Health & Vaccinations:
Food and waterborne diseases are the number one cause of illness in travelers.
Travelers' diarrhea can be caused by viruses, bacteria, or parasites,
which are found universally throughout the region and can contaminate
food or water. Infections may cause diarrhea and vomiting (E. , Salmonella,
cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver
damage (hepatitis). Make sure your food and drinking water are safe (see
|- Heart disease: A man 45 years or older, or a woman
55 years or older, who has two of the following risk factors (hypertension,
diabetes, cigarette smoking, or elevated cholesterol) should have a stress
EKG and a cardiological evaluation before the trip.
- Lung disease: Anyone with asthma and on maximum dosage of medication for daily maintenance, or anyone who has been hospitalized for asthma within the last year should not come to La Paz.
All people, even healthy and fit persons, will feel symptoms of hypoxia (lack of oxygen) upon arrival at high altitude. Most people will have increased respiration and increased heart rate. Many people will have headaches, difficulty sleeping, lack of appetite, minor gastric and intestinal upsets, and mood changes. To help prevent these complications:
- Consider taking acetazolamide (Diamox) 125 mg twice a day, starting two days before traveling, on the day of the trip, and two to three days after arriving at high altitude. This medication inhibits the enzyme carbonic anhydrase, has a slight diuretic effect, and stimulates respiration. It is available only by prescription in the U.S. Pregnant women and nursing mothers cannot take Diamox. If you have a severe allergy to sulfa, you may not be able to take Diamox.
- Avoid alcohol and smoking for at least one week after arrival in La Paz.
- Limit physical activity for the first 36 to 48 hours after arrival in La Paz.
For those with diabetes, only the blood glucose meter called One Touch II works properly at altitudes over 6,000 feet. Other models give incorrect readings of blood sugar levels.
SLEEP DISTURBANCE: "A common occurrence during sleep at high altitude is periodic breathing, a condition in which the sleeper stops breathing every cycle. At sea level, this is a serious problem, and it will get you sent to a hospital. At high altitudes, it is a common condition that causes worry for tent mates who initially think that the other person has died. The quality of sleep at high altitude is poor, with more arousals lead to a person waking up while in the middle of a dream; hence, dreams often appear more vivid that at sea level."
(Bolivia a Climbing Guide by Yossi Brain).
|ACCLIMATIZATION: "The Bolivian
Andes are considerably higher than the Rockies or the Alps, and acclimatization;
indeed, fit young men appear to have more problems than other people,
The majority of people feel ill on arrival in La Paz. This is commonly called soroche. Visitors occasionally collapse while carrying their luggage from the arrival lounge of the airport. Common symptoms of mild altitude sickness include breathlessness, a racing pulse, lethargy, tiredness, inability to sleep, loss of appetite, headache, and dehydration. These symptoms normally last for a couple of days.
The U.S.Embassy in La Paz recommends that people who fly directly to the city's 4058m/13313 ft airport from sea level should take acetazolamide (Diamox) prophylactically-preferably via sustainable-release tablets. Acetazolamide speeds up acclimatization by acidifying the blood, which increases respiration.
CDC Recommends the Following Vaccines (as Appropriate for Age):
See your doctor at least 4-6 weeks before your trip to allow time for immunizations to take effect.
"Hepatitis A or immune globulin (IG).
"Hepatitis B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay 6 months in the region, or be exposed through medical treatment.
"Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
"Typhoid, particularly if you are visiting developing countries in this region.
"Yellow fever vaccination, if you will be traveling outside urban areas.
"As needed, booster doses for tetanus-diphtheria and measles.
To Stay Healthy, Do:
"Wash hands frequently with soap and water.
"Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.
|"Eat only thoroughly cooked food or fruits and vegetables
you have peeled yourself. Remember: boil it, cook it, peel it, or forget
"If you will be visiting an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
"Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
"To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
"Don't eat food purchased from street vendors.
"Don't drink beverages with ice.
"Don't eat dairy products unless you know they have been pasteurized.
"Don't share needles with anyone.
"Don't handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague).
"Don't swim in fresh water. Salt water is usually safer.
What You Need To Bring with You:
"Long-sleeved shirt and long pants to wear while outside whenever possible, to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis, and onchocerciasis).
"Insect repellent containing DEET (diethylmethy ltoluamide), in 30percent-35percent strength for adults and 6percent-10percent for children, as well as a bed net impregnated with the insecticide permethrin. (Bed nets can be purchased in camping or military supply stores.) Bed nets may also protect against insect bites that transmit Chagas disease.
