Health, vaccinations and medical care in Peru

Altitude is what will actually affect you. Cusco sits at 3,400 m and Puno at 3,800 m, and altitude sickness (soroche) hits fit people as readily as anyone.

• Give Cusco a full day before doing anything. Most itineraries fly Lima to Cusco and start a trek the next morning, which is the single most common planning mistake here.
• First 24 hours: drink a lot of water, eat lightly, no alcohol, no exertion.
• Remedies: acetazolamide (Diamox), started before ascent, is the medical option; local Sorojchi pills and coca tea are what everyone in Cusco uses. Hotels often have oxygen.
• If a headache becomes severe, or you get confused or breathless at rest, descend. That is not ordinary soroche.

Water and food

Tap water is not drinkable anywhere in Peru. Bottled, boiled or purified only. Avoid unpasteurised dairy, raw street food and unpeeled fruit washed in tap water. Busy established restaurants are low risk.

Vaccinations and tropical disease

• Yellow fever is recommended for the Amazon departments - Loreto, Madre de Dios, San Martin - and a certificate may be required for onward travel to other countries.
• Routine: hepatitis A, typhoid and tetanus.
• Dengue is present on the low coast and in the rainforest, peaking December to April. Malaria risk is limited mainly to rural northern Amazon (Loreto).

Hospitals and pharmacies

• Private clinics have English-speaking staff and good standards: Clinica Delgado and Clinica Anglo Americana in Lima, Clinica Pardo in Cusco.
• Public hospitals (ESSALUD and MINSA) are overcrowded and under-resourced.
• Travel insurance including emergency evacuation is strongly recommended - evacuation from the Andes or the Amazon is expensive and sometimes the only option.
• Pharmacies: InkaFarma and Mifarma are everywhere and sell painkillers and altitude medication over the counter. Controlled drugs need a prescription translated into Spanish.