Before Nathan and I departed Sausalito, we made several appointments at the Adult Immunization Travel Clinic in San Francisco. Looking back, I count these appointments as some of my favorites among our travel preparations. From the reception staff to the nurses who counseled us, each person we interacted with was kind, enthusiastic, and knowledgeable. For each of the fourteen countries we planned on visiting, we were given a list of recommended and required immunizations, suggested medications, and advice ranging from what to pack in a first aid-kit to how to navigate the greatest health risk we would likely face on the road—contaminated water. The AITC nurses not only took care to familiarize us with the symptoms of particular illnesses associated with travel in Latin America, but they also managed to share our hopes for the best while preparing us for the worst. They shared their own travels and could describe the topography and climate of our destinations with encyclopedic detail layered with personal experience and insight. It was heartening to be around people who not only understood the risks of long-term travel but could speak to its virtues.
In all, we received vaccines for Yellow Fever and Rabies and preemptive prescriptions for altitude sickness, Giardia, Malaria, traveller’s diarrhea, UTIs, and yeast infections, should we need them. Most of these medications were not covered by our insurance—the three-shot Rabies vaccine alone cost us about $1,000 per person—but it gives us great peace of mind to have them. Many of these medications can, of course, be purchased cheaply over the counter in Mexico. However, since arriving in the country, we have also found that many common ailments, such as ear infections, still require a medical consultation and examination before treatment can be purchased at one of the many discount pharmacies that each town offers. And in the case of obtaining a diagnosis and treatment of Giardia, one must collect and submit stool samples over a period of several days before any healing protocol can begin. Needless to say, while it will take a bit of research and self-awareness to be able to contextualize what our bodies may be trying to tell us via any number of unpleasant symptoms, there are definite perks to our self-reliance—and that’s mainly not having to witness each other’s stool samples.
We have also incorporated a few natural remedies into our preventative health arsenal—pH balancing and anti-fungal Tea Tree oil for our feet, when our clean socks run out or when we encounter questionable shower tiles; for dabbing on canker sores; for sprinkling on aging toothbrushes; for soothing dry scalp. On the recommendation of a dear friend, we also brought a small bottle of “Theives,” an essential oil blend of lemon, cinnamon, eucalyptus, clove, and rosemary for sprinkling on damp textiles to ward off mildew and to take with hot water when head colds creep up on us.
As one who has considered raw fruit and vegetables a very important part of my preventive health regime, it’s been a challenge to contend with the fact that unless one seeks out hip, vegan and vegetarian alternative-lifestyle restaurants, (which do exist, however few and far between, and however comparatively expensive) one simply doesn’t encounter an abundance of veggies on the menus of Mexican eateries. While cantaloupe, watermelon, mango, pineapple, orange, jicama, shredded carrot, and cucumber are commonly sold by street corner carts and prepared with lime juice, salt, and chile powder, one risks cross-contamination due to lack of hand-washing facilities. So, beyond garnishes—the avocado, green cabbage, and pickled jalapeño that provide textural contrast to the tacos, tortas, chilaquiles and pozoles that are served everywhere and from which it feels almost criminal to abstain—we unfortunately have not eaten many vegetables in Mexico.
Now, I am no germaphobe. I often practice the five-second rule. But having worked in the food and beverage industry for many years and most-recently as a massage therapist, the lack of proper hand-washing facilities and protocol in many street food settings sets off clear alarm bells in my mind. At the same time, to patronize only the brick-and-mortar establishments which cater to national and international tourists is usually to be overcharged for sub-par meals and ambiances cheesier than a tex-mex quesadilla. It is to miss out on the primary social and commercial spheres of locals, from small “Pueblos Magicos” like Cuetzalan to the cosmopolitan, artsy neighborhood of Coyoacán in Mexico city. I hope you’ll forgive the certified food-handler’s geek in me as I recount how swiftly and efficiently one pork-kebab stand in Coyoacán met the demands of their immense nightly crowd, and how each crew member handled raw meat, cooked food, sliced fruit, and cash payments. Without a bottle of hand-sanitizer in sight. Did I partake of the kebabs? Sure did. Was I conflicted? You bet.
At the tianguis, or open-air market, in Cuetzalan, I bought a freshly-squeezed juice of orange, celery, and beet. After having slogged through intermittent bouts of altitude sickness in Teotihuacán and Mexico City— having dragged myself up the pyramids and along the Avenue of the Dead and down charming alleys lined with used book stores and coffee shops light-headed and slightly nauseous—I knew that a fresh juice would help combat the fogginess and fatigue that can accompany high elevation. The man selling juice at the Sunday tianguis had his two young sons or grandsons to help. When customers appeared, the boys would throw their action-figures down on the plaza’s gritty stone steps to cut and juice the fruit, accept my cash, count correct change, and return to their games. No sanitation policies here. But there was no point choosing another vendor when every other place presented much the same risk. Juice stands were tucked between tables lain with freshly butchered, unrefrigerated plucked chickens and pigs heads and blood puddings. Mothers and grandmothers, often barefoot, slapped tlayoyos, pockets of masa and refried beans, into shape with bare hands, all while minding children, giving and receiving change, smoothing escaped wisps of their hair back into place, and taking much-needed bites of lunch themselves. Most vendors had ridden the combis, the public transport vans, in from remote indigenous settlements outside of town, their cooked fare, wares, and animals in tow. It was magical and I wanted to sample and remember as much as I could.
And it was uncomfortable to realize that the standards I held for maitaining my own health and for what I considered to be potentially hazardous to it were so markedly different from almost everyone else's in town. Of course, Nathan and I are privileged to be armed with what preventative knowledge we have. Taking certain precautions matters to us because we don’t want to waste time being stuck in a hostel dorm bed or being unable to ride for hours at a time. But I bit the bullet and enjoyed my juice anyway. And it remains to be said that the Giardia for which I would begin to show symptoms later that very evening in Cuetzalan could most likely be traced to the bag of shiny, imported apples I’d bought from a big, shiny, and well-organized supermarket in Mexico City and forgot to disinfect.
My concept of what it means to stay healthy has been challenged here as much as it has been expanded. One finds convenience markets at a stone’s throw in Mexico, which are stocked to overflowing with packaged and processed snacks that present few risks of food-born illness but that are also loaded with sugar, trans fats, and artificial flavorings and colorants. Eating well and staying healthy has become a balancing act, a game. We floss. We eat what’s locally available. We take turmeric rhizome for aches from riding and sleeping on lumpy mattresses or stony ground and probiotic pills and yoghurt for digestion. When I shop for groceries in the places where we have access to cooking facilities and refrigeration, I try to keep micronutrients—the vitamin and mineral contents of foods—in mind in an attempt to fill in our dietary gaps. We bought iodine solution for disinfecting produce, drink bottled water or water that we’ve boiled or treated with our SteriPen ourselves, and take heart in the fact that most of the agricultural products we consume have at least been raised or cultivated nearby. But we don’t have it all figured out. At two-and-a-half months in, we’re not the brightest, shiniest, or healthiest we’ve ever been. And the encapsulated turmeric and probiotics will run out sooner or later. But no one ever died from not eating bougie salads, and the happiness that comes from eating something delicious, that perhaps reminds me of something my own Mexican grandmother or Mexican father fed me in my childhood, has to count for something, right?
We’ll let you know as soon as vegetables begin to make regular appearances in our diets. And until then, we raise a forkful of iron and fiber-rich beans to you and your good health this year.