"Over-the-counter antidiarrheal medicine to take if you have diarrhea.
"Iodine tablets and water filters to purify water if bottled water is not available. See Do's above for more detailed information about water filters.
"Sunblock, sunglasses, hat.
"Always use condoms to reduce the risk of HIV and other sexually transmitted diseases.
"Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).
|After You Return Home:
If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area. If you become ill with a fever--even as long as a year after your trip--tell your doctor that you traveled to a malaria-infected area.
MOUNTAIN TREKKING AND CLIMBING SAFETY: U.S. citizens are advised to exercise extreme care when trekking or climbing in Bolivia. If reasonable precautions are taken, mountain trekking and climbing in the Bolivian Andes can be a safe and enjoyable way to experience the countryside and culture. Travelers should inquire about conditions in the high country before leaving La Paz
Many popular trekking routes in the Bolivian Andes cross passes as high as 16,000 feet. Trekkers must have adequate clothing and equipment, not always available locally, and should be experienced mountain travelers. It is not prudent to trek alone. Solo trekking is the most significant factor contributing to injuries and death. Trekkers have been robbed on popular routes, most notably on the Illampu circuit, and are more vulnerable when alone. The safest option is to join an organized group and/or use a reputable firm to provide an experienced guide and porter who can communicate in both Spanish and English.
There are few telephones in remote areas of Bolivia. Make sure others (especially family and friends in the United States) know your trekking itinerary. The U.S. Embassy strongly encourages trekkers and climbers to register upon arrival in Bolivia. A registration file with your passport information, emergency numbers and travel itinerary is very useful if the Embassy needs to relay emergency information from home or locate you in case of a natural disaster or evacuation.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Bolivia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Safety of Public Transportation: poor
Urban Road Conditions/Maintenance: poor
Rural Road Conditions/Maintenance: poor
Availability of Roadside Assistance: poor.
|Road conditions in Bolivia are extremely hazardous. Although
the major population centers of La Paz, Santa Cruz, and Cochabamba are connected
by improved highways, less than five percent of all roads in Bolivia are
paved. For trips outside the major cities, especially in mountainous areas,
a four-wheel-drive vehicle is highly recommended. Travel during the rainy
season (November through March) is extremely difficult, as most routes are
potholed, and many roads and bridges are washed out. Added dangers are the
lack of formal training for most drivers, lack of lights on speeding vehicles
at night, and drunk drivers, including commercial bus drivers. Fatal crashes,
fender-benders, and car/pedestrian accidents are commonplace.
For additional general information about road safety, including links to foreign government sites, see the Department of State, Bureau of Consular Affairs home page at .
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Bolivia Civil Aviation Authority as Category 2 not in compliance with international safety standards for oversight of Bolivia's air carrier operations. While consultations to correct the deficiencies are ongoing, Bolivia´s air carriers are permitted to conduct limited operations to the U.S. subject to heightened FAA surveillance. For further information, travelers may contact the Department of Transportation within the U.S. at 1-800-322-7873. The U.S. Department of Defense (DOD) does not permit its personnel to use air carriers from Category 2 countries for official business except for flights originating from or terminating in the U.S. For information regarding the DOD policy on specific carriers, travelers may contact the Pentagon at 1-703-697-7288.
CUSTOMS REGULATIONS: The Bolivian Government has very strict laws concerning attempted theft or removal from Bolivia of any item that it considers to be a national treasure. The Bolivian and U.S. Governments are currently completing renewal of a cultural property protection agreement. In addition to the traditional examples of pre-Columbian artifacts, certain historical paintings, items of Spanish colonial architecture and history, and some native textiles, the Bolivian Government also considers certain flora, fauna, and fossils as national treasures. It is illegal to remove any such items from Bolivia without prior written permission from the appropriate Bolivian authority. Any type of fossil excavation, even picking up a fossil, without prior written authorization from the appropriate Bolivian authority, is also illegal. Violation of the law can result in lengthy jail sentences and fines. Contact the Embassy of Bolivia in Washington or one of Bolivias consulates in the United States for specific information regarding customs requirements.
CRIMINAL PENALTIES: While in a foreign country, a U.S.
citizen is subject to that country's laws and regulations, which sometimes
differ significantly from those in the United States and may not afford
the protections available to the individual under U.S. law. Penalties
for breaking the law can be more severe than in the United States for
similar offenses. Persons violating Bolivian laws, even unknowingly, may
be expelled, arrested or imprisoned.
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