Health, pharmacies
and travel insurance

Water and food: the realistic advice

Do not drink tap water anywhere in China, and do not use it to brush your teeth unless it has been boiled. Bottled water is cheap and sold on every corner, and hotels almost always provide a kettle plus a bottle or two of water in the room.

Food is a different matter. Cooked food served hot in busy restaurants is generally safe, and the busiest places are often the best bet precisely because the food turns over quickly. Be more careful with raw vegetables, unpeeled fruit and anything that has been sitting out in the heat.

The classic advice holds: if it is peeled, cooked or boiling, it is fine; if it is raw and you cannot peel it, be cautious. Street food from a busy stall with a queue is usually safer than a quiet one nobody is buying from.

If your stomach disagrees with you

A change of diet, water and time zone can unsettle your digestion for a day or two, and it is rarely serious. The main risk is dehydration, so rest and rehydrate rather than trying to push on through a long day of sightseeing.

Rehydration sachets, an anti-diarrhoeal and a mild probiotic cover most cases. If symptoms last more than a couple of days, or come with a fever, see a doctor rather than self-treating further.

It is worth saying plainly: most stomach trouble on a trip like this comes from overeating unfamiliar food at speed, not from anything dangerous. Slow down for a day and it usually passes.

Pharmacies: what you can buy and how

Pharmacies are everywhere in Chinese cities, often marked with a green cross, and the staff are trained. Many simple medicines that need a prescription at home are available over the counter here, though the brand names will be unfamiliar.

The practical way to buy is to show the active ingredient, or the purpose, in Chinese on your phone. An empty pack of whatever you normally use, with the name translated, makes it quick and accurate.

For anything more than a simple remedy, ask your hotel or your guide to help. A short conversation in Chinese with the pharmacist often finds exactly the right product, and it takes minutes rather than the half hour you would spend guessing.

• Green cross or the characters yao dian mark a pharmacy.
• Show the active ingredient or the purpose in Chinese, not a brand name.
• Simple remedies are usually over the counter; ask staff for help.
• Keep receipts if you plan to claim on insurance.

Seeing a doctor in China

If you need medical care, the big cities have international clinics and the VIP or international departments of major hospitals, where staff usually speak some English and the process is streamlined. These are the places to go for anything beyond the trivial.

Payment is usually upfront and then claimed back from your insurer, so keep every receipt, prescription and diagnosis note. In an emergency, the number to call is 120 for an ambulance, and your hotel or your guide can help you reach the right hospital quickly.

For travellers on one of our trips, the ground team can take you to an English-speaking clinic, translate at reception and handle the paperwork, which in a stressful moment is worth more than it sounds.

Travel insurance: what it should actually cover

Insurance is the one part of a trip where the cheap option is often the wrong one. Make sure the policy covers medical treatment and hospitalisation, emergency evacuation and repatriation, and the medical costs of any activity you plan to do, including hiking or a high-altitude road trip.

Check the excess and whether treatment is paid upfront and reimbursed, because in China you will usually pay first and claim later. Check too that the policy covers the whole length of the trip and every country on the route, not just the first destination.

If you take prescription medicine, confirm that a lost or stolen supply is covered, since replacing it abroad is not always simple. And keep a digital copy of the policy and the assistance number on your phone, where you will actually find it.

• Medical treatment and hospitalisation, not just accidents.
• Emergency evacuation and repatriation.
• Cover for the specific activities on your itinerary, including any hiking.
• Confirmation that you may need to pay upfront and claim afterwards.
• A digital copy of the policy and the 24-hour assistance number.

Altitude: the one to plan for properly

If any part of your trip goes above 3,000 metres, altitude is the health factor that deserves the most thought, because it is the one that can genuinely change an itinerary. The plateau begins around 2,200 metres, and Lhasa sits at about 3,650.

The problem is almost never the height itself but climbing too fast. A gradual ascent, with 500 to 800 metres of extra sleeping altitude per night, gives the body time to adapt, and an easy first day avoids most of the trouble. The symptoms of altitude sickness are headache, poor sleep, nausea and breathlessness, and they usually ease within a day or two at rest.

Some signs mean going down, without debate: confusion, breathlessness while resting, a persistent cough or loss of balance. If you have a heart, lung or blood-pressure condition, tell your doctor and tell us early, and we will design the route to sleep lower where necessary.

Staying well on long days

The unglamorous basics matter most: drink more water than you think you need, especially in the north and on the plateau; get real sleep; and give yourself a lighter day after a long transfer rather than a full schedule.

Summer heat and humidity in the cities are draining, so plan the big walking days for the morning and rest in the middle of the day. In winter, the dry air and indoor heating make dehydration common, and a lip balm and hand cream are genuinely useful.

If you wear contact lenses, bring solution and a pair of glasses, because the air in the north is dusty and dry. It is a small thing that makes a long day far more comfortable.

How we look after you on the road

Health is one of the reasons to travel with someone who is on the ground rather than on the other side of the world. ChinaTour.es, the English-language site of the JoyoTour group, builds a realistic pace into every itinerary and keeps a 24/7 emergency line open for the whole trip.

JoyoTour has been running trips in China since 1999, with a ground team that knows which clinics speak English and how to get you seen quickly, and guides who have handled exactly these situations many times before.

If you have a medical condition or a concern about altitude, tell us when you enquire. We can adjust the route, the pace and the overnights, and we would far rather redesign the plan than have you push through something that could have been avoided.