Health and safety on the Carretera Austral

Health

Before you travel, check the current Foreign, Commonwealth and Development Office (FCDO) travel advice gov.uk/government/organisations/foreign-commonwealth-development-office as well as the country-specific page, which details any travel restrictions and entry requirements, as well as safety and security advice.

Ensure that any insurance is appropriate for the type of travel that you intend to do; currently this should include cover for Coronavirus-related events such as health problems and travel disruption.

Medical facilities are limited in the Carretera – any serious accident or illness will involve evacuation to Puerto Montt or Santiago. Every village has a posta de salud, which is a minimal medical centre for minor problems. Certainly outside of Coyhaique it is unlikely that doctors will speak English.

Tap water is drinkable across Chile, although mineral water is almost always available. To be really safe, stick to mineral water (though this should not be used to make up babies’ feeds as the salt content is likely to be too high) or bring water to a rolling boil or use a water filter bottle such as Aquapure to filter any water that you drink. Anyone with a compromised immunity is more susceptible to infections. Food poisoning and cholera are not a great problem, but uncooked ceviche (shellfish) should be avoided (see opposite). Depletion of the ozone layer, coupled with dry, unpolluted air, has led to increased levels of ultraviolet radiation in southern Chile, causing sunburn and increasing the risk of cataracts and skin cancer. Be sure to wear good sunglasses and plenty of sunscreen.

While on the road, it is a good idea to carry a personal first-aid kit. Contents might include a good drying antiseptic (eg: iodine or potassium permanganate), plasters, suncream, insect repellent, aspirin or paracetamol, antifungal cream (eg: Canesten), ciprofloxacin or norfloxacin (for severe diarrhoea), antibiotic eye drops, tweezers, condoms, a digital thermometer and a needle and thread. Those suffering from allergies should bring the relevant medication or EpiPen with them to the region.

Travel clinics and health information

A full list of current travel clinic websites worldwide is available on istm.org. For other journey preparation information, consult travelhealthpro.org.uk (UK) or wnc.cdc.gov/travel (USA). Information about various medications may be found on w netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.

Inoculations

No vaccinations are legally required, but make sure you’re up to date with tetanus and diphtheria – which these days comes with polio as the all-in-one Revaxis – and measles mumps and rubella vaccine (MMR).

Hepatitis A and typhoid vaccines may be recommended. These food and waterborne diseases are more likely to occur in travellers who are visiting friends and relatives, long-stay or frequent travellers, or those going to areas where there is poor sanitation. In addition hepatitis A would be also advised for certain occupations, men who have sex with men and intravenous drug users.

Hepatitis B is carried by about 2% of the population of Chile which is classed as an intermediate/high prevalence. Vaccination should be considered for everyone ideally, but especially those who may be at increased risk. Hepatitis B can be spread by having unprotected sex, sharing needles and through working in medical settings and with children.

Chile is considered a low-risk rabies country as rabies is only reported in wild animals. Anyone working with animals in Chile should be vaccinated. Most other travellers will be at low risk, but you should consider having a pre-exposure rabies vaccine if you are travelling longer term or are going to be away from good medical care.

Yellow fever is not present in Chile and there is no requirement for proof of vaccination even if you are entering the country from yellow fever-infected areas.

The Marea Roja or ‘Red Tide’ is an accumulation of toxic algae which concentrate in shellfish and can cause death in humans; it occurs in southern Chile in hot weather. Shellfish is very closely monitored in markets and restaurants, but you should be extremely careful about any you gather yourself.

Chagas disease is caused by the parasite Trypanosoma cruzi. It is mostly transmitted to humans by contact with the triatomine bug or its faeces. The bug lives in the walls and roof cracks of houses. In the acute phase most people have mild or no symptoms. In the chronic phase it can affect the heart and the gut. It is treatable if caught early. This disease is rare in most travellers.

Andes virus (ANDV) is a type of Hantavirus found in Chile. It is a cause of hantavirus cardiopulmonary syndrome (HCPS) which can be fatal. It is predominantly found in southern Chile. Wild rodents of the family Cricetidae (in particular the long-tailed pygmy rat) carry the virus while looking healthy and can pass it to humans. Transmission occurs by inhaling aerosolised rodent excreta or through touching mucous membranes with contaminated hands. Person-to-person transmission can also occur within households. The incubation period varies from four days to eight weeks and the prodomal illness resembles flu, although sometimes gastrointestinal symptoms of diarrhoea and vomiting are the only early symptoms. There is a higher risk in huts and cabañas which have been shut up over winter, so ensure they have been thoroughly aired. Cabins and campsites where there is visible evidence of rodent activity should not be used. If camping, ensure that you use a ground sheet, or preferably a camping bed, and ensure good hand hygiene at all times.

Travelling in Chile carries a moderate risk of getting a dose of travellers’ diarrhoea. The most important prevention strategy is to wash your hands before eating anything. The maxim to remind you what you can safely eat is: PEEL IT, BOIL IT, COOK IT OR FORGET IT. Fruit you have washed and peeled yourself and hot foods should be safe but be careful with raw foods and foods kept lukewarm in hotel buffets, as they can be dangerous. Dairy products such as yoghurt and ice cream are best avoided unless they come in proper packaging. That said, most good hotels and restaurants have good standards of hygiene and travellers should be able to enjoy a variety of foods.

