Thailand General First Aid Medical Advice

This knowledge has been collated for this site, mainly by a friend who is in Medicine and other soarces including Wiki. It is intended as a guide only, and if any advice you are uncomfortable with, do not take the advice. Your Doctor is your best advisor.

Phuket Travel and Tours want you to enjoy your holiday, but wish to make you aware of some of the complications and pitfalls that can occur on your dream holiday

Before you go..

Vaccinations:

In general there are no required vaccinations for Thailand (the only exception is vaccination for Yellow fever when you fly in from a Yellow Fever endemic country).

Common sense and travel advise agencies do advice however:

Routine vaccinations (measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, polio vaccine) being up to date.

-MMR gives lifelong immunity. So if you have not been vaccinated as a kid (anyone born before 1976, I think), don't worry if you have had these diseases. If you have been vaccinated, don't worry either…..

- DT(P) The DT part gives immunity for 15 years after full vaccination (American literature says 10 years). After that, one single booster will prolong immunity for another 15 years. It is advised to get these boosters in your own country, for Thailand the risks are higher, the advice the same. The Pertussis does not have to be repeated, life-long immunity.

-Polio vaccination: Although boosters are still advised by some, Polio is really almost eradicated in the world.

Specific vaccinations:

-Hepatitis A and Hepatitis B: Hepatitis A can transmit through contaminated water and food. Children are much more susceptible than adults. Risk in tourist area's is small, much higher in rural areas.

Hepatitis B is transmitted through sexual contact or blood contact (tattooing and piercing as well).

My advice for frequent travelers would be to get a combination Hep A/B vaccination, travel with kids definitely have your kids vaccinated.

-Japanese Encephalitis: To be honest, I had not heard of this disease before looking up some things.

It seems to seem endemic in Thailand, mainly in the north (Chiang Mai valley). This is from the CDC website:

Thailand Endemic countrywide; seasonal epidemics in the northern provinces Year-round with seasonal peaks May–October, especially in the north Highest rates of human disease reported from the Chiang Mai Valley; sporadic human cases reported from Bangkok suburbs; several cases reported recently in travelers who visited resort or coastal areas of southern Thailand.

For reference: Japanese Encephalitis - Chapter 3 - 2014 Yellow Book | Travelers' Health | CDC

For the record: CDC does advice vaccination, here in Holland they don't!

Malaria:

First of.. There is no vaccine for malaria, chemoprophylaxis (tablets) is the only option. That said, it is highly discussed if there still is malaria in Thailand. Different countries and different websites give different reports.. Personally, I have never seen Malaria in Thailand, and never heard a Thai having it recently.

Let's take this map as a guideline:

Which suggest there is only a risk close to the borders, especially in low population nature area's. For myself, I do not use Malaria prophylaxis in Thailand, and would not recommend. Just be aware when you get ill, that it could be.. if you have been hiking close to the border.. Malaria has an incubation period of 2-4 weeks, so symptoms may well occur when you are back home!

If you do want to use Malaria prophylaxis, there is a high drug resistance for Chloroquine and mefloquine, so the prophylaxis of choice is Atovaquone-proguanil or doxycycline.

Dengue

From Bangkok Post (8-07-2013):

Dengue cases could hit 120,000

• Published: 8 Jul 2013 at 12.22

• Online news: Local News

The Public Health Ministry is launching a campaign to fight a sharp upsurge in dengue fever, which officials fear could hit a record high of 120,000 cases this year, reports said Monday.

In the past week, 5,276 new dengue fever cases and six deaths have been recorded throughout the country, with the highest concentration of cases in the northern region, state broadcaster MCOT reported. Public Health Minister Pradit Sintavanarong said the campaign will employ more than a million volunteers from July 10-17 to combat mosquitoes in residential areas, schools and temples while educating people about the disease.

Dengue is a fast upcoming disease, which hit Thailand more than other countries. So I will try to give some more information.

From Wiki:

Dengue fever is an infection caused by the dengue virus. Mosquitoes transmit (or spread) the dengue virus. Dengue fever is also known as "break-bone fever" or "bone-break fever", because it can cause people to have pain so bad that they feel like their bones are breaking.

Some of the symptoms of dengue fever are fever; headache; a skin rash that looks like measles; and pain in the muscles and joints. In a few people, dengue fever can turn into one of two forms that are life-threatening.

The first is dengue hemorrhagic fever, which causes bleeding, leaking blood vessels (tubes which carry blood), and low levels of blood platelets (which cause the blood to clot). The second is dengue shock syndrome, which causes dangerouslylow blood pressure.

There are four different types of the dengue virus. Once a person has been infected with one type of the virus, he usually is protected from that type for the rest of his life. However, he will only be protected against the other three types of the virus for a short time. If he later gets one of those three types of the virus, he will be more likely to have serious problems.

There is no vaccine that works to keep people from getting the dengue virus. There are a few things that can be done to prevent people from getting dengue fever.

People can protect themselves against mosquitoes and limit the number of bites they get. Scientists also suggest making mosquito habitats smaller and reducing the number of mosquitoes that exist. Once a person has dengue fever, he usually can recover just by drinking enough fluids, as long as his disease is mild or moderate. If the person has a more severe case, he may need intravenous fluids (fluids given into a vein, using a needle and tubing), or blood transfusions (being given blood from another person).

Since the 1960s, many more people have been getting dengue fever. The disease has become a worldwide problem since the Second World War. It is common in more than 110 countries. Every year, around 50–100 million people get dengue fever.

People are working on a vaccine and medication to treat the virus directly. People also do many different things to try to get rid of mosquitoes.

The first descriptions of dengue fever were written in 1779. Early in the 20th century, scientists learned that the disease is caused by the dengue virus, and that it is transmitted (or spread) by mosquitoes. Here is a picture of the little bugger:

Instead of the Malaria mosquito, which is a nocturnal mosquito and a "clean-water" breeder, the mosquito spreading Dengue is most active during the day, and has little requirement to it's breeding grounds.. It has been suggested, that the Dengue mosquito thrives because it takes the place of insects that need clean open water for their survival, which diminishes because of human pollution.

So, No vaccine, no direct medication.. Bed nets are not effective, since it is a daytime mosquito.

The only way to prevent is prevention of mosquito bites. Wearing long cloths helps, but do you want to do that in your holiday in a tropical environment? But use a repellant where your body is not covered! And apply several times a day.

Pre-existing medical conditions and prescription medication.

In my daily practice, even after almost 20 years, I am still amazed how people deal with chronic medical conditions and medication.

Many times, when I ask people about their medical history or what medication these use, I get blank stares.. Or even things like "The cardiologist said it wasn't a heart attack, but something with three names…." Or " yes, for my blood pressure I take the small white ones.."

These are not exceptions, but rather very common remarks from patients I try to help. Here we can solve this by picking up the phone and call their home, GP or hospital.. Not in a faraway country, though, be it Thailand or any other.

And the chance of pre-existing conditions playing up, or medication giving side effects or reduced effect is much higher in Thailand, due to climate change, change in diet and daily patterns.

So, regardless of what the pre-existing medical condition is, and regardless of what the medication is, some tips:

- Get a list of your prescription medication in English, using generic names of medication. Both your GP and your pharmacist can provide you with this. - Ask your consultant or GP to write your medical history in English. - If suffering from cardiovascular conditions, ask your cardiologist for a copy of a recent ECG (doctors can only reliable judge a ECG by comparing it with an earlier one) - For custom reasons, only take prescription medication in it's original wrapping, leave the prescription sticker on it. It is OK to bring prescription drugs into a country, as long as it is clear who it's prescribed to, and a pharmacy list to prove. Taking medication out of it's original wrapping (put it in a jar to safe space), can give you a lot of trouble with customs. - If you have allergies for certain types of medication, or severe allergies in general, have your GP write them up in a medical emergency pass. In general a credit card size cardr, which you can put in your wallet.

For expats or those who stay for longer periods, I would suggest to get your complete medical file (can put it on a single USB-stick), depending on the condition complete with digital X-rays, MRI's, etc.

If you intend to live in one place for a long period of time, look or search for a doctor (GP or specialist in the field of your medical condition) you feel you can trust. Make an appointment to introduce yourself and make this doctor know what your story is. Sooner or later you will need him, and it is so much easier when he knows you before.

Emergency kit.. What to take?

In general, all over-the-counter medication you can but at home is easily available in Thailand. And even prescription medication you can get after discussing your problem with the local pharmacist.

So in that perspective, there is little need to take anything.

There are a few exceptions, however:

- Do take enough of your prescription medication from home. Don't depend on finding addition medication while in Thailand. For expats, find a doctor who can prescribe follow-up medication well before you run out.. - If you have a medical condition, where emergency medication can be in order, take a dose from home, and carry the prescription, so you can replace this when you needed to use it. - When you are going to hike, or live aboard diving.. Do not depend on the tour operator for emergency medication! Many times they will have an emergency kit available, just don't count on it.. - Same as when you are travelling with kids. Make sure you have the basics right at hand..

When I travel alone, I do not take an emergency kit. I do however take some things in my toilet bag: o First, a good pair of scissors and good tweezers. Always found some use for them.. o A piece of Fixomull. Maybe named different in different countries, but it's the sticky, stretchy bandage that can prevent blisters.. Will be between my toes when walking on slippers after only using regular shoes over here. o I do always take 1 quick course of antibiotics. My choice is Azithromycin 3x500 mg (one tablet of 500 mg a day, for three days), this is one of the first choices in both gastro-intestinal infections as in upper respiratory tract infection, and also first choice for Chlamydia infections. o 2 sleeping tablets will be in my hand luggage when I go, 2 will be in my toilet bag for the flight back.

A full emergency kit when I travel with my kids will exist of: - What mentioned before.. - Some sachets of ORS (can get them in Thailand, but want them handy in the middle of the night) - Some Band-Aid and gauzes, bethadine and adhesive tape. - Fucidine ointment. In my opinion the best to treat tropical wounds. - I will also take some Paracetamol, just for emergency, you can get it at any 7/11 - And even some insect repellant and sun block.. Really no need, since you can get it anywhere, more like a didactic thing, to make them aware they have to use this all the time.

Some normal changes… no sickness or disease…

Jetlag:

From wiki:

Jet lag, medically referred to as desynchronosis, is a physiological condition which results from alterations to the body's circadian rhythms resulting from rapid long-distance transmeridian (east–west or west–east) travel on a (typically jet) aircraft. It was previously[1] classified as one of the circadian rhythm sleep disorders. The condition of jet lag may last several days until one is fully adjusted to the new time zone, and a recovery rate of one day per time zone crossed is a suggested guideline. The issue of jet lag is especially pronounced for airline pilots, crew, and frequent travelers. Airlines have regulations aimed at combating pilot fatigue caused by jet lag. No that is a mouth full.. 55 In simpler words, your body needs to adjust to a new time zone.

It is said that you cannot do anything to prevent jetlag, which is, in my opinion, not entirely true.

People with a very steady day rhythm have a more severe reaction than those who are more flexible.. And the bigger the time difference, the more severe the jetlag.. The other factors that contribute to severity of jetlag are being able to sleep on a plane, getting dehydrated (plane aircon or lots of alcohol) and the time of day you fly and arrive.

Some tips if you suffer from severe jetlag:

- Choose your flying times so that you arrive at your destination in the morning. It's easier to stay awake when you are tired, than sleeping when you are not!

