Staying Healthy in Uzbekistan

Uzbekistan is not a difficult country health-wise. Most visitors have an entirely uneventful trip, the food is fresh, and the main risks are dull ones: stomach upsets, dehydration and sunburn.

This guide covers the sensible precautions. It is general information from a travel writer, not medical advice, and anything specific to you belongs in a conversation with a doctor or travel clinic before you go.

Water

Do not drink the tap water. It is chlorinated in the cities and locals often drink it, but the pipe network is old, quality varies by district, and a stomach unused to it will notice.

• Bottled water is sold everywhere and costs very little. Check the seal.
• Tea is boiled and is safe, which is one reason it is the default drink at every meal.
• Ice in restaurants in the main cities is generally made from treated water; in small towns, skip it.
• Brushing teeth with tap water is fine for most people; use bottled if your stomach is sensitive.
• A filter bottle or purification tablets cut the plastic waste considerably if you are travelling for weeks.

Drink far more than you think you need, especially in summer. Our summer guide covers the heat side in detail.

Food

Uzbek food is cooked fresh and turned over fast, which is the best protection there is. The sensible rules:

• Hot and busy is safe. Samsa straight from the tandoor, shashlik off the grill, plov from a cauldron at lunchtime. High turnover means nothing has been sitting.
• Be careful with cold dishes in summer. Mayonnaise-based salads and cooked food left out in a display case are the usual culprits.
• Wash fruit with bottled water, and peel what you can. Unwashed bazaar fruit causes more traveller illness than restaurant meals.
• Unpasteurised dairy at bazaars is delicious and a genuine risk if your stomach is delicate. The packaged versions are safe.
• Meat should be cooked through. Uzbek cooking does this anyway.
• Pace yourself. A lot of what visitors call food poisoning is simply three days of very rich, very fatty food in a row.

If you do get ill

Traveller's diarrhoea is the most common complaint and usually passes in a day or two.

Rehydration is the treatment that matters: oral rehydration salts from any pharmacy, plus water and weak tea. Carry a few sachets from home so you have them at three in the morning in Khiva.

Antidiarrhoeal medication is useful for a long bus journey and does not cure anything. See a doctor if there is blood, a high fever, or symptoms lasting more than two or three days, and do not self-prescribe antibiotics, which are widely sold here without prescription and frequently taken unnecessarily.

Heat, sun and altitude

More trips are spoiled by these three than by anything you eat.

Heat. Summer temperatures reach the high thirties and low forties across most of the country. The danger is gradual: you walk a little too long, drink a little too little, and by mid-afternoon you have a headache and no appetite. Sightsee early and late, rest in the middle of the day, and treat a taxi as medicine rather than laziness.

Salt. In dry heat you sweat without noticing, because it evaporates immediately. Water alone does not replace what you lose; salty food, ayran or rehydration sachets do. If you feel weak and slightly nauseous after a hot day, this is usually the reason.

Sun. The light is fierce and the monuments are reflective. High-factor sunscreen, a wide hat and long sleeves beat any amount of stoicism, and the worst sunburn most visitors get is on the back of the neck and the tops of the feet.

Altitude. Only relevant if you go into the mountains, where the passes and trekking routes rise well above 2,000 metres. Ascend gradually, drink more, and take it easy on the first day at height.

Know the warning signs of heat exhaustion: headache, dizziness, nausea, cramps, and skin that has stopped sweating. Get into shade, cool down, drink with salts in it, and do not resume sightseeing that day.

Pharmacies and medication

Pharmacies, dorixona in Uzbek or apteka in Russian, are everywhere in the cities, often open late, and staffed by people who know their stock well. Many common medicines are available cheaply and without prescription.

What to know:

Bring your own prescription medication for the whole trip plus a week, in original packaging, with a copy of the prescription or a doctor's letter. Specific brands may not exist locally, and some drugs that are ordinary at home are controlled here. Our customs guide covers what needs declaring, which includes strong painkillers and psychiatric medication.

Bring a small kit: rehydration salts, painkillers, antihistamines, plasters, antiseptic, insect repellent and any personal items. Everything else you can buy on the spot.

Medical care

Tashkent has private clinics used by expatriates and diplomats, with English-speaking doctors and reasonable standards. Elsewhere, public facilities are basic, under-resourced and may have no English at all.

