Much of Ecuador is at high altitude Ė including Quito, which is at around 2,800m. As most tourists fly into Quito, this could leave you feeling rough for the first two or three days of your holiday Ė although some consider this a bonus as it prepares your body well for further ascents into the highlands.
Don't attempt high altitude hikes or climbing any of the volcanoes until youíve had several days to acclimatise in Quito. Fitness has little impact on altitude sickness so acclimatisation is the only way to prepare. You should also keep well hydrated and avoid alcohol, which makes the symptoms much worse.
Seasickness is a real possibility during GalŠpagos cruises. December to May tend to bring calmer seas, but youíre still out in the open water Ė so bring medication. Ginger is also widely believed to ease nausea.
Tap water is not safe to drink, but bottled water is readily available and cheap. Ask for juices made with mineral water, and served without ice.
Food is generally of high quality and food poisoning is uncommon. However, if travelling to remote areas itís advisable to bring medication for mild stomach upsets, just in case, as medical facilities will be limited.
Visit your GP at least 6-8 weeks before travel to ensure you have the necessary vaccinations. You may also need antimalarial medication if travelling to the Amazon or coastal rainforests, although the highlands are malaria-free.
Wear long-sleeved shirts and long trousers in the jungle, and use insect repellent. The coastal rainforests and mangroves are far worse than the Amazon for mosquito bites. Mosquito nets should be provided when necessary.
Good healthcare is available in major cities. Ensure your travel insurance covers any adventure activities you may be undertaking (including boat travel and high-altitude hiking) as well as emergency repatriation.