- Pre-adapt your times in the week before flying. So change you bed- and wake up time a few hours in the direction of the time where you go to, but also your meal times etc. By doing this, the time-gap becomes smaller and the jetlag less.

- Make sure to drink on the plane! I see many not drinking because it is such a drag to get to a plane toilet. But dehydration makes jetlag worse. And walking around a plane benefits your body in many ways!

- Try to sleep on a plane. When you cannot do this on your own, a drink or sleeping pill might help.

Climate adaptation / acclimatization

Of course, this all depends on where you come from, what season and what time of year you come to Thailand.. Being on the topic, let's just suppose coming from a climate with temps below freezing and humidity being <30%, arriving in Thailand with temperatures of 30+ C and humidity of > 80%.

To keep it simple, in cold climates your body is burning fats and sugars to keep the body temperature up. All your body systems are aimed for that, appetite center, bowels, heart and lungs, hormonal system, skin.. When suddenly coming to a climate where your body does not need to do that.. It takes time for the human body to change that.. So you are in a 30C climate, but your body is still producing heat.. Heat which your body cannot get rid of.. You start sweating, but sweating does not work as a mechanism for losing heat in a hot and very humid temperature.

The mechanism of losing heat through sweating is that evaporation costs energy, so withdraws this energy from your body.. But sweat dripping on the floor will not do anything. Anything besides you losing water and salts from your body, causing dehydration.

To fully adapt to a new climate takes about 2 weeks for athletes and soldiers, but up to three months for most of us.. So on a holiday, your body will never get fully acclimatized.

Some things help your body to get used to the changed circumstances, some things do the opposite.

Big temperature changes make it almost impossible for your body to adjust. Like sitting in the full sun all day by the pool or on the beach, and then going into the room and switching the aircon to max.

To help acclimatization, do what you want, but don't look for sun worshipping, don't use aircons overly (I set it to 27 C and leave it there). Don't skip meals, but make then light and small, drink plenty, do let your body be active, but don't overdo any exercise.

Sudden change of diet

This is not about what you eat, but about your holiday food compared to the food you eat back home.. If your usual meal is potatoes, beef or pork and some veggies, changing to rice, sea food and spicy sauces is a major attack on your bowels.

Just want to say.. be careful with foods you are not used to.. Rice or noodles will not be the problem, but gradually increase the chilies and the sea food if you haven't had that for a while.

Also, regular meals, small meals and back-home comfort food when your system is getting upset.

Some common medical problems while in Thailand.

Dehydration:

To explain anything about dehydration, it helps to look at normal hydration of the human body first. In truth, it is way more complicated than what I will explain here.. Not untrue, just simplified.

Normal Hydration:

The human body consists of a large percentage of water, depending who you believe, between 55% and 70 % of your body is water. Two thirds of this water is inside cells (intracellular), one third is extracellular. Of this extracellular water, one third is in your blood stream, two thirds outside.

There is two salts regulating a lot, Potassium is mainly inside cells, Sodium mainly outside cells.

For the rest, your heart is the pump which keeps things under pressure, your mouth is the intake route, your kidneys the most important output route.. Other output routes are the skin (sweating, mainly aimed at temperature regulation), the lungs (aimed to hydrate air when it comes into your lungs) and with your stool (which will become very important when talking about diarrhea).

Two hormones regulate most of it, ADH (anti diuretic hormone) produced in the brain, and Aldosterone, produced in the kidney.

Sounds fairly simple, but believe me, it is not.

Fluid balance:

To keep this system working, the fluid intake needs to exactly balance to fluid output. Main motive for the body is to keep the blood pressure at constant levels, the rest matters less.

Back to these to salts.. Potassium is inside the cells, and it's concentration is higher than the sodium concentration in surrounding tissues and in the blood vessels. Since water will follow salts (osmosis), the human cells will be under a slight pressure (we call this pressure turgor). Compare this to a plant for visual understanding, A healthy hydrated plant is firm, when without water, the cells will lose turgor and the leaves will start to hang.. Same thing happens in the human body!

So when blood pressure is going down due to lack of fluids, many repair mechanisms will start: - Cells lose potassium, causing the cell to lose water to the blood vessels. - The amount of salts in the blood stream will rise, giving signal to the thirst centre (make you thirsty), to the brain, releasing ADH, which will reduce urine production, and to the kidney, releasing Aldosterone, which will lose potassium to the urine, in order to save the concentration of sodium in the blood stream to draw water into the blood stream..

Now about dehydration.

From the above, dehydration will occur when there is a negative fluid balance.. This can be due to lack of water intake, or due to excessive water loss.. And third, but not to be forgotten, dehydration can occur due to loss, or lack of intake on salts, mainly sodium salts!

In general, without any real medical problem, when coming to Thailand from a moderate western climate, you will lose more water by sweating, you will lose more water through bowel movements, you will have less water intake from food (lack of appetite), so the recipe for dehydration is already there..!

Air cons add to water loss, so does drinking alcohol.. laying on the beach, driving a scooter around some tropical island add to this.

Exercise while not acclimatized and diving will add greatly to water loss. Real killers are fever and diarrhea.

For reference, the water intake calculator I posted elsewhere:

Human Water Requirement Calculator

Normal water intake in western climates: Water: 1500 cc Food: 500 cc Metabolism: 250-400 cc

Normal water loss in western climates: Urine 1000-1500 cc Skin (sweat) 500 cc Breathing 250-500 cc Faeces 100 cc

Typically, your urine production in Thailand will be about the same (add 120 ml per alcoholic consumption when in party mode).

The loss of water through breathing will be less, given the high humidity (unless you are diving).

Water loss from sweating is increased. Depending on the amount of sun worshipping, exercise, aircon use, etc. Can amount up to liters!

Water loss through faeces will be up, by how much is hard to say.

Let's see what maximum fluid losses can be?

Maximum fluid loss through breathing: Only relevant for divers, about 500cc per dive.

Maximum water loss from diarrhea: In extremes (cholera) this can be up to over 10 liters a day (lethal). Will get to this extensively when talking about diarrhea.

Maximum fluid loss through sweating: When temperature disregulation arises, like in heat stroke, this can amount upto 50 ml/min!! This would be 2000 ml/hour.. I will get to this when talking about heat related disease and heavy workout in tropical climate.

Maximum fluid loss through urine: When dehydrated, the urine production will go down. For a short period of time, this is no problem. Urine production is however essential to get rid of some waste products in your body (mainly nitrogen remainders of metabolism, ureum). Long periods of dehydration will pile up these toxic products in your blood.

Few other remarks about urine production:

-When drinking alcohol, urine production will go up, even if you're dehydrated (attempt of the body to get rid of the stuff).

- For those who take diuretics (common western treatment for high blood pressure), urine production will stay up, which can lead to very fast aggravation of dehydration. Best to talk to your doctor before travelling to tropical climates, in any way stop taking them in the tropics when suffering from diarrhea.

Some common medical problems while in Thailand.

Dehydration and alcohol

Alcohol is a substance that passes the blood-brain barrier. The human body protects the brain and most toxic substances can not get from the blood stream to the brain. Alcohol can, and that's why we like it.

But by getting into the brain, it gives some strong alarm signals in that brain. The brain feels intruded, and will start serious attempts to get rid of this toxic invader (luckily we are not aware, that would spoil the fun..).

In the attempt to get rid of the alcohol, the human body will lower the blood-pressure, both by reducing heart rate and by widening veins (explains how alcohol relaxes you).

More important when talking about dehydration, the body will stop producing ADH (anti-diuretic hormone(diuresis = peeing)). The effect of this is, that when drinking one drink (about 12ml of pure alcohol), the urine production from this is the original amount of your drink, plus about 120 ml's.

This means first, you can not count any alcoholic drinks in your fluid intake, and second that you will have to drink 120 ml per alcoholic drink consumed!

Taking this to the water calculator posted before: my personal calculations:

If I use the water calculator on myself, I get a required daily water intake of 2350 ml when I say "no exercise" and 3500 ml with 60 minutes of exercise (which is about accurate once I met the right girl..555).

But then, the effect of alcohol..

My daily required water intake was between 2350 and 3500 ml's. In Thailand I will drink about 10 whisky-coke's, which is about 2000 ml's I cannot consider as intake.. Instead, for these alcoholic drinks, I need to drink 1200ml's extra! So my daily required intake becomes between 3500 (no exercise) and 4700 (60 min exercise).

Honestly, I can not drink that much water… The explanation I think is, that what said above is true for a normal hydrated body. Once dehydrated the body becomes more focused on preserving water and the amount you pee goes down. Which does explain the moderate dehydration symptoms I feel when in Thailand.. Lack of energy, poor appetite, changed bowel movements, etc.

Some common medical problems while in Thailand.

Dehydration, symptoms and treatment

After the long post about dehydration, I better add something about how to detect this, and what to do about it.

Early signs:

The first sign of dehydration is thirst! And dark colored urine. Following symptoms are lethargy, slight headache, and dizziness when getting up (orthostatic hypotension).

Next symptoms can easily be mistaken for a hang-over: headache, general unwell being, lack of appetite, fatigue and even fainting. Different from a hang-over these are accompanied with dry skin, dry and swollen tongue and constipation.

Differential diagnose:

Although dehydration is a medical condition by itself, there can be many reasons causing this condition other than not drinking enough. Not going to name all, but fever, infectious disease, diarrhea, heat related disease, medication and diabetes are a few sole or attributing causes.

Treatment:

First and foremost way of treatment is replacement of water and salts. This can be done by drinking plenty, but always in combination with eating (even though there is no appetite). Remember that absorbing water requires salts and sugar as well.. ORS (oral rehydration solution) consists of water, salts and sugar, which helps when you can not eat.

Second, the cause of water loss should stop! What this means depends on the situation and cause of dehydration, but in general get out of the sun / heat, stop exercising, don't drink alcohol and stop taking medication that drives off fluids. If diabetic, it is likely to be out of control, seek medical advice.

Fever, diarrhea and vomiting are very common reasons for dehydration as well. If they do not clear, seek medical help!

Also when the dehydration symptoms do not improve with drinking and the simple measures mentioned before. Visit a doctor.

Some common medical problems while in Thailand.

Diarrhoea

Diarrhoea is really a symptom, and it is so very common that it is no question if you will suffer from it, but more how long and how heavy.

Diarrhoea is defined as having 3 or more loose stools per day.. Which is not really workable in Thailand, the chillies alone will do that to you!

I am not going to try to be complete about the possible causes of diarrhoea, just focus on the things you will come across as a traveller in Thailand.

Let's up the definition to start off with 6 or more watery stools in one day sounds like a signal to worry about.. (this is my definition, not western literature's).

Non-infectious causes

Important is to realize, that not all forms of diarrhoea are gastro-enteritis! In fact, I think most are not! Amongst the most common causes of diarrhoea in Thailand are:

- Sudden change of food pattern! How can you expect your bowels to be ready for large amounts of chillies, sea-food, alcohol, etc. after eating a regular western diet for months? The question is more interesting than the answer here, because we seem to do that.. Expecting out bowels to just adapt right away.

- Swallowing salt water. Underestimated as a cause of diarrhoea, but I think a very frequent one.. Beach, sea, and you just want to go.. And when crossing the surf, you get a good few big gushes of sea water.. Banana riding or jet-skiing are even worse.. This in combination with drying yourself out (laying in the full sun on the beach).. Sure your body get's more salts than it can absorb.. and the salts are excreted with water on the other end.

