medical issues

Mexican Pharmacies

Mexican Pharmacies 2048 1536 Greg Ellifritz

I just got back from spending five weeks in Mexico running from the winter. I saw this sign at the grocery store pharmacy while I was there. They won’t sell antibiotics without a prescription as of the start of 2024.

Every country has different rules about what drugs they will sell over the counter. Costa Rica hasn’t sold antibiotics without a prescription for almost 20 years.

The Mexican stand alone pharmacies will still sell you whatever antibiotic you want, but I expect that might change in the future.

Imodium for Travel

Imodium for Travel 259 478 Greg Ellifritz

Read a little about Loperamide.


Imodium’s Survival Applications: What It Is & Why Carry It Everywhere


Imodium (or generic Loperamide) is an essential drug to stockpile for both travel and survival purposes.  In addition to the reasons mentioned in the article, in any survival situation the chance of consuming bad food and water increases.  You don’t want to be disabled from the resulting diarrhea.


One caution…


There are a couple of cases where you SHOULD NOT use Imodium to control your diarrhea.  If you have bloody diarrhea or diarrhea with fever, it’s best to let it run its course.  You can make your illness worse by “stopping things up” under these conditions.


One more interesting point….


Besides controlling diarrhea, Modicum can help people suffering withdrawal symptoms from opiate drugs.  A lot of people in this country are hooked on narcotic pain meds.  The withdrawal symptoms from not taking those meds in a survival situation would be horrible.  Although Imodium doesn’t cross the blood brain barrier (and get you high), it does have a weak effect at the opiate receptors and might reduce some of the physical symptoms of opiate withdrawal.  This article explains some of the details.

Travel Motion Sickness?

Travel Motion Sickness? 460 650 Greg Ellifritz

Nausea and vomiting are medical conditions I see more often than anything else in my third world travels.


My go-to treatment has always been Ondansetron, but it’s prescription only here in the States.


There may be a quicker option than anti-nausea meds that doesn’t require any prescription.  Who knew about this alternate use for the simple alcohol prep pad?  A very neat trick for those interested in austere medical issues.


Trick of the Trade: Isopropyl Alcohol Vapor Inhalation for Nausea and Vomiting



First Aid for Sand Fly Bites

First Aid for Sand Fly Bites 960 720 Greg Ellifritz

If you travel to tropical environments (especially to beach areas in those environments) you are likely to encounter various insect bites.  The article below describes some of the likely suspects and goes over some useful treatment protocols.


Sand Fleas and Flies


I’ve had quite a bit of experience dealing with sand fly bites in the Caribbean, Egypt, and South America.  Besides the advice provided in the linked article above, I have a few more suggestions.


If the hydrocortisone cream recommended in the article isn’t stopping the itch, you could also try a topical corticosteroid called triamcinolone.  It is commonly sold in foreign pharmacies and is more potent than the OTC hydrocortisone you can buy here in the States.  The triamcinolone shouldn’t be used on sensitive areas of the body (genitals, face, etc.) because it may cause irritation or skin thickening.  I’m not a doctor and this isn’t medical advice, but I’ve had good luck with this product if OTC hydrocortisone fails.


If the rash persists for more than a couple days, visit a doctor.  You may also check out the local pharmacy.  In most countries in the developing world, pharmacies sell tubes of combination steroid/anti-fungal/antibiotic creams over the counter.  That makes a precise diagnosis unnecessary if you can’t make it to the doctor.  No matter what is causing the skin irritation, these multidrug creams take care of the problem.


If itching insect bites or rashes are driving you crazy and you have no medication, try hot water. Place the affected area under water (as hot as you can stand) for three to five minutes.  The hot water might neutralize the toxins that cause the rash.  The effect is only temporary, however.  You may need to repeat the process every couple hours.  Ammonia may also work to temporarily relieve the itching from some bites.

The author of the linked article wrote a book called Survival Medicine.  Check it out if you are looking for more medical information.  It is an excellent reference.



My arm after sleeping on the beach in a hammock in Colombia.  Unfortunately the hammock’s mosquito net was made for Colombian-sized people. When your limbs touch the net, the sandflies just chew right through…and yes, I was wearing DEET.



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