As part of a mission team to Latin America, there are many things that need to be considered to keep you and the entire team healthy. What affects you, affects the entire team. Please treat yourself with the kindness and care that you would show to another person. Please read this information, and begin the preparation now:

Immunizations:

Malaria Prevention:

Malaria prevention pills are not required for most places in Mexico. Visit the CDC website and go to the Traveler’s Health section (http://wwwn.cdc.gov/travel/default.aspx) and then locate the destination country to find out specific information about the need for malaria prophylaxis.
Careful precautions to avoid insect bites will reduce the risk of this mosquito born illness.

Insect Bites:

Mosquitoes, fleas, ants, bed bugs, spiders and other creatures can be sources of uncomfortable bites. Check out any area you are sitting or sleeping for unexpected guests. Tell your team leader if your room needs to be fumigated. Don't eat in bed…it is an invitation to disease carrying bugs to sleep with you. If you spill something, wipe it up. Don't put food wrappers in your bedroom trash can. Use DEET if you'll be outside at night, or are especially prone to insect bites. Take a B Vitamin complex pill to help prevent mosquito bites. Treat all bites with antibacterial cream. Don't scratch them. Tell your team health care provider if you have uncomfortable or infected bug bites.

Dengue Fever Prevention:

Dengue fever is endemic to certain parts of Mexico, and is worse when the mosquito population is greater. This is a very uncomfortable illness with high fever, rash, and body pain that can last for several weeks. Previous team members have contracted this illness as a result of excessive mosquito bites. Protect yourself by wearing mosquito repellent containing DEET, and protective clothing. Avoid sitting outside in the dark for long periods.

Personal Hygiene:

In the clinic setting we will be in close contact with patients from all walks of life. Some of them will have lice or scabies. These are insects that are passed from person to person in close contact or through clothing. In order to prevent becoming infected, or passing the infection on to others on the team, you are expected to shower and wash your hair daily. By paying extra attention to your own hygiene it is very unlikely that you will become infected or bring anything home with you. Every day after the clinic, please go directly to your room, take off your clinic scrubs/clothing and wash up. Do not leave dirty scrubs lying on your bed or anywhere in your room. Each day your team leader will arrange for laundry service for team scrubs. Don't come to the team room in dirty scrubs or sit around on the furniture. You may have "uninvited guests" on your clothing.

Traveler's Diarrhea:

On nearly every mission team, one or more people contract traveler's diarrhea. The only way to become infected is to eat or drink something that is contaminated with feces. This could be food, water, or your own hands. Because many people in Mexico do not have proper restroom or kitchen facilities, most public places are sources of infection. The handrails on a stairway, the seats on a bus, the hands you shake in greeting are all possible sources of contamination. It is important that for the week, you consider your hands as "unclean" and wash them well before every meal. Don't touch your face, nose or mouth during the day. Don't share water bottles, or "bites" off your food. Wash your hands thoroughly every time you go to the bathroom. All tap water in Mexico is a possible source of infection. No matter what you are told about a hotel's "filtration system," only allow bottled water into your mouth. This means no gargling in the shower, no rinsing your mouth with the tap water, and no "quick drinks" out of the tap. You may be "lucky" on one trip, but very ill the next. It is our requirement that the entire team abide by these safety rules to protect everyone else. You can be an infected carrier, have no symptoms, but make many other people sick on the team. You don't want to be the team "Typhoid Mary." Once one person is infected, it can quickly spread to others in your room, or the entire team. If you do become ill, tell your team leader or team health provider immediately so treatment can begin. There is no point in "toughing it out" because you put the entire team at risk. You will be excused from kitchen duty if you are ill.

Preventative Medications:

If you are going to eat in a public place (including church), it is a wise idea to chew 2 Pepto Bismol or Kaopectate tablets prior to the meal. This will help prevent bacteria from crossing your intestinal mucosa and making you ill. The downside of prevention with PB is that it can cause your tongue to become stained black, makes your stools black, and contributes to constipation. Brush your tongue as well as your teeth each day, don't worry about he color of your stool, and eat lots of fruit!

