Monday December 31, 2012

7:40 a.m. at the 7-11 on Zhongshan Road in Taipei

Another red-letter day of a sort. A very Doug-style red-letter day: I broke out my Survival Kit from my touring bike. I use the left rear pannier bag as my main bag when I’ve gone on my bike trips. I call it my Survival Kit because it generally contains everything of ultimate value. When I stop at a restaurant or someplace while traveling, I always unhook this bag and bring it in with me. I keep everything that I absolutely can’t live without in it. If my entire bike were stolen with all the other bags attached, I would still be okay because everything of value is with me in that one bag. It is essentially my knapsack.

It’s getting harder to put together my Survival Kit, though, because the number of valuable things I possess is growing as more technology becomes available. Still, it works. The most valuable things, of course, consist of things like ID and money. That always goes with me everywhere I go. Beyond that, my Survival Kit contains this NEO for journalkeeping, my maps, and my camera. Then it holds things that are not strictly speaking essential but necessary for day-to-day life – a jacket, basic tools for the bike, my iPod, a flashlight, and things like that. The pannier bag itself is quite heavy-duty – being an Arkel product – and all that gear is heavy, so it ends up being a heavy bag. But there is no getting around that. One poor design element of this pannier bag is that the small hand strap that is attached as a handle is too thin. I’ve modified that and added a much thicker and softer handle, so I can carry it like a suitcase. I’ve also added a special shoulder strap – one that is contoured to fit my shoulder and has a very sticky surface so it doesn’t slide off. Most over-the-shoulder straps are poorly designed and simply slide off your shoulder. They aren’t very useful. Over the years, I’ve collected lots of bags and straps and I keep and modify only the best ones. This particular shoulder strap came with a camera bag I had many years ago. I no longer have that bag, but I kept the strap.

I’ve always wanted to have a handlebar bag on my bicycle. They are extremely useful, and most cyclists use their handlebar bag as their de facto survival kit. This is the bag that contains their camera and money and other essential items. It serves quite well, but that is mainly because they don’t extend its function beyond that. I take my Survival Kit one step further and use it as my daypack, so it must also contain my journal and maps and jacket and other heavier and bulkier items. So if I use a handlebar bag, I’m now faced with two bags with the same function, and then when I pop into someplace, I’m faced with having to bring it two bags. And that isn’t very efficient. We’ll have to see how that goes. I do have a handlebar bag right now and I plan to bring it with me to the Philippines. I’ll see how it fits into my cycling routine. If it works, I’ll keep it.

It goes without saying, of course, that both my pannier bag Survival Kit and my handlebar bag are incredibly awesome. My Survival Kit has one extremely large main storage section. It is a perfectly rectangular space with an aluminum frame and solid bottom to give it shape. There is also a heavy-duty compartment at the very front that is the perfect size for my NEO or any laptop or netbook to slide into. Then there are three large pockets arranged around the outside – one on the front, one on the top and one on the side. Finally, there is a 3-compartment detachable unit on the front that is designed to hold maps, papers, and other small items. This unit can come right off and has a hidden belt that can be used as a waist belt. Then it has the standard Arkel features, such as heavy-duty zippers, triple stitching everywhere, and on and on. I’ve had this bag for a lot of years and put it through a lot of use, and it is still going strong.

My main task for the day is to go to the Travel Clinic to see a doctor about my vaccinations. I have an appointment at the clinic this morning and after I have my morning coffee here at 7-11, I’m going to head over there. I did a bit of research last night, and I refreshed my memory about the various vaccinations that one needs for overseas travel. It isn’t that complicated, really. The recommended vaccines consist basically of Hepatitis A, Hepatitis B, Typhoid, Rabies (for cyclists in particular), Yellow Fever, and Japanese Encephalitis. You should also make sure that your basic vaccinations are up-to-date: Measles, Mumps, Rubella (MMR), Diptheria, Pertussis, Tetanus (DPT), and Polio. Malaria is a bit of a wild card as there is no vaccine for that. You have to take medication orally either once a day or once a week depending on which medication you take. And there are many strains of malaria around the world, and each requires a different drug. For an extended trip, malaria medication seems like a big and expensive problem. It’s tempting to just forget about it. Perhaps, though, there is a way to strike a balance. Even within one country, malaria does not exist everywhere. If, for example, you were to spend a month or two in a big city like Manila or Bangkok, you wouldn’t have to take malaria medication. Nor would you have to if you were up in the mountains. So in theory you could monitor where the high-risk areas area and then take the malaria medication only during the time that you spend in those areas. With that in mind, a medication like Atovaquone-proguanil would be ideal. You can begin taking this medication just one or two days before you enter a malarial area and then you only have to take it for 7 days after you leave. A course of doxycycline can also be begun just 1 to 2 days before a trip, but then it must be taken for 4 weeks after you leave that area. Mefloquine has the advantage in that you only need to take a pill once a week. However, you have to begin two weeks before you enter a high-risk area and continue for four weeks afterwards. Plus, in my experience it is a heavy-duty drug with a lot of crazy side-effects. It’s also expensive. I believe doxycycline is the cheapest alternative.

