Food in the village or building site is generally simple and will consist of Dal-Bhat (dhal and rice with vegetables). If you have special needs such as diabetic or vegetarian requirements then please make this known to your Team Leader so that provisions can be made to assure your needs are meet.
The water provided is mineral water. Try not to swallow any water while taking a shower or swimming. The fruits and vegetables we serve you are peeled, thoroughly cooked or washed with filtered water.
Do not buy fruit off the streets unless you can peel or wash in iodized water before eating.
We will provide mineral water bottle to you everyday. The water can be kept at the work site. Please feel free to collect the water bottles from Hosting coordinator/Administrator everyday, or appoint somebody from your group as water in-charge. Please ensure that you drink only bottled water. It is a good idea to carry a small plastic bottle with you while in country. Drinking the local tap water is not wise!
Some basic rules:
- Fruits should be washed with purified water of peeled before eaten
- Beware of ice-cream that is being sold on the streets
- Take care with fruit juice if you suspect water may have been added
- Milk should be well boiled or pasteurized
- Tea and coffee should be okay since the water has been boiled
- Eat curd (Nepali yogurt) with most meals. This soothes the stomach and the risk of getting diarrhea
The rest of the information is from the CDC or WHO. Your team leaders cannot recommend any immunizations or medications, but we can encourage you to seek the advice of a travel medical clinic. To find a location of one near you, go to www.cdc.gov/travel/contentTravelClinics and click on your state.
Before visiting Nepal, you may need to get the following vaccinations and medications for vaccine-preventable diseases and other diseases you might be at risk for at your destination: (Note: Your doctor or health-care provider will determine what you will need, depending on factors such as your health and immunization history, areas of the country you will be visiting, and planned activities.)
To have the most benefit, see a health-care provider at least 4–6 weeks before your trip to allow time for your vaccines to take effect and to start taking medicine to prevent malaria, if you need it.
Even if you have less than 4 weeks before you leave, you should still see a health-care provider for needed vaccines, anti-malaria drugs and other medications and information about how to protect yourself from illness and injury while traveling.
CDC recommends that you see a health-care provider who specializes in Travel Medicine. If you have a medical condition, you should also share your travel plans with any doctors you are currently seeing for other medical reasons.
If your travel plans will take you to more than one country during a single trip, be sure to let your health-care provider know so that you can receive the appropriate vaccinations and information for all of your destinations. Long-term travelers, such as those who plan to work or study abroad, may also need additional vaccinations as required by their employer or school.
Although yellow fever is not a disease risk in Nepal, the government requires travelers arriving from countries where yellow fever is present to present proof of yellow fever vaccination. If you will be traveling to one of these countries where yellow fever is present before arriving in Nepal, this requirement must be taken into consideration.
Be sure your routine vaccinations are up-to-date.
Routine vaccines, as they are often called, such as for influenza, chickenpox (or varicella), polio, measles/mumps/rubella (MMR), and diphtheria/pertussis/tetanus (DPT) are given at all stages of life.
Routine vaccines are recommended even if you do not travel. Although childhood diseases, such as measles, rarely occur in the United States, they are still common in many parts of the world. A traveler who is not vaccinated would be at risk for infection.
Recommendations or Requirements for Vaccine-Preventable Diseases
Routine
Recommended if you are not up-to-date with routine shots such as, measles/mumps/rubella (MMR) vaccine, diphtheria/pertussis/tetanus (DPT) vaccine, etc.
Hepatitis A or immune globulin (IG)
Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors.
Hepatitis B
Recommended for all unvaccinated persons traveling to or working in countries with intermediate to high levels of endemic HBV transmission and who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment, such as for an accident, and for all adults requesting protection from HBV infection.
Typhoid
Recommended for all unvaccinated people traveling to or working in South Asia, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water.
Rabies
Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, hiking, or work. Also, children are considered at higher risk because they tend to play with animals and may not report bites.
Japanese encephalitis
Recommended if you plan to visit rural farming areas and under special circumstances, such as a known outbreak of Japanese encephalitis
Polio
Recommended for adult travelers who have received a primary series with either inactivated poliovirus vaccine (IPV) or oral polio vaccine (OPV). They should receive another dose of IPV before departure.
Malaria
We are going to working and living in the Jhapa region. According to information from the World Health Organization (WHO), the districts of Jhapa, Morang and Ilam in East region, Dhanusha, Mahottari, Sindhuli and Kabhre in Central region, Nawalparasi in West region, Bardia in Mid-west region and, Kailali, Kanchanpur and Dandeldhura in Far-west region (see Map below) are the most affected districts where malaria transmission is high. The total population of these districts are around 6 million ( 34%) and contributing around 90% of the total confirmed malaria cases in the country. We are, however, going to be there in the fall when it is the driest. As to whether there is still a malaria threat will be determined by your travel doctor.
Drugs to Prevent Malaria (antimalarial drugs)
If you take an antimalarial drug in Nepal, you will need to take one of the following: atovaquone/proguanil, doxycycline, or mefloquine (primaquine in special circumstances and only after G6PD testing).
