Health and Safety
There’s a saying in La Paz: On the first day, eat little, drink little, and sleep alone. Because the high altitude in the capital and in Potosí, you may suffer from soroche, or altitude sickness, when you arrive. Symptoms include dizziness, fatigue, and shortness of breath. Avoid alcohol and coffee, drink lots of water, and rest as much as you can in the first few days. It is also recommended that you eat less than usual before and upon arrival. Do not take the soroche pills sold in pharmacies within Bolivia–they are a dangerous mix of chemicals banned in the United States and Europe. Symptoms usually disappear within a week. If they do not, consult a doctor, especially if you have a history of high blood pressure. Mate de coca, an herbal (and completely legal) tea made from coca leaves, can be very effective, though you may want to avoid drinking it in the evening, as it can cause sleeplessness. Some higher-end hotels will administer oxygen to guests upon arrival. If you suffer from heart or lung diseases, or are pregnant, consult your doctor before traveling.
Food and Drink
Although the higher areas of Bolivia are relatively free of bacteria, lower altitudes harbor some really dangerous strains. To play it safe, do not drink tap water, and order beverages without ice. Avoid eating food from street vendors. You can find most of the things you want to try in restaurants and cafés for a slightly higher price. If you buy on the street or from a market, take the U.S. Centers for Disease Control and Prevention’s advice: "Boil it, cook it, peel it, or forget it."
Various nationalities entering Bolivia (including U.S. citizens) are required to receive the yellow fever vaccine, which in the United States costs approximately $150 USD and is valid for 10 years. Don’t get one from the health centers in Bolivia–they are not recognized internationally. The northern and eastern areas of the country, especially jungle regions, are more prone to yellow fever epidemics. No other shots or vaccination certificates are required for entering Bolivia, although all travelers will need a yellow fever vaccine if moving on to countries such as Brazil. If you’ll be spending time in remote areas, ask your doctor about typhoid, hepatitis A and B, and tetanus vaccinations. If you’re headed for the Amazon, consider antimalarial prophylactics.
Bring plenty of sunblock–the high altitudes feel cool, but the sun will burn you within minutes because of the thin atmosphere. Wear sunglasses and a hat as much as possible. The trek across Isla del Sol can be particularly brutal since the open landscape is void of shade. In the winter, humidity in La Paz can drop to 0%, and your skin and eyes can get very uncomfortable, so use moisturizing cream and drops if necessary.
Be careful with dogs–in the cities they are friendly, but be very wary in rural areas. Usually picking up a stone is enough to warn them off. Rabies is a real risk in Bolivia, so if you’re bitten by anything, see a doctor immediately.
Crime is not a major problem in Bolivia compared with other Latin American countries, but it’s increasing both in frequency and seriousness. In larger cities such as La Paz, Cochabamba, Sucre, and Santa Cruz, street crime–including pickpocketing, mugging, and purse snatching–is on the rise. Avoid wearing flashy jewelry, watches, or your camera around your neck, and be aware of your surroundings at all times, especially in busy plazas and on jam-packed buses. Carry only as much cash as necessary when in the city, especially in crowded market areas. When walking through busy cities such as La Paz, carry a copy of your passport rather than the original since passport theft is common. Exercise special caution around bus terminals, where cases have been reported of kidnappings and even murders of tourists. Be wary of "policemen" who ask to see your papers: be assertive, don’t let them search you, and walk away fast. Never take an unmarked taxicab, especially in the Cementario area of La Paz. For public transport, use "radio taxis" (they have a telephone number on a sign on the roof), public buses and minibuses, or the fixed-route, shared trufis.