Health and Safety

Health in India


Going to India, you have to adapt to a new climate and new food. Most travellers to India will become at least slightly ill during their stay there - even Indians returning from abroad. However, with precautions the chance and severity of any illness can be minimized. Don't stress yourself too much at the beginning of your journey to allow your body to acclimatize to the country. For example, take a day of rest upon arrival, at least on your first visit. Many travellers get ill for wanting to do too much in too little time. Be careful with spicy food if it is not your daily diet.



No vaccinations are required for entry to India, except for yellow fever if you are coming from an infected area such as Africa. However, Hepatitis (both A and B, depending on your individual circumstances), meningitis and typhoid shots are recommended, as is a booster shot for tetanus.
Tap water is generally not safe for drinking. However, some establishments have water filters/purifiers installed, in which case the water is safe to drink. Packed drinking water (normally called mineral water) is a better choice. But if the seal has been tampered, it could be purified tap water. So always make sure that seal is intact before buying.

Fruits that can be peeled such as apples and bananas, as well as packaged snacks are always a safe option. Do not eat grapes unless you wash them thouroughly.

Diarrhea is common, and can have many different causes. Bring a standard first-aid kit, plus extra over-the-counter medicine for diarrhea and stomach upset. A rehydration kit can also be helpful. At the least, remember the salt/sugar/water ratio for oral rehydration: 1 tsp salt, 8 tsp sugar, for 1 litre of water. Most Indians will happily share their own advice for treatment of illnesses and other problems. A commonly recommended cure-all is to eat boiled rice and curd (yoghurt) together for 3 meals a day until you're better. Keep in mind that this is usually not sound medical advice. Indians have resistance to native bacteria and parasites that visitors do not have. If you have serious diarrhea for more than a day or two, it is best to visit a private hospital. Parasites are a common cause of diarrhea, and may not get better without treatment.

Malaria is endemic throughout India. CDC states that risk exists in all areas, including the cities of Delhi and Mumbai, and at altitudes of less than 2000 metres in Himachal Pradesh, Jammu, Kashmir, and Sikkim; however, the risk of infection is considered low in Delhi and northern India. Get expert advice on malaria preventatives, and take adequate precautions to prevent mosquito bites. Use a mosquito repellent when going outside (particularly during the evenings) and also when sleeping in trains and hotels without airconditioning. A local mosquito repellent used by Indians is Odomos and is available at most stores.

India is home to many venomous snakes. If bitten try to note the markings of the snake so that the snake can be identified and the correct antidote given. In any event, immediately seek medical care.

Getting vaccinations and blood transfusions in low quality hospitals increases your risk of contracting HIV/AIDS- for e.g. in many private clinics.

It is very important to stay away from the many stray dogs and cats in India, as India has the highest rate of rabies in the world. If you are bitten it is extremely urgent to get to a hospital in a major urban area capable of dealing with Rabies. You can get treatment at any major hospital. It is very important to get the rabies vaccine after any contact with animals that includes contact with saliva or blood. Rabies vaccines only work if the full course is given prior to symptoms. This can be a fatal disease otherwise.


If you need to visit a hospital in India, avoid small government hospitals. The quality of treatment cannot be to your expectation. Private hospitals provide better service.

Avoiding Delhi belly

Four quick tips for keeping your stomach happy:
  1. Go vegetarian, at least for the first week or two. Meat spoils quickly.
  2. Avoid raw leafy vegetables. They are hard to clean properly.
  3. Avoid ice and unbottled water. Both the water in it and the way it's transported are suspect. Try to use only commercially available sealed bottled water.
  4. Wash hands before eating, with soap. Otherwise the dirt of India's streets will find its way onto your chapatis and into your mouth. In addition, keep nails cut short and clean.



Staying Safe in India
As a rule India is quite safe for foreigners. However, check with your embassy and ask for local advice before heading to Kashmir or northeast India (Assam, Nagaland, Tripura and Manipur), as both areas have long-running insurgencies. Also take extra caution when traveling at night in Uttar Pradesh, Bihar and Jharkhand and downmarket districts of large cities.

Unfortunately theft is quite common in places visited by tourists, but violent thefts hardly ever occur. More likely a thief will pick your pocket (see pickpockets) or break into your room. There is little risk of street robbery in India.

Some people handling your cash will try to shortchange you or rip you off. In Delhi particularly, this is a universal rule adhered to by all who handle westerners' cash. This does not exclude official ticket sellers at tourist sites, police employees at prepaid taxi stands, or merchants in all but the most upscale businesses. Count your cash before handing it over, and be insistent on receiving the correct change.

Agree on all fares and payments for services clearly in advance; some people go as far as to write them on paper! Being told that you can pay "as you like" is a sure warning sign. Don't give more than agreed, no matter what explanation is offered at the time of payment. Just take your belongings, pay what was originally agreed and walk away. The first time this happens, on your first taxi ride in India, this may be awkward, but the fifteenth time it happens, on your fifteenth taxi ride, it will be second nature. When travelling by autorickshaw, never ever get into the vehicle if there is another person accompanying the driver. This always spells trouble for unwary travellers.

