Eat your cake and have it too – how to not get sick from food abroad

The devil goes by many names: Delhi belly, Montezuma’s revenge, Pharaoh’s curse, Mummy tummy… Many of us have at least one awkward travel story revolving around uncontrollable bodily fluids, high fevers or stomachs in turmoil. And this is not only due to food poisoning – often just a new type of cuisine is enough to send our systems haywire.

For some reason I have never got sick from food when travelling. Who knows why – I have broken almost every step listed on this post at some point. I guess that just goes to show that no matter the precautions you take, it’s still almost the luck of the draw whether you get sick or not. So, follow these steps, or don’t, but at least  take heed for them and let me know if they’ve worked with you.

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A tasty snack at Khao San Road, Bangkok

Before the trip

Do research.

What kind of foods should you avoid in this particular region? Is your destination famous for cuisine that heavily relies upon something you’re allergic to? (If you’re severely allergic to something, I’d encourage you to carry a card or a slip of paper with you that states in the local language that you’ll pretty much roundhouse kick the bucket if that particular ingredient comes near you.)

Go to a restaurant.

An obvious way to gently acclimatize to a new kind of cuisine: visit a restaurant that serves the food of the region that you’re travelling to. If you’re a nervous traveller that likes to plan ahead, it’s good to have one or two trusted dishes in mind that you can always order if they don’t have an English menu or if you’re unsure what the meal contains. (My personal preference? When in doubt, palak paneer. Ooh, or pad thai.)

Get meds.

I swear on Precosa and/or Relatabs when I travel to less developed countries. Precosa is a yeast-based probiotic, whereas Relatabs contains lactic acid bacteria, but they both serve the same purpose: they settle your stomach even before the storm. When you take them throughout your trip (or for the first weeks, if you’re in it for the long run), they balance your system so that foreign food gets digested better. It’s very possible that your country doesn’t sell those specific brands, but any pharmacy should stock up on something similar.

Other great products to pack are re-hydration tablets (very good to have if you’re dehydrated!) and Imodium, which basically plugs you up in case you’re about to board a 24-hour bus over bumpy mountain roads but you’re still hugging the porcelain throne the night before. However, Imodium doesn’t really cure you but only offers a temporary relief, so it shouldn’t be used as treatment.

Medicine in third-world countries is usually cheaper and more easily available (read: you can purchase prescription meds over the counter), but if you’re thinking of filling up your first-aid kit at your destination, think again. It always pays to be prepared and when it’s 2 a.m. and you’re vomiting your guts out, there’s no crawling to the pharmacy.

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The street food market in Copenhagen, Denmark
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The mohingar that cost me about 80 cents in Bagan, Myanmar

During the trip

Eat yoghurt.

Yoghurt is usually a safe, healthy way of accustoming your system to the local bacteria and is one of the best ways to introduce it to your body. (And it’s delicious! Yoghurt 4ever!)

Ask for recommendations.

This is possibly your best bet when you arrive at your destination. Ask your hostel, a local friend or other travellers for recommendations on places they’ve eaten at before. You can also consult your guide book – Lonely Planet especially often lists some fantastic restaurants, although as a downside their prices are often higher than quoted in the book due to the success that the very same book has brought the restaurant.

 

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A whole lotta spicy mango salad as seen in Siem Reap, Cambodia

Follow the crowd.

Even Wikihow tells you to avoid street food – shame on them! Street food can be a cheap, delicious, local experience and should not be avoided. However, street food can eff you up, so watch where others are going. If a restaurant or a food stall is completely devoid of customers, there is bound to be a reason why no one wants to eat there. Many will recommend that you go where locals go and avoid the wrong kind of crowds – that is, tourists and backpackers alike -, but I personally tend to look for a mixture of locals and tourists. Local diners usually ensure the authenticity of the food, while seeing other Westerners indicates to me that 1) the food can be catered to tourists and is not so spicy that it would set my hair on fire; and 2) other tourists deemed the place clean enough, so I might as well.

 

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Coconut shells, the best kind of sundae bowls. The night market in Phnom Penh, Cambodia. Thanks Ben’s hands for being such fab models
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We did order swallows but I was not expecting whole freaking birds! Phu Quoc Island, Vietnam

Watch out for water and dairy.

