Preparing for an Overseas Trip
In our regular medical column, Dr Ricky Montalbano takes a look at how to deal with various medical conditions or situations that caravaners and campers might encounter. Dr Ricky is chairman of the SDI Group, which offers first aid courses as well as occupational health and safety services. For more information visit www.sdigroup.co.za.
Dear Bush Doctor, how do I prepare for an overseas trip?
One of the things you should do before departing on a trip is to assess what the health risks are at your destination and what your own individual health risks are. Prepare well in advance of departure. Assessing the potential dangers and what you can do to stay free of disease needs time and depends on information collected from organisations like the USA’s Centers for Disease Control and Prevention (CDC), which you then need to apply to where you are going. So visiting a travel centre at least six to eight weeks before departure (or perhaps longer) is a good idea if you are going overseas for long-term employment, placement or holiday touring. This gives you time to obtain the necessary travel medicine, immunisations, preventative medication (e.g. antimalarials) or specialist treatment.
The travel clinic may ask you to complete a pre-travel health questionnaire, which will cover your exact itinerary and any special medical problems, all of which are extremely important for the doctor. For example, the doctor will want to know which countries you are travelling to, what areas of those countries you are planning to visit, what you plan to do there, how are you getting there and how long you expect to be there.
Armed with this information, and assisted by access to computerised travel health databases and published literature, the doctor will be in a position to assist you. If you are travelling in Africa or South America (or even in Asia), you may well have to expect medical care that is, let us say, substandard. You should therefore do everything you can to avoid ending up in a medical facility in any of those countries … and some countries have no medical care to speak of: the longer your stay, the greater your risk of illness, for example malaria.
There are different disease risks at different times of year. Have you thought about access to medical care at your destination? Would it help to know some first aid? Do you have medical insurance? Always know what your medical insurance covers.
The more remote the area you are going to, the greater the risk of disease. If you are flying into a major city in South America, for example, and are being driven in an air-conditioned vechicle by the hotel chauffeur driver and sleeping in a fivestar hotel, then your risk is lower than it is for an adventure traveller who is exposed to rural and remote areas and villages and may be in close contact with local people. Some of us may travel to smaller towns and cities and stay at more modest accommodation there. This lower standard of accommodation will have an intermediate risk. Then there are some of us who will be in transit and not exposed to the local environment, for example staying in the plane as it refuels or takes on extra passengers, or perhaps having a short-term stopover in a modern airport terminal.
Always keep safety and security in mind. Many countries in Africa, for example, are experiencing civil unrest, so beware! If you are going to dive, have you thought of getting a divingspecific medical exam? Have you had surgery in the past six weeks? If you have, have you cleared your travel plans with the surgeon? Beware if you have had any dental procedures, as flying can cause severe toothache if air is caught in a new filling.