Overseas visitors, particularly women, attract the attention of
beggars, frauds and touts. Beggars will often go as far as touching you, and following you tugging on your sleeve. It does little good to get angry or to say "No" loudly. The best response is to look unconcerned and ignore the behavior. The more attention you pay to a beggar or a tout -- positive or negative -- the longer they will follow you hoping for a payback. Giving money to beggars in public is not safe as it will result in a stampede of beggars from all directions. As always in India, patience is required. Wearing local clothes will decrease the amount of attention you receive.

Travelers should not trust strangers offering assistance or services; see
Common scams. Be particularly wary of frauds at tourist attractions such as the temples of Kanchipuram, where they prey on those unfamiliar with local and religious customs. If a priest or guide offers to treat you to a religious ceremony, find out what it will cost you first, and do not allow yourself to be pressured into making "donations" of thousands of rupees — simply walk away if you feel uncomfortable. However, don't get too paranoid: fellow travelers on the train, or Indian families who want to take your picture on their own camera, for example, are often just genuinely curious.

Travelers should be cautious when visiting villages and rural areas in the night. Bandits occasionally abduct and rob tourists, as it is assumed they possess large amounts of wealth. But this is rare and happens most often in remote areas. Ask at your hotel to see if this is an issue in your area. Also, think twice about taking night buses or driving at night in these areas. Bandits are said to stop night buses with fake checkpoints and rob everyone inside. The frequency of this occurring is extremely low and the state governments are working hard to arrest these bandit groups, but take extra care nonetheless.

Homosexuality is illegal in India. This is rarely enforced though, evidenced by a vibrant gay nightlife existing in metropolitan areas and some (but very few) openly gay celebrities. That said, the most severe penalty for crimes relating to homosexual acts is up to 10 years.

Whereas Indian men can be really eager to talk to travelers, women in India often refrain from contact with men. It is an unfortunate fact that if you are a man and you approach a woman in India for even an innocuous purpose like asking for directions, you are putting her on the defensive. It is better to ask a man if one is available (there usually will be), or be extra respectful if you are asking a woman.



Female travellers

  • India is a conservative country and some Western habits are perceived as dishonorable for a woman.
  • Outside of the larger cities, it is unusual for people of the opposite sex to touch each other in public. Even couples (married or otherwise) refrain from public displays of affection. Therefore, it is advised that you do not shake hands with a person of the opposite sex unless the other person extends his/her hand first. The greeting among Hindus is to bring your palms together in front of your chest, or simply saying 'Namaste', or 'Namaskar'. Both forms are equally polite and correct, if a little formal. Almost all the people (even if they don't know English) do understand a "Hi" or a "Hello".
  • Except in major cities (and only in trendy places or in high society) women do not smoke. A woman who smokes/drinks is associated with loose moral character in much of the rest of the country's growing middle class.
  • Places such as Discos/Dance clubs are less-conservative areas. It is good to leave your things at a hotel and head down there for a drink and some light conversation.
    People are fully-clothed even at the beach. So, be sure to find out what the appropriate attire is for the beach you are visiting. In some rare places like Goa, where the visitors to beach are predominantly foreigners, it is permissible to wear bikinis on the beach but it is still offensive to go about dressed in western swim wear away from the beach. There are a few beaches where women (mostly foreigners) sunbathe topless but make sure there it is safe and accepted before you do so.
  • In local trains, there are usually cars reserved only for women and designated as such on their front. This reserved car is usually (but not always) the last in the train.
    In most buses (private and public) a few seats at the front of the bus are reserved for women, Usually these seats will be occupied by men and, very often, they vacate the place when a female stands near gesturing her intention to sit there. In many parts of the country, women will not share a seat with a man other than her spouse. If you sit near a man, he may stand up from the seat and give the place to you; this is a sign of respect, not rudeness.
  • Street parties for holidays are usually filled with crowds of inebriated men. During festivals such as Holi, New Year's Eve, and even Christmas Eve, women can be subjected to groping and sexually aggressive behaviour from these crowds, particularly in the northern and some western parts. It is unsafe for women to attend these festivities alone.
    Friendly conversation with men you meet on trains, etc. is often confused with flirtation/availability. In some scenarios, this can lead to unexpected sexual advances (this happens to Indian women as well, not just Westerners). Befriending Indian women, however, can be a wonderful experience for female travellers, though you might have to initiate conversation.
  • It's not disrespectful for a woman to tell a man eager to talk to her that she doesn't want to talk - so if a man's behaviour makes you uncomfortable, say so firmly.
  • Dressing in traditional Indian clothes, such as salwaar kameez (comfortable) or saree (more formal and difficult to wear) will generally garner Western women more respect in the eyes of locals. Show some enthusiasm for the traditional Indian way of life and you may find that men will treat you more like a 'lady' than an object.
  • "Eve Teasing" is a term used in Indian English to refer to anything from unwanted verbal advances to physical sexual assault.




Terrorism
The India-Pakistan conflict, simmering for decades in Pakistan, has in recent years manifested in terrorist attacks on India's main cities: since 2007, there have been bombings or coordinated shootings in Delhi, Bombay, Hyderabad, Ahmedabad and Bangalore. The targets have varied widely, ranging from hotels and restaurants to markets and train stations, and with the notable exception of the November 2008 attack in Mumbai, have been aimed squarely at locals, not foreigners. Realistically speaking, there is little you can do to avoid random acts, but do keep an eye on the news and any travel advisories.