Adolescence and pre-adolescence is a time when the body goes through many changes. It’s a normal part of development for young people to become more aware of their body and compare themselves to others and therefore, it’s important that the tween and teen years lay the foundation for good physical and mental health. Tomorrow, International SOS Beijing Clinic will hold a free event for parents on how to help adolescents develop a healthy body image. Dr. Stella Chan Marinaro will provide nutrition tips for both active and less active teens, will discuss common unhealthy eating habits, eating disorders, and how to help a loved one with an eating disorder.

For more information on eating disorders, we visited The National Eating Disorders Association’s (NEDA) website, an online resource that supports individuals and families affected by eating disorders and serves as a catalyst for prevention and cures. This website offers a parent toolkit for anyone who wishes to understand more about how to support a friend or a family member with an eating disorder. The toolkit also has information about signs to look out for, medical consequences, and information on treatment as well as questions to ask when choosing a treatment provider.

Photo: Pixababy

In March, International SOS Beijing Clinic began a three month-long series of “Parentcraft Classes” which focus on providing parents and parents to be with a better understanding of their baby or toddler. Classes are held by SOS’ team of family physicians, general practitioners, and gynecologists. Family Physician and Child Specialist Dr. Stephanie Teoh will be holding the majority of the classes in April.

"Parents attending the sessions will come away with strategies and know-how on how to deal with challenging developmental stages in young children. This ranges from birth preparation and sleep issues to common toddler behavioral issues," says Dr. Teoh.

See below for a description of the classes.

Nutrition for Babies and Moms
When: Thursday, April
Topics to be covered: Breastfeeding and formula, nutrition guidelines for babies and older children, age appropriate solids, pregnant and new mom’s nutrition, food and mood
Presenting doctor: Stella Chan Marinaro


Sleeping Basics for Babies and Young Children (age 0-5)
When: Thursday, April 16
Topics to be covered: Settling techniques, how to recognize signs of tiredness, establishing good sleepinghabits, SIDS awareness, sleep issues such as night waking, sleep patterns, and night terrors
Presenting doctor: Dr. Stephanie Teoh

Starting Good Eating Behaviors
When: Thursday, April 23
Topics to be Covered: Food allergies and sensitivities, introducing solids, how to establish good meal time habits, dealing with fussy eaters and tantrums at meal times
Presenting doctor: Dr. Stephanie Teoh

Toddler Taming Part 1 (6-36 months)
When: Thursday, April 30
Topics to be Covered: Positive parenting strategies, Understanding child development and behavioral differences, How to be a “helper” parent

Presenting doctor: Dr. Stephanie Teoh

For more information or to reserve a spot email seminar@internationalsos.com

Photo: Prayitno (flickr)

As we enter day six in the search of the missing Malaysia Airlines flight MH370, International SOS will host a free information session from 10-11.30am tomorrow Friday 14 to deal with the tragedy. If you can’t make it to BJU’s talk this evening, then this is your chance to get valuable advice on how best to help your family cope with disaster.

Here are the details from International SOS’ newsletter:

MH 370 Disappearance: Coping with a Disaster in the Community

On March 8th, Malaysian Airlines flight MH370 originating from Kuala Lumpur, disappeared from radar screens en route to Beijing. An international search and rescue operation continues to search for the missing flight, however the cause of the disappearance remains unclear and there have been no confirmed sightings of any debris so far.

International SOS understands the difficulty in coping with this type of disaster in a community and the impact on family and friends affected by the incident. Dr. Stephen-Claude Hyatt, Head of International SOS Mental Health and Counseling department, will lead a session to discuss how to manage the impact of a traumatic incident like this, the symptoms that might arise, how to deal with it personally and how to take care of others around you, especially children.

Speaker: Dr. Stephen-Claude Hyatt, Head of Mental Health at International SOS, Beijing Clinic
Date: Friday, 14th Mar
Time: 10.00 a.m. – 11.30 a.m.

Location: International SOS Beijing Clinic

Registration: seminar@internationalsos.com

Cost: Complimentary

This evening at 6.30pm, Beijing United Family Hospital will also hold a public forum in its fifth-floor auditorium (Bldg 2). It will include a presentation on how to discuss this issue with children and how adults can cope, as well as a question and answer session.

Click here to read an interview with BJU Clinical Psychologist George He on how to talk to your kids about the tragedy.

