Travel in India with type 1 diabetes – getting the visas

In late July 2011, exactly 7 months after Amy was diagnosed with type 1 diabetes, we backpacked around India for four weeks, in a trip we called Monsoon Meandering.

This is post 3 in the series about that trip and its planning and how type 1 diabetes played a part. This post doesn’t actually contain any information about diabetes but if you’re thinking of going to India then getting your visa is an important part.

Caveat: visa rules change quite frequently and what’s below is what happened for us in 2011.

Do I really nead a visa?

Yes, unless you’re from a country neighbouring India you’re probably going to need to organise your visa way in advance. Only certain countries’ residents can get a visa-on-arrival when landing in India.

Don’t peak too soon

The first thing about a visa for India is that it starts the moment it is processed and first timers are likely to just get a 3 month or 6 month visa.
If you’re going on holiday to India in August you might think applying for your visa in April is a good idea, just in case there’s a backlog or problems with your application. If they grant you a 3 month visa it’ll run out before your flight leaves. Even if they grant you a 6 month visa it’ll run out in October which isn’t great if you’re planning a four month stay. So timing is of the essence and the best thing you can do is find out about the current situation by joining the free forum IndiaMike.com, get yourself to the Visa section and in particular this thread.
I found it incredibly naive that the visa centre suggest that you don’t even book your flight until you’ve got your visa, yet the visa starts immediately it’s issued. Due to flight pricing getting higher the nearer the departure it means that virtually everyone will book their flights way before.

Getting photos for the visas

The photos we needed were not the normal size passport photos we’re used to – 45mm x 35mm – but instead were 50mm x 50mm. Local shops will take your photo for you but the cheapest I found at the time were £15 per person. This would have added £60 to the cost of the visas (£50 each) so I dug out my camera, took the photos, edited them using free software from the internet and saved myself probably £59 in the process.
If you go to the visa centre in person before you even get to the waiting room a clerk will check your photos are the correct size. If they’re not you’ll be sent to the nearest (probably expensive) photo booth.

Our application process

We filled in our applications electronically, printed them off and booked an appointment for the following week at the offices in Victoria. Amy’s school had a day off and we used it to have an enjoyable trip to London and sort the visas out too.
I was slightly nervous at the visa office: what if my photos were rubbish, they weren’t; what if I’d filled in all the application forms wrong, I hadn’t; what if; what if; what if.
As always I’d done my homework, stuck to the rules and our applications were fine.
It’s worth noting that normally you won’t get your visa on the day you apply as it is sent from the visa centre to High Commission of India to be rubber-stamped, presuming it’s a straight forward application. Visas are normally sent back by post or can be collected and ours were received in the post within a week, far quicker than I’d expected.

Parents taking their kids need an authorisation letter, from themselves

In yet another ‘only in India’ scenario any parent wanting to get a visa for their kid have to have an authorisation letter for each child, signed by each parent. It sounds odd but it’s in the rules so we did it, thinking all the time that we’d misunderstood them. We hadn’t, we needed those letters.
Whilst in my appointment I overheard an argument between a parent (of Indian origin) and the official. He maintained that as he was of Indian origin the rule didn’t apply to him – it did – and that he would just write a letter now, but he couldn’t as he’d made the trip to London without his wife so she couldn’t sign it. Because he didn’t read/believe the rules his trip to London was wasted.
I managed to contain my smirk at having read the rules properly.

Next up: buying travel insurance

Travel in India with type 1 diabetes – planning the trip

In late July 2011, exactly 7 months after Amy was diagnosed with type 1 diabetes, we backpacked around India for four weeks, in a trip we called Monsoon Meandering.
 
This is post 2 in the series about that trip and its planning and how type 1 diabetes played a part.
In this article there are several tips for people with diabetes identified by the text ‘tips for diabetics
 

Yet another trip of a lifetime

Our backpacking trip wasn’t a ‘land. chill. where should we go now?’ trip, instead it was a ‘we’ve got four weeks, how do we make the most of that time’ one. This meant it had to be well planned which in turn meant we had a great trip and one that didn’t cause too many problems for Amy’s diabetes management.
 
Whilst planning the trip I had some rules I wanted to follow:

  • Be adventurous, see things normal tourists wouldn’t, but…(see point 2)
  • Make this trip as easy as possible, we’ve had enough pressure on us recently
  • Make sure Amy is never in danger, medically speaking
  • Managing diabetes should not take our holiday time up
  • Don’t let diabetes stop us doing anything we want to do

 

Trains, planes and automobiles

trains: for this trip we used trains for all bar one journey which we did by car.
planes: distances in India are huge and sometimes a plane may be the best option, but honestly you’d miss so much wonderful stuff.
automobiles: for the trip in 2009 we stuck to the north and travelled by car and had a driver/car at our disposal for 10 whole days, being chauffered from place to place. You might think this would be an expensive way to travel but for four of us, petrol, tolls, driver costs/accomodation and our hotels we only paid £850!. If you’re interested in this I’d thoroughly recommend the company we went with Namaste India Tours.
 

