Health

Health

Before moving to La Paz, you must visit your doctor and have him/her assess if you can physically adapt to living at an altitude above 10,000 ft. (3,200 m).

Travel to high altitude is generally not recommended for those with a history of heart disease, lung disease, or sickle cell disease. It is also not recommended for pregnant women in their 1st trimester to travel to Bolivia.

Altitude sickness

Altitude sickness may develop in travelers who ascend rapidly to altitudes greater than 8,500 ft., including those in previously excellent health. Being physically fit in no way lowers the risk of altitude sickness. Those who have developed altitude sickness in the past are prone to future episodes. The risk increases with faster ascents and higher altitudes. Symptoms of acute mountain sickness, the most common form of the disorder, may include headaches, nausea, vomiting, dizziness, malaise, insomnia, and loss of appetite. Severe cases may be complicated by breathlessness and chest tightness, which are signs of pulmonary edema (fluid in the lungs), or by confusion, lethargy, and unsteady gait, which indicate cerebral edema (brain swelling).

Measures to prevent altitude sickness include:

• • Ascend gradually or by increments to higher altitudes

  • Avoid overexertion

  • Eat light meals

  • Avoid alcohol

  • Drink lots of water (stay hydrated)

  • Plenty of sleep the day of arrival

The symptoms of altitude sickness develop gradually so that, with proper management, serious complications can usually be prevented. If any symptoms of altitude sickness appear, it is essential not to ascend to a higher altitude. If the symptoms become worse or if the person shows any signs of cerebral or pulmonary edema, such as breathlessness, confusion, lethargy, or unsteady gait, it is essential to descend to a lower altitude. A descent of 500-1000 meters is generally adequate except in cases of cerebral edema, which may require a greater descent. Travelers should not resume their ascent until all symptoms of altitude sickness have cleared. Supplemental oxygen is helpful if available. Acetazolamide (Diamox, Sorojchi Pill) dexamethasone, and nifedipine may all be used to treat altitude sickness as well as prevent it. In most cases, acetazolamide is recommended as prevention, and dexamethasone and nifedipine are reserved for emergency treatment. Nifedipine is preferable to dexamethasone for high-altitude pulmonary edema.

La Paz is located over 4,000 meters above sea level. To ease your adjustment to high altitude, we recommend the following:

Acetazolamide (Diamox) is the drug of choice to prevent altitude sickness. The usual dosage is 125 or 250 mg two or three times daily starting 24-48 hours before ascent and continuing for 48 hours after arrival at altitude. For those who cannot tolerate acetazolamide, the preferred alternative is dexamethasone 4 mg taken four times daily. Unlike acetazolamide, dexamethasone must be tapered gradually upon arrival at altitude; since there is a risk that altitude sickness will occur as the dosage is reduced.

Drink plenty of clear fluids prior to arrival. Water is especially helpful. Avoid drinking alcoholic, caffeinated, and carbonated drinks for one week.

TIPS:

• The "mate de coca" or coca tea helps many people relieve some symptoms of altitude sickness. You can buy this in the tea section of the grocery store.

• It may help to arrive in La Paz a few days early in order to acclimate to the altitude and settle in before having to attend orientation

Immunizations: Immunizations and antibiotics are easy to get in La Paz and they are sold for a fraction of the cost you would pay in the U.S., but health offices are sometimes less hygienic. There has not recently been a recorded case of any of these diseases in La Paz; however, the U.S. Center for Disease Control and Prevention recommends the following vaccines for travelers to Bolivia:

• Diphtheria - Yes on Special Precaution

• Polio- Yes on Special Precaution

• Tetanus - Yes on Special Precaution

• MMR- Yes on Special Precaution

• Hepatitis B- Yes on Special Precaution 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.

• Hepatitis A or immune globulin (IG)- Sometimes on Special Precaution

• Malaria- Sometimes on Special Precaution. It is important to note that risk varies from area to area (as does resistance to preventative drugs); check before travel.

• Rabies- Sometimes on Special Precaution if you might be exposed to wild or domestic animals through your work or recreation.

• Typhoid- Sometimes on Special Precaution if you are particularly visiting developing countries in this region.

• Yellow Fever- Yes on Special Precaution if you will be traveling to endemic areas. It is important to note that a yellow fever vaccination certificate is typically required from all travelers over one year of age.

• As needed, booster doses for tetanus - diphtheria and measles. Hepatitis B vaccine is now recommended for all infants and for children ages 11-12 years who did not complete the series as infants.

Please note that that Inoculation regulations can change at short notice and the cost of any vaccinations is the responsibility of the teacher. Please take medical advice in the case of doubt. Where 'Sometimes' appears in the table above, precautions may be required, depending on the season and region visited.

For more information, please see the Center for Disease Control and Prevention website at www.cdc.gov/travel/tropsam.htm

Other Risks: Vaccinations for tuberculosis and tetanus are also recommended.

Food and Drink: Sanitation and hygiene are poor in some areas so be wary of what is eaten; avoid under-cooked meat and unpeeled fruit and vegetables, and only drink bottled water. Water should otherwise be thoroughly boiled or sterilized.