Treatment of Diarrhea:

Keep yourself well hydrated with bottled water and Gatorade throughout the trip. If you begin to have diarrhea, increase the fluid intake. If you develop fever, chills, severe cramping or blood in the stool, it is best to treat with antibiotics. Talk to your team Health Provider. You may want to ask your doctor for a prescription for Cipro 500mg or Bactrim DS/Septra DS to take with you on the trip. That way you will have antibiotics available should you become ill. People with a history of severe traveler's diarrhea, or a serious health problem may want to take antibiotics preventatively. Talk to your health care provider about this before you leave the country.

Foods to avoid:

• Do not eat any food prepared by a beach vendor or street vendor. They do not have proper refrigeration and hand washing facilities, so their food is usually contaminated.

• Eat only fruit that has been prepared by the team cooks, or that you peel yourself. Many fruits lay on the ground before harvesting and are contaminated with animal and human feces.

• Do not eat raw fish. It is a source of Hepatitis A and other infections.

• Do not eat at taco stands and questionable restaurants. If you choose to do this, have your special meal at the end of the week when an illness will be less likely to disrupt the work we are there to do.

Diarrhea treating foods:

• Bananas, Rice, Applesauce and Toast make up the BRAT diet often recommended for treating diarrhea. Avoid dairy products for 48 hours after a bout of diarrhea. Avoid anything spicy or high in fat for at least 48 hours.

• Gatorade or oral rehydration fluids will replace the chemicals that your body loses from diarrhea. Ask your team leader or health care provider to help you get these items if you are sick.

Cultural Expectations:

We are in a sensitive situation because we will often be offered food by patients and other friends as a love gift for the work that we do. It is unacceptable to reject a gift of food and insult the host. We recommend that you accept the food, eat it if it is in a group or team meeting setting and premedicate yourself with Pepto Bismol as a safety measure. Be subtle about taking the Pepto-Bismol to avoid insulting your hosts. (Go to a private location to take the medication, or take it before arriving at the party or meeting.) Our relationship with our hosts is extremely important. Because we will be faced with many health risks during the week, it is important that we don't take "extra risks" during our free time.

Salmonella:

Certain animals carry salmonella in their saliva and on their skin. Be careful not to pet turtles, iguanas and lizards. If you can't resist, immediately wash your hands with warm soapy water.

Constipation:

The flip side of diarrhea on a mission trip, is constipation. Lack of adequate fluid intake, and a diet high in starch and processed foods can lead to hard, infrequent stools. To prevent the discomfort associated with constipation, drink plenty of water, and eat fruit and fiber every day. If you do become constipated, increase the fruit intake. Pineapple and papaya often help relieve constipation. IF you are prone to this condition, bring your own prunes or medication for use during the trip.

Colds and Flu:

Colds and flu are transmitted by dirty hands and contaminated air. Avoid touching objects handled by sick people or being in an enclosed space with someone who is coughing and sneezing. It is very common to be exposed to a cold while traveling on an airplane. To minimize the risk to yourself, make sure you drink plenty of fluids while you are flying. Moist mucous membranes are less likely to breakdown than dry ones. Also, consider treating yourself with zinc lozenges or zinc nasal spray (Zicam) during the flight. At the first sign of a cold, start to increase your hydration and use zinc if you are able. Wash your hands frequently. Inform your team health provider so they can help you. You will be excused from kitchen duty if you have a cold or flu.

Sunburn:

One of the most common disabling conditions acquired during a mission trip, is sunburn. You can prevent yourself from being miserable by protecting your skin. Use sunscreen on your face and arms every day. Wear a hat when you are outside. Stay in the shade as much as possible. If you live in a Northern Climate, you will burn in a matter of minutes in the sun of Mexico. This is not the week to "work on your tan." If you do get sunburned, ask for help. There are lotions and medications that can reduce the pain, inflammation and itching.