Photo courtesy of Wikimedia Commons

Travellers are already setting off on vacation in anticipation of the Year of the Horse, but many medical ailments and accidents can easily be avoided with careful consideration and planning.

Dr. Craig Stark, regional medical director of International SOS North Asia, said, “Travelers can improve the chance of a stress-free holiday by planning ahead and taking some simple health precautions during Chinese New Year holiday period.”

Health Comes First
Before you leave home, make sure you know how your personal health could be affected by your destination. If traveling outside of the country, check the recommended vaccinations for your destination and immunize accordingly. Eat as healthy as you can while on the go and stay hydrated.

This year, Chinese New Year falls during flu season. And parts of Europe and the US have seen an early start to the season. If you haven’t already, it’s not too late to get vaccinated with the flu shot. This is especially important for people in higher-risk groups, such as young children, older adults, pregnant women, or people with underlying medical conditions such as asthma, or heart disease. Consult your physician before you embark on your journey. Practice good personal hygiene and wash your hands frequently.

Be aware of what you eat and drink while travelling. In destinations with a high risk of traveler’s diarrhea. If you are unsure of the safety of the water, use only boiled or bottled water for drinking or brushing teeth. Remember that ice may have been made from contaminated water and therefore may not be safe. Select thoroughly cooked food and consume it while it is fresh and hot.

Accident Awareness
Road accidents are common. If you are driving, make sure to have plenty of sleep before you hit the road. Avoid traveling by car at night and break up longer trips into shorter, more manageable drives.
If you are traveling to unfamiliar destinations or remote areas, be sure to gather information on how to access your assistance services provider in case of an emergency. Take note of any potential security threats and be aware of the common hazards wherever you go.

Be especially vigilant about petty crime. Unsuspecting travellers are often the target of opportunistic crime in the form of pick pocketing and non-violent theft. Watch your items carefully and avoid wearing expensive jewelery when you are out and about.

Plan ahead
Don’t wait until problems arise on your travels. Be proactive before you go by consulting with your travel health professional, especially if you have a chronic health problem. Be sure to bring more prescription medication than you would normally need and always place them in your carry-on luggage and in their original container.
Know your schedule, have access to good maps, learn a few phrases in the local language and research any issues in advance. Also, be sure to follow the news for the area in which you are travelling. It’s a good way to stay on top of local issues that may come up.

Note: At the time of publishing we are not sure if Dr.Craig Stark was still the regional medical director of International SOS North Asia. 

This post has been modified and first appeared on February 8, 2013. The original post appeared in International SOS website. beijingkids was granted permission to repost it.

Photo courtesy of kennymatic (flickr)

While “Movember” may be best known for bringing comical facial hair to offices around the world, it also helps put men’s health onto the agenda for one month out of the year. But only 1 percent of men diagnosed with prostate cancer – the condition that the campaign is centered around – are under the age of 50. So what health issues do men in their 30s and 40s need to think about as they cultivate their novelty moustaches?

No matter how fit you feel (and remember, the marathon world record is held by a 31-year-old), there are certain health risks that men of this age need to be aware of. Some may be a natural part of the aging process but others result from the lifestyle choices you make.

Silent Killers
Two of the potentially deadly conditions most likely to develop at this age emerge without any obvious symptoms. This is part of what makes high blood pressure (also known as hypertension) and high cholesterol – the build-up of lipids that narrow your arteries – such a worry for family doctors.
Although they are two separate conditions, these silent killers are linked, not least because the latter exacerbates the former by making it harder for the heart to push blood through the arteries. Both have similar causes and can ultimately lead to heart attacks, strokes and other severe health complications.
But while men at this age are certainly more likely to develop high cholesterol or blood pressure problems, these conditions cannot simply be dismissed as one of the inevitabilities of getting older, according to Dr. Michael Couturie, a general practitioner at Beijing’s International SOS Clinic.
“There is a significant lifestyle component to both of these problems, which is one of the reasons that men tend to be diagnosed with them in their 30s and 40s,” he says. “Many men start families around these years and are also often trying to develop a career. Thus, in addition to what can often be a lifetime of poor dietary choices, decreasing time for exercise and more time performing sedentary activities can lead to weight gain, decreased cardiovascular conditioning and elevated cholesterol.”
Quitting smoking is at the absolute top of Dr. Couturie’s priority list, and he believes that there is “literally nothing more important for your health.” Not only does smoking increase the amount of “bad” cholesterol (LDL) in your bloodstream, it also actively decreases the amount of “good” cholesterol (HDL), which is believed to carry the harmful LDL away to the liver.
The other usual suspects are all there. Exercising regularly and losing weight (if necessary) can both help, as can reducing alcohol consumption. A healthy, balanced diet low in saturated fats to counteract high cholesterol, with reduced salt and caffeine to maintain healthy blood pressure, is also an effective method of both prevention and treatment.

