The health risks in Sri Lanka are different to those encountered in Europe and North America. Watch out for bowel diseases such as diarrhoea and amoebic dysentery, vector borne diseases such as malaria and dengue fever, and a variety of fungal infections. Sri Lanoka’s physicians, though, many of whom have trained in the West, are particularly experienced in dealing with locally occurring diseases.
Before You Go
No inoculations are compulsory unless you are coming from a yellow fever or cholera area. (Cholera is very occasionally reported in Sri Lanka, so is not considered a serious risk.) However, the following vaccinations are recommended, particularly if you plan a long trip or intend visiting remote areas:
Typhoid (monovalent), Polio, Tetanus, Hepatitis A, Hepatitis B, Rabies
Children should, in addition, be protected against:
Diphtheria, whooping cough, mumps, measles, rubella
Remember to plan well ahead with vaccinations. Allow up to six weeks to receive the full course, for some vaccinations require more than one dose, and some should not be given together.
The risk of malaria exists throughout the whole country apart from the districts of Colombo, Kalutara and Nuwara Eliya. Medication has to start one week prior to travel, continue during the trip, and finish four weeks after your return. Once again, planning is essential, as well as cares to ensure the course is followed.
After You Visit
As most stomach upsets are due to the unsanitary preparation of food, it is useful to know what to watch out for. Under-cooked fish (especially shellfish) and meat (especially pork and mince) can be hazardous. Salads can be risky unless purified water has been used to wash the various vegetables. Fruit that has already been peeled should be avoided. Be careful of ice cream, in particular the varieties sold by street vendors and served at cheap restaurants. Sometimes there are power outages Sri Lanka, especially away from urban centers, so it pays to be suspicious of all refrigerated foods if you know there has been a recent outage in your area.
Tap water is not safe to drink, and boiling and filtering is sometimes done too hastily in some hotels and restaurants, so the best solution is to drink bottled water. There are now many brands available, mostly using spring water from the highlands of the island. Make sure that the bottle carries an SLS certification and that the seal is broken only in your presence. Beware of ice unless you are satisfied it has not been made from tap water, and remember the tap water you may be tempted to use to rinse out your mouth after brushing your teeth is unsafe. Keep a bottle of water in your bathroom for this purpose.
When you flop onto the beach or poolside lounger for a spot of sunbathing, always remember to apply a sunscreen product with a sun protection factor of at least 15. Remember you are just 600km from the equator. Even with sunscreen, your sunbathing should be limited in time. If you don’t apply sunscreen you are liable to become so sunburnt that it will be painful to move, your skin will peel, you will have to start afresh to get that tan, and most importantly you put yourself at risk of serious dermatological disease.
Sometimes those who have spent too long in the sun suffer what is termed heatstroke, the most common form being caused by dehydration. This condition can occur if the body’s heat-regulating mechanism becomes weakened and the body temperature rises to unsafe levels. The symptoms are a high temperature – yet a lack of sweat – a flushed skin, severe headache, and impaired coordination. In addition, the sufferer may become confused. If you think someone has heatstroke, take that person out of the sun, cover their body with a wet sheet or towel, and seek medical advice. To avoid heatstroke, take plenty of bottled water to the beach, or buy a thimble (king coconut) from an itinerant seller.
Prickly heat rash occurs when your sweat glands become clogged after being out in the heat for too long or from excessive perspiration. The rash appears as small red bumps or blisters on elbow creases, groin, upper chest or neck. To treat it, take a cold shower, clean the rash with mild soap, dry yourself, apply hydrocortisone cream, and if possible, a product that contains salicylic acid. Repeat every three hours.
Local Health Care
Minor health problems can always be treated by doctors with practices in the resorts and elsewhere in the country. If you have a more serious problem, Colombo now boasts a selection of modern, well-equipped private hospitals offering the latest in conventional medical and surgical therapies. A growing number of foreigners are taking advantage of affordable, high quality private healthcare in Sri Lanka, and combining it with the chance to take a holiday. Though the medical tourism industry in Sri Lanka is still in its early days, a number of private hospitals in Colombo are geared to provide advanced surgery and other treatment to international clients
Travelers with Special Needs
Travelers with special needs, especially if they visit Sri Lanka without a companion, should note that the country has relatively few facilities for disabled people, although greater awareness and improvements are evolving. There’s no need to worry at Colombo’s Airport as wheelchairs and assistance in boarding and disembarking are available. Buildings, offices, and banks are becoming better-equipped with wheelchair ramps and suchlike. If you aren’t travelling with a companion, you’ll find that Sri Lankans will be only too eager to assist.
Ayurveda Treatments and medicines
Ayurveda (eye-your-veda) is an ancient system of medicine using herbs, oils, metals and animal products to heal and rejuvenate. Influenced by the system of the same name in India, Ayurveda is widely used in Sri Lanka for a range of ailments.
