Gap Year Advice

Where

Staying healthy on your gap year should be pretty high up your list of priorities and is probably your parent’s number one concern! Here’s a comprehensive guide to keeping well and looking after yourself while you’re abroad.

Before you go:

Vaccinations, inoculations & jabs

Jabs should be your highest health priority while you’re still at home – I can’t underestimate how important they are. Book in see the nurse at your local doctor’s surgery at least 8 weeks before you travel, although as early as possible, i.e. months beforehand, is best – some shots need several courses to be effective, and these need to be taken over time.

Each destination has different bugs, bacteria and beasties, so check with the nurse what you’ll need for your area, and make sure to mention other areas you’re likely to be travelling to, as well. You also need to make sure you get the certificates to show you’ve had them, especially Yellow Fever, as some countries may check you’ve been vaccinated before you enter (and not let you in without a valid certificate), so keep the papers with your passport.

‘Travel Clinics’ have become more and more popular in the past few years, operating under various names, but while these can offer you a comprehensive service, they are pricey, and many injections can now be obtained free of charge on the NHS. Be sure to check with your local surgery what you can get before shelling out!

Check ups: doctor, dentist and optician

Before you go, it’s wise to have a health MOT with your doctor to ensure you’re in good condition for the road. It’s useful to find out your blood type, if you can, at this point. Visit your dentist too, so no problems develop with your teeth while you’re away. You might also like to get an eye test, and check you’ve got enough contact lenses for the duration of your trip - you’ll most likely need to wear sunglasses a lot of the time you’re abroad, so either get a prescription pair, contacts, or those natty little lenses that attach to the top of your glasses and fold down.

Medication

Another thing to consider is any medication you’re on. Make sure you let your gap company know exactly what you need to take and how much, along with any storing problems (for example, some medications need to be stored in a fridge or freezer).

Double check you have all the doses you need, as well as some extra, and also all equipment, e.g. needles and a blood sugar checker if you’re diabetic. Finally, depending on altitude you may need to take a different dose of your regular medication, so be sure to find out what altitude you’ll be staying at, and let your doctor know that when getting your supplies.

Be sure to wear any bracelets detailing your condition, and take a note from your doctor for the medications, to show any zealous customs officials that it’s all for you, not for resale! Finally, let the people around you know what to do for you in an emergency.

Malaria

You will almost certainly have to start taking your anti-malaria medicine before you leave – possibly months before – so be aware of this and put it in your diary. More info on malaria and mosquitoes can be found below.

Insurance

Make sure your insurance is comprehensive and includes all medical expenses and repatriation if required, and remember to get cover for any sports/expeditions you might undertake, i.e. diving or bungee jumping. Check with your gap company what their insurance covers. A good tip is also to find out and make a note of the emergency number of the country you’re visiting as well as the nearest hospitals and clinics, so you can immediately find out where you need to go in an emergency.

Health on the move:

DVT

You’re likely to spend a lot of time on the move to get to where you want to be, and that usually involves sitting still for long periods of time, so make sure you take a walk and stay active, if possible, right up to boarding your transport, and then regularly move your body and stretch while sitting, if you can, to avoid the blood clots that cause deep vein thrombosis (DVT).

Motion/travel sickness

Many people are prone to motion sickness, but it can ruin a journey. Antihistamines, mint and ginger all help, so drink some ginger ale if you can get it, chew mints or take a hay fever tablet before/during your trip as needed (although bear in mind antihistamines can make you drowsy). Another tip is to drink water and try and get a window seat, so your inner ear balances what you see with what you feel. A light snack before any journey can also help – an empty stomach is much more likely to make you nauseous.

Jet lag

Change your watch to the time at your destination country as soon as you board the train/plane/bus and try and immediately put yourself into that time mindset. Imagine things you usually do at the new time and do them, if you can. Consider trying to get some sleep, if it’s night once you put your watch forward or back. Try not to worry too much about jet lag, though – just take it easy for the first few days of any trip while adjusting to the time differences.

While you’re there:

Diseases

There are some pretty nasty diseases in many of the countries you might travel to – you can vaccinate yourself against lots of them, and hopefully you’re already planning to do that – but not everything can be covered. Many have flu like symptoms to begin with, so it’s important that as soon as you begin to feel ill, even if it just feels like a cold, you report it to your gap company representative, and/or to your host family and friends. Diseases can progress very quickly and while there’s a very remote chance of you contracting anything, it’s important to be vigilant and safe.

Sexual health and fungal infections

Make sure you ALWAYS practice safe sex – this is vitally important when travelling. Take some condoms with you (with British kite mark or European Standard mark on the packet) as well as any usual contraceptives. Remember that STDs such as HIV won’t be stopped by birth control pills, so always use a condom, no matter who you’re having sex with, and don’t do anything you wouldn’t do at home – getting crabs while you’re three days from the nearest shower on a cross country bus isn’t anyone’s idea of a good time!

