Health of body is important to cross-cultural service. The better you feel, the better you can perform what you came to do. Your mental state is often related to how well you are doing physically. Good health contributes to happy attitudes.

Some of you are undoubtedly too concerned and worried about your health. You should be assured that overall you are probably at no greater risk during your time of service cross-culturally than you would be doing something similar at home. Some of you may not be concerned enough about your health. You probably need this chapter the most of all! What is crucial is that a balanced view is important to success.

Your Concerns

• What are your major health concerns?
• Have you taken time to deal with them and take the needed action?
• What do you need to do before you depart?

Your Special Needs

• Do you have any special needs in relation to your health?
• Do you require a special diet or certain foods?
• What are your allergies?
• Do you require hard-to-find medications?
• Do you need certain supplies like contact lens solution, etc.?
• Have you made plans to care for these things?

Weather
Climate: Radical climate changes affect us physically. Many will go to very hot and/or humid climates. Lack of air conditioning and/or heating can have serious affects unless you learn to cope. If you have lost sleep because of the humidity you cannot expect to accomplish as much as you hoped. Pace yourself.

Sun: Sunburn in a tropical climate can be swift, painful, and debilitating. If you are going to be in the sun, be sure to have a sun screen. Dehydration can also be a problem and intake of adequate fluids must be planned for.

AIDS
AIDS is a major problem in many countries. Great care needs to be taken in handling the blood and bodily fluids of others. If you are doing medical and/or dental work or even just first aid, know the rules and wear gloves.

Needles: It is good to supply your own needle if you need an injection. Better yet, don't get any injections if at all possible. Blood transfusions should only be received if you have no other option. Then you should take all the precautions possible.

Illicit sex: It should go without saying for Christians that illicit sex is forbidden. Not only is it sin, but in today's world it is foolhardy and high risk behavior.

Inoculations
You will undoubtedly get a list of required immunizations/vaccinations from the organization that is sending you. By all means follow it! We are fortunate today to have vaccinations/immunizations for many diseases that were previously serious problems—cholera, typhoid, tetanus, polio, rabies, yellow fever, some types of encephalitis, meningococcal meningitis, and hepatitis A and B are the main ones. Not all of these are required for every area, so double check with your sending organization to be sure you have the ones needed for the specific area to which you are going.

Malaria
Even after we've had the necessary inoculation we know that there are still some serious illnesses we might encounter. One of the most serious ones is malaria. As you know, malaria is a very real problem in certain tropical areas. The incidence of malaria has been reduced in many areas today—especially cities; however, there are still pockets in many tropical countries where malaria continues to be a serious problem and is therefore something that cannot be taken carelessly. Fortunately, it is quite easily treated, especially if diagnosed and treated early, but hopefully can be avoided. If malaria is a common problem in the area where you will be serving (or traveling for any length of time) there are several important things you can do.

Since malaria is transmitted by a mosquito, one of the most important things you can do is try to avoid being bitten by mosquitoes. The female anopheles mosquito which carries malaria, generally bites only at night, so you should take extra precautions at night. Wear clothing that covers your legs, arms, and feet, use insect repellent (with DEET, if possible) on your skin and clothes, sleep in a protected place—either a room with good screens or under a mosquito net that has no holes and has been treated with an insect repellant.

In addition, you may want to take a prophylactic which keeps you from getting malaria even if you are bitten, especially if you are in an area where malaria is a severe problem. The most commonly prescribed prophylactic for adults at present, is Mefloquine. However, since some people have unpleasant side effects from the prophylactic, many prefer to use caution in avoiding mosquito bites, and then just treat malaria immediately and vigorously if they should get it.

Food Safety
Most of us are interested in eating on a relatively regular basis, aren't we? Thus the prospect that we may be unable to find food that is safe to eat is cause for some real concern. Due to the hot weather in many parts of the world, varying degrees of concern for following hygienic practices, and the presence of different strains of "bugs" to which our systems are not accustomed, it is true that it is easier to get sick from eating foods in a new place than it is at home. So, what can we do?