Ayurveda postulates that the five elements (earth, air, ether, water and light) are linked to the five senses, which in turn shape the nature of an individual’s constitution – his or her dosha (life force). Disease and illness occurs when the dosha is out of balance. The purpose of Ayurveda treatment is to restore the balance.
For full-on therapeutic treatments, patients must be prepared to make a commitment of weeks or months. It’s a grueling regimen featuring frequent enemas and a bare minimum diet of simple vegetable-derived calories.
Much more commonly, tourists treat themselves at Ayurveda massage centers attached to major hotels and in popular tourist centers. Full treatments take up to three hours and include the following relaxing regimens:
Herbal saunas (Sweda Karma) are based on a 2500-year-old design. The plaster walls are infused with herbal ingredients, including honey and sandalwood powder. The floor of the sauna is covered with herbs. Like a European sauna, a steady mist of medicinal steam is maintained with water sprinkled onto hot coals.
The steam bath (Vashpa Swedanam) looks like a cross between a coffin and a torture chamber. Patients lie stretched out on a wooden platform, and a giant hinged door covers the body with only the head exposed. From the base of the wooden steam bath, up to 50 different herbs and spices infuse the body.
The so-called Third Eye of the Lord Shiva treatment (Shiro Dhara) is the highlight for many patients. For up to 45 minutes, a delicate flow of warm oil is poured slowly onto the forehead and then smoothed gently into the temples by the masseuse.
While there are numerous spas with good international reputations, the standards at some Ayurveda centers are low. The massage oils may be simple coconut oil and the practitioners may be unqualified, except in some instances where they may even be sex workers. As poisoning cases have resulted from herbal treatments being misadministered, it pays to enquire precisely what the medicine contains and then consult with a conventional physician.
For massage, enquire whether there are both male and female therapists available; we’ve received complaints from female readers about sexual advances from some male Ayurveda practitioners. In general it’s not acceptable Ayurveda practice for males to massage females and vice versa.
Availability & Cost of Health Care
Medical care is hugely variable in Sri Lanka. Colombo has some good clinics aimed at expats; they’re worth using over options aimed at locals because a superior standard of care is offered. Embassies and consulates often have lists of recommended medical providers.
Self-treatment may be appropriate if your problem is minor (e.g. traveler’s diarrhea). If you think you may have a serious disease, especially malaria, do not waste time: travel to the nearest quality facility to receive attention. It is always better to be assessed by a doctor than to rely on self-treatment.
Before buying medication over the counter, always check the use-by date and ensure the packet is sealed. Colombo and larger towns all have good pharmacies; most medications can be purchased without a prescription.
Even if you’re fit and healthy, don’t travel without health insurance: accidents do happen. A travel or health insurance policy is essential. You may require extra cover for adventure activities, such as scuba diving. If your normal health insurance doesn’t cover you for medical expenses abroad, get extra insurance. If you’re uninsured, emergency evacuation is expensive, and bills of more than US$100,000 are not uncommon.
Specialized travel-medicine clinics stock all available vaccines and can give specific recommendations for your trip. The doctors will consider factors including past vaccination history, your trip’s duration, activities you may be undertaking and underlying medical conditions such as pregnancy.
In general the threats to personal security for travelers in Sri Lanka are remarkably small. It is more pleasant to travel with a companion as it is advised not to travel alone especially after dark. The island including the North and East is safe to visit. If you have anything stolen, report it to the tourist Police, ( a special tourist police set up to look after the needs of the tourists. Contact Number + 94 11 2382209
All top-end and midrange accommodation will have sit-down flush toilets. Only budget places that don’t get a lot of tourists will have squat toilets and lack toilet paper. Public toilets are scarce (and are grim when they exist); use restaurants, hotels and attractions like tea plantation visitor centers.
Dangers & Annoyances
Sri Lanka is open for travel, though you can check the security situation in advance at government websites. Parts of the North may remain sensitive for some time, so you may still encounter a few road blocks and security zones.
Sri Lanka does not present any extraordinary concerns about safe travel, although women will want to read about certain concerns.
Sri Lanka’s legal system is a complex, almost arcane mix of British, Roman-Dutch and national law. The legal system tends to move slowly, and even a visit to a police station to report a small theft can involve a whole lot of time-consuming filling out of forms. The tourist police in major towns and tourist hotspots should be your first point of contact in the case of minor matters such as theft.
Drug use, mainly locally grown marijuana, but also imported heroin and methamphetamine, occurs in tourist centers such as Hikkaduwa, Negombo and Unawatuna. Dabbling is perilous; you can expect to end up in jail if you’re caught using anything illegal.