Also, be aware of fungal infections. The most likely areas these might strike are the groin and feet, so keep them clean and dry as fungus grows much faster in warm, humid climates. If you think you have a fungal infection, go to a local chemist, where you can get a cream or powder for it.

Hygiene

Hygiene can sometimes be difficult on the road, as well as in environments with more basic facilities. Shower as often as you can – many local people in hot countries wash twice a day – and be sure to wash your clothes well. If there are no washing machines in the local area, improvise with hand washing – you’d be surprised how effective it is.

Also, be aware of cultural differences. The mother of the Thai family I lived with, for example, would allow me to wash my clothes in the family washing machine but not my underwear, which I hand washed. A nail brush can be really useful as part of your hand washing kit, which should include a universal sink plug and some concentrated gel or powder. For a quick guide on effective hand washing, click here.

Heat

Unless you’ve been further than the Mediterranean before, you’ll likely never have felt heat like you will in areas of Africa, Asia and Central/South America and you need to take care, especially if you have pale skin, fair hair, freckles or moles. Sun stroke can be very dangerous, as can dehydration, so make sure you’re never without a big bottle of water and a hat, and seek shade whenever you can. Apply sun cream regularly and liberally.

If you start to feel dizzy or sick, develop a bad headache or feel that you’ve had too much sun, tell a friend and/or your gap representative. If you sunburn is bad or you develop blisters, run a cold shower on the affected area, don’t expose it to any more sun, apply Calamine lotion and make sure you learn your lesson!

Stomach problems

Stomach upsets seem to be seen as almost a rite of passage to some people when travelling, but they can be avoided (mostly) if you’re careful! It might sound funny, but trust your instincts – your stomach will probably tell you if something feels or looks wrong. If you do decide to eat from street stalls, try and see the food cooked in front of you, on a stall that looks pretty clean. Another tip is to look for restaurants or stalls which are frequented by locals – you’re much more likely to get good food, but also be able to interact with local people.

Always drink and brush your teeth with bottled water – but make sure the seal is intact when you buy it. Make it a personal priority to always have a bottle or two on you, amounting to several litres if you can. If there’s really no clean water available, use tap water and add water purifying tablets.

Watch what food is washed in – fruit and vegetables/salad should always be washed in bottled water, not tap water. If you’re not sure, don’t eat it. This is also applicable to ice. Blocks of ice are often used to make ice cubes in some countries but these can be made of tap water and dragged through the streets before getting to you… the only safe ice cubes are cylindrical ones, as these have usually been made from bottled water, but they’re not universally available.

Blockers and unblockers are useful for stomach problems – British Army Biscuit Browns (block you up) and Biscuit Fruits (unblock you) are a handy not medicinal addition to your rucksack. You can buy them in your local Army Surplus store and in some camping shops. Another option are pills, such as laxatives or immobilisers. Consider adding these to your first aid kit.

Remember that some kind of light stomach trouble is almost certain, such as a single bout of diarrhoea, or a few days’ constipation. This is likely due to the different food and drink you’ll be consuming, and not down to any actual bugs. Be careful though, and always tell your representative and your host family and friends if you feel ill.

Animals: strays and rabies

You need to be careful when dealing with the local wildlife of your destination. Stray dogs and cats often abound and most are pretty harmless, but it’s still better to avoid them. If you see an injured animal and want to help, check the web – there are many organisations which provide veterinary services to strays around the world.

If you do get bitten, tell your representative, friends and family immediately, and wash the area thoroughly with bottled water and soap, and apply an antiseptic such as alcohol or iodine, if you can. It’s reassuring to know that nowadays there have been cases of people surviving rabies, but it’s very important to get treatment as soon as you can. Avoid any animals behaving strangely and/or foaming at the mouth. Also, remember it’s not just dogs which carry rabies, but cats, bats and monkeys too, so be vigilant. Get a rabies inoculation before you go.

Animals: snakes, scorpions and spiders

Snake, scorpion and spider bites are very rare, but it’s worth being aware of the right ways to prevent them, and the correct first aid should you or someone you’re with be bitten. Make sure you shake out your sleeping bag before you get in, and also your clothes and shoes before you put them on. Check the toilet before going and any standing water, such as in sinks, before using them. Don’t leave lights on and make sure any holes in your mosquito net are patched and that it’s secured around your bed. Also, be careful in long grass and forests, and wear long sleeved items of clothing.

If you do get bitten, call for help and tightly wrap a bandage around the site of the bite, then around the whole limb, and immobilise the limb with a splint. This slows down the absorption of the venom in to the blood stream. If you don’t have a bandage, improvise with clothing. The important thing is to keep still, slow down the blood flow, and get to a hospital!

Animals: sea monsters!

Be careful in the sea, there are lots of ways you can injure yourself! Corals give a nasty cut which is jagged and notoriously easily infected. Similarly, spikes from anemones break off in limbs and are particularly painful and hard to extricate. Be aware of jellyfish – their sting can be excruciating and can paralyse your limbs, so get to shore or your boat as soon as you can, and tell people around you that you’ve been stung.

