In normal circumstances, what could be the health problems faced by foreigners in Nepal? What are their causes & methods of treatment?
The two foremost health problems faced by foreigners in Nepal would be gastroenteritis and stomach infection caused either by food or water contaminated sources.
Stomach or GIT (Gastro Intestinal Tract) infection amounts to almost 60% of disease suffered by them.
It is interesting to note that bit of times 70% or more people eat the same food like 'Dal-Bhat' (traditional Nepali lunch or dinner set or even let's say pizza) and only 1 or 2 get sick. Guess it's a question of one's immunity playing a role have. Especially, we Nepalis over the years, have gotten used to the food water contaminants and develop immunity even to Cholera.
This is the exactly what happened in Haiti. Some of the UN troops from Nepal who went there were Cholera carriers which set a Cholera endemic there. But that was rare but true case.
Usually the stomach infection is either bacterial or dysentery. The common mistake I see when foreigners take OTC (over the counter) medications from pharmacy without doctor's consultation is taking dysentery medications for bacterial infection.
Bacterial infection causes watery diarrhea with or without nausea/vomiting. In worse scenario, fever will also be present. The presentation in dysentery is soft stool with mucus. Blood may be present. Lower abdomen cramps will be there.
Treatment would be:
- Anti- diarrhea capsules
- Proper Antibiotics
- Anti-Nausea mouth dissolving tablets
- Oral rehydration packets (ORP)
- Pomegranate; good natural source of diarrhea control
- Banana; good both in constipation/diarrhea
- Avoid Eggs, milk, fish, spicy foods
The other common ailment to affect foreigners would be respiratory tract infection like pharyngitis, sinusitis, tonsillitis or even bronchitis. This is due to the adverse air pollution condition in especially Kathmandu.
Treatment/prevention would be to:
- Wear Mask
- Proper antibiotics
- Gargle
- Anti- histamines
- Decongestants
- Avoid Ice, cold food items
How can Nepal's environment influence foreigner's health?
Obviously, we have already covered how the water and food are major sources of gastro intestinal infection for foreigners in Nepal. The locals may be have built up immunity over the years but the foreigners who have never been exposed to the contagion may easily fall prey to it with classical gastroenteritis also called Traveler's diarrhea or Delhi Belli.
Less common infections would be from dysentery or even worm infestation. Worms are varied like tapeworm, hookworm, pin worm, round worm, etc.
One can be infected from both semi- cooked meats like from the minced meat in momos (dumplings) or even from raw vegetables like salad.
Then again, the air and vehicular pollution specially in Kathmandu, the capital can be venomous where one can contract especially upper respiratory tract infections like tonsillitis, pharyngitis or synovitis very easily but bronchitis and pneumonia can be an issue.
Including air borne, food- borne, water- borne disease/ illness, are there any other known disease/ illness that could esp. affect foreigners in Nepal? What could be done to help prevent & treat them?
It depends on where one is in Nepal. Thus, if one is more in the northern mountain belt then there is the issue of Altitude illness where it can take two forms: HAPE (High Altitude Pulmonary Edema) and HACE (High Altitude Cerebral Edema). They were once quite common among foreigners on trekking on mountain climbing trips but has come down with common use of spirometry (finger-tip) which gives one's oxygen level and OTC (Over The Counter) prophylactic use of medications like Acetazolamide (dihmax).
It is surprising to note that contain races like Japanese seem to be affected more easily than others.
Typically, treatment is to bring more them to lower altitude, oxygen, and proper judicious medications like Nefidipine for (HACE), diamax for HAPE and dexamethasone, other medicines like antibiotics, bronchodilators, rehydration, nebulizers, etc. would be according to the context of particular patient.
On the other hand if one is towards the Southern plains of Terai belt or even Kathmandu one has to take precautions against dengue and malarias.
Many tourists are on prophylactic medication for malaria.
Have also seen many tourists with bed bug bites like ticks, mites even while staying in 5-star hotels.
Thus, using mosquito and insect repellents may not be a bad idea. But again, we are talking here in minority cases.
(Dr. Ranjeet Baral is a senior general physician and consultant cardiologist working at Vayodha Hospitals (Balkhu) and Shahid Gangalal National Heart Centre (Bansbari). He has been working as a resident doctor for numerous 5-star hotels in Nepal for the past 28 years.)