- Allergies.. Happens a lot.. We like to eat seafood, but don't really eat it that much at home.. So allergies are easily developed. Not so much for fish, but mainly for shell fish. Usually the freshness of the sea food is blamed, or the way it has been cooked, but shell-fish allergies are very common, and mainly express themselves with diarrhoea.

Infectious causes:

- Diarrhoea caused by endotoxins. Should really be in the non-infectious causes, but since these endotoxins are produced by bacteria, decided to put it here. I think this is the most common cause of what is labelled as food poisoning! Many types of bacteria produce endotoxins. And even if you cook the (infected) food all the way, it will kill the bacteria, but not the endotoxins! The type of diarrhoea this causes is typical: sudden onset diarrhoea and vomiting 2-3 hours after eating something "bad".. Very heavy symptoms, like not knowing how to sit on the toilet, since it is coming both ways.. And typically, feeling much better in the morning, only feeling weak from not sleeping and losing a lot of fluids and energy.

- Travellers' diarrhoea: usually confused with the endotoxin type and the virus type.. According to the book, travellers' diarrhoea is caused by a bacteria called E. Coli. This is a bacteria that lives in your colon anyway.. There is just different types, and a strange type can cause symptoms.. Although it can give the same symptoms as endotoxin diarrhoea, the onset is usually slower, the vomiting less profound, and fever is often present. But more important, it does not disappear overnight, you will stay feeling sick, not able to eat or drink, for days.

- Viral gastro-enteritis: Mild diarrhoea, mild vomiting, mild sickness, maybe slight temperature.. Can disappear within a few days, but can be present for weeks.. Billions of new viruses when you first come to Thailand, and your body needs to adapt. This is a condition where symptoms can vary greatly.. For one thing, it is a new travellers thing, not for the veterans and expats.

- Parasite gastro-enteritis: Not too rare in Thailand. Will most commonly be caused by Giardia (or Entamoeba Histolytica, see below). Worm infections also exist, but rare in a tourist type environment. Stools will not be watery, but loose. Commonly, no general symptoms and very little risk to become dehydrated. Really, if on holiday, you can afford to wait until you get back home.

- Dysentery: Any diarrhoea with blood (this means blood IN the diarrhoea, not ON.. Blood on the toilet paper is very common, scraping yourself with paper too many times will do that.. Haemorrhoids will help as well) is called dysentery. Without many symptoms this may point at Entamoeba Histolytica. With symptoms as fever, sickness, vomiting, general malaise, it might be one of these bacteria. Salmonella, Shigella, Yersinia, Campylobacter… These are serious infections, which will not disappear by themselves.. As a rule: Bloody diarrhoea, see a doctor!

Treatment, general:

- First and foremost thing, is to ask yourself, what may be the cause! Anything you did that day? (swim in the ocean, stay in the sun too long, eat something "wrong"?) If there is any reason, pay the prize, stay in your room and sit it out..

- Hydration! As stated before, diarrhoea will make you lose a lot of fluids! It will make you lose a lot of salts as well.. When suffering from diarrhoea, drinking becomes even more important.. Assume your water need to be 2500 cc in a normal situation, and add 200 cc for each time you visit the toilet. So when suffering from diarrhoea, 3500-5000 cc will be your required intake. Remember that your body cannot absorb water without salts and sugars, so keep drinking and eating.

- ORS: When you cannot meet your requires intake (which will happen very easily), Oral Rehydration Solution (ORS) can help. Can be bought in sachets, or pre-mixed.

Treatment, specific:

- Now I am in serious doubt.. Is it wise to prescribe yourself with antibiotics? In general, I would not recommend that! But, you are in a strange country, and where to find a doctor?

- For me (although literature disagrees), Azithromycin 500 mg once a day for three days would be the choice. First, because it does not harm your normal bowel flora, second because it is a short course (compliance..).

- Immodium (loperamide): This drug is very highly promoted by the pharmaceutical companies, but I would not use it unless a really had to.. (travelled a lot and lived in Africa for a year, but I have never used it!). What it does, is slow your bowels down. It does not treat the cause of the diarrhoea, and when the cause is infectious, it literary creates a stove for the causing bacteria or viruses.. Only one reason to use this, and that is when you need to sit in a bus, train or plane for several hours.

When to "do it yourself" and when to consult a doctor? - Bloody diarrhoea should mean visit a doctor or hospital! - For the rest, If symptoms get worse over time, visit a doctor. - When you can not drink enough, or vomit everything out as soon as you have taken it (water, food or medication), visit a doctor!

Some common medical problems while in Thailand.

Heat illnesses

Heat illnesses can be named and identified as separate conditions, with different causes, symptoms and treatment. Still, the basic underlaying cause it's the same, and one condition can develop in another if not treated. Therefore, I choose to put it in the same topic.

Your body normally cools itself by sweating. During hot weather, especially with high humidity, sweating just isn't enough. Your body temperature can rise to dangerous levels and you can develop a heat illness. Most heat illnesses occur from staying out in the heat too long. Exercising too much for your age and physical condition are also factors. Older adults, young children and those who are sick or overweight are most at risk. Drinking fluids to prevent dehydration, replenishing salt and minerals, and limiting time in the heat can help.

Disclaimer: Some of what is written next is directly copied from wiki, Mayo clinics and other websites.

Heat-related illnesses include:

Heat cramps

Heat cramps are the intermittent, involuntary spasm of muscles that occur in an individual who is physically active (for example, working or exercising) in hot or humid weather. They are often associated with dehydration. Heat cramps usually affect the major muscles that are being stressed in the hot environment. Most often these are the thigh and leg (quadriceps, hamstrings, gastrocnemius), the core muscles (abdominal wall and back) and the arm muscles (biceps, triceps).

Heat cramps can also occur after the activity has been completed. For example, construction workers or roofers can develop cramps a few hours after their work shift is over.

Treatment is stopping the activity, moving to a cool place and replace water and salts (energy drinks and ORS). Don't resume the activity in the heat for that day, or the next day if cramps occur after the activity.

Heat edema

Heat edema is a swelling of the extremities associated with exposure to high temperatures. Heat edema itself is not dangerous, but it can be a sign that a person could be at risk for a more serious heat-related illness, such as heatstroke. There are a number of measures people can use to prevent and address heat edema.

This condition occurs when the body starts to retain water and have trouble excreting salt. It is believed to be linked to an increase in the hormone aldosterone. Heat edema can set in after a day or more in an unusually warm climate, or it can onset more quickly in people who are working outdoors or engaging in heavy physical activity.

People usually notice that rings and other jewelry feel tight. Heat edema is often accompanied with flushing of the face. Garments may feel restrictive, the patient usually sweats, and there is generally a sensation of being hot and uncomfortable.

Immediate treatment for heat edema involves getting the patient into a cool place, providing cold fluids to drink, and elevating the extremities to reduce swelling. The heat edema can resolve very quickly in a location like an air conditioned building, helping the patient to feel more comfortable. This will also prevent heatstroke and more serious heat-related illnesses.

Heat exhaustion

Heat exhaustion is a condition whose symptoms may include heavy sweating and a rapid pulse, a result of your body overheating. It's one of three heat-related syndromes, with heat cramps being the mildest and heatstroke being the most severe.

Causes of heat exhaustion include exposure to high temperatures, particularly when combined with high humidity, and strenuous physical activity. Without prompt treatment, heat exhaustion can lead to heatstroke, a life-threatening condition.

Treatment for heat exhaustion includes recognizing the symptoms, stopping the activity, and moving to a cooler environment. Rehydration with water or a sports drink is the cornerstone of treatment for heat exhaustion. If nausea or vomiting prevents the affected individual from drinking enough water, intravenous fluids may be required.

Heat Syncope

Heat syncope is fainting as a result of overheating (syncope is the medical term for fainting). It is another stage in the same process as heat stroke, it occurs under similar conditions, and it is not distinguished from the latter by some authorities. The basic symptom of heat syncope is a body temperature above 40°C (104°F) with fainting, with or without mental confusion, which does occur in heat stroke. Heat syncope is caused by mild overheating with inadequate water or salt.

Treatment is the same as for Heatstroke: see below.

Heatstroke

Heatstroke is caused by prolonged exposure to high temperatures or by doing physical activity in hot weather. You are considered to have heatstroke when your body temperature reaches 104 F (40 C) or higher. High humidity, certain health problems and some medications increase your risk of heatstroke. So does being a young child or older adult.

Heatstroke is the progression of two worsening heat-related conditions. When your body overheats, you first may develop heat cramps. If you don't cool down, you may progress to symptoms of heat exhaustion, such as heavy sweating, nausea, lightheadedness and feeling faint.

Heatstroke occurs if your body temperature continues to rise. At this point, emergency treatment is needed. In a period of hours, untreated heatstroke can cause damage to your brain, heart, kidneys and muscles. These injuries get worse the longer treatment is delayed, increasing your risk of serious complications or death.

So when heatstroke is suspected, or when heat syncope occurs, move the patient to a cool place and call an ambulance! Don't even try to take a patient in your car or taxi to the hospital.

You may forget this on a beach, but this is a medical emergency! Multi organ failure (permanent damage to several organ systems) may occur within hours. Blood test should be done, iv fluids and replacement of electrolytes (salts) should start as soon as possible.

The following information was supplied by a Trip Advisor Member, Jeff Raymond.

Phuket Cheat Sheet Online Version 01 – Feb 2014

Plus some bits and pieces borrowed from the sites and cheat sheets of many experienced travellers. "Nothing beats experience". I hope you find it useful.

This sheet was originally designed to assist my daughter and a group of her Aussie friends in planning their first trip to Phuket, but should contain something of interest to anyone visiting Thailand. All care taken – No responsibility.

Where in some matters there may be a difference of opinion,

I have decided to err on the side of caution! (I gratefully accept updates and corrections – please feel free to email me).