Note: Chloroquine is NOT an effective antimalarial drug in Nepal and should not be taken to prevent malaria in this region.Malaria risk area in Nepal: Risk in rural areas at altitudes below 1,200 m (<3,937>
A Special Note about Antimalarial Drugs
You should purchase your antimalarial drugs before travel. Drugs purchased overseas may not be manufactured according to United States standards and may not be effective. They also may be dangerous, contain counterfeit medications or contaminants, or be combinations of drugs that are not safe to use.
Halofantrine (marketed as Halfan) is widely used overseas to treat malaria. CDC recommends that you do NOT use halofantrine because of serious heart-related side effects, including deaths. You should avoid using antimalarial drugs that are not recommended unless you have been diagnosed with life-threatening malaria and no other options are immediately available.
More Information About Malaria
Malaria is always a serious disease and may be a deadly illness. Humans get malaria from the bite of a mosquito infected with the parasite. Prevent this serious disease by seeing your health-care provider for a prescription antimalarial drug and by protecting yourself against mosquito bites (see below).
Travelers to malaria risk-areas in Nepal, including infants, children, and former residents of Nepal, should take one of the following antimalarial drugs listed above.
Symptoms
Malaria symptoms may include
fever
chills
sweats
headache
body aches
nausea and vomiting
fatigue
Malaria symptoms will occur at least 7 to 9 days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, you should see a doctor right away if you develop a fever during your trip.
Malaria may cause anemia and jaundice. Malaria infections with Plasmodium falciparum, if not promptly treated, may cause kidney failure, coma, and death. Despite using the protective measures outlined above, travelers may still develop malaria up to a year after returning from a malarious area. You should see a doctor immediately if you develop a fever anytime during the year following your return and tell the physician of your travel.
Items to Bring With You
Medicines you may need:
- The prescription medicines you take every day. Make sure you have enough to last during your trip. Keep them in their original prescription bottles and always in your carry-on luggage. Be sure to follow security guidelines, if the medicines are liquids.
- Antimalarial drugs, if traveling to a malaria-risk area in Nepal and prescribed by your doctor.
- Medicine for diarrhea, usually over-the-counter.
Note: Some drugs available by prescription in the US are illegal in other countries. Check the US Department of State Consular Information Sheets for the country(s) you intend to visit or the embassy or consulate for that country(s). If your medication is not allowed in the country you will be visiting, ask your health-care provider to write a letter on office stationery stating the medication has been prescribed for you.
Other items you may need:
- Sunblock and sunglasses for protection from harmful effects of UV sun rays.
- Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60% alcohol.
To prevent insect/mosquito bites, bring:
- Lightweight long-sleeved shirts, long pants, and a hat to wear outside, whenever possible.
- Flying-insect spray to help clear rooms of mosquitoes. The product should contain a pyrethroid insecticide; these insecticides quickly kill flying insects, including mosquitoes.
- Bed nets treated with permethrin, if you will not be sleeping in an air-conditioned or well-screened room and will be in malaria-risk areas. For use and purchasing information, see Insecticide Treated Bed Nets on the CDC malaria site. Overseas, permethrin or another insecticide, deltamethrin, may be purchased to treat bed nets and clothes
- See other suggested over-the-counter medications and first aid items for a travelers' health kit.
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Indigenous wild polio was present in 2005-2006 in India, Pakistan, and Afghanistan; cases from Bangladesh and Nepal were confirmed in 2005-2006.
Measles occurs in the South Asia region and can be a source of infection for unvaccinated travelers.
Be Careful about Food and Water
Diseases from food and water are the leading cause of illness in travelers. Follow these tips for safe eating and drinking:
- Wash your hands often with soap and water, especially before eating. If soap and water are not available, use an alcohol-based hand gel (with at least 60% alcohol).
- Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles.
- Avoid tap water, fountain drinks, and ice cubes.
- Do not eat food purchased from street vendors.
- Make sure food is fully cooked.
- Avoid dairy products, unless you know they have been pasteurized.
Diseases from food and water often cause vomiting and diarrhea. Make sure to bring diarrhea medicine with you so that you can treat mild cases yourself.
Prevent Altitude Illness and Sunburn
If you visit the Himalayan Mountains, ascend gradually to allow time for your body to adjust to the high altitude, which can cause insomnia, headaches, nausea, and altitude illness. If you experience these symptoms descend to a lower altitude and seek medical attention. Untreated altitude illness can be fatal.
Use sunblock rated at least 15 SPF, especially at high altitudes, where the risk of sunburn is greater.
After You Return Home
If you are not feeling well, you should get medical attention and mention that you have recently traveled.
If you have visited a malaria-risk area, continue taking your antimalarial drug for 4 weeks (doxycycline or mefloquine) or seven days (atovaquone/proguanil) after leaving the risk area.
Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the physician your travel history.
Important Note: This document is not a complete medical guide for travelers to this region. Consult with your doctor for specific information related to your needs and your medical history; recommendations may differ for pregnant women, young children, and persons who have chronic medical conditions.
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