Your medical kit is also a very important and very personal part of your travel gear. While most of us don't have to think about our health very often at home, on the Road you rarely go a day without considering the state of your bowels, whether some insect bites are going septic (infected), or whether your fatigue may be due to some dread disease. At least you may want to be taking some regular precautions against insects, fungus, blisters, sunburn, or the like. As long as you learn enough to recognize and quickly deal with any potential health problems and hazards, you shouldn't have to worry unnecessarily about your health.
The amount of medications you carry with you is largely a matter of personal choice and experience. Surveying my long list below, it may look like something you could get 10 years for at home, but I've met plenty of travelers (many in the medical profession) who carry around enough drugs to stock a small hospital in the Third World. Other people rely almost entirely on natural remedies and avoid drugs altogether. You can, and many people do travel around with just a minimal first aid kit and a few basic medications. Along the way, you will be able to pick up most of the medicines you may need at any pharmacy (chemist's) in any reasonable-sized town. Carrying a lot of medicines is not as important as knowing just what you need for a particular problem and how to use it. The more time you spend far, far from the nearest pharmacy, the more remedies you may wish to keep with you.
Disclaimer: I am not a doctor, or anything like one. I will recommend that you seek advice from a local doctor or pharmacist for any potentially serious medical condition, and take along one of the recommended Traveler's Medical Books mentioned below for more thorough information. Strictly follow dosages for any medicines and use the following information as suggestions for what medications you may want to take with you, or pick up along the way.
Please check out the 
CDC's Traveler's Health Page
(that's the Center for Disease Control), for lots of current
information and advice. Travel Health Online, by Shoreland
is another comprehensive web site with information on a variety of
travel-related health issues; give it a look!
Medical Treatment: Should you come down with a serious medical condition, you're first inclination may be to fly home immediately, and this might be called for. But often the most reliable places to get diagnosed -- and sometimes treated -- for tropical diseases are where they are most common. So I would simply recommend that you first try to get yourself to a good doctor in the nearest "modern" city (where you would fly home from anyway) for a positive diagnosis and recommendations for treatment. Then decide if you need to get home. (The local doctor in the village may or may not be as good as your traveler's medical book at diagnosis.)
"Tropical" diseases such as dengue fever, mountain fever, typhus, typhoid, schistosomiasis (bilharzia), and several virulent strains of malaria are so uncommon in modern temperate countries that few doctors in your home country will have any practical experience with them -- especially if you fail to tell them that you've been out traveling! Your family doctor at home may need to refer you to the nearest(?) "Center for Tropical Diseases" or such, just to get a correct diagnosis. While local hospitals in the tropics will be most familiar with diagnosing such problems.
Availability
Many of the medicines and remedies listed below are available overseas. Many drugs which are only sold by prescription (or are unheard of) at home, are sold over the counter in Third World countries and are very cheap. (Modern countries like Hong Kong, Singapore, and to some extent Malaysia will not sell you these drugs without a prescription.) However, they often come without any instructions other than "take according to the directions of a physician". Ask to see the whole box or the "literature" in the box to verify what the strength and dosage is, and write it down! Always check the box and the tablets for the expiration date. If it is too near in the future, go to another chemist (pharmacy) to find something fresher.
Other "middle-class" remedies like cold tablets and vitamins may be found in large cities but will be somewhat expensive, especially if they are imported. But since they are available, it is just as well to spend a little extra to get fresh ones only when you need them, than to carry too much with you. Also check with the local pharmacy (chemist) to see what local products they have to recommend.
For all of the potions and health-related items listed below, I will attempt to let you know which ones are very hard to find at all in the Third World, and which ones are so common that you can get them practically anywhere. This is quite valuable information, especially when you're making your packing list at home, and is not easily come by (if I do say so myself).
First Aid instructions -- You may not make much use of it, but every traveler should carry a brief list of basic First Aid Instructions. These cover common injuries and ailments, but usually not serious tropical diseases. Any first aid kit that you buy will come with such a list, or you can often buy them separately. It should be on tough or waterproof paper. The most important part of a remedy may be just to diagnose a problem, and it is comforting to have some written instructions for situations that you hope never to encounter.
Traveler's Medical Book -- There are now several good books on traveler's medicine, but only two I have seen are small enough and good enough to actually take along. They are: "Staying Healthy in Asia, Africa, and Latin America", by Dirk Schroeder (Moon, 1993, ISBN #1566910110) and "The Pocket Doctor", by Dr. Stephen Bezruchka (Mountaineers Books, 1999, 0898866146).
"Staying Healthy" is the size of a thin paperback (5.5 oz), is very easy to understand and use as a reference, and has a good section on first aid, complete with illustrations. It provides several alternatives and stages of treatment, and lots of details to help diagnose symptoms. Again, the most important function of such a book is often to be able to diagnose when you have -- or do not have -- a serious problem that needs medical attention. Much of the material in this book comes direct from "Where There is No Doctor" (see below), as credited in the Preface.