Useful Telephone Numbers (from within Phuket)

• Tourist Police 1155 (English normally spoken)
• Police 191 Marine Police 076 211 883/ 076 214 368
• Fire 199
• Ambulance 191 Private Ambulance 1669
• Telephone Directory Enquiries (Local) 1133
• Telephone Directory Enquiries (Overseas) 100
• Phone Translation Service (Thai/English) 1021
• Tourism Authority of Thailand (TAT) 1672
• Immigration Volunteers Hotline 090 170 7360
• Bangkok Phuket Hospital 1719 (24 hours)
• Phuket International Hospital 076 249 400 (24 hours)
• Mission Hospital Phuket 076 237 220/6
• Wachira Hospital Phuket 076 211 114
• Patong Hospital 076 340 444
• Thalang Hospital 076 311 111
• Australian Embassy (Bangkok) 02 446 300 austembassy@dfat.gov.au
• Australian Consulate (Phuket) 076 372 600
• NZ Embassy (Bangkok) 02 542 2530
• US Embassy (Bangkok) 02 2054 000
• UK Embassy (Bangkok) 02 3058 333
• Jetstar 02 267 5125 (Bangkok) or + 001 800 61 1 2957 (Australia)
• Virgin + 001 61 7 3333 6888 (Australia)
• Qantas 02 627 1701 (Bangkok)
• Thai Airlines 076 212 499 076 350 444 (Phuket)
• Air Asia 02 515 9999 (Bangkok)
• Bal Air 076 327 2307 Extension 1240 (Phuket)
• Britannia Airways 076 327 2307 Extension 1240 (Phuket)
• Cathay Pacific 1800 700 707 (Phuket – Toll Free)
• China Airlines 076 327 099 or 076 327 100 (Phuket)
• Far Eastern Airlines 076 327 2307 Extension 1352 (Phuket)
• Finn Air 076 327 2307 Extension 1252 (Phuket)
• Garuda 02 2856 4703 (Bangkok)
• Hong Kong Dragon Airlines 076 327 2307 Extension 1230 (Phuket)
• Lauda Air 076 327 2307 Extension 1238 (Phuket)
• One2Go 076 327 2307 Extension 1126 (Phuket)
• Nok Air 076 327 2307 Extension 1318 (Phuket)
• Malaysia Airlines +001 603-7843 3000 (Malaysia)
• Malaysia Airlines 076 327 2307 Extension 1232 (Phuket)
• Nova Airlines 076 345 184 (Phuket)
• Silk Air 076 304 018 (Phuket)
• Silk Air 076 327 2307 Extension 1236 (Phuket)
• Singapore Airlines 02 353-6000 (Bangkok)
• Tiger Airlines 02 649 9688 (Bangkok)
• Trans Asia Airways 076 327 2307 Extension 1361 (Phuket)
• Uni Airways 076 327 2307 Extension 1367 (Phuket)
• Phuket Bus Terminal 076 211 480 (Phuket)
• Lost Credit Cards: Visa (001) 800 441 3485
• Mastercard 02 670 4088 (001)800 0011 8876 0663
• Amex 02 273 5544 02 273 5522

Register your travel details with Smart Traveller (Australians only) https://www.orao.dfat.gov.au/orao/weborao.nsf/homepage?Openpage

Tsunami Warnings - I recommend anyone visiting Asia to register for free Earthquake and Tsunami email and SMS alerts with the Global Disaster Alert and Coordination System at http://www.gdacs.org/ It's a free and effective means of supplementing the Warning Systems that are in place throughout Thailand and other countries. You will need to activate "international roaming" before leaving home (or have a "local" Sim in your mobile).

Timezone – Local Phuket time is GMT + 7 which is 3 hours behind Sydney/Melbourne EST or 4 hours behind during Australian daylight saving time.

Visas – If you hold an Australian, NZ, or British passport you are exempt from visa requirements and will receive a 30-day entry stamp on arrival (don't go to the visa counter, proceed straight to the immigration queue/s). Your may extend your 30 days by a further 7 days at any immigration office in Thailand for a fee of 1900 baht. Always check the date on your entry stamp when you enter the country. Do not stay beyond the "permitted to stay" date (fine = 500 baht per day). If you pay the fine when leaving the country you will receive an overstay stamp in your passport but normally no other penalty. However, if during your stay in Thailand the police have cause to check your passport and find you have overstayed, you will be treated as an illegal alien and may spend a night or two in a cell before being deported to your home country and blacklisted from Thailand. Note: An Irish tourist was recently arrested for overstaying his visa by 3 days - http://phuketwan.com/tourism/phuket-dsi-campaign-targets-expats-taxis-overstayer-nabbed-18860/

There are 2 main immigration offices in Phuket where you can extend or make visa enquiries.

Phuket Town Office, 482 Phuket Road, PhuketTown, 83000 Phone: (66) 076.221.905 (On Phuket Road at the entrance to Saphin Hin). Patong Beach Branch, Beach Road, Phone: (66) 076.340 477 Only open Monday & Friday (On the beach road halfway between Bangla Road and Sawadirak Road)

For more Visa details, check: http://www.mfa.go.th/web/2482.php?id=2490

Airport Arrival and Departure Tax – Nil - Now included in the price or your airline ticket.

Call Centres For Tourists (before you leave home) - The Tourism Authority of Thailand (TAT) has set up a number of international telephone "hotlines" to help foreign visitors get updated 24-hour tourism information and have their queries answered about any aspect of travel and tourism to and within Thailand.

United Kingdom - Tel: +442033550430 or 02033550430

USA - Tel: +15166196810 or 5166196810

Australia - Tel: +61280147129 or 0280147129

The calls will be charged at the local rate for the callers regardless of whether they are calling from a landline or mobile phones. Thanks to November12010 - http://www.tripadvisor.com/ShowTopic-g293915-i3686-k3854391-Call_Centers_For_Tourists-Thailand.html

Flight times – Jetstar is the only airline that flies direct between Sydney/Phuket and Melbourne/Phuket. Virgin Australia flies from Perth to Phuket (with some connecting flights from other Australian cities). Note: all times were obtained from official airline sites, but are approximate (including transit and stopover times if applicable) and may change at any time. Direct flights home are usually a bit quicker because of a tail wind.

Jetstar - Sydney/Phuket direct (only 3 days per week) – 9 hrs 15 minutes.

Jetstar – Melbourne/Phuket direct (only 3 days per week) – 9 hrs 10 minutes.

Jetstar – Now also flies Sydney/Melbourne/Singapore/Phuket (final leg via Jetstar Asia) – obviously much longer.

Virgin – Sydney/Melbourne/Phuket via Perth – Up to 17 hrs depending on connections.

Malaysia Airlines flies to Phuket via Kuala Lumpur.

Thai Airlines flies to Phuket via Bangkok.

Tiger Airlines, Singapore Airlines and Scoot fly to Phuket via Singapore.

Air Asia flies from Gold Coast, Sydney, Melbourne and Perth to Phuket via Kuala Lumpur.

Other airlines (Qantas, etc) fly Sydney/Bangkok and you then transfer onto a local flight from Bangkok to Phuket). Times vary depending on connections in transit cities. Most are from 13 to 18 hours (some may require an overnight stop in the transit city).

If changing flights or airlines when in transit, check your arrival & departure flights are from the same airport or terminal (and confirm that your luggage is checked all the way through and whether you will have to go through customs/immigration between flights).

Jetstar Baggage (flights to Asia): Checked baggage;

Jetsaver Light – No free allowance (fee applies for checked baggage).

etsaver & Jetflex – 20kg

Business Class (formerly Star Class) – 30kg (careful, they now have two types of business classes – one gives you use of the Qantas Business Club/Lounge, the other doesn't).

Carry-on baggage; 10kg … (7kg only on Jetstar Pacific flights) http://www.jetstar.com/au/en/planning-and-booking/baggage/carry-on-baggage

Virgin Australia: Checked baggage (depends on the type of ticket); Check at: http://www.virginaustralia.com/au/en/plan/baggage/checked-baggage/

Virgin Carry-on baggage; 7kg on all flights

Note: Jetstar and Virgin will usually let you share your checked baggage allowance between two people (but normally only if both bookings are on the same booking reference). Checked baggage and excess baggage pre-booked and paid for when booking your flight is usually much cheaper than the rates at the check-in counter.

Excess Baggage - Posting Parcels Back To Australia … Costs about AU$105 for 20kg (Surface Air Lifted) http://www.thailandpost.com/servicerate_result_en.php

Travel & Medical Insurance – Don't leave home without it !! Note: We usually space our holidays about 11 months apart – that way we can purchase an annual insurance policy and it covers two or more trips.

Travel Insurance - Companies you may like to consider: (we found Webjet to be the best for our age and circumstances … but read the conditions carefully and compare what you are actually covered for):

http://www.medibank.com.au/travel-insurance/default.aspx http://www.covermore.com.au/ http://www.webjet.com.au/insurance/#travelQuote http://www.travelinsurancedirect.com.au/ http://auspost.com.au/finance-insurance/get-travel-insurance-quote.html http://www.scti.com.au/ Most single trips are $245 - Overall, the cheapest I could find

Healthcare - Phuket has a wide range of good quality healthcare facilities. Health Tourism is one of the attractions and for a much lower price than most western countries, you can avoid waiting lists and receive private treatment. The two major private hospitals on the island are:

Bangkok Hospital Phuket 2/1 Hongyok Utis Rd, Phuket Town. Tel: +66 (0)76 254 425 www.phukethospital.com

Phuket International Hospital 44 Chalermprakiat Ror 9 Rd Next to Big C on the bypass road. Tel: +66 (0)76 249 400 www.phuket-inter-hospital.co.th

Chemists/Pharmacies – Most are well-stocked and sell medicine without a prescription and also sell drugs such as sleeping tablets, Viagra and steroids on request. Smaller private chemists are more likely to sell such drugs without a prescription - just ask around. Note: most brand-name make-up and skincare is also substantially cheaper in Phuket.

Vaccinations – Normally not needed before visiting Phuket, but consult your doctor if you are visiting other parts of Thailand. Phuket does not have

Malaria but does have Dengue Fever which may be transmitted by mosquito bites. Dengue causes a very unpleasant fever and headache that will knock you off your feet for a week. It occasionally develops into a haemorregic fever in which case you will need to be hospitalised immediately. There is no vaccination for Dengue Fever. Dengue is rare in Phuket but it's worth wearing insect repellent to be safe - (see notes on "mozzie repellent" further down). For more information on Dengue Fever visit: http://en.wikipedia.org/wiki/Dengue_fever and http://www.thedoctorsdoctor.com/diseases/dengue_fever.htm

Warning: Don't feed/go near monkeys . They and other animals 'may' carry Rabies. If bitten or scratched by any animal in Thailand, go immediately to a Doctor or the nearest hospital. If you contract rabies, there's a good chance you will die! Note: Because some people hand-feed monkeys, they may attack without warning (the monkeys … not the idiot tourists!).

Dental Treatment & Prescription Glasses – Usually up to 50% cheaper than at home. Recreational Drugs – Don't attempt to use, purchase, or smuggle them – Thai undercover police have been known to sell them – If caught you may be executed.

Phuket Airport – Upon arriving at Phuket Airport, grab a yellow "goodie bag" before exiting the baggage claim. Each bag contains a map of Phuket and discount coupons offered by various shopping outlets. Also look for Free Sim Cards (normally from a yellow kiosk about 50 metres past immigration on the left). Note: Photography is banned in the Phuket arrivals hall.

Phuket Airport (on the way home) – After you check in for your flight home (and get rid of your luggage), take the lift (or the escalator) up one floor to the 3rd floor to the Thai Airways Restaurant. "Not the cheapest food we ate in Phuket, but what we ate was good. They had a wide selection of Thai & Western food and it was a nice place to relax before flying home". A good way to use up your leftover Baht .. and they take credit cards if you get caught short! Duty Free at Phuket airport (to take home) – Phuket duty free won't sell you liquor if travelling to Australia (not even on a direct flight). If you carry liquor in your hand luggage, it may be confiscated due to Australian security regulations).

Duty Free (in Australia to bring home) – When you buy your duty free to take to Phuket with you, you can order and pay for your duty free liquor to bring back in with you. They store it when you leave Australia and it saves a lot of hassle – just remember to pickup your goods before you get to immigration when you land back in Australia. You can also buy your duty free after arriving back in Australia (before going through customs and immigration). Duty free can then be carried as hand luggage if transferring onto a domestic flight within Australia … but not if transferring onto another international leg. Note: During our last visit, spirits in the shops in Khao Lak were actually cheaper than Sydney Duty Free prices (if you buy on the street, you will have to pack it in your checked baggage to bring it back).

