La Paz and its surrounding areas are often near or above 4000m. Altitude sickness is common for travelers here. Take steps to prevent the severity of altitude sickness by taking it easy upon your arrival. Refrain from alcoholic beverages and heavy physical activity your first day or two at high altitude. Mild headaches, loss of apetite and difficulties sleeping well are all common soon after arrival to high altitude areas. Drinking coca leaf tea, or chewing the leaves directly, helps to relieve mild symptoms of altitude sickness. In case of more severe reactions, oxygen, or relocation to a lower elevation, may be required. In La Paz, spending a night in Zona Sur, which is located several hundred meters lower than the city's center, may be a good option. Most of these hotels offer bottled oxygen for people who are experiencing difficulties. In severe cases seek medical attention immediately.
Be sensible about where and what you eat!
If you are going to eat food from a vendor in the street (which can be a great option!) watch the vendor! Are they busy? Are locals eating there? Are they cooking/serving in a sanitary way? If the answers to these three questions is yes then chances are the food is safe to eat. Prime examples would be the salteñas sold on lower Montes, near Plaza San Francisco, in La Paz or the fried chicken sold just off the main plaza in Coroico. In either case, you can't go wrong for the food or the price.
If you are going to eat food at a restaurant, beware, what you don't see can hurt you! Again, are they busy? Are locals eating there? Do the people running the place give off a warm and welcoming vibe (seriously!) For recommendations on good La Paz area restaurants see the "Eating" page.
If you are going to buy food in a market.... Check the date on packaged food. Wash fruit with edible skins (such as apples) thoroughly with soap and water, otherwise wash and peel. Wash greens in vinegar/water solution and consume/cook thoroughly meat soon after purchase. Good supermarkets for western style shopping are Ketal, Hipermaxi and Fidalgo. For great, local, independant produce check out Mercado Yungas, several blocks above lower Comacho or Mercado Roderiguez, a few blocks to the north of Plaza San Pedro. The markets on Villa Fatima are also known for excellent quality and prices.
Tap water is usually safe to drink in La Paz, but is best avoided. Either boil water or buy water for drinking.
If you get sick... Mild diarrhea or upset stomach is common for travelers to La Paz. Sanitary practices are not what many people from "developed" countries are used to. If symptoms such as severe and prolonged diarrhea, nausea, vomiting and weakness occur, ask the front desk person at the hotel/hostal you are staying at to direct you to a nearby clinic. In rural areas ask for the nearest farmacia. They usually stock over the counter cycles of antibiotics such as Cipro.
Vinchucas: Also known as triatomine or kissing bugs, vinchucas are flightless insects that feed on the blood of sleeping hosts, usually drawing from an area near the mouth (hence the name "kissing bug"). Vinchucas carry a blood parasite,Trypanosoma cruzi, which causes the disease known as Chagas. Chagas can cause many severe, long term, health effects, particularly affecting the heart. An estimated 7-8 million people in Latin America are infected with Chagas. Vinchucas are not present in higher altitudes, in places such as La Paz. They are however common in lower areas of Bolivia. Vinchucas are often found in adobe structures. Care can be taken by sleeping in screened rooms, tents or with mosquito netting.
Mosquitoes: Can be bad in some areas, but not in the higher country of the Yungas, due to a lack of standing water. Mosquitoes are known to carry yellow fever and malaria in Bolivia, although neither are very common. Bolivia requires a yellow fever vaccination certificate when entering from a country known to carry the disease.
Tapeworms: As Bolivia consumes lots of pork there are tapeworms. Tapeworms begin their life when they are shed as eggs from an adult living in a human host, and passed within feces. In less sanitary conditions, pigs eat the feces, and the eggs, and the eggs pass through the intestinal lining of the pig, and into the bloodstream, where they eventually come to rest in muscle tissue, growing into a cyst, which if consumed in pork that is not thoroughly cooked, will grow into a tapeworm in the new host. Occasionally, someone who has a tapeworm serves food. If they are not hygenic, they may pass tapeworm eggs to a new host via prepared food. This can result in a condition known as neurocysticercosis, in which tapeworm eggs migrate in the human bloodstream to the brain, and form cysts there. Food for thought. Not eating raw, unwashed vegetables and fruit is the best way to all but eliminate any risk. Be smart, but don't be afraid to eat raw vegetables in what locals would consider a nice restaurant. Bolivians are very aware of the risks of eating unwashed vegetables, and pork is carefully inspected for tapeworm cysts more and more often.
Sandflies: Generically, may refer to several species of blood sucking flies. In Bolivia some species are known to carry Leishmaniasis, a protozoan parasite. This parasite may lay undetected for quite some time, and can result in severe skin ulcers from a few weeks to several months after being bitten. A healthy immune system should prevent the parasite from establishing itself (the author has been bitten from head to toe numerous times and never contracted the disease) but for those who are concerned there's always DEET.
Although Bolivia has its share of poisonous spiders, scorpions, snakes, centipedes, etc., use a little common sense and they won't bother you.
Despite pickpocketing and petty crime being chronic in some areas (El Alto for example) Bolivia is realatively safe as far as Latin American countries go. That being said, don't tempt the tempted. When traveling on a bus don't leave items unattended on overhead racks while sleeping. There is a good chance you'll get robbed. Drivers tend to be quite honest, so don't be afraid to stowe your things in the cargo bins underneath. Be organized! Thieves prey on travelers who look confused or disorganized. Don't be a target! Always change money at a reputable changer. In La Paz there are plenty of small offices near Plaza Mayor (San Francisco) on the corner of Sagarnaga and El Prado, and on Calle Murillo as well. These changers offer better rates than the banks and are reputable for the most part. Avoid people offering to change bills in the street. Don't go into El Alto without a Bolivian who knows the area well, especially at night. Pickpocketing is very common in El Alto's street fair. Supporting the sex or drug trade in Bolivia comes with a laundry list of hazards, including jail time or being robbed. Our advice is to stay away from both.