A few days before I left for Cuba, I was in the car with my dad, driving to the train station.  My dad was checking that I was prepared with all the vaccinations I needed and any extra medicines I might need to take with me on my trip. On the topic of getting gastro from exotic foods, he and I started joking about what the Cuba version of "Bali Belly" might be called: the "Cuba Chunder" or "Havana Hurl" perhaps. 

Little did I think I would actually need to deal with it; having travelled in many developing countries before I had somehow convinced myself that my stomach was now tough enough and I wouldn't get sick anymore (provided I took the usual basic precautions, of course). I'm not quite sure how I managed to convince myself of that, seeing as almost every trip I had been on I had become sick at some point. But, in my head, this time would be different. 

It wasn't. 

Less than a week in to our trip, both myself and my travel buddy ended up with the Havana Hurl...and the runs. (From eating ham, as it turned out - the "Havana Ham Hurl"?). Having just arrived in our second Cuban destination, the charming, picture-perfect, cobble-stone street Trinidad, we spent the first couple of hours there alternating between each of us using the bathroom at our new casa particular (i.e. homestay).

It turned out that I was pretty sick. Not sick enough to go to hospital or anything, but according to my travellers health booklet (A Health Guide for International Travellers) my case was "severe" 3 times over, and by the time I eventually had the energy to take a shower, I almost lost consciousness doing so. Luckily my travel buddy improved a bit quicker than I, and was able to help me out, although we were both wiped out for a few days.

The experience reminded me that, as much as I love independent travelling as well, when you get sick while travelling, having a travel buddy is such a blessing. Even if they are sick too, it still makes the experience a hundred times easier to deal with. 

When I got Salmonella in Thailand in 2008, for example, and spent 3 nights in a Thai hospital in Chiang Mai, my boyfriend at the time did a pretty good job of taking care of me - staying with me 23 hours a day, bringing me movies, and helping me to deal with the horror of my first IV drip (only really a horror because it was apparently inserted wrong and ended up being quite painful - enough to still scare me every time I've had an IV since). Luckily the hospital expenses were all covered by insurance - more on that here.

Then there was the time I was sick with E. coli and amoebas in Ecuador in 2014 and basically didn't eat anything for a whole week because (not only did I have no appetite) the nurse at the medical centre had told me I had so many bugs that it was like there was a zoo in my stomach, and every time I ate I would be feeding the zoo! Fortunately during that episode I was staying in a hostel that I had already spent quite a bit of time at and had become good friends with the people working and living there. So, whilst at that point I didn't have a travel buddy as such, there were some people I could count on for help if needed. 

But probably the worst travel sickness experience I've had (even though it wasn't actually the sickest I've been) would have to have been when I had acute tonsillitis in Montenegro in 2012. After translating through the use of another a patient while their broken arm was being set in plaster, the doctor determined my tonsillitis so bad that I couldn't just take the normal oral antibiotics, but rather I instead needed to have daily injections of the antibiotics for an entire week. The good thing about getting the injections, I learned, is that they make you feel a thousand times better almost immediately after the antibiotics get into your blood stream. It's really amazing and something I hadn't experienced before. (Fear of IVs slowly being outweighed by realising how great they can be.)

The bad part was that the hospital emergency ward (the only place open at that hour) appeared to have very low hygiene standards. Having specifically dragged myself on a 7 hour bus from Bosnia to Kotor, Montenegro because I had heard that the Montenegrin medical system is much better than that of Bosnia, I was disheartened to arrive to a hospital room with dirty medical tools laying around, dried blood everywhere, and the nurse not wearing gloves or washing her hands between patients. It was such a scene that I refused the extra injection of painkillers, choosing instead just to deal with the pain. I was completely exhausted and really could have done with a hygienic hospital, or at least a buddy to laugh about it all with. (To Montenegro's credit, the medical centre I attended thereafter was a much better, and cleaner, experience.)

