Kokoda part 2 – On the Trail

Fluids

Your body’s fluid balance will be placed under considerable stress while hiking in the humid mountain jungle of Papua New Guinea.
Risks of dehydration include strenuous exercise, hot climate and illnesses such as diarrhoea. Some blood pressure medications called diuretics can also increase your risk of dehydration. Symptoms include increased thirst, dry mouth, decreaed urine output, weakness, fatigue and confusion. Severe dehydration can lead to seizures, coma and death.

Too much fluid can be equally dangerous. The practice of “drinking as much as possible” has lead to a condition called exercise associated hyponatraemia (EAH).  Symptoms of EAH include lightheadedness, confusion, weakness, seizures and even death.
Just how much should you drink? The best guide is your body’s thirst requirement.

Only drink fluids when you are thirsty.

A rough guide is a maximum volume of 750ml/hour, with 1000ml/hour the absolute limit.

Diarrhoea

Diarrhoea during travel is thought to affect 10 million travelers each year. The most common cause is a bacteria called E. coli. Traveller’s diarrhoea is characterized by frequent loose bowel motions, abdominal cramps, nausea and vomiting. On trail, it can complicate an already grueling exercise with severe dehydration and fatigue.
The bacteria that cause traveller’s diarrhoea are sensitive to some antibiotics, including ciprofloxacin, norfloxacin and azithromycin. Prophylactic antibiotic treatment is not recommended for healthy adults.

This risk of contracting traveller’s diarrhoea can be substantially decreased by strict adherence to simple hygiene precautions. Wash hands before eating and after going to the toilet, purify all water, ensure food is freshly cooked and fruit (and nuts) are peeled.

For those who get traveller’s diarrhoea while on the Trail, a single large dose of antibiotic is usually all that is required
Ciprofloxacin – 1.5g
Norfloxacin – 800mg
Azithromycin – 1g

Chafing

Chafing is a potentially serious problem in the moist jungle environment of Papua New Guinea, leading to bleeding, skin infections and extreme discomfort. It can be prevented by the wearing of bike-pants-style elastic undergarments such as Skins. Careful, early attention should be given to any areas that appear to be chafing with liberal use of barrier ointments like Bepanthen. Infected chafing areas may require antibiotic therapy.

Injuries

The Kokoda Trail traverses slippery, steep, uneven slopes and sometimes treacherous river crossings. Almost any injury is possible. Those suffering serious injuries will require evacuation, usually by a combination of jungle stretcher and helicopter.
Injury prevention measures include:

• Boots with good ankle support and grip
• Trekking poles – one or two, depending on personal preference. Trekking poles decrease the amount of force going through your knee and ankle joints and also provide stability on slippery downhills
• Personal carrier. Decreasing the load on your back will improve your balance and decrease back strain injuries. A personal carrier will also assist you across log bridges and in slippery areas of the track.

Personal medical kit

Everyone’s personal medical kit is different, but here is a list to start you off.

Malaria prophylaxis
Ibuprofen or similar anti-inflammatories
Antibiotics – We recommend cephalexin (for wound infections, urinary tract infections) and ciprofloxacin (for diarrhoea)
Antihistamine – for allergies, insect bites/stings
Antifungal ointment or powder
Bepanthen or similar barrier ointment
Mosquito repellent
Sunscreen
Disinfectant gel for handwashing
Waterproof elastoplast – two rolls
Strapping tape – two rolls
Blister dressings – prevention and treatment
Band-Aids (waterproof)
Pocketknife – with scissors, tweezers, etc
Sports drink powder – useful for masking taste of purified water.