Duty Free Concessions - General goods If you are aged 18 years or over, you can bring up to AU$900 worth of general goods into Australia duty-free. If under 18 years of age there is a AU$450 limit. General goods include gifts, souvenirs, cameras, electronic equipment, leather goods, perfume concentrates, jewellery, watches & sporting equipment. Note: If over your allowance, you may have to pay duty on all of your goods (including those that otherwise would have qualified as duty free).

Alcohol If you are aged 18 years or over, you can take 1 litre of alcohol each into Thailand and you can each bring 2.25 litres of alcohol duty-free into Australia with you. All alcohol in all accompanied baggage is included in this allowance, regardless of where it was purchased. http://travelsecure.infrastructure.gov.au/international/lags/dutyfree_to.aspx

Tobacco If you are aged 18 years or over, you can take 200 cigarettes, or 250 grams of cigars and tobacco combined into Thailand. Regulations for Australia changed on 1st Sep 2012 and tobacco into Australia is now restricted to 50 cigarettes (or 50 grams of tobacco products) per person. All tobacco products in accompanied baggage are included in this category, regardless of where they were purchased. http://www.customs.gov.au/webdata/resources/files/DutyFreeConcessionsarechangingJune12WEB.pdf

Warning When entering Australia you must declare all food (including nuts, chips, fruit, sandwiches, etc) plus all soil, sand, plant material and anything made from wood, bone, shells, or animal products. Check here: http://daff.gov.au/biosecurity/faqs

Language: It will help you a lot if you learn a few basic Thai words like:

sawat dee krup - hello, good day (if you the speaker are a man) sawat dee kha - hello, good day (if you the speaker are a woman) kap kuhn krup (or kha) thank you, mai ow krup (or kha) - I dont want any, suay - beautiful, arroy - delicious, la tree sawat - goodnight. chai – yes mai chai – no gee baht – how much is it (to answer, they will usually display the amount on a calculator) hong naam - toilet mai ped – not spicy cha-cha – slow down "mai pen rai" – means: Oh Well - or Never Mind - or It Doesn't Matter. Note: I use this one when bargaining. When they get to a stage where they won't go any lower, I just smile and say "mai pen rai" (pronounced "my pen rye" with a soft P) and start to turn away and they usually go lower.  Note: If a Thai uses it in response to a complaint, it commonly means "It's not my problem" … or, as an Aussie might say "Tell someone who cares".



Thai Language Cheat Sheets – Check the following: Thai Phrasebook - http://www.phuket-info.com/phrase.htm Thai Phrasebook - http://www.the-backpacking-site.com/countries/thailand-phrase.html Detailed Thai Phrasebook - http://wikitravel.org/en/Thai_phrasebook Thai Language Starter - http://web.singnet.com.sg/~tonym/thailang.html Useful Thai Phrases - http://www.mypattaya.com/80thaiphrases.asp

Power Supply – Aussie 240V appliances will work ok and plugs are shaped as shown. Most hotels will loan an adaptor, or you can buy one cheaply from local stores. Note: I always take a small four socket power board with me so that I can plug in and charge everything at once.

Passports – I suggest you copy the "photo and details" page of your passport plus any visa pages. Make extra copies for Car Rentals etc - don't leave your passport with them. Your partner can then carry copies of your documents and you carry copies of their documents. Having a photocopy usually makes it much easier/faster to get replacements if you lose your originals. You could also take a photo of your passport and carry it in your camera.

Note: I also type up a page which includes the emergency free-call numbers for Visa, Mastercard, Amex, etc (and the numbers of each card) just in case I wish to put an emergency stop on a card (in case of loss/theft etc). Also the policy number and emergency contact details (both local and at home) for my travel/medical insurance. On the same page I put the address and phone number of our hotels, and the same details for any tours/drivers we wish to book, etc. We both keep a copy of that sheet.

Alternatively, scan all your documents/details etc, copy onto a CD … and leave at home with one or two trusted friends. Should you need your details, they are no further away than a quick email or SMS request. You could also store them in a USB memory stick and carry it around your neck (or leave it in the safe at your hotel).

Credit Cards and Exchange Rates – Phone your credit card company and tell them when and where you're going, otherwise they may reject your overseas charges or freeze your card. Note: The Thai banks charge 150bht for each foreign withdrawal from an ATM with a Visa card, 180 baht with a Mastercard card, so it pays to withdraw large amounts rather than frequent small amounts (your own bank or credit card company will probably charge you a fee as well). There are plenty of ATM's and money exchange booths everywhere including at the airport when you arrive in Phuket. Rates may vary between local banks, but not by much and you can usually withdraw up to 20,000 baht in one hit. The exchange rates in the Banks and ATM's in Phuket are usually much better than in Australia. Only use your credit card at reputable shops/dealers and don't let it leave your sight (put a sticker over the security number on the back to prevent people copying it).

Always check ATM's for card swipers before use. Criminals put these devices on top of the actual ATM card slot to read your card details and store them for later copying. These devices are inconspicuous if you are not aware of them. ATM's on bank premises are usually safer than those in the street. If you have trouble with a credit card in an ATM in Phuket call the Financial Consumer Protection centre on 1213.

For more info on Thai currency and currency exchange visit: http://www.tripadvisor.com/Travel-g293915-s601/Thailand:Banks.And.Money.html Travellers Cheques – If taking T/C's, take them in AU$ or your own local currency (don't change to any other currency as you will then lose the difference between the "buy and sell rate" twice). The Thai government "stamp duty/tax" was 33 baht per cheque (regardless of the value), so it's better to take larger cheques but banks are currently increasing that to 153 baht in line with ATM withdrawal charges. There is no bank or exchange fee for cashing T/C's … they make their money on the spread (the difference between the buy and sell rate). When cashing T/C's most places will want to see your passport (the original – not a copy) and will give you a receipt showing the exchange rate and the government tax taken out. My Personal Money Strategy – If going for two weeks, I usually take between AU$1,000 and AU$2,000 in cash. Each day, I split my cash into four bundles … my wife carries two (in two different places) and I do the same. This limits any potential loss/theft to one quarter of my total cash. If my hotel has an in-room safe (and I've personally reset the combination), I leave half the cash in the safe, then split the rest into four bundles and we carry two bundles each. I also don't carry my "bundles" in one lump (for instance, if carrying a bundle of $400, split it into 4 or 5 small bundles with a rubber band around the lot. Then when I need cash to make a purchase I can slip out one of the smaller bundles without "flashing" my entire wad. I also take a credit card and a cash card as a backup. I use the credit card (for purchases only) at places I trust and check my balance regularly. I use the cash card at ATM's or Banks to draw down on my pre-loaded cash. Note: If the ATM prompts for a five digit pin ***** it's looking for a Thai card, try your card just once then if it doesn't go through, cancel the transaction, extract your card straight away and try another ATM (if you try the same machine two or three times, or leave your card sit in the slot for a while, it may swallow it).

Currency Cheat Sheet – Before leaving home, I suggest you visit the following site: http://oanda.com/currency/travel-exchange-rates - key in your relevant country details and print out an up-to-date "currency cheat sheet" (example below). Cut it out, stick it in your wallet and you'll always know what you are paying (to preserve it, get it laminated!). THB AUD THB AUD THB AUD 10 = 0.33 100 = 3.29 1000 = 33 20 = 0.66 150 = 4.94 2000 = 66 30 = 0.99 200 = 6.59 3000 = 99 40 = 1.32 250 = 8.23 4000 = 132 50 = 1.65 300 = 9.88 5000 = 165 60 = 1.98 350 = 11.52 6000 = 198 70 = 2.30 400 = 13.17 7000 = 230 80 = 2.63 450 = 14.82 8000 = 263 90 = 2.96 500 = 16.46 9000 = 296

Mobile/Cell Phones – You can use your own mobile phone with your own SIM card if you make arrangements with your mobile carrier for access to "global roaming" (before you leave home) … but calls may be expensive and you will pay for the international leg of incoming calls (from Australia to Phuket). If someone's calling you from home and you have global roaming activated, they just dial your normal mobile number. To dial a Thailand number from home, the country code for Thailand is +66 and the area code for Phuket is 076 (drop the 0 when dialling from overseas). An alternative is to buy a cheap local Sim card in Phuket (sold at 7-11's etc) … personally, I don't bother. If you have a "Smartphone", make sure you have global roaming switched off or you may face a HUGE bill when you arrive home.

Free Sim Cards are now available from Phuket airport – see: http://www.tripadvisor.com/ShowTopic-g293920-i5037-k3392854-Using_Mobiles_in_Phuket_Easier_and_Cheaper_FREE_SIM_Card-Phuket.html Note: Your Australian mobile phone will not work with an overseas SIM card unless it is unlocked. See: http://www.unlockingcodesforphones.com/unlock_au.html for details on how to unlock your mobile phone.

Phone Translation Service - If you find yourself in a situation where no one speaks English and you have access to a Thai phone, call *1021 for the Thai/English interpreter service. You tell them your message in English and they repeat it to whoever is with you in Thai (and vice-versa). It's a free service … you just pay the local call rate. Very handy!

Local Calls - An area code is required even if you are within the same city in Thailand, so if you wish to make a local call from Patong to Patong (or anywhere else on Phuket), you still dial the 076 area code.

The International Dialling Code from Thailand is 001 followed by the relevant country code. The code for AUS is 61 in front of the home or mobile number you are calling, but drop the zero. For Example: To dial Sydney from Phuket – 001 61 2 ****-****. If dialling an Australian mobile from a mobile in Thailand use the + sign following by the country code then the mobile number without the zero … +61 *** *** ***

SMS - To send cheap SMS's world-wide, sign up at http://www.smsglobal.com/en-au/ pay in AU$10 (they even give you a bonus of 25 free SMS to start), then log in from any computer anywhere in the world and send your SMS direct from the computer at around 8 cents each (you can program the SMS to show up as coming from your mobile phone number). Note: You can even send an SMS to a landline (it transcribes it into a recorded voice message)

Thailand Telephones – More info at: http://www.tripadvisor.com/Travel-g293915-s605/Thailand:Telephones.html

Internet Access - Internet shops are everywhere and the reliability of broadband connections is generally good. If you are near the beach, you can expect to pay two baht a minute. Further from the beach, prices drop to one baht a minute and if you get out of the tourist resorts then you can find internet shops charging 20 baht an hour. Many hotels have wireless coverage in their rooms and most have an internet desk or internet access available (charges may apply).

Free Wi-Fi http://www.stickmanweekly.com/WiFi/ThailandFreeWirelessInternetWiFi.htm

SCAM Warning - Delete all unwanted messages from your email account/s before leaving home and ensure you delete all email and log off from any email accounts you visit from public internet sites. My son's email account (yahoo) was hacked whilst he was in Europe and everyone in his address book was emailed advising he had lost his wallet and ID, etc. and desperately needed $2000. I suggest you setup a password (secret name or phrase) with your friends so that they can verify it is really you if you email them requesting help or money, etc.

