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The first is simply a reaction to being in an unfamiliar place. No "bugs" are involved, but many people develop gastrointestinal upset when tired, under stress, in an unfamiliar place, and/or eating foods that may be slightly different from those usually encountered. The best strategy if you have a tummy that is sensitive in this way is to eat light, fairly bland meals and to minimize the use of alcoholic beverages. Forget the hot peppers and the great "cerveza". Also, try to get some rest, not that this is always possible when you have a new child.

The second results from eating contaminated food or drinking contaminated water. This is a distinct possibility in many parts of the world, including Guatemala, Mexico, China, and so on. When you are on your adoption trip, remember the following:

1. Do NOT drink tap water or use ice made from tap water unless it has been boiled for a minimum of five minutes. Do not even use it for toothbrushing, and try to shower with your mouth closed. If you need to clean dishes, baby bottles, etc., you can wash them with tap water and soap, then give them a final rinse in boiled water. Be careful to ensure that children in your party do not drink from their bathwater. In some countries, where even the locals don't drink tap water, the hotels put hot pots in the rooms or supply boiling water in thermoses. I do not believe that hotels in Guatemala do this, so if you are staying in a room without a kitchenette, you might want to buy a hot pot and bring it along. Just be sure that the hot pot doesn't shut off the minute that the water boils, as it really takes a good five minutes or more of boiling to kill the "bugs" that may be in it.

2. An alternative to tap water is bottled water. It is usually quite inexpensive, and was my choice when I traveled to China to adopt. Keep a bottle by the sink in the bathroom, for use when toothbrushing. Keep a bottle in the diaper bag for use when touring. If you have a refrigerator with a freezer in your room, use it to make ice. And so on. If you like to drink water in restaurants, specify bottled water. Just be sure that the seal is unbroken when you get it. Do be aware that, in some countries, unscrupulous people have put tap water into water bottles and attempted to sell it. Usually, bottles that have been tampered with won't have a good seal, so check carefully, and only buy from reputable establishments, not from street hawkers.

3. Other beverages that are OK to use are tea, coffee, and bottled or canned sodas and juices that you open yourself. Beer, wine, and hard liquor are also OK. Just remember not to add ice to any drink unless it has been made from boiled or bottled water.

4. Some people bring Britta filters and similar filters used in the home, thinking that they will make tap water safe. THIS IS NOT TRUE. If you read the literature from any of the manufacturers, you will see that these filters remove ONLY chemicals that affect odor and taste. They do not kill bugs. If you are determined to bring a filter, read the website of the Centers for Disease Control, which has a section on acceptable filters and other water treatment modalities, and then go to a store that sells supplies for wilderness camping. Personally, however, I believe that bringing a filter is unnecessary if you are scrupulous about using only boiled or bottled water.

5. Drink fresh milk only if it has been pasteurized. Milk at most big hotels catering to tourists will be fine. If in doubt, ask your guide to check.

6. NEVER eat raw fish, seafood, or meat while traveling in underdeveloped countries. It is very likely to harbor parasites.

7. Also, do not eat raw fruits or vegetables, unless you can peel them yourself. This means NO salads and NO cole slaw in the restaurants. Stop at a store and buy things like bananas, which can be peeled. Some people stay away from fresh squeezed juice, because the fruit may not have been washed in safe water before squeezing, letting bugs get into the juice. I must say that I did drink fresh juices in big Chinese hotels, with no ill effect; however, I do not know the situation in Guatemala and would not recommend this approach.

8. Eat only food that has been thoroughly cooked. Do not order meat cooked "rare." Soups are always a good choice, since the liquid has generally boiled for some time.

9. Do not eat foods served by street vendors or in little hole in the wall restaurants. These places may not keep foods at safe temperatures, allowing growth of pathogens, and may not use food preparation personnel who practice good hygiene. When in doubt, ask your guide or check with your hotel.

10. Before travel, get the two-shot Hepatitis A immunization series and, possibly, the typhoid shot. These will help you avoid two of the more debilitating illnesses caused by contaminated food and water. Just remember, however, that they are NOT the only bugs you can get, and that having the shots does not protect you from these other bugs found in food and water.

11. Some doctors recommend using Pepto-Bismol daily while traveling to help prevent intestinal problems. Check with yours. Just remember that it is not a substitute for careful eating and drinking. Pepto-Bismol turns your stools black, so don't be shocked if it happens to you!

Even with all these precautions, it is possible to enjoy the unique cuisine of a foreign country. So stay well and have a great trip.

Sharon