Health & Safety

Due to the high altitude, semi-arid climate, and a plethora of very remote destinations, traveling in Tibet presents a unique set of health concerns. Malaria and odd strains of para-typhoid are of no concern here, but you should definitely take precautions to cope with the high altitude and coincident exposure to sun. We recommend you visit your doctor or health-care provider well in advance of your departure date to get the most up to date health information. Many cities have designated travel clinics that specialize in vaccinations and provide travel-related health information. Your health-care provider will prescribe the appropriate vaccines and medications depending on your health and immunization history, regions you will be visiting, and your planned activities. To ensure optimal preparation, see a health-care provider at least 4–6 weeks before your departure date. This will allow sufficient time for your vaccines to take effect by the time you leave. Tibet is also called roof of the world and it has totally different environment and geographical formation, although the air is very clean without any pollution but high altitude, dry air and intensive solar radiation are some factors that you need to concern about, below here we have some basic guideline for you to travel healthy and return safely by knowing the reality and learning its preventions;

 

Physical Preparation: Being physically prepared for your trip to Tibet is essential. We recommend you begin a regular exercise program well in advance of your trip, especially if you live at a low elevation. Include some day hikes in your regimen, working up to the maximum suggested number of hours for your intended trek. Wear the gear that you plan to take on your trip, so you know you will be comfortable in it. In particular, break in any new equipment (boots and pack, for example) before you go. Even if you do not plan to go on extended treks, regular exercise will help protect you from altitude sickness.

If you are planning to take more challenging treks, you should have a high level of physical fitness. You should be engaged in regular aerobic exercises - for example, swimming, cycling, running, or hiking while carrying a load on your back. Stamina is a key aspect - both physical and mental. Remember that altitude is a significant factor, and a slow but steady pace is the best way to endure in the mountains.

 

Travel Insurance: As per to the Chinese policy, all the travel companies are compulsory to buy obligation insurance for the clients, so we have basic business liability insurance. However, it will be wise for you to obtain your own travel insurance from your home country that may cover trip interruption, flight cancellation, emergency medical evacuation, and medical expenses, etc. In case of a medical emergency in remote places of Tibet, you will most likely be taken to the nearest medical facilities or airport by a car, where you can catch the next flight to a better equipped hospital in Mainland China. If your travel insurance company is not able to send you a rescue helicopter, you want to make sure that you can at least receive reimbursement for all your expenses.

If you are not so sure from where you should buy your travel insurance then World Nomads Global Travel Insurance is a trustworthy by covering residents of over 150 countries, with high levels of medical and evacuation cover, 24-hour emergency assistance and cover for a large range of adventure activities. You can buy WorldNomads.com policies online 24/7, from anywhere in the world, even if you’re already traveling. As plans often change when abroad, you can also extend your policy and even claim online. World Nomads is one of the first choice for many world’s leading travel brands such as Lonely Planet and Nat Geo Adventure.

 

Safety Concerns: In terms of safety issues such as loosing your passport or getting into trouble with the law, you may want to consider registering with your embassy or consulate before coming to Tibet. For example, The US Consulate in Chengduprovides good safety tips, advice, and additional links such as the Department of State International Travel Information Site. Be sure to make copies of all the important documents: passport, health insurance card, credit, and money order receipts, etc. and leave one copy with a family or trusted friend.

 

Jet lag: it is combination of fatigue and other symptoms caused by traveling across several time zones. It results from the body's internal rhythms being out of step with the day-night cycle at the destination. Melatonin is a pineal hormone that plays a central part in regulating bodily rhythms and has been used as a drug to re-align them with the outside world. Melatonin have not been tested nor approved by official agencies such as the United States Food and Drug Administration. Few studies have tested the use of melatonin for jet lag and have given mixed results, occasional short-term use appears to be safe, but please consult a doctor for the use of the Hormone. Other important ways to minimize the jet lag are avoid alcoholic beverage and caffeine in the flight which disrupt your sleeping schedule, so drink plenty of water and sleep as much as you can, then when you arrive in Tibet, adapt to the local time and eat accordingly. Also, exposure to sunlight during the day is helpful to alleviate the jet lag.

 

High Altitude Sickness (AMS):

Average altitude in Tibet is 4000m, its geological features and rich culture and tradition attracts travelers from every where, more and more visitors are longing to travel to the mysterious highland. Meanwhile, they are worried about the altitude sickness. Experts advised that tourists to Tibet should have a scientific and better understanding of the illness to prevent and challenge with it. All our trips are designed by arranging few days of acclimatiion in Lhasa in the beginning of the tour and then slowly increase their altitude tolerance, though there are several antidotes available to buy from local shops like herbal tea or Rhodiola drink, but it only works for some people, may not help some times, so it is strongly advised you to consult a travel clinic before you leave and come prepared with your own remedies.

