There are several different types of antimalarial medication, the choice of which depends on such factors as area to be visited, length of stay, your own medical history, medication you may already be taking, type of holiday (hotel, cruise, trekking etc).

These drugs can be loosely divided between the older formulations (Chloroquine and Proguanil) and the more recent preparations licensed for antimalarial use (Doxycycline, Mefloquine and Malarone).

Chloroquine has been used for around 50 years and during that time vast areas of the ‘malarious world’ have become resistant. As a 4-aminoquinoline derivative chloroquine prevents nucleic acid synthesis in actively dividing erythrocitic malarial parasites and thus DNA synthesis is affected. The drug is taken as two tablets weekly on the same day of each week, Countries still sensitive to Chloroquine include Costa Rica, Belize and Mexico.

Proguanil is a Biguanide which is metabolised in the body to cycloguanil, an active form that blocks the production of folic acid and subsequent synthesis of DNA. The human cells are not affected by this action except during pregnancy where your doctor will usually give a folic acid supplement to counteract a possible shortfall in the mothers cells.

As with Chloroquine there is widespread resistance now to Proguanil and it is often given in areas where the traveller is unable to take Chloroquine for some reason (such as sensitivity to the product). The Chloroquine and Proguanil when combined in one pack as Paludrine/Avloclor travel pack form a more formidable antimalarial and can be used in many more areas where the individual drugs would not be effective enough.

In the Travel Pack of Paludrine/Avloclor produced by Astra Zeneca the dosage of Proguanil is two daily which would be taken at the same time and the Avloclor (Chloroquine) is two weekly, also taken together. (A calendar pack gives an easy format and prevents mistakes in dosage whilst away.) Proguanil/Chloroquine is used in countries such as Sri Lanka, Nepal and most of India. These preparations can be purchased without prescription from Pharmacies.

The ‘newer’ group of antimalarials are helping to prevent malaria in areas where resistance has become a major problem, the malaria parasites being incredibly adept at mutating and hence overcoming the drugs used against them.

Malarone is Atovoquone and Proguanil combined to give a combination of an antiprotozoal and a biguanide. The dosage is one tablet daily for adults usually taken one or two days before entering the malarious area, during and for seven days on leaving. There is also now a paediatric formulation for children.

Lariam (Mefloquine) is a 4-aminoquinoline (as in Chloroquine) and in adults is taken as one tablet weekly. To check for side effects your doctor will often prescribe these at least two and a half weeks before travel, during and for four weeks on return.

Last but not least is Doxycycline a well tried and tested tetracycline antibiotic given as the hyclate. This was found to have marked antimalarial properties as well as being an antibiotic. It is usually given one week before travel (if it has never been taken before), during and for four weeks on return.

These last three products are prescription only and can only be obtained from a Pharmacy on supply of a private prescription issued by your doctor or travel clinic. Depending on your medical history etc., your doctor will decide which of these preparations are suitable for your travels.

Chloroquine for example is not normally given if you suffer from psoriasis or epilepsy. If taking Warfarin for blood thinning always check this out with your doctor, and likewise if pregnant or hoping to become pregnant then again you must consult your doctor first before taking an antimalarial drugs.

Your G.P. or Travel Nurse will check out the area you are about to visit and together with medical history and knowledge of the type of holiday will prescribe the relevant antimalarial.

For prices and supply of any of these preparations you can log on to www.travelpharm.com or ring us on 01395 233771

The day not long born – Bloody hot already, the sun reflecting off the tarmac and I could already feel the weight of the heat on my back and head, even through my Tilley hat. The fragile looking little single-engined plane, nicknamed in Brazil a ‘Teko Teko’ because of its resemblance in sound and vision to a child’s model plane driven by elastic bands – It stood there and shimmered and glowed in the sunshine while the temperature had not yet even reached 42 degrees Celsius.