Mozzie repellant - The Thai people believe that black clothing attracts mosquitoes and it's the little blighters that bite during the day (not at dusk) that usually spread dengue fever. If you go to Priceline before you leave home, you can buy a tube of Bushman's Repellent with 80% DEET which also contains sunscreen (so it's worth carrying at all times). I have recently been advised by one disgruntled friend that is dissolved her nail polish

A popular local mozzie repellent in Thailand is "Off" (I have also been told that it dissolves furniture varnish). Other popular local products are Sketolene and Wild Lives – they are both cheap and effective and obtainable at most local supermarkets, 7-11s, pharmacies etc. Sketoline costs about 80-100baht for a 125ml spray (the yellow one containing 20% Deet). Note: Before using DEET it may pay to check the following sites and make up your own mind: http://en.wikipedia.org/wiki/DEET http://www.naturalnews.com/001586.html

Sunburn – If you sit outdoors without sunscreen (even on overcast days), you will get burnt. Dettol (antiseptic) Handwipes or Gel – worth carrying … we use the gel to clean our hands before eating out (you never know what your hands have been in contact with) … and paper money is usually crawling with germs (I sometimes think they use it to wipe their b-ms).

Tissues – worth carrying – Many public toilets don't have toilet paper (or they charge for it). Now - to complete your education - The following is reproduced from an article at http://www.associatedcontent.com "One of the most amazing Asian inventions is the toilet hose or 'bum gun'. This is a small hose with a spray nozzle on the end that's attached to the wall in practically every toilet in Thailand and is used after you've been to the loo, to spray your nether regions to get them clean.

It's a wonderful invention as, unlike in the US and England, where we tend to just wipe around with some toilet paper, smearing **** all over our private areas, in Thailand the locals use the bum gun to spray water on themselves, then use soap that they bring with them to make sure they're completely clean, and then use the toilet hose again to rinse off.

A quick dry with some toilet paper, and they're just as clean as when they left home that morning. The bum gun really is a wonder invention but, how do you use it ? First things first, test the water pressure before you use it. It's called the "bum gun" for good reason. The nozzle on the end of the hose is shaped a bit like a gun, with a trigger that you press to release the water. The secret to using the bum gun correctly is this – every one of them has a different pressure so, before you start spraying around your nether regions, make sure you test the pressure first by spraying some water into the toilet. Some bum guns have very high pressure and you could literally, just about shoot yourself off the toilet if you use it with too much force." Don't Panic - I've never needed to use one … and have never had a problem – Jeff

Stings – I always carry a small plastic bottle of vinegar in my bag. It helps neutralise most jellyfish and sea lice stings and usually stops mosquito bites and scratches from itching and becoming infected. Or buy a tube of "Soov" from your chemist before leaving home.

Weather – Most days will have an average temperature of between 26 and 30 (with a maximum of 35) regardless of the season (it will usually feel hotter because of humidity). In the green (wet) season it will rain most days, but usually during the night (with anything from 5 minutes to perhaps an hour or two during most days). The green season (April/May through October) is still a very comfortable time to visit and it's much cheaper. Most hotels usually charge around 50% of high season rates and many other services are also cheaper. More info on weather http://weather-in-phuket.com/ For current daily forecasts check: http://www.wunderground.com/global/stations/48565.html

Keep in mind that although May shows a higher rainfall than April and June (in the chart below), much of that rain is usually at night … so it normally has a minimal effect on the average tourist. Note: We spent 13 days in Phuket (June 2010) and had rain on only 2 days for about 30 minutes each day (but heavy storms overnight). Even less rain during an 11 day visit in May 2011 and 10 days in May 2012, with no rain in 10 days in July 2013). – Jeff

Weather Charts

Dec through to Mar can be relied upon to be dry and sunny. May through to Oct can be relied upon to be rainy with May, Sep and Oct having the heaviest rainfall. Apr and Nov are transitional months where you can't be certain exactly when the rainy season will start or end.

Temperatures in Phuket are fairly constant throughout the year. The average high temperature ranges between 29 and 33 degrees centigrade. The average low temperature ranges between 22 and 26 degrees centigrade. The months Feb to Apr can be a little too hot for comfort.

Humidity levels are lower from Dec through Mar. During the rainy season, humidity levels are high and it can feel a little clammy but generally, when not raining it is comfortable.

Thai Royalty – Don't say anything contentious about the King or Queen and if you drop a banknote or coin, don't put your foot on it unless you plan on an interview by police, or even a small holiday behind bars. They take royalty very seriously.

Local Customs – Don't touch a Thai person on the head and don't point your feet at people (the foot is the most unclean part of the body and the head is the noblest part of the body). A sincere apology should be offered immediately if you touch someone's head unintentionally.

Women should NEVER touch a monk otherwise he has to go through a prolonged cleansing.

The traditional Thai greeting (hands together in front of the body in a prayer-like position) is the "Wai" (pronounced "why"). The junior person normally Wai's to the senior person first. Children are not normally Wai'd to. It is not expected that Westerner's will Wai back to a Thai, but I find that a respectful bow of the head is well received in response to a Wai.

Thais address each other using the title Khun and their first name. John Smith would be addressed as Khun John and not Khun Smith.

A smile is the Thai unspoken communication for happiness and pleasure.

Topless or Nude Sunbathing Thai people are very modest and any form of public nudity is frowned upon. There are NO legal nude or topless beaches in Thailand.

Public Displays of Affection Any overt display of kissing, cuddling etc, in public view is frowned upon.

More on Thai Customs - http://www.tripadvisor.com/Travel-g293915-s606/Thailand:Tipping.And.Etiquette.html

Temple Behaviour: Don't pose with Buddha. Don't raise your voice or swear. Don't point at anything with your feet, particularly towards any statues of Buddha. Be respectful at all times, a temple is a sacred place.

If entering a temple, point to your camera … the attendant will let you know whether photos are ok or not. Most people don't mind you taking their photograph, but pay them the courtesy of seeking permission first. I found that by smiling at them and pointing at my camera, most of them would simply nod, signifying that it's ok.

Dress for Temples: - Show some respect – it will be appreciated. No bare shoulders, stomachs or legs (knee-length shorts are ok for guys). Most temples will offer a sarong or scarf to cover up with if you're a little on the bare side … but no swimmers or skimpy attire please. Remove your shoes, hat and sunglasses before entering any of the buildings.

Personal Dress – I usually wear neat, clean shorts and sandals everywhere (including our expensive night/s out … and also on the plane). I do take the golf shirt off and put on a button up shirt for a big night out. You may need something a little warmer for your plane trip.

Bargaining (or haggling) – The term used by many people is "Bartering" which is incorrect (to barter is to exchange goods without cash). Unless you are in a fixed price shop (a 7-11 or department store, etc), you are expected to bargain … Do it with a smile and you'll find it much more enjoyable and will usually have more success.

Always bargain the price for one item first … then bargain down further for multiple items etc. Be Warned: It is not unusual for a seller to quote up to 5 times the normal price when first quoting to an unsuspecting buyer. If they ask what hotel you're staying in, tell them you're staying with friends who live in Phuket and have been in Phuket for 4 weeks (that way, they'll expect you to have a better appreciation of the "normal" price).

Inspect the goods carefully, find an imaginary fault or two (they will actually respect you for this), smile, then make your first offer one fifth of what they ask ... then, (after they have stopped jumping up and down and rolling their eyes), keep smiling and let the negotiations begin. And unless you really, really want it, don't go over one half of their first price (which may be over what you should pay anyway).

Remember … it's all a game! I found our cheapest prices (with the least haggling) at the stalls at Chalong Temple and the street shops at Promthep Cape. – Jeff

Reclaiming VAT on Purchases - http://www.tripadvisor.com/Travel-g293915-c125905/Thailand:Reclaiming.Vat.html

Two-tier Pricing - It's legal. The Thai government funds or supports many tourist establishments, therefore the Thai taxpayer has already contributed. For instance, current entrance fees to the Aquarium are: Farang (Foreigners) - 100 baht for adults and 50 baht for children. Thais - 50 baht for adults and 20 baht for children.

Shopping – Check http://www.braun-rentacar.com/phuket-Shopping.htm for a wealth of information on shopping and shopping centres.

Drowning – The biggest killer of tourists in Thailand. If the red surf warning flags are up, don't go in the water. Patong and Karon beaches usually have one or two tourist drownings every week in the green season. Thai lifeguards are not "Aussie trained". Be Warned - Four tourists drowned in 4 days on Phuket beaches - July 2013

Drink only bottled water (I even use it to brush my teeth). Most hotels supply one or two bottles per person free of charge each day (Hint: If it's in heavy glass bottles, tip it into your own plastic bottle to carry around with you) … and it's cheap in the 7-11's. 7-11 stores also have a good supply of snacks, etc and beer ranges from 30 to 50 bht per can.

Note: Check that any bottles of drink are correctly sealed when presented to you. The ice served in drinks (little cylinders with holes through the centre) is treated and is safe. Don't use the ice from the fridge in your room unless you make it yourself from bottled or boiled water (it may have been re-filled with untreated tap water by the previous occupant). Be warned … my wife spent 3 days in hospital after consuming ice from the fridge in our room !

Advice from a local: For severe stomach/intestinal problems buy Disento from a local pharmacy - 4 tablets within 24 hours and everything is usually OK.

Accommodation – When choosing a hotel/motel anywhere in the world, I always do my research at http://tripadvisor.com – My method is as follows:

1.. First decide on the area you wish to stay in, then go to http://tripadvisor.com and search on that city/area. i.e. Patong, or Karon, or Kata, etc. 2.. Click on "hotels" which will then display all the hotels in that city/area, listed from highest to lowest according to the ranking/reviews given to them by trip advisor members. 3.. I then read the first 10 or 20 testimonials/reviews for each of the top ten hotels (certainly those reviews listed in the past 6 to 12 months) ... then check the price for each hotel and make my choice according to the best reviewed hotel (that suits my needs) within my budget. 4.. Just remember that not all people have the same needs and you will occasionally find very conflicting reviews. However, if 8 out of 10 reviews are good and describe the hotel as one that would suit you, then it probably will (reviews are personal and highly subjective and you will always get one or two people that are hard to please). But … watch out for badly worded reviews, which may be a sign that it's been posted by a local (maybe a friend of the hotel owner?) … also watch out for reviews that have been posted by first-time reviewers (who may have been rewarded by the owner for posting a favourable review). This is reported to have happened in a hotel in Karon (Phuket) where one guest advised they were provided with free drinks poolside for filling out their coerced reviews. Note: 22 out of 24 reviews were by first-time reviewers (an extraordinary statistic when compared with other high-ranking hotels). Those "suspect" reviews shot the hotel to Number One in popularity (for a short-time only). It quickly reverted to about Number 27 which is probably where it belongs (maybe Trip Advisor smelt a rat and relegated them?). However, most experienced "trip advisor" users would quickly recognise that the reviews all had a similar "ring" to them (particularly when most were from first-timers) … and would therefore be suspicious. 5.. Before booking your chosen hotel, compare their rates on a number of booking websites (if you enter the hotel name into "Google", you will usually get a list of sites that book that hotel) … and don't forget to check the hotel's own website where they may sometimes list off-season specials "pay for 5 – stay 10 nights" etc. Note: Many small boutique-style hotels do not list with online booking wholesalers and will have to be booked direct … but don't be afraid to email them and ask if they have any specials – "If you don't ask, you don't get". When comparing hotel rates check that the 10% service charge and 7% government tax have been included - also check if there are additional charges for car parking or internet use, etc. Check out the airlines package-deal prices … they sometimes have good deals (flights & accommodation combined), but may be limited in their hotel choices. Don't just accept the airline description of the hotels they list … check them out on "Trip Advisor". Airlines have been known to "run off at the mouth" when promoting their hotels. Personally, I always have better results doing my own research and booking my flights and accommodation separately. 6.. Finally, when you return home, do the rest of us a favour and post a Trip Advisor review (good or bad) on the hotel you stayed in. That way, we all benefit from your experience.

