Obtain advice on current health conditions at all travel destinations and routes, including general standard of living, sanitation, local health conditions and disease outbreaks. Find out about accommodations, food and water sources during travel and at final destination.
Consider traffic safety: learn about and be aware of direction of traffic flow, road and sidewalk conditions, lighting, motor vehicles and bicycles, and public transportation conditions. This is even more important if you will be in a developing country.
Be aware of crime against tourists. Use common sense and follow the same precautions that you would at home: be aware of your surroundings, avoid being alone in risky areas, don't carry lots of money, give up valuables if confronted. Find out about the potential for civil unrest at your destination- try to be aware of political conditions.
Sexual harassment, especially for women, can be an uncomfortable reality during travel. This can be a mere annoyance but may escalate to become a dangerous situation. To minimize risk: be assertive, use a buddy system, and use a ‘broken record' technique when someone will not take no for an answer. Be aware of local customs- try to make friends with local women and learn from them how to protect yourself. Cross cultural sensitivity does not include relaxing your personal boundaries. If you feel uncomfortable, pay attention to this and remove yourself from the situation right away. See Newport's articles in the SAFETI Newsletter for more info: http://www.globaled.us/safeti/newsletter.html
Consider environmental conditions: climate, humidity, wind, sun, altitude, pollution. Is the water safe to swim in? Avoid contact with animals, as bites can result in wound infections and even rabies.
Review and update immunizations with a health care provider and have a copy to carry with you. Many routine immunizations including: Tetanus/Diphtheria, Hepatitis A and B, influenza, and meningococcal can be given at CHWS. Consider having a PPD/tuberculosis skin test before, and 2-3 months after travel if possible exposure has occurred.
This is especially important if you will be traveling in developing countries. However, food born illnesses can occur even in Europe, Australia, and right here at home.
Food: Choose well cooked and hot foods to avoid infectious agents, especially in meat and fish. Be cautious eating food purchased from street vendors. Avoid leafy, unwashed vegetables and salads, as these may be contaminated by bacteria and parasites. Safest are fruits, nuts and vegetables with a thick skin/peel that you can peel yourself before eating.
Beverages: Ask someone reliable about the safety of drinking water. Safest are beverages made with boiling water and carbonated beverages. If concerned about water safety, avoid ice cubes as well. Use straws and disposable glasses, or drink directly from a newly opened container. Remember to use boiled or bottled water for brushing teeth.
Look in your medicine cabinet and bring the things you use regularly. Include first aid supplies such as band aids, gauze pads, adhesive tape, disinfectant, Ace wraps and soap. Bring your prescription medicines for chronic medical conditions and for conditions brought on by stress. Keep these in the original labeled containers and keep a list of what you have with you and what it is for. If you wear glasses, bring an extra pair, and a copy of your prescription.
Over the counter medicines for common health problems and minor injuries might be hard to find where you will be going. Consider bringing ibuprofen (Motrin or Advil) or acetaminophen (Tylenol) for fever/pain; hydrocortisone cream or diphenhydramine (Benadryl) for skin rashes; loperamide (Imodium) for diarrhea; antibiotic ointment for minor cuts; as well as anything that you normally use frequently. Personal sanitary supplies might be another item to pack. Finally, include copies of your vaccine records, medications, allergies, and the name, address, phone and Fax numbers of primary and specialty health providers.
Take along well fitting, broken in shoes. Do not walk around barefoot. Wear protective foot gear during activities on the beach and in natural bodies of water. Carry first aid supplies for blisters, splinters, athlete's foot, and insect bites.
Be informed about sexually transmitted infections. Unprotected sex can transmit many different infections and might result in unintended pregnancy. Bring a supply of condoms with you if you plan/choose to be sexually active and use them. Be cautious with alcohol and other drug use as this often impairs judgment. Avoid intimate contact with commercial sex workers.
Insect bites are annoying and uncomfortable; some insects spread serious diseases. Wear protective clothing to minimize skin exposure when insects are out. Avoid flowery, bright clothes and scented soaps, perfumes, and hair spray if you want to keep bees away.
If you use insect repellent, the most effective ones contain DEET, and a higher concentration requires less frequent application. Check the label. Apply to exposed parts of the body. If also using sunscreen, apply that first, wait for ½ hour, then apply insect repellent. Botanical insect repellents are less toxic and may be effective if applied frequently. Avon Skin So Soft protects for @ 30 minutes.
Malaria is a potentially fatal illness. Get up to date information on the risk for malaria exposure at your destination and travel routes. Your health care provider will select an anti-malarial drug regimen for prevention based on your personal health factors, travel plans and expected exposure to mosquitoes. Remember- these drugs will only help you if you take them!
Most cases of traveler's diarrhea (more than 3 loose stools in 24 hours) are short term and do not need treatment other than fluid replacement. Carry medication for self treatment such as the anti-motility agent Imodium or Pepto Bismal for symptoms that last for longer than a day. If you will be in an area with limited access to medical care and poor water quality, talk with your health care provider about prescription antibiotics for treatment of traveler's diarrhea.
Check health insurance coverage and obtain additional coverage if needed for emergency medical care and evacuation during international travel. Be sure that you have signed consent forms so that family members can access your medical records at home and facilitate sharing important medical information with health care providers at your destination, if this becomes necessary. Travelers with chronic health conditions should carry with them a summary of their condition, current medications, significant lab and test results, and a treatment plan. Carry the name, address, phone, and fax numbers of your primary care provider with your travel documents. Have an extra copy for your resident director along with a copy of your passport and any other important documents. Find out where the American Embassy and/or Consulate are located. Prepare a contingency plan for emergency communication and evacuation.
Centers for Disease Control and Prevention information line: 1.800.CDC.INFO (1.800.232.4636)
U.S. Department of State Citizen's Emergency Center: 202.647.5225
CDC Traveler's Health www.cdc.gov/travel
U.S. State Department www.travel.state.gov
World Health Organization www.who.int/en
Pan American Health Organization www.paho.org
Shoreland Travel Health Online www.tripprep.com
SAFETI newsletter www.globaled.us/safeti/newsletter.html