In what seemed like slow motion a fat mechanic slowly hand pumped fuel into the plane’s tank. The smell of aviation fuel added itself to the tropical morning smells as Adam Baines and I stood waiting nervously to load and board this Teko Teko. Denis, the pilot, stood there in his beautifully cut, fashionably faded Khaki. This forty-something, athletic pilot exuded confidence as he emerged from the cockpit holding a slender glass phial which he dipped in the fuel tank. Denis looked at the yellow liquid in the phial against the blue, blue sky. He slowly brought it to his nose and gently sniffed it and rolled it under his nose with the concentration of a wine connoisseur. In Cruzeiro the pilot’s nose makes the final decision between aviation fuel and anything else that could find its way into tank!

Denis eyes turned to us, then drifted slowly over our baggage. He was not in a good mood. We were last minute passengers with extra weight, forcing him to remove all his various boxes, destined for different jungle stops and reload the craft again. On top of that we were going to pay the $900-00 with travellers’ cheques instead of US dollars cash. Denis looked us over. I could feel him wondering if the traveller’s cheques would bounce. He starred at these two Europeans and he probably wondered if we knew what we were getting into. I said, “The traveller’s cheques are paying for the return as well as the outward journey and, if they bounce; you won’t have to bring us back. Chief Biraci will vouch for us anyway”. Right he said, looking at my waistline “Back to the cargo hanger to get you weighed”. Finally, now having to believe that I really did weigh 85 Kilos, we approached the plane again.

Instrument checks done, the tower gave us clearance, chocks away. Propeller whirling, he shouted above the engine in English, let us sway. Mystified for a moment, then Denis loudly said the Lord’s Prayer in Portuguese and asked for the Lord to watch over our journey. A moment of reality came through the excitement and I prayed to whatever gods are up there, please keep an eye on us. The plane slowly surged forward, gathering speed, it lifted off and skimmed above the trees. Cruzeiro gradually disappeared behind us. At last, the adventure was to begin as we soared up, up and away.

I saw a carpet of green under the sky blue canopy, the sea of endless forest stretching as far as the eye could see to the edges of the horizon. I had a feeling of how small and insignificant are men in comparison to this wonder of nature. We flew on, gradually leaving behind the amazing golden beaches of the snaking river Jurua, so different from any riverbank I had come across before in either Africa or Australasia.

I was sitting in the seat by the pilot with my camera at the ready. Ready for what? I looked down at the trees so tightly packed together, my imagination was running away with the thought of what might happen if our one motor took sick and died. Chief Biraci had said, “There are no bad old pilots in the Amazon. Bad pilots die young; and so do their passengers”. Quickly glancing round I saw Adam starring out of the window, obviously moved by the sight of such beauty. Not the time to spoil his dream with a possible nightmare, for at that moment a rainbow appeared across the jungle and made what was already wonderful, magical. I looked at the Chief relaxed in his seat. I began to feel some of passion he had for his home, and also began to understand how he stood up at a conference in Panama and caused consternation by tearing up a prepared speech while shouting, “The Yawanawa want their land back”.

This man, who had lived on the building sites of Rio Branco and earned a pittance of money, had not only fed and clothed his body, but also fed his mind and soul and to become a survivor. At a time when most Indians ended up on the bottom of the human scrap heap, became alcoholics and the low life of the gutters of these fifth world towns. Chief Biraci had educated himself, fought for Indian rights to become their spokesman at the various conferences that became fashionable in the 80’s when the 1st world became aware of environmental issues. This plane journey was giving Biraci a small escape from his almost constant responsibility for the tribe. We had been in the air now for about 75 minutes, a journey that would have taken about fifteen days on foot or twenty by canoe.

Denis, the pilot, banked the plane and we moved on to another compass heading. He shouted over the roar of the engine in as much of a conversational tone as possible, “Don’t forget to be back on the grass strip on the date we agreed. We were cutting it fine by planning to be back just a couple of days before the start of the rainy season and the plane would be unable to land if the strip was waterlogged. I had already had a bad landing on a previous trip on a water soaked landing strip, the plane had tipped up on its nose – So, I had been there, done that and had no desire to repeat the excitement. “I make two passes and then I leave – That’s the deal”. I shouted back to the pilot,” I won’t forget, nor will Adam we both know that a seventeen day walk as the wet season starts could be the end for us”. Denis smiled,”Could be? It definitely would be”. “Thanks for the vote of confidence”, I shouted. We banked again and Denis said, “Sete Estrellas, time to land”. We swooped down low, crossing the river Gregoria and making for the grass strip by the side of the small group of thatched huts that was the village of Sete Estrellas and the jumping off point for our trip into the unknown.

