Your Health

The Indian health system is an experience that most travellers will want to forgo. Here's some advice on what to expect, keeping healthy on the road, making a pincushion out of your arm, and preparing your medicine cabinet.

Cleanliness

Someone once said that Cleanliness is next to Godliness. We wouldn’t take it that far, but keeping scrubbed is important while on the road. Guesthouses and hotels have showers – though sometimes they masquerade as the Indian style tap and bucket of hot water. It’s tougher to keep clean when camping, thanks to the dusty roads and the glacial water – hardly conducive to that leisurely, after ride soak. Fear not though. We’ve selected camp spots next to fresh water whenever possible, so we’ll be sure of at least a face wash and modest body sluice.

Try and give T-shirts, underwear and cycling chamois a regular rinse to keep fungi at bay – they’ll dry like crisps within minutes in the sun. On the plus side, you’ll find that you sweat very little as the air is very dry at high altitude. We recommend using a biodegradable soap, such as Dr Bronner’s 18-in-1 liquid soap (www.21stcenturyhealth.co.uk) or Lifeventure’s Concentrated Soaps (www.lifeventure.co.uk), so as not to pollute the waters.

Most importantly, keep your hands clean and away from the mouth and eyes, especially after you’ve been handling well-thumbed Indian rupee bills – the perfect excuse to ditch that nail biting habit!

Water Purification

Bottled water is available throughout the Himalaya. But to cut back on the enormous environmental impact of unrecycled plastics, we strongly recommend purifying your own. After all, if 6 people buy 6 bottles a day, that would be well over 750 bottles in a trip...

Always start with the cleanest possible water source – fresh mountain streams and glacial meltwater is best. In villages, locals often distinguish between what is and what isn’t drinking water - so ask - and then purify. Purification can be done by bringing water to a boil, adding chemicals such as iodine or chlorine (e.g. Lifesystems Iodine Tablets, www.lifesystems.co.uk), or using a water filter. We recommend a combination of iodine tablets/drops for purifying large amounts of water and a water bottle with built in filter, such as Aquapure’s Traveller (www.aquapuretraveller.com) or Katadyn’s Bottle (www.katadyn.com) for on-the-bike convenience. Please bring enough iodine or chlorine tabs to purify 7 litres a day (about 150 tablets). The kind that work in 15-30 minutes are far better than waiting around for the 2 hour variety. We will be bringing a Katadyn Pocket Microfilter (the best in the business) and boiling water when cooking during the evenings.

Some guesthouses are becoming more aware of the effects of plastic waste and offer to fill your bottles with pressure boiled water – also available for a small charge at Dzoma’s shop in Leh.

Toilet Habits

Welcome to the extraordinary World of Indian Toilets. Shitters (pardon the language) range from full-flushing extravaganzas to eco-friendly Ladhaki long drops where dirt is shovelled down the abyss. In between, there's the Indian take on western toilets (a built in jet wash helps clean you up, but beware of its sputtery pressure) and basic squat loos. Just to confuse things, schitzo loos are shaped in the western style, with the added bonus of foot platforms on the seat. Make sure you don’t slip in your cleats!

On the whole, Indians don’t use toilet paper. Instead, they make use of a low tap, a small bucket, the left hand, and…we’ll let you imagine the rest. It's actually a very clean way of doing things - if you chose to ‘go local’, keep a bar of soap handy. Toilet paper is available everywhere but the toilets themselves aren’t designed to handle it, so put your t.p. in the bin provided. While camping, we’ll make sure the camp toilet is well away from clean water. Please make use of the trowel to bury the waste and burn your t.p.

We provide a welcome pack with a few bits and bobs to get you started – toilet roll, lighter (to burn it), and hand sanitizer gel. The gel is useful for cleaning hands before snacks and lunches while on the road when there’s no tap and soap to hand.

Vaccinations

Speak to your doctor well before you intend to travel as some jabs are most effective when taken in courses - the first and booster shots are often 4-6 weeks apart. Travel clinics such as Trailfinders (www.trailfinders.com/clinic.htm) will also do vaccinations, and list these jabs for travelling to India:

• typhoid
• diphtheria
• tetanus
• polio
• hepatitis A
• advice on malaria pills given in person

As we are only briefly in Delhi where malaria is very uncommon, and spend the rest of our time above 2000m where the strain rarely survives, we don't take malaria tablets ourselves. But please be sure to consult your GP or a travel clinic before making your own decision - especially if you intend to stay on in India after the trip or take day trips out of the capital. We do recommend bringing a strong mosquito repellent and taking precautions not to be bitten, such as covering up at dawn and dusk.

www.masta.org is a very useful travel health site with details on jabs and other medical matters.