 

Causes of Altitude Sickness(AMS):

Altitude sickness, also known as acute mountain sickness (AMS), is a pathological effect of high altitude on humans, caused by acute exposure to low air pressure (usually outdoors at high altitudes). It usually occurs 3,000 meters above sea level.
 
Cold, high fever and extreme fatigue all could lead to altitude sickness.
 
The rates of acute altitude sickness 3,000 m, 3,700 m, 3,900 m, 4,520 m and 5200m above sea level are 40 percent, 57.3 percent, 63.8 percent, 89.24 percent and 100 percent, according to a survey. However, experts point out that human bodies have a very magic capability of acclimation. In China, as breakthroughs have been made in the causes and treatment of altitude sickness, the cure rate of the two most common acute altitude sickness -- high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE) -- have reached 99 percent. Therefore, altitude sickness is not that scary. Altitude sickness is divided into acute and chronic altitude sickness according to the length of the time a person stays on highlands.
 
Acute altitude sickness refers to the illness that happens on the spot or within the following days after the person arrives on a highland or goes to areas with a higher altitude. The symptoms include low-oxygen symptoms like ache, dizziness, palpitations, lack of strength, nausea and vomiting.
 
Clinical symptoms include acute altitude reaction, acute high altitude pulmonary edema and high altitude cerebral edema. HAPE and HACE can exist simultaneously.
 

Acute altitude reaction usually occurs within hours or days after a person goes up to a highland above 3,000 meters above sea level from a region with a lower altitude. The symptoms include headache, dizziness, nausea, vomiting, palpitations, shortness of breath, lack of strength and appetite, sleeping problems, peripheral edema and oliguria. The symptoms can be reduced or gone after a person takes a rest or receives proper treatment.

 

Prevention of Altitude Sickness (AMS):

To prevent the occurrence of altitude sickness, visitors should have a proper rest and avoid strenuous activities days before you get into Tibet. After getting off the plane, you should try not to carry heavy things or run and avoid outdoor activities.

Nifedipinum, Nuodikang Capsule and Suoluomabao Capsule (also known as Hongjingtian Capsule) may help some people prevent the occurrence of altitude sickness when they are taken three days before arrive in a highland.

 

Who should avoid traveling into high altitude places?

Visitors with a severe cold, a high fever, acute or chronic pulmonary diseases, severe cardiovascular diseases and long pregnant women and kids under three years old should avoid traveling to regions with a high altitude.

 

Treatment of Altitude Sickness(AMS):

Proper rest and taking in oxygen can both help relieve altitude sickness. If a patient does not show any sign of improvements after three to four hours, he/she should go to a hospital for treatment.

 

Sunburns

Tibet is well known for its rich culture and tradition, peculiar geographical formation and friendly people. Moreover breath taking views of natural lakes and mighty peaks under the sunny blue sky is one of the “Dream holiday” destinations. A little bit of precaution can help that perfect plateau holiday from turning into a sunburned and uncomfortable week of redness.
 

Cause of Sunburns

The main cause of sunburns is not the sun itself but the ultraviolet energy. Just to complicate matters, there are three main types of ultraviolet (UV) energy, designated A, B and C. Erythema is what your skin gets after a day in the sun, which is redness, some slight swelling and pain. Doses of UV energy and its effect on the skin are measured in units called minimal erythema doses (MED). This MED represents the smallest doses of UV energy to cause that “sunburn” appearance.
 

Explorers are typically exposed both UVB and UVA. Almost all of UVC is absorbed by the Earth’s atmosphere. There is increasing evidence that shows both UVA and UVB can be harmful to human skin and both can cause skin cancers.

 

UVA rays penetrate the skin more deeply and are largely the cause of aged skin and wrinkles. UVB is generally responsible for most “sunburn” effects and has traditionally been thought of as the cause of most skin cancers. Ideally, All our clients are highly advised to make sure protecting themselves with a sunscreen that blocks both UVA and UVB.

 

How to choose a Sunscreens

Sun protection factor (SPF) is the ability of a sunscreen to protect skin from ultraviolet induced erythemas (sunburn). This SPF number is calculated based on the length of time it takes to cause one MED in protected versus non-protected skin. Basically, SPF is the amount of time it takes to causes a sunburn in someone with sunscreen protection versus someone who is unprotected. At present, most sunscreens protect largely against UVB only, although there are some products that are beginning to protect against both UVA and UVB. 