1. The USA has more personal computers than the next 7 countries combined.

2. Americans and Icelanders go to the pictures on average 5 times a year, while Japanese go only once.

3. The United States spends more money on its military than the next 12 nations combined.

4. Kazakhstan is the world's largest landlocked country.

5. Most people live in poverty in most African countries.

6. Only two countries in the world are doubly landlocked: Liechtenstein and Uzbekistan.

7. Senior gentlemen might consider a trip to Russia, where there's two over 65 women for every man.

8. Sick of crowds? Try Greenland where there's 38 sq km per person.

9. Sri Lanka has lowest divorce rate in the world – and the highest rate of female suicide.

10. South Korea is the heliport capital of the world.

Michelle writes: I felt compelled to write about my second visit to The Gambia, it was all so different and held so many new experiences for me than from my first visit back in February this year. I also appear to have 'dodged' the bumsters – as I got to know and befriend a few the first visit – hey life is hard they need to live yeh! And you fail to mention poverty in Gambia – as a 'developing country' in your news letter! I appreciate bumsters can be annoying – I just tend to say 'no abaracca' (thank you) and emphasise I'm staying at Kololi compound like a Gambian and they leave me alone!

Yes, I stayed at a compound/lodge (£6 per night) and was no 5 star hotel – but if travellers want to experience The Gambia, what better way than to live the true Gambian experience? Ok sometimes it is a trickle from the cold water shower, the electricity is on 50% of the time, the two ring gas cooker is outside, and there’s a flea bitten dog guarding the gates to the compound..but hey my Gambian friends can visit – they are not excluded as they were when I stayed on a complex. I'd also like to mention the compound like the one mentioned below was moderately clean enough!

The benefits of befriending Gambian people whether they are bumsters or taxi drivers or people from my friend Fakeba's compound – and they do not have the luxury of a toilet or running water there (water from the well in buckets) – or adequate schools for the children – (a tin hut!) is sharing experience. One of the best true experiences was sharing Koriteh holiday – the end of Ramadam with 14 adults and 10 children all living in one compound (about 8 one bedroomed houses) and sharing together excellent food from 4 large bowls and green tea. The children so nice and happy with no toys dressed in their Sunday best, the women worked so hard to make the meal. And other children and friends all come around from other compounds..is sooo nice.

So I have my best soul mate Fakeba to show me around – I am charged as a Gambian not as a tourist..and my money is going into the local economy and not to the 'middle man' in an hotel! This cuts my costs down by at least 50%. So try the market in Serrekunda – I feel I was the only white person there – but food shopping is much cheaper than the supermarket – and as fresh – though the meat market was something else! (Very hot with flies and smelled!) though the food my friends cooked for me after – wow! So I return in kind..it is not hard, what I can save I can give – especially to the children. Please don’t ever go to the Gambia without some clothes for them or stationery for their school (special mention for Karin Nursery School, Serrekunda). Or why not give stationery to the children in a compound who do not go to school – less than 50% of the children can read or write.

So my new experiences apart from those I mention above? Seeing dolphins coming back from St James Island – look out for them, and its a wonderful swim there! Seeing the women going out on their small canoes to pick oysters at Lamin Lodge.. my favourite place.. Seeing monitor lizards at Bijilo (monkey park). I'd also recommend going to Brufut fishing village – I rode by bike – but I’m sure there are easier ways to get there – saw cows being herded on the beach and the boats were so colourful – is sooo beautiful.

I would say more about less beautiful encounters I witnessed between my friends and the police…. but I may get censored!

I'd like to give a special mention to Kotu Point beach bar..one of the best and only bars that does not discriminate against Gambians trying to make a living by selling things.. or 'hanging out' there… the views are wonderful as are my friends and the music there – and especially 'bongo man' who will teach anyone to play! I’d also like to say to all you tourist not happy with Gambia – please remember it is a developing country that does not have the same access to health care, sanitation, education, social security and employment we in the west are privileged to have.. the culture is different – celebrate it along with all the similarities of humanity we all share! Share a smile on the smiley coast yeah – it is nice to be nice! I'm going back for more smiles next March… and especially looking forward to meeting my friend Fakeba's family who are Mandinka 180 miles up the river Gambia:)

This is the first in a series of trip reports sent to the Beetle by Globetrotter Steve who is travelling around South America and Easter Island, the lucky chap! So, if you are planning trip to Suth America or are interested in knowing more about it, you may find Steve’s trip reports of interest.

