The last thing anyone wants is to be caught throwing up in a public place, much still, in a bus. Yet there are times when being in such a spot of bother becomes difficult to avoid, all because you are in a moving item and something in your ear fails to balance your body, leaving you dizzy, nauseated and eventually throwing up.

All it takes is that bus navigating a bend or going uphill; a bit of choppy water on a boat; a few turbulence on an airplane; or a fast moving theme park ride to mess up your equilibrium and make you feel disoriented and nauseous.

Motion sickness can make life miserable.

Gladys d’Amour Ingabire is one such person. On a recent journey from Rubavu to Kigali, Ingabire sat in the middle seat at back of the bus.

"The windows were closed because it was raining and I felt suffocated. Next I knew was I was kind of gargling… I couldn’t help puking,” Ingabire says.

Motion sickness is an onset of dizziness, nausea, vomiting, sweating, and a sense of feeling unwell. These symptoms arise from the inner ear (labyrinth) due to changes in one’s sense of balance and equilibrium.

The experience can be as disgusting as it is embarrassing.

Faith Butera, a regular traveller, also reports several likely occurrences while in a bus negotiating a sharp bend. "Whenever we are taking a bend, I feel like throwing up.”

Dr Rachna Pande, an internal medicine specialist at Ruhengeri Hospital, says it occurs when the brain senses motion through input coming from the receptors in limbs, from eyes and the balancing system present inside ear (labyrinthine apparatus) and in brain (cerebellum).

Several studies have also concluded that motion sickness may be triggered by some other factors such as reduced circulation of blood.

Olivier Twahirwa, a general practitioner in Kibagabaga Hospital, says once the brain fails to get enough blood flow, there is a feeling of being light headed. This may be caused by sudden changes in body positions and it is common in individuals with high blood pressure, diabetes or high cholesterol levels.

Similarly, people with inadequate cardiac (heart) function, hypoglycemia (low blood sugar), or anaemia (low iron) are at the risk of motion sickness.

Certain drugs also decrease the blood flow to the brain, especially stimulants such as nicotine and caffeine. Some diseases of the nerves can affect balance, such as multiple sclerosis, syphilis and tumors also cause motion sickness.

Anxiety can be a cause of dizziness and light headedness. Unconscious over breathing can be experienced as overt panic, or just mild dizziness with tingling in the hands, feet, or face.

Prevention of motion sickness

However you may escape motion sickness by planning ahead. If you are travelling, reserve seats where motion is felt least:

Dr Pande also says: "One can prevent motion sickness by taking light meals before travelling, looking straight in place of down or sideward.”

Taking a labyrinthine sedative or centrally acting drug like promethazine, meclizine, 30 minutes before travelling helps to prevent motion sickness.

In case of severe problem, keeping eyes closed would be useful as well.

One should avoid rapid changes in position such as head motion while turning and twisting, eliminate or decrease use of products that impair circulation.

These include tobacco, alcohol, caffeine, and salt. Travellers should minimise stress and avoid substances to which they are allergic.

Taking enough fluids to keep the body rehydrated helps to control motion sickness while controlling infections for the ear, colds, flu, sinus congestion, and other respiratory infections.

Individuals subject to motion sickness should not read while travelling, sit in the rear seat or facing backward.

One should avoid strong odours, spicy or greasy foods immediately before and during travel.