don't drink it. Many fountains in German-speaking countries are for drinking, but others are just for show. Look for Trinkwasser ("drinking water") or Kein Trinkwasser ("not drinking water").

The water (or, just as likely, the general stress of travel on your immune system) may, sooner or later, make you sick. It's not necessarily dirty. The bacteria in European water are different from those in American water. Our bodily systems — raised proudly on bread that rips in a straight line — are the most pampered on earth. We are capable of handling American bacteria with no problem at all, but some people can go to London and get sick. Some French people visit Boston and get sick. Some Americans travel around the world, eating and drinking everything in sight, and don't get sick, while others spend weeks on the toilet. It all depends on the person.

East of Bulgaria and south of the Mediterranean, do not drink untreated water. Water can be treated by boiling it for 10 minutes or by using purifying tablets or a filter. Bottled water, beer, wine, boiled coffee and tea, and bottled soft drinks are safe as long as you skip the ice cubes. Coca-Cola products are as safe in Syria as they are at home.

Seeking Treatment

If you're sick on your trip, don't be a hero. Get help to get on the road to recovery as soon as possible. Throughout Europe, people with a health problem go first to the pharmacy, not to their doctor. European pharmacists diagnose and prescribe remedies for most simple problems. They are usually friendly and speak English, and some medications that are by prescription only in the US are available over the counter (and surprisingly cheap) in Europe. If necessary, the pharmacist will send you to a doctor or the health clinic.

A visit to a clinic (or the emergency drop-in section of a hospital), while time-consuming, is actually an interesting travel experience. You'll sign in with the receptionist and answer a few questions, take a seat, and eventually meet your nurse or doctor. Every year I end up in a European clinic for one reason or another, and every time I'm impressed by the efficiency, effectiveness, and price. (Visits to the doctor at the neighborhood clinic are generally free — even for a traveler.)

If you're sick in your hotel and would rather not go out, the hotel receptionist can generally call a doctor who will make a house call. In this case, you'll be diagnosed, billed, and required to pay on the spot. Prescription in hand, you'll trudge off to a 24-hour pharmacy, pick up the necessary medicine, and be on the mend pronto.

For traveling beyond Europe, getting an English-speaking and Western-trained doctor is a reasonable concern. In that case, consider joining IAMAT, the International Association for Medical Assistance to Travelers. You'll get a list of English-speaking doctors in member countries who charge affordable, standardized fees for medical visits (membership is free but a donation is requested, tel. 716/754-4883). Those needing IAMAT-type services, but who don't have a membership, can get referrals for medical help from other agencies that deal with Americans on the road (such as embassies, consulates, tourist offices, large hotels, and American Express offices).



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