Outside magazine’s inaugural ‘Travel Awards’ winners

travel awardsWith twenty-three categories and every continent up for consideration, the competition is fierce, but today Outside magazine released its picks for its new Outside Travel Awards. The winners include everything from travel companies and locales to cameras, suitcases, hotels, and apps, road-tested by those in the know (you know, those people).

Amongst the chosen is Seattle-based Mountain Madness, a mountain adventure guide service and mountaineering school, for its new Tsum Valley trek in Nepal, named “Best Trip in the Himalayas.” Known in sacred Buddhist texts as the “Hidden Valley of Happiness,” the Tsum Valley lies on the edge of the more visited Manaslu Conservation Area, which opened just three years ago to tourism.

Best travel company Geographic Expeditions (GeoEx) has “consistently taken travelers to the most remote regions of the world, from Everest’s north side to Patagonia’s glaciers to the far reaches of Papua New Guinea. This year its trailblazing new terrain with a 27-day trek to the north face of K2 ($11,450).” Bonus: “the price of every GeoEx trip includes medical assistance and evacuation coverage from Global Rescue and medical-expense insurance through Travel Guard.” Not too shabby.

Also making the list: Myanmar is the “Best New Frontier;” Canon Powershot G-12 makes the “Best Camera;” the “Best New Adventure Lodge” is the Singular, outside of Puerto Natales, Patagonia, Chile; and the “Best Eco-Lodge” is the architectural marvel, The Mashpi in Ecuador.

[Photo credit: Flickr user tarotastic]

Ten bizarre travel diseases that can ruin your next vacation

travel diseasesOn some level, catching a weird disease or picking up a little-known tropical parasite on your travels gives you bragging rights. “Look at me, I’m so hardcore!” Trust me, I’ve been there. But with Multidrug-Resistant Tuberculosis (MDR TB) making headlines worldwide, I’d like to remind fellow travelers that these diseases are no joke, and even those of us with healthy immune systems and access to industrialized medicine aren’t impervious.

The reality is, you never know what you might be susceptible to. In my case, my doctors and medical research indicate that I may be lacking an enzyme that made me vulnerable to an extremely rare but serious tropical disease caused by the bacteria Bartonella bacilliformis, which causes Oroya Fever (and its precursor, Verruga Peruana). I’m still recovering from a three-year battle with the disease that has resulted in permanent organ damage because of a failure to protect myself against sand flies in the Amazon Basin region of Ecuador. Regular applications of DEET could have prevented that, as well as the various misdiagnoses of tuberculosis, histoplasmosis, and Hodgkin’s lymphoma, but that’s another story.

A lot of tropical and uncommon travel-related ailments are difficult to diagnose, and sometimes even more problematic to cure (if they don’t kill you, first). Statistically, however, most travelers–even if they’re in extremely sketchy parts of the world–will stay healthy if they take the necessary precautions. Having a trustworthy travel doctor is also helpful if you spend a lot of time in developing nations.
Being prepared before you leave home is key. You should never take travel wellness lightly, but don’t let fear ruin your trip. I certainly don’t follow every bit of medical advice out there (I honestly don’t see the point of traveling if not to eat epic quantities of street food.). If you’re going to be completely paranoid and don’t own a Hazmat suit, perhaps it’s better to stay home. But don’t ignore CDC warnings for recommended (or required) vaccinations, and if you know you’re going to be in a malarial or otherwise-dangerous insect-or-disease-inhabited region, prepare accordingly.

Just remember to do your research before you go, and remember that while it most likely won’t happen to you, it’s not impossible.

After the video (graphic, but it illustrates just how devastating TB can be, as well as provides important information on Multidrug-Resistant Tuberculosis), a gallery of bizarre diseases you’ll want to avoid during your travels.


%Gallery-144934%

Top five things to look for in a travel doctor, and why you should have one

travel doctorsDespite writing about food and adventure travel for a living, I used to be somewhat blasé about the concept of travel medicine. Multiple incidents of Giardia/dysentery/traveler’s diarrhea/full-body outbreaks of mosquito and sand fly bites just taught me to carry a serious stash of antibiotics in my first-aid kit. At least I’ve always been conscientious about travel immunizations and educating myself about the primary diseases indigenous to my destination.

When you’re young and healthy, it seems silly to have a travel medicine specialist. Although this article is primarily directed at adventure travelers, odds are, the worst thing you’ll come home with is a backpack full of crappy souvenirs. But no one’s invincible, and should you require a specialist for something not responding to conventional treatment or with progressive symptoms, time is of the essence. Many “exotic” diseases progress rapidly, and can cause irreversible damage or death if not properly diagnosed and treated. Even with incurable diseases, the earlier you catch them, the easier it will be to manage symptoms and prevent them for worsening.