Online Hotel Booking Sites – Check here: http://www.tripadvisor.com/Travel-g293915-c121265/Thailand:Suggested.Online.Hotel.Bookers.html Taxis – Normally only available from Phuket airport and a few hotel taxi stands. To get a taxi at the airport, ignore all the touts (don't even acknowledge them), walk out the front of the terminal, turn hard right, go about 100 metres to the end and you will see a yellow taxi kiosk. Pay the girl in the kiosk 100bht and she will allocate a cab. Tell the taxi driver you want to go straight to your hotel (no shops, tour desks, travel agents, timeshare, jewellery stores, etc) and make sure he turns the meter on. You pay him what is on the meter and it's normal to give him the small coins change (don't forget that a 20bht note is only about AU 70 cents). A cab to most popular hotels should cost between 600 and 700 baht depending on location and traffic - it takes 40 minutes to one hour into Patong or Karon/Kata, so it's not a bad deal. It may help if you have a Thai translation of your hotel address – (usually available from the hotel website). Note: The official taxi booking desk is closed between 1am and 7.30am.

Latest "official" taxi fares: http://www.phuketgazette.net/library/articles/image.asp?/newsimages/map/GZ20120913153525-ZbKPVqYMYFX.jpg

Don't take an airport limo, they are usually more expensive and will stop off at tour agencies, etc, where they may attempt to pressure you into booking tours (or even worse, tell you that your hotel has burned down or is booked out).

If unsure, book a car through your hotel and they will have a driver waiting for you at the airport with a sign displaying your name. It will probably cost 200 to 400 baht more through the hotel. Note: Hotel cars are often on a fixed price contract and some tend to drive very quickly (more jobs per hour, more money) – our first arrival in Phuket at 9pm saw us transported to our hotel at up to 110kph on dark winding roads. Cabs on the other hand don't mind slowing down when they are on the meter. If a cab is going too fast just smile and say "cha-cha" (slow down). http://www.tripadvisor.com/Travel-g293920-s304/Phuket:Thailand:Taxis.And.Rental.Cars.html

New Taxi Service: You can now pre-book a metered taxi from the airport direct with one of the drivers http://www.phuket-taxi-meter.com/ (also minibus transfers for 1 to 10 people)

Private Minibus Service: They usually carry 8 to 13 people. They normally work out cheaper than 2 taxis –

Recommended Driver: I recently hired "Manop" for a personal airport to Kata transfer. He is highly spoken of on Trip Adviser and charged 600 baht for 2 people. He also does minibus transfers and reasonably priced tours etc. Seems like a nice guy! – Check his up to date prices at: http://showmephuket.com/services.htm

If you are going to Khao Lak 'Boss' at 'Cheaper than Hotel Taxis' in Khao Lak also comes very highly recommended and may be contacted at cheaperkhaolak1@gmail.com or cheaper_khaolak@ymail.com

Tuk-Tuks … Some are nice guys … some are notorious little thieves. The going rate in 2009 was 100bht within Karon, 200bht Karon to Kata, and 300bht Karon to Patong. It's all a rip-off, as they'd rather sit on their lazy butt's and get one fare @ 200 than ten fares @ 100. Note: The Tuk-Tuk fare is for all of you (normally up to 4 to 6 people) ... not each. Make sure you negotiate the fare (before getting in) and agree that the fare is for the whole group, not per person. They are usually perfectly safe, but will band together to stop fares being reduced (otherwise known as the Tuk-Tuk Mafia). If going shopping or out to dinner, it's usually cheaper to negotiate a return fare (and the driver will wait two or three hours for you). Note: You can probably now add at least 100bht to all of those prices shown above - Jeff

Note: Make sure you have sufficient small notes to pay them the exact negotiated fare … they will usually claim they have no change . Don't tip them … they are charging up to 10 times what their counterparts in other areas of Thailand charge. If you do tip them you are demonstrating you are willing to pay more and encouraging them to continue charging their outrageous rates. Pay them the exact amount (when you get out), smile and tell them "Sorry, don't have any change for a tip".

If you're satisfied with a particular driver, ask for his mobile number and get a quote for a day or half-day tour (this can work out very cheap if 4 or 6 of you go together). To get you to pay more, they may tell you they should only carry 4 people - CRAP - I've seen 9 in one!

Public Bus Service – There are Songtaews (blue public buses) that run from most major beaches to Phuket Town for around 30baht per person each way. Note: With the exception of Kata and Karon (where they loop back), they do not run between beaches. For example: to get from Patong to Karon (about 7 klm) you must catch the bus from Patong to Phuket Town on the other side of the island, then another bus from Phuket Town back to Karon (they only run every 30 mins, so the total return trip could take up to two hours). But, it's a good way to see a bit of the island if you're not booking a tour. Apart from the terminus and turnarounds, there are no bus stops, just wave them down when you see them and tell the driver when you want to get off. Pay the driver as you get off.

Car Rental – There are several recommended car rental companies … Small cars (Automatic Honda City, Toyota Yaris, etc with A/C), usually rent for between 1000 and 1200bht per day for a 7 day hire (including insurance but with an excess - usually 5000bht). Make sure you inspect the car carefully and photograph "any" damage or scratches before you drive the car. They may tell you that it's not necessary, but unless you have an International Drivers Permit (obtainable from your local Auto Club, etc), you may not be fully covered by your travel insurance policy and may be fined by local police. Be warned: Anything rented for less than 1000 baht per day (especially the so-called 'Jeeps') will probably be very old, very dilapidated and very under-powered.

The following car hire firms are reported as being reputable: Most will have your car waiting at the airport, or will deliver to your hotel (I suggest you book online in advance): http://www.braun-rentacar.com/index.htm#SELECTION (my choice) … or http://www.andamancarrent.com/car.htm or http://ww.rhinocarhire.com

I have now rented from http://braun-rentacar.com/ five times in the past 3 years and have always been pleased with their service. Competitive rates, current models, and first class insurance (including a bail bond in case of an "at-fault"accident). Stuart (their English manager) is pleasant to deal with and has personally delivered the car to our hotel and arranged for us to return it to the airport at no extra charge. Driving In Phuket – More info at: http://www.knowphuket.com/driving.htm

Motor-cycle/scooter hire: The second biggest killer of tourists in Phuket – don't do it. If you decide to do it, you must have a motor-cycle licence at home and it must be endorsed for a motor-cycle. Some also claim you must have an International Drivers Permit (endorsed for a motor-cycle). In spite of what the hirer tells you, your private health or accident insurance may be invalidated if you are unlicensed or your licence is not endorsed.

Be Warned: There is no accident or theft insurance on motor-cycles/scooters and any loss or damage will be your full responsibility. If you can't pay, you could be held in jail until you can arrange payment. You must wear a helmet (the police often let the locals go whilst booking tourists). Remember, in an accident you may automatically be assumed to be at fault.

Private Car Tours: If you want to see the island and tourist sites, etc, I suggest a private car tour. Note: many drivers are not licensed tour guides, but are very reputable and have been providing this service for years. We did the trip below in June 2009 and it ran from 9am until approx' 3.45pm. The total cost was 1200 baht & we tipped the driver 200 baht (obviously a little dearer now). The best quote we could obtain elsewhere was 1500 baht and other quotes ranged up to 2000 baht (with one T/A recommended driver wanting to spread it over 2 days @ 1500 baht per day).

Our driver was very careful and I don't think he exceeded 60kph all day. Even when we left the car to visit a tourist site, he left the air conditioning running so that it was cool when we returned and he was always there to open the car door for my wife. We invited him to have lunch with us but he declined (I think the drivers sit around together discussing their clients whilst we have lunch) . Our car tour was one of the highlights of our holiday. I suggest you do it early in your stay as it gives you a good grounding on the location and layout of various attractions. You then have time to go back to "special places" and explore on your own with more confidence.

You can book by email with Miss Cat - Phuket Travel and Tours Mobile - International +66871889047 - Local 087 188 9047 - Tel/Fax +6676344654 120/1 Rat-U-Thit Song Rou Pee Rd, Patong, Phuket 83150 Thailand. (very easy to deal with … no deposit needed),

Suggested day tour itinerary. Pickup from Hotel - maybe 9am Drive-by Karon & Kata Beaches Kata viewpoint Kok Chang - feed elephants with bananas and/or 1/2 hour elephant ride? Nai Harn beach Promthep Cape viewpoint (shopping stalls with good prices) (1/2 hour or hour ATV ride … if you're into that sort of thing ??) Rawai Beach (shell stalls and souvenirs) Friendship beach (short stop for soft drink, coffee … or a beer?) The Big Buddha Wat Chalong (Temple & shopping stalls with good prices) Lunch at Rang Hill - Tungka Ka Restaurant (cheap with great views) Phuket Town Siray Island (sea gypsy village then feed monkeys … from a remote platform) Tesco Shopping Centre (if supplies are required …but not on a Sunday – it's bedlam) Return via Patong (maybe a short stop to look around, then return to Hotel (approx' 4pm)

Note: Manop at http://showmephuket.com/services.htm will now do a Phuket and shopping tour from 800 baht (it's probably a fixed itinerary and he probably gets petrol coupons for taking you to various jewelry shops, nut factory, etc).

Boat Tours: A must do ! We did the Koh Phanak and Hongs Tour and spent a day with Captain Mark of 'Phuket Sail Tours' (an Aussie) on his small yacht that carries a maximum of 10 (some of the cheaper tours carry up to 100 people). Highly personalised and highly recommended. You get picked up at your hotel at around 7.45am and returned to your hotel at around 6.00pm. Lunch is prepared fresh on board (or on the beach) from seafood they purchase (just caught) from one of the longtail fishing boats. The cost for the day was 3000bht each (we left a 200bht tip for the crew). Others may have cheaper tours, but you get what you pay for … and safety and over-crowding can be a big issue with the cheaper tours! Mark won't go out if it's unsafe!

You can check his website at: http://www.phuketsailtours.com/itinerary.html and some of his testimonials at: http://www.tripadvisor.com/ShowUserReviews-g293920-d661198-r32411689-Phuket_Sail_Tours-Phuket.html

Peanut and other Allergies - Note: Many Thai dishes contain ingredients that some people may be allergic to. If you have a food allergy, visit http://www.tripadvisor.com/Travel-g293915-s604/Thailand:Important.Phrases.html where you will find a number of translations for various allergies (examples below). Cut & paste and print out the relevant translations and show it to Restaurants and waiters etc.

You will find they are most careful and helpful when/if they are aware of your condition.

I am allergic to nuts I am allergic to shellfish. Restaurants and Bars - Prices etc: "No matter where we ate, the food was consistently good. The prices varied but every single dish we ate was to our satisfaction. We don't particularly like seafood, so the prices below may be a little less than what you may pay. In general, most street restaurants (not street stalls) had chicken and pork dishes ranging from 85 to 125 baht, plus another 25 to 50 baht for the same dish with beef or seafood. And yes … you can pay a lot less … and you can pay a lot more … I am generalising in accordance with our experience. Street stall food is much cheaper (maybe 50 to 100 baht for each dish).