Drinking bad water is probably one of the biggest reasons travellers get upset stomachs. If you’re travelling in a country where tap water is not safe to drink, avoid it at all costs and only drink bottled water. (You could also purify the water with iodide pills or a filter, but those might be a burden to carry around and while they are extremely effective, they don’t necessarily weed out all the impurities, including cholera.) When you buy a bottle, make sure that the lid is sealed – some people will try to sell bottles re-filled with tap water. Of course there are also ways of making the lid look like it’s sealed, so you might still end up drawing the short straw.

However, don’t try to be a weirdo and not drink water at all. In hot climates you need to stay hydrated, and even more so if you’re suffering form travellers’ diarrhoea.

While in India, Ben fell incredibly sick just a few days into the trip while I felt fine, despite the fact that we had shared all our food so far. The only explanation we could find was that he accidentally brushed his teeth with tap water a couple of nights. While I habitually used the tap water to brush my teeth in South East Asia, I made sure I never swallowed it, and in places like India where the water supply might be tarnished with diseases like cholera, I would not recommend doing that.

Another things to watch out for are ice cubes (often made from tap water) and vegetables and fruit (often rinsed under tap water). While I’d agree that ice cubes can be bad, don’t try to steer completely clear off all the delicious exotic fruits that you can get so cheaply from the street vendors! However, it’s best to buy your own fruit and take it to the hostel with you than buy those pre-peeled pieces of fruit that have been sitting there since Charlie Chaplin could grow a moustache.

Many sources also advice that you’d avoid dairy-based products such as ice cream, but as a great aficionado of ice cream I have broken this rule damn many times.

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*Homer Simpson voice* Mmm, tarantula… Siem Reap, Cambodia
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Hoi An has probably the best street food in Vietnam

Make a health checklist

Some things to pay attention to:

– Is the stall or restaurant constantly busy? A crowd, as I already mentioned, is a good sign. In addition, if the business is blooming, it means that they need to be constantly cooking new food.

– Are they cooking food as they go or is it just sitting there? If you can, try to always get your food straight out of the grill / fryer / whatever. Food that’s just been sitting there in (possible) summer heat is more likely to be bad.

– Does the kitchen or the dining hall look dirty? Obviously a dirty kitchen is a clear warning sign. If you’re unsure about the sanity of a place, some restaurant will let you peek into the kitchen, However, this can be considered rude and will definitely grant you some weird looks from your fellow eaters.

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Ah yes, my favourite kind of lunch. Cham Islands, Vietnam

Sanitize.

Wash your hands with soap, try not to eat with dirty fingers and carry hand-sanitizer. Personally though, I’ve never been big on using hand sanitizer unless I really need to. In fact, it can weaken your immune system if used too frequently and counter-productively make you more vulnerable to bad bacteria. You know what they say about kids who eat sand…

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An Indian sweets (?) shop in Jaisalmer

After the trip

Treat anything you might’ve picked up.

Sometimes despite your best efforts, you end up bringing home a nasty souvenir lurking in your system. In that case a visit to a doctor’s is in place. In some cases you might even have to get a certificate saying that you’ve been sick with something and that you’ve been treated for it; salmonella is one of these if you work in a restaurant.

Bring the new cuisine to your kitchen.

To end in a slightly happier note – now’s your time to try making the foods that you’ve been sampling all throughout your trip. Try not to give yourself a food poisoning 😉

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Potato curry and deep fried sugar for breakfast, anyone? Varanasi, India (Ben’s hands are seriously in all my food pictures, why is that)
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Fresh pulpo (octopus) at a food festival in Barcelona, Spain

Now, this is where I leave you: even if you do everything right, it is possible that you catch some unsavoury bug and end up crawling on all fours on that filthy bathroom floor somewhere in the Badlands of Backpackistan. Even if at the time it might feel like you’re dying (or you rather would do just that), eventually those moments will turn into stories that you can tell with a pint and a laugh at your local pub. The best advice I can give you is: practice caution, but if there’s something you desperately want to try, eat whatever the hell you please.

Oh, and hey – it’s always possible that your good ole food poisoning turns into something more serious, so if your symptoms point that way, head right over to a doctor’s. That’s why we have travel insurance.

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Selling bread at the Borough Market in London

Have you ever got sick from food on a trip? Have you got any tips on how to avoid that?


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