La Paz is 3,650 m and El Alto airport 4,060 m, so altitude sickness is the near certainty, not the risk. Tap water is not drinkable anywhere, and yellow fever cover is needed for the lowlands.
- Altitude is the headline health issue and it starts the moment you land: the airport is at 4,060 m and La Paz about 3,650 m. Soroche hits fit young people as readily as anyone.
- Do nothing for the first 24 hours - rest, drink water, eat lightly and skip alcohol entirely. Coca tea is what everyone drinks and it genuinely helps.
- Descend if symptoms turn severe: confusion, breathlessness at rest or a headache that will not respond is no longer ordinary soroche.
- A yellow fever certificate is required for the endemic lowlands - Santa Cruz, Beni, Pando and the Yungas - while La Paz and Sucre have no dengue or malaria risk at all.
- Tap water is not drinkable anywhere in Bolivia, and private clinics want cash or a card guarantee before admission. Check your insurance covers high-altitude evacuation.
Altitude is the headline health issue and it starts the moment you land. El Alto airport is at 4,060 m and La Paz itself at about 3,650 m. Soroche - headache, nausea, fatigue, breathlessness - affects fit young people as readily as anyone.
- Do nothing for the first 24 hours. Rest, drink plenty of water, eat lightly, skip alcohol entirely.
- Coca tea (mate de coca) is what everyone drinks and it genuinely helps. Sorojchi pills, an over-the-counter caffeine and aspirin blend, are sold in every pharmacy. Acetazolamide (Diamox) is the medical option and works best started before you ascend.
- Consider sleeping lower. Zona Sur in La Paz is about 450 m below the centre.
- Descend if symptoms turn severe - confusion, breathlessness at rest, or a headache that will not respond. That is no longer ordinary soroche.
Vaccinations and tropical disease
- Yellow fever certificate is required for the endemic lowlands - Santa Cruz, Beni, Pando and the Yungas - and for onward travel from them.
- Recommended: hepatitis A and B, typhoid, tetanus.
- Dengue in the tropical lowlands during the wet season, December to April. Malaria only in remote lowland Amazon border areas.
- La Paz and Sucre have no dengue or malaria risk at all - the altitude rules out the mosquito.
Water and food
Tap water is not drinkable anywhere in Bolivia. Bottled, boiled or micro-filtered. Avoid ice in informal places, raw salads and unpeeled fruit from street stalls. Hot, fully cooked street food is fine.
Hospitals and pharmacies
- Private clinics are the right choice: Clinica Alemana (+591 2 2432155) and Clinica CIMA in La Paz, Clinica Foianini (+591 3 3362211) in Santa Cruz. They require cash or a card guarantee before admission.
- Public hospitals such as Hospital Viedma in Cochabamba and Hospital Santa Barbara in Sucre are under-resourced with long waits.
- Travel insurance covering high-altitude medical evacuation is strongly advised. Standard policies sometimes exclude activity above a certain altitude - check yours, because most of Bolivia is above it.
- Pharmacies: Farmacias Chavez, Farmacorp and Hipermaxi Farmacia stock the basics. Prescription narcotics need a Bolivian prescription; bring your own in original packaging with a translated doctor's letter.
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