Japanese encephalitis is an interesting case. Apparently, the vaccine – Ixiaro – is a relatively new thing. Before Ixiaro hit the market, the only available vaccine was something that they got from mouse brains, and it had a lot of side-effects and was perhaps not even effective. This new vaccine is much safer and more effective. Doctors recommend getting it now. I’m not sure it is available, but I assume I’ll find out today. I’ll also find out how much all of this is going to cost…

 

Later:

It is now 11:40 a.m. and I am at the 7-11 on Chang-An Road after my appointment at the Travel Clinic for my vaccinations. Just to end the suspense, I will say that I am sitting here with vaccines coursing through my system for measles, mumps, rubella, Japanese encephalitis, polio, meningitis, tetanus, diphtheria, flu, rabies, and yellow fever, all for the princely sum of NT$7,732. And this is just the first stage. I have at least two more appointments to complete the vaccinations stages for Japanese encephalitis, rabies, and polio. Luckily, my immunizations for hepatitis A and hepatitis B are still up to date. It appears I have had enough boosters of that for it to be lifelong protection. And in Taiwan, there doesn’t seem to be any demand for the typhoid vaccine, so they don’t carry it. I’ll have to look into that to see how important it is.

It was absolute smooth-sailing at the hospital. Being such a cold day and being a holiday, only six people had signed up for the clinic and out of those only two actually showed up and I was the first on the list to be seen. Therefore, the doctor, a lovely young woman with serviceable English, spent over an hour with me talking about my intended travels and my vaccination needs as well as other health concerns. There were a couple of bumps in the road initially where I thought perhaps she didn’t know her stuff, but once we found the groove, it was no problem at all. They have an exceptionally well-organized system for all of this and once we’d established which vaccines I needed and wanted, everything was entered into the computer and it organized everything into a perfect series of injections on a set number of appointments on subsequent Monday mornings. They also produced what I was most concerned about – an official and very well-documented International booklet to keep a record of all these vaccinations, plus an official certificate for Yellow Fever and Meningitis – a document you need at the border of many countries around the world. It was just fantastic.

When the flurry of paperwork was over, I was handed a sheaf of papers listing my appointments. There was also a list of the vaccinations I was getting today. I had to go to the cashier in the main lobby and pay. Once I did that, I went straight to the pharmacy in the lobby. This was all done so quickly, I couldn’t imagine that my vaccines would be ready, but they all were. The entire package was sitting there ready to go – and we are talking about a BIG package. It was ridiculous in a way. Of course, every vaccine is just a small vial of liquid, but it has to be in a package inside a bag and by the time it was all gathered up, it was like I’d just come out of a grocery store with my food for the week. It was a big bag, and it astonished me that all of that was going to go into my body shortly. I was concerned about getting so many vaccines at one time, but the doctor said that was perfectly normal and there should be no adverse reactions between them. I wasn’t so sure, but it’s how the system works.

Once I had paid and had my giant bag of vaccines, I went back up to the Travel Clinic to the treatment room. There, a nurse was expecting me and in very short order I was given a long series of needles – a bunch in my left arm, a bunch in my right arm, a bunch in my left buttock, and then a bunch in my right buttock. I am proud to say that I did not flinch even the tiniest bit. As far as vaccinations go, they were the least painful I’ve ever gotten. I barely even felt them. The only awkwardness came when we had to deal with my buttocks, of course. I assumed that would be the case, so I had made sure to wear my most presentable underwear on this excursion. Even so, there was a moment when I dropped my pants to reveal my underwear and butt in all their glory. The nurse kind of hesitated and went “Oh!” I have no idea what that meant. Something was surprising to her about the underwear and butt of this foreigner. Something confused her. It could have been any number of things, but I can’t even hazard a guess on what exactly it was. But once we got that “Oh!” out of the way, I was jabbed many times without incident and I could pull my pants back up. Then I returned to the clinic and the lovely doctor to get my official vaccination booklet with everything stamped and signed. I hung around in the waiting area for a while as ordered – to make sure that I didn’t collapse with some kind of allergic reaction, and then I popped down into the MRT and headed here – with only the slightest of a tingling sensation and a swelling on my right buttock. I don’t know which vaccine is causing that sensation, but it is the only one. I can’t feel anything on my arms or left buttock at all. Nothing. No swelling. No pain. I can’t even locate the places where I got the injections.

I would say the only real after effect of this process is a mental one – a psychological one. As I was talking to this doctor about all the vaccinations and then as I was paying for them all, it struck me how serious a thing this was. It’s one thing to decide willy nilly that as a traveler, you should go to other countries. But once you start paying that much money for protection for all the insidious diseases (and as I said, this is only the first installment), you start to wonder if this is a wise idea. Why do this? Why leave a nice safe country like Taiwan where you have a good income and total security? Why, in fact, ever leave Canada? What’s the advantage? Why take the risk on a lark? This brings me back to the story I’ve often told of an older woman in Ethiopia getting quite angry with me for simply leaving Canada. She felt it was stupid of me to leave Canada and come to Ethiopia when I didn’t have to. I had no right to make my mother worry. And if I didn’t value my Canadian citizenship, then why don’t I stay in Ethiopia and HER son can go to Canada in my place? She had a very good point. And as I was counting out my eight one-thousand NT bills, I was thinking the same thing. It’s one thing to risk rabies and malaria and Japanese encephalitis and Dengue fever and Yellow Fever when you have a good reason to – like you’re out there doing something important. But just wandering about because it seems like it would be fun? It hardly seems wise.

Of course, that mood will pass. I’m hoping that this will be one very exciting year with a lot of new horizons.

 

Tags: bike, Canada, Ethiopia, Survival Kit, Yellow Fever