No, I’m not a doctor, although I come from a medical family. But I got seriously schooled after visiting Ecuador two years ago. After a fantastic month of adventure activities in remote parts of the Andes and Amazon Basin, I fell seriously ill the last day my trip. Two years of at-times crippling symptoms, 10 CT scans, five medical facilities, dozens of specialists, four surgical procedures, two surgeries, one cancer diagnosis, and near-medical bankruptcy later, I’ve become an expert at being my own advocate.

My infectious disease doctor believes that I contracted a form of bartonellosis called Oroya Fever after being bitten by sand flies. The good news: My health is currently stable, but we don’t know if the disease is in remission or not. But I have permanent cognitive damage, scarring or tumors on most of my internal organs, and intermittent arthritis. But believe me, I feel lucky.

I don’t want anyone to go through the health and medical nightmare I’ve endured, so I’ve compiled a list of essentials in a travel medicine doctor. Ergo, number one with a bullet:

1. Is he/she a travel or tropical medicine specialist?
Pre-bartonella, I used an internist as my GP/prescriber of antibiotics. If you can find an internist, gastroenterologist, or infectious disease doctor who is also a specialist in travel medicine, that’s a huge plus.travel doctors 2. Does he/she have personal experience traveling or practicing in developing nations?
There are a lot of practicioners who aren’t globally aware, so to speak. You can’t diagnose what you don’t understand, know about, or have first-hand experience with. Period.

3. Is he/she a good listener and empathetic?
It’s difficult to find these qualities in any doctor, especially in today’s medical climate. But it’s imperative to find someone you can communicate with, and who understands what you’re going through if you’re suffering from a mystery travel ailment. Don’t settle, even if you need to travel to another state or country to seek treatment (what stumps doctors here is often commonplace in the country of origin).

4. Does he/she have a good network of colleagues in multiple specialties (including travel/tropical medicine) to consult for additional opinions?
My current mantra is to seek a third opinion, from at least two different medical facilities. That, and to have a travel physician who actively consults colleagues and does additional research to assist with a diagnosis and/or treatment. My infectious disease doctor talked to specialists at a medical school in Peru on my behalf, and even tracked down a relevant medical paper from 1897 as he honed in on a diagnosis. And while I wouldn’t consider it a deal-breaker if the answer is no, see if your doctor is an active and participating member of the International Society of Travel Medicine.
travel doctors
5. Does he/she return your calls/provide you with email, pager, or office number so you can get in touch directly?
I’ve learned that a good doctor who is invested in your recovery will provide an open line of contact to address questions, concerns, and exchange pertinent information. Tip: Please don’t abuse this privilege. Physicians work insanely long hours, under constant stress. And don’t expect to hear back immediately if you leave a non-urgent message; be realistic. A couple of days, fine (many specialists aren’t in clinic every day). A week? Make a polite follow-up.

Whether or not you end up getting a travel doctor, the International Association for Medical Assistance to Travelers (IAMAT) provides loads of useful information, including a directory of global travel medicine clinics with English-speaking staff, and a destination-specific travel health planner. And depending upon what you plan to do on your trip, where you’re traveling, and your financial situation, you may want to invest in travel insurance.

[Photo credits: blood transfusion, Flickr user CarynNL;patient, Flickr user kk+; legs, Laurel Miller]

The Ultimate Travel First Aid Kit

Nuts about Peru’s Tambopata National Reserve

Nuts–if you think about these things, which evidently I do–evoke blustery fall afternoons, or wintery evenings before a roaring fire. You bust out the nutcracker, and get to work. At least, that’s what my family did when I was a kid, even though I grew up in Southern California where, let’s face it, the weather is seldom blustery. Anyways, we always had a lot of Brazil nuts in the communal bowl, and consequently, they’re one of my favorites. They’re big and easy to crack, with rich, oily meat.

Nuts have been associated with the winter solstice since Medieval times (they provided much-needed fat and nutrients). What most of us don’t associate nuts with are steaming jungles, machetes, or endangered wildlife. I certainly didn’t, until I visited the Brazil nut camp in Tambopata National Reserve (TNR), in Peru’s Amazon Basin.