"Pocket Doctor" is significantly smaller at 2.5 oz, has all the basic information in a briefer format, and may be a little more difficult to use for diagnosis. He tends to recommend antibiotics for several moderate conditions, without suggesting alternatives.
I can recommend either book to be more than adequate and useful for most travelers. Most people will get along fine with a list of first aid instructions for emergencies, and the information in many guidebooks (just borrow one), but I do recommend that you read up on traveler's medicine before leaving -- whether or not you bring a book -- just to familiarize yourself with the precautions you can take. For serious problems, you should try to consult with a doctor or chemist, anyway. Still, it can be comforting to have a good source of medical advice handy. "Health Guide for International Travelers", by Drs. Thomas Sakman, Pierce Gardner, and Gene N. Peterson, is also very small and cheap, but not as useful.
Eagle Creek publishes a nifty new (1998) traveler's medical handbook -- Guide to Healthy Travel that is only about 1 ounce, cheap, and comes in its own zip-lock plastic bag. There are good checklists for medical and other travel items, and timetables for preparing for your trip. The medical advice is good and clear, and it's so small that it would be very easy for every traveler to take along. But I just think it's not quite complete enough for serious Third World travel. They don't list typhoid, hepatitis, dengue fever, cholera and several other dread diseases. While your chances of contracting these conditions is small, it can be very comforting to verify that you don't have all the symptoms -- and if you do, you'd really want to know about it.
The most thorough book I have seen on traveler's medicine is "The Medical Guide for Third World Travelers", by Dessery and Robin, (KW Publications, 1992, ISBN #0929894065); it is a very good reference book on the subject, but at the size of a novel, I can't recommend carrying it for ordinary travel. Another source is "Where There is No Doctor", by David Werner, (Hesperian Foundation, 1992, ISBN #0942364155) translated from the Spanish and used by most volunteer health agencies in Latin America. There is stuff in here you don't ever want to need -- how to set bones, deliver babies, stitch up large cuts, treat gunshot wounds -- but lots of information on health and medicines. This book is much too big to consider taking along.
Kit Box -- You should organize your medical kit in some container. I find that things are best organized by frequency of use and fragility. So some medicines end up in my handy toilet bag if I find I use them often, while items that can easily be damaged go into a rigid container that may also contain flashlight bulbs, sewing needles, and such. Small metal cans (spice tins) and soft plastic food containers give reasonable protection from damage and moisture. You should at least be organized enough to know that what you need will be found in one of three locations. You can also buy "complete" first aid kits of varying sizes, with their own soft pouch. This can be a good start, but you will probably want to modify the contents for your trip; if very few of the items are really the ones you need, you can just as well put together your own kit.
Adhesive Bandages (band-aids, telfa-pads, elastoplast, sticking or "sticky" plasters) -- You will need these from time to time for small cuts, and just to protect sores or blisters from the dirty environment. The ones you buy locally will usually stick for at least an hour or two, so bring some from home. You will find imported ones in some major cities. Try to keep them flat, but sprinkle a few around in your various bags so you always have one when you need it.
Gauze Pads, Tape -- It's not a bad idea to carry a few small gauze pads and some narrow cloth tape for little emergencies. You probably won't need them, but someone else might. I rarely use much tape, so I get a fresh roll (it loses its "stick" with age and humidity) and leave half of it at home.
Scissors -- You will often need to have a little pair of scissors handy, so take at least one in addition to any little one you may have on your knife. Nice little folding travel scissors take up very little room, so they can be stashed in your day pack, coin purse, or waist pack. There are several varieties, one is hinged and another collapses into itself; neither of these is much bigger than a couple of house keys. You can find them in a number of cities in the Third World if you look hard.
Cotton (cotton wool) -- A common use for cotton is to put in your ears, to protect them from dust, moisture, and noise. Cotton will also 'wick' a certain amount of moisture out of your ears after swimming. You can put it between your toes to prevent irritation to blisters, and to help them air out when you get a fungus of some kind. Buy it wrapped in paper, and keep it clean that way; but don't take an entire roll, it is far too much. You can buy sterile cotton most anywhere. You may find some in your pill bottles, but nowdays much of it is synthetic, and it may not be at all sterile in the Third world.
Moleskin, Molefoam -- This is a foot plaster made of thin felt with an adhesive on one side. It is quite good at preventing friction, and should be used before a blister actually develops on the foot. They stick like the devil and won't come off for days unless softened by a long soaking. Molefoam is a thicker foam, and can be used to protect a sore or blister when you have to walk anyway; just cut out a small hole in the foam before applying. Molefoam doesn't stick quite as long, and takes up more room. If you will be doing a lot of hiking, you may consider bringing a few sheets of these plasters. You will be able to find them (moleskin, at least) in pharmacies in some modern cities. Use band-aids (sticky plasters) as a less durable alternative.
