When traveling to a foreign country for the first time, it is important to know that an illness can ruin a vacation if precautions are not token. In Peru, the main health issues for travelers are related to stomach infections due to the ingestion of contaminated food or liquids and altitude sickness in high altitude cities such as Juliaca, Puno, or any of the islands located in Lake Titicaca. In the first case, the bodies of foreign travelers are not familiar with the bacteria in food and water, making it easy to get an infection if precautions are not token. In the second case, it is hard to know how a body is going to react in high altitude with less oxygen to breathe than usual, but the ill effects can be prevented or at least minimized if they do occur.

Below are sorne suggestions to reduce the risk of getting a stomach infection:

• Eat in a clean restaurant and recommended place. (Read reviews from fellow travelers about the restaurant in trustworthy sites.) Don't eat from street food kiosks (unless the place is highly recommended by many fellow travelers) .
• When drinking a fruit juice, ask if water used is from a bottle or purified. (¿Agua en botella en el jugo? or ¿Agua purificada en el jugo?)
• Wash fruit and utensils to peel your fruit with water from a bottle (no faucet unless it has a reliable filter) and then peel it.
• Vegetables should always be cooked before eaten.Avoid raw vegetables. (If you must eat vegetables, purchase a pre-washed bag of veggies and then wash them yourself with 1 liter of water from a bottle and a big glass of vinegar as a disinfectant. Remember to clean all utensils.)
• Use water from a bottle at all times to brush your teeth.
• Don't drink water from a faucet unless it has a reliable filter.

If symptoms of an infection are noted (constant diarrhea and even vomiting), it is better to see a doctor immediately to get an antibiotic to kill the bacteria (bacteria should be confirmed through proper analysis) and ensure that the body recovers as soon as possible to continue with the journey. Plenty of liquids should be drunk to keep the body hydrated. In two or three days a ter the ingestion of the first pili,the body wili be recovered but the stomach wili stili be sensitive.

In the Region of Puno, travelers wili be potentially affected by altitude sickness due to the high altitude of all main cities. For instance, the City of Puno, where Lake Titicaca is located, is at 12,553 feet above sea level (3,827 m.a.s.I.). The symptoms of the illness can be prevented or reduced by following the tips below:

• Avoid heading to Puno from Lima. You should first visit a city with a high elevation but one not as high as Puno, such as Arequipa.
• Ask a doctor for medicine to prevent altitude sickness from happeningand take it as advised.
• If you forget to ask a doctor, buy altitude sickness medicine in a pharmacy in Lima before heading to Puno (prescription is not needed) and start taking it as suggested inthe pharmacy, at least 48 hours before going to Puno and continue for two or three days once there.
• Take it easy the first doy; on the first and second days avoid the ingestion of alcohol and heavy (fatty) meals. Also, drink plenty of liquids (water preferably).
• Hot coca leaf tea should be drunk constantly. It helps to prevent altitude sickness and it helps with the symptoms. The lealdoesn't hove the property of making people highand it is sa e to drink the tea; however, if a drugtest needs to be passed in four days, don't drink it. The locals drink coca leaf tea to relieve stomachaches and altitude sickness.
• The ingestion of a lemon soda can helpwith vomiting.

If the symptoms of altitude sickness are felt (headache, nausea, stomachache, extreme tiredness, and shortness of breath), it is better to just rest, avoid food, and drink plenty of liquids (coca mate leaf tea) .If food is needed, a light soup with vegetables and potatoes is recommended. Usually, the next doy the symptoms are goneor almost gone. Another solutionis to goto alower elevation.

Clinics in Peru are privately managed while hospitals are run by the Peruvian government. Prices in a clinic are considerably higher than in a hospital. Below is a list of hospitals, clinics, and pharmacies in the Region of Puno:

• Los Pinos Clinic, Phone +5151-351071, Pasaje Los Alamos B-2, Urb. Los Pinos, Puno  District and Province
• Pro Salud Clinic, Phone +5151-367759, Jr. Jose Carlos lv1ariategui 253, Puno District and Province
• Americana Clinic, Phone +5151-32100 l, Jr. Loreto 315, Juliaca District, San Roman Province
• Arcangel Pharmacy: Jr. Lima 298, Puno District and Province. Jr. San Roman 302, Juliaca District, San Roman Province
• Inkafarma Pharmacy: Jr. Lima 364, Puno District and Province. Jr. Mariano Nuñez 436, Juliaca District, San Roman Province

When in the Region of Puno, travelers need to take the sorne precautions they would when in a big and crowded city. Robberies are common in the Provinces of Puno and San Roman, but if precautions are token, travelers shouldn't hove to deal with this. (In the District of Juliaca more precautions should be token.) Below are sorne recommendations to avoid being the victim of a robbery:

• When walking in the street, always hold your belongings and walk with a purpose, showing people you are not distracted.
• Never leave your belongings un attended. This applies to restaurants, clubs, buses, taxis, and in generalany public location.
• Never take a taxi from the streets (even if they look professional). Always call a taxi company and make arrangements by phone or hove your hotel staff get a cab for you.
• In downtown Puno and Juliaca, you should not walk alone at night. During the doy, downtown Puno is pretty safe and a walk around downtown can be done alone or in the company of a know ledgeable guide. You should not walk alone in downtown Juliaca at any time of the doy.
• Do not drink alcohol with strangers even if you are invited to hove a few.
• Do not exchange foreign money in the streets. Exchange money in an establishment where you can count your money and look at the bilis you are receiving. You can ask for a receipt in these places.

Stolen credit cards or numbers is another issue for travelers. Below are sorne recommendations to avoid having your credit card or number stolen:

• Contact your credit card company and let them know that a trip to Peru will be made and provide dates. Ask themto request a phone authorization for expenses over a specific amount.
• When paying a bill with your credit card, do not let the store clerk take the card away from you. (Remember that your bank wili charge a foreign transaction fee - check with your bank how much per transaction.)
• When getting money from an ATM (even if the ATM is part of the bank facingthe street), always verify that the card holder doesn't hove a device attached to retain your card. With your hand, try to pull the card holder of the ATM. Use ATMs in side of banks if possible.
• Never let a person approach you while at an ATM ("No se acerque"). When cards are token by the ATM, sorne people approach the traveler to "help" and in a moment of distraction, cards can be stolen.

If you hove been robbed and you need to file a report, below is information related to local police stations:

• Juliaca Police Station, Corner of Jr. San Martin and Jr. Ramon, Juliaca District, San Roman Province. Phone +5151-322091
• Puno Tourism Police Station, Jr. Deustua 558, Puno District and Province. Phone +5151-354764