The route

So, you’ve seen the route – it’s up there on the right, click the picture for a bigger version – which saw us take 8 trains over 2700 miles during the course of our journey. The route looks a bit like a crazy waste of time but there’s good reason and that’s where rule number 1 comes in. But before that a word about booking trains.
 

A word about trains in India – you need to book

The railways in India are popular, very popular and many trains can be booked up many months – currently 4 – before the date of travel. If you turn up to a station without a ticket it’s highly unlikely you’ll be going anywhere. If you want to know how to research and book trains in India please read this guide way before you travel.
For our trip I researched the whole route way before the earliest date I could book the first train. When the booking day arrived I got up early to make sure I was one of the first to get my seats. This might sound like I’m a bit OCD but on our longest train – an 18 hour overnight journey from Jhansi to Aurangabad – there were only 4 possible berths available and I needed them all. Worse still, there was only one train a day.
 

Rule #1 – the most direct route isn’t always the best route

For any travel in the UK I’d always plan the fastest or most direct route from A to B but this isn’t necessarily always the best idea.
India is a vast country, the distances are huge, trains can run for up to three days from their starting station to their destination station and most trains are ‘sleeper’ trains, having padded benches which convert into beds between 9pm and 6am. To read more about the different types of trains in India take a look at this guide on Seat61.com.
Overnight trains have three massive advantages, one we found especially useful for type 1 diabetics:

  • you don’t have to pay for a hotel too. If you were to catch a long day time train you’d stay one night in a hotel, spend much of the next day on a train doing nothing, arrive and book into a hotel. So that’s two hotel prices and a wasted day.
  • you don’t waste a day doing nothing. Catch an overnight train and you can check out of your hotel just before lunch, leave your luggage there and go sightseeing, eat, come back to the hotel, catch your train, sleep, wake up in a new town
  • tip for diabetics: from a diabetic’s point of view catching an overnight train means you don’t really need to worry about food, its carbohydrate values or injecting on a moving train.

 

Rule #2 – you can’t always arrive and leave when you want

If you’re travelling off the beaten track using some of the minor train lines then you’ll have precious little choice of what time you catch the train as there will possibly only be one train a day. On some of our routes such as Hampi (station:Hospet) to Goa (station:Madgaon) there’s only a few trains a week. We had wanted to stay for only 4 nights in Hampi but due to train connections we were forced to stay for 5, something which turned out very well for us as we loved Hampi.
 

Rule #3 – the fastest train isn’t always the best train

On one of our routes – Aurangabad to Hyderabad – had a train which left at 9pm and got in at 7am, a seemingly brilliant timed train considering what I wrote in Rule #1. A little more research showed that they had a train from 7pm to 9am, a whole four hours longer on the train but it was the better train for us due to two reasons:

  • if you arrive very early you’ll need to wait to check in to a hotel. What’s the point getting the fast train, arriving at the station, transferring to the hotel only to have to wait there for hours for your room to be ready.
  • if your train arrives early you need to be up and ready to get off, otherwise you’ll miss your stop. Indian trains are sometimes (very) late but many aren’t and arrive at the specified time, with the minimum stop time of only 1 minute at some stations. Believe me, waking up at stupid o’clock in the morning realising that your station is next and your luggage is all chained up as the station nears isn’t much fun. Best to give yourself some time to wake up first.

Tip for diabetics: from a diabetes point of view catching the faster train would have proved a better option if our slower train was delayed as we didn’t take any breakfast with us. We could have also eaten dinner at a more normal time (for us) of 7:30pm, rather than having an early dinner. Also, Amy could have done her Levemir (basal) insulin at her normal time of 8:30pm.
 

Rule #4 – avoid the main meals on the sleeper trains

Actually, this is down to personal preference but having taken a look at the food served on sleeper trains I’d do anything I could to avoid having to eat it. I did eat some mutton dish but it was inedible, very fat and generally not very nice. So my suggestion is as before, try and catch an overnight train which leaves at 9pm or 10pm and eat a proper meal before hand. On a long day time train – Goa to Mumbai – we even took sandwich style food with us; okay I’ll admit it, we took a footlong Subway each, that was dinner but much more preferable to eating a train main meal.
 

Rule #5 – DON’T avoid the main meals on the Shatabdi trains

The Shatabdi trains are completely different to the normal sleeper trains, they have airplane style seats and waiters/hosts who serve you food, all on a lovely tray. If you go for the top class your soup will be served in a china dish. The food was lovely, not full of fat or rubbish meat.
 

Rule #6 – For road travel always carry some food with you.

Tip for diabetics: on most of India’s roads there are cafes known as Dhabas which serve tasty snacks like samosas, pakoras and full meals too, but they aren’t everywhere and we got caught out when expecting to find one to eat lunch in. We had to keep going until 2pm until we managed to find a small shop, which only sold crisps and chocolate and high-sugar drinks. Amy’s blood glucose levels were all over the place for the next 24 hours. It’s an obvious tip really but we didn’t realise how long it would take to reach our destination.