Dehydration:

One of the most common causes of fatigue, weakness and illness on a mission trip is dehydration. Each person needs to drink at least 2-3 quarts of water per day. Bring your own water bottle, or buy one on arrival. Keep it full, and drink regularly throughout the day. Fluids such as coffee, tea, cola and crystal light are full of chemicals that make you lose more water than you take in. Whenever possible, drink plain tap water or juice. You should be urinating at least once every 4 hours, and your urine should be light in color. If your urine is dark and less frequent than normal, you are either dehydrated or retaining fluid in your body. You can easily correct dehydration by increasing your water intake. You also lose a lot of fluid through perspiration, so if you are sweating more than normal, increase your intake. Often the first sign of dehydration is a headache. Start increasing your fluid intake immediately at the onset of a headache. Severe dehydration can lead to dizziness, abdominal cramps, nausea and passing out. Take care of yourself before it gets to that point. Tell someone if you are having any of those symptoms so they can help you.

Heat related illness:

Excessive heat and dehydration can lead to a serious illness and even death. Just like football players in the heat, we are susceptible to being overcome by heat related conditions. Dress lightly, stay out of the sun, and keep up your water intake. Tell someone if you are feeling dizzy, having abdominal pain or nausea. If you are feeling hot, but not sweating, this can be a danger sign. When treated early, the recovery is fast.

Fluid Retention:

If you are not urinating enough, but your fluid intake is good, chances are you are "storing up" fluid in your abdomen, face, hands and legs. This can become extremely uncomfortable and lead to further problems. To prevent fluid retention, avoid salt in any form. We will try to cook team meals with minimal salt. Take the time to put your feet up several times per day if they start swelling. If it becomes a problem, tell your team health care provider. "Water pills" will be available for those that have a significant problem. Most fluid retention clears up within 48-72 hours of arriving home.

Strains and Sprains:

We often try to take our "out of shape" bodies directly from home to the mission field without preparation, and end up with lots of aches and pains as a result. It is important to keep in mind that you are a "soldier" for the Lord for this week, and need to put yourself through "boot camp" at home prior to departure. It is best to start 8-12 weeks before you leave on a daily walking, stretching and strengthening program. We will be standing on cement or dirt floors for hours without breaks. We will be expected to carry luggage, equipment and food long distances without help. Roads and sidewalks are uneven, and invitations to twisting an ankle or falling down.

Tips to avoid an injury:

• Daily home or gym exercise program for 8-12 weeks prior to departure. Include walking.

• Lose a few pounds ahead of time if you need it. Extra weight increases risk of injury.

• Start practicing walking with your eyes on the road and sidewalk looking for hazards.

• Tell your team leader if you have a disability, and make arrangements with a teammate to help you. Example: "I'll do your kitchen duty if you will carry my bag each day."

• Help your teammates. If you see someone struggling with a heavy object, offer to help him or her. Help the team prevent injury.

Injuries:

It is important to remember that we are serving in a foreign country that does not have the same safety requirements as the U.S. You will often see people riding without seat belts, "jaywalking" or doing other things that may increase the risk of injury. Areas of increased risk include: transportation, walking, crossing streets, beach activity, climbing. As part of a team, you are required to take all safety measures seriously. One person's lack of caution can impact the ministry of the entire team. For this week, you need to ask yourself, "if I do this, could it hurt the team?" We don't want you to be injured, and we want to maximize our effectiveness as a team during our short stay.

Theft/Robbery:

Previous teams have had the unpleasant experience of being robbed or pick pocketed. Here are some things you can do to minimize the risk:

• Travel with little cash. Use your ATM card to take out pesos when you need them.

• Leave your good jewelry at home.

• Don't flaunt your money or possessions.

• Keep your doors locked at all times.

• Don't leave valuables unattended. Have few valuables.

• Don't keep your money in your pockets. Use a "money belt" under your clothing.

• Don't leave anything in cars, vans, busses, or unattended in church or clinic.

• Don't walk anywhere alone, especially after dark. Be careful on the beach at night. Only walk in groups of 3 or more.

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