The risks of sexually transmitted infection are moderately high in Chile whether you sleep with fellow travellers or locals. In 2020 about 0.6% of the population aged between 15 and 49 were living with HIV. Be safe and use condoms or femidoms, which help reduce the risk of transmission. If you notice any genital ulcers or discharge, get treatment promptly since these increase the risk of acquiring HIV. If you do have unprotected sex, visit a clinic as soon as possible – this should be within 24 hours or no later than 72 hours – for post-exposure prophylaxis.

Long-haul flights, clots and DVT

Any prolonged immobility, including travel by land or air, can result in deep-vein thrombosis (DVT), which can be dangerous if the clot travels to the lungs to cause pulmonary embolus. The risk increases with age, and is higher in obese or pregnant travellers, heavy smokers, those taller than 6ft/1.8m or shorter than 5ft/1.5m, and anybody with a history of DVT or pulmonary embolism, recent major operation or varicose vein surgery, cancer, a stroke or heart disease. If you think you are at increased risk of a clot, ask your doctor if it is safe to travel.

To help prevent DVT, wear loose comfortable clothing, do anti-DVT exercises and move around when possible, drink plenty of fluids during the flight, avoid taking sleeping pills unless you are able to lie flat, avoid excessive tea, coffee and alcohol, and consider wearing flight socks or support stockings, which are widely available from pharmacies. Symptoms of a pulmonary embolus – which commonly start three to ten days after a long flight – include chest pain, shortness of breath, and sometimes coughing up small amounts of blood. Anyone who thinks that they might have a DVT needs to see a doctor immediately.

Animal/insect bites

There are no venomous snakes, although the recluse spider (araña de rincón), found in many homes, has a venomous bite which can kill. There are biting insects in summer in the south (and sometimes around Arica) but they don’t carry diseases such as dengue, chikungunya or zika. Tabanos (horseflies) are prevalent across Patagonia in the summer. They are a nuisance but not life-threatening; they attack humans – particularly short-sleeved-shirt- and shorts- wearing trekkers – often in swarms, and do give a nasty bite. However, they are slow and easily swatted once they have landed on exposed skin. Motorcyclists should keep their visors closed if there is any danger of tabanos.

Safety

The entire region of the Carretera Austral is astonishingly safe. The greatest threats are road accidents, or accidents relating to outdoor activities. Consider that communications are often poor, ambulances may have to travel extended distances on poor-quality roads, and medical facilities are limited.

The best means to avoid road accidents are: drive slowly; avoid driving at night; always use headlights (even during the day); use a vehicle suitable for the road conditions; ensure you can see through the rear-view mirror; assume there will be an oncoming truck or horse in the middle of the road on every blind corner and brow of a hill; do not stop on a corner; and pull off to the side of the road when snapping a photograph.

Outdoor activities such as climbing, rafting, diving and horse riding carry inherent risks. Ensure the guide is qualified, has insurance, and participate according to your abilities. Use reputable operators, and if in doubt ask to see the SERNATUR qualification. Companies offering water activities require a licence, although informal and unlicensed companies also operate. Trekking, particularly in mountains, can be lethal for the ill-prepared. Although not as high as other parts of the Andes, weather can deteriorate rapidly.

Glaciers are potentially dangerous. Large chunks of ice fall at random intervals, often emitting small shards of ice in the process. When ice falls into lakes the subsequent wave can be sufficient to topple a boat. Trekking on glaciers should only be done with guides, as crevasses are not always visible.

Women travellers

Women travellers are equally safe. Care must be taken in certain rougher areas of Puerto Montt largely due to the prevalence of drunks. Taxis are the best means to travel at night. South of Puerto Montt there are very few safety issues. Around the mining areas it is possible to encounter the occasional drunk miner, but the same common-sense rules apply here as at home. Bars with suspicious red curtains are generally not the safest places in town, as they offer a range of ‘services’ not found in standard bars, and are perhaps best avoided by women travellers.

LGBTQ+ travellers

While same-sex unions were legalised in Chile in April 2015, this remains a very conservative country and gay couples would be best advised to avoid public displays of affection. The only gay bar along the Carretera Austral is Club Angels in Puerto Montt.

Travelling with a disability

The UK’s gov.uk website gov.uk/government/publications/disabled-travellers
provides general advice and practical information for travellers with disabilities preparing for overseas travel. Where possible this guide lists hotels and restaurants with facilities for travellers with disabilities; unfortunately, these are few and far between. Significant sections of the Carretera Austral are not paved and, although this is slowly changing, the reality is simply that disabilities have not been considered in the construction of the vast majority of towns, buildings, restaurants, hotels, public transport options, roads or tourism facilities, and nor are the inhabitants of this region accustomed to assisting those with disabilities. It is rare to see people with disabilities, whether visitors or residents, along the Carretera Austral. However, this is changing. Otras Huellas offers a range of programmes enabling those with physical or cognitive disabilities to enjoy Patagonia.

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