Next up: getting the visas

Travel in India with type 1 diabetes – introduction

In late July 2011, exactly 7 months after Amy was diagnosed with type 1 diabetes, we backpacked around India for four weeks, in a trip we called Monsoon Meandering.

This is post 1 in the series about that trip and its planning and how type 1 diabetes played a part.

 

A bit of background

Jane and I have always travelled, it brought us together, we married abroad, but it all stopped when we had kids. It took some time to decide to travel again and with many nerves we took Emilia and Amy to Rajasthan in 2009, in a trip we named Big Cats and Holy Ghats, they were 11 and 8 at the time. Two years later we decided on a much more adventurous trip which would mainly focus on Ladakh, an area sandwiched between the Himalayas, Pakistan, China and Tibet. We broke the news about the trip in October 2010 during a meal in our favourite Nepalese restaurant in Winchester, the Gurkha Chef.

A change of plan

I’d almost booked the flight tickets, just before Christmas 2010, but a few days later Amy was diagnosed with type 1 diabetes and our world briefly fell apart. Any thoughts of going to India at all were discarded. Within 24 hours of diagnosis one of Amy’s first questions to the diabetes nurse was “does this mean I can’t go to India anymore?” and after hearing this I was determined to go to India, as long as it was safe. It should be they said.

Diabetes forces a change of route

Diabetes didn’t actually force the change of route but I was unwilling to travel to Ladakh anymore. The road across the Himalayas goes over 5000m three times and travellers run the risk of getting Acute Mountain Sickness (AMS), especially if you have to stop for any length of time. To avoid this some recommend drinking sugary drinks, something that doesn’t sit well with diabetes. This is compounded with the similarities between a hypoglycaemic attack and the symptoms of AMS such as confusion and dizziness. None of this means a diabetic can’t go to Ladakh or other high altitudes but there was no way I would put Amy, or us, through that so soon after diagnosis. We needed a new route and opted for Delhi to Mumbai – via Amritsar, which anyone who knows the area will tell is a bit of a long way round. We decided to do virtually all the travel using trains, all booked by ourselves, without a Travel Agent in sight, it seemed quite daunting.

A little research is required

We knew no-one with type 1 and we knew no-one who’d been to India with type 1, so I turned to my favourite India forum – IndiaMike – and asked some advice. They told me straight:

  • India is one of the top 2 diabetes countries in the World
  • Amy’s medication Novorapid and Levemir was available
  • food could be challenging but could be handled.
  • India has some of the world’s best Doctors.

And so it began, a frantic few months of deciding the route, researching what diabetes specific things we need to plan for and take, oh yeah, and coping with the daily difficulties of a newly diagnosed diabetic.

 

Next up: planning the trip.

Does this mean I can’t go to India anymore?

One of the things they did as soon as Amy was diagnosed was to give her a pen and a pad, so that she could write down any question that popped into her head. In the next 24 hours many questions were written down but there was one that surprised me, pleased and relieved a personal doubt I’d given myself.

“Does this mean I can’t go to India anymore?”

We’d been planning a trip to India, our second family trip there and it was going to be a big one: one month away and visiting the roof of the world, the Himalayas and the regions near by. The centre point would be Ladakh and a two day coach trip through the Himalayas from Manali to Leh. I’d been planning this for months, reading for hours a day and I was just about to buy the flight tickets.

As soon as Amy was diagnosed and when I had a few minutes to myself I thought about the trip and one thing made me decide we wouldn’t go, we shouldn’t go, we couldn’t go. The trip to Leh in Ladakh goes over mountain passes as high as 5300m and at such heights Acute Mountain Sickness (AMS) can be a real problem which can prove fatal if not treated quickly.

Dr Google told me one of the preventative treatments is to drink sugary drinks.
Sugary drinks + diabetes + risk of AMS = no way am I doing that.
(It turns out Dr Google was once again wrong but I only found this out many months later.)

When Amy read out the questions she’d written down I couldn’t believe that with everything currently going on she was worried about the trip. It was at that point I made a promise to myself never to let diabetes stop us doing something we wanted to do, to never let the ‘it’s easier not to do it’ attitude take control, as long as we weren’t going to be reckless. With recklessness in mind and because of my limited knowledge of AMS and even more limited knowledge of diabetes we decided to skip Ladakh and go elsewhere.

What resulted was a 2700 mile backpacking trip using overnight and daytime trains, over four weeks, from Amritsar in the north, to Goa. We prepared for the trip with our recently learned diabetes knowledge and with the hospital’s email addresses and phone numbers close at hand. Everything went very well and whilst we had a few diabetes related problems it never stopped us from doing what we all wanted to do.

But we never would have gone if Amy hadn’t had asked that question.


You can find out more about that trip by reading our Monsoon Meandering blog.