Travel Reference
In-Depth Information
sunglasses are an absolute must. Up to forty percent of the sun's rays can be reflected back
up from water or sand, even if you're sitting in the shade; nor is an overcast day free from
damaging UV light. When travelling in a dugout - a likely scenario if exploring the Darién
or Guna Yala - you could be faced with hours without any protection. Serious sunburn, sun-
stroke and heatstroke are therefore all very real health hazards and far more likely than catch-
ing a tropical disease. Keeping up your fluid intake to avoid dehydration is just as essential.
Malaria
There is low risk of
malaria
in more remote areas of the Caribbean lowlands in Bocas and
Veraguas, and a slightly higher risk east of the canal, in the Darién and in more isolated areas
of Guna Yala. Transmitted by a parasite in the saliva of an infected anopheles mosquito (act-
ive from dusk to dawn), its symptoms - fever, chills, headaches and muscle pains - are easily
confused with flu.
It is most effectively combated through
prevention
- wearing long loose sleeves and
trousers for protection, dousing yourself in repellent and sleeping under a mosquito net or
in screened rooms. Most effective chemical insect repellents contain DEET, with the 25-35
percent varieties considered adequate for most needs. However, a few recent studies have
started to raise questions about DEET's possible neurological side effects as well as damage
to the environment. Whatever the medical opinions on the subject, you have to wonder about
a solution that will melt your pen if it gets too close. Recently, more organic, non-chemical
products, based on oils such as eucalyptus, citronella, cedar or verbena, are appearing on the
market. They are generally more expensive but give less fierce protection, which wears off
much more quickly. They can be effective enough when used with other preventive meas-
ures, although if you are in a malarial area you might want to stick to DEET. Mosquito coils
are widely available across Panama, even in small villages; if seeking a natural alternative,
candles can help deter the insects. In neither case should they be used in enclosed indoor en-
vironments.
A range of anti-malarial tablets are on the market, all of which should be purchased prior
to arriving in Panama and started in advance of visiting the malarial area, though a public
medical centre (
centro de salud
) in a malarial area should stock a supply for post-exposure
treatment. West of the canal, chloroquine is the drug of choice, generally taken once a week
a fortnight in advance of entering a malarial area and for four weeks afterwards. East of the
canal, where mosquitoes are chloroquine-resistant, mefloquine (also known as Larium) is of-
ten prescribed, though it can have particularly severe side effects. Malarone is a less contro-
versial alternative but is currently the most expensive anti-malarial drug on the market. It is
taken daily only two days before entering an infected area, to be continued for a week after
leaving. Whatever you choose, it is important to finish the course of anti-malarials because
