I have been quite lucky in my travels throughout Ecuador in terms of not becoming significantly ill. My family and I have gotten the stomach and associated aliments for maybe a day or two after visiting some of the more remote rural areas. A few doses of Pepto-Bismol, Citrucel and some yogurt or lactobacillus tablets were generally sufficient to reestablish intestinal stability. Once or twice I resorted to anti-diarrhea medication, so far I have not had to resort to any antibiotics (usually CIPRO). I did get sick real bad one time, but that was due to motion sickness while riding in the back of a bus along the curvy and rough roads prevalent throughout the country, so having some motion sickness medications might prove helpful. She should bring and use hand sanitizer often. She should bring her own first aid supplies and may consider purchasing a kit which has needles, syringes, sutures and other sterile medical supplies, that can be hard to come by in many areas.

Quito, is around 10,00 ft and no matter how fit one is (my daughters 18-22 yo were at the time, competitive swimmers and still had as much problem as their old unfit dad) or is not, the altitude can have a profound effect on your ability to function. Climbing stairs/hills cannot only make you winded, but you muscles will burn and headaches may be common. For us, it is hard to acclimate to the altitude, as we will often leave for the coast (sea level) or other low-lying areas for a few days and then return Quito. You can get DIAMOX, which works by increasing respiration rates and can offset some of the signs and symptoms of mild altitude sickness, but for severe altitude sickness (pulmonary edema) the only easy remedy is to get to a lower altitude.

For water purification or beverages, stick to bottled/canned soda, boiled water (not bottled, unless it is sealed and a major brand) or use some type of purification system. I have and use the Katadyn Exstream Purifier Water Bottle most of the time, as it provides a ready source of drinking water (and for brushing one’s teeth) without being too insulting to our hosts. If, I belive the circumstances warrants not using the water bottle, I will either ask for tea/coffee or bottled/canned soda –no ice (Coke products are widely available, even in some of the smaller towns). I also bring an MSR ceramic filter, Steri-Pen and MIOX and use these as needed, mostly to produce larger quantities of clean water or for others to drink or for medical applications.

I avoid fresh vegetables and salads whenever possible and try and eat only fruits with a peel (plantains, bananas, oranges, mangos, papaya, etc,) although I have been known to eat a washed apple. She might want to bring snacks to munch on and to make friends by sharing.

Make sure to get all of the vaccines (yellow fever, Hep A, typhoid, etc.) recommend in enough time for them to be effective. I also take anti-malaria medication, use insect repellent (if I remember) and sun block (I received a severe case of sun burn on the top of my bald head during my first trip). Mosquitoes are not a problem in the higher elevations, but if she travels, she needs to consider being prepared.

As to safety, we have been very fortunate, in that we for the most part we travel with native Ecuadorians, although we have been placed on the bus a couple of times alone, but so far without any problems. For the most part wherever we travel in-county, we are accompanied with someone who speaks Spanish fluently and in most of the smaller towns and villages, we are treated as honored guests/family and the residents keep a close eye out for our safety. We have had a few near “incidents” where things could have gotten dicey, but local intervention kept things to minor inconveniences. The roads are terrible and very dangerous, especially in the mountains – no guardrails (several thousand foot drop), narrow (it is nothing for them to pass two-three deep including buses and trucks on a narrow-windy road) and in many areas washed out or non-existent. Pedestrians have no right-of-way, be very careful crossing busy streets. Adherence to red lights is spotty at best.

I generally, do not bring anything I would be sorry to lose; I have a cheap Timex watch, distribute my money (do not bring traveler’s checks), they are useless, even in the bigger cities and found only one bank in all of Quito that would even cash them) into several wallets and have a “throw-away” wallet with a few dollars to surrender if needed. We are lucky, in that Ecuador uses the US Dollar as legal tender, so no conversions, although I understand the new president has considered going back to the Sucre (sp?). Ecuador mints it’s own coinage, but also uses US coinage, so even their coinage is standard with US coinage (pennies, dimes, nickels and quarters) and also like the US coin dollar, since it lasts so much longer then paper money. Small bills are preferred, so mostly $1s, $5s and $10s. Twenties can be a problem. Even though, she is not going to Ecuador, I suggest smaller Bolivian bills and coins. We take a chance with our cameras and so far have been lucky. We carry large quantities of medical/rescue/fire equipment and supplies and again have been very lucky, I think once people find out we are providing medical/rescue care and training, they take extra care to make sure we are okay. Still I am very cautious in the bus terminals and areas where the locals really don’t know who we are and why we are there.

I make several copies of my passport, drivers license, airline tickets and in-country contact information and distribute these copies throughout my luggage. I also carry my Paramedic license, and since I was made a formal member (I have the rank of lieutenant) of the Tosgua Fire Department, the ID they presented to me, just to demonstrate that I have in-county contacts and that I am there for the benefit of the people.

We have stayed in some very nice hotels/hotels and some very bad ones. Most of the homes we have stayed in are nicely maintained. Have her bring her own toilet paper and carry some with her at all times, most of the public rest rooms/out houses do not have TP. On our first trip, while traveling on a bus to the coast, we stopped at a roadside restaurant and my daughter went to the bathroom, on her way some guy was waving TP and trying to get her to buy some, she did not realize until she got into the stall there was no TP.

If I think of any more items or if you (she) have any questions, I would be glad to try and help out.

Congratulations to you and your sons.

Pete