First aid for jellyfish stings involves washing the wound with salt water, and (if available) white vinegar, then carefully removing any tentacles still attached. Don’t put fresh water or urine on the wound as it will make it worse! Seek medical advice if you feel ill.

Stingrays can be dangerous, but very rarely. They tend only to attack when they find themselves held down and can’t swim away, so if you’re in an area where stingray live, shuffle your feet when walking on the sea floor, instead of walking normally and you’re unlikely to trap any rays lying just under the surface of the sand.

If you do get stung, put the stung area in the hottest water you can stand to break down the toxins, then, when it feels less painful, run water in the wound and get out any pieces of the sting left in there. Then see a doctor!

Finally, sharks! You are very unlikely to be bitten by a shark, and even if you are bitten, many sharks will bite once and then retreat, giving you a chance to escape. Get to shore or on a boat if you suspect an aggressive shark is in the vicinity. If you are bitten, alert those around you and try and to escape. Once you’re safe, compress and elevate the wound to stop blood loss, try and keep warm and get to a hospital. However, try not to worry too much about shark bites – in 2006 only 62 people were bitten in the whole world, and of those only 4 died. One thing to think about if you plan to dive, is that shark skin is as rough as sandpaper, and can cause abrasions, so be careful of rubbing against it.

Animals: ticks and leeches

A lot of animals carry ticks, a bite of which can lead to diseases like tick bite fever. Similarly, if you’re in tropical rainforest, leeches can attach themselves to you without you even feeling it. If you do find a tick or leech on your body, grab its head and pull it off – be sure not to grab its body, as squeezing it will push its innards through its mouth and into you! This can lead to infection. Another good method if you can’t get a grip on it, is to hold a lit match or cigarette lighter on the body, which will cause it to drop off (but be careful not to burn yourself!). Finally for leeches, sprinkling salt on them also makes them drop off.

Once the animal has been removed, make sure you care for the wound – both animals have anticoagulants in their saliva, which stops your blood clotting so they can suck it more easily. Unfortunately, that means that when they’re removed, the wound might bleed for a while afterwards, so compress and elevate it, clean it and keep an eye on it. The lesson here is to be sure to check your body regularly for anything which may or may not have attached itself to you!

Animals: mosquitoes and malaria

You’ll probably need to begin taking your malarial medication a few weeks before you leave and continue taking it while you’re away and once you’ve returned for a while. Don’t skimp on it – if you get malaria you have it forever – it can’t be cured, and the attacks recur at regular intervals, although these do get longer as you get further away from the date of infection. The best thing to do is to keep taking your tablets and not get bitten! Use a mosquito net if possible, patching up any holes with duct tape, and use insect repellent spray, especially if you’re outside at dusk and into the night, when mosquitoes become active. Wear light colours and cover up during the day if possible; generally try and keep yourself free of bites. Malaria symptoms, like many tropical diseases, are largely like getting bad flu, so let people know if you feel ill.

Mental Health

In making sure you get the jabs and take the tablets, mental health can be ignored, but it is very important while travelling, and can make or break a trip. Homesickness is probably the biggest issue people face, but anxiety is also common, as is depression, anger and excessive worrying. Try and relax and spend some time learning as much as you can about the culture of the country you are now visiting. This will help you feel tolerance rather than annoyance when faced with any delays or problems.

Be proactive about homesickness. Making contact is essential – find your local internet café and frequent it, emailing and calling home as regularly as you need to. A good idea is to set up a free travel blog and update it regularly with your exploits. Give the web address to your friends and family, and encourage them to comment on your entries, so that you’ll have something to read every time you log in, even if no one else is online.

Take photos of your family and friends, and maybe of your home town, or even your pets with you – they’re very light to carry and can help with feelings of loneliness. Plus, your host family and new friends will be excited to see them.

Above all, keep things in perspective – make sure you remember that you’re not alone – your representative will always be there to hear your problems, whatever they might be. Think about this trip in relation to the grand scheme of the world and your life – wherever you are, it’s not more than a couple of days’ journey home, and a very short amount of time that will go very quickly.

On your gap year, you’re surrounded by a big organisation who can help you to come home if you do want to – you’re supported out there – things like changes to plane tickets and help with getting to airports will be there for you, if you really need it.

Most people feel homesick, scared or anxious at some point, but hardly anyone gives up, and you’re unlikely to either. Talk about it openly – you’ll certainly find there are others who share your feelings and it’ll help you feel that you’re not on your own, you’re part of something special – taking some time out to do something worthwhile and wonderful.

On your return:

Keep taking your malaria medication, and complete any courses of drugs prescribed to you while away. If you start to feel ill and go to hospital or see a doctor be sure to mention that you’ve been away, where you’ve been and what you’ve done.

Give yourself time to adjust to living back in the UK – reverse culture shock can be just as common as the usual kind! Allow some time for your emotions, so you can get your head around the fact that you’re not saving turtle babies or teaching a crowd of kids or living in the rainforest now – you’re back home, and it’s time to move on…