Note: Hot, freshly cooked street food (served on clean plates) may be more hygienic that a "big hotel buffet" that has been sitting barely warm for a number of hours. The safe storage temperature for food is below 4 degrees C or above 60 degrees C. Some hotel buffets are not maintained within that "safe" temperature zone. Look for where the locals eat!

Barring major international-type hotels, beer and cocktails are relatively inexpensive in bars and restaurants, but due to local taxes, wine is very expensive. Chang beer is cheap and quite palatable. Singha beer is maybe 20% dearer. Look out for bars that have "happy hours" usually between 5-7pm with discounts up to 50% off (or sometimes "buy one – get one free"). Note: Accepting free drinks from anyone in Thailand is just as risky as it is at home! Unless asked for payment when served, it's usual for a bar to put your tab in a glass in front of you. They total the tabs and you pay your bill when ready to leave. I suggest you check each tab as it's received as some are known to overcharge (or place extra tabs in your glass).

Cheap Drinking – Buy supplies from the 7-11 to take back to your hotel (around 110-120 baht for a 4 pack of Chang Beer … be careful … it's 6.4%).

Spicy Food – Thai food usually comes as: Spicy, Medium, or Not Spicy. If you don't want it hot just say "kor mai phed" (not spicy please) or just "mai ped" (with a shake of the head), or "ped nik noy" (a little bit spicy). Be warned – we like very hot food at home – we found their "medium" was usually equal to or just a little hotter than what we would class as "very hot".

Cheap Food - Patong – In the basement of Jung Ceylon shopping centre (very close to Bangla Rd) there is a food court with around 8 or 10 stalls. You buy a cash card at the cashier counter (I bought a 500 baht card – about AU$15) and then go to each stall and pick what you want - hand them the card and they swipe it. When finished take the card back to the cashier and they refund your change. We pigged out from 3 different stalls. Spring Rolls 80bht – Lab Gai 65bht – Boiled Rice 20bht – Beef Pad Thai 50bht – Thai Omelette 20bht. The food was fantastic and every dish was prepared fresh (they even rolled the spring rolls in front of us). Note: The Jung Ceylon centre contains 200 shops plus a large department store, supermarket, restaurants, a night club and entertainment complex (5 cinemas and a bowling alley). For a good cup of coffee or western-style snack try "Black Canyon" (they have a chain of about 200 outlets throughout Thailand). http://www.phuket.com/shopping/jungceylon.htm Note: I visited the food court again in July 2013 and thought it was much more expensive … but still very handy for a quick feed.

Suggestion – Do some shopping in Jung Ceylon shopping centre and the "That's Siam" handicrafts centre in the basement, then head into the food court for an early dinner, then out into Bangla Rd to the famed "Aussie Bar" for a couple of drinks. Try to get a seat upstairs at the front overlooking the street and you can spend an enjoyable hour or so watching the freak show pass by. Good clean entertainment (take your camera). It cost around AU$7 or AU$8 for 2 drinks (a beer and a bacardi & coke). http://www.aussiebarphuket.com/default.html

Risque Night Life – Bangla Rd (Patong) at night is full of bars, restaurants, go-go girls, ladyboys/katoeys (see photo), bar girls, ping-pong shows (use your imagination), etc, but is regularly patrolled by police and is recognised as being quite safe if you behave yourself (and don't steal bar towels). If you stop to have your photo taken with any of the inhabitants (or take close-up photos of them) you may be expected to pay … don't argue, just pay. The going rate is 100 to 200 baht for each person you are photographed with (5 ladyboys = minimum 500 baht, or 2 of you and 1 ladyboy = 200 baht). Warning: Don't have your photo taken with any wildlife (monkeys, lizards, birds, etc), it's expensive and is illegal. http://www.phuket.com/nightlife/bangla.htm http://www.knowphuket.com/naughtynightlife.htm

Tipping – Many will argue over this, but most expat' locals advise to give no more than 20 baht in a normal street restaurant. A local restaurant owner I know (a Kiwi) told me he never tips in any restaurant that has a service charge on the bill … at the most, just leave any loose coins change – The service charge should be shared between the staff ... if the owner is keeping some of it then that's their problem. Some restaurants will suggest tipping American style (15% or 20%) - forget it, most will be charging a service charge which should cover the tip.

Check all prices carefully before purchasing or consuming (if it says ++ it means "plus 10% service charge, plus 7% government tax"). Note: most hotel/resort restaurants charge ++ … most street restaurants do not charge ++. In bars, change normally arrives in 20 baht notes, so maybe leave 20 baht as a tip.

Tip 50 Baht to a masseuse and about 100 Baht for a guide, but again only if the service was good. It's not necessary or even expected to tip hotel staff. However, I normally leave around 25bht per day for the girl who cleans our hotel room (up to a maximum of 200bht), but only at the end of the stay (providing the job had been done well).

Jet-Ski's – Potential Rip-off Merchants – They may attempt to charge you for pre-existing damage and can get very agro if you refuse to pay. They were recently the subject of a major governmental investigation.

Don't shake hands with anybody on the street. It's usually a ploy to get you to stop and they then try and physically drag you into their shop (whilst refusing to let go of your hand).

Tailors – Most have touts at the front of their stores and are very persistent. If you want a good tailor I can recommend "Niphon's Rich Collection" - check their website at www.instylefashion.com – They are very good, make good clothes that fit, and do not haggle. I had one suit, plus one jacket, plus one sports trousers and two shirts tailor made for around AU$500 … less than a quarter of what I would expect to pay for tailor-made clothes at home - and everything looks and fits great. Order early as I had one initial measure, two fittings, and a final try-on/pickup. They will pick you up from your hotel if you wish and on the final night they picked us up from our hotel, drove us to their store for my final try-on and payment, then delivered the clothes back to our hotel so we could go straight on to dinner.

Places & things I didn't visit or do: The Phuket Zoo – Reported to be scruffy and has a history of mistreating animals http://www.tripadvisor.com/members-reviews/fgs_1979 The Butterfly Farm or Museum – Some like it others think it's decaying and miserable. Rafting – Many enjoy it but others report coming close to drowning ATV tours – Most people enjoy it – some claim the operators attempted to charge them for pre-existing damage to the vehicles. If you must go, photograph any damage before you ride. Monkeys picking coconuts – Mistreated animals. Often beaten to make them perform. Jet-Skiing – Scammers

For further detailed information on Phuket visit: http://www.tripadvisor.com/ShowForum-g293920-i5037-Phuket.html http://www.virtualtourist.com/travel/Asia/Thailand/Southern_Thailand/Phuket-1444813/TravelGuide-Phuket.html http://www.cathyandgarystravelpages.com/ http://www.knowphuket.com/practical.htm http://phuketvogue.com/ http://www.phuket.com/info/phuket-airport.htm

Note: I thankfully acknowledge that some of the information on these pages has been borrowed from the links above purely as a quick reference for you. I encourage you to visit those pages as they contain a wealth of useful information (far beyond the scope of my pages).

My Comments: To me, Phuket is a magic place. It's not a Singapore or Hong Kong, but it's a lot like they were 20 or 30 years back. It's got all the comforts and amenities you could want, but is still a bit on the primitive side. Sure the drains may stink in many streets, but cross the road if it bothers you (they normally only have drains on one side ) … and it has one thing the rest of Asia doesn't have … Thai people. Most of them are gentle, caring people and there are many stories of honesty and lost wallets/goods, etc being returned ... even reports of cab drivers saying "don't worry" when the passenger was a small amount short of the full fare (try that in Sydney or Melbourne).

Scammers – Yes … you get them everywhere, but most Thai's will go out of their way to help you for nothing but good karma. If they don't respond or help, it's often because they don't speak good English.

My Philosophy: Bargaining is fun, but don't sweat the small stuff. Nobody likes to be ripped-off, but keep it all in perspective. As a couple you probably pay AU$2000 or thereabouts for your airfares, up to the same amount for accommodation and meals, so why bother trying to screw some poor local for 50 cents or a dollar when it won't really make that much difference to you or your all-up holiday costs..

Smile – Thai's like friendly people who smile at and with them – they respond badly to displays of aggression and arguments – they see it as a weakness and losing face. Don't ever threaten them – they may gang up (particularly "Lady Boys" "Bar Girls" and "Tuk-Tuk drivers"). However, they are usually funny people … When I asked in a shop if they had a shirt to fit me the reply was "No elephant shirts here" – Note: They were being funny, not purposely offensive (I only wear XL … but that's Aussie XL not Thai XL).

To a Thai, admitting a mistake or a lack of knowledge is to lose face. They will often make a joke instead (or point you in a random direction rather than admit they don't know the way).

Maps

Karon & Kata Beach http://phukhao.com/download/maps/Karon-Kata-map-1.gif Karon & Kata Beach http://thaiwaysmagazine.com/phuket_map/phuket_map_kata.html Kata & Kata Noi Beach http://patongbeachmaps.com/images/katamap900.jpg Kok Chang Elephant Trekking http://www.kokchangsafari.com/location.html Chalong Bay & Rawai Beach http://phukhao.com/download/maps/Chalong-Rawai-map-1.gif Patong http://phukhao.com/download/maps/Patong_map_4.gif Patong http://thaiwaysmagazine.com/phuket_map/phuket_map_patong.html Bangla Rd http://www.knowphuket.com/map_Bangla_Road.htm Phuket Island http://phukhao.com/download/maps/Phuket-map-5.gif Phuket Town http://phukhao.com/download/maps/Phuket-town-map-4.gif Phuket Airport & Surrounds phuketindex.com/images/map/00457-map.gif Bang La On (north of Phuket) …walagata.com/w/…BANG_LA_ON_FEBR_2013.jpg Bang Niang (north of Phuket)walagata.com/w/…Bang_Niang_Map_2013.jpg Khao Lak South (north of Phuket) …walagata.com/w/arandora/KL_Maps/2137445.jpg Khao Lak North (north of Phuket) including Khuk Khak, Pak Weeb, Pakarang and Bangsak Beaches http://file.walagata.com/w/arandora/KL_Maps/Khao_Lak_Nord_10-02-2013_Kopie.jpg

My Accommodation Recommendations – I usually choose to stay away from the rat-race of Central Patong. So far I've stayed at Kamala, Karon, Kata, Rawai, Tri-Trang, South Patong, and at 4 different hotels in Khao Lak on the mainland (about 75 minutes north of Phuket airport) ... and all were great. For more information read my personal reviews at: http://www.tripadvisor.com/members-reviews/jjumpstart (yes, that's jjumpstart with 2 j's … my fingers stuttered! ).

PS – I have also compiled an 8 page "Kids-Sheet" with kid's activities, suggestions, places for kids to eat, etc. Email me if you would like a copy.

The Formal Bit!

Errors/Omissions/Corrections etc – I encourage you to email me with any corrections, comments or contributions you may have. jeffraymond@mail.com or jeffray@tpg.com.au

Contributors – Some of the information contained herein has been copied from the public domain and from contributions to various forums (Trip Advisor etc). If you lay original claim to any of the information reproduced here, please advise me your reference of the relevant information and I will be happy to quote you or your website etc, as being the source.

Copyright – Please feel free to cut & paste any of the information contained herein. If you pass it onto anyone else, please forward them the entire "cheat-sheet" intact – with the © notice attached. This will afford any original contributors their due recognition – Thanks Jeff.

Updated: February 2014 © Jeff Raymond 2009-2014 jeffraymond@mail.com