Aside from preparing all your own food, (a pretty unrealistic idea) what can you do? Since most bacteria that cause illness are destroyed by heat, one of the best guidelines is to eat food that is well-cooked—preferably eating it "hot off the griddle". Since much food is prepared on the spot, this is a real possibility. Foods that are dry are also much less likely to be contaminated than foods that are moist (especially if they are prepackaged and sealed.)

It's true that the local people and some of the "old time" missionaries may eat all kinds of things that you probably should not eat—especially when you first arrive. Your immune system is not ready to deal with a lot of new "critters" at first. Gradually you will probably develop some immunities that will enable you to be a bit more adventuresome, but "being safe rather than sorry" is good advice for a newcomer.

Drinking Water and Other Fluids
Bottled water: It can be a solution, depending where you get the bottles! In some places, even the local bottled water is not safe.

Ice: Unfortunately the same holds true for local ice. On a hot day it may be hard to resist, but you may regret your indulgence.

Water Safety
An additional area of concern is the water supply. It is very important for you to drink a lot of liquid, but at the same time, the water supply in many places is less-than-safe. What can you do?

• Use some kind of chemical treatment on the water. Various kinds of water purification tablets are on the market and most work fairly well if they are fresh. I often used a solution of iodine called Lugol's solution during my missionary itinerating days in Asia. You can also use Clorox bleach. One capful of bleach per 2 gallons of water should fix things.
• Boil the water. Be sure that it comes to a rolling boil and stays that way for at least 10 minutes.
• Buy bottled water if you can find some that is safe. (Buy only bottles that are sealed, from companies that have a reputation for safety.)
• Drink bottled drinks—especially sodas from international companies that have a worldwide reputation to protect.
• Drink tea—In many countries "tea" (which may be made from real tea leaves or various and sundry other plants) is a very safe alternative to water. It has been boiled, is usually very weak, and is in covered containers so tends to be safe.

What to Do if You Get Diarrhea
Though it is important for you to take reasonable precautions, the chances are that at some time you'll probably get some kind of a gastro-intestinal upset. The most common type is referred to as "travelers diarrhea", a self-limited illness that lasts a few days and is most commonly caused by a form of e-coli bacteria. Having diarrhea is never pleasant or convenient, but it can actually be a good thing since it is the body's way of getting rid of "the bad guys". The most important thing for you to do initially, then, is to avoid getting dehydrated. If you are able to drink liquids this is very important. Keep drinking (or sipping if you are also nauseated).

Rehydration drink (see the recipe below) is good if packets or bottles of commercially-prepared rehydration fluids are not available. If the symptoms continue for more than two days (in adults), or if symptoms of serious dehydration occur, you may need to see a doctor (if one is available) or bring out the "bigger guns"—antibiotics (e.g. Cipro, Bactrim, etc.) and medication that stops the symptoms by stopping the diarrhea (e.g. Pepto Bismol, Imodium, Lomotil). Obviously, any diarrhea that continues longer than a few days, or is accompanied by bloody stools and/or fever should be treated by a doctor, and may even require hospitalization.

Crime
Violent crime is probably less likely in most places than it is in North America. On the other hand rip-offs, scams, and petty theft abound in many places. Your mental health can be ruined temporarily by such things.

Women: In many places women who go places alone are considered fair game. There is safety in numbers. Don't be presumptuous and test your guardian angels!

Taxis: Both men and women should be cautious when taking taxis. Whether the motive is robbery or rape, taxi drivers have been known to take advantage of foreigners in many countries. Traveling in groups is an obvious precaution. Avoiding taxi travel at night is another. And for women, never getting into a taxi alone is very wise advice.

Centers for Disease Control and Prevention. Health Information for

International Travel (there is an updated edition each year). Atlanta, Georgia: U.S. Department of Health and Human Services. Public Health Service. HHS Publication No. (CDC) 95-8280. This is the most authoritative source of information on health concerns in international travel. For updates check the CDC website http://www.cdc.gov.

Remember that the best places to find out any special information about immunizations and particular health advice are your mission organization, your physician, travel clinic, or health department. Immunizations may be required for entry into some countries.