U.S. students going abroad come from an OSHA certified world where torte law ensures that anyone with potential responsibility for injury has a stake in preventing accidents. The big upside of this is that we have far fewer accidental deaths than we might otherwise. The downside is that our students have been deprived of the opportunity to develop the risk management skills necessary to navigate a goodly portion of the low and middle-income world.

I was in a typical Bhutanese hotel last year. There were 6 floors and only one stairwell winding around the one elevator. There were no fire escapes, sprinkler systems, smoke alarms, evacuation diagrams or fire extinguishers. There were candles and matches provided for guests in each room. When I visited the local fire department, it was apparent that their ladders would not reach beyond the third floor and they’d only have access to those windows that opened onto the street.

Have you ever held a condescending view of the adventurous eater who courts gastronomic disaster, only to be laid low yourself despite a religious adherence to “boil it, cook it, peel it, or forget it”?

Or are you the adventurous eater?

The old adage of boil, cook, peel, or forget it has persisted as the conventional wisdom since 1985 when the National Institutes for of Health issued the statement that “meticulous attention to food and beverage preparation can decrease the likelihood of developing Travelers’ Diarrhea (TD).” However, six of the seven studies that the NIH had available to them at that time, showed no correlation between the recommended food and water precautions and the likelihood of developing TD, so it is not surprising that the overall risk of acquiring TD has not decreased in 50 years. (Shlim, 2005).

I was sitting up with a visiting program affiliate, a syringe laid out on the table between us. She had come to my room and awakened me to say that she had a problem. She had a pronounced history of being allergic to nuts and at the buffet table she’d carefully reviewed all the ingredients of all of the dishes being served – except the salad dressing. Some 20 – 30 minutes after eating, she started to experience some unpleasantly familiar sensations.