Thermometer -- These are almost entirely glass and not easy to carry around safely, considering the number of times you might really need it. Modern digital thermometers are a bit bulky, especially if you rarely need one. My doctor has one-use disposal "paper" thermometers; she gave me a few, but I have never seen them for sale.
Syringe -- Don't try getting one of these at home. But if you will be traveling in some backcountry areas where you would not trust the sanitation of the local doctors -- and especially where AIDS, hepatitis, or other serious blood-transmitted diseases are prevalent -- you may want to carry you own clean syringe, just in case. You could also use it if forced to get an inoculation in places you can't trust. Disposable plastic syringes are sold in pharmacies all over the Third World, for very little money; just ask. Chances are very small that you will ever need one, but if you do, you don't want to worry about how many other people were using that needle before you. Since you can usually buy one in any city, only consider this if you will be going off into the bush in countries with such health risks. Also, don't try bringing it back home; it really gets customs officials excited in First World countries.
Snake Bite Kit -- I used to carry one of these all the time, until I decided that in most places -- even a lot of jungles -- the danger of being bitten by a poisonous snake is amazingly small. Still, if you are headed into dangerous snake-infested bush, those little green rubber kits are fairly small. You can use the suction cups in the slightly more probable instance that you are stung by bees, hornets, spiders, or a scorpion. Weight: 1 oz. I am always reminded of the old prospector who carried a basic snake-bite kit of only two elements: a bottle of whisky, and a snake.
Water Purifying Filters -- These are pump systems which filter unsanitary water to remove debris, some microbes, and perhaps protozoans. They include a pump, water container, and a filter element which may be cleanable or replaceable. You may have to buy and carry replacement filter elements for any long trip. These filters are getting much smaller and lighter (which isn't difficult, after the old boat anchors they used to make), but I still think they are unsatisfactory for travel, considering the cheap and small alternatives. They don't stop viruses (hepatitis), and until recently they did not even claim to filter out protozoans (amoebas) or flagellum (giardia flukes). The best thing they do is remove debris, which you can accomplish with a cloth filter like a "coffee sock", and they work much faster than chemicals.
Yet another purifying system is the Water Purifier or Travel Well cups. They are cups containing a special "resin" with iodine crystals; you put 5 oz. (150 ml. only!) in the cup and in less than a minute it filters "pure" water out the bottom. It weighs about 100 g (3.5 oz) including a second plastic 9 oz. cup and can purify a liter in a few minutes, if you have somewhere to put it. They still recommend letting "questionable" water stand for several minutes (to let the iodine finish its job). Because it uses iodine, it does a fine job of purifying but it is not a filter; you must pre-filter any "cloudy" water. It's main advantage, like filters, is speed, but it is a better purifier than filters. Disadvantages are small capacity, carry size, and the fact that it eventually depletes itself, after 3000 cups! Okay for tourists, but why not just use iodine and wait for it, saving the cost and space?
Coffee Sock -- Okay, now I mentioned it, I have to explain it. This looks like a miniature butterfly net with a conical cloth bag, wire opening and handle. It weighs almost nothing and can be found at "serious" kitchen supply or coffee stores. It is made for filtering hand-brewed coffee and tea, and will just as easily filter much debris from dirty water. It won't turn green water crystal clear, but it will get all the big bits out. You still have to purify it, but you won't want to drink purified water if it is full of scum, dirt, hair, and ....well, you get the picture. Turn the sock inside out to clean it. You will very seldom need this unless you do quite a bit of back-country exploring or camping out; you can always try straining things through a thin shirt or bandana!
Iodine -- This is perhaps the best way to purify water. You use only 2 or 3 drops per liter (quart) to purify water, and let it sit for 30 minutes before drinking. It kills amoebas, giardia, and hepatitis, as well as any other microbes floating around in there. I prefer the chemical flavor of iodine to that of chlorine, but iodine colors the water a little brownish, while chlorine does not kill giardia.
Liquid iodine is also an excellent disinfectant and anti-bacterial agent. Use it on any wound after washing and before applying antibiotic powder. You can also use it to disinfect needles or knife blades; apply it after "sterilizing" metal with a flame and wiping off the soot. The main drawback is that it runs all over the place and stains terribly! At home you can buy de-colored iodine. Use a cotton swab instead of pouring iodine directly on the wound. Keep iodine in an air-tight opaque plastic bottle (I use an old Cutter's repellant bottle), and keep that in a small zip-lock bag. You don't want to spill this stuff anywhere!
Tincture of iodine can be purchased at any pharmacy in any village in the world (if you find a village that doesn't have it, let me know). For some reason, the name always sounds something like "yodo" in almost any language! It costs almost nothing and a tiny amount will last you for your whole trip.
