Introduction:
 Don't
let 'Banjul Belly', otherwise known as travellers'
diarrhea (TD), ruin your holiday in The Gambia.
Mild, moderate or severe diarrhoea affects about 40%
of European travellers who spend a fortnight or more
in The Gambia, but by adopting a number of food and
water precautions you can minimise the chances of being
one of them.
Food:
To avoid travellers' diarrhoea in Gambia do not eat
food that is either not piping hot or below 5C in the
case of chilled foods. Cooked meals that have been kept
at room temperature are particularly prone to high bacteria
levels.
Don't eat vegetables or fruits unless they have been
cooked properly, peeled or shelled as in the case of
groundnuts. Don't eat fruits that have damaged skin
as they could contain toxins or bacteria that can lead
to food poisoning. Mouldy fruits could contain Botrytis,
and should also be rejected. Eating from mobile street
vendors is risky as they often do not keep their raw
meats and fish refrigerated or on ice, and are prone
to being landed on by flies. Furthermore they maybe
tempted to carry over their meat from yesterday. Undamaged
fruits and nuts that can be peeled or shelled are a
safer option to buy from street vendors.
 When
eating in a restaurant avoid raw or undercooked fish
or meat. Certainly do not order rare steak. Certain
kinds of fish may contain bio-toxins even after cooking.
Avoid eating certain reef and predator species such
barracuda, grouper, seabass, red snapper, jack,
as it could lead to ciguatera fish poisoning (CFP).
Ciguatoxin is very heat-resistant, so ciguatoxin-tainted
fish can't be detoxified by conventional cooking.
So the simple rule is this: boil it, cook it, peel it,
or forget it!
Drinks & Ice Cream:
Tap water, unpasteurised milk, dairy products such as
locally made ice cream and
ice cubes are linked with increased risk of getting
TD in Gambia. If you want to have ice cubes you have
to be sure that it is made from purified water otherwise
it's just like drinking the tap water. As for ice-cream
you need to make sure it has been imported and made
from pasteurised milk. Only drink purified or
mineral bottled water or water that has been boiled,
micro-filtered or purified with tablets such as iodine.
Bottled and packaged soft drinks, hot tea or coffee,
beer, and wine, are usually safe to drink.
Brushing Teeth:
Travellers often ask "Is it safe to brush my teeth
with tap water" in their hotel. The fact is that
tap water in the resorts and residential areas along
the coast is chlorinated and shouldn't really cause
any problems, but if you are really concerned you might
want to use a mouthwash afterwards. If you really aren't
confident about the water then use bottled water which
is readily available in most small stores and supermarkets.
Diarrhoea Treatments:
• Pharmaceutical
Remedies
There are a number of over-the-counter antidiarrhoeal
medicines available to treat the unpleasant intestinal
disorder such as bismuth subsalicylate and loperamide.
Bismuth subsalicylate is quite effective for temporary
cases of diarrhoea, if you have a chronic attack, then
you'll likely need something more powerful. The remedy
works by balancing the way liquid moves through your
intestines. It also lessens inflammation and inhibits
the growth of certain viruses and bacteria that cause
diarrhoea from growing in the intestines and stomach.
Loperamide works by decreasing the speed with which
food moves through your bowels. This gives your intestines
more time to absorb fluid so that you have more solid
stools and fewer bowel movements a day. It is normally
taken after a diarrhoeal episode.
In addition to the above antidiarrhoeal drugs travellers
to The Gambia should consider packing antibiotics which
have been demonstrated to be effective. Among these
are azithromycin, levofloxacin and rifaximin and if
available prulifloxacin. These antibiotics might be
taken as a prophylaxis in situations where a traveller
has a history of digestive disorders, such as irritable
bowel syndrome, or whose immune system is weakened.
• Prevent Dehydration
A bout of diarrhoea usually lasts only a few days and
is often mild to moderate. The problem usually goes
away on its own, without using any remedies. If you
get a prolonged bout of diarrhoea or vomiting it can
cause your body to excrete more fluid than is taken
in. This leads to dehydration which can be particularly
dangerous in the aged and children. It is important
to increase your fluid intake when you get an attack.
Adults can increase their intake of water by taking
in little regular sips throughout the day. The other
method to combat diarrhoea in adults is to consume select
sports drinks. Their salt and sugar contents taken together
allows water to be absorbed by the body. Avoid drinks
that can exacerbate the symptoms such as alcoholic,
sugary or caffeinated drinks. For some individuals dairy
products such as milk can worsen the symptoms.
The best way to combat dehydration, particularly for
children, is Oral Rehydration Therapy. This is a type
of fluid replacement which is drunk as a treatment for
dehydration. It replaces the lost fluids and essential
salts thus preventing or treating dehydration and lowering
the danger. It is basically salt and sugar dissolved
in water in precise proportions, though there are commercially
available rehydration salts which contain glucose and
other ingredients. The solution is also drunk throughout
the day in little sips and is available in most of Gambia's
Greater Banjul area pharmacies.
• Plain
& Simple Diet Treatment
One way to reduce the severity and length of a diarrhoeal
episode is by going on a bland diet, particularly in
the first 24 hours of an attack, as certain foods can
worsen symptoms. Among a few recommended foods are plain
rice, porridge, bananas, toast, mashed or boiled potatoes,
plain crackers, probiotic yogurt, white bread, plain
pasta, canned fruit, applesauce, squash, carrots, low
fat smooth peanut butter, skinless baked chicken, Tapioca
pudding, boiled eggs.
Avoid eating fatty foods, dairy products such as milk
and ice cream, alcohol, sorbitol, and tainted foods.
Note carefully:
Always seek the advice of your medical doctor before
deciding to take or not to take any medications or health
precautions. The above information does not and is not
intended to replace or substitute the advice and / or
recommendation from your doctor or other authorised
medical practitioner. |
