Estación Biológica Cocha Cashu
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MEDICAL ISSUES

Everyone should make sure they are up-to-date on all recommended vaccinations. You will need to see a physician about the latest recommendations.  Also, you can check out the most recent information provided for the region by looking at the Web site of the Centers for Disease Control, http://www.cdc.gov (Choose Traveler's Health).  Standard immunizations include: yellow fever, typhoid, tetanus, and hepatitis A and B. Chloroquine or other malaria prophylaxis is optional, though a US physician is likely to insist that you take prophylaxis as a precaution. 

It is important to convey to your doctor that you will be in a very remote region with no medical care available. Past experience has shown that some doctors find it hard to grasp the remoteness of Cocha Cashu, and will refuse to pre-prescribe medication. If your doctor declines to cooperate, we suggest you see a different doctor. Bring supplies of any medications you use regularly or occasionally. The station maintains a medical kit, including antibiotics and first-aid supplies, but the station does not accept responsibility for having on hand any possible drug or therapeutic device that might be needed in an emergency.

Prospective visitors should be keenly aware of the station's remoteness. In the event of a life-threatening emergency, an aircraft can be chartered by radio to land at a grass strip 200 km (1 1/2 days) downstream. Evacuation by aircraft is a possibility available only in good weather. In bad weather, a patient would have to be evacuated through Puerto Maldonado, a 2-3 day river trip downstream. There are doctors in Puerto Maldonado, but the quality of medical services available there leaves much to be desired. Evacuation all the way to Lima is highly preferable, but will require another day after reaching Puerto Maldonado.

Be advised that the cost of an emergency medical evacuation will be in the thousands of dollars and will be charged to the patient. In case all this is alarming, you should also know that in the 25-year history of the station, no one has yet had to be evacuated in a life-threatening situation.

Leishmaniasis. Contracting leishmaniasis is a serious possibility at Cashu. Several dozen investigators have developed cases during or following stays at the research station. The disease is transmitted by a tiny, transparent fly that holds its wings up at a steep angle when at rest. The flies are most abundant in moist places in the forest, especially under fruiting trees. Primatologists are therefore particularly at risk. The disease is not fatal, or even painful, but is cured by a long and unpleasant treatment (up to 90 injections of pentavalent antimony solution). Wearing long sleeves and pants, and using repellent while in the forest, will reduce your chances of infection.

VERY IMPORTANT

In the last two years we had outbreaks of Fungus "killer" (resistant to most fungicides, except Ketaconazol), Conjunctivitis, Giardiasis and Creeping Eruption (ancylostomas): We strongly recommend that you bring your own medication. The station will charge you for the use of station-specific medical supplies (just antibiotics).

Medications:

    Altitude sickness pills (for Cuzco)
    Antacid
    Anti-diarrheal medicines
    Antibiotics: Ciprofloxacina, Amoxicilina, Tetraciclina
    Antihistimine (Benadryll)
    Bandages & tape
    Buffered aspirin
    Foot fungus medication (Ketaconazol, since there are resistant types of fungus)
    Hydrocortizone cream
    Malaria pills (requires prescription, although there are no reported cases)
    Optical antibiotic (esp. w/contacts) , Terramicina
    Otical antibacterial (swimmer's ear)
    Pain killer (by prescription)
    Powder
    Sun block (for river trips)
    Topical antibacterial cream
    Tylenol/advil
    Metronidazol (Flagyl) for giardiasis

    Foot powder (a lot, strongly recommended)

    IMPORTANT TIPS

    The end-of-the-day bath/swim is a time-honored ritual at Cashu. Usually, the various aquatic concerns (sting-rays, caimans, piranhas and otters) pose no threat or can be avoided (shuffling if walking on lake-bottom for stingrays), or monitored safely (caimans/otters).  However, in 1998 piranhas living near logs around the bathing area attacked a total of 6 times (out of thousands of hours of person-swim-hours).  Injuries were always individual bites to toes and fingers; a couple were fairly serious injuries.  The best prevention is to stay away from logs, although wearing socks on both hands and feet is an untested, but apparently successful strategy for discouraging such attacks.  

    The greatest risk of serious injury at Cashu is not snake bite (zero cases to date) but being struck by a falling limb or tree. Be very careful when scouting out a tent site (up trail 6 or 7). Check the area around your tent for overhanging dead limbs and leaning trees, and remember that some trees are over 50 meters tall, which, when lying on the ground, is half a football field. If you hear a tree or limb falling, the best advice is probably to dive toward the nearest standing tree trunk, provided that it is not the tree that is falling.

    Do not capture or handle snakes unless you honestly know what you are doing. Most Amazonian snakes are non-venomous, but several are extremely dangerous. Do not capture or molest a venomous snake under any circumstances. Avoid them and leave them alone.

    If you unwittingly run into a wasp nest, run away as fast as you can as soon as you hear the buzzing sound. Some nests are very large and contain hundreds of wasps. Multiple stings can cause serious allergic reactions in some people.

    Be sure someone instructs you about stinging ants after you arrive. Some have stings as bad as any wasp.