Take travel insurance that covers medical evacuation. It is the single most important precaution in this guide, because the realistic answer to a serious problem outside Tashkent is a flight rather than a local hospital.

Dental care in Tashkent is inexpensive and often good; emergency dental work is one thing you can safely get done locally.

Keep your insurer's emergency number saved offline, along with your policy number and your embassy's contact details.

Vaccinations and other risks

Check with a travel clinic six to eight weeks before departure; requirements depend on your history and your itinerary. Routine vaccinations are usually the priority, and hepatitis A and typhoid are commonly discussed for this region. Rabies is present in Central Asia, so treat stray dogs with respect and seek immediate advice after any animal bite.

Mosquitoes exist around water in summer and are a nuisance rather than a major disease risk in the areas most visitors go to. Repellent is worth carrying for Aral, riverside and mountain trips.

Air quality in Tashkent can be poor in winter, which matters if you have asthma. In Karakalpakstan, dust blown off the dried Aral seabed carries salt and agricultural residues; if you are doing the Ustyurt expedition, a buff over the face on windy days is sensible.

A simple medical kit

Everything here fits in a small bag and covers the overwhelming majority of what goes wrong.

Oral rehydration salts, at least six sachets. Painkillers you know you tolerate. An antihistamine. Anti-diarrhoeal tablets for travel days. Plasters, a small roll of tape and antiseptic wipes. Sunscreen and lip balm with UV protection. Insect repellent. Hand sanitiser, because bazaar taps and soap are not reliably paired. Any personal prescription medication, in its original box, with a copy of the prescription.

Two additions worth considering for longer trips: blister plasters, since Uzbek sightseeing involves far more walking on uneven brick than people expect, and a small supply of electrolyte tablets that are pleasant enough that you will actually drink them.

Leave out the elaborate first-aid kit. Pharmacies are everywhere and cheap, and anything genuinely serious needs a clinic rather than a bag.

Toilets, hygiene and small realities

Unglamorous, and it is what people actually want to know.

Public toilets at monuments, bazaars and bus stations are frequently squat-style, often charge a small fee in cash, and rarely provide paper or soap. Carry tissues and hand sanitiser at all times; this is the single most useful habit on an Uzbek trip. Hotels and restaurants in the cities are western-style and generally clean.

Wash your hands before eating with your fingers, which you will do often, since bread and many dishes are eaten by hand. Bazaar food is handled a great deal before it reaches you.

For women, sanitary products are available in city supermarkets and pharmacies, though the choice is narrower than at home; bring what you prefer. Breastfeeding in public is uncommon and best done discreetly.

Finally, pace the whole trip. The distances are long, the days are hot, the food is rich and the hospitality is relentless. Most people who feel unwell in Uzbekistan are not ill; they are tired, dehydrated and three plov lunches into a week of it.

One more piece of practical advice for a long trip: build in a slow day. Two or three nights in one city with nothing scheduled does more for your health than any supplement, and Uzbekistan's itineraries tend to be built around transfers that leave no room for recovery. A morning spent in a teahouse instead of a monument is not a wasted morning.

Frequently Asked Questions

Can I drink the tap water in Uzbekistan?

Better not to. Stick to bottled or filtered water and tea. Locals drink the tap water in many cities, but the network is old and quality is inconsistent, and an upset stomach is a poor use of a short trip.

Is the street food safe?

Generally yes, when it is hot, freshly cooked and busy. Samsa from a tandoor and grilled meat are cooked in front of you. Cold dishes sitting in a summer display case are the thing to avoid.

Do I need vaccinations?

There is no universal requirement for most travellers, but your routine vaccinations should be current and a travel clinic may recommend others based on your plans. Book that appointment six to eight weeks ahead.

Are pharmacies good?

Yes, widespread, cheap and well stocked with common medicines, many available without prescription. Bring your own specific prescription drugs, since particular brands may not be available.

What about medical care outside Tashkent?

Basic. Tashkent's private clinics are the realistic option for anything serious, which is why evacuation cover in your travel insurance matters more here than in Western Europe.

Featured image: Ekaterina Kvelidze (CC BY-SA 4.0) via Wikimedia Commons.