Life has it's ups and downs. On Tuesday I started the journey with a tour to the Altiplano National Parks. There were just three of us in the group, myself and two Germans. We went first to the local farmer’s market to stock up on fresh vegetables and fruit for picnics on the trip. Then we headed inland for a view of ancient petroglyphs showing herdsmen and llamas. There was a tomato farm nearby where we bought fresh produce, exceptionally huge tomatoes.

The next call was a Hari Krishne monastery where we had lunch and then started to climb. It was the main road to La Paz and there were some heavy lorries on the road, one of which had started to roll backwards and had come a cropper. We called at a fortified site over 2000 years old where the entrance to a fertile valley was guarded by a series of semi circular walls. The countryside was now very dry and we climbed through an area of cactus found only in that area of Chile. Near Socompa we went for a short walk down an Inca roadway and we started to see the first wild guanaco and llamas in the fields. We entered the village of Sacompa and looked at the very old church with its squat detached tower. From there we climbed to Putre where we were to stop for the evening. Unfortunately for me I was unable to eat the evening meal as I was feeling light-headed and wasn’t hungry. I had a very poor night’s sleep and was sick in the morning. Nevertheless I set off with the group up to Lauca National Park. There were spectacular views of the volcano across the lake and vicuña to be seen. The group went for a walk but I wasn't feeling well enough to go and so stayed with the vehicle. In fact I slept most of the time they were away. When they returned I was unable to keep fluids down. We returned to Pucalpa as planned but once there the group leader took me to a doctor who said my blood pressure was dangerously low because of the altitude and I needed to travel down to sea level immediately. They tested my blood pressure before oxygen, while breathing oxygen through a mask and then again after the mask was taken off. It immediately fell to very low levels. And so the tour leader drove me down to Arica immediately and the tour carried on without me.

The next day my appetite returned a little. I got a bus to Iquique and booked into a hotel for a couple of nights there. Iquique is a very strange city. It is set at the foot of cliffs that must be above 3000 feet high. An enormous sand dune extends into the Southern part of the city. The old downtown area was very run down and poor, but right next door are two large sandy bays and a lot of quite wealthy looking seaside developments – a casino, sailing club and smart hotels. In the old town is one long street of big houses built when the city was wealthy from the nitrate trade. This extended from an Opera House where Caruso sang to the sea. The whole street is listed and the buildings, built of timber shipped from Oregon in the 19th century, are being restored. It has all been pedestrianised with timber side walks, Victorian era lamp posts and street furniture installed and a new horse tram route is being constructed. Apart from these features it was quite a dull place and so yesterday I boarded another bus and spent four hours twisting down the spectacular coast with cliffs and mountains on one side and the Pacific on the other but nothing growing and no settlement. The road then turned inland past the Santa Elena Nitrate plant and an enormous copper mine to Calama where I changed bus and travelled the last hour to San Pedro, through the desert, as the sun set and the mountains glowed in oranges, reds and gold.

As the bus pulled in I saw one of the Germans who had been on the National Parks tour and chatted to him. I found myself a pleasant hotel and then went out for a good dinner in a restaurant with live musicians where I bumped into a retired Irish teacher from Maidstone who I had met in Arica.

After the problems of the Andes, San Pedro proved a welcome change. I took it easy on the first day, just going to the wonderful museum. I chose the same time as a SAGA group. What has happened to adventure travel? One member of the group was so overweight she wasn’t able to manage the whole museum tour and commented that the thin gold used for face masks looked as though it had been made to cover chocolate.

