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226 IN AFGHANISTAN •• Women’s Health

use a strong sunscreen (at least SPF30), and always wear a wide-brimmed hat and sunglasses outdoors. If you become sun- burnt stay out of the sun until you have recovered, apply cool compresses and take painkillers for the discomfort. One percent hydrocortisone cream applied twice daily is also helpful.

Insect Bites & Stings

Bedbugs don’t carry disease but their bites are very itchy. They live in the cracks of furniture and walls and then migrate to the bed at night to feed on you. You can treat the itch with an antihistamine. Lice can inhabit various parts of your body but most commonly your head and pubic area. Transmission is via close con- tact with an infected person. They can be difficult to treat and you may need numer- ous applications of an antilice shampoo such as permethrin. Pubic lice are usually contracted from sexual contact. Ticks are contracted after walking in rural

areas. They are commonly found behind the ears, on the belly and in the armpits. If you have had a tick bite and experience symp- toms such as a rash at the site of the bite or

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elsewhere, fever or muscle aches, you should see a doctor. Doxycycline prevents tick-borne diseases.

Anyone with a serious bee or wasp al-

lergy should carry an injection of adrenaline (eg an Epipen) for emergency treatment. For others, apply ice to the sting and take painkillers.

WOMEN’S HEALTH

Emotional stress, exhaustion and travelling through different time zones can all con- tribute to an upset in the menstrual pat- tern. If using oral contraceptives, remember some antibiotics, diarrhoea and vomiting can stop the pill from working and lead to the risk of pregnancy, so remember to take condoms with you just in case. Sanitary towels are available in the larger cities, but tampons are hard to find outside Kabul. Heat, humidity and antibiotics can all contribute to thrush. Treatment is with anti fungal creams and pessaries such as clotrimazole. A practical alternative is a single tablet of fluconazole (Diflucan). Uri- nary tract infections can be precipitated by dehydration or long bus journeys without toilet stops; bring suitable antibiotics.

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