Water Purification Tablets -- Halazone and Potable Agua are tiny tablets you put into water, one tablet per liter. You still have to wait about 20 minutes. This method is not as messy as iodine, but eventually you run out of the little tablets. They are a bit expensive (about $6 for 50 tablets) and virtually unavailable in the Third World. There are numerous brand names, but look for iodine-based tablets, such as Potable Agua, rather than those based on chlorine (such as Halazone), which is not as effective as iodine. The active ingredient should be some kind of "-iodide"; those made from chlorine are "-chlorides".
Cotton Swabs -- A few of these will come in handy for cleaning ears, applying liquids such as iodine, and several functions you would never think of until the time comes. They must be packed in a plastic bag, or preferably inside a tin or plastic box to prevent the tips from getting frayed and dirty. They aren't absolutely necessary, and can be purchased in most cities anywhere.
Rubbing Alcohol -- This is readily available cheaply in most places, usually in large plastic bottles, and has many uses, but there are better alternatives for most of them. Alcohol can be used as a disinfectant, but is not as good as iodine (except it won't stain). You can rub it all over your mosquito bites to keep them from itching for a short time. Rubbed on feet, it will eventually toughen up the skin, so perhaps the best use is before you leave home, if you're a tenderfoot. If you need a small amount of alcohol, there is a good chance that some of the liquids you carry (Boric acid solution, perfume?) are at least 95% alcohol. You can use them for any of the above purposes.
Tiger Balm salve -- This is the traditional Asian cure-all ointment, based on mentholated spirits. You can now buy it at home (try a Chinese shop) or anywhere in Asia. (As always, there is only a cheap imitation in India.) Tiger Balm is not for the stylish or faint-hearted; it has a strong smell. Use it as a balm for tired, sore -- or cramped -- muscles. Placed under, or even inside the nostrils, it will clear your sinuses. Dab it on unbroken mosquito bites to keep them from itching for quite a while. Mosquitoes won't come near the strong smell either! Since it contains 5% clove oil it can be used on sore teeth or gums; it has an unpleasant aftertaste, but gives you charming breath! A dab between the eyes is supposed to center your spiritual concentration; on the temples it is claimed to cure headaches. The red version, available in Asia, is even stronger than the white, but it will stain your clothing badly; the packages are very similar.
Clove oil -- The best natural medicine for toothache. Modern toothache remedies contain clove oil as an "inactive ingredient". Since it can be bought in many places, wait until you need it to buy some. In a pinch, use Tiger Balm (ugh!)
Aspirin -- Aspirin is a natural remedy for fever, headache, and for relaxing tired muscles and nerves. It seems to be good anytime you have a cold, but no one knows why. I rely on it to relax my muscles and nerves during and after a grueling bus ride. It's as good as a few beers for calming frayed nerves; just take a few and lie down for ten minutes. The normal dosage is two 325 mg. tablets every four hours.
As alternatives you can take Tylenol, acetominiphen, or ibuprophen. Only about 20% of people get irritated stomach from aspirin; if you're not one, then aspirin should be okay. You will not be able to find these alternatives overseas. Aspirin is reasonably priced in Latin America, but more expensive and not as easy to find in Asia and Africa where it is not commonly used.
Rehydration Salts -- This is basically like the "isotonic" sports drinks at home, which replenish natural body "salts" and chemicals lost through sweating. In the Third World, they are used to treat severe dehydration due to diarrhea, especially in children, who regularly die from this condition. They usually come as a powder in packets, and must be mixed with purified water, before drinking. They are now widely available in the Third World pharmacies if you know what to look for; Electrol is one common brand name. For travelers, they are useful if you are suffering from excessive fluid loss due to diarrhea or sweating in tropical climates. They are also highly recommended to keep your strength up and combat lethargy if you go without food for several days because you are ill, or just trying to starve out an intestinal problem.
Cold tablets /Antihistamine/Decongestant/Allergy -- Bring along a small supply of whatever basic cold pills you usually take at home. You will be able to replenish them in a few large cities, as long as you plan ahead. Antihistamine pills are also good to reduce the swelling of various skin rashes, bee stings, and spider bites. The common antihistamine drugs are chlorpheniramine maleate and triprolidine hydrochloride; decongestants are pseudoephedrine hydrochloride and phenylpropanolamine hydrochloride. Whatever that means. Allergy tablets are just antihistamines.
Nasal Sprays -- If this is one of your necessary cold remedies, bring a small amount along, as it will not be readily available where you go. Phenylphrine HCl will irritate your nasal passages if you overuse it. For general use, Vick's or Benzedrex inhalers or even Tiger Balm are good alternatives for clearing up a stuffy nose without taking strong drugs.
