lonely-planet-myanmar-burma-11-edition

386HEALTH IN MYANMARthat receive less air, such asthe groin, the armpits andbetween the toes. It startsas a red patch that slowlyspreads and is usually itchy.Treatment involves keepingthe skin dry, avoiding chafingand using an antifungalcream such as Clotrimazoleor Lamisil. Tinea versicolor isalso common – this funguscauses small, light-colouredpatches, most commonly onthe back, chest and shoulders.Consult a doctor.Cuts and scratches easilybecome infected in humidclimates. Take meticulouscare of any cuts and scratchesto prevent complications,such as abscesses. Immediatelywash all wounds inclean water and apply antiseptic.If you develop signsof infection (increasing painand redness) see a doctor.Divers and surfers should beparticularly careful with coralcuts as they easily becomeinfected.SnakesMyanmar is home to manyspecies of both poisonousand harmless snakes. Assumeall snakes are poisonousand never try to catchone. Always wear boots andlong pants if walking in anarea that may have snakes.First aid in the event of asnakebite involves pressureimmobilisation with an elasticbandage firmly wrappedaround the affected limb,starting at the bite site andworking up towards the chest.The bandage should not beso tight that the circulation iscut off, and the fingers or toesshould be kept free so thecirculation can be checked.Immobilise the limb with asplint and carry the victimto medical attention. Do notuse tourniquets or try to suckthe venom out. Antivenom isavailable for most species.Women’s HealthPregnant women shouldreceive specialised advicebefore travelling. The idealtime to travel is between 16and 28 weeks, when therisk of pregnancy-relatedproblems is at its lowest andpregnant women generallyfeel their best. During the firsttrimester there is a risk ofmiscarriage and in the thirdtrimester complications –such as premature labourand high blood pressure – arepossible. It’s wise to travelwith a companion. Alwayscarry a list of quality medicalfacilities available at yourdestination and ensure thatyou continue your standardantenatal care at these facilities.Avoid rural travel in areaswith poor transportation andmedical facilities. Most of all,ensure that your travel insurancecovers all pregnancyrelatedpossibilities, includingpremature labour.Malaria is a high-riskdisease in pregnancy. WHOrecommends that pregnantwomen do not travel to areaswith Chloroquine-resistantmalaria. None of the more effectiveantimalarial drugs arecompletely safe in pregnancy.Traveller’s diarrhoea canquickly lead to dehydrationand result in inadequateblood flow to the placenta.Many of the drugs used totreat various diarrhoea bugsare not recommended inpregnancy. Azithromycin isconsidered safe.In Yangon and Mandalay,supplies of sanitary productsare readily available.Birth-control options may belimited, so bring adequatesupplies of your own formof contraception. Heat,humidity and antibioticscan all contribute to thrush.Treatment is with antifungalcreams and pessaries suchas Clotrimazole. A practicalalternative is a single tabletof Fluconazole (Diflucan).Urinary tract infections canbe precipitated by dehydrationor long bus journeyswithout toilet stops; bringsuitable antibiotics.TraditionalMedicineThroughout Myanmar traditionalmedical systems arewidely practised. There is abig difference between thesetraditional healing systemsand ‘folk’ medicine. Folk remediesshould be avoided, asthey often involve rather dubiousprocedures with potentialcomplications. In comparison,traditional healing systemssuch as Chinese medicine arewell respected, and aspectsof them are being increasinglyused by Western medicalpractitioners.All traditional Asian medicalsystems identify a vitallife force, and see blockageor imbalance as causingdisease. Techniques such asherbal medicines, massageand acupuncture are usedto bring this vital force backinto balance or to maintainbalance. These therapies arebest used for treating chronicdisease such as chronicfatigue, arthritis, irritablebowel syndrome and somechronic skin conditions.Traditional medicines shouldbe avoided for treating seriousacute infections, such asmalaria.Be aware that ‘natural’doesn’t always mean ‘safe’,and there can be drug interactionsbetween herbalmedicines and Western medicines.If you are using bothsystems ensure that you informboth practitioners whatthe other has prescribed.