Making Ch-Ch-Changes
It will come as little surprise to hear that leading a healthier lifestyle is the best way to fight off the emergence of these long-term health risks. Most of us know from an early age that eating properly, exercising regularly and limiting alcohol intake can prevent heart disease – or worse.
But there is a difference between awareness and action.
Men often find it difficult to shrug off feelings of invincibility that often accompany their 20s, especially when issues of genuine concern can feel symptom-less and distant.
Although 34-year-old Kenny Hegarty describes discovering that his cholesterol was higher than expected in his mid-20s as a “wake up call,” it was not until he decided to start a family that he began to make serious lifestyle changes.
“I had been fit in the past but when my partner Kat and I moved to Beijing, there were a lot of opportunities to socialize. In the first couple of years I really enjoyed that aspect of life here,” he explains. “When we decided we wanted to start a family, we made the conscious choice to be fitter and healthier, not just for ourselves but for the sake of good parenting. We wanted to have some good habits for [our child]to pick up on.”
For many new dads, the pressure of adding a child to their responsibilities means that there is even less time to prioritize a healthy lifestyle. But for Hegarty, a teacher at Dulwich College Beijing, his partner’s pregnancy was the beginning of a journey that saw him lose approximately 13kg in a little over a year and a half. His cholesterol is now back within safe limits.
When taking on a high-intensity exercise regime he “actually found certain things easier” than when he was in his 20s because of the weight loss. “I’m in much better shape and feel so much better for it,” he says. “We know Bella is too. She’s 11 months old now and she’s just starting to eat solid food. She’s really enjoying all the fruit and vegetables!”

Beyond Lifestyle
But while Hegarty was able to take matters into his own hands, not all health complaints that surface during your 30s and 40s can be put down to lifestyle alone. Naturally decreasing testosterone is a common problem, for instance; one that may lie behind a lack of motivation to stay in shape, according to Dr. Nizar Al-Salahat, medical director at Puhua International Hospital in Shuangjing.
“Testosterone levels gradually fall as you get older, typically lowering by about 1 percent every year after the age of 30,” he explains. “This can cause weak erections, low sex drive and decreases in muscle strength and mass.
“First of all we need to work out the source of the problem for each patient,” he says. “It could be an ‘acquired’ problem but it could also be congenital, something that you’ve had since birth, like a more complex syndrome for example.”
So while certain lifestyle choices can impact on your hormone levels, testosterone deficiency could be the result of factors beyond your control. That does not mean that there is nothing that can be done after diagnosis, however, and hormone replacement therapy can help when lifestyle changes cannot.
Testicular cancer is another health risk with causes seemingly beyond one’s control. You may be years from reaching high-risk ages for most other cancers, but men in their 30s are especially at risk of being diagnosed with this disease.
Although some sufferers will feel an aching sensation in their lower abdomen, they will rarely experience acute pain. As such, regularly checking one’s testicles for painless lumps and bumps is necessary. But again, while most men are aware of the risk, the evidence suggests that not enough take it seriously. A 2011 study in the US found that 40 percent of men performed self-examination no more than once a year.
There are clearly rare cases where uncontrollable factors take their course, but for the most part your health is in your hands. Taking simple steps to counter silent threats in your 30s and 40s may well mitigate the serious conditions that can follow.

Resources

International SOS 北京国际救援中心
As well as offering a variety of medical services at its Beijing clinic, from counseling to dentistry, International SOS operates a 24/7 alarm center hotline and dedicated air ambulance. Dr. Couturie is a general practitioner and specialist in internal medicine. He gives consultations in English and Spanish.

Daily 9am-6pm, Sat-Sun 9am-6pm. Suite 105, Wing 1, Kunsha Building, 16 Xinyuanli, Chaoyang District (6462 9112, 24hr hotline 6462 9100) www.internationalsos.com 朝阳区新源里16号琨莎中心一座105室

Puhua International Hospital, Shuangjing 普华国际门诊
Puhua International Hospital offers a range of inpatient and outpatient services at its Shuangjing site. As well as being the hospital’s medical director, Dr. Al-Salahat is trained in family health, emergency medicine, orthopedics, trauma surgery and sports medicine. He speaks fluent English and Arabic, with conversational Chinese.