Medicine kit

These are the necessities for your personal medicine kit, also listed in the Kit List. Bring any special medication from home and ask your doctor to prescribe antibiotics. Most medicines and natural remedies are available over the counter at pharmacies in Delhi, Manali and Leh (for a fraction of the cost in the UK)– but don’t rely on them in case they’re out of stock.

Antibiotics. See your doctor for advice. We recommend bringing a course of broad-spectrum antibiotic such as amoxicillin for infections and a course of antibiotics for treating diarrhoea – we’ve used ciproflaxin or metronidazole (travellers have also suggested Tinidazole and Norflaxin) Talk to your doctor beforehand and ensure you know the side effects, dosages and directions for the drugs, and whether you have any allergies.

Suncream SPF 30+. High altitude sunrays will fry your skin. Bring at least factor 30 for the body and if you’re fair, 60+ for the face does the trick. Supplies can be hard to find and expensive in India, so bring enough for the entire trip – a 250ml bottle should do.

Lip balm with SPF 15+. Keeps chapped lips at bay and protects lips from sunburn.

Moisturiser. The dry air, sun and wind rob moisture from the skin, especially the face. You don’t want to end up all wrinkly after just a few weeks in the Himalayas! Aloe vera based lotions work well and help ease sunburn.

General painkiller. Paracetamol works well at treating mild pain and fever.

Imodium. Used for emergency relief of diorrhea, but should not be taken lightly.

Oral rehydration powder. Better than water at replacing electrolytes after a hot day’s ride, or a bout of sickness. A must bring item – at least 12 sachets. The powder should always be dissolved in clean, purified water.

Insect repellent. Products with at least 30% Deet content are most effective, but harder on the skin. There are gentler alternatives such as Boots Repel Natural Insect Spray.

Antiseptic. Choose either a Cream/liquid (eg Dettol), Betadine drops (very effective), or for a natural antiseptic/antifungal - tea tree oil.

Bandages/Plasters. Bring a small selection of bandages for larger cuts and plasters for minor scratches.

Scissors and tweezers. For preening...

Cold and flu tablets, throat lozenges, nasal decongestant. The dry air tends to aggravate throats and the dust can bring on allergies and sniffles.

Multi-vitamins. Helps fill the gaps in your diet and keep the body strong. Extra vitamin C boosts immunity to colds and has been shown to work well in chilly environments.

Contact lenses and glasses. Bring out all the solution you’ll need, spare lenses and a set of glasses - it can get dusty on the roads.

Girly stuff. Feminine pads and sometimes tampons are available in Delhi, Manali, Shimla and Leh, but you should bring all the supplies you’ll need from home. If you’re on the pill, make sure you bring enough, and do be aware that sickness/diarrhoea can prevent it from working. The body is under different stresses when bike travelling and your cycle (no, not your bike…) may become irregular, so be prepared.

Note that we’ll be bringing a full medical kit including needles, syringes and an assortment of bandages and plasters.

Additional natural remedies

Here are a few more recommended items from the natural cabinet that we’ve found work really well.

Echinacea. Seems to work wonders at warding off coughs and colds, which the dryness in the air can aggravate. Begin taking it daily before travelling and continue throughout the trip. We’ve had trouble finding Echinacea in India - so bring a supply with you.

Glucosamine/Chondroitin. There are some big, big climbs on this trip. If you're prone to knee problems we've found these joint supplements help (as well as correct gear ratios and spinning the cranks in a high cadence) - start taking them 2 months prior to the trip. Available in UK health food shops. Fish oils with Omega 3 are good for keeping those knee joints well lubed.

Lactobacillus acidophilus. This ‘friendly bacteria’ seems to help keep bad stomach karma at bay by replacing the good bacteria in your gut, especially useful after a course of antibiotics. Pills are available in UK health food shops or in India as a convenient sachet that mixes up into a fruit-flavoured drink. Delicious!

Gingko Biloba. We’ve had good feedback from cyclists arriving at high altitude who've taken Ginkgo Biloba a week before departure. This natural supplement has shown to increase blood flow, which may help acclimatisation, amongst other things (nod nod, wink wink…). Please see Acclimatisation in The Region section for more information on dealing with altitude.

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