The Tambopata is a tributary of the Amazon, and the 275,000-hectare Reserve is home to some of the world’s most diverse and pristine rainforest. This conservation area, and the adjacent Bahuaja-Sonene National Park were designated by the Peruvian government to protect the watersheds of the Tambopata and Candamo Rivers. Rainforest Expeditions operates three Puerto Maldonado region eco-lodges within the confines of the Reserve: the Posada Amazonas and Refugio Amazonas eco-lodges, and the Tambopata Research Center. It’s at Refugio that one can visit the Brazil nut camp, and harvest the nuts (April through July).

%Gallery-100753%

Even if nuts aren’t your thing, there are plenty of other reasons to visit. The area is noted for its wildlife, especially birds. If there’s an active nest, there are tours to check out endangered harpy eagles (they live in Brazil nut trees), or hike to clay licks teeming with macaws or parakeets. That may not sound thrilling, but it’s an amazing sight to see (and hear) that many explosively colorful birds in one spot.

Rainforest Expeditions integrates its jungle properties with educational/voluntourism experiences for adults and families. Besides the clay licks, activities include forest walks, wildlife viewing, philanthropic visits to local communities, seminars on the ecology and biology of the region, kayaking, catch-and-release piranha fishing, or cooking with the indigenous staff (an activity reserved for rainy weather, and something I really enjoyed, from a cultural standpoint).

Refugio is located in a 200-hectare private reserve (which is adjacent to the greater Reserve, you see). To get there, one must fly into the tiny jungle port of Puerto Maldonado from Lima. From there, it’s an hour drive to the boat launch in the indigenous community of Infierno, which works in partnership with the Posada Amazonas Lodge. The Refugio property is a two-and-a half-hour trip upriver, through a park ranger checkpoint.

The gorgeous, four-year-old, open-air lodge is built from traditional native materials such as wood, palm fronds, wild cane, and clay. It has a communal dining room with a bar (yes!), and clean, breezy rooms with gauzy, mosquito-netted beds. There are also luxe touches, like the pretty little guest soaps made of–wait for it–Brazil nuts. The food–a daily buffet of international and Peruvian dishes, and loads of fresh fruit, far surpasses what you might expect. Some of the produce comes from organic farmer Don Manuel, across the river. He grows tropical and citrus fruits, yucca, and chiles; on his farm tours, (if you love food, definitely go for it), you can sample Amazonian fruits such as cupuaçu and pacay.

Getting back to nuts, the brazil nut camp is a concession owned by the Peruvian government, although a local indigenous family has rights to the nut harvest. There are thousands of Brazil nut concessions in this region. They’re an important cash crop that provides the local families with income, which also helps to protect the Reserve from slash-and burn-agriculture.
The local Ese’eja, as well as other indigenous peoples of mestizo and Andean descent, live within four communities in the buffer zone of the Reserve. Many are employed by Rainforest Expeditions (the company tries to hire as many local people as possible), or harvest Brazil nuts during the wet season.

The nuts are technically an edible seed, clusters of which are found within thick seed pods. The trees don’t make good timber, although they are tapped for rubber in the dry season. They’re considered one of the most sustainable crops because their harvest and tapping have little ecological impact, especially in areas where hunting is prohibited or restricted during harvest season.

Brazil nut trees are an interdependent species, because they rely upon several animals to perpetuate their life cycle. Agoutis and other rodent species eat the nuts, spreading seeds in their droppings. A species of rainforest-dwelling bee is necessary to pollinate the trees, which is why they aren’t cultivated.

It turned out I’d just missed the harvest, but I walked the short trail to the deserted camp to check it out–basically, some leftover seed pods in a small clearing. Back at the lodge, however, Brazil seed pod cracking is like an Olympic sport, in part because it brings out the competitive spirit. They’re exceedingly difficult to open, necessitating a scimitar-like machete and serious hand-eye coordination- something I am seriously lacking. I finally managed to whack one apart without losing any digits, and made use of the lodge’s industrial-strength, communal nutcracker. You see a lot of people walking around, picking Brazil nuts or bits of shell out of their teeth.

The handsome, coconut-like pods turn up all over the lodge in the form of napkin holders, and votive-receptacles on recycled wood chandeliers. At the Puerto Maldonado airport, you can find Brazil nut candy, and oil, which is intoxicating, with a smooth, clean, complex flavor. Unfortunately, it has such a short shelf life that it isn’t suitable for the export market, but it’s worth bringing a bottle home with you (I honestly have no idea if Customs permits this, but that’s never stopped me before). Use it to dress salads, or drizzle on roasted potatoes or root vegetables.

Refugio and its sister properties may take some getting to, but if you’re looking for responsible, soft rainforest adventure, it’s well worth the trek.
All the more reason to load up that bowl with Brazil nuts.