Daily 9am-6pm. 54 Wusheng Beilu, Dongsanhuan, Chaoyang District (8773 5522, 8911 6665) www.puhuaclinic.com 朝阳区东三环武圣北路54号

Beijing Health Portal (www.puhuaclinic.com/bbs)
A new ask-a-doctor service from Puhua International Hospital. Users can leave a health-related question and qualified doctors will try to get back to them within 24 hours, free of charge.

Photos by KEN

This article originally appeared on p22-23 of the beijingkids November 2013 issue.

Check out the PDF version online at Issuu.com

Our area hospitals and clinics often present special coffee talks and doctor presentations for the general community to join – worthwhile topics of discussion that we all benefit from attending. This week there are two on the agenda: one by International SOS on Tuesday (today!) and the other by Beijing United Family Hospital on Wednesday.

Learn about “Managing Family Relationships Abroad” with Dr. Stephen-Claude Hyatt today from 10-11:30am. While expat life can be fulfilling, it can also be challenging – often directly affecting family relationships. Get tips on life balance and maintaining healthy relationships during this event, held at the Beijing International SOS Clinic. Check out other monthly seminar topics on their website, www.clinicsinchina.com.

“Health Concerns for Children in Beijing” will be the topic of choice by Dr. Leila Sabet of BJU on September 26 beginning at 9am. From air quality to diet and stress, learn what we can do to help our children thrive in the Beijing community during this presentation. The BJU talk will be held in the boardroom of the British School of Beijing (Shunyi). No reservations necessary. Other event information can be found on their website, http://beijing.ufh.com.cn.
 

Today, women hold one in five senior management positions globally and make up 45 percent of the corporate travel market. In other words, there are more women traveling for business than every before. However, organizations still have a long way to go when it comes to providing the right travel safety advice to female employees. Areas of concern include sexual and opportunistic crime, managing cultural sensitivities, and understanding local systems and health risks.

In a recent pre-travel training program for women in business, International SOS found that 75 percent of those surveyed felt that their organization should be more prepared to address the specific travel needs of women.

Compared to 2011, International SOS has seen a 20 percent increase in the number of women travelers calling its Assistance Centres for medical and travel security advice, with 751 women calling in the last two months and 400 in June alone.   

With that in mind, here are some health and safety concerns to keep in mind for women traveling abroad:

1. Access to medication which may be in short supply in less-developed or low-income countries

• Make an appointment with your doctor or travel clinic for a basic checkup at least 6-8 weeks before you depart. If you have an ongoing medical condition, ask your doctor about any additional precautions you’ll need to take while away and find out if any vaccinations or health checks are required for your destination.
• Always take a medical kit wherever you go, and consider packing medical items in a personal carry-on bag so it will not be affected if checked luggage is lost or delayed. We’d advise you to carry your medication in its original packaging, and keep copies of your prescription with you.
• Women travelers can be susceptible to urinary infections and thrush, and there can be side effects from certain kinds of malaria tablets. If you think you may be at risk, ask your doctor if you can take some medication with you.

2. Sanitary supplies and contraception

• If you are due for a period while you are away, it would be wise to take sanitary supplies with you as they may be unavailable in some cultures. Alternatively, you may wish to speak to your doctor about continuing your contraception to avoid having a period while away.
• If the issue of contraception comes up, make sure that you plan ahead, discuss contraception with your doctor, and consider packing supplies. If you suffer from diarrhea while away, this can interrupt the absorption of the pill and may leave you unprotected.

3.  Risks to personal safety

• Dress modestly to avoid drawing attention to yourself, avoid wearing expensive jewelery, and respect local clothing customs. If you do receive attention from local men, ignore any propositions or suggestive comments they may make.
• When walking alone in the street, keep your handbag and luggage away from passing traffic. Familiarize yourself with your itinerary, walk purposefully, and avoid using a map in full view. It is also a good idea to separate your credit cards from your cash; if one source is lost or stolen, you still have a backup.
• When driving, roll up windows to within a few inches of the top, park in well-lit areas, and always lock your doors.
• Ensure your hotel room numbers remain confidential. Do not display the room’s key tag in public areas, and stress to the front desk that your room number should not be given out to any inquirers. When checking in, ask the receptionist to write the room number down, rather than tell you within earshot of others.
• Insist that the hotel room has a key chain, deadlock, and spy hole, and that the door and window locks work properly. Never open the door to anyone without taking precautions. If someone claims to be a member of staff, get their name and department and check with reception.