The next day I was feeling more adjusted to the altitude and walked out to a pre-Inca fort 3km from town. I arrived shortly after the SAGA party. The fort is built on a steep hillside where the river leaves a gorge and forms the oasis. The stonework was interesting, similar if cruder than Inca work. There was a maze of rooms, passages and who knows what leading up to an excellent viewpoint. The SAGA group didn't get there. The area has an interesting history. The Incas were only dominant for 60 years. The local people just submitted to them so were not defeated. However when news came that the Spanish had defeated the Incas the community leaders decided they weren't going to be dictated to about changing their names to match a new not understood religion. They therefore rebelled and retreated to their 11th Century fort. The Spanish, with horses and assisted by some local antagonistic neighbours defeated them in short time and executed the leaders. San Pedro de Atacama then became the sleepy backwater it remained until recently.

Next day, feeling full of confidence, I joined a tour to the Salar de Atacame to see the birds. The Salar looked like thawing snow, a grubby white and crunchy underfoot, with surface water in places. In the distance the distinct shape of the flamingos could be seen although even with strong binoculars you couldn't tell what species of the three found there were in sight. When they flew they looked even pinker and had an unusual Concorde profile with the wings far back along their bodies. In the distance Volcano Lascar steamed. It erupts every four years, the last time being 2000! It seems it throws out ash, not lava, and the winds always take the ash into Argentina. So that was alright.

The next stop was the isolated village of Socaire which had a very small stone church and tower. The church had become unsafe and so the community built a replica on a new town square but were now repairing the original. Around were terraces used for growing vegetables but slowly going out of use. Local men work in the Lithium extraction plant at the Salire and so the local economy is becoming cash based.

From the village we ascended to the deep blue Lakes of Miscanti and Miñques at above12,000 feet. We walked along a ridge from one to the other with stunning views and then back close to the shore. It was an important site for the flamingos to breed. They’re poor parents producing one chick which they will abandon if disturbed. It was the breeding season so we had to keep back from the lake shore. I was pleased to manage the walking without breathlessness or losing lunch!

The final stop was the village of Tocanao which is at the end of a gorge with a stream flowing through it. The stream is used for irrigating figs, quince, grapes and other fruit. The contrast between the arid highlands and the deep green of the valley was outstanding. It reminded me of Dovedale with surreal colour enhancement. Walking along the valley was a real pleasure after the heat and exertions of the rest of the day.

San Pedro de Atacama has an odd mix of visitors. There is a 'hippy' Chilean element, European gap year students, young European Professionals and elderly Islington or Baden Baden types having an alternative retirement holiday. The restaurants are a little more expensive than usual in Chile but have some adventurous combinations on the menu and the wine is delicious.

Well, I moved on to Antofagasta. Antofagasta is lack lustre. It's just a busy city and a bit down at heel. I decided to spend half a day looking at an industrial museum a little out of town. At the bus station this morning there were several ticket windows with bored staff sitting behind them and closed signs firmly in place. I went to the enquiry desk where three men were assisting one customer. After a while one broke away to see me. Can I have a ticket to Bacquedano I asked. I was told to get on the bus already in the terminal quickly and buy a ticket from the conductor. After half an hour the bus left. (Why the hurry?) “Bacquedano” I said to the conductor. “Calama?” he replied. “No, Baquedano.” I said. “Maria Elena?” he said. “No. Baquedano,” I said firmly and pointed to it in heavy print in my guide book. “Ah, Baquedano” he said, “$1 000”. I paid.

The museum was hopeless, uncared for, vandalised and derelict. I nosed around, did a sketch and went top the village for lunch. I had a tasty empenada and a cola for about a pound and then asked where was the best place to get a bus back to Antofagasta. The cafe owner said they were every half hour and you could flag them down infront of the cafe. He would bring me a chair so I could sit in the shade. As he was telling me this a bus went past. I sat in the shade for an hour before the next bus came. I waved. The driver and conductor waved back and drove past in a half empty bus. I decided to walk up to the police check point at the entry to town were all buses and trucks have to stop. After half an hour of standing in the early afternoon heat a bus came and I got on. He then stopped and picked someone else up outside the cafe where I had been sitting half an hour earlier.

Back in town I felt I deserved a coffee and lemon pie. After quite a while the waiter returned with the coffee but said there was no lemon pie. I’m going to treat myself to a nice sea food dinner and white wine. Wish me luck.

Next Steve goes to Easter Island.