Cough Medicine -- Liquids are clearly no good unless you buy them when you need them. You will usually be able to find some kind of cough syrup (often with codine) when you need it, but it doesn't hurt to carry a few tablets with you. It's no fun being in a dorm with someone who is coughing all night, and worse if that someone is you. Codine cough syrup should stop your cough and put you right to sleep. Dextromethorophan is the leading cough-suppressing ingredient of tablets and lozenges available in pharmacies at home and in cities of the Third World. Look for it on the label -- sometimes the name includes a "DM". (You're really getting to be a pharmaceutical encyclopedia, aren't you?)
Vitamins -- If you normally take a specific vitamin for a specific condition, then bring plenty along. In general, like at home, you don't really need to take vitamins regularly if you maintain a reasonable diet. Vitamins tablets are available in cities and, like cold remedies, they will be expensive. But it is hardly worth loading yourself down with quantities of these things which may easily become 'stale' or damaged on the way. On a short trip you shouldn't need any vitamins at all.
Some people swear by large doses of vitamin C for colds (I am one of them); you have to choose among paying for a bottle of tablets, doing without, and getting a big bag of oranges or chili peppers. If you travel for a long time, and suffer from a vitamin deficiency, it will usually be vitamin B. Vitamins B6 and B12 in combination will fix up sluggishness if this is the problem, but there are many things (including heat, salt deficiency, and homesickness) that will make you sluggish. If you've been traveling hard for several months and losing weight, you may want to take some vitamin B, or a multi-vitamin for a while just to be safe. B vitamins are also good for hangovers.
Antacid tablets -- These probably aren't necessary, but a few times you will be glad of something to settle your queasy stomach. It's not a bad idea to take a small roll along for the beginning of the trip when your stomach is getting accustomed to all that culinary abuse. The best have aluminum and magnesium hydroxide in them (sounds like you would set off the metal detectors at the airport!) Don't use these together with tetracycline. You will sometimes find them in larger modern cities. Milk of Magnesia also works as a laxative if you take a double dose. Cheap ones just have bicarbonate of soda. On the Road, you can buy some bicarbonate of soda or just drink soda water or 7-Up for a little relief. If you normally suffer from "nervous stomach", the traveler's life will probably cure you of this. If you have diarrhea, you need a different plan.
Caffeine -- On one trip I carried a few caffeine tablets to keep me awake on buses in "dangerous" countries. I also used them a couple of times when arriving in a new and challenging country on little or no sleep. They aren't really necessary, as you can usually find some coffee somewhere.
Dramamine -- The old standby for motion-sickness can be purchased in most any city pharmacy in the world. Or take along one for each boat trip you may be taking. Dramamine (dimenhydrinate) can make you sleepy, and is only good if taken an hour before the motion begins. Alternatives include Bonine (meclizine hydrochloride), and the little "transdermal" patches you put on your skin. The patches actually contain a drug, scopolomine, with will last up to three days. You must put them on at least two hours before launch, and they can still cause drowsiness or blurry vision in some people. You will not find them overseas, but they are small enough to bring. Another new device I have no experience with is wrist bands that use acupressure points on your wrist to prevent motion sickness.
Antiseptic -- This is usually a liquid used to kill germs that could quickly cause a cut or scrape to infect ("go septic"). If you don't already carry iodine for water purification, you can use an alternative antiseptic and disinfectant such as merthiolate, mercurochrome (5%), potassium permanganate, or even rubbing alcohol in similar ways. Get a tiny bottle, or put it in a small plastic squeeze bottle. You can easily get most of these overseas.
Antibiotic cream -- You can buy this at home and it is good for preventing infections in wounds, but is not nearly as useful as antibiotic powder (see below). If you take some, get the smallest little tube you can find (14 grams or .5 oz). The few cases where it is preferable are on skin which is not broken and moist, or on sores in places where it is difficult to apply powder. Sores inside of your nose can be quite painful and become a serious problem if not treated quickly. The antibiotics tend to be a combination of bacitricin, neomycin, and polymycin.
Antibiotic powder -- Get some of this and use it instead of antibiotic cream to prevent infection on any broken skin. It contains the same stuff but is much better in the tropics. The powder hardens into its own scab over the broken skin and is not easily brushed or washed off. It will last for hours or even all day without being covered by a bandage, and promotes drying of the wound. Creams brush off easily, must be covered, and just leave the wound soggier than before. Dab the powder on any and all broken skin, especially insect bites you have scratched. Do it every night; a little bottle goes a long way, and you can always get more.
You might not find the powder at home but it is sold in pharmacies everywhere in the Third World. Originally there was sulfatiazole, then Cicatrin, then bacitricin. A previous standard was neomycin-sulphate combined with bacitricin and has several trade names (Baneocin). The current latest is a mix of Polymyxin and bacitricin, sold under the trade name Polysporin. Just ask for any of these names and they will give you the latest version; or you can order Polysporin powder from Amazon.com. It should come in a little plastic bottle with a tiny hole in the top. Hold this hole just above the "wound" and tap the bottom of the bottle until a little dash or two of powder covers the affected area. Like all such bottles, if the cover or cap is not attached to the bottle itself, try to attach it to the bottle somehow with thread (and needle) so you won't drop it irretrievably between the floorboards while treating yourself.