4. Implications for pregnancy while traveling

• If you’re planning to travel while pregnant, be sure to see your doctor well in advance. Make sure your travel health insurance covers pregnancy-related conditions and neonatal care. It’s also worth checking your airline’s rules for pregnant passengers, as some require a letter from your doctor confirming your stage of pregnancy.
• Water quality can vary widely, so only drink boiled or bottled water – and plenty of it – and avoid ice. Avoid any pre-peeled fruit or salad; only eat fruit and vegetables that you’ve peeled and washed yourself.
• Avoid malarial zones, if possible. Even when taking anti-malarial drugs, pregnant women are particularly vulnerable to the illness, which tends to affect them more severely.
• Steer clear of destinations higher than 12,000 feet in altitude, as it’s unknown what effects this may have on an unborn baby.

5. Know your surroundings

• Finding out some information about your destination can be very important, while assumptions can be quite dangerous. Start by finding out which time zone your destination is in early on, so you can start mentally and physically preparing for the adjustment.
• Have you been there before? Do you know where the office is located and what local contacts will be available to support you? If not, speak to colleagues at home and abroad who may be able to provide you with this information.
• Some countries offer female-only hotels, which you may prefer to stay in. When booking your hotel room, keep in mind that floors 3-6 give good security, as they’re far enough away from the lobby area but are still reachable by a fire engine in the event of an emergency.
• Will you be able to review the streets surrounding your hotel and the route to the office in the daylight? An understanding of the basic geography of the city and potential trouble spots may be invaluable, so look up the hotel website and speak to work security experts and people who’ve visited the country before.

These tips are courtesy of International SOS, which offers a number of security measures for women traveling abroad, including an emergency hotline and pediatric services.

Photo by Victor1158 via Flickr

Protecting and maintaining children’s health and well-being is the number one priority on every parent’s list. Childhood immunization is one weapon that helps prevent our children from getting devastating diseases like meningitis, pneumonia and polio. However, navigating the immunization process while living in another country or moving between countries can seem like a daunting process.

Which childhood immunization schedule should you follow? What are the differences between the schedules? What if you want to add something to your home country’s standard schedule? What about special immunizations tailored to life in China? 

Many countries have generally agreed on which childhood immunizations are essential; however, there may be minor differences from country to country. Many times, parents will choose to follow the schedule of their home country and supplement it with other immunizations recommended by organizations like the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC) in the US. 

It’s fair to say that most countries include tetanus, diphtheria, whooping cough (also known as pertussis), haemophilus influenza B (which causes meningitis and a serious disease of the upper airway called epiglottitis) and hepatitis B in their immunization schedules.

This may sound like a lot of needles, but fortunately new combination vaccines (like the 5-in-1 vaccine) are available right here in Beijing. Other standard immunizations cover polio, meningococcal, pneumococcal, measles, mumps and rubella (also known as German measles). The 2011 outbreak of polio in northwest China highlights the importance of keeping up-to-date on vaccinations for kids. Additional vaccines found on some countries’ schedules include BCG (to protect against tuberculosis), chicken pox (varicella) and rotavirus (which causes serious gastroenteritis in young children).

Older kids and teenagers are also included in the vaccination schedule. Having booster shots at the right time is essential for them to stay protected as they get older. There are also several vaccines specially geared towards teens, such as the human papilloma virus (HPV) and meningitis vaccines. The HPV vaccine is recommended around the ages of 12-13 to help protect against cervical cancer in women. The meningitis vaccine is highly recommended for teenagers going off to university – especially for those who will be living in dorms. 

In addition to the standard childhood vaccinations, there are other vaccinations to consider for living and traveling in China. These include hepatitis A, typhoid, rabies, and Japanese encephalitis. Hepatitis A and typhoid fever are serious infections usually transmitted by contaminated food or water, while Japanese encephalitis is carried by mosquitoes and has been found in some areas of Beijing.

Any mammal – including cats, dogs, monkeys and bats – potentially carries rabies, a deadly disease. Since China has many strays, the rabies vaccine is particularly recommended for children and those traveling in rural areas of China. Last but not least, all children and adults should get the Influenza vaccination every year. Kids are particularly vulnerable to infection.

