Maintaining Optimal Health For Your VolunTour
If a VolunTourist is truly interested in being of service to the community and/or environment in a given destination, then that individual's health must be a top priority throughout the Life Cycle of the VolunTourism Experience. What can be done in preparation for your trip? What can you do during your trip? How can you best communicate with your physician after your trip regarding any health challenges you had during your experience? I have asked Dr. Donald S. Herip, of Palomar Pomerado Health, to answer this issue's 3Q's.
1) What about your personal experience led you to select health and travel as a professional interest?
"My United States Navy career of 27 years involved travel around the world and living overseas for more than 6 years. I was responsible for medically preparing large groups of military service members for travel to developing areas in the world. I have also evaluated and treated many patients who acquired travel related diseases.
While in developing countries I have participated in many Medical Civic Actions Programs which provide medical care for the local population abroad. This experience has allowed me to personally experience the health status of the local populations in developing countries. One soon realizes that these populations have many health problems that have not been addressed by the standard of care we are used to in the United States.
Presently our clinics prepare corporate travelers, recreational travelers and church mission groups for overseas travel. This preparation serves to decrease some of the worry associated with foreign travel. Most travelers from developed countries are not aware of the health risks while traveling abroad.
For voluntourists, there is probably a greater risk of health challenges, particularly food-born illnesses, as they are often interacting at a very localized level with communities. What would you recommend as preventative measures and recommended interventions for voluntourists as they prepare themselves for their voluntourism experiences?
"Travelers should research the local community destination prior to travel. What diseases and other health risks are present there? What are the medical capabilities of the local community?
Review your own personal health. Are you up to date in routine medical and dental care?
A routine dental problem can result in significant pain and require a change in travel plans to enable an early return home for care. Travelers would be well advised to obtain their routine dental care prior to their travel.
Are you physically fit to perform the anticipated activities? Do you have any other medical conditions that may be affected by travel such as heart disease, lung disease, pregnancy, etc? Will you be traveling to high altitudes that would stress on your heart and lungs? Be sure to check with your physician to be sure you are fit to travel. Many times people are more active during their trips. They may not be accustomed to walking long distances carrying heavy luggage. Thus, they should train with an appropriate exercise program to assure they are physically fit for the extra physical stress that accompanies travel.
Are your immunizations up to date? Routine immunizations like tetanus, measles, influenza, etc. need to be updated. Additionally travel specific immunizations such a typhoid fever, yellow fever, polio, etc. may be required depending on the destination areas. Your physician can provide specific advice regarding immunization requirements.
Thus, preparation for an overseas trip must be planned well ahead of time to assure adequate time to accomplish routine medical care and establish immunity from vaccine preventable infectious diseases.
Do not forget to adhere to other safe practices that may lead to injuries while traveling. Travelers should be aware of the significant hazards involved with motor vehicle accidents while in developing countries. Vehicles, road conditions, and driving habits in developing countries are quite different from what people experience. Be sure to use caution when traveling on unfamiliar roads.
What will you do should you become ill? Do you have a medical evacuation plan? What medical expenses will your health insurance cover should you become ill while abroad? Check your health insurance policy before traveling to determine what medical expenses are covered while abroad. Travelers may also establish contingency plans should a natural disaster occur such as an earthquake, flood, volcano eruption, etc.
3) H1N1 certainly had its influence on travel in 2009; in some circles it is anticipated it will have an even greater impact in 2010 and beyond. What other infectious diseases and illnesses do you think are far less publicized yet voluntourists should be aware of in their travels abroad?
"Infectious diseases not normally seen in the United States are more common in developing countries such as measles, tuberculosis, tetanus, diphtheria, etc.
Traveler's diarrhea is a very common travel acquired infectious disease. The water and sewage infrastructure in developing countries is many times not adequate allowing contamination of the water supply. Thus travelers must pay strict attention to their food and water supply. Travelers also to be aware of self treatment interventions should they experience diarrhea. Once symptoms develop travelers need to assure adequate hydration with appropriate fluids. They should also carry a prescription antibiotic medication in its original container used to treat bacterial diarrhea if the symptoms are severe. The choice of antibiotic needs to be discussed with your physician.
Sexually transmitted diseases are also common among travelers. While abroad some travelers may not exercise common sense and restraint regarding casual sexual contact. They should be advised to avoid contact with commercial sex workers.
Insects may spread a variety of disease. Most travelers are aware of mosquitoes transmitting malaria. However, many other diseases spread by mosquitoes and other insects. Thus, travelers need to wear appropriate clothing, sleep in screened areas, and use insect repellents. The most common insect repellents contain N, N,-diethyl-M-toluamide (DEET). The repellent should be applied to exposed skin. Adults should use a formulation with 20-50% DEET concentration whereas a lesser concentration of DEET is recommended for children to prevent adverse effects such as skin irritation. The repellent benefit is not greatly increased by using higher concentrations of DEET. If DEET creams are used with sunscreens apply the sunscreen first. The efficacy and duration of repellent protection is affected by temperature, perspiration, exposure to water, and other factors.
About Dr. Donald S. Herip
If travelers do become ill when traveling or upon their return from a trip they need to make their physician aware of where they have been. Otherwise the physician may not consider a travel related disease as the cause for your symptoms.
By taking simple medical precautions travelers will be able to enjoy their trip and decrease their chance of experiencing adverse health effects.
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