Cortisone cream (hydrocortisone acetate) -- This is now commonly sold at home in small tubes. A small quantity may come in handy for skin rashes and irritations due to poison plants, insect bites, chemicals, impetigo, and dermatitis (unknown skin rash). It is a more compact, more general, and stronger remedy than calamine lotion, but don't use it more than 3 or 4 times a day. It can also be safely used in your anus or vagina for general itching. Not generally available overseas.
Calamine Lotion -- The "pink stuff" is useful for insect bites and rashes from poison plants, but bulky and usually comes in glass bottles. You can get it overseas in some, but not all areas. The bulk is not worth carrying it around for the few times you may need it. Wait to buy some when you need it, or carry cortisone cream instead.
Anti-Fungal Cream -- For treatment of athlete's foot, ringworm, crotch rot (fungus in the groin), and skin fungus. Clotrimazole is the best broad-spectrum anti-fungal; you can buy it overseas, often as Calesten, or in the US as Lotrimin, which is now available without a prescription. You can spend a whole trip without needing any, and if you do get a fungus, you should be able to get some strong medicine near where you are, but little 12 gram tubes are available. A good preventative is an anti-fungal powder.
Similar creams will work on vaginal yeast infections, but make sure it is safe for that use. Women may be able to get clotrimazole in vaginal tablets from your doctor or in shops (Lotrimin), if you are prone to yeast infections; nystatin and miconazole nitrate (Monistat-7) are similar alternatives for this purpose.
Aloe Vera -- The "juice" of the aloe vera plant is one of the best treatments for burns there is. It cools and soothes, but also promotes quick healing and retards scarring to an amazing degree! The plant is an agave and grows wild in the sub-tropics of the western hemisphere. You can just slice a thick leaf and smear it on a bad sunburn, but it is slimey and can stain clothing. If you look hard at home you can find a burn medicine which contains mostly aloe vera. Some of them only contain about 10% of "95% Aloe Vera!" You probably won't need much unless you do a lot of camping and cooking out, so it's hardly worth taking unless you can find a tiny tin to carry some in.
Le Funelle -- This is a lightweight paper funnel which
allows a woman to urinate while standing up. Le Funelle is made of
biodegradable paper, not unlike a paper coffee filter, but designed to be
easy to handle and use. Frankly, I don't know anyone who has used them on
the Road, but they have received rave reviews, so if it sounds good, find
a packet of 10 at a travel store and try them out. They are very light,
compact, and include tissues. They are not especially cheap, so save them
for emergencies. There are now several different brands of such products
which you may find, for example, in Magellan's catalog ("Uri-Mate").
Tampons -- OB tampons take up the least space, 16 come in a tiny packet taking up a 2 inch (5 cm) cube and weighing only 2 ounces; and they come individually well-wrapped so you don't need the box either, once you've opened it. Best of all, you can now get them, as well as Tampax, etc, in larger, more modern cities. Tampons are not used in many Third World countries, and can be quite hard to find outside of major centers. Stock up when you can, or substitute the old napkins, which are much more readily available.
Update 10/01: A helpful reader has recommended a tampon alternative called "the Keeper" which is a "little rubber cup that lasts for decades, is way cheaper in the long run, environmentally friendly, is actually safer than tampons, and easier to carry and use." She highly recommends you check it out at
Condoms -- You may think you won't need any, but if you do, you will be very glad you brought them. Aside from contraception and protection from new partners who may carry venereal diseases, condoms can protect you and your regular partner from urinary and vaginal infections which are way too easy to get in your less hygienic travel environment. You may want to use condoms when you can't be completely clean, regardless of other contraceptives you use. Now available almost everywhere, although quality and selection may be limited.
Birth Control Devices -- In some countries you can buy contraceptive pills over the counter; you would need to know just how strong it is in order to match what you have taken in the past. In some countries they are almost unavailable, but you may be able to get some through a doctor. Since they are quite small, it is best to bring your own supply, but also get a copy of the prescription, just in case. If you bring your own diaphragm, include a reasonable amount of your jelly, as it will be very difficult to find overseas. Spermicidal foam tablets, sprays, and sponges will not be available in most countries. Condoms are the best available alternative.
One thing that all of the following 'serious' drugs have in common is that they can best (or only) be purchased after your arrival in the Third World. Just go a big pharmacy (chemist's) and ask for them by their medical names; brand names change from area to area. Even small pharmacies will have them, but they may be older and not properly stored. In a few modern cities, you will be told you need a doctor's prescription; seek out a more backward pharmacy.