One of the hardest practical things about being alone when you're sick in a foreign country is trying to get food when you know you really should eat, but you just don't have the energy to go outside and find something (particularly if you're in a new city/country and are not even sure what options there might be or where to start looking to find them). Depending on what you're sick with, it's also possible that you need to be careful of what you're eating, which can make it even harder in a place with unknown food options. It's also possible that you're not convinced you won't pass out while out on your food mission, and be all alone. And the longer you put it off or try to get up the energy, the less energy you have. Particularly if you're like me and have a tendency for low blood pressure and blood sugar.

This is another occasion where having a travel buddy really helps. In Kotor, Montenegro, I was on my own; and every time I needed to eat it was a huge mission. In Trinidad, Cuba, luckily my travel buddy had a bit more energy than me and could go out and find us a random assortment of foods to bring back to our casa. In Thailand the hospital supplied my food, and in Ecuador it didn't matter since I couldn't eat for a week anyway (just water - if I got really hungry I was allowed chicken soup broth only!). 

Lessons learned

1.  Allow extra travel time in your itinerary to account for sick days when travelling,

particularly if you're travelling somewhere with different foods than you're used to. Feeling the pressure to push on with your travel plans when you're not feeling up to it can make things worse, and you're unlikely to have a make the most of your experience in those days as well. The benefit of a few days rest can be incredible. Sometimes there's no option and you need to push on, but where it can be avoided its best to do so!

In Bolivia, for example, my travel buddy and I were on a tight schedule to make it to Peru in time for our pre-booked Inca Trail. Rather than skipping a destination on the way there, she preferred to push on through my gastro-induced weakness, opting for her (a small but very strong girl) to carry both of our large packs, one on her back and one in front, and me take our smaller day packs. It was a pretty good sight for on-lookers. Whilst I didn't get as much out of those few days as I would have liked, I still was able to experience the beauty of Isla del Sol when I otherwise would have had to skip it.

A good rule of thumb would be to allow at least an extra 3 days per month to your itinerary.

2.  Travel with a basic first aid kit and travel medicines,

but not over-packing, remembering that (unless you're going remote) in most places you can easily source what you need from pharmacies, and it may even be cheaper than at home (particularly in Cuba!). Its always good, however, to have a starter pack of things that you might need urgently and not have time (or energy) to find when you need them. With that in mind, I take with me:

• Imodium Zapid or similar (this is a more expensive anti-gastro med, but as they dissolve on your tongue without water they're ideal for when you have potentially limited access to clean water at the moment you need to take it). I always carry a few in my wallet (rather than just in my pack) just in case, though having said that, I barely ever actually take Imodium unless its absolutely necessary (eg for bus travel), as I prefer to let the body cure itself. You may also want to carry with you an anti-parisitic med for more severe cases of gastro, anti-nausea meds, and/or general antibiotics as well. Best to chat with your doctor about those ones before you go, when you're getting any injections you may need.
• Dissolving electrolyte tablets/sachets e.g. Gastrolyte - important for combating dehydration when you have diarrhoea and/or vomiting, but also just generally good for hot/dry climates particularly if clean water is limited (and also useful for hangover days). 
• Generic painkillers eg paracetamol and/or ibuprofen; and a few cold & flu tablets as well. Whilst these are always available overseas, I like to have a few on me to start with just in case.
• Travel sickness tablets (such as Kwells, and/or a homeopathic option) for those bumpy bus rides on less-than-ideal roads, but also for boat trips, especially when I'm diving. Whilst I don't normally suffer sea-sickness, there's nothing like ruining a diving drip or whale shark trip with sea-sickness.
• Depending on where I'm going, anti-malaria meds, such as Doxycycline (chat with your doctor about which ones are right for you, as many people have adverse symptoms to Doxy), which can usually be topped up (probably for cheaper) in the destination country if it turns out I need to take them.
• A basic first-aid kit with bandaids and antiseptic at a minimum, but possibly also with extra supplies especially if I might be going hiking and/or camping, such as blister packs, a bandage, burn gel, cotton buds/Q-tips, etc.

3.  Take out travel insurance

before you leave, just in case you end up in hospital or with otherwise costly medical bills. Read more on that here.