SPF:

% UVB absorption

2

50.0

4

75.0

8

87.5

15

93.3

30

96.7

50

98.0

Clearly, one can see that UVB protection increases with the higher SPF and use of SPF 30 is becoming more and more advised.

 

What is in the sunscreen?

The ideal sunscreen spread onto your skin easy, does not cause allergy, pimples and does not stain clothing. PABA (para-aminobenzoic acid) is the most common cause of sunscreen dermatitis and effects 4% of people. Creams and lotions spread on the skin well. Oils spread very easily but may cause pimples. For extreme conditions a wax or ointment will help resist skin chapping. Aerosols are often wasteful and leave parts of the skin over coated and others under protected due to difficulty in ensuring even spray.

 

How to Apply Sunscreen

Apply liberally to all areas of exposed skin including backs of hands, ears, nose and neck.

Sun protective clothing
Clothing that has been tested and proven to block the UV energy is designated by the term Ultraviolet protection factor (UPF) which is identical to SPF for sunscreen.
 
The tightness of the fabric’s weave is most important in determining how effective it will be in blocking UV energy. A good example of this is Lycra which can block nearly 100% of UVR when relaxed but only 2% when stretched tight. A typical white cotton t-shirt has a UPF of about 5-9.
 

Wide brimmed hats are especially good for protecting the face, head and ears. Sunglasses should be labeled to protect against UV energy and side shields do work in decreasing the amount of UV absorbed by the eyes.

 

Treating a Sunburn

Sunburns are largely self-limiting and will typically resolve on their own. Treatment is largely centered on relieving symptoms. Skin moisturizers and cool compress or cool water baths may help decrease the pain. There is little evidence to suggest tradition treatments such as baking soda, aloe and oatmeal are effective pain relief but there is also a lack of decent studies. Oral pain control can be achieved with either aspirin, acetaminophen or ibuprofen. After a day in the sun, dehydration is also a factor and adequate water intake should also be assured.

 

Diarrhea (Source from WebMD)

Home treatment for Diarrhea

Adults: Make sure you do not become dehydrated if you have diarrhea. Drink plenty of fluids.

Ø         The type of drink is not as important as simply replenishing lost water. But avoid milk. It will make diarrhea worse. Diet soft drinks do not provide the calories that dehydrated people may need, so regular soda or soft drinks may be selected to replace lost water.

 

Ø         Try to eat. The food does not need to be bland, but try to avoid greasy or fatty foods. Infants and children should be encouraged to eat bananas, rice, applesauce, and toast -- called the BRAT(Banana, Rice, Applesauce and Toast) diet -- a combination used for decades to treat diarrhea. If diarrhea is accompanied by nausea, suck on ice chips until the nausea stops. After the diarrhea stops, avoid alcoholic beverages and spicy foods for two more days.

 

Ø         Continue your usual activities if you are mildly ill with diarrhea but avoid strenuous exercise until you feel better because it increases the risk of dehydration.

 

Children: Dehydration is also a concern.

Ø         Very young infants pose special problems because of their increased risk of dehydration. They should be offered a bottle frequently. Solutions such as Pedialyte may be more appealing than water. These fluids also contain necessary salts lost with diarrhea. But avoid salt tablets. They may worsen diarrhea and should never be used.

 

Ø         Children with frequent stools, fever, or vomiting should stay home from school and daycare until these symptoms go away. In addition to allowing the child to rest and recover, this also helps prevent other children from becoming ill.

 

Medical Treatment for Diarrhea

To replace fluids, the health care provider will often start an intravenous line if you are dehydrated from diarrhea and cannot eat or drink. Salt solutions flow through the intravenous line, which replaces the lost fluids and often brings quick relief.

 

Because viruses cause most cases of diarrhea, antibiotics will not work. Even the more severe diarrhea caused by bacteria will usually go away in a few days even without antibiotics. In fact, antibiotics appear to make some bacterial diarrhea worse, specifically those caused by the E. coli bacterium (often a source of food poisoning).

 

Ø         Antibiotics may benefit some adults with diarrhea. If selected carefully, antibiotics may decrease the severity of illness and shorten the duration of symptoms. If you have recently traveled out of the country or have been camping (and may have been exposed to contaminated water in the wilderness), your health care provider may prescribe specific medication used to treat traveler's diarrhea or certain intestinal parasites.

 

Ø         Your provider may recommend using over-the-counter antidiarrheal medication. These drugs, such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol) may help some people with diarrhea, but should be avoided by others. Antidiarrheal drugs are not usually recommended for infants and children with diarrhea.

 

Ø         If you have severe diarrhea, especially if you are dehydrated, you may require hospitalization to receive intravenous fluids and to be observed.

 
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