Health and Safety

Macchu Piccu

Cam Honan | Machu Picchu, Peru, 1996

Many people are dissuaded from hiking in developing countries due to health and safety concerns. The list of potential hazards is long: malaria, rabies, amoebic dysentery, dodgy medical facilities, robbery, kidnapping, etc. That being said, it is worth remembering that for the vast majority of people who hike in Third World countries, the worst issue they end up facing is a three-day bout of the runs. In other words, don’t worry too much. Do what needs to be done preparation-wise and then just go.


A great place to start your health & safety research is one of the Travel Doctor websites (Australia, UK). These pages are full of useful information pertaining to Third World travel. Once you have done the groundwork, visit your doctor and/or clinic and organize any necessary vaccinations and medications. For tips on medicinal items, you may consider packing for your journey, see First Aid Kit in the HEALTH & SAFETY section.

Two of the above-mentioned health issues that generally don’t concern backpackers in developed nations are malaria and rabies.  Let’s take a brief look at these two diseases, and how they specifically relate to hiking in developing countries.


Lake Manasarovar Trek | Tibet, 2006 | This photo was taken not more than 10 minutes before I was surrounded by four Tibetan mastiff dogs. Things were not looking good, until a quick whistle from a local gentleman saw the dogs retreat and a relieved yours truly continue on without further issue.


When hiking in first world countries, mosquitos generally represent more of an annoyance than a serious threat to our health. In the developing world the situation is quite different. Mosquito-borne diseases such as malaria and dengue fever account for thousands of deaths every year.  Before trekking in developing countries consult with your doctor about the potential health risks. The UK Travel Doctor website is a comprehensive source of information regarding malaria and other mosquito-borne diseases.

One of the most commonly asked questions when planning a hiking trip to developing countries is whether or not to take anti-malarial tablets. One important consideration in making this decision is the elevations at which you will be trekking. Mosquito-borne diseases do not usually occur above an altitude of 2000m, therefore if you are traveling to a high altitude country (e.g. Nepal or Peru) specifically to go trekking, then there is often no real need to take anti-malarial tablets. Notable exceptions to this point include Ethiopia, Kenya, and Papua New Guinea. The common denominator amongst these three countries is warmer climates, even at relatively high altitudes. With global warming on the rise, it may not be long before other high altitude areas previously exempt from such diseases need to be reassessed.


Rush Phari Trek | Karakorum Range, Pakistan, 2008 | As virtually all of my time in Pakistan was spent at high altitude, I chose not to take malaria tablets during my two month stay.

What type of trip? 

If you are combining your hiking with other travel activities at lower altitudes, anti-malarial tablets may need to be considered. Research the areas you are planning to visit and consult with your doctor before making your decision.

Prevention is Better than Cure

Irrespective of whether you are hiking in a First or Third World country, the key to dealing with mosquitos is prevention. Measures include: 

  • Clothing: Long sleeves and pants. Lightweight and light coloured. In areas where mosquitos are particularly ferocious, you may consider treating your clothes with permethrin.
  • Head Net: Head nets weigh next to nothing and can be a sanity-saver in infested areas.
  • Insect Repellent: DEET-based repellents are the most effective (30% is sufficient). Be careful not to apply too much to your face.
  • Campsite Selection: Whenever possible, pitch your shelter at an elevated location where you are more likely to benefit from a breeze. Avoid camping right next to water sources where bugs are more prevalent.
  • Dawn & Dusk: When hiking through mosquito country, particularly during their most active periods at dawn and dusk, avoid taking lengthy breaks. Alternatively plan to be inside the confines of your shelter during these times of the day.
  • In -own: A permethrin-permeated bed net is a good investment for town stops, as a lot of budget hotels will hot have screens on their windows.


According to the World Health Organization (WHO), over 55,000 people per year die of rabies. The majority of these cases are due to dog bites. If you are planning on hiking in developing countries, it pays to educate yourself in regards to the threat posed by rabid dogs.  Five points to consider:

  • Vaccinations: Whilst rabies vaccinations do not preclude you from contracting the disease, they do buy you more time in case you are bitten. This fact could potentially prove life-saving if you happen to be hiking in a remote region where medical attention is not readily available. It is important to note that even if you have been vaccinated, you still need to seek medical treatment ASAP.
  • Wide Berth: Nomads encampments invariably have guard dogs. These animals are extremely territorial, and not that friendly to strangers. It is wise to give such campsites a wide berth unless you are actually invited in by the owners as a guest. Tibetan mastiffs are probably the most consistently aggressive canines I have encountered. A little ironic, considering how genuinely friendly and hospitable the Tibetan people are.
  • Rocks: In developing countries, dogs are accustomed to having rocks thrown at them. Hikers can use this knowledge to their advantage. When confronted with an aggressive canine, shape up as if you are going to throw a rock at it – going through the motion of actually bending down to pick up a rock can make your act even more convincing. More often than not the dog will cower away. In the event that it calls your bluff, it pays to have a couple of real rocks at the ready in order to show you mean business.
  • No Fear: If faced with an aggressive canine do not turn your back on it and definitely don’t run.
  • What to do if you are bitten?: Wash the wound with soap and water for a minimum of five minutes. Seek medical attention immediately.


Generally speaking, whether you are in a First World or a Third World country, you are safer out in the wilderness than you are in a big city. Nonetheless, never take your safety and/or the kindness of local people for granted. Before leaving home garner as much information as possible in regards to any health, cultural, political or economic issues pertaining to your proposed journey.


Mashuleh, Iran | I spent a few days (including my birthday) wandering around the mountains of this area in 2008 | Beautiful scenery, incredible hospitality.

The two keys to hiking safely in developing countries are thorough preparation and keeping your wits about you at all times. A few other observations:

  • Be aware, without being paranoid: The vast majority of people you encounter will be honest and friendly. However, there is no way around it, poverty often breeds crime. If you are in a poor rural area and happen to be camping in the vicinity of a village or town, keep a watchful eye on your belongings – just as you would if you were in a poorer area of a First World country. It is worth noting that theft is much more common on popular treks such as the Inca Trail and the Annapurna Circuit. Generally speaking, more tourists equate to a greater incidence of petty theft.
  • Low Profile: Don’t bring attention to yourself by wearing fancy clothes or accessories. Be understated and humble.
  • Leave Trip Details: Just as you would when hiking at home, be sure to leave details of your itinerary and your planned return date with a responsible contact person. Once you are finished, be sure to inform them.