One of the unique challenges of living in Beijing’s expat community is good record-keeping. For families that are often on the move and get vaccinated in different countries, this can be difficult. Using an International Immunization Record book for each of your children will ensure that the right vaccinations are given at the right time. Catching up on immunizations is recommended for kids who might have missed out on some essential vaccines.

There are many questions when it comes to vaccinating children against common childhood and travel-related illnesses. Getting reliable information and discussing your concerns with your doctor is very important. Taking the time to talk about vaccinations with your doctor can help maximize your child’s health and well-being. 

Dr. Lyn Wren is a child specialist and family physician at International SOS. She has a strong interest in women’s health, adolescent health, preventative healthcare and counselling. Dr. Wren is originally from Western Australia and has been living in China for over three years.

Photo by Jeff Lau

Holiday travels peak during festive periods. With the Lunar New Year around the corner, overseas assignees are making their way back to their hometowns to celebrate with their families while leisure travelers are departing for their holiday destinations. Some are also taking advantage of the long holiday to catch up with their loved ones based overseas. With so many travelers on the road, there is an increased chance that plans, schedules, and travels can go awry. 

“When traveling in China or overseas during the Chinese New Year period, it’s important to take adequate precautions and prepare yourself and your family, so as to prevent illness or injury during your holidays,” says Dr. Jon Craig, chief medical officer for International SOS China. “Some travel destinations may expose you to health risks and hazards; you should always seek the advice of a medical practitioner before you travel, to make sure that vaccinations are up to date and medications are in order.”
To help you stay healthy and safe, and to avoid unnecessary travel disruption on the road this year, International SOS advises travelers to look out for the following:

• Prescriptions: Without early preparation, traveling with medication can be an issue. If you rely on a medication to manage an ongoing condition, you must prepare extra supplies and back-up information about your prescription drugs. Physically carry the medication on you while passing through immigration. When travelers in Europe were grounded for days because of the ash cloud, many ran low on critical medications and struggled to get refills at local pharmacies. Carry a list of all your medications and their scientific names (brand names differ from country to country), as well as extra doses and copies of each prescription.
• Wear and tear: Even a smooth flight can leave you with aches and fatigue. Add unanticipated hours on the tarmac, long waits on uncomfortable airport furniture, and radical time zone changes, and the body can suffer. In some cases, risks of travel-triggered conditions like deep vein thrombosis (resulting from long periods of sitting) may be increased. Make sure you stay hydrated and well-fed, avoid alcohol, and move about the cabin frequently when it’s permitted. If you suffer from a chronic condition such as high blood pressure or diabetes, consult your doctor before any extended air travel.
• After you land: Flights often get delayed, resulting in arrival after nightfall. To minimize this risk, you can arrange for ground transportation before your arrival with help from your hotel. Avoid spending more time than necessary in pickup and drop-off zones in front of the airport. Maintain a low profile at all times by talking discreetly about your plans with companions, airport, and hotel staff, wearing minimal jewelery, and staying away from bright colors and logos that could identify you as a tourist.
• Traffic accidents: Vehicle crashes are the number one danger for travelers. Be careful when driving after a long flight, especially in areas that you’re unfamiliar with. Drowsiness coupled with a strange highway – or even driving on the “wrong” side of the road – is a recipe for disaster. Take a cab or have transportation arranged ahead of time. Keep in mind that traffic accidents are one of the most common reasons for a medical evacuation.
• Nutrition on the go: It’s not always easy to maintain a healthy diet while traveling; there may be a lack of healthy choices and unfamiliar food. It’s important to stay hydrated. Aim to drink 1.5-2L of water each day – more if you’re in a hot and/or dry climate. Try to eat 5-9 servings of fruit and vegetables per day to get the vitamins your body needs. When unfamiliar with the health and sanitation issues in your destination country, drink bottled water and eat only fruit you peeled yourself.
• Cash and travel documents: For those traveling in crowded trains or buses, look out for pickpockets and other petty criminals. Keep your travel documents – especially your passport – safe, since embassies may be closed; you might not be able to obtain a temporary passport until they reopen and this can delay your return trip. Carry enough cash, as some places may not accept cards and other forms of payment. Don’t put all your money in one location. Spread it between yourself, and companions, and luggage, because banks may not be open for you to withdraw money when you need it most.