Antibiotic Pills -- You can buy various forms of penicillin and sulfa drugs over the counter for very little money in much of the Third World. But you must know how to take them yourself, because there will be no directions! It can be a good idea to carry a full "course" (7 to 10 days) of antibiotics with you, especially if you are heading out into the bush. It is a better idea never to use them unless you are pretty certain that they are the only way to cure what you have.
First, antibiotics will kill all of the friendly bacteria in your system that normally help you live through all those greasy tacos and microbial curries. After taking a course of antibiotics, be careful what you eat, and take in plenty of yoghurt for several days to restart the bacterial cultures in your body. Second, overuse of antibiotics may leave you body more susceptible to disease. If there are any organisms that do survive, they will be resistant to the antibiotics. For this reason, once you have taken one kind of antibiotic, you should not take the same kind again for a long time. The problem is made worse if you begin a course and do not finish it completely. If you stop before all of the organisms are killed, (just because you feel much better), the few that remain will be very resistant to the antibiotics, and when they reproduce, you will have a body full of antibiotic-resistent disease!
Among the useful antibiotic pills readily available are tetracycline, teramycin, penicillin, ampicillin, and erythromycin. For those with allergies to penicillin, you may be able to find cotrimoxazole (trimethoprim with sulfamethoxazole) which is also good for severe diarrhea. Tetracycline and teramycin are closely related and tetracycline (at least) will make your skin overly sensitive to the sun; it's no problem as long as you are not at the beach at the time you take it. Ampicillin is one of the broadest and strongest; it is often prescribed for venereal diseases, urinary infections, many types of baccillary dysentery and is even reputed to kill several kinds of amoebas. Amoxicillin and Cipro are more recent broad-spectrum antibiotics, that may become available abroad. For any of these, get the 500 mg. (milligram) capsules whenever possible, so you only have to take them twice a day, and have half as many to carry around.
Antibiotic Prevention? -- I've never tried this but... I know people who did. For Short trips, you may get your doctor to prescribe a low dose of antibiotics that you can take every day as a preventitive against 'normal' traveller's diarrhea. It would usually be 250 mg or less per day, but you should not do this for more than two or three weeks. For a possibly better alternative, read about Grapefruit Seed Extract, below.
Boric Acid Solution -- This is for the treatment and prevention of "swimmer's ear", excess water in your ears which can eventually cause ear infections. Just a few drops in your ear are all that's needed from time to time. You can buy very mild (2%) versions of this at home if you will be doing a lot of swimming or if you are prone to ear infections. If you have trouble on the Road, ask a pharmacy for a "boric acid solution for ears"; they may just mix some up for you. The normal proportion is 1 teaspoon of boric acid powder in 8 oz. of alcohol; but just 1 ounce should last quite a while.
Eardrops, antibiotic -- If you get a real ear infection, application of antibiotic eardrops can fix you up, but don't use them for just any earache. If you go into any pharmacy in the Third World and ask for eardrops, they will likely show you the ones with antibiotics. They should contain neomycin-sulfate, teramycin, or a similar antibiotic (look for "-cin" or "-cilin"). If not, ask for these drugs by name, in the eardrops. I've never seen these used in the U.S., where oral antibiotics are usually prescribed, but a pharmacist recommended some to me once in Indonesia (worked fine!), and I later bought some in Sri Lanka.
Lomotil, Interobioform -- These are two very strong remedies for diarrhea. They both work by paralyzing your intestines. Immodium is a good alternative if you can get it; if it doesn't work, you may need a cure for dysentery! Lomotil is readily available in the Third World, and is illegal in several First World countries!
Immodium -- This is the common "over-the-counter" diarrhea medicine sold in the western world. It also works by "paralyzing" your intestines, but is not nearly as nasty as lomotil or interobioform. Carry a few of them around for emergencies, especially on long journeys and check the correct dosage and frequency of use.
Tinidazole (sometimes spelled "tinadazole") -- For some reason, this drug is almost unknown -- and is not available -- in the U.S. It is the best way to cure giardia, and also kills most amoebas. It works fast and has no obvious side-effects. Tinidazole works overnight and cures giardia for good! You should also avoid drinking alcohol with tinidazole. Buy tinidazole anywhere in Asia -- under the trade names Fasigyn or Tiniba -- and some places in Africa. It is now available in Latin America under the trade name Troxxil. Take 2,000 milligrams one night for giardia, or the same dose three nights running for amoebas.
10/98 -- When I wrote this about four years ago, none of the traveler's medical books had even heard of Tinidazole. I'm happy to see that both "Staying Healthy in Asia, Africa, and Latin America", and the new Eagle Creek booklet now recommend Tinidazole over Flagyl for giardia. You still can't get it in the U.S., but that's not (hopefully) where you'll need it.
