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Health

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While the potential dangers of Sri Lankan travel may seem worrisome, most travellers experience nothing more serious than an upset stomach. Travellers tend to worry about contracting infectious diseases, but infections rarely cause serious illness or death in travellers. Note that hygiene standards are casual at best and downright bad at worst in many kitchens throughout the country.

Ayurveda

Ayurveda (eye-your-veda) is an ancient system of medicine using herbs, oils, metals and animal products to heal and rejuvenate. Influenced by the system of the same name in India, Ayurveda is widely used in Sri Lanka for a range of ailments.

Ayurveda postulates that the five elements (earth, air, ether, water and light) are linked to the five senses, which in turn shape the nature of an individual’s constitution – his or her dosha (life force). Disease and illness occurs when the dosha is out of balance. The purpose of Ayurvedic treatment is to restore the balance.

For full-on therapeutic treatments, patients must be prepared to make a commitment of weeks or months. It’s a gruelling regimen featuring frequent enemas and a bare minimum diet of simple vegetable-derived calories.

Much more commonly, tourists treat themselves at Ayurvedic massage centres attached to major hotels and in popular tourist centres. Full treatments take up to three hours and include the following relaxing regimens:

  • Herbal saunas (Sweda Karma) are based on a 2500-year-old design. The plaster walls are infused with herbal ingredients, including honey and sandalwood powder. The floor of the sauna is covered with herbs. Like a European sauna, a steady mist of medicinal steam is maintained with water sprinkled onto hot coals.
  • The steam bath (Vashpa Swedanam) looks like a cross between a coffin and a torture chamber. Patients lie stretched out on a wooden platform, and a giant hinged door covers the body with only the head exposed. From the base of the wooden steam bath, up to 50 different herbs and spices infuse the body.
  • The so-called Third Eye of the Lord Shiva treatment (Shiro Dhara) is the highlight for many patients. For up to 45 minutes, a delicate flow of warm oil is poured slowly onto the forehead and then smoothed gently into the temples by the masseuse.

While there are numerous spas with good international reputations, the standards at some Ayurvedic centres are low. The massage oils may be simple coconut oil and the practitioners may be unqualified, except in some instances where they may even be sex workers. As poisoning cases have resulted from herbal treatments being misadministered, it pays to enquire precisely what the medicine contains and then consult with a conventional physician.

For massage, enquire whether there are both male and female therapists available; we’ve received complaints from female readers about sexual advances from some male Ayurvedic practitioners. In general it’s not acceptable Ayurvedic practice for males to massage females and vice versa.

Availability & Cost of Health Care

Medical care is hugely variable in Sri Lanka. Colombo has some good clinics aimed at expats; they’re worth using over options aimed at locals because a superior standard of care is offered. Embassies and consulates often have lists of recommended medical providers.

Self-treatment may be appropriate if your problem is minor (eg traveller’s diarrhoea). If you think you may have a serious disease, especially malaria, do not waste time: travel to the nearest quality facility to receive attention. It is always better to be assessed by a doctor than to rely on self-treatment.

Before buying medication over the counter, always check the use-by date and ensure the packet is sealed. Colombo and larger towns all have good pharmacies; most medications can be purchased without a prescription.

Health Insurance

Even if you’re fit and healthy, don’t travel without health insurance: accidents do happen. A travel or health insurance policy is essential. You may require extra cover for adventure activities, such as scuba diving. If your normal health insurance doesn’t cover you for medical expenses abroad, get extra insurance. If you’re uninsured, emergency evacuation is expensive, and bills of more than US$100,000 are not uncommon.

Vaccinations

Specialised travel-medicine clinics stock all available vaccines and can give specific recommendations for your trip. The doctors will consider factors including past vaccination history, your trip’s duration, activities you may be undertaking and underlying medical conditions such as pregnancy.

Required Vaccinations

The only vaccine required by international regulations is yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone within the six days before entering Sri Lanka.

Recommended Vaccinations

The US Centers for Disease Control (CDC) recommends travellers consider the following vaccinations for travellers to Sri Lanka (as well as being up to date with measles, mumps and rubella vaccinations).

Adult diphtheria and tetanus Single booster recommended if none in the previous 10 years.

Hepatitis A Provides almost 100% protection for up to a year.

Hepatitis B Now considered routine for most travellers.

Japanese Encephalitis Recommended for rural travel, people who will be doing outdoor activities or for anyone staying longer than 30 days.

Polio Incidence has been unreported in Sri Lanka for several years but must be assumed to be present.

Rabies Three injections in all. A booster after one year will then provide 10 years’ protection.

Typhoid Recommended for all travellers to Sri Lanka, even if you only visit urban areas.

Varicella If you haven’t had chickenpox, discuss this vaccination with your doctor.

Water

Tap water is not safe to drink. Use bottled or filtered water; for the former, look for the small round ‘SLSI’ logo which shows the water has been tested by the government’s Sri Lanka Standards Institution (the majority of local brands).