Metronidazole (Flagyl) -- This is the usual medicine prescribed for giardia, and amoebas. It is absolutely god-awful stuff! Flagyl often gives you headaches, body-aches, and even worse stomach cramps. You cannot take it with many other medicines or with alcohol unless you want to wind up in hospital. It takes five to seven days to get rid of the symptoms, which may still come back two to five months later! Better you check out Tinidazole, above. Metronidazole vaginal tablets can be used effectively on serious cases of gardnerella infections, but that's a different condition.
Malaria tablets (Chloroquinine, Fansidar, Maloprim, Dariprim, Paladrim, Primaquin, Mefloquin (Lariam), Doxycycline, etc.) -- These are various tablets you take regularly to prevent getting malaria. Some of them can also be used to treat malaria until you get to a hospital. You may need two kinds, the ordinary chloro-quinine variety, and a second type for quinine-resistant strains of malaria. You must begin taking the medicines one week before exposure, and two to four weeks after your last exposure. Usually you take them only once a week. For those with weak stomaches, paladrim and primaquin are milder ones that you take every day.
Almost all of these medicines have some potentially dangerous (if rare) side-effects associated with them! But then malaria -- especially the cerebral type -- can also be quite dangerous; so what are you going to do? Most people who will be exposed for a few months usually take the pills. Fansidar has a bad reputation (rare kidney failure, etc.) and should not be taken for more than three months at a time; Maloprim is much preferable if you can find it, but also has some side-effects. Both Fansidar and Maloprim are different combinations of Pyrimethamine. Lariam is currently the most commonly prescribed, but it is now suspected of "psychotic" side-effects (AKA "crazy Tuesday", homicidal veterans, and numerous incidences of suicide) and has generated a number of law suits! Doxycycline has perhaps the least (known) side-effects but may also be a little less effective; you must take it every day, while most of the others come in once-a-week dosages. It is a version of tetracycline and causes some skin-sensitivity to sunlight; it can also block the effects of contraceptive pills! You may be able to get a small quantity of some of these tablets from your doctor at home, so you can be protected from the start, but the best (and cheapest) place to buy them is in tropical and Third World countries. In my experience, some countries (or pharmacies) tend to have only certain types of malaria pills on sale; if you are looking for a particular type, try another pharmacy, or wait until the next country to try again.
See also the Preventing Malaria
web site for more up-to-date information.
Diamox (altitude pills) -- Mountain-climbers use Diamox (acetazolamide) to prevent and treat altitude sickness. You can buy it in many places overseas where you might want it. It is sold as a "diuretic" -- not specifically for "altitude" -- and in fact, it makes you want to urinate a lot. It speeds up your metabolism and seems to have a beneficial effect on altitude sickness, especially if taken early. Don't overuse it; it won't be necessary below 3,000 meters (10,000 feet), and should only be needed for a day or two while you acclimatize. Better yet, don't take any at all unless you really need it, although you might want to take it a day or so before a very long ascent. You can take one 250 mg. tablet three times a day, but don't go into this program unless you are sure you are getting altitude sickness already. Don't use it if you have sulpha drug allergies.
As you may have guessed, I rely more on pharmaceuticals than traditional medicines. But there are many natural cures that are just as good as drugs in some situations. Fasting is often the best cure for diarrhea. I have also mentioned clove oil, and probably a few other "common" remedies. If you seriously want to avoid taking drugs in most situations, you may already know of more good natural medicines than I do.
Papaya Seeds -- Like many fruit pits (and most medicines), papaya seeds contain a small amount of toxins which may help in killing off intestinal bugs of various kinds, but especially roundworms. I usually eat 5 or 10 whenever I get a papaya, just for general purposes. If you have the opportunity, you can dry them out and grind them up into a powder (I do this in a pepper grinder at home). A small amount of powder may help with some stomach problems. Note that the papaya fruit itself is very good for digestion and may help settle a queasy stomach.
Willow Bark -- Willow bark contains a natural pain reliever and febrifuge (fever reducer), much like aspirin. You can make a tea from the dried bark which activates this substance.
Deadly Nightshade (Flor de Cunda, Angel's Trumpet: datura arborea) -- The leaves can calm intestinal cramps and stomach ache, but it is potentially deadly stuff! Soak one or two leaves for a day in 100ml of water; then give 10 to 15 drops every 4 hours for adults only.
Grapefruit Seed Extract -- This is something I've just learned about, but it sounds good. An extract from grapefruit seeds is reputed to cure a lot of things, including various bacteria, yeast, fungus, protozoans, and even some viruses. Some claim that it kills giardia flukes as well as amoebas! If true, this would be a good idea for Third World travellers. The best news it that it comes as a liquid and you can take a few drops (2 to 4) daily as a preventative. It tastes pretty bad, so put it in some juice or cola! Yeah, I take some after sushi, just in case. It's a bit expensive -- $10 for 2 ounces -- but this should easily last for many months, if taken daily. A common form is named "GSE" -- get it in a nice little plastic bottle at health-food stores.
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